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CAT is often described as a “map and change” therapy. It helps you identify unhelpful patterns (sometimes called procedures or traps), understand how they formed, and develop new ways of coping. CAT usually includes written or diagram-based tools that make patterns easier to recognise in everyday life.

What happens in CAT?

Early sessions focus on assessment and shared understanding. The therapist may write a reformulation letter or create a diagram (“map”) of your patterns. Middle sessions work on recognising these patterns in real time and trying alternatives. Ending is planned and includes reviewing progress and strategies.

What can CAT help with?

  • Anxiety and stress patterns
  • Depression and low mood
  • Relationship difficulties and repeating dynamics
  • Long-standing patterns linked to self-criticism or shame

Suitability

CAT can be a good fit if you want a structured approach with clear formulation. If you have significant trauma symptoms or high risk concerns, ensure you work with an appropriately qualified clinician and a treatment plan matched to your needs.

History of Cognitive Analytic Therapy

Cognitive Analytic Therapy was developed in the UK in the late 20th century, integrating ideas from cognitive therapy and psychoanalytic/relational approaches. It is used across NHS and private settings as a structured, time-limited psychotherapy model.

Typical conditions that use Cognitive Analytic Therapy

Showing 3 conditions where Cognitive Analytic Therapy is commonly used.

Condition Evidence Notes

Anxiety

strong

Structured formulation and pattern change.

Low mood

strong

Targets repeating depressive patterns.

Low self-esteem

moderate

Self-criticism/shame pattern work.

Frequently asked questions

Is CAT short-term?

Yes. It usually runs for 16–24 sessions plus review.

Will I get written summaries?

Yes. Maps and letters help clarify themes and progress.

Can CAT be combined with medication?

Yes; coordinate with your prescriber for integrated care.