Workshops

Presented by: Steve Jefferis, Anna Smith & Attilio Colosi

Abstract

Aims:

·         Reflect critically through group exercises on what CAT has to offer in adult primary care services, and to service users whose needs are not routinely met by them

·         Present the results of two recent studies: a Case Series exploring CAT with people who have not recovered with standard IAPT treatment, and an exploration of the experience of delivering CAT in Primary Care.

CAT is recognized by NHS England as an evidence-based treatment for complex relational problems. Earlier in the pathway, there are many who do not reliably recover from standard Primary Care treatments but do not meet the thresholds for treatment in Secondary Care. Yet there are few recognized treatments to fill the gap.  CAT is in principle a strong candidate here, so this gap is a suitable target for attention in CAT research.

1). Anna Smith’s study “A peaceful pain”: Exploring Cognitive Analytic therapy for individuals with personality and relational difficulties who have not recovered after Improving Access to Psychological Therapy (IAPT) interventions.  This is a multiphase single case design (SCED) study of three post-IAPT clients treated with standard CAT.  Changes on daily measures of relational integration and target problems, reliable and clinically significant change are presented, offering tentative support for the use of 16 session CAT as an alternative treatment in IAPT.

2) Attilio Colosi’s study CAT in primary care: What can be learned from the experience and observations of context, delivery, and outcomes from clinicians?  A model, based on clinicans’ experiences, is offered to theorise the use of CAT in Primary Care. There are three core categories 1) Systemic Landscape, 2) Primary Care Landscape, 3) Delivering CAT. The theory highlights the benefits of CAT in Primary Care, both at a service level and therapeutically for patients. 

Biographies

Steve Jefferis is a CAT Practitioner, Supervisor, Trainer and Clinical Psychologist at Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust.  He is Clinical Lead for the CNTW CAT Service, and CAT Training Lead for the service which delivers the NHS England funded CAT Practitioner training in Newcastle.  Alongside other things, he has long been interested in how to grow the CAT evidence base including the use of routine outcome data.  The work presented here is the first outcome of a workstream exploring how a specialist CAT service might to contribute to the growth of the CAT evidence base.

Anna Smith is a Clinical Psychologist at Sunderland and South Tyneside NHS Foundation Trust

Attilio Colosi is a Clinical Psychologist at Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust.

Using CAT within homelessness, with a particular focus on formulation and consultation rather than direct therapeutic work’
Presented by Cristina Tabacu

Abstract

Biography

‘CAT in a tent and other stories: How CAT is informing our work with rough sleepers in Leeds’

Presented by: Bethan Davies, Erica Milton, Corey Morgan-Forsyth

Abstract

Biographies

Presented by: Prof Stephen Kellett, Dr Benjamin Michael, Ruby Warren and Mathilda Hall

Abstract

This workshop aims to introduce Cognitive Analytic Therapy-Guided Self Help (CAT GSH) as an evidence based, low intensity psychological intervention within NHS Talking Therapies. Drawing on ongoing research and service implementation work, including an ongoing trial in Leeds and Tameside, the session will outline the theoretical rationale for CAT GSH, its structure, approach and its clinical application at Step 2 of TT services.  The step 2 leads will present their experience of implementation.

The workshop will present key findings from CAT GSH research, including the case series completed and the large patient preference randomised control trial comparing CAT GSH with CBT GSH. Particular attention will be paid to the role of expanding patient choice, engagement with recurrent service users, and the relational focus of CAT GSH within a guided self help framework.

By the end of the workshop, participants will:

•             Understand the core structure and principles of CAT GSH and how CAT concepts are adapted to low intensity work

•             Be familiar with the emerging evidence base for CAT GSH, including effectiveness and acceptability outcomes

•             Appreciate how CAT GSH can broaden treatment choice and engagement within Talking Therapies services

•             Reflect on the potential role of CAT GSH within their own service or clinical context

The workshop will begin with a short presentation outlining the development of CAT‑GSH, the research programme, and outcome data from recent project with repeat service users within Leeds and Tameside NHS Talking Therapies. This will be followed by an open Q&A, encouraging discussion, reflection, and questions from participants about clinical application, training, and service implementation.

Biographies

Prof Stephen Kellett

Steve is a Consultant Clinical Psychologist within Rotherham Doncaster and South Humber NHS Foundation Trust, with roles spanning clinical work, supervision, and research. He has a longstanding interest in developing and strengthening the evidence base for Cognitive Analytic Therapy (CAT), particularly within routine NHS settings.

Steve has led a programme of research exploring CAT informed guided self help interventions, including CAT GSH for anxiety and depression within NHS Talking Therapies. His work has focused on treatment acceptability, patient preference, engagement, and clinical outcomes, alongside the practical realities of delivering low intensity psychological interventions. He is a frequent contributor to CAT research, training, and professional forums, and continues to collaborate with services nationally on the development and evaluation of CAT based innovations

Dr Benjamin Michael

Ben is a Clinical Psychologist based within Primary Care Psychological Therapies at Leeds and York Partnership NHS Foundation Trust. He also holds a Service Development and Training Lead role, with a focus on workforce development, supervision, and the implementation of evidence based psychological interventions across primary care settings.

Ben has a particular interest in Cognitive Analytic Therapy (CAT), including its application in brief and low intensity formats, and is actively involved in supporting CAT informed practice within NHS Talking Therapies services. His work includes facilitating training, supervision spaces, and clinical forums, and supporting service innovation that balances accessibility, clinical depth, and relational practice.

Ruby Warren

Ruby Warren is a Clinical Lead within NHS Talking Therapies in Leeds and a qualified Psychological Wellbeing Practitioner. Alongside her clinical leadership role, she is the Principal Investigator for the CAT GSH research project at the Leeds site.

Ruby has a strong interest in the development and improvement of treatment modalities within NHS Talking Therapies, with a particular focus on ensuring that innovations are both evidence based and clinically meaningful within routine services. She is also passionate about staff satisfaction and the importance of supporting practitioners to train in and deliver new therapeutic approaches, recognising this as central to sustainable service development and high quality patient care.

Mathilda Hall (Tilly)

Mathilda Hall (Tilly) is a Clinical Lead within NHS Talking Therapies in Leeds and a qualified Psychological Wellbeing Practitioner. She is the Deputy Investigator for the CAT GSH research project at the Leeds site, working closely with colleagues to support the delivery and evaluation of CAT informed guided self help interventions.

Tilly shares a strong interest in improving treatment modalities within NHS Talking Therapies and is particularly committed to enhancing staff experience through opportunities to train in new and developing therapeutic approaches. Her work reflects a focus on innovation, collaboration, and the practical realities of implementing new models of care within NHS services.

Presented by: Rowan Tinlin-Dixon & Vikki Ball

Abstract

Aim:

Take the participants on a journey from the familiar powerful---powerless reciprocal role of services/lived experience, to a state of empowerment (the ‘empowered healthy island’).

Learning outcomes:

•             Understand more about the exclusion and fragmentation experienced by the gender-diverse community, and how this can also be mirrored for clinicians working in gender services.

•             Understand more about self-system reciprocal roles in relation to intersectionality and all facets of identity (for example, ethnic minorities, neurodiversity etc).

•             Be able to map how power exists within self-self, self-other and self-system reciprocal roles for the gender diverse community.

•             Practice discussing and creating a healthy island, with power, inclusion and social division in mind.

Content:

Explore how the RR powerful---powerless features in trans healthcare. With a focus on the lived experience of trans and gender diverse people, staff working in gender clinics, and at a service and wider society level. For example, the controlling---controlled RR of societal forces (funding/commissioning/policy) that services exist within. Or the fearing/dismissing RR that the trans community experience with the media, which impacts relationships with services and clinicians.

After we share information, lived experience and research related to the above. The workshop will run through these themes in relation to self-self, self-other, self-system, and at each point participants will be invited to map this out live, and consider their own identity, services, clinical practice and how this might influence their therapeutic relationships.

We will then explore together how to move from a powerless position to an empowered state. This will include the generation of a ‘’empowerment island’’ (a healthy island that participants will co-create, alongside stories from our practice and experience working in gender services as CAT practitioners).

Biographies

Vikki Ball

I have been a Specialist Nurse with the Northern Region Gender Development Service for 4 years. Alongside being a qualified nurse, I am also an accredited Cognitive Analytic Practitioner. I believe passionately about inclusion, and equal access to healthcare for marginalised communities. Although my background is in adult nursing, I have spent almost all of my 20-year career working within mental health settings, specifically with those isolated and marginalised from society. The CAT model has been extremely useful in our work with gender diverse and neurodiverse individuals, and specifically helpful in thinking more broadly thinking about the interplay with services and society too.

Rowan Tinlin-Dixon

I am a Clinical Psychologist working in the Northern Region Gender Dysphoria Service, specializing in gender identity and neurodiversity. I am an accredited CAT practitioner and have been involved in researching the applicability and efficacy of CAT.

I have worked in NHS mental health services for ten years and more recently held a clinical academic position which allowed me to fine tune my passion for clinical research and improving access and treatment options for those belonging to an oppressed group or whom are isolated from society.

Presented by Harriet Fletcher & Alex Perry

Abstract

Aims:

•             to share some of our experiences and dilemmas when working in the CAT model with people who are autistic or otherwise neurodivergent (the main focus will be on autism)

•             to facilitate a group discussion on this subject, to reflect together and share insights and learning with each other

Content:

•             we will share a short presentation (approx. 20-25 minutes) covering a brief update about understandings of neurodevelopmental conditions in mental health services (including different ideas about the relationship between trauma and neurodivergence). We will then share a case example and some reflections about the challenges for psychotherapists in general and CAT therapists in particular, based on our own experience, as well as about ways in which CAT is well suited to this work, and insights which can be brought in from other therapeutic models

•             We will facilitate small group and wider group discussion about the issues raised

•             In terms of the themes of the conference, we will have a particular focus on neurodivergent people as a social minority who suffer exclusion and disempowerment, thinking about how CAT can offer therapy which is sensitive to this context and how as CAT therapists we can be mindful of our power and positionality when working with a neurodivergent client

Format:

•             this will be an interactive workshop with at least half of the time spent in discussion, first in pairs/small groups and then in the wider group

Learning outcomes:

•             for participants to have the opportunity to explore their assumptions and learning needs and gain insights from others in the group

Biographies

Harriet Fletcher is a consultant psychiatrist in psychotherapy in NHS mental health services in Leeds.  She is a CAT practitioner and also has training in psychodynamic psychotherapy and in DBT.  She has additional training as a psychiatrist in working with neurodevelopmental conditions and has an interest in working therapeutically with neurodivergent people as well as with people who may have been given a label of personality disorder.

Alex Perry is a consultant clinical psychologist and CAT practitioner in Leeds.  He leads a service providing psychological therapy for people who may fall into the gap between NHS Talking Therapy services and Community Mental Health Teams.  A significant proportion of the people accessing the service are neurodivergent and have frequently come to this understandingldiagnosis later in their life.

Presented by: Kate Reilly, Steve Potter & Katy Woodward

Abstract

•             Introductions and how we came to create this workshop and participants expectations

•             Overview of the societal issues that are leading people to seek solace in ‘big ideas’, and the fallout when we get over-attached to our ideas, overvalue them to the point that they become over inflated and fragile and cannot see beyond them to the extent that they become divisive and depleting. (Narcissism in Ideas Chapter 12, Talking with a Map, Potter 2022).

•             Rebecca’s Solnit’s (2020; 2025) writing to think through the dangers of “deference to intolerance”

•             Revisit the conflict of ideas between Hannah Arendt and Eric Fromm as they seek a philosophy strong enough to face up to authoritarianism and fascism in the wake of WW2.

•             Illustrations of current societal issues that are simultaneously personal and political

•             Experiential exercises individually and in small groups noticing, naming and negotiating contrasting attachments to different ideas . Exploring how we might tell a “fortified story” about how opinions differ and seek common ground with those we disagree with. What practical steps might open this up to “push where it moves”?

•             Reflection on how these issues come into the therapy room, affect our emotions and the debate around whether-or-not when we engage with identity we also engage with ‘ideology’ and politics.

•             The workshop will be interactive, and participants will go away with CAT informed ideas about how to work with narcissism in ideas as part of personal, professional or societal and political ideologies.  

Biographies

Kate Reilly is a Clinical Psychologist and CAT Therapist working in HIV Services in the North East of England; a role which constantly prompts reflections on intersectionality, power and privilege. She is passionate about using CAT to get alongside people struggling with HIV stigma and trauma.

Steve Potter is a CAT psychotherapist (UKCP) life member of ACAT and past chair of ACAT and ICATA.  He is a trainer and supervisor and the author of three books on CAT www.mapandtalk.com

Katy Woodward is a Consultant Clinical Psychologist and CAT therapist working for Newcastle-upon-Tyne Hospitals. She takes a Human Rights approach and has an interest in working with marginalised communities such as refugees. She is also passionate about engaging with the climate and ecological crisis.

Presented by: Nargis Islam & Rhona Brown

Abstract

Therapeutic work is always shaped by context: history, culture, power, and difference. This workshop draws on Cognitive Analytic Therapy’s relational and dialogic foundations to explore how therapists and clients navigate difference that involves structural inequality, marginalised experience, and epistemic harms. The workshop will introduce the concept of epistemic harm as applied to CAT theory and process.

Drawing on Bakhtin's dialogic model of selfhood, we consider how internalised 'voices', shaped by social positioning, privilege, and marginalisation, emerge in the therapeutic relationship. We discuss how epistemic harm can arise across individual clinical practice and organisational systems, even within empathic, technically sound CAT work, inadvertently displacing social-historical meaning and leaving clients with misrecognition, shame, or withdrawal. Explicitly noting that not all voices carry equal authority, the workshop explores what happens when a client's knowledge or experience is heard but not believed or actively dismissed or rendered invisible within the dominant clinical framework. We consider how epistemic harm operates not primarily through individual therapist bias, but through the reproduction of broader social and institutional hierarchies within the clinical encounter; here understood as systemic as well as an individual account of epistemic injustice (Fricker, 2007; Islam, 2026, in prep). The workshop explores with participants how such issues might be considered when working with recognition, enactments, repair, and contextually grounded reformulation.

Aims & Learning Outcomes

•             Deepen understanding of the dialogical social self and how epistemic authority is distributed within the therapeutic relationship.

•             Develop familiarity with epistemic harm as a concept applied to CAT theory and process.

•             Recognise how systemic epistemic hierarchies may reproduce themselves within clinical practice.

•             Identify clinical signals through which epistemic harm may manifest in the therapeutic relationship.

•             Explore the therapist's own positioning within social and epistemic structures, and its implications for practice.

Format & Participant Interaction

This workshop is interactive throughout. It includes some didactic input, a clinical vignette, a mapping exercise, and structured reflective discussion. Participants are invited to draw on their own practice experience. No prior knowledge of epistemic theory is assumed.

Biographies

Dr Nargis Islam

Nargis Islam is a Consultant Clinical Psychologist, CAT Practitioner, and Clinical Lead for Inpatient Psychological Therapies (Buckinghamshire) at Oxford Health NHS Foundation Trust. She has held Clinical Psychology Doctorate tutor posts at the Universities of Lancaster, East London, and Oxford, also supervising research primarily on social inequality.  Since 2014, Nargis has worked in Development and Humanitarian settings on mental health, workforce planning, and practitioner training, including a 2019 publication on transnational belonging and the mental health of displaced communities.  With a focus on systems processes, her approach is shaped by CAT's relational framework, applied to power, hierarchy, and inequality, particularly within academia, health organisations, and the wider public sector. Nargis chaired the BPS Accreditation Committee for Training in Clinical Psychology (2021–2025), recently completed an MSc in Global Healthcare Leadership at the University of Oxford, and is a Council Member and EDI Lead for PPN-SE. She works with senior NHS Leaders on inclusive systems and organisational transformation and delivers training on working with difference to trainees and qualified staff.

Rhona Brown

Rhona Brown is a CAT Practitioner and Supervisor with a core training in clinical psychology. She recently left a 40 year career in the NHS, the majority of that time spent working clinically in the north west of England.  Her interest in inequality issues grew particularly from working within Manchester’s many diverse communities. CAT as a model continues to support her in the ongoing process of exploring, understanding and responding to the complexities that inequalities bring to us all.  She has published a number of related articles and chapters, including ‘CAT and Social Context’ in the Oxford Handbook of Cognitive Analytic Therapy. Within ACAT, Rhona has worked towards enhancing public engagement and CAT, and with its Equality & Diversity Committee.   She also works with Catalyse in the north west, contributing to training and other activities.

Presented by: Julie Lloyd & Lorraine Welch

Abstract

•             To empower us as clinicians to push back against the increasingly regressive political commentary leaking into society and negatively influencing our lives.

•             To brainstorm real‑life exits to the problem of EDI initiatives and strategies in organisations feeling piecemeal, and to explore how the response of partakers can become performative or virtue‑signalling.

•             To acknowledge the felt danger experienced by affected people in response to the rise of harmful, exclusionary, and fascist‑leaning ideologies.

•             To come up with real‑life exits that can make discussions about inequality within organisations feel less overwhelming, less irrelevant, and more genuinely productive.

Biographies

Julie Lloyd CAT Practitioner & Supervisor and Clinical Psychologist, past Reformulation co-editor, and  co-editor of ‘CAT for People with Intellectual Disabilities and their Carers’ and ‘CAT and the Politics of Mental Health’, now in independent practice after 40 years in the NHS. 

Lorraine Welch is a Cognitive Analytic Therapist and supervisor in the NHS where she also co-runs a reflective space for therapists to explore culture-related themes in client work. She is trained in EMDR and is qualified in MBT, with a background in community and forensic mental health nursing.

Her work and writing is deeply informed by issues of difference, belonging, identity, relational trauma, intersectionality, enactments and inequity in therapeutic relationships, and the wider historical, social and cultural contexts that shape them. She is an active member of the ACAT Equality and Diversity Committee.

Presented by Mel Moss

Abstract

To allow participants to explore a conflict situation and use CAT approaches to understand the experiences of different parties. Using the materials to find a way to defuse one's own emotional reaction to the context and maintain a stance of 'principled impartiality'

The programme is supported by the World Council of Churches and works in parallel with the UN taking strong steps to avoid any bias or accusations of anti semitism.

Biography

In 2025 I undertook a placement as a human rights monitor in the Occupied West Bank (Palestine/Israel) using the international model of protective presence in humanitarian work.   This involves taking an independent approach of 'principled impartiality' and acting in accordance with international human rights law and humanitarian law by recording and documenting incidents and standing in solidarity with vulnerable groups as a protective presence.

Much of the training for peace workers focuses on Marshall Rosenberg's model of Non-Violent communication emphasizing identifying one's feelings and associated needs and expressing them in a non-confrontational/non-judgmental manner.  This is a very helpful approach to avoid escalating tensions and is adopted by the UN as a model.

As a CAT practitioner I had the opportunity to work with my team and look at the reciprocal roles amongst the different parties in the situation and to try and help us understand the connections between the feelings and motivations of different groups involved in the situation.   Sadly, many of those involved were young people (children and adolescents) but this made it easier to identify with the various groupings

‘Adapting the Five Session Cognitive Analytic Consultancy Model in a Community Learning Disability Service’

Presented by Dr Luke Yates & Dr Anna Sampson

Abstract

Many people with learning disabilities (LD) experience multiple traumatic events and psychological distress. In addition, people with LD often rely on others to support them with daily living and functioning skills. Therefore, many of the difficulties experienced by people with LD can be understood through an interpersonal lens. Cognitive Analytic Therapy (CAT) is being adapted for people with LD to help service users formulate how their distress is maintained through dysfunctional interpersonal patterns, and then ideally share this formulation with their care team. Cognitive Analytic Consultation (CAC) uses CAT principles to generate this formulation with a service user within five sessions. This workshop aims to discuss how this model was adapted people with LD within a community LD service.

We can discuss two case examples of how CAC was used with people with LD and guide attendees thought the exercises used in the CAC model. We aim to show how CAC can be a useful model of input for people with LD and requires further research into.

Biographies

Dr Luke Yates- I am a recently qualified Clinical Psychologist, working in the Rotherham Community Learning disability Team. I have been interested in working with people with LD since being an assistance psychologist and throughout my training. My main passions are making psychology therapy/resources available for people with LD, especially CAT, and improving research in this area.

Dr Anna Sampson- I am a Principal Clinical Psychologist and a Lead for the Psychological Professions (East Locality) for Working Age Adults at LYPFT. My diverse clinical background informs a formulation-led, relational approach to therapy, consultation, and systemic leadership. As a Cognitive Analytic Therapy (CAT) Practitioner, I integrate this framework across all domains, from individual interventions to managing complex team systems and supervisory relationships. I am passionate about offering neuro-affirmative practice and adapting the CAT model for under-served communities facing complex trauma and health inequalities. With over 20 years of experience working with people with learning disabilities and neurodiverse needs, I am particularly inspired to develop adaptations to CAT interventions for this marginalised group, ensuring therapy is accessible and inclusive for all.

and

‘Mapping Climate Distress: A CAT-Based Workshop Using the Climate and Ecological Emergency Booklet’

Presented by Jackie Edwards

Abstract

The climate and ecological emergency (CEE) evokes distress that is often difficult to name, share, or work with — both for clients and for therapists themselves. This experiential workshop introduces the CAT Climate and Ecological Emergency Booklet, based on the original psychotherapy file, a practical tool for recognising the procedural patterns that maintain disconnection from climate reality. The booklet maps climate-specific vicious circles / traps (e.g., the Avoidance Loop, the Burnout Spiral, the Purity Trap), dilemmas that polarise engagement (e.g., “focus obsessively on climate” vs. “avoid the topic entirely”), and relational conflicts where climate distress meets everyday life — in relationships, across generations, and between values and behaviour. It also identifies common “odd reactions” — moments where climate conversations suddenly derail through scapegoating, whataboutism, or defensive optimism — and considers the psychological functions these serve.

In the workshop, participants will work with the booklet material in small groups. First, we map our own patterns: which vicious circles, dilemmas, and odd reactions do we recognize in ourselves as practitioners? Second, we explore relational exits — the booklet’s proposed movements from, for example, paralyzing guilt toward activating responsibility, or from crushing shame toward a sense of adequacy. Third, we reflect on what it means to use CAT tools when the distress is not only intrapsychic but ecological and shared. The workshop is designed for clinicians, trainees, and anyone curious about how CAT’s procedural thinking applies to the climate crisis. No prior experience with climate psychology is needed — only a willingness to stay with difficult feelings. Grounding practices are built into the session structure. The booklet has been developed within the ICATA CEE Special Interest Group and is available in English and Finnish. A chapter is also currently being edited for inclusion in The Cambridge Handbook of Psychology and the Planet: Environment, Climate, Sustainability and Nature

Biography

Dr Jackie Edwards is a Chartered Clinical Psychologist with more than 25 years of experience working in the NHS with adults, couples and families with complex psychological and mental health issues. Jackie has post graduate training in CAT, DBT and EMDR. She is currently working in private practice, specialising in work with complex trauma & dissociation. A particular area of interest is in working with women who are engaged with the Family Court System. She also works as a Specialist Clinical Psychotherapist with the Clinic for Dissociative Studies (CDS UK), a national charitable organisation which provides long term psychotherapy funded by the NHS for people with Dissociative Identity Disorder (DID). Jackie is a CAT practitioner and accredited senior supervisor and is currently the interim chair of the ACAT ethics committee.

Presented by Chiara Sacco & Nargis Islam

Abstract

Inpatient wards are not neutral spaces: they are informed and influenced by social and institutional hierarchies, professional power differentials and the inequalities that staff and patients carry in from the wider social world. This workshop will explore the relationship between staff attitudes towards reflective practice within inpatient settings and the development of reciprocal role procedures (RRPs) within teams, drawing on Cognitive Analytic Therapy (CAT) principles.

The workshop will consider how staff engagement, or disengagement, with reflective spaces shapes relational dynamics within teams and how these are subsequently enacted in staff–patient interactions. Inpatient settings can generate polarised relational positions, which become enacted across staff and patient groups alike. Particular attention is given to transference and countertransference processes, and how these are influenced not only by individual clinicians but also by team culture and systemic factors.

A central aim of the workshop is to create an interactive and reflective space in which participants can actively engage with these ideas. Following a brief theoretical overview, attendees will take part in experiential exercises and group discussions using anonymised clinical scenarios, inviting reflection on their own team contexts. Participants will be encouraged to consider how professional roles and personal characteristics shape engagement with CAT maps and formulations, how they may position themselves differently in relation to reciprocal roles, and how these dominant relational patterns influence both team functioning and staff–patient interactions.

Aims:

To engage with and apply CAT theories of how staff attitudes towards reflective practice influence team relational patterns and patient care.

To apply CAT concepts, including reciprocal roles, polarisation, and systemic enactment, to the dynamics of inpatient teams

To explore how professional roles, seniority, and social position shape relational positioning.

To critically examine how team relational patterns and power dynamics are enacted in staff–patient relationships, with attention to transference and countertransference.

To consider how inequality and polarisation from the wider social world – including race, class, and institutional power – enter the ward and shape both staff and patient experience

Biographies

Chiara Sacco

Chiara Sacco is a Senior Psychologist working in acute inpatient services at Oxford Health NHS Foundation Trust. She trained in Malta and brings extensive experience across a range of clinical settings, particularly in CAMHS community and inpatient services. She is trained in Cognitive Analytic Therapy (CAT) and is currently undertaking IRRAPT training, reflecting her ongoing commitment to developing integrative, relational approaches to psychological care. She is particularly passionate about CAT and its application within complex, high-intensity settings. Her clinical approach is shaped by CAT and dialogic perspectives, with a focus on how language, relationships, and wider societal structures shape and at times constrain the narratives around patient care. She is interested in how these narratives influence both patient experiences and staff practices, particularly within acute and inpatient contexts. Chiara is also engaged in thinking about how systemic pressures within healthcare can limit opportunities for creative, innovative, and individualised care, and is committed to exploring ways to maintain relationally-informed, person-centred approaches within these constraints

Dr Nargis Islam

Nargis Islam is a Consultant Clinical Psychologist, CAT Practitioner, and Clinical Lead for Inpatient Psychological Therapies (Buckinghamshire) at Oxford Health NHS Foundation Trust, previously having worked in AMH community settings, and in CAMHS. Alongside her clinical work, Nargis has held Clinical Psychology Doctorate tutor posts at the Universities of Oxford, East London, and Lancaster, also supervising research on social inequality. Since 2014, Nargis has worked in Development and Humanitarian settings on mental health, workforce planning, and practitioner training, including a 2019 CAT informed publication on delivering mental health services to displaced communities. Her approach is grounded in CAT's relational and dialogic framework to analyse how power, hierarchy, and inequality operate and how they are sustained within social institutions and systems. Nargis chaired the BPS Accreditation Committee for Training in Clinical Psychology (2021–2025), and is a Council Member and EDI Lead for PPN-SE. She works with Senior NHS Leaders on inclusive systems and organisational transformation, drawing on CAT's relational theories to support more equitable and effective ways of working

‘The political uncertainty within healthcare: Can CAT help to navigate Organisational and System change?’

Presented by Dr Raj Dhanjal & Dr Sophie O‘Connor

Abstract

Aims

•             To reflect on the experiences and dilemmas surrounding Organisational Change, applying the CAT model to make sense of these experiences

•             To facilitate a group discussion and reflections on mapping organizational change, considering the roles systems, teams and individuals (peer, leader, manager, colleague etc) may occupy

•             To support colleagues and teams to consider ways to best support employees in such processes (exits)

Content:

We will share a short presentation considering organizational change and the learning from working in staff wellbeing hubs. Within this, we will consider the MSSM and its application in such situations.

We will share our own experiences of the ‘change of management process’ and with this the key dilemmas and traps that were experienced using CAT as an anchoring framework

We will share a Reformulation letter written to the NHS / system and a CAT map that reflects the narrative

We will consider the exits used to enable healing from organizational hurt and pain. 

Format:

•             This will be an interactive workshop with time to spend on small group discussions

For participants to have the opportunity to understand and gain insight into the impact of change management process for employees, teams and systems.    

Biographies

Dr Raj Dhanjal: Is a Principal Clinical Psychologist and CAT Practitioner. She has a long history of working in complex trauma services using CAT in teams, groups and individually. More recently she took up a systems leadership role within the West Yorkshire Staff Mental Health and Wellbeing Hub. Within this role she was keen to understand how CAT can be used to consider the dilemmas that arise within leadership where power and inequity arise. 

Dr Sophie O’Connor is a Consultant Clinical Psychologist and CAT Practitioner. Sophie’s clinical background has been working in both inpatient and community adult mental health services before moving into a staff psychology role within an Occupational Health service in 2020. Since this time Sophie’s work has primarily focused supporting health and care staff at the individual, team and system level. 

and

‘Enhancing Compassion and Reducing Burnout in Support Staff: Contextual CAT Training and Reflective Practice in Residential Care’

Presented by Dr Christine Omar, Dr Zahra Ahmed, Joseph Onyia, Princewill Obeni, Maisie Hawes and Niamh Somodi-Spence

Abstract

Support staff in residential services for children and adults with "challenging behaviour" face significant pressures from systemic power dynamics, risk, and organisational demands, which shape everyday practice. This workshop aims to show that burnout and compassion fatigue are not just individual stress reactions but arise from complex relational and systemic factors. It presents findings from a mixed-methods evaluation comparing a contextual Cognitive Analytic Therapy (CAT) training and reflective practice model with a resilience-focused programme and invites participants to learn how CAT can improve staff wellbeing and promote safer relational practice.

In the evaluation, staff attended either a two-day contextual CAT training with monthly CAT-informed reflective sessions, or a resilience-based training with parallel reflective spaces. Quantitative measures (Maslach Burnout Inventory and Professional Quality of Life Scale) showed no significant pre–post changes in burnout or professional quality of life between groups. However, qualitative analysis of staff interviews revealed seven themes: healthier boundaries; enhanced compassion and empathy; organisational culture and power; self-care as a protective factor; and the emotional containment and validation provided by CAT-informed sessions. Anonymised staff quotations and a brief fictional vignette will illustrate how reciprocal role mapping and CAT-based formulations help staff recognise and avoid patterns that risk repeating experiences of neglect, criticism, or abandonment for service users.

This workshop will present concise research findings and introduce the contextual CAT framework, followed by practical mapping exercises and a group debrief using a vignette. The session is designed to equip participants with a clear understanding of how to view burnout through relational and systemic CAT concepts, and to provide concrete strategies for implementing CAT-informed reflective practice to enhance staff wellbeing and reduce harm in residential and similar environments.

Biography

Dr Christine Omar is a Clinical Psychologist and CAT practitioner working within Tees‑Valley Care’s clinical team, with extensive experience supporting staff in residential services for children and adults who present with complex relational needs and behaviours described as challenging. She has led the development and delivery of contextual CAT‑informed training and reflective practice within the service, with a particular focus on staff wellbeing, relational safety and organisational culture.

The workshop draws on work undertaken by the wider Tees‑Valley Care clinical team who co‑designed, delivered and evaluated the training and reflective practice model presented. Together, the team contributed to the design, coordination and analysis of the mixed‑methods evaluation informing this workshop.

Presented by Rachel Akande & Susie Black

Abstract

CAT was developed as a model drawing upon analytic thinking within the confines of NHS provision.  We notice that, for many therapists, working in the NHS has become too hard.  It feels as though we are leaving in droves. We are curious about this.

The presenters will share experiences and explore psychological growth that has followed difficult work experiences.  We would like to unpick the concept of resilience that might cause us to form hardened hearts and thus reduce our capacity to open ourselves to the distress that our patients and our colleagues carry with them.  We are curious about how we can be strong enough to feel, then recognise and use our observations to promote change.  Or do we just need to “get out” of the toxic situation we find ourselves in – what happens when it’s too much? How do we make decisions about this? What helps us to survive and learn?

The format of the workshop will include some reflections by the presenters which we hope will be thought provoking and stimulate discussion in small groups/dyads.  Participants will be invited to reflect upon how they experience the current climate/context that they are operating in.  What feels difficult and what strategies are available to exceed survival and move into thriving.

Biographies

Rachel and Susie are two thirds of the CAT Cymru team, based in South Wales.  They organise and host the South Wales CAT practitioner course, are experienced CAT supervisors and trainers.  Their experiences include posts in clinical and physical health, mental health, across the age range from Adult to Older Persons services.

They were part of the hosting team for the 2024 CAT conference in Swansea.  During that conference they participated in a reflective piece around their experiences of working in difficult environments.  2 years on, things have changed.  Both have found “looking back” and talking about what happened reparative and a learning opportunity.