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CAT — MRCPsych Paper B MCQ

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ModeratePsychotherapyCATMRCPsych Paper B

A patient is offered a structured, collaborative, time-limited psychotherapy, usually delivered over 16 sessions. Early sessions produce a written reformulation and a shared diagram of recurrent relational patterns. Target problem procedures may be described as traps, dilemmas and snags. Therapy then progresses through recognition and revision, including the development of alternative “exits”. Which psychotherapy is being described?

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Correct answer: E — Cognitive analytic therapy

The correct answer is **D, cognitive analytic therapy (CAT)**. CAT is a collaborative, time-limited integrative therapy commonly delivered over 16 sessions. Its characteristic sequence comprises reformulation, recognition and revision. A prose reformulation and sequential diagram are used to map reciprocal roles and target problem procedures, traditionally classified as traps, dilemmas and snags; revision involves developing alternative “exits”. CBT is also structured and collaborative but does not use this specific terminology or reformulation sequence. DBT centres on behavioural targets and skills such as distress tolerance and emotion regulation. MBT aims to improve understanding of one’s own and others’ mental states. Schema-focused therapy works with schemas and modes, often over a longer course, rather than CAT target problem procedures.

Reference: NHS England, National Curriculum for Cognitive Analytic Therapy, Appendix 3: CAT principles and Recognition & Revision, 2023. https://www.hee.nhs.uk/sites/default/files/documents/National%20Curriculum%20for%20Cognitive%20Analytic%20Therapy%20v1.0%20.pdf