Reformation as a minimal intervention : a preliminary patient series outcome evaluation of 4-session cognitive analytic therapy

This study represents an early-phase outcome evaluation exploring the potential value and feasibility of two versions of 4-session reformulatory CAT preliminary to implementation of a large-scale controlled or naturalistic study. A consecutive series of thirty-two GP-referred patients were sequentially allocated to one of two 4-session interventions. Prose plus Sequential Diagrammatic Reformulation (PSDR) or Sequential Diagrammatic Reformulation (SDR). In a time series design, patients completed the Beck Depression Inventory (BDI), Symptom Checklist 90R, and Inventory of Interpersonal Problems at Pre-Screening, Screening, Post-Termination and Follow-Up; an idiographic measure, the Target Problem Rating Scale (TPRS) was completed at Post-Termination and Follow-Up. In addition, patients' subjective evaluations of the helpful and hindering aspects of either intervention were assessed at Post-Termination using an adaptation of the Session Impact Scale.;Statistical analyses indicated highly significant mean change overall from Screening to Post-Termination and Follow-Up, with no significant interaction effects between treatment variation and time-point. Effect sizes across standardised measures emerged as large (0.8 to 1.2) in the case of the PSDR cohort and, in the main, small (0.1 to 0.4) for the SDR cohort. With respect to the TPRS, effect sizes were large (0.7 and 1.0) for both treatment variations, with a size advantage for the PSDR cohort. Depending on the outcome instrument selected, within-group analyses of individual change confirmed that between 37.5% and 50% of patients the PDSR cohort and between 10% and 11.7% of patients in the SDR cohort achieved clinically significant and reliable improvement at Post-Termination. At Follow-Up, between 25% and 56% of PSDR patients and between 0% and 48% of SDR patients had made clinically significant and reliable gains.