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Freeman, E., Williams, L., 2008. Measuring Outcomes in CAT. Reformulation, Winter, p.14.
There is an increasing emphasis within the NHS on monitoring outcomes of healthcare interventions, both as a part of clinical governance to improve the quality of services and in relation to the agenda of increasing accountability to the public and healthcare commissioners (Fonagy, Matthews, & Pilling, 2005). In line with Department of Health guidelines and also to support best clinical and service level practice, the Halliwick Psychological Therapies Service at St Ann’s Hospital, London decided to pilot the use of Clinical Outcomes for Routine Evaluation (CORE) (Evans et al., 2002) for routine outcome measurement of the therapies they provide including Cognitive Analytic Therapy.
Over a period of a year, the pilot established and tested a method for the administration, collection, and reporting of data collected within the CORE system. During this time, 100 assessment and treatment cases were dealt with, 18 of which were CAT cases in which patients completed the CORE. The functioning of the system was monitored and adapted during the pilot in order to lay the groundwork for its expansion to the whole service.
While the pilot picked up several areas in which the system could be modified to function more efficiently, it showed that the system could be successfully implemented for Cognitive Analytic Therapy within the Psychological Therapies Service.
Notably, although general conclusions cannot be drawn because of the low numbers involved in the pilot, the trend within CAT, was for statistically reliable improvement of around 67% which compared well with a recent survey of nine years of outcome data from a secondary care adult psychology service giving a figure of around 50% of patients reliably improving (Westbrook & Kirk, 2005).
Ed Freeman and Laitan Williams
Evans, C., Connell, J., Barkham, M., Margison, F., McGrath, G., Mellor-Clark, J., et al. (2002). Towards a standardised brief outcome measure: psychometric properties and utility of the CORE-OM. The British journal of psychiatry 180, 51-60.
Fonagy, P., Matthews, R., & Pilling, S. (2005). The Mental Health Outcome Measurement Initiative: Best practice guidance for local implementation adapted from the Report from the Chair of the Outcomes Reference Group. National Institute for Mental Health in England.
Westbrook, D., & Kirk, J. (2005). The clinical effectiveness of cognitive behaviour therapy: outcome for a large sample of adults treated in routine practice. Behaviour Research and Therapy, 43(10), 1243-61.