Psychology and Psychotherapy: Theory, Research and Practice

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Volume 73 Issue 2 (June 2000), Pages 145-288

A CAT‐derived one to three session intervention for repeated deliberate self‐harm: A description of the model and initial experience of trainee psychiatrists in using it (pages 179-196)

  • Author(s): Tim Sheard, Jonathan Evans, Debbie Cash, Jane Hicks, Amanda King, Neil Morgan, Ben Nereli, Ian Porter, Harvey Rees, John Sandford, Rebecca Slinn, Keerthi Sunder, Anthony Ryle
  • Published 16 Dec 2010
  • DOI: 10.1348/000711200160417

We describe a new Cognitive Analytic Therapy (CAT)‐based intervention for those who repeatedly self‐harm. It is specifically designed to be deliverable by staff with no training in psychotherapy. The intervention is simply manualized into sequential tasks that are mediated by new CAT‐style standardized tools. A particular feature of this intervention is the deliberate use of feelings elicited in the therapist (‘counter‐transference’) as (a) a guide to how professional poise is being threatened or lost and (b) an indicator of the appropriate focus for this very brief therapy. The psychiatrists' reflection on their elicited feelings is mediated by a new CAT tool, the ‘Assessor's Response File’ developed in this project. Audiotape analysis suggested that following a very brief learning period, trainee psychiatrists were able to adhere to the structure of the model and arrive at an appropriate reformulation in the first session but tended to be collusive in reciprocating the patients' dysfunctional coping styles.

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