Clinical Psychology Unit, Department of Psychology, University of Sheffield, UK.
Psychol Psychother. 2011 Sep;84(3):299-313. doi: 10.1348/147608310X531164. Epub 2011 Apr 13.
Formulation is argued to be of central importance in most psychotherapeutic approaches, yet little is known about client's experience of this. This study sought to explore the client experience of receiving cognitive analytic therapy (CAT). It aims to gain a better understanding of the use of specific CAT tools (e.g., reformulation letters and diagrams) and how these tools relate to clients' understanding of change.
Grounded theory methodology utilizing a three-stage analysis process was used to explore client's retrospective accounts of change in CAT.
Fifteen semi-structured interviews were conducted with nine participants who had received CAT. Data analysis involved initial coding of transcripts and further theoretical sampling and interviewing followed. This led to the production of a model that was then taken to three further participants for exploration in further interviews. An audit was conducted of the analysis process.
A core conceptual framework of 'doing with' the therapist emerged from the analysis and represented clients' experience of receiving CAT and participating in the reformulation process. This framework subsumed four interrelated themes; 'being with the therapist', 'keeping it real', 'understanding and feeling', and 'CAT tools'.
CAT was seen as an active and emotional experience facilitated by a trusting and collaborative therapeutic relationship. The CAT reformulation was seen as important but only when embedded within this context. Whilst, this was a small study theoretical generalizations are discussed about the process of change and further clinical and research recommendations are presented.
在大多数心理治疗方法中，配方被认为是至关重要的，但人们对客户的体验知之甚少。本研究旨在探讨客户接受认知分析疗法（CAT）的体验。它旨在更好地理解特定 CAT 工具（例如重新表述信和图表）的使用方式，以及这些工具如何与客户对变化的理解相关。
利用三阶段分析过程的扎根理论方法用于探索客户对 CAT 中的变化的回顾性描述。
对 9 名接受过 CAT 的参与者进行了 15 次半结构化访谈。数据分析涉及对转录本的初始编码以及进一步的理论抽样和访谈。这导致产生了一个模型，然后将其应用于另外三名参与者，以在进一步的访谈中进行探索。对分析过程进行了审核。
分析产生了一个核心概念框架，即“与治疗师一起做”，代表了客户接受 CAT 和参与重新表述过程的体验。该框架包含四个相互关联的主题：“与治疗师在一起”、“保持真实”、“理解和感受”以及“CAT 工具”。
CAT 被视为一种积极而情绪化的体验，得益于信任和协作的治疗关系。CAT 重新表述被认为很重要，但只有在这种背景下才重要。虽然这是一项小型研究，但对变化过程进行了理论上的概括，并提出了进一步的临床和研究建议。
