Applying Cognitive Analytic Therapy (CAT) to Inform Reflective Practice within Secure Children’s Services: A Grounded Theory Study of Cognitive Analytic Reflective Practice (CARP)

Objectives: The SECURE STAIRS framework has been mandated into the children and young people’s secure estate to establish reflective and trauma-informed services, but little research has been attempted on process or outcome. This research therefore sought to explore the application of cognitive analytic therapy to reflective practice groups (CARP). Methods: Twenty-four staff members, working within four staff teams, within a secure children’s home (SCH) participated in the research. Each staff team attended four CARP sessions, over a one year period (N=16). Grounded theory (GT) was used to guide data collection and analysis. At the point of saturation, a total of eight CARP sessions were analysed; two per staff team. Four focus groups were conducted as part of the theoretical sampling, using semi-structured questions informed by the constructed GT categories. Further theoretical sampling of sessional measures, exploring self-reported group cohesion and helpfulness of CARP, were also used to confirm theoretical saturation. Results: A GT model of CARP processes was constructed from the data. Three main interrelated categories were constructed from the analysis: ‘establishing a reflective space’, ‘widening awareness of the self, other, and system’ and ‘changing relational dynamics and finding exits’. The constructed categories and subcategories were supported by sessional measures, indicating that group members found CARP sessions helpful and groups became more cohesive over time. Conclusions: The findings suggest that CARP provides a model of reflective practice which facilitates reflective processes for staff. The GT model highlighted the relational nature of reflection in CARP and indicated that these processes were linked to enhanced group cohesion.