Cognitive Analytic Therapy

What is Cognitive Analytic Therapy (CAT)?

Cognitive Analytic Therapy (CAT) merges concepts from analytical psychology and cognitive therapy. The aim of the therapy is to help the person understand how their current patterns of thoughts, feelings and behaviour have been influenced by past experiences and events. Once these patterns have been identified, the therapist and client work together to develop new, alternative coping strategies.

CAT therapy is conducted over 4 – 24 weekly sessions depending on the complexity of the issues under discussion. It follows a general structure that is tailored to meet the individual’s needs.

Cognitive Analytic Therapy was developed by Dr Anthony Ryle in the early 1980’s while working in a busy London hospital. He incorporated a number of established therapies into a new, time-limited therapy that was structured to effectively meet the mental health needs of the high volume of patients within the large health service. The CAT approach has continued to be researched and refined to this day.

How is Cognitive Analytic Therapy used?

In Cognitive Analytic Therapy, you and your therapist work as a cooperative team. The therapist is free to express their thoughts and the two of you make joint decisions about the direction and pace of the therapy sessions.

CAT has both cognitive and analytic components. During the initial analytic phase, you are encouraged to discuss and explore events and experiences in your past that may be linked to the issues you are currently having difficulty with. Using a variety of strategies, your therapist will aim to help you see how and why things may have gone awry in the past (and also where things went well).

The strategies used often include:

• Questionnaires that focus on mood patterns.
• Written ‘maps’ of your underlying issues and their flow-on effects.
• Letters written by the therapist at specific points in the treatment that list the issues and proposals discussed.

Putting these patterns and issues on paper helps both of you analyse the thoughts and behaviors that may have contributed to the current situation. You can also use the documents to help monitor changes in your mood and behaviour between sessions.

The sessions then progress to a more active, cognitive phase where the aim is to find ways to change negative patterns or create more positive strategies. In the final sessions, your therapist will create a summary of what you have achieved and note the strategies you can use on your own at any time. You will also be given the written documents for your own reference and will be invited back for a follow-up session 2-3 months after the completion of therapy.

How does Cognitive Analytic Therapy differ from Cognitive Behavioural Therapy?

Both therapies require a collaborative relationship between the client and therapist. Both have a limited time-frame and focus on a specific range of issues or goals raised by the client. However, they differ in that, in Cognitive Behavioural Therapy, the therapist generally withholds their thoughts and uses impartial observations. People referred to a therapist for CBT often have a confirmed diagnosis of conditions such as depression or anxiety and there are specific and proven techniques that can be employed to meet the individual’s needs.

On the other hand, in CAT the therapist can share their thoughts and suggestions freely. They take a much more inter-personal approach and are not too concerned with specific condition names or labels. Instead, the client chooses the areas they want help with and together with their therapist, they decide how they want to make the changes to improve their life.

In some cases, the therapist may decide that using a combination of these and other treatment approaches will lead to the best possible outcome for the client. For example, the client may take some form of medication or use exercise or mindfulness meditation to help manage their energy and emotions.

When you are choosing a therapist, be sure to find out what their qualifications and specialties are, what treatments they offer and which ones they suggest may work best for you.

Related therapies

• Acceptance and commitment therapy (ACT)
• Behavioural therapy
• Cognitive behavioural therapy (CBT)
• Cognitive therapy