Category Archives: CAT through others

The COVID Struggles List

Many cognitive analytic therapists use CAT ideas as part of reflective practice, to help support staff groups and teams. This might involve a regular meeting of staff on a ward or similar service setting. Team members can share how the work they are doing impacts on them and how well they are working together. They may reflect on the care they are offering patients or residents. Having space to think is an essential component of providing good quality care. So this kind of reflective space can also be useful to improve care where things have gone wrong.

During the COVID 19 pandemic many staff working in mental health and other health settings had to cope with enormous changes to the way they work. In response to these challenges, Steve Jefferis, the CAT service lead for Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust, developed a tool to help staff in his Trust reflect on their impact. He called it the “COVID Struggles List“.

In the video below, Steve outlines why and how he developed the COVID Struggles List. He also shares the results of an evaluation of its use over 2020. Steve was presenting his findings to other ACAT members at an online meeting in September 2020. He is happy to share his talk here as one example of CAT reflective practice. You can also see tweets about it under the hashtag #COVIDStrugglesList

The List has been revised since it was first developed. Steve notes the support of the North East & North Cumbria Staff Wellbeing Hub in helping him update it. You can download a copy of the latest version below:

Also you can read more about this work on the CNTW website at

Thanks go to Steve Jefferis for his contributions to this page and all original materials relating to the COVID Struggles List.

The COVID Struggles List Blog by ACAT Public Engagement Team is licensed under CC BY-SA 4.0

You may also be interested to read how CAT ideas were used elsewhere to help understand and respond to the impact of the COVID 19 pandemic on NHS staff. Read a blog from Sara Casado of Kent and Medway NHS and Social Care Partnership Trust at this link –