Centre for Psychological Services Research, University of Sheffield, UK.
Clin Psychol Psychother. 2013 May-Jun;20(3):216-25. doi: 10.1002/cpp.796. Epub 2011 Nov 23.
This study sought to examine the competency of cognitive analytic therapy (CAT) delivered under routine care conditions and to identify the effectiveness of CAT for patients with borderline personality disorder (BPD). Ten cognitive analytic therapists in six National Health Service Trust sites treated 19 patients with BPD using the standard CAT BPD contract of 24 sessions plus four follow-ups. The methodology was small N repeated measures deign, with patients interviewed at the third follow-up session using the Change Interview. Results indicate a high treatment and follow-up compliance rate (89.47%). Significant reductions in psychological distress, risk and dissociation over the time course of the CAT occurred, with a significant increase in personality integration. Most sessions (92.85%) were delivered in a competent manner. Reductions to psychological distress occurred early in treatment and were sustained, whereas increases in personality integration typically occurred later on in treatment. Patients tended to attribute change to the therapy received. Benchmarking against extant CAT BPD evidence notes a moderate effect size across routine care and trial contexts. The results are discussed in terms of identified methodological shortcomings, clinical implications and the contribution made by the CAT model to the treatment of BPD.
本研究旨在检验常规治疗条件下实施的认知分析疗法（CAT）的效能，并确定其对边缘型人格障碍（BPD）患者的疗效。六位认知分析治疗师在六个国民保健服务信托机构中以标准的 24 次疗程加四次随访的 CAT-BPD 合同治疗了 19 位 BPD 患者。该方法采用小样本重复测量设计，在第三次随访时使用改变访谈对患者进行了访谈。结果表明，治疗和随访的依从率很高（89.47%）。在 CAT 的整个过程中，心理困扰、风险和分离的显著减少，而人格整合显著增加。大多数疗程（92.85%）以熟练的方式进行。心理困扰的减少发生在治疗早期并持续存在，而人格整合的增加通常发生在治疗后期。患者倾向于将变化归因于所接受的治疗。与现有的 CAT-BPD 证据进行基准比较，在常规治疗和试验环境下均具有中等的效应量。结果从已识别的方法学缺陷、临床意义以及 CAT 模型对 BPD 治疗的贡献等方面进行了讨论。
