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 supported therapeutic experience itself, actively held by skilled clinicians. FLOAT is the integration arc that follows, the longer, quieter stretch in which change settles and takes root. 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 lasting patterns."

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

First you are held. Then you are carried.

The names are deliberate. Swimming is active and needs someone watching the water. Floating asks for something different: less effort, more trust, and time for what happened to become part of you.

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 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.

Sessions within this movement are longer than standard appointments where the work requires it, and they are never open-ended. There is a defined beginning, a defined close, and a clinician with responsibility for both.

  • Screening and suitabilityPhysical health, history, medication and risk, reviewed before anything begins
  • PreparationShared understanding of the aim, the process, and what may be difficult
  • Clinician-held sessionsContinuous presence and support, with intensity adjusted in real time
  • A defined closeEvery session ends deliberately, with orientation and a plan for the hours after

FLOATThe integration arc

The weeks and months afterwards, in which what shifted is understood, practised, and allowed to become ordinary.

FLOAT is the part of the framework we are most insistent about, because it is the part most often missing. An experience that is not integrated tends to become a story someone tells about a good week. An experience that is integrated becomes the way they live.

Practically, FLOAT is a rhythm of contact rather than a single session: reflective work to put language to what happened, behavioural work to translate insight into something you actually do differently, and steady attention to sleep, movement, relationships and routine, because those are where new patterns are either supported or quietly eroded.

The rhythm is deliberately front-loaded and then tapered, so that support is densest when it is most needed and steps down as the change holds on its own. If it does not hold, contact increases again. That decision is made on evidence, with you, rather than on a fixed schedule.

  • Integration sessionsMaking sense of what happened, in language you recognise
  • Behavioural translationTurning insight into specific, repeatable changes in daily life
  • Daily foundationsSleep, movement, breath and nutrition attended to as part of the work
  • A tapered rhythmSupport that steps down gradually, and back up if it needs to

The two movements are one piece of work. We do not offer SWIM without FLOAT. Where someone cannot commit to the integration arc, 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.

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

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

First you learn the map.
Then you are held by the journey.

SWIM teaches you to navigate oceanic states.

The four frames

This is where SWIM begins.

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.

SSomatic
WWisdom
IInterdependence
MMetacognition
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 four frames are not a staircase. They are currents in the same water, and a clinician works with all of them at once: the body shapes the story, the story shapes the body, relationship alters what feels possible, and attention decides which of it becomes usable afterwards.

Applied across

The three stages of care.

Assessment identifies which pattern is most live for a person: fear that braces, a grip that will not loosen, or anxiety that scatters. The most relevant FLOAT capacity then becomes a concrete, rehearsed skill before anything begins.

The framework guides tracking and minimal, well-timed support: reading the movement from contraction toward ease, protecting the quiet stretches, holding possibility open rather than directing where it goes.

The work turns insight into changed living, distinguishing the shift a single session can begin from the slower developmental and relational work that no single session can shortcut.

Select a stage to hold it while you read.

FLOAT begins where navigation gives way to belonging.

What it means for you

How the framework shapes your care at Karuna.

If SWIM & FLOAT applies to your treatment, you will notice it in three concrete ways: what happens before, what happens during, and how long we stay with you afterwards.

01

Preparation

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

Session support

During the work itself a clinician stays with you throughout. Intensity is adjusted as it goes, and difficulty is met rather than avoided or pushed through.

Sessions are given the length the work needs, and they close deliberately: orientation, a few words about what happened, and clarity about what comes next.

03

Integration rhythm

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.

Progress is reviewed formally at set points. The rhythm tapers as change consolidates, and it can be intensified again if the evidence says that is what is needed.

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.

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.

Next step

Want to know how this would apply to you?

Speak with our team about what you are looking for, for yourself or for someone you care for. We respond within one business day.

Send a referral → Make an enquiry → Call our team · 1300 KARUNA

Karuna is not a crisis service. If you or someone you know is in immediate danger, call 000. For 24/7 support: Lifeline 13 11 14 · Suicide Call Back Service 1300 659 467 · Beyond Blue 1300 22 46 36