Cognitive analytic therapy for self-harm with young people: protocol for the RELATE-YP feasibility randomized controlled trial.

Abstract

Background: Self-harm is a major health concern amongst young people that is increasing in prevalence. Cognitive analytic therapy (CAT) is a relational, integrative psychotherapy that is theoretically consistent with our growing understanding of self-harm. The aim of this study was to ascertain the feasibility and acceptability of evaluating brief CAT in young people aged 13-17 who self-harm using a randomised controlled trial (RCT) design.

Method: Sixty young people with experiences of self-harm will be recruited from child and adolescent mental health services. Participants will be randomly allocated (1:1 ratio) to brief CAT plus treatment as usual (TAU) or TAU alone. Assessors will be blind to treatment allocation. Assessments will occur at baseline, 8, 16, and 20 weeks after randomisation. A qualitative process evaluation will investigate experiences of the therapy and trial procedures. The primary outcome for this study is feasibility, judged against a priori progression criteria relating to recruitment, retention, adherence to therapy, and missing data.

Discussion: Brief CAT may help young people struggling with self-harm, but research is needed. In order to undertake a definitive RCT, it is first necessary to resolve a number of feasibility uncertainties. The planned feasibility trial will help inform a larger definitive trial focused on the efficacy of brief CAT for young people who self-harm.

Trial registration: The trial was pre-registered (01/08/25) on ISR CTN (ISRCTN code: ISRCTN11505839).