Systemic Practice:
Fitting and Teaming Up
By Nick Child
My friend and social work colleague, June Jones, and I visited Poland in October 1998, returning Dariusz Baran's to Scotland in 1992 'from periphery to periphery of excellence'. This is the bones of my presentation at the Carpathian Regional Conference on Developing Family Therapy in Central Europe, held in Kosice, Slovakia. It has been published in this form in Context, AFT's magazine.
INTRODUCTION
We use the term 'systemic' variously. I follow the dictionary roots of the word 'system'. When we talk of a system we are interested in how the parts of the system FIT, and actively TEAM UP to achieve some aim. A team can seem to fit together and even have the same aim, but still be quite ineffective and unhappy through not really working together. In an effective team, the members know and look after each other well, using strengths and allowing for weaknesses. The questions of 'fit' and 'teaming up' apply in all kinds of system and situation. Systemic Practice is the broader application of the same principles we otherwise know best in our more specialist work with families and in the field of Family Therapy. Each of the headings below would take a chapter or two to cover. Here a practical example or two illustrates how we are simply describing the ordinary good basic practice of all helping professions that is universally preached and perhaps rather less commonly practiced.
1. How do I fit and team up here and now?
The question of how 'I' fit and team up in the 'here and now' is the ever present task for all human beings and workers. Buddhists would look to have 'skill' and receive 'every moment as a miracle'. Existentialists say 'the crossroad moves with you'. With historically excluded awareness of life's rich ritual process, I say 'always find a sense of occasion'. Here - typing what you, the reader, are now reading - the connection isn't easy. Nor was it in Kosice. There was no easy way to prepare. The language difficulty was illustrated in one workshop where translation passed from Hungarian to Slovakian to Polish and finally to English for us. So, fitting and teaming up was a challenge. Then I remembered that family therapy was famously said to have begun in John Bell's international misunderstanding that John Bowlby was routinely seeing whole families together. So, giving the interpreter some difficulty, I suggested that, in Kosice, creative misunderstanding like that would be a fitting outcome for the occasion!
2. How does the problem and its solution fit and team up with the person who has it and with their family, community and cultural system?
This is the familiar family therapy systems approach. No examples of this are needed for you, the readers of Context, AFT's magazine of family therapy. [But for readers of this website, I should provide some examples. But then I'd be trying to summarise the whole of the large field of family therapy. Sorry!]
3. How does a worker fit and team up with their team and their service context? And with their management systems?
From lots of concepts about teams, accounts of our experience of teams and live teams at Child and Family Clinics (CFC) Motherwell, ways of professional working, and effective office administration systems, I will not here publicise the best example of team-work, what we call 'the secretary test'. That is our industrial secret for you to guess at. Instead, I contrast two concepts of teams, multi- or uni-disciplinary. The most obvious concept of teams is based primarily on the individual's job or, in multi-disciplinary teams, their specialism in which each member is trained and appointed. In a multi-disciplinary team, each worker employs their distinctive skills and responsibilities alongside their colleagues' different skills etc. Sooner or later (or never), these professional people may learn something about each other as people 'outside' their professional roles. In contrast, as is common in effective organisations and businesses, and despite those official structures of employment, I prefer the concept that the team is primarily the workers as people, working together on their shared professional task. Only secondarily to that collective task, do the members of the team consider together how and when to bring in their individual or specialist remits and responsibilities. I think this concept is more than preferable in a field like ours in providing social and mental health services, especially if we explicitly do so in relationship-based approaches. The 'personal team' concept and practice is essential. It is also the best concept, if uncommonly found in practice, for workers with their managers.
4. How do the worker and team fit and team up with the client family?
Again, from lots of ideas on how to work with ordinary demystified language, flexibility over what the family prefer, live team, standard referral process, information for families, friendly reception, routine pattern to the week and so on, the example I choose is from our ('audit') list of standard parts of our first appointment interview. Actually, it's what we at CFC take for granted so much, that we forgot to include it in the list. In fact, we were reminded only by re-reading Dariusz's description (Baran 1993). On re-entering the family's room after the consultation break, during which the worker explicitly leaves the family in privacy in the interview room, the worker knocks on the door before entering. That is, we carefully try to respect the family's boundary.
5. How does the service fit and team up with other services?
Examples would include any dedicated attempts to create positive working relationships in general or particular with other agencies and workers. Such meetings can be very difficult to set up, and expectations and ways of creating good team work are often notably absent. Within your day to day work, finding an acceptable way to identify and contact other agencies involved before (or instead of) seeing the family can require skilled, careful and persistent telephone work , and then some! We at CFC have also taken great care with our information sheets about our own service for professionals and clients, including sections on how CFC fits with other services. We find that working in the 'peripheries of excellence' allows a better fit and teaming up between agencies than in the centres of excellence where there is inevitably more division, competition and conflict.
6. How does the method of working fit together and team up, both within itself and with the client?
Examples here are listed in 'Family Therapy: The Rest of the Picture' (Child 1989) where I addressed the question of how the family therapy method fits together. About 90 component parts of family therapy's powerful 'teaming up' of elements can be separated out. There are basic things like the worker having a mature personality, suitable working space, skill in use of letters and organising time. And less basic things like our special family interviewing skills, technology, training methods, and special theories. The point of this is to enable systemic practitioners who are not employed specifically as family therapists, to select those parts of family therapy that fit and team up well with them and their work, leaving aside those parts that may not. For example, family therapy can be done without mirrors and technology, and live consultation can be in the room with one person. Live consultation is not just for training purposes either. Even on your own without team colleagues, and whatever your specialism - a consultation break can be effective.
The question of how the method fits and teams up with the client has always been a major theme for family therapy, again familiar to CONTEXT readers. The simplest examples at CFC - a small, comprehensive, state, service to a large population - would be that we are flexible in various ways in our initial invitation to meet those involved in the family. And, in all our work, we always try to use the most ordinary language we can. With clients or colleagues, we just do not think or talk about what we are doing as 'Family Therapy', nor, for that matter, as 'Systemic Practice', though that's what it could be called. We do it because, by any account, it's just a good way to do our job as a child, adolescent and family mental health service.
7. How does the training and learning fit and team up with the worker and their job?
If you are employed in one of the more standard helping professions that - if you own a family systems approach to it - would class you as a systemic practitioner, how does a family therapy training fit you for your job? It is obvious, isn't it, that family therapy is not a strange totally new method, but the development of more ordinary universal human functions like listening, talking and conversation? It is also, in many ways, just sustaining widely known broader values of basic good professional practice. Miller et al (1997) calculate that 85% of any psychotherapeutic success is due to other and non-specific aspects of any specific approach. If all psychotherapy trainings were 85% about the nonspecifics, then there wouldn't be nearly such a big problem when fitting and teaming up the training with non-psychotherapist systemic practitioner jobs. But, understandably, most family therapy trainings fit you to 'team' up better with the job of Family Therapist than they do if you are continuing as a Systemic Practitioner.
SUMMARY In summary, echoing AFT's aims, history and strapline, I've developed the widely evident notion that Family Therapy is one part of the broader field we call Systemic Practice. The unifying principles of Systemic Practice (and so of Family Therapy too) are very simple and unexceptional. They also integrate us with our broader field of training and practice as helping professionals and human beings. The themes are: 'fit' and 'teaming up'. This seems all too obvious and unarguable. But if it is, then we in AFT need to balance our efforts better by developing our ideas, research and methods within the broader frame of Systemic Practice to match the mountain of activity we presently have to climb in support of that special, sometimes over-mystified, and certainly valued, sub-system of Systemic Practice called Family Therapy.
REFERENCES Baran, D (1993) From periphery to peripheries of excellence. CONTEXT, 16, 20-22
Child, N (1989) Family therapy: the rest of the picture. Journal of Family Therapy, 11, 281-296
Miller, S, Duncan, B, Hubble, M (1997) Escape From Babel:Toward a Unifying Language for Psychotherapy Practice. Norton:New York
We use the term 'systemic' variously. I follow the dictionary roots of the word 'system'. When we talk of a system we are interested in how the parts of the system FIT, and actively TEAM UP to achieve some aim. A team can seem to fit together and even have the same aim, but still be quite ineffective and unhappy through not really working together. In an effective team, the members know and look after each other well, using strengths and allowing for weaknesses. The questions of 'fit' and 'teaming up' apply in all kinds of system and situation. Systemic Practice is the broader application of the same principles we otherwise know best in our more specialist work with families and in the field of Family Therapy. Each of the headings below would take a chapter or two to cover. Here a practical example or two illustrates how we are simply describing the ordinary good basic practice of all helping professions that is universally preached and perhaps rather less commonly practiced.
1. How do I fit and team up here and now?
The question of how 'I' fit and team up in the 'here and now' is the ever present task for all human beings and workers. Buddhists would look to have 'skill' and receive 'every moment as a miracle'. Existentialists say 'the crossroad moves with you'. With historically excluded awareness of life's rich ritual process, I say 'always find a sense of occasion'. Here - typing what you, the reader, are now reading - the connection isn't easy. Nor was it in Kosice. There was no easy way to prepare. The language difficulty was illustrated in one workshop where translation passed from Hungarian to Slovakian to Polish and finally to English for us. So, fitting and teaming up was a challenge. Then I remembered that family therapy was famously said to have begun in John Bell's international misunderstanding that John Bowlby was routinely seeing whole families together. So, giving the interpreter some difficulty, I suggested that, in Kosice, creative misunderstanding like that would be a fitting outcome for the occasion!
2. How does the problem and its solution fit and team up with the person who has it and with their family, community and cultural system?
This is the familiar family therapy systems approach. No examples of this are needed for you, the readers of Context, AFT's magazine of family therapy. [But for readers of this website, I should provide some examples. But then I'd be trying to summarise the whole of the large field of family therapy. Sorry!]
3. How does a worker fit and team up with their team and their service context? And with their management systems?
From lots of concepts about teams, accounts of our experience of teams and live teams at Child and Family Clinics (CFC) Motherwell, ways of professional working, and effective office administration systems, I will not here publicise the best example of team-work, what we call 'the secretary test'. That is our industrial secret for you to guess at. Instead, I contrast two concepts of teams, multi- or uni-disciplinary. The most obvious concept of teams is based primarily on the individual's job or, in multi-disciplinary teams, their specialism in which each member is trained and appointed. In a multi-disciplinary team, each worker employs their distinctive skills and responsibilities alongside their colleagues' different skills etc. Sooner or later (or never), these professional people may learn something about each other as people 'outside' their professional roles. In contrast, as is common in effective organisations and businesses, and despite those official structures of employment, I prefer the concept that the team is primarily the workers as people, working together on their shared professional task. Only secondarily to that collective task, do the members of the team consider together how and when to bring in their individual or specialist remits and responsibilities. I think this concept is more than preferable in a field like ours in providing social and mental health services, especially if we explicitly do so in relationship-based approaches. The 'personal team' concept and practice is essential. It is also the best concept, if uncommonly found in practice, for workers with their managers.
4. How do the worker and team fit and team up with the client family?
Again, from lots of ideas on how to work with ordinary demystified language, flexibility over what the family prefer, live team, standard referral process, information for families, friendly reception, routine pattern to the week and so on, the example I choose is from our ('audit') list of standard parts of our first appointment interview. Actually, it's what we at CFC take for granted so much, that we forgot to include it in the list. In fact, we were reminded only by re-reading Dariusz's description (Baran 1993). On re-entering the family's room after the consultation break, during which the worker explicitly leaves the family in privacy in the interview room, the worker knocks on the door before entering. That is, we carefully try to respect the family's boundary.
5. How does the service fit and team up with other services?
Examples would include any dedicated attempts to create positive working relationships in general or particular with other agencies and workers. Such meetings can be very difficult to set up, and expectations and ways of creating good team work are often notably absent. Within your day to day work, finding an acceptable way to identify and contact other agencies involved before (or instead of) seeing the family can require skilled, careful and persistent telephone work , and then some! We at CFC have also taken great care with our information sheets about our own service for professionals and clients, including sections on how CFC fits with other services. We find that working in the 'peripheries of excellence' allows a better fit and teaming up between agencies than in the centres of excellence where there is inevitably more division, competition and conflict.
6. How does the method of working fit together and team up, both within itself and with the client?
Examples here are listed in 'Family Therapy: The Rest of the Picture' (Child 1989) where I addressed the question of how the family therapy method fits together. About 90 component parts of family therapy's powerful 'teaming up' of elements can be separated out. There are basic things like the worker having a mature personality, suitable working space, skill in use of letters and organising time. And less basic things like our special family interviewing skills, technology, training methods, and special theories. The point of this is to enable systemic practitioners who are not employed specifically as family therapists, to select those parts of family therapy that fit and team up well with them and their work, leaving aside those parts that may not. For example, family therapy can be done without mirrors and technology, and live consultation can be in the room with one person. Live consultation is not just for training purposes either. Even on your own without team colleagues, and whatever your specialism - a consultation break can be effective.
The question of how the method fits and teams up with the client has always been a major theme for family therapy, again familiar to CONTEXT readers. The simplest examples at CFC - a small, comprehensive, state, service to a large population - would be that we are flexible in various ways in our initial invitation to meet those involved in the family. And, in all our work, we always try to use the most ordinary language we can. With clients or colleagues, we just do not think or talk about what we are doing as 'Family Therapy', nor, for that matter, as 'Systemic Practice', though that's what it could be called. We do it because, by any account, it's just a good way to do our job as a child, adolescent and family mental health service.
7. How does the training and learning fit and team up with the worker and their job?
If you are employed in one of the more standard helping professions that - if you own a family systems approach to it - would class you as a systemic practitioner, how does a family therapy training fit you for your job? It is obvious, isn't it, that family therapy is not a strange totally new method, but the development of more ordinary universal human functions like listening, talking and conversation? It is also, in many ways, just sustaining widely known broader values of basic good professional practice. Miller et al (1997) calculate that 85% of any psychotherapeutic success is due to other and non-specific aspects of any specific approach. If all psychotherapy trainings were 85% about the nonspecifics, then there wouldn't be nearly such a big problem when fitting and teaming up the training with non-psychotherapist systemic practitioner jobs. But, understandably, most family therapy trainings fit you to 'team' up better with the job of Family Therapist than they do if you are continuing as a Systemic Practitioner.
SUMMARY In summary, echoing AFT's aims, history and strapline, I've developed the widely evident notion that Family Therapy is one part of the broader field we call Systemic Practice. The unifying principles of Systemic Practice (and so of Family Therapy too) are very simple and unexceptional. They also integrate us with our broader field of training and practice as helping professionals and human beings. The themes are: 'fit' and 'teaming up'. This seems all too obvious and unarguable. But if it is, then we in AFT need to balance our efforts better by developing our ideas, research and methods within the broader frame of Systemic Practice to match the mountain of activity we presently have to climb in support of that special, sometimes over-mystified, and certainly valued, sub-system of Systemic Practice called Family Therapy.
REFERENCES Baran, D (1993) From periphery to peripheries of excellence. CONTEXT, 16, 20-22
Child, N (1989) Family therapy: the rest of the picture. Journal of Family Therapy, 11, 281-296
Miller, S, Duncan, B, Hubble, M (1997) Escape From Babel:Toward a Unifying Language for Psychotherapy Practice. Norton:New York
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