1. “Systemic Family Who?”:
Learning through unsafe uncertainty to developing non-expert position.
Roland Glover, Julie Bird, Lois Gillott and Bonnie Haughton
Possibly the most alarming thing for us fledgling Systemic Family Practitioners right at the beginning of our CYP-IAPT SFP training was the prospect of sitting down with families for the first time without any idea of what to do.
We were all experienced practitioners in our various fields, Nurses, Psychologists, Social Workers and Art Therapists but the expectation that we should work systemically left us de-skilled and anxious. We later discovered this had a name in systemic literature: safe uncertainty (ref).

2. Formulation and Circularities
So what is a circular question? Who notices first when one is asked? Who notices next? And; what’s it like being asked that?
We quickly got hold of the idea that using circular questioning was useful. But! We had no idea what it was or how to do it. I doubt there will be many in this room who don’t know what they are but it is not the most obvious or intuitive way to engage with a family. They of course provide wonderful, effective and interesting ways of engaging families in tracking relationships. We know that now and we’re beginning to tentatively put those out there.

3. What constitutes a formulation?
“Initially I hypothesised that it was basically just an informed guess”.
OK, so many of us work in CAMHS services who provide talking therapies. Formulation is central to psychology and the psychologists among us struggled less with the term. For me it was something the psychiatrists in our team used to ask in MDT (Multi-Disciplinary Team) and I would usually say lots of stuff in the hope that some of it answered their questions. It usually worked because people often talk rubbish in MDT anyway.

4. Unsafe uncertainty (Mason ) What’s it like for the family?
Holding a position of expert
Forgets collaboration
The practitioner starts from the beginning feeling deskilled by her lack of any idea about how to go about doing systemic practice. Feels frightened by her lack of any tools or instructions.
What does this feel like for the family? What is the practitioner giving off? Self-doubt? Uncertainty? The family are likely to have come to the session feeling anxious and perhaps seeking some containment and reassurance from the practitioner. Are the family left feeling uncontained? Or do they feel they have not been listened to?
The practitioner seeks comfort in adopting an expert position. Already the second order systemic approach is compromised (ref). The practitioner directs the session and collaboration is lost.

5. Reflexivity and modelling: Listening to feedback
Teaching systemic theory systemically
Although it didn’t seem like it at the time, the tutors had a plan. They were reflexively adapting the plan they had used for the previous cohort in response to their feedback about what worked for them. In other words they were trying to teach systemic theory and practice, systemically. But they could have told us! We didn’t know what reflexive was. When we were told that’s what they were doing, most of us disagreed with the previous cohort.
They had set out to do an introductory review of the various approaches with a view to returning to those in more detail later. Unfortunately that left us all baffled and hungry for a deeper understanding of Structural, Milan, Functional, Constructivism versus Social Constructionism, Modernist versus Post-modernist; which is actually quite a big ask. Having now returned to each of these models or approaches it makes more sense to summarise first.

6. It’s all relatives (After Einstein)
The lightbulb/sparkling
moment
The light bulb moment happens when you realise that it is all relational. When you start to think in circularities, when you start to recognise pattern and exceptions and maintaining factors. And then just when we begin to think that we’re getting the hang of this, bang! They hit us with it:

7. Non-expert position! Systemic theory is riddled with paradox!
CYP-IAPT SFP CLASS OF 2016
So we spent our first few weeks meeting families not knowing what to do only to learn some months down the line that a not-knowing position is what works best.

8. Relational Reflexivity (PPRR) (Ref: Burnham 1993, 2005)
Looking at this technique to address how we felt at the very start of the course and using the quadrants to seek where we thought we all were.

9. Languishing in language
CMM and the speech act
We went on to learn about the subtle assumptions there are in every day language and that everything we say implicates power and that our tutors collaborative teaching style was mindful of their power as ‘experts’.
Pearce and Cronen’s Coordinated Management of Meaning (CMM) taught us that all speech is action and therefore contains an act of commission or an act of subversion perhaps.

10. Relational Reflexivity (PPRR) (Ref: Burnham) End of Course:
Looking at this technique to address how we felt at the very start of the course and using the quadrants to seek where we feel we are now!