Cognitive Analytic Therapy (CAT)

therapy session

What is Cognitive Analytic Therapy (CAT)?

CAT is a type of talking therapy developed by Dr Ryle at Guy’s and St. Thomas’ hospital in London. It helps people understand how they relate to themselves and others. It’s like a conversation where you talk about your feelings and thoughts, and it can help with feelings of sadness, worry, or low self-esteem. It’s beneficial when people feel stuck in unhelpful habits or patterns.

In all the years that I worked as a psychologist, I would say that I used CAT to inform my thinking or practice instead of working tightly and solely within the model.

When I say inform my thinking, I found it most helpful when thinking about current difficulties an adult might have and trace these difficulties back to when they were a child when the behaviour served a purpose for them. For example, adults may not get their needs met as they are always trying to please others. As an adult, this behaviour does not work for them, but it could have served a purpose when they were a child, as the could have discovered that they got attention from a parent when they did things to please them.

How Does CAT Work?

  • As kids, we develop ways to deal with challenging situations. These become our habits and patterns in how we think and act.
  • Sometimes, these habits are helpful when we’re young but cause problems when we’re older.
  • CAT helps people see these patterns and learn new, healthier ones.

How Can CAT Help Me?

  • You and a therapist will discuss your problems, determine where they come from, and how to change them.
  • It’s all about your needs and goals.
  • You’ll learn which habits are hurting you and develop better ones.

What Do I Need to Do?

  • Think about what problems you want to discuss and what you hope to achieve.
  • You need to commit to regular weekly meetings.

What Happens During CAT Sessions?

  1. Early Sessions: You’ll share your story, and you and your therapist will figure out the patterns causing problems.
  2. Middle Phase: You’ll focus on changing specific patterns with your therapist’s support.
  3. Ending: You’ll reflect on what you’ve learned and how you feel about ending therapy.

How Long Does it Last?

CAT usually has 8, 16, or 24 sessions, each lasting about an hour. You’ll discuss the number of sessions at the start.

What Happens After?

You’ll have a follow-up appointment to see how you’re doing after the therapy ends. This is to check how things are going and if you’re using the new patterns you learned.

Benefits and Risks

  • Benefits: CAT can’t change the past but can help you gain control and make positive changes.
  • Risks: Talking about problems can be tricky, and making changes can be challenging, especially for those close to you.

What if It’s Not Working?

You can always stop if you feel it’s not helping. It’s important to tell your therapist if you’re struggling, and together, you can adjust the therapy to suit your needs better.


CAT is about understanding your habits and learning new, helpful ones. You take a journey with a therapist to be happier and healthier. It requires commitment but can positively change how you relate to yourself and others.

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