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90 Minute Workshop Series

5 Session CAT Care Planning and Complex Trauma: Staying off the map and promoting helpful relationships


Mental health services can repeat problematic relational patterns and cause further harm to people who have experienced trauma. 5 Session CAT Care Planning is an approach that aims to minimise this. From the model of Cognitive Analytic Therapy, this “here and now” intervention is used to help develop the relational thinking of mental health services and guide treatment/care planning for service users. A CAT therapist meets with the service user and their key staff member (usually over 5 sessions) with the aim of creating a joint understanding of both problematic patterns of relating and healthy parts of self. This is done via a jointly created CAT “map” or diagram and then “exits” or ways out of problematic patterns are agreed.

The approach is usually offered when there are difficulties in the relationship between staff and the service user, and/or when the staff might be feeling stuck as to the best way to help. The difficulties, therefore, are considered as within the care dyad relationship rather than located “within the service user”, with the aim of reducing the likelihood of services repeating damaging relational patterns.

Although not exclusively developed for people who dissociate, the approach is often used with people who have complex difficulties (they may be struggling with intense emotional states, dissociation, self-harm, and unable to tolerate talking therapy) and struggle with a sense of integration of self as a result of early trauma.

Within our workshop we will share examples of this way of working, both from a community mental health team and an inpatient Forensic setting. We will also share results from our recent evaluation of the approach, with interview feedback from service users.  We hope to have a Service user present with us.


Dr Kate Freshwater, Consultant Clinical Psychologist.

Kate Freshwater has worked as a Psychologist in mental health services for over 30 years. She is passionate about the utility of CAT – both as a collaborative, side-by-side way of working within individual therapy, as well as the accessibility of the model in helping staff and organisations to reflect and step out of problematic relational patterns.

Dr Jayne Finch, Highly Specialist Clinical Psychologist.

Jayne Finch works as a psychologist and CAT practitioner in a busy community based affective disorders team. Within her role she utilises CAT in different ways to promote relational awareness and therapeutic change for those with lived experience of trauma. 

Dr Lauren Moon, Principle Clinical Psychologist. TEWV NHS Foundation Trust.

Lauren Moon works as a psychologist and CAT practitioner with the Forensic Mental Health Service. She also has an interest in the use of CAT as a consultancy model with staff teams, as well as working individually with clients to understand the role of their offending and trauma history within a relational model.