ABSTRACT
Implementation of the NHS and Community Care Act (DoH, 1990) put considerable strain on workers in health authorities, social service departments and voluntary sector agencies. The legislation was experienced as a form of managerialism which aimed to create and maintain structures at the expense of addressing the nature of the processes that occur within systems of care. Processes between people and between different parts of a system are both the cause and the product of anxieties experienced by users and workers. The skills needed to address process issues are the same therapeutic skills of containing, managing and metabolizing anxiety that one utilizes in client work. If anxieties remain unaddressed, then the system operates defensively, as depicted in Figure 16.1. A defensive system in which anxieties remain unaddressed https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9780203360576/787a06b6-a96d-456b-9b99-2954006a64f1/content/fig16_1_B.tif" xmlns:xlink="https://www.w3.org/1999/xlink"/>
