Letter from the Chair of ACAT

Jason Hepple, 2013. Letter from the Chair of ACAT. Reformulation, Winter, p.5.


As we approach another winter I just want to mark that it has been a hard year for many members of ACAT. I am aware of several redundancies and service re-configurations that have made it very difficult for people to hold on to the work that they do and to feel valued and supported. For many this has been a very distressing experience; who is there to contain us when we are feeling anxious and uncertain? In our work with complex clients it is ourselves who are expected to and need to be able to contain fear and anxiety. It is at these times that we have to look to each other and find new ways of getting the support and care that we need in order to continue with our work.

CAT has always been a strong and supportive community – it is the main reason that I was drawn towards it at the beginning of my career when other roads offered themselves up for exploration, and I have never been disappointed. At the conference in March there was a lot of mutual support and care offered but also the chance to acknowledge our fear and even paranoia and feelings of helplessness in the face of such big changes in the systems in which we work. I hope that Tony Ryle’s recorded message to us gave some direction to our battles. He was clear that we need to be organised, stick together and write and publish accounts of what we are doing, what good things have been lost and to share ways of adapting and moving forward.

I have just come back from the ICATA conference in Malaga, which was hosted brilliantly by the Spanish association, and have a real sense of a wider, international community, that are all ‘talking the same language’ and have shared values about the importance of relationships and dialogue. For once the UK was not the major delegation with the Finns outnumbering us. There were also sizeable groups from Italy, Greece, Australia and Ireland and people representing CAT in India, Nigeria, Chile, France and Palestine. In hearing how CAT is surviving in some countries more affected by the economic crisis than the UK, it was striking that when the going gets really tough, CAT is often in the best position to adapt and provide ‘something’ when money is very tight and therapies have to be shortened and more focussed. This was particularly the case for our colleagues in Italy and Greece. The progress in training coming from the Indian association and the determination of one doctor from Nigeria to get things going there was quite inspirational.

I had been asked to reformulate the ‘European Crisis’, which I did by trying to unpack some of the political language, both new and old, that has been used to describe events since 2009. I was able to draft a map and delegates added exits to a poster version of this which I hope to feed back on soon so that those of you who were not there can add your voices to this too. As we left the conference centre for a meal out we encountered a group of protesters in the middle of Malaga led by one of the newly named ‘yayoflautas’ or ‘old flutes’ – protesting elders determined to have their voice heard. Thank you to Annie Nehmad for translating that the protest was indeed about the crisis, pensions and the behaviour of the banks.

In the UK we do have some ‘reasons to be cheerful’. CAT is now accepted in the IAPT personality disorder stream of Serious Mental Illnesses (SMI) and, following a very constructive training committee away day with an excellent new chair, Anna Jellema, we are debating how to make CAT training accessible to IAPT and to other groups of professionals without ‘throwing the baby away with the bath water’. In 2014 CAT will be thirty years old and to mark this Tony Ryle is contributing to a paper commissioned by the Royal College journal ‘Advances in Psychiatric Treatment’, which looks at the ethos and history behind CAT, the current evidence base and the way ahead in the UK. We hope to celebrate CAT’s birthday at the next ACAT conference to be held right at the beginning of July in Liverpool – probably at Hope University – which is as good a name for a venue as any!

I look forward to seeing many of you again at this event if not before, and wish you all a peaceful Christmas and New Year in the meantime.

Full Reference

Jason Hepple, 2013. Letter from the Chair of ACAT. Reformulation, Winter, p.5.

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