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You know what your problem is... [enter unsolicited conclusion]

Updated: Jul 18, 2023

Who has ever liked hearing that... chances are, if you are a therapist and you have said that to a client, it won't have gone down very well!

As people, we are complex. Sometimes we might ask for advice, but actually find ourselves just wanting someone to listen and nod-along.

The draw, particularly when working in high pressure and low resource settings, is that we often need to fix things quickly. We therefore run the risk of almost taking short-cuts with our client's understanding, when at first glance something might seem obvious to us.

I would argue that this can and does spill over into the therapy room and the act of 'formulating' a client could be rushed through without making sure that the client themselves is truly involved in the process. It could therefore be experienced by them in a similar way to "You know what your problem is..."

Cognitive Analytic Therapy (CAT) actively tries to resist this, in part, by the very deliberate renaming of 'formulation' to Reformulation.

By changing the emphasis to Reformulate, we overtly acknowledge that the client themselves will have come to therapy with their own formulation of how they ended up in this situation. With their consent, it is then our job to carefully take this formulation that they have worked on and to add to it with them, Reformulating to bring about a new shared understanding together.

“As the process [of reformulation] is primarily descriptive and not interpretive and as the patients are encouraged throughout to comment on, challenge or revise what is said or written out, the danger of imposing false understandings is slight”

(Ryle and Kerr 2002)

As alluded to above by Dr Ryle, CAT uses a few different tools in this process as part of the Reformulation stage of therapy which I will introduce you to later in this blog mini-series.


Are you looking to start therapy? If so, feel free to book in a call

Or perhaps this has sparked your interest in training as a Cognitive Analytic Therapist? If so, click below to find out more



Ryles A, and Kerr I, B (2002) Introducing Cognitive Analytic Therapy: Principles and Practice. Eastbourne: Wiley & Sons.

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