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Chapter 18 - Psychodynamic Reflective Practice Groups

from Beyond 1:1 Therapy: Working Psychodynamically with Clinicians, Teams, and Organisations

Published online by Cambridge University Press:  25 August 2023

Adam Polnay ,
Rhiannon Pugh ,
Victoria Barker ,
David Bell ,
Allan Beveridge ,
Adam Burley ,
Allyson Lumsden ,
C. Susan Mizen  and
Lauren Wilson
Foreword by
Nancy McWilliams
Adam Polnay
Affiliation:
The State Hospital, Carstairs and Royal Edinburgh Hospital, Edinburgh
Victoria Barker
Affiliation:
East London NHS Foundation Trust, London
David Bell
Affiliation:
British Psychoanalytic Society
Allan Beveridge
Affiliation:
Royal College of Psychiatrists, London
Adam Burley
Affiliation:
Rivers Centre, Edinburgh
Allyson Lumsden
Affiliation:
NHS Greater Glasgow and Clyde
C. Susan Mizen
Affiliation:
Devon and Exeter NHS Foundation Trust, Exeter
Lauren Wilson
Affiliation:
Royal Edinburgh Hospital, Edinburgh
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Summary

Staff in the caring professions often have to contain troubling and unpredictable communications (projections) from those they work with. It is usual and expected for staff to have feelings in response to these communications – this is part of the process of emotional containment. If reflected on, the professional’s feelings and inner responses (countertransference) can be a vital source of information about the relational dynamics the service user carries with them and how the staff member is responding to these. However, if staff members do not reflect on and process their countertransference, there is the potential for increased stress for the staff member, and to inadvertently re-enact the patient’s relational difficulties rather than provide containment for them. A reflective practice (RP) group brings a whole clinical team together with the primary task being to reflect on and process staff-patient, teamm and organisational dynamics, to sustain caring relationships with patients and reduce the stresses of the work for staff. This chapter offers an introduction to psychodynamic RP groups, aimed at both participants and group facilitators. We discuss the theory of RP groups and their intended purpose, outline a process of starting a group, and consider what is expected for both participants and facilitators.

Keywords

reflective practicegroupspsychodynamicre-enactmentcontainmentcountertransferenceBalint groupsapplied psychodynamic work
Type
Chapter
Information
Cambridge Guide to Psychodynamic Psychotherapy , pp. 269 - 277
Publisher: Cambridge University Press
Print publication year: 2023

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References

Adshead, G, Sarkar, J. The nature of personality disorder. Advances in Psychiatric Treatment 2012;18(3):162–72.Google Scholar
Moore, E. Personality disorder: its impact on staff and the role of supervision. Advances in Psychiatric Treatment 2012;18(1):44–55.CrossRefGoogle Scholar
Melchior, ME, Bours, GJ, Schmitz, P et al. Burnout in psychiatric nursing: a meta-analysis of related variables. J Psychiatr Ment Health Nurs 1997;4(3):193–201.CrossRefGoogle ScholarPubMed
O’Connor, S. An analytic approach in a psychiatric intensive care unit. Psychoanalytic Psychotherapy 1998;12(1):3–15.CrossRefGoogle Scholar
Mental Welfare Commision. Too Close To See – Mr F. 2009.Google Scholar
Fallon, P, Bluglass, R, Edwards, B. Report of the committee into the personality disorder unit at Ashworth Special Hospital. 1999.Google Scholar
Evans, M. Making Room for Madness in Mental Health: The Psychoanalytic Understanding of Psychotic Communication. Karnac Books; 2016.Google Scholar
Patrick, J, Russell, K, Polnay, A. Traditional approaches to reflective practice – history, aetiology, evidence and approaches. In Reflective Practice in Forensic Settings: A Cognitive Analytic Approach to Developing Shared Thinking. S.l.: Pavilion Publishing and Media Ltd; 2021. pp. 21–34.Google Scholar
Banardo’s Scotland. Supporting the mental health and wellbeing of education staff through professional supervision structures [Internet]. 2019; www.barnardos.org.uk/sites/default/files/uploads/supporting-mental-health-wellbeing-education-staff-through-professional-supervision-structures.pdfGoogle Scholar
Patrick, J, Kirkland, J, Maclean, C et al. Reflective practice paper and competency guidelines framework. Forensic Network Matrix Group; 2018.Google Scholar
Johnston, J, Paley, G. Mirror mirror on the ward: who is the unfairest of them all? Reflections on reflective practice groups in acute psychiatric settings. Psychoanalytic Psychotherapy 2013;27(2):170–86.CrossRefGoogle Scholar
McAvoy, P. Significant events in ward-based reflective practice groups. 2012.Google Scholar
Thorndycraft, B, McCabe, J. The challenge of working with staff groups in the caring professions: the importance of the ‘team development and reflective practice group’. British Journal of Psychotherapy 2008;24(2):167–83.Google Scholar
Adlam, J. ‘Not keeping it in the family.’ A mentalisation-based approach to facilitating reflective practice Groups for multi-disciplinary staff teams in forensic settings. 2016.Google Scholar
Balint, M. The Doctor, His Patient and the Illness. London: Pitman; 1957.CrossRefGoogle Scholar
Rüth, U. Classic Balint group work and the thinking of W.R. Bion: how Balint work increases the ability to think one’s own thoughts. Group Analysis 2009;42(4):380–91.Google Scholar
Hawkins, P, Shohet, R. Supervision in the Helping Professions. 3rd ed. Blacklick: Open University Press; 2007.Google Scholar
Benson, J. Working More Creatively with Groups. 4th ed. London: Routledge; 2018.Google Scholar
Scanlon, C. The traumatised-organisation-in-the-mind: opening up space for difficult conversations in difficult places. In The Therapeutic Milieu Under Fire: Security and Insecurity in Forensic Mental Health. Jessica Kingsley Publishers; 2012.Google Scholar
Johnson, AH, Nease, DE Jr, Milberg, LC et al. Essential characteristics of effective Balint group leadership. Fam Med 2004;36(4):253–9.Google ScholarPubMed

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