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Training in CAT || Appendix 1

Supervised Clinical Practice as part of CAT Training

It is important to note that all trainees undertaking accredited training courses must be supervised by a supervisor who is both accredited by ACAT and a current member of ACAT.  For training at Foundation, Practitioner and Psychotherapist level supervision is 15 minutes minimum per client per week for all training cases. Trainees on the Psychotherapy level training must be supervised by an accredited supervisor who is also a CAT Psychotherapist. CATs preferred model is face to face group supervision but circumstances will arise when a group may not be possible for a part of trainee’s training and we explore alternative arrangements. Supervision appraisals are conducted individually.

Most trainees are employed by NHS or statutory organisations, they have access to their own caseload of clients through their workplace. The course helps trainees to organise their own locally based supervision with an ACAT accredited supervisor. Supervision may be accessed through their own workplace if the supervisor is employed in their own organisation; through a clinical placement where trainees see patients from within a NHS Trust or other statutory service in exchange for skilled supervision and the additional experience of being a member of that therapeutic team. Normally this does not involve any direct financial cost to the trainee. In the absence of these arrangements a trainee will need to fund supervision for their training cases. Psychotherapy course trainees may also be seeing patients privately and therefore setting up their own supervisory arrangement with an Accredited CAT supervisor who meets the course requirements.

Reports of the trainees’ clinical practice and use of supervision would usually be completed with each trainee at six monthly intervals by the supervisor.  This will allow the trainee an opportunity to make changes where the supervisor identifies areas for development.  The reports will include the supervisee’s self-evaluation and a report by the supervisor.  The supervisor’s report is carried out in discussion with the trainee and includes evaluation against the core CAT competencies. 

Can clinical practise prior to CAT training be counted?

CAT Practitioner trainees can in principle 'count' a maximum of two CAT cases as part of the eight cases needed for training as Accreditation of Prior Learning (APL). This decision is made on an individual basis towards the end of CAT Practitioner training as it depends if a trainee is on track in terms of their learning and development on the course to meet the competences of CAT practitioner. It is usual that one or two cases are accepted but occasionally a course may suggest that a trainee takes new cases or a trainee may choose to if they are progressing quickly and can see the advantages of doing 8 training cases over the two years. Consequently, we adopt a flexible position. Applicants for training sometimes ask their supervisor to ‘sign off’ a case on the ACAT accreditation form so they have a record but this is not a necessity. These cases need to be supervised by an accredited supervisor and meet all the requirements of a training case.  

Training and supervision conducted remotely

The use of distance technology assisted supervision and training (TAST) was well-embedded in the CAT world prior to March 2020 (Covid-19) and these methods facilitated the development of international trainings. However, CAT training until 2019 had largely been conducted in person. All training cases were conducted in person and supervision was only conducted remotely if trainees had limited access to an accredited supervisor due to location, distance, travel time and to support access to supervisors in specialisms.

The ACAT Training Committee has started to explore TAST. We recognised that there were advantages, for example it encourages positive diversity and equality of access for those who would be at a disadvantage to access training and supervision (e.g. rural locations, physical disability); it assists with the real pressures that trainees face regarding long commutes for weekly face-to-face supervision; and it allows access to a wider range of supervisors, across a variety of specialties, without geographical barriers. However, there were also concerns regarding TAST. Can it maintain the integrity of the relational CAT model for training and supervision? Are supervisors confident to offer online supervision and/or have sufficient understanding of the specific issues that working online involves? And there are security, confidentiality and data protection issues.

Although TAST was growing, the ACAT Training Committee took the view that in-person supervision and group supervision were the recommended format for learning a therapy (i.e. for the training cases). For situations where this is not possible then TAST would be considered for some (but not all) training cases. This would be considered in consultation with Couse Directors on a case-by-case basis. ACAT intended to advise members of information and guidance on TAST, continue to keep abreast of developments, remain open to TAST, and develop knowledge of the safest systems. We would provide information on practical issues to consider when setting up TAST supervision, and a Special Interest Group was established to share learning and support members in this area.    

Since March 2020 all aspects of CAT training have been conducted remotely: teaching, therapies, supervision and seminars. Written work has included reflections on working remotely. ACAT remains flexible in responding to this situation and our future training will include blended learning.   

Revised December 2020

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