Effectiveness of cognitive analytic therapy for bipolar affective disorder: A co‐produced single subject cumulative treatment design with extended follow‐up (A¹/B/A²/C‐FU)

Abstract

Objectives Evidence for the treatment of bipolar affective disorder with cognitive analytic therapy (CAT) is limited, and so this study sought to intensively evaluate outcomes in a co‐produced single‐case experimental design (SCED). Design An A1/B/A2/C with extended follow‐up SCED with a female patient meeting diagnostic criteria for bipolar disorder. Methods Following the 6‐week baseline period ‘A1’, treatment occurred in two phases (18 ‘B’ and 6 sessions ‘C’) sandwiching a 12‐week treatment withdrawal phase (‘A2’) and a 24‐week structured follow‐up phase. Five idiographic daily measures were collected daily to create a 622‐day timeline. The PHQ‐9 and the Mania Rating Scale were completed after each treatment session. The participant held two roles: as the patient and provider of the idiographic/nomothetic outcomes and also as part of the research team through providing a commentary on the outcomes identified. Results CAT was a partially effective intervention. There were improvements to idiographic measures of self‐criticism, self‐acceptance, body dissatisfaction and worry. Nomothetic outcomes showed little change. CAT did not insulate from the occurrence of a hypermanic relapse during the follow‐up phase. The change commentary mirrored the idiographic outcomes in noting that the ‘exits’ were harder to implement during the manic relapse. Conclusions This co‐produced SCED suggests a partially effective CAT intervention, but with exits much harder to sustain during manic relapse. Methodologically, it is possible to improve SCED methodology through widening the participant role further beyond that of data collection.

The effectiveness of Non-invasive Brain Stimulation (NIBS) in combination with Cognitive Analytic Therapy (CAT); a complex cocaine abuser case

“…Furthermore, a study sought to intensively evaluate the outcomes of CAT for bipolar affective disorder, indicating the limited evidence for its treatment and the need for further research in this area. Overall, while there is some evidence supporting the effectiveness of CAT for bipolar affective disorder, further research is needed to establish its efficacy definitively (Kellett et al, 2022). However, according to the findings of the present case study, optimization of illegal brain movement seems to be needed for the development of treatments.…”

Effectiveness of cognitive analytic therapy for mixed anxiety and depression in the context of borderline traits: A quasi-experimental single case design evaluation.

“…No active change methods are used during the baseline. Kellett, Alhadeff, et al (2021) have illustrated that therapist contact and no-therapist contact during the assessment phase of CAT has little effect on ideographic outcomes and the baselines remain stable. During the intervention phase (“B”), the ideographic measures continued to be collected and during this phase active change methods were used (McMillan & Morley, 2010).…”