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

MODEL OF CONSULTATION Process 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 TO 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 Conversion Inputoutput 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 TASK/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 TASK SMALL GROUP DISCUSSION How would you define the primary task(s) of;  a) Your role  b) Your team  c) Your service

THE PRIMARY TASK SMALL 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 USER: THE IMPACT OF ‘TRANSFERENCE’ AND ‘COUNTER-TRANSFERENCE’ 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 ‘TRANSFERENCE’ AND ‘COUNTER- TRANSFERENCE’ IN CLINICAL WORK What is the most challenging aspect of your contact with service users? What might be the challenges for others in the team?

ANXIETY GENERATED FROM THE STRUCTURE OF 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 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 (BASIC ASSUMPTION FUNCTIONING) 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/FLIGHT B A FIGHT/FLIGHT

B A PAIRING

B/A ONE-NESS

ME-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 involves 1.Attention to the here and now experience 2.Consolidation of learning which is already held 3.Clarification of barriers to learning 4.Revealing what may be known but unspoken 5.Identifying what may lead to creativity 6.Determining an action plan

KEY IDEAS OF THE APPROACH 1) 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 APPROACH 2) 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 APPROACH 3) Reading and understanding the Individual experience of members from an organisational context what does it feel like to work here? What does my experience say about the team?

KEY IDEAS OF THE APPROACH 4). 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 READING Stapely,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