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Cognitive analytic therapy for past mistakes

What Is Cognitive Analytic Therapy?

Cognitive analytic therapy was founded in the UK with the aim of providing an affordable short-term form of psychological support through the National Health Service. The client is an active participant in the therapy sessions, which is not that common in the world of psychotherapy. The cognitive analytic theory encompasses elements such as reformulation as well as cognitive and analytic techniques. Practitioners of this form of therapy look for patterns in motivation, thoughts, emotion, and events and strive to understand why and how a central issue, for instance drug abuse, came into being. Similarly to some other psychological paradigms, such as object relations, the cognitive analytic therapy views the problem as embedded between relationships with significant others and not solely within the patient. Consequently, models of behavior that are based on the functionality of relationships are usually established during childhood and reveal themselves later on in adulthood. Therefore, cognitive analytic theorists postulate that the individual repeats old relationships in order to do better in them this time around or rid themselves of the dysfunctional bonds. For instance, women who grew up without a proper father figure are prone to having romantic relationships with older men. Or, persons who were neglected as children grow up to be very sensitive to the feelings of neglect in most of their friendships and relationships as adults.

Where Is Cognitive Analytic Therapy Used?

As previously mentioned, the therapist and the client work together to identify and modify the patterns of behavior that interferes with daily functioning, i.e. holding a job, maintaining friendships, or sometimes even participating in simple activities such as performing chores and daily duties. The initial goal of therapy is to help the person recognize the central issue and understand its origins. The subsequent purpose of cognitive analytic therapy sessions is to teach the client coping strategies or new behaviors altogether that are far better adaptive. When it comes to duration, the therapeutic process usually takes between 8 to 24 weeks, depending on the needs and desires of the client. In most cases the time is set at the beginning and sessions are planned accordingly. During the first few meetings, the therapists assesses the person by administering a battery of tests as well as by performing one on one interviews in order to find out the problem that manifests itself in everyday life. The therapist will also be interested in past experiences and the person’s perception of them to try and pinpoint the root of the problem. Once the assessment stage is finished the practitioner writes a reformulation letter to the client, explaining in detail how he or she views the situation. The therapists will pay special attention to behavioral patterns formed in childhood and their recurrence or impact on the adult life. The client has to agree with the therapist about what the main issue is and how it originated in order for therapy to proceed. As is the case with many kinds of psychotherapy, the client will be asked to keep a journal and record the instances of maladaptive behavior as well as the context in which they occurred. The stage that follows is called the recognition phase, during which the client and the therapist identify and explain the maladaptive and unhelpful procedures that maintain and cultivate the issue. The patient is supposed to recognize the context in which the behaviors occur as well as any possible triggers. The second half of the therapy process is characterized by planning the exit strategies from situations that call for maladaptive behavior. For instance, if the patient is taking drugs or drinking excessive amounts of alcohol every time he or she feels angry, an exit strategy would be expressing the anger in a manner that does not involve self harm. Lastly, the patient and the therapist will write the so called “goodbye letters” stating what has been accomplished and what remains to be done. The therapy usually ends after the numbers of sessions agreed upon at the beginning but follow up meetings are arranged so that the state and progress of the individual is monitored and encouraged. A typical process lasts for about 4 months and when it ends the therapist and the client might meet once a month for as long as there is a need to go over what is happening with the maladaptive behaviors and the exit strategies.

Empirical Evidence for Cognitive Analytic Therapy

This type of psychotherapy is relatively young but there have been research studies conducted to assess its procedures and effects on disturbed individuals. So far there is not enough data to make concrete conclusions but the therapy seems promising and more research is recommended. Experts agree that cognitive analytic therapy could play a substantial role in treating borderline personality disorder. Also, there are finding that point to improvement in persons suffering from anorexia nervosa.  


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