The acceptability, effectiveness, and durability of cognitive analytic therapy: Systematic review and meta-analysis

Hallam, Craig, Simmonds-Buckley, Melanie, Kellett, Stephen, Greenhill, Beth ORCID: 0000-0003-4948-6796 and Jones, Andrew (2021) The acceptability, effectiveness, and durability of cognitive analytic therapy: Systematic review and meta-analysis. PSYCHOLOGY AND PSYCHOTHERAPY-THEORY RESEARCH AND PRACTICE, 94 (S1). pp. 8-35.

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Abstract

<h4>Objectives</h4>This paper sought to conduct a meta-analysis of the effectiveness and durability of cognitive analytic therapy (CAT) and assess the acceptability of CAT in terms of dropout rates.<h4>Design</h4>Systematic review and meta-analysis.<h4>Methods</h4>PROSPERO registration: CRD42018086009. Searches identified CAT treatment outcome studies eligible to be narratively synthesized. Pre-post/post-follow-up effect sizes (ESs) were extracted and synthesized in a random-effects meta-analysis. Variations in effect sizes were explored using moderator analyses. Dropout rates were extracted. Secondary analyses synthesized between-group ES from trials of CAT.<h4>Results</h4>Twenty-five studies providing pre-post CAT treatment outcomes were aggregated across three outcome comparisons of functioning, depression, and interpersonal problems. CAT produced large pre-post improvements in global functioning (ES = 0.86; 95% CI 0.71-1.01, N = 628), moderate-to-large improvements in interpersonal problems (ES = 0.74, 95% CI 0.51-0.97, N = 460), and large reductions in depression symptoms (ES = 1.05, 95% CI 0.80-1.29, N = 586). All these effects were maintained or improved upon at follow-up. Limited moderators of CAT treatment effect were identified. CAT demonstrated small-moderate, significant post-treatment benefits compared to comparators in nine clinical trials (ES = 0.36-0.53; N = 352). The average dropout rate for CAT was 16% (range 0-33%).<h4>Conclusions</h4>Patients with a range of presenting problems appear to experience durable improvements in their difficulties after undergoing CAT. Recommendations are provided to guide the further progression of the CAT outcome evidence base.<h4>Practitioner points</h4>Large pre-post reductions in global functioning and depression outcomes and moderate-large reductions in interpersonal problems are evident after CAT. The effects of CAT appear durable, and interpersonal functioning significantly improves over follow-up time. CAT produces small-moderate benefits compared to trial comparators. CAT appears to be an engaging psychotherapy that maintains patients in treatment.

Item Type:	Article
Uncontrolled Keywords:	cognitive analytic therapy, effectiveness, meta-analysis
Depositing User:	Symplectic Admin
Date Deposited:	24 Jun 2020 10:38
Last Modified:	04 Sep 2023 18:58
DOI:	10.1111/papt.12286
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3091477