What is CAT?

So what is Cognitive Analytic Therapy?


As an individual therapy CAT is a model of brief, focused and structured therapy which was developed in the public health service in the UK and in Finland, Greece, Ireland, Australia and Spain. Now it is developing more widely in Italy, New Zealand, Hong Kong, India, Poland and Chile. CAT helps link the relational origins of hard to change patterns of cognition, behaviour and emotion to the powerful way they are reproduced through interaction with self and others in the present. It uses maps of different states of mind and the patterns that connect or isolate them within the wider sense of self. It uses compassionate writing to describe the dance of these patterns internally, socially and interpersonally and to give meaning to their origins in the formation of a sense of self and social identity. As well as being a method of therapy, CAT is proving useful as a consultative method and as a means of relational skills training for people in a wide range of medical and health roles. In this context CAT has become a dialogic way of understanding the interaction of psychology and psychotherapy, and the relationships involved in the provision of care and treatment in mental health and health services more widely.

Key Points of CAT

  • Cognitive analytic therapy combines a relational approach to the cognitive and behavioural therapies with current aspects of psychodynamic thinking about personality problems, childhood development and the power of the helping relationship.
  • CAT offers a well-developed, user-friendly and collaborative system for assessment, reformulation, engaging in a therapeutic relationship and managing and structuring the focus, progress and ending of therapy.
  • It is a therapy which has proven popular with a wide range of professionals responding to the complex needs of hard to help clients whether in mental health or general health.
  • In recent years it has been used to teach enhanced communications and relationship skills in the context of therapy, medical and caring roles for multi-professional teams.

History of CAT

CAT developed as a form of individual therapy in the 1980’s at Guy’s and St Thomas Hospitals in London. It was a pragmatic and collaborative response to the psychological needs of people in distress with personality or mental health problems. The founder of the model, Dr Anthony Ryle offered a common language for joining up the understanding derived from psychoanalytic ideas of how we develop personality and cope with trauma to cognitive and behavioural ideas about how we get fixed into patterns of thinking, feeling and behaving. The model was popular with clinicians working with complex needs and who wanted to understand how the helper and the systems of help such a community or inpatient team got pushed and pulled into unhelpful responses. In particular CAT has developed as a method of working with the influence of relationships on beliefs and behaviour and the interaction between the helping relationship and the past and present relationships that shape the client’s world. Much use is made of collaborative mapping out and tracking of patterns of interaction and of shared writing as well as the immediate experience of the therapeutic and educational aspects of the helping relationship. The CAT approach has been popular with multi-professional groups and psychiatrists, psychologists, nurses and social workers have all been attracted to the training which is now carried out in eight centres around the country.

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