Cognitive Analytic Therapy (CAT)
Cognitive Analytic Therapy (CAT) is a time-limited therapy (typically
4-24 sessions) that assists with difficulties in relating to yourself and
others, by drawing on your early experiences. Early experiences shape who we
are and how we interact with the world and how we relate to/care for ourselves.
By working together with your therapist, you will learn about the unhelpful
patterns of relating that you may have developed and understand how they might
make life more difficult for you. This will hopefully lead to you being able to
make effective changes to your life.
Cognitive Analytic Therapy (CAT) is an effective therapy
that can help with a number of difficulties. These can include problems such as
depression, anxiety, stress, self-harm, eating disorders, trauma, abuse, rape,
personality disorders, difficulties in relationships, physical health
difficulties, problems looking after yourself and substance misuse.
Cognitive Analytic Therapy (CAT) was developed from a
combination of other therapeutic approaches/models including psychodynamic
theory. An important part of the therapy is your relationship with the
therapist. In CAT, your relationship with your therapist will actively be used
to understand your patterns of relating and how they might impact others and
The structure or format of the therapy typically follows
three stages. The first stage is called the 'reformulation' stage. During the
first several sessions, you and your therapist will spend time discussing your
early experiences and childhood. This will help you both to begin to form an
understanding and appreciation of the difficult life situations that have led
to your current difficulties. You will discuss your typical patterns of
relating to yourself and others and your therapist will draw these out to form
collaborative working diagrams that start to make links between how you think,
feel and act. This stage of therapy ends with what we call a 'reformulation
letter'. This is a letter written by your therapist to you, which describes
their understanding of how your early experiences have affected you and how you
live your life in the here-and-now. This will also give some ideas for how you
can start moving towards achieving the goals you have set out for therapy.
The next stage is where you and your therapist work together to help you to start changing your unhelpful patterns of relating, to more adaptive and helpful patterns. This will be done at your pace and with the aim of helping you to achieve your therapy goals. So for example, if you cope with difficult emotions by emotional eating, you and your therapist will work together to help you find more helpful coping strategies that mean that it feels safe and OK to be in touch with your emotions without feeling overwhelmed by them.
The final stage of therapy is where all the progress you have made comes together and you start thinking about ending therapy. At this point of therapy, you will likely have made a number of changes to your unhelpful patterns of relating and will have developed more helpful ways of thinking, feeling and acting. The therapy will end with a goodbye letter from your therapist. This summarises the work you have done together and the changes you have made, with comments on how you can continue to maintain and build on these changes once you leave therapy.