VINCENT SQUARE EATING DISORDER SERVICE
Cognitive Analytic Therapy (CAT): Information for Clients
CAT is a psychotherapy developed in the early 1980s. It is an integration of cognitive and
analytic psychotherapy, developed for use in the National Health Service, across a range of
disorders and difficulties such as depression, anxiety, personal relationship problems and in
eating disorders.
What is CAT?
CAT focuses on maladaptive relationship, thinking and behaving patterns and establishes a
shared understanding of how these patterns may keep your eating disorder going. It is an
individual therapy and is time-limited. The number of sessions will be decided with your
clinician. Problems are understood in the light of personal histories and life experiences. In
CAT, the relationship with your therapist is important in uncovering unhelpful relationship
patterns/coping mechanisms, negative beliefs and behaviours and then exploring how they
can be adapted and changed.
There are three stages in the therapy:
 Reformulation- In the early sessions, the therapist will ask you to give an account of
your early life experiences and long-term pains and difficulties from a relational
perspective. They will then write a letter to you summarising how certain patterns
have evolved, highlighting unhelpful coping mechanisms.
 Recognition: This is the stage when we focus on identifying these patterns in your
relationship with your therapist and your everyday interactions.
 Revision: The later stages of therapy focus on helping you learn to change unhelpful
relationship patterns and develop more healthy ways of relating to yourself and to
others. You will then have less need to rely on your eating disorder.
Why choose CAT in your case?
The National Institute for Clinical Excellence (NICE - a government body that reviews
research evidence and consults with experts in the field) recommends CAT as a treatment
option for anorexia nervosa. It may also be a helpful treatment for people with other types of
eating disorders, particularly for people with other complex emotional and/or relationship
difficulties alongside their eating disorder. (See the NICE leaflet for more information –
available from the service.)
What does it involve?
The aim is for your working relationship with your therapist to be a collaborative one. Both
you and your therapist will need to be active participants. Sessions are 50 minutes long and
at weekly intervals. It is important that you attend regularly.
What can I expect of my therapist?
Your therapist works as part of a team and will discuss your case with members of the team
from time to time in a confidential and respectful manner. Your therapist will respect your
position as a patient. This means that they will try to be punctual, not cancel at short notice,
give you as much information as possible, not meet with you outside agreed times or outside
the clinic, and touch only as would be normally courteous (such a hand shakes). Your
therapist will put your interests first. If you are uncertain or uncomfortable, it is important to
discuss this with your therapist. If you are still experiencing difficulty, you are very welcome
to approach Tanya Paxton (Service Director) or Dr Frances Connan (Consultant
Psychiatrist).
An advocacy service is available if you feel that you are not being listened too, or would like
help to get your views across. You can also access help through the Patient Advise and
Liaison Service (PALS). Your PALS representative at Vincent Square is Pamela Taft
(Service Administrator), and she is based at Reception.
Updated April 2013