Association for Family Association for Family Therapy Annual Conference Therapy Annual Conference Liverpool 2014Liverpool 2014“An unholy marriage? A systemic/psychodynamic approach to consultancy”

Sandy BrysonSBryson@globalnet.co.uk

MODEL OF CONSULTATIONMODEL OF CONSULTATIONProcess Consultation Model

The Consultant, works collaboratively and co-creates a thinking space where the presenting problem can be examined, understood in context, and managed in a way that is helpful to the consultee.

Assumptions

1) The consultant and consultee are jointly involved in understanding the problem, and the consultee is encouraged to find their own solutions

2) The problem is solved more permanently because the consultee has learned the skills necessary to address similar future difficulties

SYSTEMIC/PSYCHODYNAMIC APPROACH SYSTEMIC/PSYCHODYNAMIC APPROACH TO CONSULTANCYTO CONSULTANCY

Systems: organisational structure including roles, authority, accountability and the management of boundaries

Psychodynamics: the management of work related anxiety and the need for relatedness

ORGANISATIONS AS OPEN SYSTEMS

ConversionInputoutput

External environment

ANXIETY AND ITS IMPACT ON TEAM EFFECTIVENESS

Anxiety generated from; the task/service user

the structure of the organisation

the team culture

the wider environment

ANXIETY GENERATED FROM THE PRIMARY ANXIETY GENERATED FROM THE PRIMARY TASK/STASK/S

There are usually vast differences between:

What an organisation thinks it is doing What it wants to do What it is actually doing What other organisations think it is doing

THE PRIMARY TASKSMALL GROUP DISCUSSION

How would you define the primary task(s) of;

a) Your role b) Your team c) Your service

THE PRIMARY TASKTHE PRIMARY TASKSMALL GROUP DISCUSSIONSMALL GROUP DISCUSSION

What would you like to do that you are not currently doing?

What do others think you are doing, both in the team and the wider organisation?

What for you is the most stressful aspect of your work?

ANXIETY GENERATED FROM THE SERVICE ANXIETY GENERATED FROM THE SERVICE USER: THE IMPACT OF USER: THE IMPACT OF ‘‘TRANSFERENCETRANSFERENCE’’ AND AND

‘‘COUNTER-TRANSFERENCECOUNTER-TRANSFERENCE’’ IN CARE SERVICES IN CARE SERVICES

Unmanageable levels of anxiety result in either Boundary violation=Psychological withdrawal or a

desire to get rid of the problem/over-involvement with the service user

Emergence of anti-task phenomena in the team

THE IMPACT OF THE IMPACT OF ‘‘TRANSFERENCETRANSFERENCE’’ AND AND ‘‘COUNTER-COUNTER-TRANSFERENCETRANSFERENCE’’ IN CLINICAL WORK IN CLINICAL WORK

What is the most challenging aspect ofyour contact with service users?

What might be the challenges for others in the team?

ANXIETY GENERATED FROM THE STRUCTURE ANXIETY GENERATED FROM THE STRUCTURE OF THE SYSTEMOF THE SYSTEM

Healthy teams have: Clearly defined roles for members, which are

appropriate to their level of skill, properly authorised and managed from above, and command appropriate followship from below

A capacity to manage the boundaries between tasks, workflow, and/or groups

A functioning structure for containment of difficult feelings arising from the work.

ANXIETY GENERATED FROM THE TEAM ANXIETY GENERATED FROM THE TEAM CULTURE. CULTURE.

Teams are subject to both conscious and unconscious processes, from individual group members, the group, and from the wider context in which the group operates.

When anxiety becomes overwhelming, a culture characterised by anti -task phenomena will may emerge.

ANTI TASK PHENOMENA (ANTI TASK PHENOMENA (BASIC ASSUMPTION BASIC ASSUMPTION FUNCTIONINGFUNCTIONING) ARISES IN TEAMS WHICH HAVE) ARISES IN TEAMS WHICH HAVE

Unclear or conflicting tasks,

Difficult/painful tasks to perform which give rise to intolerable anxiety in members

And A Lack effective leadership which can manage

difference and contain anxiety,

BASIC ASSUMPTION DEPENDENCY

B A FIGHT/FLIGHTB A FIGHT/FLIGHT

B A PAIRING

B/A ONE-NESSB/A ONE-NESS

ME-NESSME-NESS

ORGANISATIONAL DEFENCES AGAINST ANXIETY

What gets projected onto an organisation by wider society?

How does the organisation defend itself against unrealistic/unhelpful projections?

Also known as social defences- routines, formal/informal procedures and patterns of behaviour that are anti task……..

ANXIETY FROM THE WIDER ENVIRONMENT.

Rapidly changing relationship to work Increasing complexity of the task:

Changes in commissioning, increased competition and uncertainty.

Disintegration of established workgroups

A SYSTEMIC?PSYCHODYNAMIC APPROACH TO CONSULTANCY

An approach which gives both the Consultant and the Consultee space to think about their work

It involves1. Attention to the here and now experience2. Consolidation of learning which is already held3. Clarification of barriers to learning4. Revealing what may be known but unspoken5. Identifying what may lead to creativity6. Determining an action plan

KEY IDEAS OF THE APPROACHKEY IDEAS OF THE APPROACH1) The assumption that working means feeling anxiety and other emotions

What is difficult to talk about in relation to the work?

KEY IDEAS OF THE APPROACHKEY IDEAS OF THE APPROACH2) Identification of the primary task of the

team: the roles taken up by members, both formal and informal, and the locus of authority

What am I doing and why?

KEY IDEAS OF THE APPROACHKEY IDEAS OF THE APPROACH3) Reading and understanding the Individual

experience of members from an organisational contextwhat does it feel like to work here?

What does my experience say about the team?

KEY IDEAS OF THE APPROACHKEY IDEAS OF THE APPROACH4). Appreciation of the wider context which

impacts on a workgroup or organisation

What is around which affects the workgroup? Are external factors known?, predictable?, turbulent?

FURTHER READINGFURTHER READINGStapely,F. Individuals, Groups and Organisations beneath the surface. (2006) Karnac

Gould, L, Stapely, L and Stein, M (eds.) The Systems Psychodynamics of Organisations (2001)Karnac

Huffington, C. et al. eds. Working Below the Surface. (2004) Karnac

Cooper, A and Lousada,J Borderline Welfare: Feeling and fear of feeling in modern welfare ( 2005) Karnac