ABSTRACT
The potential for teams to re-enact clients’ early patterns of interaction with other care givers is high when working with treatment-resistant clients. Dysfunctional staff-client interactions can reflect dynamics such as splitting (Davenport, 2006) and malignant alienation syndrome (Holmes, 2004) or in behavioural terms mutual reinforcement of avoidance and the use of punishment behaviours. Staff can also develop unhealthy dependency issues and may assume complete responsibility for those whom they care for (Hinshelwood, 2004). Although aspects of the Shared Assessment, Formulation and Education (SAFE) process are designed to help address these patterns of care giving we recognise that other processes will be required to ensure that staff can engage in a more therapeutic way with their clients and maintain appropriate boundaries with them. Ongoing training, detailed supervision of clinical work and the provision of staff support are integral to psychologically informed practice (Holmes, 2004). These form part of a package we have developed in order to successfully implement SAFE-informed practice. In this chapter we highlight the need for training, supervision, reflective practice and staff support groups and provide an overview of how we have undertaken this process.
