Training in CAT || Appendix 2

Personal Development and Personal Therapy as part of CAT Training

As CAT is a relational approach, the way therapeutic work impinges on and requires the use of self and self-reflection is a core element of CAT training. This is explored in the experiential elements of the training days and in supervision.

At all levels of CAT training we make a commitment to personal development in order to manage our own selves (roles and procedures) so that personal difficulties are not enacted unhelpfully with our service users in the working environment or on the course. This requires developing the capacity for self-reflection, responsiveness to feedback from the supervisor and fellow trainees and consolidating flexible self-management skills. We use the CAT concepts (e.g. Reciprocal Roles RR) for personal reflection with experiential exercises throughout the components of the training (teaching days and supervision) and explore our RRs in relation to the course, to learning and our work roles. Trainees are encouraged to keep a learning log and help each other in self-understanding and in specific more personal learning opportunities.

At the psychotherapist training level, experiential learning is central.  During each residential meeting, and in the seminar groups there are structured experiential exercises relevant to the focus of the module carefully facilitated by the trainers. As this training is residentially based it offers learning opportunities that are less easy to access during a single study day. The dynamics of the groups and interactions between members of the course all offer rich material for personal development and the application of CAT thinking.

In addition, at each level of training there is a personal therapy component. At CAT Skills Case Management and Foundation level this involves a brief ‘personal reformulation’ experience as described below;  at CAT Practitioner level this is a 16 session CAT;  at Psychotherapist level trainees will be expected to commit to an ongoing programme of personal psychotherapy throughout the two years of the training.

CAT Skills and Foundation Courses: Personal Reformulation (PR)

Course members are not required to complete a full 16 session CAT personal therapy but the course involves a brief 'personal reformulation' experience.  The aim of this is to offer participants the opportunity to explore with a CAT therapist, ideally from out of area, what it is ‘they bring to work’.  The starting point for this experience is often through reflecting upon the use of self in relation to a clinical case or scenario.  It gives participants not only some flavour of what it is like ‘at the receiving end’, but also shows that work in this area of mental health inevitably involves personal reactions and requires an openness to discussion of these issues in supervision.  It is stressed that this is not therapy but simply an opportunity to explore these issues in confidence.

The concept of the personal reformulation experience is now relatively well developed and focuses upon the shared mapping out of patterns, roles and coping strategies that have most bearing on professional practice.  This cognitive analytic approach can help monitor difficulties and opportunities in working relationships.  The format will typically be one of two forms

  1. An extended single session of 2.5 hours with an introductory hour or so of exploration and discussion, based ideally on completion of the psychotherapy file, followed by a break and then an attempt at and/or a brief written reformulation.
  2. A two hour session with a follow-up session at an agreed interval.

Trainees are of course welcome to arrange additional follow-up meetings beyond that funded by the course fee.

Therapists providing the personal reformulation are familiar with the aims and methods of the course and CAT personal reformulation approach.    

It should be emphasised that this is an optional component of the overall package but is a necessary requirement for those wishing to obtain the ACAT skills or foundation accreditation.

Details about Personal Reformulation for Personal and Professional Development will be provided by the course at the start of training.  Alternatively ACAT members can click into ACAT 'Training Resources' (under 'Training' on a personal home page) to access the downloadable document or  please click here 

Please note: Although personal CAT therapy (16 sessions) is not a requirement of the CAT Foundation course / Certificate in CAT Skills, this is mandatory for further CAT training.  We would encourage any trainee who wishes to arrange for personal therapy at this stage of their training. In addition, Foundation course trainees who intend to proceed to year 2 to complete training as a CAT Practitioner would be encouraged to do a 16 session CAT in place of their PR, although of course they can choose to do both. 

CAT Practitioner Course: 16 session CAT

At the CAT Practitioner level, the ACAT requirement is that a standard 16 session CAT training therapy (with one follow-up session three months later) must take place before a trainee can be accredited. This should be conducted by an accredited CAT therapist.

CAT Psychotherapy Training:

All trainees will be expected to commit to an ongoing programme of personal psychotherapy throughout the two years of the training.  This must include a further experience of time limited CAT at some point within the two years.  Trainees are also expected to seek additional experiences of personal psychotherapy during the two years which reflect the integrative nature of CAT and their personal interests and developmental needs.  Personal psychotherapists are expected to be registered with UKCP or an equivalent psychotherapy accreditation body. 

APL Route in CAT Training

Reference should be made to the practitioner and psychotherapy guidelines.  It is recognised that trainees may already have had previous experience of other forms of psychotherapy or may be already engaged in personal psychotherapy and this will be taken into account when discussing individual programmes for self-development with the portfolio tutor.

Confidentiality of PRs and Personal Therapy

The confidentiality of the trainee's personal relationship with their personal therapist will be respected at all times and other than the submission by the trainee of a signed Completion of Therapy form no formal or informal communication about the trainee will take place between the course staff and the trainees’ personal therapist. 

In the extremely unlikely event that the therapist has a major concern about the suitability of a practitioner to practice clinically then they will be expected to break confidentiality and alert the Course Director.  Good practice suggests that they would discuss this with the Practitioner beforehand. 

Accessing Therapists

For Practitioner and Psychotherapy training it is ultimately a trainee's responsibility to set up arrangements for their personal therapy. A list of accredited CAT therapists and psychotherapists practicing privately can be found on the ACAT website.  Some courses provide additional listings of therapists who are willing to offer training therapy, but are not otherwise listed on the website as private therapists. In addition trainees already have contacts within the wider CAT community which they share with each other when approached. Sometimes trainees may have to travel long distances for their personal therapy. If they are encountering particular difficulties in setting up their therapy they are encouraged to discuss with their course director. 

For Skills and Foundation training, lists of personal therapists, offering the ‘personal reformulation experience’ in relation to these courses are commonly provided. Therapists will often come from out of area, in order to ensure that they do not encounter the trainee in any other work or social setting.

Personal Therapy as part of Training

There may be issues uniquely pertaining to training therapy, e.g. the need for special attention to boundaries and to the possibility of seeing one’s therapist in a professional context.  But an overstated concept of a ‘training’ therapy as a different thing to an ordinary therapy could collude with a wish as trainee CAT therapists to ‘disown’ or deny the wounded, ‘ill’, damaged or unassimilated parts of ourselves. Addressing one’s own unmet needs, difficult feelings or damaging/-ed reciprocal role procedures, and therefore one’s potential for re-enactments, and tackling them honestly, fully and without restrictions in therapy, as a ‘patient’, is therefore seen as a core part of psychotherapy training. This may paradoxically pose a particular challenge for professional therapists who could feel that they should be mentally healthier and more ‘together’ than their patients/client. We have some guidance about some of the particular issues for the trainee and the therapist providing training therapy which is available to ACAT members. 

 

Revised February 2019; updated March 2020

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33rd October 2024
CAT Introductory Event: Two Day Introduction to CAT - offered by Norfolk & Suffolk NHS FT
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