Working in the human services has always been stressful, and the current massive changes in the organization of these services, together with dwindling resources and ever greater demands for cost effectiveness, add to the stresses inherent in the work. Even in the best run and best resourced organizations there are pockets of irrationality where unconscious institutional processes undermine both effectiveness and morale.
The contributors to this book use ideas drawn from psychoanalysis, open systems theory, Bion's work with groups, and group relations training to explore the difficulties experienced by managers and staff in a wide range of care settings. Each concept is illustrated with examples from practice to make it recognizable and useful to the reader.
Each chapter develops a theme relating to work with a particular client group or setting (including hospitals, schools, day centres, residential units, community services and many others), or explores aspects of work organization (for example, the supervisory relationship, facing cuts and closure, or intergroup collaboration). By describing both the difficulties and their own feelings and thoughts while consulting to these institutions, the authors offer the reader new ways of looking at their own experiences at work which will be both enlightening and helpful.

chapter |10 pages


The institutional roots of consulting to institutions
ByJames Mosse

chapter 1|8 pages

Some unconscious aspects of organizational life

Contributions from psychoanalysis
ByWilliam Halton

chapter 2|9 pages

The unconscious at work in groups and teams

Contributions from the work of Wilfred Bion
ByJon Stokes

chapter 3|11 pages

The organization of work

Contributions from open systems theory
ByVega Zagier Roberts

chapter 4|12 pages

Authority, power and leadership

Contributions from group relations training
ByAnton Obholzer

chapter 5|9 pages

The dangers of contagion: protective identification processes in institutions

Projective identification processes in institutions
ByDeirare Moylan

chapter 6|7 pages

Attending to emotional issues on a special care baby unit

ByNancy Cohn

chapter 7|8 pages

Containing anxiety in work with damaged children

ByChris Mawson

chapter 8|9 pages

Till death us do part

Caring and uncaring in work with the elderly
ByVega Zagier Roberts

chapter 10|7 pages

Working with dying people

On being good enough
ByPeter Speck

chapter 11|9 pages

Where angels fear to tread

Idealism, despondency and inhibition of thought in hospital nursing
ByAnna Dartington

chapter 12|11 pages

The self-assigned impossible task

ByVega Zagier Roberts

chapter 13|8 pages

Institutional chaos and personal stress

ByJon Stokes

chapter 14|10 pages

The troublesome individual and the troubled institution

ByAnton Obholzer, Vega Zagier Roberts

chapter 15|8 pages

Facing an uncertain future

ByFrancesca Cardona

chapter 16|9 pages

Finding a voice

Differentiation, representation and empowerment in organizations under threat
ByJames Mosse, Vega Zagier Roberts

chapter 17|13 pages

Asking for help

Staff support and sensitivity groups re-viewed
ByWendy Bolton, Vega Zagier Roberts

chapter 18|10 pages

Managing social anxieties in public sector organizations

ByAnton Obholzer

chapter 19|8 pages

Balancing care and control

The supervisory relationship as a focus for promoting organizational health
ByChristopher Clulow

chapter 20|10 pages

Conflict and collaboration

Managing intergroup relations
ByVega Zagier Roberts

chapter 21|9 pages


Organizations learning from experience
ByRob Leiper