Reflections on the Relational Skills in CAT Supervision Residential Training

Teresa Greenfield, 2016. Reflections on the Relational Skills in CAT Supervision Residential Training. Reformulation, Winter, pp.39-40.

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CAT supervision training has several components. Following the completion of the minimum requirements, (two years post qualification as a CAT practitioner and the completion of 16 CAT cases), therapists may begin the process which leads to supervisor accreditation. Traditionally, therapists have sat in with a senior supervisor for a period of at least six months prior to starting the second stage of the process, which involves starting their own supervision group with a senior supervisor. The residential supervision course is an intensive training which can be used either as an alternative to the sitting in period, (useful in areas where the availability of senior supervisors may be sparse), or, ideally, as an additional component. What follows is a description of my experiences of attending the course in February 2015 with trainers Steve Potter and Jane Stephens at Holland House in Worcestershire.

Following completion of the 2009 Brighton practitioner training course, as an OT in an adult mental health community setting I was able to offer a limited CAT therapy service. However, owing to time restrictions within my somewhat generic role, I have always felt a tension between the need to focus on the core activities of my job description and a desire to utilise my CAT training to the full. I therefore embarked on the course with slightly mixed feelings, with doubts relating to the commonly felt position of CAT practitioners in non-psychological therapy roles. The key issue for me lay within in the expectations inherent in such roles, which tend to include large case loads, extremely limited time for reflection and an assumption of some care co-ordinator capacity, with its implicit ‘available in a crisis’ subtext. The CAT supervisor is a practice based teacher, a role which is hard to perform well from the ‘jack of all trades’ position inhabited by most band 6 allied health professionals; I felt uncertain of my readiness to become a supervisor. However, anticipating the usual enrichment which comes from within the CAT community at every CAT event, I felt sure that I would learn something anyway, and I arrived at Holland House keen to enjoy the experience.

The venue, a retreat and conference centre set in beautiful surroundings, was itself a treat. Holland House is run on principles of mutual respect and reciprocal trust, with no locked rooms, shared meals and honesty boxes for payment of additional extras. This facilitative environment complemented the relational training perfectly, and the feeling of being well nurtured helped all of the course participants to maintain a constantly intensive level for two and a half days. The course content matched this sense of plenty, with a packed programme combining the opportunity to experience the relational processes of supervision with a deepening understanding of CAT theory. The teaching utilised CAT tools to the full, with lots of ‘map and talk’ exercises and letter writing punctuated by brief formal teaching sessions highlighting relevant theory. These moments felt a bit like the arrows on a diagram, and were essential in helping us to make meaningful connections between our described supervisory experiences and the CAT ideas underpinning them. However, the most memorable learning came from our experiences of each other within the small group exercises. We were able to consider our own particular CAT styles, practice speed supervision through mapping, explore difficult moments in supervision and reflect on our own part in the process.

For myself, I noticed that my propensity to assume that others are more qualified and knowledgeable can lead to me standing back too readily, risking a withholding procedure. The same assumption can also lead to me being overly striving and spoon feeding supervisees information, potentially inhabiting a rescuing role in an attempt to prove my worth. Whilst I do believe that there is much to be gained by developing supervisory skills under the watchful eye of a more senior supervisor, in these groups it is sometimes hard to eliminate the implicit hierarchy in the room, which can be a barrier to taking an effective lead. The residential course provides a unique opportunity to practice within a group of equal standing, and the key skills of knowing how and when to intervene to support the learning of another person can develop more effectively.

Over all, I came away from the course with a feeling of greatly deepened knowledge, and a greater awareness of my own strengths and limitations. Most obviously, I gained the clearer understanding which comes from the chance to totally immerse oneself in a particular subject for a short space of time, and I cannot imagine this being possible in a non-residential setting. The course demanded the same skills inherent in any CAT therapy, namely the ability to enter fully into an intense experience and remain present in the moment, whilst holding in mind the need to disengage and prepare for an ending after a brief time together. As professionals, we are working collaboratively with our clients, gradually shifting the balance from a starting position of expertise to an end point where the client is able to take up the baton themselves and be their own therapist. The residential supervision course is achieving something similar; by combining the knowledge and skills of the trainers with the wealth of experience within the course participants, it facilitates a level of confidence within each person to enable them to proceed to the next stage.

With this in mind, and with a great deal of support and encouragement from senior CAT colleagues, soon after completing the course I decided to embark on the second stage of training and set up my own supervision group. The group has now been running for almost a year, and so far has included junior doctors and a psychotherapy trainee. I have found this to be an enormously enjoyable experience, and apart from meeting a local need for more supervision, a great source of learning for myself. I have discovered the truth in the old adage that the best way to learn something is to teach it, and enjoyed the reciprocal benefits inherent in all relational groups where the learning is shared, and everyone, supervisor and supervisees alike, can discover something new. I have also become more involved in supporting the Brighton CAT practitioner training course as a tutor and marker. I would strongly encourage any prospective CAT supervisors, (especially those whose core profession is outside of the typical psychological therapies), to take the plunge and apply for training. In many areas there is a chronic shortage of available supervisors, and, whilst many junior doctors are seeking CBT training, CAT can give them a much deeper understanding of the relational formation of the person which is universally applicable in every role.
I have now applied for supervisor accreditation, and would compare the supervisor training process to that of learning to drive. With the accumulation of all past CAT learning, (the theory test), and a good number of lessons from a well- qualified instructor, (my senior supervisor and the trainers on the supervision course), I was able to practice with my L plates on and finally felt competent enough to apply for my licence . I still feel like a relative novice, but I believe that I will continue to develop as a supervisor throughout the journey ahead and, whilst I am happy to be at the wheel, I look forward to many fellow CAT passengers enriching my journey.
Acknowledgements
I would like to thank Dr Jane Blunden for encouraging me to train as a supervisor, Steve Potter and Jane Stevens for providing an excellent training course and all of the course participants from whom I learnt so much. Most importantly, I would also like to mention my first CAT supervisor Christine Mckenna for providing the original nurturing environment, and my subsequent senior supervisor Val Coumont for enabling my further development.
Teresa Greenfield,
OT and CAT Practitioner,
Crawley and Horsham Assessment and Treatment Service
Sussex Partnership NHS Foundation Trust

Full Reference

Teresa Greenfield, 2016. Reflections on the Relational Skills in CAT Supervision Residential Training. Reformulation, Winter, pp.39-40.

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Reflections on the Relational Skills in CAT Supervision Residential Training

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