Developing a competence framework for cognitive analytic therapy

Abstract

Objective This paper describes the development and summarizes the content of a competence framework for delivery of cognitive analytic therapy (CAT). Design The framework was developed using the evidence‐based method developed by Roth and Pilling (2008, Behavioural and Cognitive Psychotherapy, 36, 129). Methods A review of the CAT outcome literature identified where CAT interventions had evidence of efficacy. Standard texts on CAT were primary sources for details of theory and practice. This process was supported by an expert reference group (ERG). The role of the ERG was to provide professional advice on areas where the evidence base was lacking, but where CAT interventions were commonly used by therapists trained in the model. Results A framework was produced and structured in terms of core knowledge, core skills, and meta‐competences (which require therapeutic judgement rather than simple adherence to a treatment protocol). Conclusions The framework enables trainees, service users, service managers, and commissioners to better understand a) the core features of CAT and b) what competences need to be in place for CAT to be skilfully delivered in practice. Practitioner points It is possible to define the core competences of CAT. Whilst generic competences are important, there are five CAT‐specific domains of competence. The CAT‐specific competences reflect the three‐phase structure of the therapy: reformulation, recognition, and revision.

Evaluation of a Mobile App to Enhance Relational Awareness and Change During Cognitive Analytic Therapy: Mixed Methods Case Series

“…The competence with which therapy was delivered could have been assessed using the competence in CAT measure [ 51 ]. Using the app during therapy does not change the key competencies of the CAT model [ 24 ], and this needs to be evidenced in future studies. The lack of interviewing of patients that dropped out did not enable their particular difficulties with the app to be understood.…”

“…The procedural sequence object relations model anchors target problem procedures in reciprocal role activation [ 19 ]. CAT has been recently summarized into a competency framework [ 24 ]. CAT uses a 3-phase approach: (1) an initial “reformulation” stage during which target problems and target problem procedures are summarized in narrative and diagrammatic reformulations, (2) a middle “recognition” stage facilitating self and relational awareness, and (3) a final “revision” stage that is focused on change.…”

Evaluation of a Mobile App to Enhance Relational Awareness and Change During Cognitive Analytic Therapy: Mixed Methods Case Series (Preprint)

“…The procedural sequence object relations model anchors target problem procedures in reciprocal role activation [19]. CAT has been recently summarized into a competency framework [24]. CAT uses a 3-phase approach: (1) an initial "reformulation" stage during which target problems and target problem procedures are summarized in narrative and diagrammatic reformulations, (2) a middle "recognition" stage facilitating self and relational awareness, and (3) a final "revision" stage that is focused on change.…”

Reformulating the relationship between cognitive analytic therapy and research: Navigating the landscape and exploring new directions

“…The development of tools such as the competency in cognitive analytic therapy measure or CCAT (Bennett & Parry, 2004), which provide a systematic means of evaluating whether core CAT competencies are present in therapy, has therefore been an important development. Within this special issue, the paper by Parry, Bennett, Roth, and Kellett (2020) on developing a framework of key CAT competencies signifies a further step in establishing the clinical skills and activities that are essential to CAT, providing a way it can be evaluated consistently alongside retaining its flexibility. It may also be helpful to consider developments in trial methodology and analysis, especially approaches for modelling heterogeneity in treatment processes and investigating mechanisms of change (Dunn & Bentall, 2007; Stice, Rohde, Seeley, & Gau, 2010).…”