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