CAT in Spain
The origins of CAT in Spain date back to the 1990s when the therapeutic model was introduced by Carlos Mirapeix. This modality has since been taken up by professionals and organisations across the country. The focus has been on teaching activities for mental health professionals and research on the effectiveness of the therapeutic approach.
In 2013, the Association for CAT in Spain (APCE) was established with both Carlos Mirapeix as Honorary President and Mavi Gómez de Ramón Fuster as President of the organisation.
The 5th International Congress of CAT was celebrated in Málaga, Spain, in 2014. The definitive support from the international community has enabled the organisation to develop clear structures for professional CAT accreditation in Spain and has inspired the pursuit of scientific outcome measures for change.
CAT is now being taught and practised in different parts of Spain such as Santander, Murcia, Madrid, Barcelona, Sevilla, Málaga and Algeciras.
The first national congress of CAT took place in October, 2016. The organisation is currently running the first year of a university accredited Advanced Skills Course in CAT, which is recognised as a breakthrough in terms of the formation and widespread dissemination of this therapeutic model in Spain.
Who is who in Spain:
Members of the Executive Committee in APCAE
Honorary President and International Link to ICATA
Carlos Mirapeix Costas: Psychiatrist, CAT Psychotherapist, Trainer and Supervisor
President and contact person for training and accreditation
Mavi Gómez de Ramón Fuster: Clinical Psychologist and CAT psychotherapist, Trainer and Supervisor
Vice President and International Link to ICATA
Gabriele Stabler: RMN, RGN, CAT psychotherapist, Trainer and Supervisor
Secretary and Treasurer
Carlos Chiclana Actis: Psychiatrist and CAT psychotherapist (in training)
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History of CAT in Spain:
Cognitive Analytic Therapy in Spain was first taught and practised in Santander in 1994. It was organized by the Institute for Psychotherapeutic Studies and accredited by the Spanish School of Psychotherapy (which is a member of the Spanish Federation of Psychotherapeutic Associations).
In 1996 we organized the second training program and in 1998-1999 a specialized training in CAT for therapists with previous experience and training in psychotherapy was set up. The two initial programs were 3 years long with the first year focusing on integrative models of psychotherapy and basic concepts and tools using a common factors approach to psychotherapy.
The two following years were devoted specifically to CAT; the second year to a general overview of CAT and its application to basic disorders and living problems and the third year to personality disorders treatment, CAT in different formats and technical difficulties in psychotherapy. We received supervision and support from ACAT.
The two initial supervisors in 1995 were Claire Tanner and Virginia West, followed by Dr Shakir S. Ansari who supervised our group from 1996 until 2000. We are in debt to these supervisors as they have facilitated our understanding and technical development in CAT.
We applied the CAT model in private practice settings from the very beginning. From 1997, we also worked with insurance companies and from 1999 with public services. The population was initially neurotic patients however we developed an increasing interest for personality disorders. This population was very well served by CAT and in 2001 we started a pilot phase of the Cantabria project for personality disorders. This evolved into the Unit for Personality Disorders, a public service outpatient intensive care unit for personality disorder, which uses CAT as its main theoretical and technical framework. In this context we are using the SDP as a tool with three functions: pedagogie, evaluation and research.
Something we have learnt from the very beginning is that those who teach us most about the different mental states are the patients themselves. The SDP is extremely useful for the patients (and also therapists), helping them to quickly understand their multiple shifts from one state of mind to other.
Our research has focussed on the effectiveness of CAT in personality disorder, with an ongoing naturalistic study in our Unit. After we have obtained data on positive outcome, we will move to an RCT in this area. Our commitment to research is increasingly important due to economic factors. Insurance companies and clinical audits in the public sectors require data on efficacy of the applied therapy.
The need for empirically validated treatments is encouraging the CAT community to move into the arena of research as a main focus in the next years. Dissemination needs to be supported by data demonstrating efficacy.
ICATA Member Association: