Peter Taylor, Isabel Adeyemi, Katie Marlow, Sarah Cottam, Zerena Airnes, Victoria Howells, Barnaby D. Dunn, Rachel Elliott, Mark Hann, Cameron Latham, Fanyi Su, Catherine Robinson, Clive Turpin, Stephen Kellett
• RELATE is the first funded trial of cognitive analytic therapy for self-harm • All prespecified progression targets were met with high rates of retention and engagement with therapy • Results show that it is feasible and acceptable to undertake a trial of 8-session cognitive analytic therapy for self-harm in adults • Eight-session cognitive analytic therapy shows early clinical promise as a treatment for self-harm in adult There is currently a dearth of psychological support available to clients who self-harm in the NHS and there is a need to develop brief, targeted interventions to better fill this treatment gap. Cognitive analytic therapy (CAT) is a relational psychotherapy that holds promise for helping people who self-harm. A brief version of CAT has been developed and now requires evaluation. To evaluate the feasibility of evaluating 8-session CAT to adult outpatients accessing community services who self-harm in a subsequent definitive trial. A feasibility randomised controlled trial evaluating 8-session CAT for self-harm in adult outpatients. Participants were randomly allocated (1:1) to brief CAT plus treatment as usual (TAU) or TAU alone. Rater-blind assessments occurred at baseline, 12-weeks and 18-weeks. Pre-specified s tudy progression criteria concerning recruitment (n = 60 recruited over 12 months), retention (92%), missing data on clinical outcomes (< 7%) and engagement with therapy (90% attended ≥ 4 sessions within a 10-week window) were all met. Urges to self-harm and psychological distress declined in the CAT arm and to a greater extent than the TAU arm (self-harm urges: 80% CI: -6.22 -1.68; psychological distress: 80% CI: -5.95, -2.22). The results support the feasibility of evaluating brief CAT for self-harm and so progression to larger-scale definitive efficacy trial is warranted. CAT shows initial promise as a treatment for self-harm in adults but this now requires evaluation within a definitive trial. The trial was pre-registered (21/10/22) on ISRCTN (ISRCTN code: ISRCTN75661422)