In my last post I suggested that I would talk further on this model's approach to thinking about an Organisation (or Institution - same thing really) might demonstrate symptoms of malfunction and as to how here, we might think of that differently to that other managerial approaches.
The Setting: A Mental Health Team in the NHS
A new manager has taken over the overall management of a Team which consists of several sub-teams inc. say, (this will not be a precise description) an Affective Disorder Team, an Adult Crisis Team, an Early Interventions in Psychosis Team etc.
They are all based within part of a wider hospital setting and within which their part consists of a long corridor with rooms leading off it which house each separate team and the end of the corridor opens out into a larger kitchen area.
The difficulty: The teams are always cross with each e.g. blaming each other for various problems which revolve around not communicating with each other, complaints from patients, relatives and managers that patients are not being seen properly (urgently, on time etc).
So patient safety is seen as being put at risk, investigations are instigated and each team gets more and more upset with the others.
Staff turn-over is seen to be high (though there is no proof that is really historically so), sickness is high and there is a pattern (culture?) of grievance and complaint.
So, the new manager partly has a brief to address this all and decides that somehow barriers need to be broken down - if teams intermingle more they will get to know each other more, projections will be diluted and acrimony reduced.
S/he (doesn't really matter which) notices that, while all teams use the communal kitchen, they only do so to store their lunch, milk, tea/coffee etc but then take any drinks or meals back to their room (off the corridor, remember) and consume it there within their team room.
Later in these Blogs, we can think about projection as a defence mechanism and more importantly, think about the Paranoid Schizoid - Depressive position continuum but it would be safe to say here, that, while our new manager did not use that model s/he did realise that teams mingling together might well reduce friction.
Here it it is worth going back to the formula that we discussed at the start of these Blogs:
Difficulties = symptoms = defences - leading then to the question - against what are they defending?
The Manager's solution:
The manager decided that from now on all Teams would eat lunch together in the kitchen at more or less the same time and that there would be something like a general 'tea, coffee and milk' fund into which all of the teams' members's would contribute monthly.
All would share, all would mingle and the projections would melt away and the difficulties listed above, would melt way with them.
It's worth saying here, that this was a real case presented by one of the participants who attended a one-day work shop, which I presented to staff who worked within a Mental Health Trust. The workshop was called of course, The Tavistock Model of Organisational Consultancy and we can talk about how this particular case panned out in our next Blog.
In the meantime, let's go back to the main question upon which should now ponder:
Difficulties = symptoms = defences leading then to the question - against what are they defending?
Do spend some time looking at this scenario and especially so, bearing in mind the above questions and we can think about that in our next Post.
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