An Evaluation of the Influence of Cognitive Analytic Therapy (CAT) Personal Reformulations (PRs) on Reflective Capacity in Trainee Clinical Psychologists

Introduction: Cognitive Analytic Therapy (CAT) ‘personal reformulations’ (PRs) have been offered at some Doctorate in Clinical Psychology (DClinPsy) programmes as an opportunity for continuing personal and professional development through reflection. It might be hoped that CAT PRs would increase reflective capacity, although no published research on reflective capacity and CAT PRs exists. Aims: This service evaluation aimed to evaluate the effect of CAT PRs on reflective capacity and to understand how they were experienced by trainees. Methods: A mixed methods approach was used. The quantitative Reflective Practice Questionnaire was administered pre- and post-CAT PRs, and thematic analysis was used on qualitative data collected in an online survey. Results: Twenty trainees participated. There were no significant group-level differences between pre- and post-CAT PR scores on components of reflection. Reliable Change Index (RCI) calculations indicated some individual-level improvements on nine sub-scales, although a mixed picture is found. Qualitative data suggests the experience was helpful for personal and professional development for some trainees, although issues with timing and the content of sessions were identified. Conclusions: Data does not support CAT PRs as the specific mechanism for change, and only a small number of participants indicated how changes in reflection would translate to practice. Findings may reflect overambition in expecting CAT PRs to increase reflective capacity, given their brevity, or methodological limitations of the evaluation. There are inherent challenges in disentangling influences of CAT PRs from other learning occurring through academic and placement-based training.