Cognitive Analytic Therapy (CAT)
CAT is a NICE (National Institute for Clinical Excellence) Guidance recommended brief interpersonal therapy. Typically, CAT can be 8, 16, or 24 sessions in length depending on aims for treatment.
You may notice feeling ‘stuck’ or ‘caught’ within unhelpful patterns of relating to yourself and others. Such patterns of coping and relating may be impacting your relationships, your sense of self, and your emotions. In CAT, we work together to recognise such patterns and identify ways to revise these.
CAT is an open and upfront form of therapy. It is a relational approach where you and the therapist work in collaboration to make sense of your difficulties and explore change. This means that you will use your therapeutic relationship as an opportunity to notice and name when your unhelpful patterns are arising in real-time in your sessions.
CAT considers an individual’s social and cultural context which has shaped their early and later life experiences.
CAT is a time-limited therapy meaning we would make an agreement about necessary number of sessions and the therapy will end following completion of the agreed number of sessions.
CAT has three ‘phases’:
- Reformulation: You will work alongside the therapist to talk about your early and significant life experiences which have led to the difficulties which brought you to therapy. You will also be encouraged to explore areas of your life which have brought satisfaction to you and consider your qualities, strengths and values a a person. You may be asked to complete a questionnaire named the ‘Psychotherapy File’ which collates commonly experienced problematic patterns that develop instinctively as ways to survive and cope. The therapist will produce and read a ‘Reformulation Letter’ to you which is a draft written account of the shared understanding you have built thus far together.
- Recognition: We will utilise our shared learning from the key problematic patterns drafted in your Reformulation Letter to build a visual ‘map’ of such patterns. This is another tool to promote further self-awareness and reflection as you build recognition of when these patterns occur, the consequences of these, and how they leave you feeling ‘stuck’. Sometimes change feels hard, so it is important that you can build your own evidence of why these patterns of coping no longer work for you. You will be asked to monitor the patterns between-sessions using your map or other therapy tools and resources.
- Revision: This phase of CAT explores making change whilst considering that this is challenging. You and the therapist will work together to identify ways in which you can exit your unhelpful patterns of coping, allowing you to develop healthier alternative ways of meeting your emotional needs and relating to yourself and others. A key strength of CAT is that you will have therapy resources to take away to continue to build on the positive changes you have made after the therapy ends. In exploring change, CAT offers flexibility in drawing on resources and skills from a range of other relevant evidence-based approaches such as, Compassion-Focused Therapy (CFT), Dialectical Behavioural Therapy (DBT), and Acceptance and Commitment Therapy (ACT).
- Ending: Within CAT we recognise that the end of therapy can bring up mixed feelings and can feel difficult if particularly if you have experienced problematic or traumatic endings in your life. The end of therapy is therefore a key part of the therapy from session 1, but there is a particular dedicated focus on working through how this feels using ‘Goodbye Letters’ that both you and the therapist will develop and share at the end of therapy.
- Follow-up: Usually, at least one follow-up appointment is recommended in order to review and reflect on the continued changes you have made and any challenges you have faced.
For further information about CAT, please visit the Association for Cognitive Analytic Therapy (ACAT) website by clicking here.