CAT Identification — MRCPsych Paper B MCQ

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ModeratePsychotherapyCAT IdentificationMRCPsych Paper B

A patient undertakes a structured, time-limited individual psychotherapy with a standard course of 16 weekly sessions. The therapist and patient collaboratively produce a written reformulation and a sequential diagrammatic reformulation. Target problem procedures may be categorised as traps, dilemmas or snags, and the work progresses through reformulation, recognition and revision. Which psychotherapy is being described?

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Correct answer: B — Cognitive analytic therapy

The correct answer is B, cognitive analytic therapy (CAT). CAT is a collaborative, time-limited psychotherapy integrating cognitive and psychodynamic ideas. Its distinctive tools include a written reformulation and a sequential diagrammatic reformulation or “map”. Problematic procedural patterns may be described as traps, dilemmas and snags, and therapy is organised around reformulation, recognition and revision. A standard CAT course commonly comprises 16 sessions. CBT uses cognitive and behavioural formulations but not this characteristic CAT terminology and three-stage structure. DBT centres on behavioural analysis and skills such as emotion regulation and distress tolerance. MBT aims to improve understanding of mental states, while schema therapy works with schemas and modes. Neither uses traps, dilemmas and snags as its defining formulation framework.

Reference: NHS England, National Curriculum for Cognitive Analytic Therapy, sections 6.1, 13.4 and Appendix 3, 2023. https://www.hee.nhs.uk/sites/default/files/documents/National%20Curriculum%20for%20Cognitive%20Analytic%20Therapy%20v1.0%20.pdf