Cognitive analytic therapy

Cognitive Analytic Therapy is a talking therapy that looks to develop an understanding of how a person thinks, feels and acts, and how this links to the events and relationships that form the basis for these experiences.


CAT is a time-limited therapy, usually 16 sessions, but the number chosen is based on the needs and situation of the individual. It can be less, such as 8 sessions, or more, such as 24 sessions – or any other number as agreed between the client and therapist.

Central to the experience of CAT is the empathic relationship between the client and therapist. This is held within the therapeutic boundaries, and is used to help develop the understanding of the client’s situation and to find ways of making changes.

CAT is an integrative therapy, bringing together ideas and understanding from different therapeutic approaches. Once the understanding of the problem has begun, and difficulties recognised and named, then different techniques from different approaches can be used to help the person make the changes that they want to make. The individual and therapist consider the different options together and find the ones best suited to that person, or that situation.

CAT can be used as a therapy, working directly with people struggling with mental health problems, of all severities. It can be used to understand and work indirectly with people by focusing on the contextual relationships, either in home/family situations or within professional relationships. It is also a model that can be used to inform practices within supervision, management and organisational contexts.

CAT has been demonstrated as effective in a wide range of clinical settings, for a wide range of emotional and physical health difficulties.

When would I choose CAT?
The evidence base for CAT suggests that it is good for complex situations, where they may be a mixture of symptoms from a number of other diagnoses such as depression and anxiety. It is good where the difficulties seem to be relationship based, or where they keep causing problems in relationships. CAT is a good therapy for exploring the development or origin of difficulties and understanding why they remain.


What is a Reciprocal Role?
In CAT the reciprocal role is the basic way of understanding the relationship patterns that have developed for the individual from childhood and that are still present in the here and now. They tend to dictate the way that the individual finds themselves thinking, feeling and behaving, often in response to what they assume or anticipate someone else will do, think or say.


Please can you tell me differences between traps, dilemmas and snags?

This is the situation when someone believes that they have a limited choice of responses to a situation, based upon the reciprocal roles that they have. The choices can often appear as polar opposites: They can be described as ‘either … or’, or as ‘if … then’ choices.


These are self-reinforcing patterns of thought and behaviour, or vicious cycles. Essentially a negative belief held by a person leads them to do something, the result of which are seen to confirm the original belief.


This is a combination of thoughts, feelings and responses that lead a person to give up on, or sabotage something they want either because of the assumptions they make about what other people think and feel about them, or because they feel irrational guilt about anything that they allow themselves to have.


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