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Cognitive Analytic Therapy

Cognitive-analytic therapy (CAT) is an integrative approach that focuses on the problems that bring the individual to therapy (often termed ‘target problems’) and the deeper patterns that underlie them.

CAT is an active therapy that invites the client to be an observer of their own life and the parts that need to change. The changes may be small or might be more significant such as needing to find new ways of being in relationships. The process of CAT involves looking at patterns of relating and the effect they can have on the individual and their relationships with others. One of the aims of CAT is to help the client see the way to change learned attitudes and beliefs about themselves and others and help them focus on making better choices.

In CAT, the therapeutic relationship is a collaborative one and there is an expectation that the patterns that tend to get repeated for the client outside of therapy are likely to be enacted in the therapeutic encounter. This is a powerful experience that can facilitate significant changes for the client as they begin to connect their cognitive understanding with their emotional understanding.

CAT can be an effective therapy for depression, anxiety and the treatment of borderline personality disorder. It is also a recommended approach for the treatment of eating disorders such as anorexia. If you are coming to therapy feeling troubled by your relationships with other people, then CAT might be the appropriate therapeutic approach for you.

What can I expect if I receive cognitive-analytic therapy (CAT)?

  • The first few sessions of CAT are the ‘reformulation phase’. During this stage of the therapy you will discuss your current difficulties and go over your developmental history in some depth. You are likely to reflect both on areas of achievement and satisfaction with your life as well as areas of difficulty.
  • During the initial phase you are likely to complete a questionnaire called the ‘Psychotherapy File’. This aims to understand some of your difficulties and patterns within the CAT model.
  • Around the fourth or fifth session your therapist will read to you a ‘reformulation letter’ which is a written account of a shared understanding of the story of your life and how some of your past experiences might be affecting you now. The letter will also form the foundation of what you are trying to change through therapy.
  • After the reformulation letter, your therapist will also map out the patterns in your life on paper. This can then be a useful map through which you will develop exits from existing patterns together.
  • CAT is a short-term therapy and often lasts between 16-24 sessions. Towards the end, the focus of the work is on endings particularly if you had difficult endings or losses in your early life. Just before the final session the therapist will write you a ‘goodbye letter’ and will invite you to do the same. You will be usually offered a follow up appointment one to three months after the end of the sessions.