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A feasibility and pilot additive randomised control trial of attachment security priming during behavioural activation

Published online by Cambridge University Press:  07 November 2023

Charlotte Heathcote ,
James Walton ,
Stephen Kellett Open the ORCID record for Stephen Kellett [Opens in a new window] ,
Abi Millings ,
Melanie Simmonds-Buckley  and
Andy Wright
Charlotte Heathcote
Affiliation:
Sheffield Health and Social Care NHS Foundation Trust, UK
James Walton
Affiliation:
Tees, Esk and Wear Valleys NHS Foundation Trust, UK
Stephen Kellett*
Affiliation:
Rotherham, Doncaster and South Humber NHS Foundation Trust and University of Sheffield, UK
Abi Millings
Affiliation:
Sheffield Hallam University, UK
Melanie Simmonds-Buckley
Affiliation:
Rotherham, Doncaster and South Humber NHS Foundation Trust and University of Sheffield, UK
Andy Wright
Affiliation:
Tees, Esk and Wear Valleys NHS Foundation Trust, UK
*
Corresponding author: Stephen Kellett; Email: stephen.kellett@nhs.net
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Abstract

Background:

There is some initial evidence that attachment security priming may be useful for promoting engagement in therapy and improving clinical outcomes.

Aims:

This study sought to assess whether outcomes for behavioural activation delivered in routine care could be enhanced via the addition of attachment security priming.

Method:

This was a pragmatic two-arm feasibility and pilot additive randomised control trial. Participants were recruited with depression deemed suitable for a behavioural activation intervention at Step 2 of a Talking Therapies for Anxiety and Depression service. Ten psychological wellbeing practitioners were trained in implementing attachment security priming. Study participants were randomised to either behavioural activation (BA) or BA plus an attachment prime. The diagrammatic prime was integrated into the depression workbook. Feasibility outcomes were training satisfaction, recruitment, willingness to participate and study attrition rates. Pilot outcomes were comparisons of clinical outcomes, attendance, drop-out and stepping-up rates.

Results:

All practitioners recruited to the study, and training satisfaction was high. Of the 39 patients that were assessed for eligibility, 24 were randomised (61.53%) and there were no study drop-outs. No significant differences were found between the arms with regards to drop-out, attendance, stepping-up or clinical outcomes.

Conclusions:

Further controlled research regarding the utility of attachment security priming is warranted in larger studies that utilise manipulation checks and monitor intervention adherence.

Keywords

AttachmentBehavioural activationImproving Access to Psychological Therapies programme (IAPT)
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 52 , Issue 3 , May 2024 , pp. 301 - 316
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of British Association for Behavioural and Cognitive Psychotherapies

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