Graceful Daisies in July

In this blog, Rhona Brown outlines her forthcoming half day workshop co-led by CAT and systemic family therapist Paddy Crossling.

There is a current push within ACAT for trainers, supervisors and therapists to develop skills and confidence in considering and addressing protected characteristics. Finding ways to more actively take such issues into account in therapy is recommended by UKCP’s HIPC EDI Guidance on teaching Equality, Diversity and Intersectionality in HIPC training organisations. These are shaping how ACAT-accredited training embeds aspects of equality, diversity and intersectionality throughout training and CPD. I’m involved in a working group thinking through how this can progress.

CAT has always been a model that situates the individual in their unique social context. The work of Vygotsky and Bakhtin underscored its radical social model of the self. Ryle and Kerr proposed that training therapies include ‘culture mapping’ to enable practitioners to recognise their own cultural influences and biases. However how realistic this is in each training therapy is another matter. And of course learning and personal development around these issues is life long, as we and the world continue to be fluid and unfinalised.

In contemplating tools to help us in this endeavour, a couple of years ago Paddy Crossling and I explored how we might adapt a systemic family therapy framework. The Social GGRRAAAACCEEESSSS was first proposed and shared by Alison Roper Hall and John Burnham. As a conceptual device they developed it to aid reflection on how aspects of identity impact on our relational exchanges. The letters in the mnemonic refer to Gender, Geography, Race, Religion, Age, Ability, Appearance, Accent, Class, Culture, Ethnicity, Employment, Education, Sexuality, Sexual orientation, Spirituality. Most recent descriptions include a catch-all additional S for ‘something else’.

These hold some similarities to items included in CAT’s Psychosocial Checklist (PSC), first developed by Yvonne Harris and Janet Toye in 2004. Janet and Rachel Pollard went on to update it in 2006 but it has not been widely adopted in CAT. Like the Psychotherapy File (PF), it primarily centres the relational experience of the client. Neither of these CAT tools necessarily prompt reflection about the self of the therapist. In systemic thinking the lense is broadened to include the therapeutic system, whereby reflection gives way to reflexivity. This refers to the ability to reflect on action and use it to inform future action. The GGRRAAAACCEEESSSS help to scaffold therapist reflection in such a way that it brings to the fore what may be visible, invisible, voiced or unvoiced in our own personhood. This in turn can help us, in our actions, stay open to conversations about the interaction between client and therapist perceptions of our respective social selves.

Therapy, after all, is often about opening up conversations that are often not easy to have, in authentic ways. Inevitably this involves the complex and multifaceted personhood of both parties. Aspects of assumed, perceived and subjective identit(ies) can be powerful mediators of both the therapeutic alliance and rupture. The collaborative nature of CAT starts from a place of humility in its gradual co-construction of shared meaning. Yet understandings are seldom complete. And of course each of us brings a myriad of different life experiences and contextual positionings in the social world.

Finding our way through these can feel uncomfortable and challenging. Without some waymarks we can feel a bit lost. Often, strategies and procedures we employ to feel more safe or secure in our professional roles can powerfully influence the direction therapy takes. In order to hold space for respectful, curious conversations around aspects of identity, we need to feel at ease with uncertainties and discomforts that such exchanges can provoke. Moreover we need to be able to respond helpfully when our clients step into that space with us.

Paddy is on the cusp of retirement from the NHS, following a career spanning some fifty years. She brings much clinical wisdom as a jointly trained CAT therapist and supervisor, and systemic family therapist. Paddy also offers DBT in her busy role in an NHS psychotherapy service. Preparing for our ‘A Graceful CAT’ workshop in 2019 opened up a creative space from which emerged a ‘graceful’ daisy. In addition to the approaching season, this inspired the image we chose to advertise our forthcoming event. In our experiential workshop Paddy and I will provide an overview of these complementary frameworks and introduce this fledgling tool. There will be opportunities for both personal reflection and practice in pairs or small groups. We hope the workshop will provide a safe space for therapists feel more comfortable and confident in working reflexively with similarities, differences and power in the therapy room.

To find out more or book onto this half day in Manchester on the morning of 15th July, visit the “A Graceful CAT: Embedding Social Graces in CAT Dialogue” event page at this link.