Diagrams or letters first?

Diagrams or letters first?

Of course the letter comes first:  the reformulation letter gives shape and direction to the therapy and should be completed by session four or five.   Subsequently some clients may benefit from a diagrammatic reformulation, part of which may have been rehearsed during sessions 1-3 using sketches of patterns and positions in the life of the client.

Of course the letter comes first:  the reformulation letter gives shape and direction to the therapy and should be completed by session four or five.   Subsequently some clients may benefit from a diagrammatic reformulation, part of which may have been rehearsed during sessions 1-3 using sketches of patterns and positions in the life of the client.

No, of course the diagrams or active mapping comes first:  the use of active mapping is the key to CAT and should enable and accompany the therapy like traffic signs enable and accompany a journey in a car.  The mapping holds, makes safe, opens up and teaches the client how to be their own therapist and combines an educational and therapeutic alliance in the moment to moment evolution of the therapy.   Then the letter gets written from the rich texture of the maps and is more manageable and less intrusive because its main elements have been jointly discovered and partially crafted in the mapping work.    Does this seem like a trivial question and is the answer simply that the therapist decides with the client which tool to use when and the only CAT rule to follow is Tony Ryle’s  principle of push where it moves.

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