Experiences of receiving Cognitive Analytic Therapy (CAT) for those with complex secondary care mental health difficulties

Purpose
Cognitive Analytic Therapy (CAT) was established as a time-limited and integrative psychotherapeutic approach (Ryle, 1995). A review was conducted to identify what is known about the service user’s experience of CAT. Following this empirical research exploring service user’s experience of CAT for those with complex mental health difficulties was completed. An executive summary of the empirical research undertaken has also been developed for service users. Method
A systematic search of HDAS, Web of Science, Cochrane and Ethos was conducted. As a result, twelve papers were selected for review. These were appraised using CASP tools and then thematically synthesised. Following this, six semi-structured interviews were completed with service users exploring their experience of CAT. Transcripts were analysed using Interpretative Phenomenological Analysis (IPA).
Results The literature review and empirical research highlighted that CAT tools helped service users to gain an understanding of themselves. However, CAT also evoked negative emotions in terms of feeling scared, worried and a painful process. Service users reported gaining knowledge and skills and considered the therapeutic relationship important. The literature review identified how CAT in a group is experienced differently to one-to-one CAT and the empirical research identified how service users with complex mental health difficulties can find it difficult to make changes following CAT.
Conclusions The review and empirical research highlight the helpfulness of CAT in developing service user’s understanding of themselves and how CAT evokes strong emotions. It is suggested that therapists need to adopt a more compassionate stance in the delivery of CAT and give more attention to containment and signs of rupture to the therapeutic relationship. The empirical research identified how it can be difficult to make changes following CAT and suggests incorporating systemic working for service users with complex mental health problems.