Cognitive analytic therapy

What is CAT?

As its name suggests, cognitive analytic therapy has two elements - the analytic side and the cognitive side. The analytic side of the therapy involves the exploration of previous events and experiences that could link to the current issues you are facing. The therapist will aim to help you understand why events from the past could be affecting you now, and why things may have gone wrong in the past.

In this short video, counsellor Paul Johanson explains what cognitive analytic therapy is.

After your therapist helps you understand the implications of such experiences, they will look at the ways you currently cope with the problem. Investigating the effectiveness (or otherwise) of your current coping mechanisms, a cognitive analytic therapist will then use techniques from cognitive therapy to help you develop new tools that allow you to cope in a way that is healthy and beneficial to your well-being.

Each programme of therapy is tailored to the individual's needs, taking into account their current situation and the problems they're dealing with. Considered a time-limited therapy, cognitive analytic therapy can last between four and 24 weeks, depending on the nature of the problem being explored. Generally, an average of 16 weeks is considered the norm.

The foundations of cognitive analytic therapy rely on an empathetic relationship between the client and the therapist. The purpose of this is to help those seeking help make sense of their situation and uncover ways of making changes for the better. Forming a trusting relationship is key, as this will help you be more open about the way you feel during your sessions.

How does CAT work?

Cognitive analytic therapy is considered a very active therapy type and one in which you as an individual ultimately have control. Inviting you to observe your life from an objective standpoint and take part in identifying what needs to change, the therapy allows you to have a say throughout every step of the process.

The therapy works by identifying any learned behaviours or beliefs from your past and investigating whether or not they are contributing to your current difficulties. Cognitive analytic therapy aims to show you how you can change such beliefs and help you focus on ways of making better choices in the future.

The process also allows you to work with the therapist to devise ways of coping that will be suitable for you in your life. This collaborative effort will, therefore, require you to be honest with your therapist about what works and what doesn't, so that together you can devise a strategy that will work for you.

What are CAT sessions like?

In your initial sessions, your therapist will create a safe, confidential space for you to share your personal history and life experiences. Together, you'll explore the challenges you've faced, as well as the moments when things went well. This process helps build a deeper understanding of your unique journey and sets the foundation for tailored support moving forward.

After this initial phase, your therapist may ask you to complete some questionnaires to track mood changes or identify specific symptoms. These assessments help pinpoint patterns of thinking or behaviour that may be contributing to the issue at hand. Once you and your therapist have gained a clearer understanding of the challenges you're facing and what led you to therapy, your therapist may write a "reformulation letter" to put these thoughts onto paper.

Next, your therapist will work with you to map out problem patterns on paper to help develop your capacity to understand why you may repeat certain patterns of thinking. The therapy will continue in an active nature, helping you to figure out ways of changing such negative patterns. Your therapist should be very upfront with you, telling you their thought processes as well as encouraging you to share your own.

Towards the end of your programme, your therapist will look back over what you've learnt and achieved through therapy and how you can progress after the therapy sessions are over. Your therapist may then invite you to a follow-up appointment two or three months after your sessions finish to see how you are doing.

At CAT's heart is an empathic relationship between the client and therapist within the therapeutic boundaries, the purpose of which is to help the client make sense of their situation and to find ways of making changes for the better.

What can CAT help with?

Cognitive analytic therapy looks to focus on the issues that brought you to therapy and the underlying reasons, rather than traditional psychiatric terms or labels. The aim of this is to treat each person as an individual, rather than treating the condition.

Issues that are often looked at within cognitive analytic therapy include:

• addictions
• anxiety
• depression
• disordered eating
• obsessions and compulsions
• phobias
• relationship issues
• self-harm
• stress

If you're interested in exploring whether cognitive analytic therapy might be helpful for you, the next step is to speak with a therapist who offers this approach. This way you can ask any further questions you may have and gain a clearer understanding of how the therapy could help you. You can find a cognitive analytic therapist by using our advanced search.