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Objective: This paper describes the development and summarizes the content of a competence framework for delivery of cognitive analytic therapy (CAT). Design: The framework was developed using the evidence‐based method developed by Roth and Pilling (2008, Behavioural and Cognitive Psychotherapy, 36, 129). Methods: A review of the CAT outcome literature identified where CAT interventions had evidence of efficacy. Standard texts on CAT were primary sources for details of theory and practice. This process was supported by an expert reference group (ERG). The role of the ERG was to provide professional advice on areas where the evidence base was lacking, but where CAT interventions were commonly used by therapists trained in the model. Results: A framework was produced and structured in terms of core knowledge, core skills, and meta‐competences (which require therapeutic judgement rather than simple adherence to a treatment protocol). Conclusions: The framework enables trainees, service users, service managers, and commissioners to better understand a) the core features of CAT and b) what competences need to be in place for CAT to be skilfully delivered in practice. Practitioner points: It is possible to define the core competences of CAT.Whilst generic competences are important, there are five CAT‐specific domains of competence.The CAT‐specific competences reflect the three‐phase structure of the therapy: reformulation, recognition, and revision. [ABSTRACT FROM AUTHOR]

Graduate employment rates and self‐reported employability are increasingly a feature of higher education funding measures. However, graduate outcomes do not denote the whole learning experience of the student nor is the student experience reducible to a single statistic. This paper discusses a design‐centric approach to employability development which was enacted within a hybrid learning space. The study engaged 52 final‐year speech pathology students, their lecturer, the lead researcher and a career practitioner (advisor) at an Australian university. Students first created personalized employability profiles using an established online self‐reflection tool. The online tool produced a personalized report and enabled students to access developmental resources relating to employability and student success. The project team used anonymized student data to transform a previously generic "careers" workshop into a targeted workshop in which students explored individual and cohort findings and participated in developmental activities informed by the data. The initiative's contribution to learning space research is in its composition as a hybrid learning space in which educators and students engaged as learners and developers of their online learning spaces, and educators collaborated to analyze student data and inform learning and teaching enhancements within the same study period. It is anticipated that the data from subsequent years will inform the curricular review, particularly if subsequent student cohorts express similar concerns. Implications for higher education policy and practice are discussed. [ABSTRACT FROM AUTHOR]

The economic, social and cultural contributions of the creative industries are essential elements of many societies and their governments' policies. However, there is growing evidence that precarity, competition and lack of regulation within these industries is exacerbating inequalities with respect to gender, race and class. With a focus on gender and sexual harassment among female workers, this study involved 32 in-depth interviews with women working in the Netherlands' creative industries. Data were analyzed using content analysis. Findings suggest that sexual harassment is prevalent, and many women considered it to be part of their occupational culture and career advancement. Four factors influenced this phenomenon: competition for work; industry culture; gendered power relations; and the importance of informal networks. Implications include the need for a climate of non-tolerance, sector-specific research and guidelines, sensitivity training and further work with unions and professional associations to provide worker protection strategies traditionally undertaken by organizations. The article concludes that effective sexual harassment prevention requires action at the individual, educational, sectoral and governmental levels, beginning with public conversations to convey the message that sexual harassment is never acceptable. [ABSTRACT FROM AUTHOR]

This study sought to examine the competency of cognitive analytic therapy (CAT) delivered under routine care conditions and to identify the effectiveness of CAT for patients with borderline personality disorder (BPD). Ten cognitive analytic therapists in six National Health Service Trust sites treated 19 patients with BPD using the standard CAT BPD contract of 24 sessions plus four follow-ups. The methodology was small N repeated measures deign, with patients interviewed at the third follow-up session using the Change Interview. Results indicate a high treatment and follow-up compliance rate (89.47%). Significant reductions in psychological distress, risk and dissociation over the time course of the CAT occurred, with a significant increase in personality integration. Most sessions (92.85%) were delivered in a competent manner. Reductions to psychological distress occurred early in treatment and were sustained, whereas increases in personality integration typically occurred later on in treatment. Patients tended to attribute change to the therapy received. Benchmarking against extant CAT BPD evidence notes a moderate effect size across routine care and trial contexts. The results are discussed in terms of identified methodological shortcomings, clinical implications and the contribution made by the CAT model to the treatment of BPD. Copyright © 2011 John Wiley & Sons, Ltd. Key Practitioner Message Narrative and diagrammatic reformulation in CAT offers the opportunity for early and effective engagement and potential symptomatic change in patients with BPD., It is possible to measure outcomes on a session-by-session manner with patients with BPD., Assessing fidelity to the treatment model is useful in practice-based studies. [ABSTRACT FROM AUTHOR]

Background. Alliance ruptures and premature drop out from psychotherapy are very common with patients who have a diagnosis of borderline personality disorder, limiting the clinical effectiveness of treatment. Aim. To test and refine a model of how therapists successfully resolve threats to the therapeutic alliance involving enactment of problematic relationship patterns in the cognitive analytic therapy of borderline personality disorder. Method. Task analysis (Greenberg, 1984a) of 107 enactments from 66 sessions in four good outcome cases, compared with 35 enactments from 16 sessions in two poor outcome cases. This systematically compares a rational model of process with empirically coded transcripts of therapy sessions where independent raters have identified an alliance threat event. Results. The process stages of the rational model were observed, and 20 refinements were made, including a new process stage, heuristic principles and 'when--then' steps. Therapists were found to cycle between stages. Therapists in good outcome cases recognized the majority of these enactments and focused attention to them in contrast to poor outcome cases where therapists usually failed to notice or draw attention to the alliance threat and did not adhere to the model. Conclusion. Competent resolution of alliance-threatening events is crucially dependent on therapists' ability to recognize them, and secondarily on their adherence to the principles in the refined model. The model is consistent with prior research and can be used in supervision and quality improvement strategies. [ABSTRACT FROM AUTHOR]

Patients with Borderline Personality Disorder are prone to switch between contrasting states in ways that are confusing to themselves and others. The Multiple Self States Model provides an explanation of this. Based on this model, a method of guided patient self-reflection is described, which can contribute to the recognition and characterization of the individual patient's array of contrasting states and provide a guide to treatment and management. A case example is provided, illustrating the understandings derived from the procedure. Copyright © 2004 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Twelve patients with borderline personality disorder (BPD) completed the States Description Procedure (SDP). The descriptions applied by these patients to the ten states named on the form are reported. The findings support the Multiple Self States Model of BPD and indicate how the phenomenology of BPD may be further studied using this approach. It is suggested that the diagnosis and case management of borderline patients need to incorporate these structural understandings. As a result of the study a modified form of the procedure (SDP(R)) is proposed. Copyright © 2005 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]