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Cited by 68Psychotherapy Techniques and ApplicationsPersonality Disorders and PsychopathologyAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Cognitive analytic therapy: A review of the outcome evidence base for treatment

Calvert, Rachel, Kellett, Stephen·2014·Psychology and Psychotherapy: Theory, Research and Practice
DOI 10.1111/papt.12020
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Abstract

Purpose: This study reviews the quality of the extant outcome evidence for cognitive analytic therapy ( CAT ) to inform clinical practice and to stimulate a future CAT research strategy. Method: An electronic search identified CAT efficacy and effectiveness studies and these were subject to systematic review. The methodological quality of studies meeting inclusion criteria were appraised using two validated research study quality checklists and studies were fitted to an established model of psychotherapy evaluation. Results: Twenty‐five outcome studies met the inclusion criteria, including five randomized controlled trials. The CAT evidence base is predominated by small‐scale practice‐based studies, in typically complex and severe clinical populations – 44% were focal to the treatment of personality disorder. Although the quality of extant CAT evidence is generally sound (52% of studies were high quality), the depth and breadth of the evidence base is currently limited. Where comparisons with other modalities are available, CAT appears largely equivocal. Conclusions: Cognitive analytic therapy is a popular and promising intervention for complex presentations. However, the evidence base currently lacks wider credibility due to having largely bypassed the rigours of the controlled phase of the hourglass model of psychotherapy evaluation. There is a particular need for further CAT outcome research with common mental health problems. Practitioner points: CAT can be an effective intervention across a range of mental health difficulties. Consider a 24‐session CAT contract for those patients presenting with complex and severe difficulties. Practice research networks could make a significant contribution to the CAT evidence base.

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Authors
Calvert, R., & Kellett, S.
Affiliations
  • Sheffield Children's NHS Foundation Trust (GB)
  • Sheffield Health and Social Care NHS Foundation Trust (GB)
Corresponding author
Calvert, Rachel
ORCID
Kellett, Stephen
Venue
Psychology and Psychotherapy: Theory, Research and Practice
Publisher
Wiley
Published
2014-03-09
Volume
87
Issue
3
Pages
253-277
ISSN
  • 1476-0835 (ISSN-L)
  • 2044-8341
DOI
10.1111/papt.12020
OpenAlex
W2031217804
Cited by
68
References
5
Citations by year
2026: 8 · 2025: 2 · 2024: 4 · 2023: 4 · 2022: 8 · 2021: 7 · 2020: 8 · 2019: 4 · 2018: 7 · 2017: 7 · 2016: 5 · 2015: 2 · 2014: 2
FWCI
0.81
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Psychology and Psychotherapy Theory Research and Practice (publishedVersion)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
cognitive analytic therapy, psychotherapy efficacy, psychotherapy effectiveness, personality disorders, common mental disorders, practice-based research, practice research networks, randomized controlled trials
MeSH terms
Mental Disorders, Humans, Psychoanalytic Therapy, Cognitive Behavioral Therapy, Treatment Outcome

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