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A new UK-wide clinical trial is testing whether Cognitive Analytic Therapy (CAT) is a feasible and effective treatment for self-harming adolescents aged 13 to 17. Funded by the National Institute for Health and Care Research and co-led by The University of Manchester, the study offers hope for young people and families facing self-injury.

Self-harming is becoming increasingly common in young people and is associated with a range of other psychological difficulties, short and long-term. The increase in self-harming behaviour has a wider impact on families, NHS services, and young people themselves.

CAT, also known as Cognitive Analytic Therapy, is a relational approach that focuses on the relationships people form with others and with themselves. It is a short-term talking therapy that helps people understand and change unhelpful patterns in their thinking, feeling, and behaviour, especially in relationships. It focuses on identifying repetitive habits learned in the past that may now cause problems, like anxiety, low mood, or self-harm. Through collaboration with a therapist, people map out these patterns and learn new, healthier ways of coping, usually over 8–24 sessions. The goal is to improve self-awareness, relationships, and overall mental well-being.

A new clinical trial, RELATE-YP, co-led by University of Manchester researchers, aims to explore CAT for young people aged 13-17 who are self-harming.

RELATE-YP is a feasibility trial, meaning it is an early step in testing whether CAT is suitable for young people who self-harm. The study will analyse whether young people find CAT helpful and whether a larger trial would be appropriate.

The trial is currently running across three NHS Foundation trusts: Pennine Care NHS Foundation Trust, Greater Manchester Mental Health NHS Foundation Trust and Rotherham, Doncaster and South Humber NHS Foundation Trust. The study is recruiting young people through Child and Adolescent Mental Health Services (CAMHS).

Dr Peter Taylor, from The University of Manchester and co-lead of the trial, said: “We know that difficulties with self-harm often begin during adolescence, and for some people they can have a lifelong impact. Talking therapies can help. We believe CAT has potential here, but further research is needed.”

Professor Stephen Kellett, from Rotherham, Doncaster and South Humber NHS Foundation Trust and the other co-lead, added: “CAT is different from many therapies currently used for self-harm, as it focuses more on the relationships young people have with others and with themselves, and how these patterns can contribute to self-harm.”

Cameron Latham, a co-investigator who also has personal experience of self-harm, commented on why this research is needed: “Self-injury affects the lives of so many people, and a brief, effective, available therapy for young people would be a valuable addition to treatment. Throughout this trial, part of my role is to further ensure the well-being of those who self-injure and, through PPI involvement, ensure the voices of patients, parents and carers are heard.”