Читать книгу Introducing Cognitive Analytic Therapy - Anthony Ryle - Страница 22

CAT is undertaken with an explicit focus on time limitation (not simply brevity), and on what we have previously described as “ending well” (Ryle & Kerr, 2002). “Ending” from a CAT perspective will be described more fully below in Chapters 2 and 7. Typically, however, an initial CAT therapy contract would be for 16–24 sessions, given that for many such a period is clearly clinically effective. A focus on time limitation also helps maintain focus and addresses the major problem of therapeutic “drift,” or creating an unhelpful dependency on the part of the patient, or indeed a mutual, ongoing narcissistic gratification for both therapist and patient. In CAT, “ending well” is seen, therefore, as an important aim in itself. However, therapy may need sometimes to be extended longer term in treating more disturbed and damaged patients (see, e.g., discussion of “borderline”‐type disorders, or psychosis in Chapters 10 and 9). Therapy may also be shorter (e.g., 4–8 sessions) where the threshold to consultation is low, for more focal problems, or for less distressed or less damaged patients. Some patient groups (e.g., adolescents) may find longer (or indeed any!) formal therapies hard to engage with, and contracts may need to be modified collaboratively and accordingly.