Tag Archives: Cognitive Analytic Therapy

25 years of CAT Practitioner Training in the North banner - black background with gree Catalyse Logo, conference details and image of eggshell with small green shoot growing out of it

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

Cropped image of multicoloured woven fabric in blue and purple hues

CAT Across Cultures: Challenge & Encouragement in Equal Measure

Are you using Cognitive Analytic Therapy across languages? With culturally diverse communities? Do you supervise or support such work by other therapists? Do you use CAT consultation in teams where staff get stuck around cultural or religious issues? Have you struggled to incorporate the impact of race and racism in formulations? Does your own heritage and identity figure strongly in how clients engage with you? Has your CAT training sufficiently addressed issues of power?

These can be emotive topics and can evoke powerful responses in us. How do we manage such responses and where can we take these within our CAT practice? 

CAT practitioner Rhona Brown shares some background to Jessie Emilion’s forthcoming training day and why it may be of interest.

We at Catalyse are delighted that Jessie Emilion took up the invitation to lead a day “Exploring Issues of ‘Race’, Culture and Language within a CAT Framework” on 20 July in Liverpool.

Cognitive analytic therapy is of course a radically social model which is explicit about how issues of cultural and subcultural difference are procedurally enacted in therapy. It offers us a way to make the political personal and create shared meaning across cultural divides. Establishing CAT training in Bangalore in India over the last six years, Jessie’s had ample first hand experience of adapting CAT in response to the cultural context in which it’s practised. She also articulates how CAT concepts are shaped by such international experience. Along with Hilary Brown, she published a chapter in Deborah Pickvance’s book, on CAT supervision in the Indian context which brought to life ways in which CAT theory is extending in order to more explicitly realise its radically social basis.

“…through our case discussions, we came to think about dilemmas, traps and snags as being held in the culture rather than exclusively in the individual….. A snag might actually be a prohibition, a dilemma a threat of exile as the punishment for non-conformity and a trap a vicious cycle created by poverty and disadvantage …..The metaphor of the ‘dance’ [in CAT theory] in which each individual seeks reciprocation from others, fails to acknowledge the power dynamics at work in a society. ….The dance does not happen in a vacuum but is structured on the basis of positioned roles, selectively occupied on the basis of class, race, age or gender.”

The Catalyse practitioner training has long included space within its twenty training days to consider what has become known as the “SCOPE of CAT” – social, community, organisation, political and economic aspects. It was a privilege to be able to contribute to these training days for a few years, thinking together with successive trainee cohorts on how to engage with such issues, alongside Deborah Pickvance.

The diversity of perspectives held within CAT’s interdisciplinary community felt like a resource to be mined on these days. We all bring with us our own personal identities, our pre-course experiences, and a range of core trainings with their own professional cultures. We each have our own baseline with regards to culturally competent practice. However to acknowledge areas where we may feel less competent and skilled, or feel perhaps more personally invested, can be a challenge. Starting to unpick some of these issues on SCOPE days always felt like an enriching dialogue, although as a white British facilitator I always felt limited in my capacity to authentically represent the lived and living experience of people of colour.

Diversity in groups we work, supervise and train within gives us all daily opportunities to engage with life experience that’s unfamiliar, but do we have places to take what this can evoke? Uncomfortable reciprocal roles and enactments might arise around ‘silencing-to-silenced’ or ‘privileged and well-resourced to exploited, neglected and marginalised’. Experiencing, or simply witnessing ‘hostile and attacking to harmed’ along racial lines can throw up intense emotions which might be difficult for client and therapist to name if a sense of safety within the alliance is uncertain. Such themes, ever-present for many communities, may more frequently be on the cusp of entering conversations within our consulting rooms in recent times where Trump, Brexit, austerity, #MeToo and Windrush have thrown the impact of power and social positioning into stark relief.

Insidious or more frank psychological sequelae of world affairs impact on all of our lives, illuminating multiple aspects and intersections of identity for both client and therapist. How we as therapists respond when such conversations arise can be crucial to the success or otherwise of a psychological therapy.  CAT gives us various ways to “name it, name it, and name it again”, and experimenting with ways to weave such themes  into formulations, diagrams and letters in authentic ways can be important.  At last year’s international conference in Nottingham, Jessie touched helpfully on putting CAT tools such as mapping to good use by helping to name & navigate ‘gut feelings’ felt by both client and therapist around racism & discrimination.

As team consultants or supervisors, when staff and supervisees share what’s come up in their work around social power and difference, do we feel equipped to respond? At her presentation in Nottingham, Jessie also made the gentle provocation:

“….if issues around race and culture have never come up in your supervisory practice, what’s being missed?”

So, have we had enough in our trainings to feel confident and competent as therapists and supervisors able to engage authentically with such issues, with sensitivity, respect, empathy where possible, and a lack of defensiveness? Perhaps it’s most useful to think about engaging in SCOPE issues as an ongoing learning journey for us all, rather than a certain destination we arrive at by the time we complete practitioner, psychotherapy or supervisor training. As the world and society changes, we and those we work with change, and hence the SCOPE in CAT is never finalised.

In my experience there’s nothing quite like a contained face-to-face dialogue with peers where we can feel safe enough to share both difficult procedures, and also approaches that we’ve found helpful.  Jessie, as a solid ‘more knowledgeable other’ can help take us into an area of more stretch and challenge, also providing an opportunity to develop and take away skills to apply in day-to-day work.  Her experience as psychotherapist, trainer and supervisor lend her many practical tools and resources to share with those attending.  Her training and experience as an interpreter offers an uncommon perspective on language and mothertongue in the nuances of emotional expression and intimacy in therapy. For those considering or already working with interpreters, this specific angle, merged with her CAT lense, may aid in understanding and managing the complexity of triadic relationships.

I expect she will bring to the day equal measures of challenge and encouragement. She herself hopes:

“…we could have an open dialogue about these difficult and complex issues without feeling blamed, frightened or persecuted and that we could use CAT’s mapping and positioning to understand and learn from the discussion”.

The event is open to therapists of all persuasions who are familiar with CAT concepts, plus all within the CAT community, including trainees, supervisors, and those applying CAT skills in case management and indirect work. We hope you’ll join us there.

For more information and to book on to ‘Exploring Issues of ‘Race’, Culture and Language within a CAT Framework’ click on this link.

Crop of presentation image of an hourglass with research words

Inspiring and Connecting Through Research into Cognitive Analytic Therapy

ACAT chair Alison Jenaway reports back on April’s joint research conference in this, her first guest blog for Catalyse.

“Only connect” wrote E.M. Forster, in his book Howards End, as isolation is a killer. I am paraphrasing, but this is what I had in mind when I was planning the idea of a regular Cognitive Analytic Therapy (CAT) research day. I wanted to be able to gather a group of experienced researchers and lock them in a room with CAT therapists who are keen and interested in research. My hunch was that by some magical process, this would produce a future Professor of CAT.  Call me naïve if you like, but this was my hope when I persuaded Stephen Kellett and Glenys Parry to organise the first research conference to showcase CAT.

To be honest they did not take much persuading. I don’t think the people who agreed to present their research on the day did either, nor the experienced researchers that gave up their time to support the day. My plan was that I would just be there to introduce the reasons behind the conference, and then watch the connecting happen from the sidelines. What I was not expecting, was how much I personally would be inspired by the day.

It really was fascinating, not so much the content of the research and the results, but the way each presenter described why they did what they chose to do, what went well, what went wrong, what they might do differently if they started again, and what they would like to do next. This felt different to other research presentations I have listened to in the past, where the presenter seems to be determined to convince you that the way they did it was the right way, indeed the only way it could have been done. It was like going behind the scenes at the theatre, and gave me more of an insight into the “researcher’s attitude”. It really made me feel that perhaps one day, just maybe, I could do this too.

The morning was made up of presentations for research projects at various stages of completion. Peter Taylor kicked off with an explanation of what a Delphi study is, and how his team used it to explore whether CAT seemed, to therapists, to be a helpful therapy for patients with psychosis.  Good luck to anyone who thinks they can get a group of CAT therapists to agree about anything, but there did seem to be some common themes emerging. His team have recently published a case series of CAT in psychosis which includes qualitative data from patients.

Craig Hallam was next, describing a huge amount of work, juggling multiple ethics committees and associated paperwork, in his study on CAT outcomes for people with learning disabilities.  Despite much solid effort and goodwill – his own, his supervisors’ and CAT colleagues working in this area – recruitment remained a challenge. Craig was pragmatic in moving on to a more manageable project that could be completed within the timeframe of his clinical psychology training. I hope that he will find a way to keep the study going once qualified, given the amount of work already put in. There were plenty of nods of recognition around the room as he generously shared a CAT map of reflections on this process.

Mark Evans described a fantastic piece of work, his small pilot randomised controlled trial of CAT for bipolar disorder, carried out with a tiny amount of funding, and what sounded like a massive amount of good will. Katie Ackroyd is similarly amazing, in her ability to get research into CAT consultancy going in the real world of a busy clinical job.

We have all come to expect that now from Steve Kellett, of course, which is unfair of us. As Steve said, he was jealous of the tiny amount of funding that Mark Evans had to spend! Steve presented his work exploring whether narrative reformulation is really necessary in eight session CAT for depression within an IAPT service, conveying in the process how much fun research can be if you are doing it as a team.

There was some great networking over lunch, and Barney Dunn, from Exeter University was available to talk to people who might be interested in applying for an NIHR ICA fellowship programme. In his view, this was one of the best chances we have in ACAT of getting funding for CAT research projects, and developing a future academic researcher into CAT, at the same time. He and other NIHR advocates are happy to support people looking for research funding .

After lunch we divided up into small groups and so I only have a small fraction of what went on. Frank Margison and I had a group of three keen people who were just starting to think about what research they might be able to do, and we all got excited about the possibilities. Frank has a great overview of how to frame a research question and how you might go about answering it. He didn’t seem to mind me interrupting every now and then to say “I’ve just had another great research idea”.

I think everyone else at the day was as inspired by it as I was. I am planning to lock people up in a room together again next year, for a similar day in London, but it may be that Barney Dunn’s ideas are a more practical way forward in the long run.

Dr Alison Jenaway is a Consultant Psychiatrist in Psychotherapy in the Liaison Psychiatry Service in Cambridge, working with patients with physical health problems and medically unexplained symptoms. She is a CAT therapist and supervisor and has been using CAT for around 20 years. She is currently Chair of the national Association for Cognitive Analytic Therapy (ACAT)