“Young people can sniff out inauthenticity a mile away”

We’re fortunate that Lee Crothers is running a CPD day with Catalyse while she is in the UK in June. Her day “A CAT Approach to Inclusive Practice With Young People” takes place on 9 June in Manchester. You can also join the day remotely, using the Zoom platform. Over the course of the day, Lee will share with UK cognitive analytic and other therapists her rich perspective and experience working with adolescents, young people and their families in the Australian context. Curiosity got the better of us, and we posed Lee a few questions in advance of the day.

How did you find CAT?  What was your journey into CAT?

I was fortunate to be part of Orygen youth health when we were offered training by a UK group including Ian Kerr that initially visited Australia in 2003. I was even luckier that Eva Burns Lundgren supervised me through phone conference (no zoom then!), supported by Louise McCutcheon. The three of us would huddle around the phone very early or very late in the day and fax our maps and reformulation letters.

What brought you into work with young people in particular and why do you like it?

I like the energy and hope young people bring to the room. Don’t tell my two teenagers but I like a bit of attitude too! Of course, you can have attitude and energy at any age but it is more common in young people who are finding their feet in the world. I also like how young people’s emerging perspectives of the world can challenge me and be challenged too. Young people are adaptable. They are often keen to try new things and haven’t got long histories of being stuck in relational patterns.

In your work with young people, is there a CAT tool or idea that tends to work particularly well or that you find yourself drawn to?

I am often drawn to mapping with young people. I like it when they take a photo of it on their phones and change it up with memes or phrases. Recently one of my clients told me the map needed a “glow up”. I use the visual of a target problem and maps do that well.

The idea of the target problem is one I value highly and use in my work with young people even if I am not doing traditional CAT. Establishing a shared sense of the problem is crucial; a must-do. Digging down to the real issue does bring relieved looks. I am often saying things like “it seems that what got you here was your parents being concerned about self-harm but the real issue seems to be that you feel like you don’t belong”. Writing or reformulating in a narrative way is fun to do through email exchange. Together we can put it together from bite sized pieces. It is how we take in information now – through small pieces. Putting it together with the young person is a useful process.

What is it about CAT that makes it so useful with your work with young people?

The collaborative, doing with style of CAT and the adaptable tools. I also like the direction but not the rigidity of CAT and how the ‘Three Rs’ are useful signposts. CAT has given me permission and confidence to use myself in the room in a relationally helpful way. And you can be transparent about it! Young people can sniff out inauthenticity a mile away.

While young people might lack life experience they often carry many strengths and resources to enable healing, recovery and growth. What have been the most useful ‘healthy islands’ or strengths you’ve seen in this client group over the years?

I think I may be repeating myself but the flexibility and openness of young people is a great resource. Young people today have access to so much information and I admire their energy and ability to synthesise and engage with it. They often want to help others with what they have learned. I feel hope about the world and its future working with young people. They have inherited a great climate burden and yet show such sensitivity and passion in change and shaking us up.

As well as your therapy practice you’ve done lots of work with headspace National and running CAT trainings via Orygen. What are you proudest of in this part of your work?

I feel proud and lucky that I have been part of new innovative ways of working with young people. Particularly at Orygen I’ve been part of early intervention services for young people seen as the most complex and at risk.

Recently I am proud of writing with headspace National and Orygen about a relational definition of complexity in young people. I am proud of the message that often the complexity is within the relationships between worker, system and young person rather than solely located within the young person. This became a practice principle for Orygen and headspace National that supports over 150 headspace centres in Australia. It worries me that young people take in this label of being “complex”. This work has sparked training called Relate and Reflect www.relateandreflect.com.au that teaches the relational formulation skills to headspace centres.

And….I am really proud of the book I am editing with Nick Barnes, Honorary Associate Professor at UCL. For this I’m writing a chapter with a young person, Mel, about a relational approach to working with young people with eating disorders. We had so much to say and we think we could fill a whole book. It’s a start to a working friendship that I hope continues.

In the UK there is much concern about the lack of available therapy services for people generally, and young people in particular.  Is there anything you think services here can learn from the Australian experience?

The headspace services have been a great initiative where young people aged 12 to 25 can access services without referral or cost. Professor Pat McGorry has been a tireless advocate for early intervention for youth. headspaces are youth friendly accessible services that don’t just offer counselling but things like vocational support. Often the referral pathways make access difficult for young people and there is a “no wrong door policy” with headspaces.

Because of the huge space of Australia and young people in rural and regional areas we are well prepared in offering ehealth and eheadspace is an exceptional service, well set up before lockdowns of COVID-19. Of course, we have the same difficulties of recruiting and retaining workforce. headspace National and many other CAMHS and CYMHS have early career programs or new graduate programs that perhaps UK have as well? The headspace National one supports hundreds of early career nurses, OT, social workers and psychologists over two years with extra training, supervision and clinical support.

If you’d like to hear more from Lee and build your own skills for working with young people, you can find full details and booking for her day at this link.