Excerpt from a large visual recording image from Liverpool Multiple Complex Needs conference in 2016 -

A Relational Approach to Recovery: Liverpool YMCA

In this guest blog, Ellie McNeil , Chief Executive of YMCA Liverpool and Sefton, shares reflections on the journey both she and her organisation have taken in developing a CAT-informed approach over the last few years.  She offers an opportunity to shape the development of a new residential rehabilitation programme where CAT will be embedded throughout.

The use of CAT in YMCA Liverpool and Sefton has been and continues to be a journey of reflection, challenge, hope and change. Working with Dr Karen Shannon, we initially brought in the CAT approach to enable the delivery of a project supporting people with multiple and complex needs. Disenfranchised, excluded, rejected and frightened manifested as aggressive, disengaged, self sabotaging, and rejecting. We knew we needed a different approach, not only to elicit change with service users but more so to support the staff in their roles.

The team were trained in CAT Case Management, and we started to use reflective practice. Over the subsequent years we tweaked and changed our way of working. With the support of Karen, we had created a framework to work within. We’d developed a shared understanding of why the people we supported behaved the way they did and what we could do to change our response so that we could support them more effectively.

From our current use of CAT I could see the breadth of application that the approach could give Liverpool YMCA as an organisation. It helped us understand the perspectives of our service users, staff, processes and policies, and the wider impact of the system. I was particularly interested in how CAT could help us in note the pulls and pushes of the outside world, including relationships with commissioners, funders, policy makers and influencers.

I myself embarked on the CAT Case Management course to gain a fuller understanding of this. The learning I have gained has helped me feel that change is possible. Through making changes to myself I can begin to ensure the organisation and the people in it have the best possible chance of change too.

Following a significant journey of reflection together, through some challenges and hurdles, we now have a strong leadership reflective practice group. This provides a safe space for us to work towards bettering the organisation for the staff and service users. I am incredibly proud of where we are as a team and believe we have got to this place because of the shared understanding, language and framework that CAT gives us. Working in a CAT informed way helps me to ensure the organisation can be a positive place for service users and staff members now and in the future.

In partnership with two other organisations, we have recently been successful in tendering for a range of recovery services in Liverpool. We will be delivering the accommodation based rehabilitation service. This is a 12 week treatment programme supporting people to understand and move on from their substance use. Our model for the residential rehabilitation service sets out a Relational Approach to Recovery (RAR) using CAT.

At the heart of this approach is a commitment to be collaborative and flexible.  We will get alongside and ‘do with’ our service users in providing support and rehabilitation, not ‘do to/for’ them. Our service delivery will build further on the genuine psychologically informed approach we take in our other services, building and fostering hope and working alongside people to achieve sustainable recovery. We’re currently inviting expressions of interest in a Cognitive Analytic Therapist role to help progress this work.

We will work with our partners, ensuring good planning, co-operation and collaboration across organisations. We intend to agree and jointly own procedures for all stages of the interaction between service users and agencies. This includes the journey from referral to assessment, information sharing to planning, transitions, service provision to funding and review. We will hold operational and strategic reflective practice groups across the partnership. Both groups will be facilitated by Dr Karen Shannon. The recovery pathway across Liverpool will be dynamic and groundbreaking, providing a service that is therapeutically rich and provides the best possible opportunities for change.

The future of YMCA Liverpool and Sefton feels bright and vibrant. We are an organisation that genuinely reflects. We commit to noting challenges, and learning and growing from them as well as celebrating successes. Our staff team across our services are outstanding. Their resilience, commitment and kindness makes me so proud. Ultimately, however, we are here to serve the people that need us. Every person using our services shows bravery, courage and the ability to change when they step through the door. Through our understanding and use of CAT we are now able to get alongside them and support them to a brighter, sustainable future.

You can read more about how CAT has been used as an organisational framework at Liverpool YMCA in the following two Reformulation articles from 2016 and 2017 (full details are listed on Karen Shannon’s profile page):

Use of Cognitive Analytic Concepts; A relational framework for Organisational service delivery and working with clients with Multiple Complex Needs (MCN) at the Liverpool YMCA

‘Seeing the unseen’. Supporting organisational and team working at YMCA Liverpool with multiple complex clients. The use of Cognitive Analytic concepts to enhance service delivery

For more details and downloads about the CAT Therapist post with YMCA Liverpool & Sefton, click on this link.  Expressions of Interest are invited prior to an open evening on 20 March 2019.

Banner announcing 17th May 2019 Conference on '25 year of CAT practitioner training in the north: a celebration of past, present and future CAT training

25 Years Conference – provisional outline now available

Provisional details of our celebratory 25 years conference on 17 May 2019 are now available and booking is open.  We’re looking ahead to May and already imagining the leafy surrounds of our venue, Chancellors Hotel and Conference Centre in Manchester’s spring sunshine.  Some beech leaves have even crept onto the flyer describing what’s included on the day.  You can download the provisional outline from the event page here

Thanks to all the many colleagues who have offered to present, sharing how they have developed CAT in their practice and services since training with us as CAT Practitioners.  Organisers Mark Evans and Dawn Bennett are busy pinning down finer details of workshops, keynote presentations, posters and more.  We will announce more of the content in the weeks ahead.

We hope you will join the course team alongside many colleagues across the North and  beyond for a full and stimulating day.  We also invite you to stay for the evening which includes a drinks reception, evening meal and entertainments.

For more details and to book a place on the 25 Years of CAT Training in the North conference , click on the link here.  You can also follow tweets about the day on Twitter using the hashtag #CAT25conf

Image of neon lit letters spelling out HOPE, placed roughly on fallen leaves in a dark woodland

Café CAT – reflections so far and plans for 2019

Join us for our next Café CAT meeting which takes place on Wednesday 30th January at a new Manchester city centre venue between 6.15 and 8.15 pm. The theme is Hope.

Café CAT has met four times since October 2017 as a forum for peer contact, particularly for graduates from our practitioner training who wish to maintain cognitive analytic therapy (CAT) networks. A CAT focus to the meetings provides a form of continuing professional development (CPD) for local therapists. It also functions as an “open door” for CAT in the north for people curious about CAT training at a future point. We were interested in whether and how Café CAT met these aims, and the results of our recent survey are summarised below.

In the meantime, we invite you to the first Café CAT meeting of 2019 on Wednesday 30th January, 6.15 to 8.15 pm in a new venue, the Salutation Pub in Manchester city centre. It’s a new year and a new venue so it feels apt to consider the topic of hope. Feeling a bit disheartened by the state of the things in the world currently, and wanting to free ourselves from the winter doldrums, our exit was to start the year focusing on something to lift spirits.

Rhona Brown will start off a CAT-leaning conversation at this Café meeting. Do come along if you can to be part of this conversation, and bring your own thoughts on hope. What helps us find it, or lose it? How do we communicate hope in therapy? What CAT concepts or approaches help us to mobilise this precious resource for psychological survival? You’re welcome to bring and share anything that helps connect you to a sense of hope.

The Salutation Pub serves food until 9 pm. We very much hope you can join us. There’s no need to book, just come along. Entry is £5 on the door and we have sole use of the upstairs room.

Café CAT survey – is it a useful forum?

We were interested to know what those attending any of our four Cafés made of it, but also what obstacles there were in coming along. Is this a valuable addition to events for the CAT community in the north and is this how you might like it to develop? We were also keen to invite people to get more involved so that Café CAT could become more peer-led and self-sustaining. We ran an online survey between July and September 2018. Thanks to all fifty-three people who completed this.

Who did we hear from?

Two thirds of respondents were trained to at least CAT practitioner level, and a sizeable minority were practitioner trainees. Around half of respondents were clinical psychologists with a spread of other core professions.

Why did people come and what did they get from meetings?

The strongest themes emerging from responses related to the value of connecting with CAT and CAT peers, networking and CPD. Most of this group valued learning about CAT and the informal format, although a minority wanted a bit more structure, or materials shared in advance as a way to prepare.

Why did some people not come along?

For many of those who were interested but hadn’t yet attended, the timing and location of meetings were obstacles. People expressed various preferences about either an earlier meeting during work hours, or a later evening meeting allowing for easier travel after work. However there was no consistent message to help guide a definite change. Some people asked for more advance notice or different ways to advertise the meetings.

Location

There were a number of suggestions for new geographical locations in the north where Café CAT could happen, including Liverpool and Sheffield. We were pleased to hear some respondents’ enthusiasm to have Café-style meetings in more distant locations like London, Brighton and Wales, although obviously this would be way beyond the Catalyse remit.

Topics and leaders

One or two suggestions were made for issue-based topics but unfortunately no volunteers came forward to lead a future session. We concluded that those within the northern CAT communities may be a shy and/or a very busy lot.

What did we conclude?

  • To explore different venues in Manchester, especially ones offering food and refreshments. We thought a more central venue might make for easier travel by public transport.
  • To experiment a little with the structure of the meeting, perhaps opening up topics to broader issues and encouraging a diversity of people to lead.
  • To arrange and advertise dates well in advance
  • Planning ahead is most possible if we can identify volunteers willing to start off the meeting with their perspective on a topic of particular interest. Volunteers please!
  • We can pay Café ‘leaders’ £40 for their preparation time and initial direction at meetings. There will always be members of the Catalyse group present to provide support and help keep the conversation flowing.
  • To advertise more widely to reach everyone, via NWPPN, plus local core training courses such as clinical and counselling psychology doctorates. If you have contacts with other networks (eg psychiatry trainees, therapeutically minded GPs, social workers, etc) please do share flyers or point them to our website.
  • There’s no reason why CAT colleagues in the north can’t set up their own regular local meetings outside of Manchester. We could provide support and mentoring for this, but local meetings don’t have to be under the Catalyse/Café CAT umbrella. You might have ideas about how informal CPD and networking will work best in your own context. Several models exist, including regional ACAT groups, Collaborate CATchup meetings in Cambridge, and CAT Cumbria meetings in the Lakes.

Next steps

So for the start of 2019 we will make some of these changes and very much hope that you will join us on the 30th. Further plans for Cafe CAT in 2019 will be agreed in January and we welcome any further feedback on the timing and choice of venue as well as what may make it something of value for you. We’d especially like to hear from anyone with a topic they’d like to share and explore with a group of colleagues. Consider leading a future conversation.

For more information about Café CAT, check out the hashtag #CafeCatalyse on Twitter, take a look at the page at this link, or read Clive Turpin’s last blog about it – Cafe CAT:the Story So Far

Black and white image of geese journeying together across a cloudy sky in a rough formation

Journeying Together: A Second CAT Research Conference

Plans for a second research conference hosted jointly between ourselves and ACAT have now come to fruition.  ACAT is leading on the organisation of this second event – The Research Journey From Start To Finish: Motivating-to-Motivated – which takes place in London on 1 March 2019.  Again this conference aims to bring together people interested in hearing about and developing the evidence base for cognitive analytic therapy.

You’ll be welcome to attend whether you want to gain an update on current and future research in CAT, make connections and develop your research networks, or get support in developing your own research ideas.  Those with roles supporting the research activity of others are also most welcome to attend.  This could be a useful day to attend if you are a research tutor or supervisor on a core professional training.  Similarly if you have responsibility for supporting psychotherapy research activity within a  mental health or learning disabilities trust, you may make helpful connections.

The theme of a research journey was present throughout last year’s conference.  People shared stories of projects at different points along the way and reflected on what had helped or hindered them complete different stages. Alison Jenaway’s guest blog about the 2018 conference tells you more about that day.

When thinking about an image to help promote the 2019 event, we liked the metaphor of migrating geese.  Apparently they fly together to help reduce air-drag and conserve energy.  Different flock members move in and out of the front position depending on who has energy and resources to lead.   Of course following is as important as leading in this context.  We share a direction and learn from each other.  As peers we can reciprocally motivate with helpful “honking” in order to keep up a pace.

Of course none of this precludes solo flyers who want to take their own direction.  After all, would CAT ever have developed without a bit of independent thinking?

We’re not content, of course, with merely developing a metaphor or an understanding of relational processes in research.  As with the CAT model, some action is expected and encouraged.  To support concrete action getting “off the ground”, this year ACAT is offering three free places for people planning a project on CAT.

To be considered for one of these places, you’re invited to share a maximum 2000 word outline of a realistic project you can take forward, complete and publish. This should include:

  • Your main research question
  • Why it is important
  • The method you are planning to use to answer it
  • Any previous work or publications that you would be building on
  • The next steps you intend to take to get the project off the ground

The deadline for submissions is 10 January 2019.  If you’re successful we may be able to match you with a mentor from within the CAT community or related networks.  We will of course welcome you back to present at a future CAT research conference.

Whether or not you wish to apply for a free place, you can get some inspiration from the list of presentations lined up for the day, offered by Stephen Taylor, Barney Dunn, Steve Kellett, Steve Jefferis, Liza Messing and Samantha Hartley.   Topics include integrative models for nurse supervision, learning from research into other therapies, making use of data on CAT in IAPT, qualitative research into mapping, group interventions, and coproduction with young people around brief therapy for self harm.

You can also follow the hashtag #CATres19, and add to it with any queries and comments. Please also feel free to share any links or resources you think may be useful in the run up to the conference.

We look forward to seeing you there.

For more details and to book your place at the conference – The Research Journey From Start To Finish: Motivating-to-Motivated – visit ACAT’s event page at this link