Cognitive Analytic Therapy
What is Cognitive Analytic Therapy (CAT)?
CAT is a time-limited therapy which focuses on repeating patterns that were set up in childhood as a way of coping with emotional difficulties and deprivations . The CAT therapist and the patient, work together to recognise their maladaptive patterns and then to revise and change the patterns. CAT is particularly helpful for helping patients recognise relationship patterns that continue throughout life and are difficult to change without help.
Features specific to CAT include the therapist writing a reformulation letter to the patient early in therapy, which is the working hypothesis for the therapy and helps promote change. The therapy is usually 16-20 sessions with the ending identified from the start.
What sort of problems can CAT help with?
CAT is used with a wide variety of problems such as relationship difficulties, self-harm, substance misuse and eating disorders.
Is there research evidence that it works?
There is evidence that CAT is effective for treating general mental health problems and eating disorders. There are several research projects underway exploring the use of CAT in the treatment of a number of mental health disorders. CAT is recommended in NICE (National Institute of Cinical Excellence) guidelines for several disorders.
How long does therapy last?
A CAT therapy is weekly for 50-60 minute sessions. A course of therapy can be from 16-24 sessions – this is negotiated with the therapist at the start of therapy. Between 1 and 5 follow-up sessions are offered after the end of regular therapy. Again this is negotiated with the therapist.
What qualifications can I expect the therapist to have?
A CAT therapist will have a professional qualification in a mental health related profession and a qualification from the Association of Cognitive and Analytic Therapists. This qualification enables therapist to practice CAT. Some CAT therapists will also be members of the United kingdom Council of Psychotherapists.
What can I expect when I go for an assessment appointment?
You will be offered a 90 minute assessment appointment. This will be held in an office with two CAT therapists who will take notes and ask questions about the main problems that led you to seek help. You will also be asked about your personal history and your family history.
At the end of the assessment you will be asked if you have any questions. If you are suitable for Cat you will be asked if you would like to start therapy. You will be informed of the approximate waiting time. You will also be sent a copy of the assessment letter yourself.
Once I start therapy what can I expect from the appointments?
The appointments are weekly, in the same room. The therapist and patient sit in chairs for the sessions. The first three sessions concentrate on history taking and technique such a genograms, time lines and the CAT Psychotherapy File. A reformulation letter will be presented in the first half of therapy. This is a collaborative working hypothesis of a patients problems and the origins of these problems.
Maladaptive procedures and harmful relationship roles will be identified and the therapist and patient will work on recognising these patterns, as they occur both in the room with the therapist and in the patient’s life.
The therapeutic relationship between the patient and therapist is intended to be warm, non-judgemental and empathic. Patients will be given homework tasks from time to time to encourage recognising and revising maladaptive procedures.
When the ending is approaching, the therapist and patient will attend to this in the sessions and goodbye letters are exchanged at the last therapy session. These letters help the process of ending therapy and enable patients to hold on to the gains made in their CAT.