Tag Archives: Cognitive Analytic Therapy

cropped image of an arrow etched into a wall

Interesting, engaging, curious minded people?

With our joint Catalyse/ACAT conference Encouraging-to-Engaged in CAT Research now less than two weeks away, CAT practictioner Rhona Brown reflects on the backdrop to the day and conversations with some of those involved in making it happen.

Since qualifying as a CAT practitioner I’ve had several opportunities to hear colleagues presenting on research at ACAT conferences and through other local CAT networks. I’m always impressed by both the rigour and commitment of researchers and the favourable results emerging from recent work. I tend to leave with a more optimistic and energised state of mind in relation to the idea of research. Sadly in the wake of other demands, must-do’s, and familiar patterns of clinical working, this dissipates fairly quickly. I return to another annual conference back at my familiar starting point, ready to be impressed and energised again. But what changes?

I suspect I’m not alone in this somewhat tame and occasional aspirational state. Within CAT there’s great enthusiasm for the model and a subjective and anecdotal sense that it’s an approach which can help both therapists and those seeking therapy to become unstuck and move on. Experience suggests that this is particularly the case where there’s a level of complexity in presenting difficulties, often where other more manualised and less relational approaches have yielded fewer benefits.

While the lived experience of both parties in the therapeutic endeavour can be favourable in CAT, we know that in terms of an evidence base, its “emerging” status  can lead to it being excluded as a recommended therapy within the majority of formal guidelines. Most recently, the updated NICE guidelines for eating disorders dropped CAT, despite a jointly produced submission by ACAT on the various RCTs which have demonstrated its value with this presenting difficulty.

So how can this change? The research meeting at the joint ACAT and ICATA 2017 conference in Nottingham brought together a small critical mass of research champions within ACAT’s membership. They updated each other on current work, generated ideas for future funding possibilities, and considered how we could collectively generate a list of manageable projects which could be picked up by those on D Clin Psych training. This meeting dovetailed with Alison Jenaway’s election as ACAT Chair.  Alison admits to being a “bright ideas” type of leader, generating new plans and possibilities, and “pushing where it moves” in a system to enable change.

At a time of much internal and external change, it’s a bonus that ACAT can benefit from this energy in relation to refreshing its research strategy. Outgoing chair Jason Hepple continues to hold a steady space for ACAT’s research committee.  Alison’s ideas for refreshing a research strategy stimulated northern-based research allies and Catalyse associates Glenys Parry and Stephen Kellett to put their networking and persuasive powers together. They have engaged a range of researchers with differing experience and stories to tell about how they have planned, conducted and reported on CAT research.  Glenys, Stephen and Alison will be joined by another six research-active colleagues on 13th April in Manchester to help deliver the first in what’s hoped to be a series of research-focussed events for the CAT community and other stakeholders who want to be involved.

So far the event’s attracted applications from a substantial group of enthusiastic CATs plus one or two others more new to CAT but keen to think alongside CAT community members about researching application of the model in their own fields. There’s a reduced bursary fee for people keen to attend but for whatever reason unable to cover the whole cost of the day.

Stephen Kellett, active in generating or supporting much of CAT’s recent evidence base, is characteristically optimistic about what might be covered. He considers that the evidence for CAT as an intervention with people with complex difficulties attracting a diagnosis of “personality disorder” is “looking good” to the extent that CAT can be considered an evidence based treatment according to the NICE bar for entry. Catch him on a day when he’s not too busy researching to share more ideas and he’ll tell you that the building evidence around CAT’s versatility enables us to “cut [our] cloth accordingly in terms of session contracting…..it’s useful to use 8 session CAT for common mental health problems or focal problems and extend to 16 and 24 for more complex presentations”. His recent work on the impact of reformulation letters demonstrates that “narrative reformulation is helpful for complexity, while less so for common mental health problems”. He goes on to highlight how the Personality Structure Questionnaire (PSQ) “is now a CAT specific outcome measure with really good psychometrics”. Get him onto evidence for CAT consultancy and he’ll enthuse that it “doesn’t really have a peer”.

When I asked Stephen what helped him get started (and keep going) in practice-based research, he shared that this has been possible through “thinking up clinically relevant questions whilst working with clients, matching an appropriate method to [them] and working with interesting, engaging and curious minded people”.

I expect that the research conference will be an opportunity for those assembled to distill and refine such questions based on their own clinical setting, and weigh up best methodologies alongside these key research guides. They’ve walked these paths before, know a whole lot more about the terrain than I do, and I hope that their insights and tips, combined with shared reflections from the larger group, can help make my research journey one which might actually get underway. Another hope is that the day will provide a stronger sense of those relational supports and networks which can keep momentum going between April and the next opportunity to hear the research component at an annual conference.

If you might be one of Stephen’s “interesting, engaging and curious minded people”, open to hitching a ride on Alison Jenaway’s energy for building CAT’s evidence base by starting or completing a research journey yourself, then please consider joining us in Manchester.

To book a last minute place at the conference, visit this page.  You can follow tweets about the day on the hashtag #CATres18

Black and white image of outstretched hand with grains of sand falling through the fingers

Embodiment Event Now Open to Bookings

Tim Sheard’s two day workshop on Embodiment, Relational Space and Working with Trauma to the Sense of Self is now open for bookings.  The workshop, which takes place on 30th and 31st May, builds on previous training he’s delivered elsewhere in the UK and Finland.  In it he aims to provide an embodied and theoretical exploration of our relational selves, narcissistic wounding to the sense of self, and how embodiment may reduce what he refers to as therapist burdening.  This can take the form of stress, tiredness, exhaustion, burnout and vicarious trauma.

Tim offers understanding of these as embodied manifestations of a “hidden but powerful type of collusive reciprocation”, often occuring in a context of complex developmental trauma. He notes “the therapeutic relationship takes place in an embodied relational field, not simply between two reflective “minds”……embodiment skills may render it more tangible”.   His position is that developing such awareness “may help clarify the kind of relational presence we offer as therapists” to people who have experienced significant early trauma.  He believes that learning and practising embodiment skills can help to support the development of therapist self care via “healthy self-to-self reciprocal roles to resource us in the therapy room”, with potential benefits for both therapist and client.

His article in the Summer 2017 issue of Reformulation provides a more detailed account of how his experiential workshops, involving over 200 therapists to date, have evolved over the last seven years.  It also provides more information about the kinds of areas he’s likely to cover over the two days.

He welcomes applications from CAT therapists at any level of pre- or post-qualification.  Other therapists working relationally with people who have experienced complex developmental trauma, and who are well-versed in key CAT concepts such as reciprocal roles, are also welcome to attend.

This event takes place in Manchester in the leafy surroundings of Chancellor’s Hotel, and we hope that a more typical spring will have arrived by the end of May so that participants can enjoy the grounds.  It is offered on a non-residential basis so those attending will need to arrange their own accommodation.  Tim wishes to keep the event quite small so that participants can gain the most from it.  If you’re keen to take advantage of his trip to the north, then we encourage you to book soon.   Full details are at the event page at this link.

To book on to this event please click here.  The hashtag for the workshop is #CATerst18

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First States Day Fully Booked

The first run of the CPD day offered by Sarah Littlejohn and Dawn Bennett on States, Self-states & State Shifts on 19th March has proved very popular and is now fully booked.  If there’s sufficient interest it may be possible to run the day again at a later stage.  Contact us if you’d like to be added to a waiting list for a repeat of the event.

CAT diagram showing reciprocal role and procedure around research, with exit of coning to this research conference

Building Our Research Community Together in Manchester

Have you seen details of the research conference which we are running run jointly with ACAT?  This takes place on 13th April in Manchester. The title “Encouraging to Engaged” sets out what we intend it to do, through bringing together CAT peers to consider how we can all become more confident, skilled and active in relation to research. Manchester does of course have an international airport for easy connections with other countries where CAT has a presence.  Colleagues from beyond the UK are most welcome to attend too.

A range of research-active colleagues involved in psychotherapy and practice-based research, and already playing a part in building CAT’s evidence base, will present and share their experience as “more knowledgeable others”.  Small group work focussed around participants’ needs will provide thinking space, practical support and scaffolding to help us all feel more able to make use of CAT’s evidence base in our practice and to develop it further. It doesn’t matter what your starting point is in relation to research, there will be something for everyone on the day.  Further details of the programme will be available shortly. (Update February 2018 – full programme is now available as a download on the event page here.)

Of course it wouldn’t be a CAT event without a CAT angle on the process of engaging in research.  In addition to the playful map Alison Jenaway offered as an image to help promote the day, there’s a promise of more SDRs from presenters.  Perhaps Alison’s diagram has already prompted you to draft your own?

We very much hope you can join us in April to play a part in further building our research community and renewing ACAT’s research strategy together.

If you have any thoughts, questions, suggestions or discussion points in relation to the day, do please add them here, or on Twitter using the #CATres18 hashtag.  You can also use the members’ only Research Chatterbox on the ACAT site.  Perhaps we can get a conversation started in advance of the conference: we  certainly look forward to the conversations on the day.

You can find out more about the day and book a place by clicking on this link.  The early online booking rate of £95 applies until March 12th.  If you need anymore information or advice about accommodation options in Manchester, please contact us.