Cognitive Analytic Therapy (CAT) is a distinct form of talking therapy that primarily focuses on the patterns of our relationships, both with others and with ourselves. The core principle of CAT is that early life experiences significantly shape how we interact with the world and ourselves, often leading to the development of ingrained behavioral patterns. While some of these patterns are healthy and beneficial, others can become unhelpful or unhealthy, repeating themselves throughout our lives. Experiencing or anticipating these problematic relationship dynamics can be overwhelming, leading to feelings of being let down, hurt, or rejected, and contributing to issues such as depression, anxiety, low self-esteem, avoidance behaviors, difficulty with assertiveness, and a tendency to find oneself in vulnerable situations. CAT involves a collaborative process with a therapist to identify and understand these problematic patterns and the underlying difficulties an individual may be experiencing. The therapy is highly personalized, tailored to the individual’s specific needs and achievable goals.
How CAT Can Benefit You
CAT is a well-established and safe therapy commonly utilized for individuals dealing with depression, anxiety, eating disorders, self-harm, and personal or relationship difficulties. Throughout the therapeutic process, you will delve into how you manage your relationships and cope with challenging emotions or situations. This exploration involves identifying specific patterns of thinking, feeling, and behaving. By examining these patterns closely, you will gain clarity on which are helpful and which are unhelpful, understand their origins, recognize the factors that perpetuate their repetition, and discover more effective strategies for managing them to prevent negative experiences from recurring. The ultimate aim of CAT is to reduce the emotional distress experienced in relationships with others and with oneself.
Preparation and First Steps
No specific preparation is required for CAT. However, it can be beneficial to reflect on what you perceive as your main challenges and what you hope to achieve through therapy. A commitment to attend regular weekly appointments is essential. Your initial session with the therapist will involve a discussion about your reasons for seeking therapy and what the process entails. This first meeting serves as an opportunity for you to determine if CAT is likely to be a suitable approach for you, to assess your comfort level in working with the therapist, and to ask any questions you may have.
The Therapeutic Process
Following the initial session, you will likely be asked to complete a questionnaire or psychotherapy file to document the common problems or patterns you experience. You might also receive “homework” assignments, such as tracking your mood or behavioral patterns. Early sessions will focus on hearing your story and exploring how certain problematic patterns may have originated in your childhood. The therapist does not require an exhaustive recounting of every detail; the pace of the work is determined by what you feel comfortable managing. Together with your therapist, you will begin to identify the recurring patterns that contribute to feeling trapped in negative emotional cycles. Your therapist will collaborate with you to write a letter that outlines your story and identified patterns, helping you to define the specific areas you wish to focus on during therapy. You will then work together to create diagrams or “maps” that visually represent both the problematic and the healthy/helpful patterns. This process involves examining your relationships with yourself, your therapist, and others in your life. The remainder of the therapy is dedicated to recognizing and transforming the patterns that are causing distress. At the conclusion of therapy, you and your therapist will exchange a “goodbye” letter, reflecting on the therapeutic journey, your feelings about the ending, and your outlook for the future.
Duration and Follow-Up
CAT is considered a form of ‘brief’ psychotherapy. Your therapist will inform you of the estimated number of sessions at the outset, which typically ranges between 16 and 24 sessions. Appointments are usually held weekly and last for 50 minutes. Following the completion of therapy, you will generally be offered a follow-up appointment within two to three months to review your progress.
Benefits and Potential Risks
Participating in CAT can provide you with valuable tools, such as letters and diagrams, to enhance your self-understanding. You will gain a clearer insight into your problematic patterns as well as your strengths. The collaborative nature of the therapy ensures your voice and opinions are heard, and your therapist will support you in developing a positive therapeutic relationship. These outcomes can empower you to exert greater control over self-care, self-harm tendencies, and interpersonal relationships, facilitating positive life changes. However, as with any form of talking therapy, focusing on your problems may initially lead to increased distress before improvement is felt. Therapy can also be challenging as it may lead you to make changes in your relationships that are healthier for you, even if some friends or family members react negatively to these shifts.
Alternatives and Further Information
A variety of alternative psychological therapies are available, which you may wish to discuss with your care team. Reviewing information leaflets for these therapies can help you decide which approach best suits your needs. Your key worker can provide further information on psychological therapies. For more details, you can consult the CAT practitioner in your area or visit www.acat.me.uk. The Department of Health also offers a helpful guide titled “Choosing talking therapies,” which outlines various talking therapies and their associated risks.
Referral and Documentation
If you are interested in being referred for CAT, please discuss this with your key worker. Recent guidance from the Department of Health indicates that you have the right to receive copies of any letters and reports sent between healthcare professionals regarding your care. Please inform us if you wish to receive these documents.
Feedback and Concerns
We encourage you to provide feedback to your care team regarding the usefulness of this information, any missing details, or aspects you find unclear. If you have concerns or complaints about a service, you can speak with a staff member, call our complaints team at 0800 052 0219 (freephone), or email [email protected].
Accessibility
Information from our website and leaflets can be provided in various formats, including different languages, large print, audio, and braille. Please ask a member of staff if you require information in an alternative format.
Leaflet reference: L250
Version: 9
Publication date: 04/02/2025
Archive date: 04/02/2028
