Looking at past events and experiences, the therapy aims to understand why a person feels, thinks and behaves the way they do, before helping them problem solve and develop new ways of coping.
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.
What is cognitive analytic therapy?
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.
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 CAT 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.
The foundations of cognitive analytic therapy rely on an empathetic relationship between the client and the therapist. The purpose of which 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.
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.
– Read more in ‘What is cognitive analytic therapy, and is it for you?’
What is the difference between CAT and CBT?
Both cognitive analytic therapy and cognitive behavioural therapy are short-term therapies, focusing on helping you develop tools so that you can better deal with any future psychological problems yourself.
Where they differ is largely in their focus. Whereas CBT is particularly concerned with the link between actions, thoughts, and feelings in the here and now, CAT delves into the past. This allows the therapist to help the client focus on what their problems and challenges are, how they started, and especially how they are relational.
Origins of cognitive analytic therapy
Cognitive analytic therapy was developed in the early 1980s by Dr Anthony Ryle at Guy’s and St Thomas’ Hospital in London. The therapy was developed as a response to the mental health needs of a busy inner-London city.
Dr Ryle felt it was important to be able to offer a time-limited therapy within the health service that integrated the best of different approaches. The therapy was created with the view that it would continue to be researched and refined with the growing experience of therapists and clients – which has happened. It’s also worth noting that the initial concern of equity and access to mental health support remains a core part of this therapy type.
How does cognitive analytic therapy 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 cognitive analytic therapy sessions like?
Your therapy sessions will be tailored to you and your individual needs, however, there is a model of practice that most CAT therapists follow.
The following Sussex Partnership NHS Foundation Trust film explores what you can expect from cognitive analytic therapy:
During your first few sessions, you will get the opportunity to talk openly and confidentially to your therapist about your personal history and life experiences. You will explore when things went wrong and also when things went right.
After this initial phase, your therapist may ask you to complete some questionnaires to establish mood shifts or symptoms. The purpose of these papers is to decipher what sort of thinking or behaving is contributing to the problem. Once you and your therapist have developed an understanding of your problems and what brought you to therapy, your therapist may write what is known as 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 at 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.
What can cognitive analytic therapy 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:
- disordered eating
- obsessions and compulsions
- relationship issues
If you think this type of therapy may work for you, speaking to a counsellor who offers CAT should be your next step. This way you can ask any further questions you may have and gain a clearer understanding of how the therapy could help you.