Tag Archives: Personal Reformulation

November 2021 News

It’s been a while since we published a newsletter to update on new developments. At our recent Executive group meeting in November 2021 we thought we’d try updating more regularly on the blog. If you’re interested in following Catalyse activities this is another way to stay informed.

Practitioner Training

We made the decision to defer the next intake of the Practitioner Training until 2022. However this doesn’t seem to have made 2021 a less busy year. We’re pleased to have had a great deal of interest in the course already. The deadline for applications is May 6th next year and we look forward to checking our inbox then. Marisol Cavieres provided her final training day in October, and has now moved on from her tutor role after ten years of working with us. This makes way for trainer Jo Coggins to take on the tutor role for our new October 2022 intake, working alongside Kathyrn Pemberton who is the tutor for the 2021 cohort.

People

This year we’ve also had further additions in that David Harvey has joined us as an associate. Jenny Marshall has also joined and taken on a lead role for Personal Reformulations. Additionally, Cath Laverty has come on board in a Non-Executive Director role. Glenys Parry made the transition to a Non-Executive Director role after retiring from her Executive and Finance roles at the end of August. Her inimitable mix of wisdom, strategic precision, seemingly limitless practical skill, plus her warmth, irreverence and humour, have aided Catalyse since its inception. We miss her in our Executive meetings. However we’re pleased she’ll remain involved in a number of other ways. Alongside their practitioner training roles, Dawn Bennett and Sarah Littlejohn are now Co-Chairs of Catalyse and Dawn is Finance Director.

CPD

After a pandemic-related pause, four CPD events over the second half of this year have been well received. Our December event on Therapy for Parents and the Family Court Process is the most well-subscribed of the year, but there are still spaces if you wish to book on. David Harvey will be repeating his in-person CPD day on CAT as a Tool for Leadership on Thursday 5th May 2022. More details and booking options for this will be available soon.

CPD lead Jo Coggins is in touch with several colleagues about a number of other stimulating CPD days over the coming year. We’ve streamlined the CPD proposal process so that there is a bit less form-filling. Instead the process includes more conversation with Jo to begin developing a proposal. We hope this will help prospective presenters move from an idea to something firm. If you have chats with Jo on Zoom you may not spot her swapping a tentative pencil for a more confident pen. Have no doubt she will be working towards getting a definite date in the calendar. Then the website work gets properly underway and we can start to advertise your event.

Many of you completed our CPD survey earlier this year. In response, for 2022 we’re planning to offer a range of different events to suit different pockets and purposes. This includes a mix of face-to-face and online events, and we will share more details soon.

Catalyse Training Films

It’s just over a year since the Catalyse training films became available to stream. Vimeo recently informed us they have had over one thousand views. We’re about to launch a brief survey to ask more about the experience of those who have used them to date in training, or their own learning. Catalyse practitioner course trainees have direct access to them throughout training. Other CAT Practitioner training courses and Clinical Psychology courses have purchased subscriptions too, and some have also arranged for their trainees to have direct access at a small cost-per-head fee. Being able to watch the films at any time means that learners can use the materials more flexibly. In addition to viewing them direct during remote training days, they can also review them in their own time.

We didn’t really anticipate that individuals might want to subscribe to the films as a preparation for training in CAT. However we’ve discovered that there is some interest in this. As a result we’re reviewing the subscription costs to make it more possible for people to access them in this way. We’ll share details of new subscription arrangements shortly.

Training Films: Take Two

Not content with one series of materials, supporting initial skills development in cognitive analytic therapy, we are well underway with a second series. This is thanks to a generous donation from a charitable endowment fund by Greater Manchester Mental Health NHS Foundation Trust. Their contribution is enabling Kathryn Pemberton and a small group of CAT colleagues to plan and produce a further five short films, in conjunction with Brickoven Media and a number of local CAT colleagues.

The first series is suitable for introductory and year 1 practitioner training. Using different fictional scenarios, this second series of films will demonstrate a range of situations presenting more complex therapeutic challenges. From countertransference and strong expressed emotions, to rupture linked to values and world-views, the films aim to demonstrate more advanced CAT skills and competences. Again they will not be striving to show ‘perfect’ clinical practice. Instead, they explore the richness of such therapeutic encounters and possible responses by CAT therapists. As learning resources we hope they will facilitate exploration, discussion and debate around more advanced CAT skills and competences.

The recent weekend of improvisation and filming at GMMH premises in Manchester deserves a blog in its own right. Until that emerges, you can see a few visual highlights and glimpses of therapists who kindly gave up parts of their Sundays to help us, on the #CatalyseFilms hashtag on Twitter. If you’re not on Twitter you can scroll back to view the Twitter feed here on the website.

Staying involved with Catalyse

As ever, we welcome approaches from ACAT-accredited CAT therapists across the North of England who would like to become involved in the work of Catalyse in some way. There are plenty of possibilities. You can read more about how to go about this in Dawn and Glenys’ guidelines here. And of course you can always contact us through our administrator Frances Free.

Personal Reformulations in the Workplace

In this blog, Catalyse Associate Jenny Marshall shares some thoughts and experience on how personal reformulation can aid difficulties in the workplace.

I’ve worked hard in my career and this has always served me well until recently. I was struggling in a new more senior role and the harder I worked, the worse it seemed to feel. I just didn’t seem to be able to find a way out”.

For the first time, I really feel like I understand burnout; ever increasing demands felt impossible and I found I couldn’t switch off from increasing anxiety”.

The examples above may sound familiar. We may have seen aspects of them in colleagues, people we manage or people managing us. We may have felt these experiences within ourselves. In both examples, there is a narrative that the usual ways of coping or surviving in the workplace, are no longer working. There is a sense of stuckness, a drive to find an alternative way of being but not knowing or understanding how to do this. In such situations, this may be a good starting point for a personal reformulation (PR).

There may be many reasons why someone may not choose to have therapy in this situation. Instead they may want help in understanding why old patterns of working and coping now feel unhelpful and are keeping them stuck. These patterns, whether relating to others or to self, are a good here and now place to start in a PR.

We all experience change in our working lives and with change brings uncertainty and anxiety. How we respond to this depends on our individual relational patterns and ways of coping. Having an awareness of our own patterns can help us to navigate these changes.

The first example,

I’ve worked hard in my career and this has always served me well until recently. I was struggling in a new more senior role and the harder I worked, the worse it seemed to feel. I just didn’t seem to be able to find a way out”.

on further reflection, had been triggered by a change in role. This led to the usual strategy: work hard, always meet or exceed expectations no longer being possible. This can happen in more senior roles when staff are no longer only responsible for their own work but for the work of others. Exploration of this pattern in more detail also flagged up how not only was it not working; it was actually hindering performance. Working harder and taking more on was compromising the ability to deliver on expectations. It was only when this was acknowledged through mapping and the reflective process, that a shift became possible. It was easier to understand what needed to change. This pattern is represented below as a series of boxes and arrows.

The second example represents an pattern commonly seen in healthcare.

For the first time, I really feel like I understand burnout; ever increasing demands felt impossible and I found I couldn’t switch off from increasing anxiety”.

As carers, we can often feel a natural pull to being responsible, caring and looking after others. However this can become problematic when we do this to the extent of neglecting our own needs. Similar to the first example, creating a safe space to explore these dynamics is key to understanding what needs to change.

With both the above examples, we could take the reformulation further, to reflect on early childhood patterns. This helps us see similarities between the relational patterns in the here and now and in early relationships. There may be a narrative around the current coping strategies and how they have developed from childhood. With a personal reformulation, the focus is on the here and now, within the workplace. Some individuals may choose to go on and follow this up with a personal therapy. For others they may not and PR may be sufficient for understanding and/or change.

PRs may be helpful for those workplace situations where we start to notice, ‘I am struggling, I feel stuck and am not sure what to do’. We might perhaps notice feeling like ‘I’ve been here before, feeling like this, I want to do things differently’. If we notice and think about patterns causing us difficulty – which we all have – at an early stage, it may prevent further difficulty or even sickness from work. It may allow for different choices, decisions and what CAT terms ‘exits’ from these patterns.

As a PR is briefer than therapy, I feel it is worth a note about the ‘healthy’ parts of a map. If you are coming to a PR in relation to current challenges in the work place, space to explore multiple positions on the map may help by allowing a ‘zooming out’ from the difficulties. This can help you consider when things have been different. Space to remember and learn from times when we have felt more able to overcome difficulties may give us the ‘exits’ we need from our current difficulties. As we all have problematic patterns, we all have strengths and ways of surviving which are effective and allow us to feel good about ourselves.

There are different ways of doing PRs. Traditionally they took place over one longer session (up to three hours with a break). They were adapted to an extended (usually two hours) session with a follow up session (up to an hour). Since online working has become common, a further adaptation has been to conduct the PR over three hourly sessions. With all options, it is important that the therapist is trained in cognitive analytic therapy.

Catalyse personal reformulation therapists are listed on the page at this link. They are all accredited CAT practitioners or CAT psychotherapists and are familiar with the aims and methods of the CAT personal reformulation approach. Feedback from PRs has been very positive. People say that they value the process both personally and professionally. Generally feedback suggests it has helped them gain insight, recognition, awareness and understanding. Read more at the All About Personal Reformulation page.

If you are interested in exploring the idea of a personal reformulation further, contact one of the PR therapists who will be happy to discuss this further with you.

Preparing for a Personal Reformulation

To follow on from Clive Turpin’s last blog on Personal Reformulations (PRs), he shares some thoughts the Catalyse PR therapists have put together about preparation for a PR.

In this we attend to the questions:
Is there anything I can do to prepare for my Personal Reformulation?
What things might be helpful to consider before undertaking my Personal Reformulation?

These are really important questions and the details below attempt to provide some answers.  Firstly there are some practicalities that can be useful to think about.

Timing: When should I arrange to have a PR?
What feels important here is that you will have the time and space to think and reflect, not only in the session, but afterwards too.  This helps you to make full use of the richness of what is explored in the session and to give yourself as much of an opportunity to reflect and use the work to support recognition and work towards change. Therefore periods of increased stress or workload or study might not be the best time to undertake your PR.

Who do I see for a PR?: Choosing a therapist
For those doing Doctorate of Clinical Psychology courses, or CAT Skills courses, which have an agreement with Catalyse to provide PRs, there is information on our PR therapists on the Catalyse website to help you decide who to see and where this will be.  Sometimes locality and convenience can feel important as well as distance from your local area.  The gender or other characteristics of the therapist may be important to you.  Their current or past areas of work may also be something that feels relevant to your choice.

If you don’t have access to the Catalyse PR therapists through your course but would like to work with one of us, you can contact us to explore options.  Alternatively you can check ACAT’s listing of accredited members providing private therapy in your area.  You can ask those you approach whether they have experience of providing PRs. The link for this listing is here.

Aims: What do I want to get out of a PR?
Prior to the PR it can be very helpful to reflect on what you would like to get from the sessions in a general sense and also consider any specific goals. Taking some time to reflect on your relational patterns, with yourself and with others, can also be very helpful.  You might think about things that regularly occur that you would like to explore, understand better, and work towards changing. This could focus on a particular pattern or feeling that you struggle with or that gets stuck.

What tools are available to help me get the most out of a PR?
It might be helpful to look through the Psychotherapy File prior to the meeting.  This is a standard CAT tool developed by Tony Ryle and is available from your PR therapist on request.  This can be a useful aid to recognising repeated patterns of relating and how you manage currently. Your reflections can then inform the initial conversation of the PR and help to establish an agreed focus.

There are other tools which are used to aid self reflection in the CAT model, including the Psychosocial Checklist and the Helper’s Dance (Potter 2013).  Again you may want to look at these before the meeting.  However the main focus of the PR is more likely to be the narrative that develops between you and the PR therapist through your conversation, so don’t worry if you haven’t been able to look at these other tools.

Let us know if this information has been useful in preparing for your PR.

If you’ve had a Personal Reformulation and want to share what helped you feel ready and make the most of it, let us know, or feel free to leave a comment below.

Clive Turpin, representing the Catalyse PR therapists.

You can follow Clive on Twitter: @Clive_Turpin

Personal Reformulation: A little CAT can go a long way

Image of Clive TurpinIn the second of our occasional blogs, Clive Turpin answers some common queries about Personal Reformulations to supplement information about this on our webpages.

What is a Personal Reformulation (PR)?
A PR is a way of using a cognitive analytic therapy approach, delivered in a brief and contained framework, to help people develop or improve relational awareness; ways of relating to themselves and others. It was originally developed to support those in helping or therapeutic roles to better understand their own relational pushes and pulls and how this might impact on their work roles. It also gives a bit of a taste of what it is like being in the ‘other chair’ as a client in therapy.   As helpers we all bring with us our own history, our strengths and vulnerabilities, and in a CAT way of thinking, our own reciprocal roles and patterns of relating with ourselves and others.  A PR provides a safe and confidential opportunity to identify and reflect on such relational roles and patterns, and how they impact on work roles.

So, are you really talking about personal therapy?
No, a PR is not a full therapy. People who train as a CAT practitioner over a 2 year course are required to complete a 16 session cognitive analytic therapy. This is an essential part of the course and highly valued as an opportunity for direct experiential learning about the CAT model.  It can also be valuable at a personal level for the training therapist. Being aware of our own identity and what has shaped our thoughts, feelings and ways of relating, helps us a great deal in identifying how these might impact on our role as a therapist or helper.

A PR on the other hand provides a very brief and contained opportunity to use CAT’s approach of collaborative mapping to provide a structure to identify and explore prominent relational roles and patterns as a framework to build upon. Although the personal and professional parts of us are obviously linked, a focus on work and professional roles sets a clear agenda and helps the person make the most of the brief and contained nature of the PR experience.  A typical PR includes a two-hour initial session plus a further one-hour follow up session at a later date.

Who can have a PR?
At the moment PRs are mainly used by trainee clinical psychologists and other professionals doing CAT skills training courses. A number of Doctorate training courses in Clinical Psychology highly value the benefit of PRs and have embedded them into training.  However PRs could be of benefit to a wide range of professionals such as GPs, nurses, psychiatrists, counsellors and others wanting to learn more about the CAT approach.

What happens if something unexpected comes up during the PR?
Personal exploration is likely to connect us to feelings and vulnerabilities that we might sometimes try to limit or hold back from sharing with others. Even during a brief PR you might connect with feelings in a way that can initially feel very intense and overwhelming.  Although this might feel hard in the moment, the therapist will be thoughtful with you about how to manage this and make sense of it. These moments, albeit challenging, can be very rich ground from which to learn within a safe and contained environment.  In feedback from people who have had a PR these are often referred to as important aspects of the experience which help to develop awareness and understanding.

An important part of the PR (and the CAT approach) is exploring “exits” through collaboration and conversation.  Exits are alternatives to well-worn patterns, or strategies to help manage relational pulls and responses. This is why the jointly produced map takes centre stage as it provides an immediate way of capturing what is being felt and thought about together.  The map provides some scaffolding to help develop awareness so that the person can more easily notice times when patterns are happening.  This gives an opportunity to think about ways of approaching things differently. An example of this could be of establishing a new healthy reciprocal role which encourages the person to pause, reflect and consider before responding or getting pulled into patterns.

Is it confidential?
Yes.  What is discussed in a PR is confidential and ordinarily there is no feedback to the course about content of the sessions or the trainee.  All therapists adhere to ACAT’s Code of Ethics and Practice.  As in any therapeutic contract, if an issue of risk or concern about professional conduct arises, the therapist is obliged to inform relevant third parties (in the case of a trainee clinical psychologist this would include the course, as employer).  If such concerns were identified they would be discussed in the session.

What sort of feedback have people given?
Feedback is generally very positive.  The Doctorate in Clinical Psychology courses at Universities of Lancaster and Liverpool highly rate PRs and have had ongoing contracts to enable their trainees to access them over the last 8 years. Some trainees from other Doctorate in Clinical Psychology courses access PRs independently.  Other courses are also expressing interest due to the positive experiences and feedback of those who have used PRs. Six-month long CAT Skills courses continue to incorporate PRs as an essential part of the training experience.

The University of Lancaster DClinPsych course has published internally two research projects on the impact of PRs.  Feedback gathered and collated by Catalyse is very positive with PRs being highlighted by some as one of the most valuable parts of training.   Specific feedback also includes how PRs can help the trainee:

  • both personally and professionally;
  • gain insight, recognition, awareness and understanding;
  • identify and name difficult roles and patterns;
  • improve their understanding of CAT and how it can be used/applied; and
  • have some experience and insight into what it’s like to be a client and in “the other chair”.

Mapping out roles and patterns is consistently cited as being the most helpful aspect.  The map acts as a summary of the work, a portable tool to refer to later, and from which further exits can be developed.

There is an acknowledgement about the importance of therapist/client fit and some of the challenges when the fit is not a good one.

For most the brief time frame feels enough; for some it can feel a bit short.

The follow up sessions are considered “very helpful” to “essential”, enabling review of the initial session and revisiting the map to work further on recognition and exits.

Why might I consider having a PR?
In addition to the feedback above, in CAT the emotional world of the therapist or helper is seen to be important to address so that as therapists we can manage ourselves in a way that doesn’t interfere with the client’s needs.  Managing the psychological and emotional impact of clinical practice is also embedded into standards for mental health professionals, for example HCPC standards of practice for practitioner psychologists.

Relational awareness helps us to understand and separate out emotional responses that we encounter in therapeutic and working relationships, and is an explicit part of many therapeutic models.  For all therapists working in a relational way this is an ongoing process which is supported by clinical supervision.  A PR can be considered an early step towards building relational awareness, specifically using a CAT perspective.

Who offers PRs and how do I know they are skilled in this approach?
All therapists offering PR sessions will either be an accredited CAT practitioner or CAT psychotherapist. Currently there is a list of approved therapists on the Catalyse website. The listing includes location and some brief information on the therapist to help people decide who they are likely to work with best.

There is not a specific training required to offer a PR, but through experience and feedback some guidance has been established to ensure a standardised approach.  Naturally each PR will differ as each combination of people creates something unique and independent within the relational encounter.  However there is an established framework that contains the approach.

In addition to this I co-ordinate a process of governance amongst the network of existing PR therapists working as Catalyse associates.  This takes place through telephone conferences and an annual workshop, and actively uses feedback and peer review.

Does my course offer access to PRs?  
CAT Skills training course participants have a PR as part of the training.  Currently Lancaster University and the University of Liverpool provide funding for their DClinPsych trainees to access PRs if the trainee wishes to take this up.  These DClinPsych courses, plus those run by the University of Sheffield and University of Exeter, have selected CAT as one of their second therapeutic models under new BPS/DCP requirements.  As such, each of these courses are required to provide access to PRs for their trainees.

To help meet this expansion, ACAT is putting on a number of workshops for CAT therapists interested in offering PRs, to help to share good practice. The first is in Exeter on 7th October 2016.

Many trainees from other DClinPsych courses arrange PRs on a self-funding basis.  If you are interested in accessing a PR but are not sure how to go about this, you can find out more by contacting me.
 
I have other questions about PRs – how can I find out more?
Comments on this blog or via Twitter (@Clive_Turpin) are very welcome although I may not be able to respond immediately.  It would be good to hear what people make of the information and ideas shared in this blog.  You may help nudge us to write another!  If there is anything further you’d like to know about PRs, you can also contact me via Catalyse.

Clive Turpin, CAT Psychotherapist
Clive is on Twitter @Clive_Turpin

More information about ACAT’s forthcoming Exeter event on 7th October 2016 for therapists interested in providing PRs is available here.  A further course is due to be run in Reading at a later date.