Cognitive analytical therapy was developed by Anthony Ryle in the UK with the main aim of providing short-term, effective and affordable therapy to people within the public health system. This therapeutic approach integrates notions and theories from both cognitive and analytical psychotherapies, as well as drawing influences from Vygotsky’s and Bakhtin’s theories. Today, cognitive analytical therapy still preserves the tradition of a short time, intensive therapeutic program that has become a self-standing psychotherapy orientation, useful both in the public health system as well as in the private sector.
Usually the duration of therapy varies from 8 to 24 sessions, each session lasting for one hour. It is usually an individual-based approach, but it can be successful for couples, groups or organizations as well. Because it is short-term in nature and very intense, the client has to become deeply involved in the therapeutic process, needs to be motivated and determined, for in the end he/she will be able to rightfully claim and attribute to him/herself the success of the process. The therapy usually ends with an exchange of letters between the client and the therapist. This exchange has the role of summarizing what has been realized during therapy and what remains to be achieved by the client on his/her own further down the road.
How it works: principles and steps
This therapy approach puts a great deal of emphasis on the implication and collaboration of the client. His/her motivation of making real progress is essential. An unmotivated client, undecided and showing a great degree of resistance will not be successful in this type of therapy. The therapist is not there in order to “forcefully” heal the client, but to aid him/her in understanding his/her own defective behavior patterns, to understand their causes and to develop strategies in order to overcome them.
Reformulation phase: it happens at the start of the therapy and is marked by a reformulation letter that the therapist writes addressing the client. In it, the therapist analyzes the possible relations between the individual’s childhood experiences and his/her current problems. On its basis, the following phases of the process are constructed.
Recognition phase: In this phase, the client is helped to understand the context and the nature of the problems that appear within that context. Thus, he/she establishes contact with his/her problems and gets to better understand them and the way in which he/she reacts to them.
Revision phase: This is the most active phase when the client is expected to learn to deal with his/her problems, not just to recognize them. Specific strategies and methods to overcome the difficulties that the client encounters are developed.
What is very important in this type of therapy is not only that it offers the client a method to help him/herself in a given situation, but also that it represents a method that may prove to be useful in future situations, in other types of problems that one might encounter. For instance, in the case of someone with anger management issues, one can learn to control one’s anger in moments of maximum intensity in other ways than hitting walls in a blind rage or hurting him/herself. Alternatives are being presented and offered, such as sports, breathing exercises or listening to relaxing music. Searching for alternative behaviors in difficult situations (that don’t always fall under the anger management category) becomes a life strategy and self-regulating one’s behavior becomes natural.
The end of therapy is marked by “goodbye letters” and by the promise of meeting once more for a few follow-up sessions.
Who is it suited for?
A very large spectrum of psychological issues can be addressed through cognitive analytical therapy, such as anxiety disorders, depression, intentional self-harm, abnormal behaviour caused by certain physical conditions (e.g., diabetes), eating disorders and personality disorders (Cowmeadow, 1994; Fosbury, 1994; Ryle, 1997). Cognitive analytical therapy has proven to be one of the most effective approaches in treating borderline disorder (Denman, 2001).
However, there are certain situations when cognitive analytic therapy’s success rate might seem limited. Drug or alcohol conditions are some of these situations, due to the physical addictions which usually need more than 24 meetings to be eliminated (Ryle, 1997). Also, any other mental condition that keeps the motivation of the patient at very low levels (for example, depression) might also inhibit the process’s rate of success..
If you are in need of a short term, pragmatic yet not at all superficial therapeutic approach (bearing in mind its analytical background), if you want to overcome your problems through methods that will prove to be helpful in the future as well, for other problems that might come up, if you want to gain a better understanding of yourself and to develop as a person, then surely cognitive therapy is the perfect choice for you.
References:
Cowmeadow, P. (1994) Deliberate self harm and cognitive analytic therapy. International Journal of Short Term Psychotherapy, 9, 135–150.
Denman, C (2001). Cognitive-analytic therapy. Advances in Psychiatric Treatment, 7, 243–252, doi: 10.1192/apt.7.4.243
Fosbury, J. A. (1994) Cognitive analytic therapy with poorly controlled insulin-dependent diabetic patients. In Psychology and Diabetes Care (ed. C. Coles). Chichester: PMH Production
Ryle, A. (1997) Cognitive Analytic Therapy for Borderline Personality Disorder: The Model and the Method. Chichester: John Wiley & Sons
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