There are many other therapies and it can be confusing to work out which is right for you at this particular time.
Therapists can disagree about which is “the best” or most effective. Some view their preferred therapy model as “deeper”, or more searching and meaningful. This carries a suggestion that some therapies are more like sticking plasters which help in the short term but do not get to the root of the problem.
When it comes to finding a therapy for yourself, one of the most important things is probably that the type of therapy fits with how you think about your problems, and the kinds of things that you think will help you. This may change at different times in your life.
An aim of CAT therapy is to try to integrate lots of different ways of working into one therapy model. This means that a CAT therapist can be flexible in using whatever seems to fit the client best. We call this “pushing where it moves”.
How do I decide on what therapy will suit me best?
It might be useful to know more about different therapies so that you can match these with what you would prefer. You can decide what will fit you best at this time in your life. For example:
- How much does the therapy focus on here-and-now problems affecting me at the moment?
- How much does it focus on past experiences and early life history?
- Are the sessions quite structured,? Will the therapist ask me questions and set homework tasks? Or are they very unstructured? Can I just talk about whatever comes into my mind?
- Do I want the therapist to support and soothe me, seeing things from my point of view at all times? Or would it be helpful for them to introduce a bit of challenge to my way of thinking, and encourage me to consider ways to change?
- Is the therapy about trying to change the way I think and behave, or is it more about exploring relationships?
- How much does the therapist focus on the relationship between themself and me (the therapeutic relationship)?
- Is there usually a fixed number of sessions or do I keep going to therapy until I feel ready to stop?
Psychotherapy researchers have developed a questionnaire you can complete online to help you think about what you would prefer in therapy. Find out more about the Cooper–Norcross Inventory of Preferences (C-NIP) by clicking on this link.
Some common types of therapy are:
Cognitive Behavioural Therapy (CBT)
Many people have heard of this therapy which is now widely available within the NHS. It mainly focuses on here-and-now problems. It can help clients to be more aware of the way they think and how this affects feelings and behavior. The aim is to notice faulty ways of thinking, such as seeing things in very all-or-nothing terms. Through CBT you can learn how to spot these and change them.
The therapist encourages you to use diaries and do homework tasks. The therapeutic relationship with the therapist is not usually a focus.
CBT has developed over time and there are more varieties available. CBT therapists may include approaches such as mindfulness and learning how to be more compassionate towards yourself.
Between twelve and twenty sessions of CBT are typically offered. Some people need longer term CBT therapy, for example for long-term depression, or for more complex difficulties.
This therapy can be harder to get in the NHS because it is usually a longer term therapy. However some more brief forms of psychodynamic therapy exist. There tends to be less structure to the sessions. The therapist encourages you to talk about whatever is on your mind. The therapist will be interested in both your early life experience and your relationships.
A key focus of the therapy will be your relationship with the therapist. Your therapist will be interested in working through issues that come up between you in the therapeutic relationship. This is seen as helpful in making changes in the way you relate to other people.
Gradually, you and the therapist start to understand how events in your life have shaped the way you think, feel and behave in the world. You may find yourself slowly making changes.
Interpersonal Therapy (IPT)
This therapy developed as a treatment for depression. It has since been used for other mental health problems too. The focus is on how your relationships might protect you from getting depressed when difficult events happen in your life. This might be a bereavement, a big change in your life such as having a baby or retiring, or conflict with people close to you. The therapy is structured. Together, you and the therapist will try to work out how to improve your relationships and therefore your mood. The therapy is usually around 16 sessions and the therapeutic relationship is not a main focus.
Cognitive AnalyticTherapy (CAT)
In CAT the therapist will try to work out with you how your early life and other experiences have shaped the kinds of relationships that you have. This includes the relationship you have with yourself, such as how you take care of yourself. CAT also has a focus on how you relate with others . Sessions are somewhat structured. You will be expected to work on your therapy goals between sessions.
Together with the therapist you are likely to create a diagram or map of your problems. The therapist may write you letters at the start and end of therapy, and may invite you to write back. The therapy is usually 16 sessions, with some people needing a longer therapy of 24 sessions.
The therapeutic relationship will be of interest to your therapist. They will see what happens between you as useful information for you both to think and talk about. Together, you will explore how it fits on your diagram.
What about other therapies?
There are many other therapies available through the NHS which we have not yet included in this article. These include:
Dialectical Behaviour Therapy (DBT)
Mentalisation Based Therapy (MBT)
Eye Movement Desensitisation Therapy (EMDR)
This list is not exhaustive, and there are many other therapies available. It is advisable to check the registration of any therapist with their professional or regulatory body such as the Health & Care Professions Council.
For CAT therapists, you can check the therapist’s level of qualification and accreditation with us through our Register of Members.
To read more about what ACAT accreditation means, read our page ‘How Do I Know My Therapist Is Qualified to Deliver Cognitive Analytic Therapy?’ at this link