Enhanced descriptions from Syndetics:

This is a comprehensive, up-to-date introduction to the origins, development, and practice of cognitive-analytic therapy (CAT).

Written by the founder of the method and an experienced psychiatric practitioner and lecturer, it offers a guide to the potential application and experience of CAT with a wide range of difficult clients and disorders and in a variety of hospital, community care and private practice settings.

Introducing Cognitive Analytic Therapy includes a wide range of features to aid scholars and trainees:

? Illustrative case histories and numerous case vignettes
? Chapters summaries, further reading and glossary of key terms
? Resources for use in clinical settings

Essential reading for practitioners and graduate trainees in psychotherapy, clinical psychology, psychiatry and nursing.

Table of contents provided by Syndetics

• List of figures (p. xi)
• About the authors (p. xiii)
• Preface (p. xv)
• Acknowledgements (p. xix)
• 1. The Scope and Focus of CAT (p. 1)
• CAT is an integrated model (p. 1)
• CAT is a collaborative therapy (p. 2)
• CAT is research based (p. 3)
• CAT evolved from the needs of working in the public sector and remains ideally suited to it (p. 3)
• CAT is time-limited (p. 4)
• CAT offers a general theory, not just a new package of techniques (p. 4)
• CAT has applications in many clinical settings (p. 5)
• 2. The Main Features of CAT (p. 6)
• The early development of CAT practice (p. 8)
• The theoretical model (p. 8)
• The development of the basic model of practice (p. 9)
• The development of sequential diagrammatic reformulation (p. 10)
• The course of therapy (p. 12)
• Time limits (p. 13)
• The development of a Vygotskian object relations theory (p. 13)
• The scope of CAT (p. 14)
• Case history: Bobby (p. 15)
• Background (p. 15)
• Assessment and reformulation (p. 16)
• The course of therapy (p. 17)
• Termination (p. 19)
• Follow-up (p. 19)
• Further reading (p. 20)
• 3. Development of the Self: Background Considerations (p. 21)
• Evolutionary psychology (p. 22)
• The evolution of cognitive capacities and of culture (p. 23)
• Evolutionarily pre-programmed psychological tendencies (p. 25)
• Genetics and temperament (p. 26)
• Implications of our evolutionary past and biology for psychotherapy (p. 30)
• Further reading (p. 32)
• 4. Normal and Abnormal Development of the Self and Its Implications for Psychotherapy (p. 33)
• The CAT concept of self (p. 34)
• The permeability of the self (p. 36)
• Contrasts with other psychodynamic concepts of self (p. 37)
• Cultural relativity of models of self (p. 37)
• Studies of infant development (p. 38)
• The contribution of Vygotsky's ideas (p. 39)
• Vygotskian ideas in CAT (p. 42)
• Developmental studies of role acquisition (p. 43)
• Bakhtinian contributions (p. 44)
• Models of individual development and their relation to CAT (p. 46)
• Psychoanalytic models (p. 46)
• Attachment theory (p. 47)
• Cognitive psychology and cognitive therapy (p. 49)
• Abnormal development and therapeutic change (p. 50)
• Persistent negative role patterns (p. 51)
• Avoidant, defensive and symptomatic role replacements or 'coping strategies' (p. 51)
• Dissociation (p. 52)
• Common therapeutic factors (p. 53)
• Childhood development and the CAT model of therapeutic change (p. 53)
• Who does the therapist speak for? (p. 54)
• Avoiding collusion (p. 55)
• Self-esteem (p. 56)
• The 'false self' (p. 57)
• Underlying philosophical divergences; dialogism versus Cartesianism (p. 57)
• Dialogism (p. 59)
• Conclusion (p. 59)
• Further reading (p. 60)
• 5. Selection and Assessment of Patients for Individual Cat (p. 61)
• Referral (p. 61)
• Assessment data (p. 62)
• The conduct of the assessment interview (p. 63)
• Nora (p. 65)
• David (p. 66)
• Nick (p. 67)
• Debby (p. 68)
• Evelyn (p. 69)
• Diana (p. 70)
• The six cases (p. 71)
• Other considerations (p. 72)
• Combining CAT with other treatment modes (p. 73)
• Depression (p. 74)
• Anxiety (p. 74)
• Obsessive-compulsive symptoms (p. 75)
• Somatisation (p. 75)
• Implications of some specific diagnoses and behaviours (p. 75)
• Assessing the risk of suicide (p. 75)
• Assessing the potential for violence (p. 76)
• Assessing motivation (p. 77)
• Other therapeutic modes (p. 78)
• Paper and pencil devices (p. 78)
• Treatment contracts (p. 79)
• Conclusions (p. 79)
• 6. The Reformulation Sessions (p. 80)
• Case formulation and CAT reformulation (p. 80)
• The process of reformulation (p. 81)
• The effects of reformulation (p. 82)
• The reformulation letter (p. 83)
• Case example (p. 83)
• General principles of writing reformulation letters (p. 86)
• Diagrammatic reformulation (p. 87)
• Simple flow diagrams (p. 87)
• The principles of sequential diagrammatic reformulation (p. 88)
• Sequential diagrammatic reformulation; practical procedures (p. 89)
• Case example (continued) (p. 91)
• Single or multiple cores in diagrams (p. 92)
• Sequential diagrams and self state sequential diagrams--a recapitulation (p. 94)
• How many cores in a diagram? (p. 94)
• The order of reformulation (p. 96)
• The impact of reformulation (p. 97)
• Exits (p. 97)
• Further reading (p. 98)
• 7. The Therapy Relationship: Working at Changing (p. 99)
• The working alliance in the ZPPD (p. 100)
• Transference and countertransference (p. 102)
• Psychoanalytic understandings (p. 102)
• CAT understandings of transference and countertransference (p. 103)
• Personal and elicited countertransference (p. 104)
• Identifying and reciprocating countertransference (p. 104)
• Dialogic Sequence Analysis (p. 105)
• Case example: Alistair (p. 105)
• Transference, countertransference and the working relationship of therapy (p. 106)
• Technical procedures (p. 107)
• Rating progress (p. 107)
• Recognising procedures as they occur (p. 108)
• Recapitulating and reviewing the session (p. 108)
• Homework (p. 109)
• Accessing painful memories and feelings (p. 110)
• Not recognising procedures as they occur (p. 110)
• The CAT model of resistance (p. 111)
• Dropping out of therapy (p. 112)
• Recognising procedures at termination; goodbye letters (p. 113)
• The course of therapy (p. 114)
• Case history: Rita (p. 114)
• Further reading (p. 118)
• 8. The Detailed Cat Model of Therapist Interventions and Its use in Supervision (p. 119)
• CAT, psychodynamic psychotherapy and cognitive-behaviour therapy (CBT): a comparison of practice (p. 120)
• Evidence for the specific effects of CAT techniques (p. 121)
• Therapist interventions in CAT (p. 122)
• Acknowledgement, exploration and linking (p. 124)
• Negotiation, seeking consensus, explanation and contacting unassimilated feelings (p. 124)
• Apparently psychologically unsophisticated patients (p. 125)
• Case example: Grace (p. 125)
• Supervision of therapists in CAT (p. 128)
• Audiotape supervision (p. 129)
• Group supervision (p. 129)
• 'Parallel process' (p. 130)
• Distance supervision (p. 130)
• 9. Cat in Various Conditions and Contexts (p. 131)
• The problem of diagnosis (p. 131)
• Competing paradigms (p. 132)
• The scope of CAT (p. 133)
• Practical methods--symptom monitoring (p. 134)
• Procedural monitoring (p. 135)
• Strategic issues: when to address symptoms directly (p. 136)
• Panic and phobia (p. 136)
• Generalised anxiety disorder (p. 137)
• Obsessive-compulsive disorders (p. 138)
• Case example: Susan (p. 139)
• Post-traumatic stress disorder (p. 145)
• Case example: Richard (p. 146)
• Case example: Hannah (p. 148)
• Depression (p. 149)
• Somatisation (p. 150)
• Deliberate self-harm (p. 151)
• Eating disorders (p. 152)
• CAT and the management of medical conditions (p. 153)
• Management of insulin-dependent diabetes (p. 153)
• Management of asthma (p. 154)
• Substance abuse (p. 155)
• CAT in old age and early dementia (p. 156)
• Gender issues (p. 157)
• The effects of childhood sexual abuse (p. 157)
• True or false recollections of abuse (p. 158)
• Unresolved mourning (p. 159)
• CAT in primary care (p. 161)
• Psychosis (p. 161)
• Current models of psychotic disorder (p. 162)
• Current psychological treatments for psychotic disorders (p. 163)
• A CAT-based model of psychotic disorder (p. 164)
• Case example: Sarah (p. 167)
• Case example: Andrew (p. 171)
• Learning disabilities (p. 172)
• CAT in groups and organisations (p. 174)
• Further reading (p. 175)
• 10. The Treatment of Personality Disorders (p. 176)
• The concept of personality disorder (p. 177)
• Borderline personality disorder (BPD) (p. 178)
• The causes of BPD (p. 178)
• The CAT multiple self states model of BPD (p. 179)
• Recognising partial dissociation (p. 180)
• The reformulation and therapy of borderline patients (p. 181)
• Case history: Deborah (p. 182)
• Results (p. 184)
• The course of therapy (p. 185)
• Narcissistic personality disorder (NPD) (p. 185)
• Case history: Olivia (p. 187)
• Case history: Sam (p. 189)
• Conclusion (p. 197)
• The treatment of BPD: research evidence (p. 198)
• The relation of CAT to current models of BPD (p. 199)
• Further reading (p. 201)
• 11. The 'Difficult' Patient and Contextual Reformulation (p. 202)
• Causes of difficult behaviour (p. 204)
• Physical causes (p. 204)
• Psychiatric causes (p. 205)
• Staff team dynamics (p. 205)
• General approaches to the 'difficult' patient (p. 205)
• Contextual reformulation (p. 205)
• Constructing a contextual reformulation (p. 206)
• Examples of simple contextual reformulations (p. 207)
• Case example: Brenda (p. 207)
• Case example: Paula (p. 209)
• Uses and applications of contextual approaches to the 'difficult' patient (p. 213)
• Further reading (p. 213)
• Afterword (p. 214)
• Distinctive features of CAT (p. 214)
• The continuing expansion of CAT (p. 215)
• The evidence base and research (p. 216)
• The implicit values of CAT (p. 217)
• Glossary (p. 219)
• Appendix 1 CAT-related research publications and the evidence base for CAT (p. 223)
• Appendix 2 The Psychotherapy File (p. 232)
• Appendix 3 Personality Structure Questionnaire (PSQ) (p. 241)
• Appendix 4 Repertory grid basics and the use of grid techniques in CAT (p. 243)
• References (p. 245)
• Index (p. 261)

Author notes provided by Syndetics

Written by the founder of the CAT method, ANTHONY RYLE, South London and Maudsley NHS Trust and Guy's, Kings, St Thomas' (GKT) Medical School, Munro Clinic, Guy's Hospital, London, UK.

IAN B. KERR South London and Maudsley NHS Trust, York Clinic, Guy's Hospital, London,UK, an experienced psychiatric practitioner and lecturer.