What’s it like to have Cognitive Analytic Therapy?
Here we’d like to offer you a glimpse into the practical experience of CAT. There’s a general account of the course of therapy, and some reflections on CAT from the therapists themselves. The general description is given as a guide to the process of therapy. It is likely that your experience of therapy will differ in many ways from the patterns shown below, however these are the key themes you may expect to find. Everyone’s different and so you and your therapist will also create a unique experience of therapy. If you have any questions then either email ACAT directly, or talk with a local CAT therapist.
Assessment
Starting CAT
Reformulation
Doing CAT
Endings
Cognitive Analytic Therapy
Assessment
When you contact a therapist he or she will normally arrange a meeting to talk with you about your reasons for seeking therapy, and to share with you their idea of the scope and purpose of CAT in concrete terms as it relates to you and the things you want to talk about. This initial assessment session allows you and your therapist to see if you are happy to work together in a course of Cognitive Analytic Therapy, and to answer any specific questions you may have about the therapy.
The therapist will then draw up a contract with you for a set period of time. CAT is a “brief” form of psychotherapy and normally takes 16 sessions, however the therapist may also recommend 8, 12, or 24 sessions as he or she feels appropriate, and will discuss her reasons for doing so with you. CAT therapists rarely work to an unlimited time period. The dates and times of the therapy sessions are then worked out with you at a mutually convenient time.
Starting CAT
After the first session you will be asked to complete a “Psychotherapy File” which asks about typical, common problems or patterns, described as Traps, Dilemmas and Snags. You may also be given the task of monitoring your mood, or behaviour patterns.
The early therapy sessions will be concerned with hearing your story and beginning to piece together the patterns that make up your life and to start to understand how they work.
Reformulation
At or around the fourth therapy session the therapist will work with you on a written “Reformulation” of your situation. It will give a description of your life so far as you’ve shared it with the therapist, and it will describe the problems and patterns that lead you to seek therapy. It will also illustrate the situation you are in as a series of Target Problem Procedures which may be drawn as a diagram (also known as an SDR, or sequential diagrammatic reformulation). These show how the situations you’ve experienced in the past still influence your current behaviour, and how this old pattern may be causing you problems in the present. You and your therapist then work from these Target Problem Procedures, checking that they describe your situation, and then beginning to look for Exits from these unhelpful ways of living.
Doing CAT
The following sessions of the therapy will be focused on the SDR and Reformulation as a means for helping you learn new ways of dealing with situations you face now. The therapist will work with you on the Target Problem Procedures to help to understand the choices that you have in your current situation when you find yourself acting out of the old and unhelpful patterns.
You may be asked to complete various “homework” activities, and will be encouraged to give attention to your thoughts, actions and feelings in the course of the therapy. You and your therapist will use these observations and the experiences you share in the course of the therapy sessions to give you a greater insight into how you make positive changes in your life.
Endings
In the last 3 or 4 sessions you and your therapist will work towards a good ending to the therapy. You will be given a chance to talk through the feelings and thoughts you have about ending the therapy, and will be able to consolidate the key themes that you have shared with your therapist over the previous sessions. You and your therapist will then exchange a “Good-bye” letter which allows both you and your therapist a chance to close the therapy process.
Normally you will be offered a follow-up appointment in the next couple of months to meet with your therapist and discuss how things have gone for you following the therapy.