Working with Challenging Situations in Cognitive Analytic Therapy
Five films showing a range of clinical scenarios which may be encountered in cognitive analytic therapy.
This second series of films have been developed to support reflection and debate about possible therapeutic responses to challenging therapeutic moments in CAT. They depict five different therapist-client dyads, and you can read a little more about each scenario above each film.
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Film 1: Working With Self States
In this first scenario we meet client Sophie and therapist Jo in their second session, as they start to discuss how Sophie found completing the Psychotherapy File. They quickly move into a difficult enactment when Jo tries to bring Sophie’s focus back to the task, and Sophie feels closed down. We watch how Jo uses what’s happening between them to try to repair the alliance and map some emerging states. The films helps to depict how a Sequential Self States Diagram might develop across later sessions.
Film 2: Working With Countertransference
The second film in this series depicts therapist Annie becoming aware of a strong countertransference response to the material client Billy is bringing to their sixth CAT session. We listen in to her internal dialogue (self-to-self) and watch how she makes use of her reflections to help her start to name and address an enactment with Billy.
Film 3: Strong Emotion Online
In this third scenario, we join client Amy and therapist Andy in their second remote session where they encounter the frustrations of a poor data connection. Their dialogue is repeatedly interrupted, leading to Amy becoming upset. We watch how Andy tries to manage this while attending to the early tasks of therapy.
Film 4: Values Rupture
Two alternative scenarios are presented in this fourth film, showing client Jade and therapist Tom at the start of their ninth session, after some non-attendance by Jade. She struggles to put into words what makes her feel less able to work with Tom, and he is finding it difficult to understand what is going on. We first watch a withdrawal rupture which ends with Jade leaving the session. We then rewind, and watch Tom taking an alternative approach to his uncertainty which makes it possible for them to take early steps in resolving this values-related enactment.
Film 5: Difficult Endings
The last in this series of five films shows client Alex, at session thirteen of a sixteen session CAT, asking therapist John to extend the therapy to twenty-four sessions. John explores with Alex the feelings behind her request but compassionately shares the rationale for holding the boundary. This negotiation enables them to make therapeutic use of CAT’s time-limited nature.
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