PT32 Use the resources of a team in family and systemic therapy

Overview

This standard shows how the systemic therapist works with the team and technology. For example, using one way screens and video feedback as a way of generating reflexive practice within the team and as a therapeutic intervention with the client. The therapist is open to imaginative ways of using the team’s contributions, including developing a relationally reflexive relationship between team, therapist and client, in which the client can help shape how the team contributes to the therapeutic process. This standard describes therapeutic practice that has been shown to benefit families and other clients engaged in family and systemic therapy. (See reference in the additional information section on page 3.) To apply this standard, practitioners also need to take account of the multiple problems and complex co-morbidities that clients may bring to therapy. Family and systemic therapy should be offered as part of an explicit and structured approach agreed within the treatment team and with the client and the system. Users of this standard will need to ensure that practice reflects up to date information and policies. This standard should be understood in the context of the Digest of National Occupational Standards for Psychological Therapies. Version No 1

Knowledge and Understanding

You will need to know and understand:

Therapeutic teams

techniques of team involvement and consultation in and out of room
models of mutual support among team members
team dynamics in the setting of systemic therapy
reflexive practice in the team setting

The therapeutic relationship
ethical, non-oppressive and anti-discriminatory practices
how to form and maintain collaborative relationships in age and culturally appropriate ways with everyone in the system
how to make use of self and relational reflexivity to enhance therapeutic relationships
the impact of personal and professional narratives on the therapeutic process

Risk
the assessment of risks to individuals and the risks they pose to others in a range of settings
current legislation and local guidelines and procedures about child and vulnerable adult safeguarding
the relevant professional systems of health care, social care, local authority and education applicable to safeguarding
how to balance the risk or safety and opportunity in therapeutic interventions
ethical issues of valid consent for all members of a system

Systemic principles that inform the therapeutic approach
the range of contexts in which the client needs to be viewed
ways in which people understand themselves and the world around them
the influence of power relationships and different socio-cultural contexts on the development of meaning, relationships and behaviour for the client and the therapist
the influence of varied individual accounts of the same event on relationships and understanding in the system

Systemic approaches that enable therapeutic change
the role systems can play in psychological problems and health
how patterns of interaction and relationships within systems contribute to and maintain psychological, social, relational and cultural problems and health
explanations of how changes in any part of the system may have an impact on the rest of the system
how members of the system make use of resources that promote resilience and maintain change
psychological, social, relational and cultural problems that arise from lack of fit between attempted solutions and the current contexts
how systems develop helpful and unhelpful patterns of interaction and meaning systems and narratives
how to use the members of the system and the system as a whole as a resource for the promotion and maintenance of change
how the therapist, colleagues and the broader professional system interact with, and form part of, the system with which they are working

Basic principles and rationale of systemic approaches
the various systemic models and other related concepts and their limitations
theories of systemic change and clients’ theories of change
the assumptions contained in the various systemic models
how to develop an account of patterns in relationships in families and wider systems
family based attachment theories across the life cycle from a systemic perspective

Performance Criteria

You must be able to do the following:

obtain consent from the client for the use of the team and its working methods based on a clear rationale and an open and transparent discussion of advantages and disadvantages
review from time to time, in conjunction with the client and the team, how the team is involved in the psychotherapeutic work through any ‘reflecting team’ interventions
ensure the team is consistent in responding to the client’s language, developmental stage and capacity to make use of the team’s contributions
make use of the team’s diversity of culture, knowledge and skills through contributions to the work that are helpful for the client
take account of the dynamics of the team in relation to you and the client and evaluation of the biases of the team in relation to the family
attend to family dynamics that transfer to team members
take account of ethical dimensions of practice when working with complex and delicate relational contexts
have a reflecting conversation between team members in the presence of the client system if this is considered useful by the client
monitor, together with the client and the team, the team’s contributions and facilitate clear feedback to the client
allow opportunity for the client to reflect on the impact of the team and its interventions
adjust the direction of therapeutic work in response to the team’s observations about your position in the client’s system and your therapeutic stance
contribute to the team and its reflexive practice from your own personal and professional contexts
encourage team members to support each other in the face of difficult and complex work

Additional Information

This National Occupational Standard was developed by Skills for Health. This standard is derived from research reported in Roth, A., Pilling, S. and Stratton, P (2009) The competences required to deliver effective Systemic Therapies. Centre for Outcomes Research & Effectiveness (CORE) University College London. This standard has indicative links with the following dimension within the NHS Knowledge and Skills Framework (October 2004): Dimension: Core 2 Personal and people development