The SWIM & FLOAT Model

A framework for change that lasts.

SWIM & FLOAT is the clinical framework our team uses to prepare for, support and integrate significant therapeutic experiences, so that moments of insight become lasting patterns rather than passing ones.

What the model is

A structure for the part of therapy that usually goes unheld.

Many people, in the course of good therapy, arrive at an experience that genuinely moves them: a session where something long defended finally gives way, where grief is felt rather than managed, where the shape of a pattern becomes visible for the first time. These experiences matter. They also fade, unless something is built around them.

SWIM & FLOAT is our answer to that problem. It is not a therapy in itself and it is not a product you can buy. It is a clinical framework: a defined sequence of preparation, support and integration that our clinicians work within whenever a piece of therapeutic work is likely to be significant.

The framework has two movements. SWIM is the active work, supported and held by skilled clinicians. FLOAT is the receptive movement that runs alongside it: rest, renewal, and the willingness to stop gripping, so that what is ready to change is allowed to. Neither works well without the other, and the second is the one most often left out.

"Our whole purpose is to turn moments of insight into lived wellbeing."

In plain terms

  • It is a framework, not a treatmentIt shapes how care is sequenced and supported. The treatment itself remains whatever your care plan says it is.
  • It applies across our servicesPsychotherapy, group work, immersive therapies and extended programs are all delivered within it where a significant experience is anticipated.
  • It was built hereDeveloped by Karuna's clinical team from clinical practice and the research literature, and refined against our own outcome data.
  • It is clinician-led throughoutA treating clinician holds responsibility for care at every stage, including the parts that happen between sessions.
  • You do not have to ask for itIf it is relevant to your care, your clinician will explain how it applies to you before anything begins.
The two movements

Learn to Navigate the Map. Be Held by the Territory.

The names are deliberate. Swimming is active and needs someone watching the water. Floating asks for something different: less effort, more trust, and a willingness to be held while what is ready to change does its own work.

SWIMThe supported experience

The therapeutic experience itself, actively held by skilled clinicians, so that you can go further than you safely could alone.

SWIM covers the work of the session and everything that makes that session possible: careful screening, a clear understanding of what may arise, an agreed plan for how it will be met, and a clinician whose whole attention is on you while it happens.

The value of skilled holding is that it changes what a person can afford to feel. When someone knows resources they can invite, trusts that the clinician will be steady, and that there is a plan for the difficult part, they can approach material with a deliberate mindset and skillset.

  • Screening and suitabilityPhysical health, history, medication and risk, reviewed before anything begins
  • PreparationShared understanding of the intention, the process, and resources to support what may be difficult
  • Learning that carries into lifeContinuous presence and support in session and through online learning portals to support self-practice
  • A defined transitionEvery session ends deliberately, with orientation and a plan for the hours after. Supported by online learning, complementary supports and embodied practice

FLOATThe receptive movement

Learn to Rest and Renew: the receptive movement within SWIM & FLOAT, where effort softens and what is ready to change is allowed to.

FLOAT is the receptive movement within SWIM & FLOAT. It helps a person recognise when to use their skills, and when the impulse to manage, interpret or improve has itself become the obstacle.

To FLOAT is to Feel what is present. Let go of what no longer needs to be held. Open into the space that remains. Rest in Awareness. And allow what is ready to Transcend, to move beyond its old form and become something new.

This is not passivity. It is responsive effortlessness: present without grasping, open without becoming unmoored, and trusting enough to let experience reveal its own movement.

  • Feeling what is presentMeeting sensation, emotion and need without rushing to change them
  • Letting effort softenReleasing the grip that control, resistance and analysis can become
  • Opening into spaceRoom for a new perspective, and for what has not yet found words
  • Rest and renewalBeing held rather than working, so that what is ready can move

The two movements are one piece of work. We do not offer SWIM without FLOAT. Where someone cannot commit to the integration stage of care, or where circumstances make it impossible to support properly, we will say so before beginning rather than afterwards. That is a clinical position, and it is the reason the framework exists at all.

Why SWIM & FLOAT

Oceanic boundlessness.

People reach for the language of the ocean when they try to describe a therapeutic experience that genuinely moved them: a sense of scale, of connection, of something long held finally giving way.

The ocean is not only calm. Beneath a bright surface there are unfamiliar depths, strong currents, waves of feeling, the undertow of personal history and the wider tides of grief we all carry. There is real beauty and real healing in this water. There is also water a person can find themselves out of their depth in, which is precisely why the work is structured and held rather than left to chance.

Oceanic boundlessness is a dimension of deep experience described in the research literature (Dittrich, 1998).

There is vast beauty in the ocean of experience. And a person can find themselves out of their depth.

This is where SWIM begins.

SSomatic
WWisdom
IInterdependence
MMetacognition

Four frames of knowledge and practice: staying connected to the body, meeting intensity without being swept along by it, staying in relationship while it happens, and making meaning afterwards with care.

The four frames of SWIM

They are currents in the same water, and a clinician supports each person to work with all of them: the body shapes the story, the story shapes the body, relationship alters what feels possible, and awareness can support freedom in perspective.

SWIM at a glance

Four frames.
Sixteen lenses.
One living system.

SWIM is not a staircase. The four frames are currents within the same water.

The body shapes the story. The story shapes the body. Relationship alters what feels possible. Awareness decides what becomes usable afterwards.

Rest on a frame, and it will speak.

S Somatic
  • Agency
  • Neuroception
  • Regulation
  • Embodiment
W Wisdom
  • Perspective
  • Contemplation
  • Ethics
  • Flourishing
I Interdependence
  • Relationship
  • Connection
  • Creativity
  • Belonging
M Metacognition
  • Mindset
  • Mindfulness
  • Multiplicity
  • Meaning

The value of skilled holding is that it changes what a person can afford to feel. When someone knows the room is safe, that the clinician will not flinch, and that there is a plan for the difficult part, they can approach material they have spent years avoiding. That is the therapeutic opportunity, and it is why SWIM is defined in structural terms rather than left to instinct.

The receptive movement

FLOAT

Learn to Rest and Renew

Not every change comes through effort. Some things can only emerge when we soften our grip and make room for what is already here.

FFeel
LLet go
OOpen
AAwareness
TTranscend
F

Feel what is present

L

Let go of what no longer needs to be held

O

Open into the space that remains

A

Rest in Awareness

T

Transcend: allow what is ready to move beyond its old form and become something new

We learn to SWIM when action is needed, and to FLOAT when it is time to be held, restored and renewed. Transformation asks for both.

SWIM teaches you to navigate oceanic states.

FLOAT begins where navigation gives way to belonging.

Learn the map.
Be held by the territory.

Learn more about SWIM & FLOAT at Anam Cara Centre →

SWIM & FLOAT professional training and education are offered by the Anam Cara Centre.

What it means for you

How the framework shapes your care at Karuna.

If SWIM & FLOAT applies to your treatment, you may notice it at different stages: what happens before, what happens during, and how long we stay with you afterwards.

Hover or select a stage to hold it while you read.

01

Before any significant piece of therapeutic work, you and your clinician establish what you are working toward, what the process involves, and what may be difficult about it.

Preparation is scheduled time, not a conversation squeezed into the first ten minutes. It includes screening, consent that is genuinely informed, and a plan for the hours immediately afterwards.

02

During the work itself you are supported and resourced. You will have practised ways of meeting experience mindfully: turning toward difficulty rather than away from it, staying connected to the body, and holding your intention lightly.

A clinician stays with you throughout. Intensity is adjusted as it goes, sessions are given the length the work needs, and they close deliberately, with orientation and clarity about what comes next.

03

Afterwards you have a defined rhythm of contact, agreed in advance, running over weeks and months rather than days. It is written into your care plan, not left to be arranged later.

You are supported through therapy, complementary interventions and online learning materials to integrate your insights in your daily life.

Whether this framework applies to you, and in what form, is a clinical decision made after comprehensive psychiatric and psychological assessment. Not every treatment involves a significant therapeutic experience, and not every person is suited to the ones that do. Individual responses to treatment differ, and no particular outcome can be promised.

Karuna's services →

Where it comes from

Developed by our clinical team, tested against our own results.

SWIM & FLOAT was written by the clinicians who use it, drawing on the research literature on therapeutic change, and it is revised as our own outcome data and the evidence base develop.

Clinically authored

Written and maintained by Karuna's psychiatrists and psychologists, out of what they observed working and failing in practice.

Research-informed

Grounded in established literature on therapeutic alliance, trauma-informed practice, habit formation and relapse prevention.

Outcomes tracked

We use validated measures at defined points, so change is recorded rather than assumed, and reported honestly whichever way it goes.

Revised, not fixed

The framework is a working document. Where our data or new evidence contradicts it, the framework changes rather than the interpretation.

Outcome measurement is used to guide and review individual care and to improve the framework over time. It is not a prediction of how any one person will respond. Where research is conducted, it is conducted under appropriate ethical oversight and with explicit consent, separately from your treatment.

Meet our team → Learn about Karuna's services →
Next step

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