Introducing Cognitive Analytic Therapy : Principles and Practice of a Relational Approach to Mental Health.
- 2nd ed.
- 1 online resource (385 pages)
Cover -- Title Page -- Copyright Page -- Contents -- About the Authors -- List of Figures -- Preface to the Second Edition -- Acknowledgments -- The Structure of the Book -- Further Information -- Chapter 1 The Scope and Focus of CAT -- CAT Is an Integrated Model -- CAT Is a Collaborative Therapy -- CAT Is Research Based -- CAT Evolved from the Needs of Working in the Public Sector and Remains Ideally Suited To It -- CAT Is Time-Limited -- CAT Offers a General Theory, Not Just a New Package of Techniques -- CAT Has Applications In Many Clinical and Other Settings -- Chapter 2 The Main Features of CAT -- Background -- The Early Development of CAT Practice -- The Theoretical Model -- The Development of a Vygotskian and Bakhtinian Object Relations Theory -- The Development of the Basic Model of Practice -- The Development of Sequential Diagrammatic Reformulation ("Mapping") -- The Course of Therapy -- Initial Phase -- Mid Phase -- Time Limits and Ending -- The Clinical Aims of CAT -- Concluding Remarks -- Chapter 3 The CAT Model of Development of the Self -- The CAT Concept of Self -- Neuroscience Research and the Self -- The Permeability of the Self -- Cultural Relativity of Models of Self -- Studies of Infant Development -- The Contribution of Vygotsky's Ideas -- The Social Formation of Mind -- Sign Mediation -- Internalization -- The Zone of Proximal Development (ZPD) -- Developmental Studies of Role Acquisition -- Bakhtinian Contributions -- Contrasts with Other Concepts of Self -- Cognitive Psychology and Cognitive Therapy -- Genetics and Temperament -- Our Evolutionary Past -- The Evolution of Cognitive Capacities and of Culture -- Evolutionarily Pre-Programmed Psychological Tendencies -- Chapter 4 The CAT Model of Abnormal Development of the Self and Its Implications for Psychotherapy -- Abnormal Development of Self and Its Consequences. Persistent Negative Role Patterns -- Avoidant, Defensive, and Symptomatic Role Replacements or "Coping Strategies" -- Dissociation -- Broader Implications of a Relational Adversity and Trauma ("Deficit") Based Model of Psychopathology -- Common Therapeutic Factors -- Damaged or Abnormal Development of the Self and the CAT Model of Therapeutic Change -- Understandings of "Transference" and "Counter-Transference" and Avoiding Collusion -- Use of Personal and Elicited Counter-transference -- Identifying and Reciprocating Counter-transference -- Self-Esteem -- The "False Self" -- Who Does the Therapist Speak for? -- Implications of Our Evolutionary Past for Psychotherapy -- Concluding Remarks -- Chapter 5 The Practice of CAT: Selection and Assessment of Patients for Therapy -- Referral -- Assessment Information -- The Conduct of the Assessment Interview -- Nora -- David -- Nick -- Debby -- Evelyn -- Diana -- The Six Cases -- Other Considerations -- Assessing Motivation -- Combining CAT with Other Treatment Modes -- Assessing the Risk of Self-Harm and Suicide -- Assessing the Potential for Violence -- "Paper and Pencil" Devices and Questionnaires -- Treatment "Contracts" -- Concluding Remarks -- Chapter 6 The Practice of CAT: The Early Reformulation Sessions -- Case Formulation and CAT Reformulation -- The Process of Reformulation -- The Reformulation Letter -- Diagrammatic Reformulation or Mapping -- General Principles of Creating Diagrams or Maps -- Historical Background: Simple "Flow Diagrams" -- Diagrammatic Reformulation or Mapping: Practical Considerations -- Single or Multiple Cores in Diagrams -- Exits and Aims -- The Order and Process of Reformulation -- Formal Evaluation of the Impact of Reformulation -- Concluding Remarks -- Chapter 7 The Practice of CAT: Later Phases of Therapy, Working at Changing and Ending. Later Sessions-General Considerations -- Change and the Working Alliance in the "ZPPD" -- Making Use of Transference and Counter-transference in Enabling Change -- Transference, Counter-transference, and the Working Relationship of Therapy -- Dialogic Sequence Analysis -- Technical Procedures -- Rating Progress -- Recognizing Enactments and Procedures as they Occur -- Recapitulating and Reviewing Sessions -- Homework -- Accessing Painful, Possibly Traumatic, Memories and Feelings -- Not Recognizing Enactments and Procedures as they Occur -- The CAT Model of Resistance and of the "Negative Therapeutic Reaction" -- Dropping out of Therapy -- Recognizing Enactments and Procedures at Termination and Ending Well -- Concluding Remarks -- Chapter 8 The CAT Model of Therapist Activity and of Supervision -- The Competence in CAT (CCAT) Measure -- Therapist Activities in CAT -- Acknowledgment, Exploration, and Linking -- Negotiation, Seeking Consensus, Explanation, and Contacting Unassimilated Feelings -- Supervision of Therapists in CAT -- Audio-tape Supervision -- Dialogical Sequence Analysis -- "Parallel Process" -- Group Supervision -- Reflective Practice -- Distance Supervision -- Chapter 9 CAT in Various Conditions and Contexts -- The Problem of Diagnosis -- Diagnosis and Formulation -- The Scope of CAT -- Strategic Issues: When to Address Symptoms Directly -- CAT in Some Specific Conditions and Settings -- Anxiety Related Disorders -- Obsessive-Compulsive Disorders -- Panic and Phobia -- Depression -- Unresolved Mourning -- Trauma and Post-Traumatic Stress Disorders -- The Effects of Child Sexual Abuse -- Somatization, "Somatoform Disorders," and "Medically Unexplained Symptoms" -- CAT and the Management of Medical Conditions -- Eating Disorders -- Deliberate Self-Harm -- Intellectual/Learning Disabilities and Neurodevelopmental Disorders -- Psychosis. A CAT Perspective on Conceptualizing and Treating Psychotic Disorders -- Particular Considerations around CAT for Psychotic Disorders -- Substance Abuse -- CAT in Old Age and Early Dementia -- Sexual and Gender-Related Issues -- Perinatal Mental Health -- CAT in Forensic Settings -- CAT with Children and Adolescents -- CAT in Primary Care -- CAT in Groups and Organizations -- CAT Across Cultures -- Concluding Remarks -- Chapter 10 The Treatment of "Severe and Complex"Personality-Type Disorders -- The Concept of Personality Disorder -- Borderline Personality Disorder (BPD) -- The Causes of BPD -- The CAT Multiple Self States Model -- The Therapy and Reformulation of Borderline Patients -- Aids to Reformulation -- Summarizing SDP Data -- The Course of Therapy -- Narcissistic Personality Disorder (NPD) -- The MSSM and NPD -- Therapy with Patients with Features of NPD -- Conclusion -- The Treatment of "Severe and Complex," Personality-Type Disorders: CAT and the Research Evidence -- Concluding Remarks -- Chapter 11 The "Difficult" Patient, Contextual Reformulation, Systemic Applications, and Reflective Practice -- The "Difficult" Patient -- Causes of "Difficult" Behavior -- Physical Causes -- Psychiatric Causes -- Staff Team Dynamics -- General Approaches to the "Difficult" Patient -- Contextual Reformulation -- Constructing a Contextual Reformulation -- Examples of Contextual Reformulations -- Broader Uses and Applications of Contextual and Systemic Approaches -- Reflective Practice -- Background -- CAT and Reflective Practice -- Concluding Remarks -- Afterword -- Distinctive Features of CAT -- The Continuing Expansion of CAT -- The Evidence Base and Research -- The Implicit Values of CAT -- Glossary -- Appendix 1 The Psychotherapy File -- Keeping a Diary of Moods and Behavior -- Patterns that Do Not Work, but Are Hard to Break -- Traps. Dilemmas (False Choices and Narrow Options) -- Snags -- Difficult and Unstable States of Mind -- Different States -- Appendix 2 Cognitive Analytic Therapy (CAT) Competences for Individuals with Personality Disorder -- Knowledge of CAT Theory -- Knowledge of Key Features of CAT -- The Psychotherapy File -- Reformulation -- Knowledge of the CAT Theory of BPD -- Key skills of CAT -- Reformulation -- Constructing the Sequential Diagrammatic Reformulation (SDR) (or "Map") -- Constructing Target Problem Procedures (TPPs or "key issues") -- Formulating Aims or Exits -- Moving Between Task and Process -- CAT Methods of Intervention -- Ability to use CAT Skills to Manage the Ending of Therapy -- Ability to use CAT‐Specific Measures to Guide the Intervention -- CAT Skills of Particular Relevance for Work with Borderline Personality Disorder -- Engagement -- Developing the reformulation -- Sustaining and Consolidating Positive Change -- Using CAT to Facilitate Work with Wider Systems (Contextual Reformulation) -- Appendix 3 Personality Structure Questionnaire (PSQ) -- Appendix 4 Repertory Grid Basics and the Use of Grid Techniques in CAT -- References -- Index -- EULA.