COGNITIVE ANALYTIC THERAPY (CAT)

How does CAT Work?

Cognitive Analytic Therapy takes a structured and collaborative approach with the aim of helping individuals understand and change their patterns of thinking, feeling and behaving to improve the way they relate to themselves and the people in their life. Here is an overview of how CAT works:

Assessment and Problem Identification: The therapy sessions begin with an assessment phase during which the therapist and client work together to identify the client’s main difficulties and concerns. These are referred to as “target problems”, and the focus of the sessions as well as the goal setting remains on these identified target problems. During this phase of the process, the therapist will also gather information about the client’s personal history, current circumstances and relationships to get a deeper understanding of problems and difficulties outlined.

Reformulation: This step is central in the process of CAT. It involves creating a written diagram or map that illustrates the client’s patterns of thinking, feeling and behaving in relation to their target problems. The function of reformulation is typically to identify key roles and patterns that the client adopts in their life, with a specific focus on early experiences and relationships. 

Recognising Patterns: With the help of the previous step, the client and the therapist work collaboratively to trace the recurring patterns that contribute to the target problems. These patterns can include a series or type of unhelpful thoughts, emotions, behaviours and interpersonal dynamics.

Building Awareness: In this step of the process, the therapist helps increase the client’s awareness of patterns and their impact on the client’s wellbeing and relationships. This increased awareness is a crucial step as it results in resolving the target problems.

Target Problem Procedures: The therapist helps the client develop strategies to change their problematic patterns and adopt more adaptive and helpful ways of thinking, behaving and feeling.

Testing and Homework: Client is encouraged to test new ways of approaching their target problems in real-life situations. They may be assigned tasks as homework to practice and implement the changes discussed in therapy.

Time-Limited and Structured: CAT is a time-limited therapy with predetermined number of sessions (which the therapist discusses and decides collaboratively with the client). The sessions can be anywhere between 16 and 24, on a weekly basis and are usually 50-60 minutes long. The structured characteristic of CAT helps create a sense of focus and urgency in working on the identified issues.

Ending and Closure: CAT places importance on the ending phase of therapy. This includes a formal closure process in which the therapist and client reflect on the progress made and prepare for a life without therapy. This final step in the process is an opportunity for the client to consolidate their gains and develop strategies for managing their problems self-sufficiently in the future.

During the course of the therapy, the therapist will be collaborative and supportive in their approach to resolve the target problems. This helps the client gain insight into their difficulties and develop more adaptive ways of coping. The focus on patterns and interpersonal relationships is a distinctive feature of CAT, allowing the client to assess the origins as well as current impact of their problems. The end goal of CAT is to equip the client to adopt healthier ways of coping in the future without the need of therapy once the treatment comes to an end.