Clients' experience of change: An exploration of the influence of reformulation tools in cognitive analytic therapy

Tyrer, Rebecca Anne; Masterson, Ciara

doi:10.1002/cpp.2339

Cited by 10 publications

(19 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of note, one of the least helpful treatment components rated by clients involved the completion of the reformulation letter. Regarding the reformulation letter, findings from the current study are somewhat inconsistent with findings reported by Tyrer and Masterson (2019) who indicated that clients in their sample reported the benefit of the reformulation letter in helping to note re‐enactments although this did not necessarily lead to significant change on levels of insight or symptom reduction. The actual additive benefits of reformulation tools have been brought into question as regard clinical effectiveness and may be largely redundant amongst those accessing a primary care level intervention (Kellett et al ., 2018).…”

Section: Discussioncontrasting

confidence: 99%

An exploration of group cognitive analytic therapy for anxiety and depression

et al. 2020

View full text Add to dashboard Cite

Objectives Cognitive analytic therapy has been shown to be an effective psychological treatment for a range of differing presentations but little research to date has focused on the use of Group CAT (GCAT). The aim of this study was to explore the acceptability, feasibility, and preliminary effectiveness of GCAT for clients with mood and anxiety disorders in primary care. Design This study utilized a mixed method design. Method A 12‐session GCAT programme was developed covering key CAT concepts. The structure reflected the three phases of CAT – reformulation, recognition, and revision. Participants completed outcome measures pre‐ and post‐treatment and at 3‐month follow‐up. Acceptability was reported using session attendance and participant feedback in addition to asking clients to rank the utility of CAT treatment components. A therapist interview was also completed. Results Fifty‐five per cent of clients completed the treatment, and feedback suggests that GCAT is an acceptable and feasible intervention for a primary care population. Clients also reported on the utility of specific CAT treatment components. Clients demonstrated positive change on a number of outcome measures. Conclusions Group cognitive analytic therapy shows promise as an acceptable and feasible treatment for clients with mood and anxiety disorders presenting to primary care services. Further larger and more controlled studies are indicated. Practitioner points The study supports the idea that GCAT is an acceptable and feasible treatment for clients with mood and anxiety disorders in a primary care setting. Clients indicated the utility of various aspects of GCAT The study provides tentative evidence for the effectiveness of GCAT in ameliorating symptoms of stress, anxiety, and depression in primary care.

show abstract

Section: Discussioncontrasting

confidence: 99%

An exploration of group cognitive analytic therapy for anxiety and depression

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Five studies investigated service users’ experience of CAT Tools (Hamill, Ried & Reynolds, 2008; Rayner, Thompson, & Walsh, 2011; Stockton, 2012; Taplin, 2015; Tyrer & Masterson, 2019). One study focused on the experience of CAT tools in general (Rayner et al ., 2011), two focused on letters (Hamill et al ., 2008; Stockton, 2012), one on sequential diagrammatical reformulations (Taplin, 2015), and one on reformulation tools (Tyrer & Masterson, 2019).…”

Section: Resultsmentioning

confidence: 99%

“…Three studies focused on service users with a range of mental health diagnoses and difficulties (Fusekova, 2011; Rayner et al ., 2011; Tyrer & Masterson, 2019) and eight on service users with particular diagnoses, including personality disorders (Kellett et al ., 2013; Kellett & Hardy, 2014), depression (Sandhu et al ., 2017; Stockton, 2012), panic disorder (Tzouramanis et al ., 2010), psychosis (Taylor et al ., 2019), Axis 1 disorders (Shine & Westacott, 2010), and anxiety and depression (Hamill et al ., 2008). Ruppert (2013) and Taplin (2015) included service users defined as having significant mental health problems.…”

Section: Resultsmentioning

confidence: 99%

“…Tyrer and Masterson (2019) found that service users were able to accept their feelings, they became less self‐critical, and less overwhelmed by worry. Reformulation tools were described as being helpful for service users in recognizing patterns.…”

Section: Resultsmentioning

confidence: 99%

“…This theme was related to the tools that are used in CAT such as the SDR, reformulation letter, and goodbye letter. Ten of the papers reviewed contributed to this theme (Evans & Parry, 1996; Hamill et al ., 2008; Kellett & Hardy, 2014; Rayner et al ., 2011; Ruppert, 2013; Shine & Westacott, 2010; Stockton, 2012; Taplin, 2015; Taylor et al ., 2019; Tyrer & Masterson, 2019).

It was nice to have the summary in paper rather than just being told (Participant 2; extracted from Taylor, Perry, Hutton, Tan, Fisher, Focone, Griffiths & Seddon, 2019).…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

A systematic review of service user’s experience of cognitive analytic therapy (CAT)

et al. 2020

View full text Add to dashboard Cite

PurposeIt is increasingly acknowledged that understanding of the process and impact of psychotherapy is enhanced by awareness of the experience of service users. Cognitive analytic therapy (CAT) was developed as a time‐limited and integrative psychotherapeutic approach. Although reviews have been published on CAT outcome studies, no reviews are currently available on service users’ experience of CAT. This paper aims to systematically review and synthesize what is known about service users’ experience of CAT.MethodsA systematic search of HDAS, Cochrane, and Ethos databases was conducted. Following this, fourteen papers were selected for review, appraised using CASP tools, and then thematically synthesized.ResultsCAT therapy enabled service users to acquire useful knowledge and skills. Most service users found CAT tools helpful in gaining insight into their reciprocal roles and patterns. However, CAT was experienced by some service users as a painful, frightening, and upsetting process, particularly in relation to the sequential diagrammatical reformulation (SDR) and reformulation letter. The importance of the therapeutic relationship was highlighted, as well as difficulties some service users had with trusting their therapist.ConclusionsCAT is helpful in supporting service users to understand their patterns and to identify useful coping skills. However, some service users can experience strong emotions in therapy and struggle to trust their therapist. Greater attention to working within the service users’ zone of proximal development (ZPD) and engendering hope during the reformulation stage may attenuate some of these risks. Recommendations are made for future research directions.Practitioner points CAT therapy enables users to develop insight to their reciprocal roles and patterns and helpful coping skills. The service user’s ZPD should be worked with when delivering CAT to manage risk of distress and reciprocal role enactments and enhance the working alliance. CAT therapists should explore ways to engender hope by attending to any helpful reciprocal roles, patterns, and exits.

show abstract

Reformulation letters in cognitive analytic therapy: The practitioner's experience

Slettevold

Fisher

Leddy

2023

Couns and Psychother Res

View full text Add to dashboard Cite

ObjectivesThe aim of this study was to explore (1) cognitive analytic therapy (CAT) practitioners' experiences of receiving their own reformulation letter as part of their training and (2) CAT practitioners' perceptions about how receiving their own reformulation letter altered their clinical practice.DesignSemistructured interviews were used to elicit participants' (N = 9) experiences of having received their personal CAT, with a particular focus on the reformulation letter, and their perceptions of its impact on them as clinicians and their clinical practice.MethodsInductive “bottom up” thematic analysis was used to analyse the interview transcripts and extract overarching themes and subthemes across all participants.ResultsFour overarching themes emerged from the data: the power of the reformulation letter; inhabiting the client's role; absorbing thinking as a CAT practitioner; and evolving the therapist's technique.ConclusionsCognitive analytic therapy practitioners report experiences of the reformulation letter that indicate a positive impact on their self‐awareness, learning about CAT and consciousness about how their own clients experience therapy. This was also the case when the reformulation letter did not resonate with them to the desired extent as learning from their therapist's limitations was experienced as having an impact on their learning and subsequent practice.

show abstract

Clients' experience of change: An exploration of the influence of reformulation tools in cognitive analytic therapy

Cited by 10 publications

References 33 publications

An exploration of group cognitive analytic therapy for anxiety and depression

An exploration of group cognitive analytic therapy for anxiety and depression

A systematic review of service user’s experience of cognitive analytic therapy (CAT)

Reformulation letters in cognitive analytic therapy: The practitioner's experience

Contact Info

Product

Resources

About