| Summary: | Formulation is argued to be of central importance in most psychotherapeutic approaches. Yet, despite the many claims made about its benefits, it remains an under-researched area. Formulation in Cognitive Analytic Therapy (CAT) is known as 'reformulation' and involves both a diagrammatic and narrative component. The diagrammatic component, called the Sequential Diagrammatic Reformulation (SDR), is a key element of CAT. Previous research addressing the impact of formulation suggests that quantitative methodologies are not suited to capturing the complexity of the experience of reformulation. Recent qualitative studies have started to address this gap, but there is still a paucity of research focussed solely on the use of the SDR, in particular little attention has been paid to the perspectives of both clients and their therapists. The present study aimed to address these gaps by conducting an in-depth exploration of clients' and therapists' experiences of using SDRs in CAT. Seven participants, comprising four clients and three therapists, were interviewed. The data was analysed using Interpretative Phenomenological Analysis (IPA). Six master themes emerged that represented how the SDR had impacted on the clients' journeys through therapy: 'Increases understanding', 'Facilitates conversations', 'Collaboration', 'Facilitates change', 'Impact of the SDR beyond therapy', and 'Doing it right'. The analysis revealed many similarities between the clients' and therapists' accounts. This study supports the hypothesised benefits of the SDR and helps to further our understanding of the processes by which these are achieved. The results have clinical implications, which suggest ways in which therapists can maximise the potential benefits of the SDR. Future research is needed to validate these findings and investigate whether the experiences of these participants can be generalised to other CAT therapists and clients.
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