The torchlight model of mapping in cognitive analytic therapy (CAT) reformulation: A qualitative investigation.

Abstract

Despite the central role of formulation in psychological therapy, there is limited research on how formulations are constructed in clinical practice. In Cognitive Analytic Therapy (CAT), a formulation diagram (or CAT map) is used in transforming the client's narrative into a psychological understanding of the difficulties. The objective was to build a theoretical model of the processes involved in the early stages of CAT mapping. A qualitative research design using constructivist Grounded Theory Methodology (GTM) incorporating Interpersonal Process Recall (IPR) methods. CAT therapists participated in a role-play therapy session with an actor (the 'client') and made an initial attempt at formulation by mapping. A video recording then formed the basis for a semi-structured therapist interview. Following data analysis, a conceptual model and visual metaphor of the early process of CAT mapping was generated. The Torchlight model conceptualizes the mapping process as a coming together of unique factors brought by client and therapist, alongside the conceptual apparatus of CAT. Each factor brings a unique light to the unfolding process of mapping and intermixes through a dialogical, collaborative process, analogous to coloured lights mixing to form new colours. The model outlines the mapping process itself as an iterative sequence of tasks, achieved through collaboration, within a growing therapeutic relationship. The model offers an empirical underpinning to existing accounts of CAT mapping, and a potential tool for training. The process by which individual CAT reformulation diagrams are started appears to be as unique to the therapist-client dyad as the contents of the map, on the basis of the findings. Mapping faithfully enacts the dialogical and developmental theoretical principles underpinning the CAT approach. The Torchlight model is the first empirically based model of the processes taking place in the creation of CAT reformulation diagrams, in the early stages.