Editorial

Julie Lloyd and Rachel Pollard, 2013. Editorial. Reformulation, Winter, p.3.


This 41st edition of Reformulation offers accounts of CAT work that fall into three main themes. The first theme is about teaching CAT and, in true reciprocal role fashion, the first of two articles describe CAT’s educational work and the second about what it is like to learn. Jenny Marshall, Kate Freshwater and Steve Potter describe undertaking a CAT skills certificated course within the forensic mental health service in which delivering an accredited skills course posed numerous challenges. Louise Johnson, a trainee clinical psychologist reflects on her experiencing of learning by doing, from first hearing the term ‘CAT’ ‘What on earth is CAT?!’ to undertaking a first case under supervision.

This 41st edition of Reformulation offers accounts of CAT work that fall into three main themes. The first theme is about teaching CAT and, in true reciprocal role fashion, the first of two articles describe CAT’s educational work and the second about what it is like to learn. Jenny Marshall, Kate Freshwater and Steve Potter describe undertaking a CAT skills certificated course within the forensic mental health service in which delivering an accredited skills course posed numerous challenges. Louise Johnson, a trainee clinical psychologist refThe second theme is found in four articles exploring CAT’s systemic approach. We start with an account by Mel Moss and Claire Tanner who apply CAT as a model for development of leadership skills in psychiatry. Clinical leadership and management skills are a core part of psychiatry and psychology training. Indeed one of us was asked yesterday in her NHS job to fill in a form about how ‘compelling a vision’ she delivers; a vague, fuzzy phrase which is hard to quantify. The paper by Moss and Tanner offers a useful reflective account in which they used CAT to explore styles of leadership and their implications for psychiatrists. Next we present an article by Angela Carradice who describes her work with staff caring for clients who experience complex difficulties at a level where they would not benefit from individual psychotherapy in the community. Her paper describes ‘Five Session CAT’ consultancy as a method to work jointly with mental health workers and their clients to map the team’s understanding of clients’ current difficulties and patterns of coping, which is then used to guide care planning. Lorna Gray describes her reflections of her experience working in an extremely pressurised and under-resourced Adult Community Mental Health Team in the NHS, specifically about how the struggle to experience and tolerate ‘disappointments’ seemed to be being enacted in the behaviours and responses of staff in the CMHT, resulting in what could be termed as a pathological relational system.

This 41st edition of Reformulation offers accounts of CAT work that fall into three main themes. The first theme is about teaching CAT and, in true reciprocal role fashion, the first of two articles describe CAT’s educational work and the second about what it is like to learn. Jenny Marshall, Kate Freshwater and Steve Potter describe undertaking a CAT skills certificated course within the forensic mental health service in which delivering an accredited skills course posed numerous challenges. Louise Johnson, a trainee clinical psychologist refThe second theme is found in four articles exploring CAT’s systemic approach. We start with an account by Mel Moss and Claire Tanner who apply CAT as a model for development of leadership skills in psychiatry. Clinical leadership and management skills are a core part of psychiatry and psychology training. Indeed one of us was asked yesterday in her NHS job to fill in a form about how ‘compelling a vision’ she delivers; a vague, fuzzy phrase which is hard to quantify. The paper by Moss and Tanner offers a useful reflective account in which they used CAT to explore styles of leadership and their implications for psychiatrists. Next we present an article by Angela Carradice who describes her work with staff caring for clients who experience complex difficulties at a level where they would not benefit from individual psychotherapy in the community. Her paper describes ‘Five Session CAT’ consultancy as a method to work jointly with mental health workers and their clients to map the team’s understanding of clients’ current difficulties and patterns of coping, which is then used to guide care planning. Lorna Gray describes her reflections of her experience working in an extremely pressurised and under-resourced Adult Community Mental Health Team in the NHS, specifically about how the struggle to experience and tolerate ‘disMaggie Gray with additional comments by Maria Falzon: describes a ‘Hard-to-Help’ course using CAT’s reciprocal roles to aid reflection. Working in a multidisciplinary team means striving to develop a common language to talk with staff about interpersonal difficulties and the different interpretations of the patient’s behaviour. They comment on how they approach the team’s dilemma between treating patients as suffering from an illness or responding to what they see as manipulative behaviour.

he third theme in this edition offers examples of CAT practice. Alison Jenaway describes how she finds a developmental explanation of reciprocal roles very useful when talking to parents with psychological difficulties of their own. John Mulhall, in his paper on CAT with groups of adolescents within an inpatient psychiatric setting, reflects on his experience of working when it can be hard to achieve collaboration in the usual CAT sense. Peter Spencer offers a research paper in a study in which there were many CAT participants. Using an experimental task derived from therapy materials, this study examines the strength of intuitive and deliberative modes of processing for three groups representing different levels of psychotherapy expertise. Jayne Finch considers CAT’s scientifically and theoretically based view of the universal importance of intersubjectivity and social relatedness and how mindfulness can be used to enhance our understanding of this.

Our aim as editors is to continue to encourage the high standard of articles submitted to this and recent issues of Reformulation and we are pleased to announce that from the next edition onwards, this journal will be peer reviewed. This is an exciting development, which we think will help Reformulation to reflect a wider number of voices. We have established an editorial board and will send out each submission for peer review by two reviewers. Ideally, we would like to have each article reviewed by one reviewer who is familiar with the scope of the article and one for whom the topic is novel. This does mean that we have had to shorten the submission time for the next edition, because the peer review process will take more time.

Jason Hepple’s letter and the photo comments from Marie-Anne Bernardy-Arbuz offer a flavour of the recent international CAT conference in Malaga and how difficult and varied socio-economic contexts impact on people’s psychological well-being. The conference was also a marvellous opportunity to discover more about the differences and similarities in people’s lives and working practices across the CAT community. The 16+1 interview with Carlos Mirapeix in Spain offered an interesting example of how we can make cultural assumptions, as the interviewer had not realised that her question about a ‘desert island luxury’ was a British metaphor!

Our next edition will be a special edition on disability in its various forms. Included in this definition of ‘disability’, are all aspects of the reciprocal roles and therapeutic process that can Our next edition will be a special edition on disability in its various forms. Included in this definition of ‘disability’, are all aspects of the reciprocal roles and therapeutic process that can act as roadblocks, including when the therapist is disabled by their own lack of knowledge, understanding or experience. We invite you to offer articles, poems, letters, art works or other reflections by Friday March 7th 2014. Act as roadblocks, including when the therapist is disabled by their own lack of knowledge, understanding or experience. We invite you to offer articles, poems, letters, art works or other reflections by Friday March 7th 2014.

Full Reference

Julie Lloyd and Rachel Pollard, 2013. Editorial. Reformulation, Winter, p.3.

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