Mary Dunn, 2005. ACAT Chair's AGM Report. Reformulation, Autumn, pp.34-35.
This year in ACAT has been characterised by a Council who seek to think creatively about the future development and growth of this organisation. I think we may be unique in that we do not operate in a commercial context. Our values are squarely grounded in the NHS, and, at the moment we function as a voluntary body with a paid administrator and a contracted Website administrator. We are fortunate in having a small office in St Thomasâ€™s, and we gain in many ways from this position. However our rate of growth is exponential, and we have a grave responsibility both to find a way of meeting the needs of many more members, but also to ensure that the role of the Administrator is sustainable.
Council began the year by organising an Away-day in comfortable surroundings in central London. We find our Council meetings are very time-constrained with a packed business agenda, and we felt the need to give ourselves a greater expanse of time to brainstorm and free-wheel a little! We allowed ourselves to dream, to use metaphors to describe our function, to claim the ACAT house-style as â€˜free of grandiosityâ€™ â€“ democratic â€“ open â€“ relatingâ€™. We even fantasised an East Enders plot-line involving a CAT! We challenged ourselves to think outside of the box about where therapy might be going, and how therapists might seek to be supported, accredited and regulated in the future.
My report will outline the results of all this creativity, which has probably not fulfilled all of its promises, but which is set on a path, which we outlined on that day. I would like to thank members of Council who are so challenging and collaborative in their creative thinking. I have great confidence that, with this level of competence at our disposal we will move forward steadily.
In analysing our structural development, I realise that we have evolved from a star shape, in which the centre of the star would have been a â€˜Queen Beeâ€™ kind of administrator, who, alongside Council, would have had a finger on all pulses - to something of a â€˜netâ€™ shape, where each node of the net represents a locally-based, responsive, appropriate, supportive structure to regional trainings. With the help of images of the star and the net, we can see how there will be tension between centralising and localizing â€“ I think the Roman Empire may have suffered the same tension! In our case, CAT North has led the way in becoming a strong and effective organisation with its own funds and lines of accountability. Council are assessing those functions which are best conducted from the centre and those best localized, so that we stay relevant - with a â€˜net-shapeâ€™ which is stretchy but not so stretched that it is likely to fragment and tear. The more decentralized we become, the more we need to be clear about the shape of the infrastructure, which will best strengthen autonomous aspects of the regions of the organisation. ACAT â€˜branchesâ€™, such as CAT North, remain the responsibility of ACAT with regard to training standards, accreditation and complaints. Increasingly, we find we must be clear about costs and liability for regional conferences, and we need to be sure that the CAT model is being maintained in a dynamic but recognisable form. These structural issues become acutely important when we begin to look at the wider political environment in which statutory regulation is the next agenda item, and where â€˜integrativeâ€™ could become the word which causes distinct therapy models to disappear altogether. Council are in the process of debating possible changes to our Constitution to update it and clarify the roles and responsibilities of ACAT and its developing regional settings. It is important that we hear from our membership on their experience of the organisation, both centrally and locally.
Structural issues within the NHS leads me to evidence-base and our credibility within the NHS. The â€˜evidence-based practiceâ€™ mantra needs to be superseded by â€˜practice-based evidenceâ€™ in which all our work is evaluated, rather than a contrived sub-set of our work. ACAT are very fortunate in having the opportunity of pioneering the use of CORE as an on-line measure across the whole organisation. In order to set up a Practice Research Network (PRN), we have funded a feasibility study which is being carried out by Glenys Parry, assisted by David Saxon, a Research Associate and a project team; myself, Steve Potter and Jon Sloper.
Professor Parry will present the results of the feasibility study at the CAT Conference in March. We are the first national therapy organisation to test the web-based version of CORE, which should provide us as therapists with immediate feedback on therapy progress, as well as aggregated, anonymised data which will show CATâ€™s effectiveness in different settings. A PRN dataset would also support ACAT membersâ€™ research interests. The feasibility study will test the viability, acceptability, usefulness and value-for-money of this technology, beginning in a small number of centres (Manchester, Sheffield, London & Yeovil, and possibly IRRAPT).
The aim is to supplement existing research (e.g. randomised trials or intensive single case replications) with a large dataset of evidence from routine practice. Our aims are that the CAT model should be nationally recognised as effective, and that we, as an organisation, have information to support our membersâ€™ training, research and practice needs. Members will hear a great deal more about PRN as we move towards hearing the results of the feasibility study and then taking a decision about setting it up, to involve as many people as possible.
As we read the tea-leaves about the future of therapy, and the form is which we can best prepare ourselves, we are keen to create a financial structure which will allow the different arms of the organisation to work within a clear budget and with clear financial objectives. We are trying to rationalize the work of our Administrator. To this end we will be announcing in Reformulation a time of day when he can be contacted, in order to allow him the rest of the day uninterrupted by the telephone. In addition, our accounting package, (which is called Quick Books), calls for time and concentration which he increasingly does not have. We are considering outsourcing the day to day financial/accounting work, which may allow us to dispense with a separate Auditor. We also hope that this will be part of our gradual move towards re-applying for Charitable status. By next year we hope to have set a budget with subdivisions earmarked for Training, Conferences, Events and Research, and with greater clarity about criteria for eligibility in applying for funds. The Practice Research Network will require an unknown amount for running costs when the feasibility study is complete. Since our view is that this is core business for us, we are beginning to seek both external and internal funding in anticipation. We are very grateful to Michael Knight for his devoted work in this field which requires so much skill and forethought, as well as dedicated time and commitment.
This yearâ€™s Conference was a great success, introducing some of the hot topics of the wider world of therapy, and seeking to evaluate them from a CAT perspective. Great thanks are due to Miranda Buckley and Jonathan for their very expert conference organisation. This was followed by a lecture day in September. Two eminent speakers were given a session each, and we greatly enjoyed the expansiveness of time in which they could speak in depth and be questioned at leisure. John Bristow has made it possible for high-quality events to be maintained for our members, and we are certainly fortunate to benefit from his enthusiasm and hard work. ACAT has maintained regular and interesting events for the Continued Professional Development of its members, and we hope to involve even more people in the provision of these days, so that an interactive community of dialoguing therapists is supported.
In December we met with the UKCP assessors for the HIPS Quinquennial Review. It was a fascinating process, and Debbie Pickvance, as Chair of Training, put in a great deal of work to provide them with the information they needed about our trainings. The Course Directors, in particular Hilary Beard, presented their trainings and their students very creatively and fully, and all of this took many hours of devoted work, for which we are very grateful. The process benefited us, both at the preparation stage and in the conversation and feedback. Heward Wilkinson and Richard Cleminson were very complimentary about both our model and our organisation. Apparently we are the fastest growing therapy organisation and they were very keen for us to â€˜punch our weightâ€™ within UKCP. They highlighted a number of minor points that we should think about, in particular with regard to our dual qualification (practitioner/Psychotherapist). However, there was nothing that they felt they needed to insist on changing. ACAT is very grateful to Debbie Pickvance for the highly professional nature of the Training Committee. Its agenda is always very long; it contains representatives of each of the trainings, and its meetings are awesome to organise. Liz Fawkes, as Chair of Exam Board, has contributed many woman-hours to ironing-out some of the wrinkles in the accreditation system, as well as archiving all our graduateâ€™s details. We are tremendously grateful to her. Sally Gray is now Chair of Supervisor Training. I would like to thank her, as well as Sally-Anne Ennis, who has taken over as Chair of Accredited Prior Learning (APL). Many thanks are also due to Claire Tanner who has valiantly held responsibility for APL. As UKCP moves towards a different way of grouping the therapies in order to better fit the Governmentâ€™s regulation agenda, our representatives, Michael Knight and Cynthia Pollard are deeply involved in the struggles which characterise that organisation. We are very grateful to them for all the work they do to maintain our presence within UKCP, but also a great deal of work within the mechanisms of UKCP itself. I will be attending the UKCP Chairâ€™s Day at the beginning of December and Council will try to stay abreast of the complex political issues which will certainly affect our members in the future.
I am immensely grateful to Jonathan, to Eva Burns Lundgren and to Steve Potter for the support they have given me in this first year as Chair of ACAT. It is a privilege to be involved in such a professional and dynamic organisation with so much potential and energy, and I genuinely enjoy the creativity of its atmosphere, and I hope I have conveyed to you something of the activity and style of life within Council. The ongoing health of ACAT depends upon a regular turn-over of its membership willing to become involved in Council, and I will be delighted to hear from anybody who thinks they might value the experience.
Chair of ACAT :: November 2005
Developing New Systems for ACAT Administration and Communication
Sloper, J., 2002. Developing New Systems for ACAT Administration and Communication. Reformulation, Autumn, pp.31-33.
CAT and the Cultural Formation of a Case of Anorexia Nervosa: An Italian Case Study
Cristina Fiorani and Marisa Poggioli, 2005. CAT and the Cultural Formation of a Case of Anorexia Nervosa: An Italian Case Study. Reformulation, Autumn, pp.13-17.
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