Applying Psychoanalytic Thinking in a Staff Support Group to Reflect on Service Change and Clinical Practice in a Specialist Psychiatric Service

Iapt, Anxiety and Envy: A Psychoanalytic View of NHS Primary Care Mental Health Services Today

“…This is by no means easy, as Menzies Lyth (1959) and Jaques (1955) have already noted and as the above case example suggests. The instigation of practices such as ‘reflective practice’ groups for staff, as a means of facilitating and maintaining a space where different perspectives can be held and thought about, rather than eliminated or homogenized, can be valuable, as Morante's (2005) discussion of a working group for nurses in the NHS highlights. Of course, the value of any such group depends on the team members' willingness and sustained capacity to reflect on their emotional role and significance within the organization; and we should not underestimate the difficulties in establishing and retaining a ‘culture of enquiry’ (Main, 1983) within the NHS, given its potential for destabilizing the kinds of organizational and social defence systems discussed earlier.…”

“…Many studies since Menzies Lyth's, including those, for example, by Nightingale and Scott (1994), Hinshelwood and Skogstad (2000, 2002) and Morante (2005) have used a psychoanalytic perspective to observe, understand and enhance the functioning of mental health professionals within the NHS. Obholzer (2003) has pointed out the significance of the institution as a container for anxiety, suggesting that the NHS can be considered as:…”

The Nursing Decision Making Process in Seclusion Episodes in a Psychiatric Facility

“…Follow-ups of this type are not carried out systematically with members of the careprovider team, and they are rarely conducted with the patient. However, the use of post-incident review with nurses working in mental health has shown that the expression of their emotions leads them to critically analyze clinical practices, explore the appropriateness of the therapeutic skills they use, and contribute to the development of safe practices (Morante, 2005). Also, because the post-incident review involves reflecting on a practice, we think it would enable teams to enhance their understanding of aggressive behaviour, discuss relational care, and support the notion of partnership with the client.…”

On the margins: a psychoanalytic perspective on the location of counselling, psychotherapy and counselling psychology training programmes within universities

“…Many studies since Menzies-Lyth's, including those, for example, by Nightingale and Scott (1994); Hinshelwood andSkogstad (2000, 2002); and Morante (2005) have used a psychoanalytic perspective to observe, understand and enhance the functioning of mental health professionals within the NHS. However, there has been far less interest in those professionals working within the education sector.…”

“…Just as within individual psychotherapeutic practice, where containment of projections is achieved by thoughtful 'reverie' (Bion, 1962a(Bion, , 1962b and responsiveness rather than retaliation, so a team may need to find new ways of thinking about and containing some of the projected anxieties of the institution. Morante (2005) has recently discussed the value of a weekly staff support group for nurses to reflect on the impact of organisational and structural change on their clinical work within the NHS. Given the increasing emphasis within most if not all forms of psychology on reflective practice, it seems obvious that a similar work discussion group could be extremely useful, with or without an external consultant, in order to encourage reflective thinking about the team's role and capacity to manage the changes to and demands of task requirements within a university setting.…”