The effectiveness of brief cognitive analytic therapy for anxiety and depression: A quasi‐experimental case—control study
Open accessAbstract
Objectives: To investigate the effectiveness of an 8‐session cognitive analytic therapy (CAT) protocol for patients with anxiety and depression in the context of relational problems, personality disorder traits, or histories of adverse childhood experiences and then to compare outcomes with cognitive behavioural therapy (CBT). Methods: The study was conducted in a single Improving Access to Psychological Therapies (IAPT) service and used sessional outcome monitoring. Propensity score matching was used to derive equivalent CAT ( N = 76) and CBT ( N = 73) samples through matching intake characteristics. Longitudinal multilevel modelling (LMLM) compared patterns of symptomatic change over time between the two therapies. Results: LMLM found no significant differences between CAT and CBT in depression, anxiety, and functional impairment outcomes and showed similar symptom change trajectories. Small between‐therapy post‐treatment effects and medium‐to‐large within‐therapy effects were found. CAT patients attended significantly more sessions, and the CAT dropout rate was significantly lower. Conclusions: Brief CAT appears acceptable and effective for patients with anxiety and depression in the context of complex relational problems when delivered within the high intensity tier of an IAPT service. The potential added value of CAT in IAPT services is discussed. Practitioner points: Practitioners (under appropriate supervision) could use 8‐session CAT when treating patients with anxiety and depression in the context of clinical complexity. The 8‐session CAT model holds organizational promise in IAPT services. Brief CAT interventions should retain theoretical integrity.
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Cognitive analytic therapy yielded favourable results in managing mood conditions in the context of personality disorders.
“Also, CAT yielded favourable results in managing mood conditions in the context of personality disorders.12”
From A randomized controlled trial of cognitive analytic versus compassion-focused therapy for PTSD in Iran-Iraq War Veterans. (2024) · cites this paper as [12]
The Abstract (page unavailable) reports favourable outcomes for anxiety and depression after CAT in patients selected partly for personality disorder traits. However, the Study limitations section (page unavailable) says no formal diagnostic methods or measures of those traits were used. The findings therefore do not establish outcomes specifically for patients with diagnosed personality disorders. (LLM, conf=0.88)
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- Authors
- Wakefield, S., Delgadillo, J., Kellett, S., White, S., & Hepple, J.
- Affiliations
- University of Sheffield (GB)
- Sheffield Health and Social Care NHS Foundation Trust (GB)
- Somerset Partnership NHS Foundation Trust (GB)
- Corresponding author
- Kellett, Stephen
- Venue
- British Journal of Clinical Psychology
- Publisher
- Wiley
- Published
- 2021-01-17
- Volume
- 60
- Issue
- 2
- Pages
- 194-211
- ISSN
- 0144-6657 (ISSN-L)
- 2044-8260
- OpenAlex
- W3122877156
- Cited by
- 26
- References
- 55
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 7 · 2023: 4 · 2022: 6 · 2021: 3
- FWCI
- 3.42
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- British Journal of Clinical Psychology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- cognitive analytic therapy, brief psychotherapy, anxiety, depression, cognitive behavioral therapy, Improving Access to Psychological Therapies, adverse childhood experiences, personality disorder traits, relationship problems, treatment discontinuation, functional disability
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Anxiety, Depression, Female, Humans, Male, Middle Aged, Cognitive Behavioral Therapy, Case-Control Studies, Treatment Outcome, Young Adult, Propensity Score, Non-Randomized Controlled Trials as Topic
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