Journal of Family Therapy (1981) 3: 187-199

The family therapist and staff-group consultancy

Eddy Street*

For the therapist who ascribes to a systems model of family functioning it should be recognized that theoretically the family is only one of a number of primary groups that can be described utilizing this theory. Regular work groups in both the commercial and the caring world and even consistent groups of voluntary organizations should, if the systems approach has any general validity, also contain some of the properties which family systems therapists recognize and attempt to influence. But the field does not con- tain any guidance as to how an intervener would attempt to alleviate any problem or maximize any advantage in work groups for, as yet, family therapy as an orientation has not yet approached this problem systemati- cally. One should however be able to assume that the literature on thera- peutic models and techniques as applied to families should have some relevance to other primary groups.

Overall the sociological as well as the social psychological literature reveals many approaches to the study of work-groups ; the principal focus is however a descriptive-analytic one. There does not appear to be any consistent pattern as to how a consultant who seeks to assist change should approach various organizations. However three trends stand out to the extent to u-hich they are cited by others and which appear to have been circumscribed by themselves. The trends do address themselves to the activities of those who wish to consult, advise and help work groups im- prove in their effectiveness. Firstly, there is the development from organ- izational psychology, which as an area of study is concerned with the behaviour of individuals and groups in organizations (Glen, 1975 ; Schein, 1965). From the viewpoint of consultancy this would appear to be an area where theoretical and conceptual analysis have developed at a faster rate than any practice skills. Burke (1971) notes that ‘there is a large body of literature on the processes of organizational change, which is obviously relevant to the r81e of the consultant and offers many insights. However

* Senior Clinical Psychologist, Preswylfa, Child & Family Centre, Clive Road, Canton, Cardiff.

187 0 1 6 3 4 5 / 8 1 / 0 2 0 1 8 7 + 13 $02.00/0 @ 1981 The Association for Family Therapy

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most of this work emphasises ways in which a client’s system was changed rather than how it was changed.’ His view is that this lack of knowledge is due to both the practice of business consultants and social scientists. The type of contract engaged on by consultants do not lend themselves to research activity and the ethics of business means that if there is a good idea, it is not shared. Social scientists have unfortunately separated the process of understanding organizations from the process of improving them. Burke notes however that there has developed four types of con- sultant-client involvement, three of which he quickly dismisses as not being very productive and points to the fourth called ‘Process Consultation’ as being the most helpful in constructing alternative strategies for con- sultant involvement. Process consultation is characterized in the writing of Bennis (1966), Schein (1969) and Argyris (1970). Essentially they have explored the rBle of consultants and the problems of organizational diag- nosis. Argyris (1970) adopts the view that ‘change is not a primary task of the interventionist . . . his primary tasks are to generate valid information to help the client system make informed and responsible choices and to develop internal commitment to these choices. One choice that the client may make is to change aspects of their own system.’ He indicates that an interventionist needs to be familiar with the processes of group dynamics, so that groups may be used as mediums of change for individuals. In his work he provides descriptions of the qualities and behaviours that inter- ventionists require in order to be effective in the promotion of organizational change. Particularly he lists the behaviours as owning up to, being open toward, and experimenting with ideas and feelings ; helping others to own up, be open and experiment with ideas and feelings; and contributing to the norms of individuality, concern and trust ; communicating in observed directly verifiable categories with minimal attribution to valuation and internal contradiction. Essentially this view is of the consultant acting as a model of clear, open congruent communication, so that the client-system might begin to own the problem and examine the norms and values that they hold. Central to the view is the ability of the consultant to be able to offer an appropriate diagnosis of the problem for the organization. At present much of the work in this field is to aid this diagnostic development and hence can be seen as being concerned with preparing a taxonomy of organizational processes and possible malaise.

A second trend is that which involves the work of the Tavistock Institute of Human Relations, London, which Rice (1963) and Emery and Thorsen (1969) for example have produced some well written examples of how organizations are a combination of technology (task requirements, physical layout equipment available) and the social system (a system of relationships

Staff-group consultancy 189 of those who must perform the job). In common with many other socio- logists, notably Parsons (1960), these authors conceive of formal organ- izations as being open systems in constant interaction with themselves and with the external world. This systemic view of social organization naturally leads us to the conception of the family as an open system (cf. Parsons and Bales, 1955) which now finds its echo in therapeutic work. The view of the authors associated with the Tavistock Institute is that for any organization to make an effective change both aspects of the socio- technical system need to be taken into account. Here the emphasis for the consultant is clearly placed on the task of leadership, where the leader has to manage the relationship between the enterprise and the social system so as to permit optimum performance of the primary task of the enterprise. Rice (1965) sums up the task of managers, ‘the techniques of management, the kind of organization required, the control mechanisms used and the criteria for judgement of performance vary according to what has been managed, but all managers, administrators and professional workers in whatever field they work have to use more than techniques ; as a minimum they have to come to terms with themselves and with the personal and group characteristics of those who man the institutions in which they work. To be successful they have to make constructive use of their own person- alities.’ Rice further goes on to describe a series of stranger group exercises designed to enhance individual insight and leadership qualities and these exercises have some theoretical underpinning from the psychoanalytic understanding of human functioning. A notable feature of this process of group exercises is the individual being given the r81e of consultant to other small groups. Although reasonably well established the ‘Tavistock’ model rests on the assumption that the first step of organizational change involves the internal individual processes of the leader and although this un- doubtedly is an important aspect in consultancy it does not offer a com- prehensive framework for an outsider being involved with a total active group.

The third trend can be characterized as being the sensitivity group or T-group movement. Rogers (1965) has provided a brief history and back- ground to the development of these groups which emanate from the work of the psychologist Kurt Lewin. Essentially the aim of the group is to provide a setting in which individuals can observe the nature of their interactions with others and so be taught about their own human relation- ship skills and how to improve these. By taking part in the group process it is hoped that the individuals come to understand their own functioning in the group so that they may become more competent in their own job situ- ation and be able to deal more ably with difficult interpersonal situations.

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These groups can be work or stranger groups. In reviewing the com- munality between such groups Rogers outlines the skills that the facilitator should possess to enable such groups to be effective. These should be an acceptance of both the group and the individual, and empathic communi- cation is stressed as well as operating in a congruent way. Gibbs (1970), and later Smith (1975), have reviewed the evidence on the effect and the outcome of sensitivity training. Smith’s review notes that a number of studies did show an effect after training but in particular he notes that the sensitivity training process lacks the backing of an adequate theory and therefore the area must be ‘groping in the dark’. In a more recent review of the whole area of training in work organizations Goldstein (1980) also echoes this comment as he too concluded that ‘the literature must be described as non-theoretical and non-empirical’.

It can be seen that these three trends do find echoes in the other. There is some stress on individual open congruent communication and one might speculate that Truax and Carkhuff’s (1967) central therapeutic ingredients are also applicable to staff group consultants. There would however appear to be no agreed theoretical foundation for the actual activity of the therapist/consultant and scant scientific validation is pro- vided for the efficacy of any of the methods that are adopted. The work of consultants to organizations is merely at the level of description and it is noticeable that there is little tie-up between conceptions of change as related to organizations and theories of change that have developed therapeutically.

The family therapy literature yields little in the way of articles written from its perspective and applied to groups other than families. A par- ticularly important development however is the ‘ecostructual’ approach outlined by Aponte (1976). Here is a situation where a school requests that parents seek help for an ‘acting-out’ boy. Aponte demonstrates how the ‘ecological’ context of this problem can be seen as the interrelated systems of the child, the family, the school and the community organization. He comments that, ‘the transactional patterns that characterize the relation- ships among the component systems of this complex incorporate the laws by which the parts of these systems function with respect to one another’. He goes on to note that mental health professionals have tended to address themselves to one or another of these component systems, ‘but the challenge is to develop methods for intervening where the systems touch each other’. In the particular case which Aponte describes, the therapist’s initial response was to conduct an interview involving elements of the school and family systems, so that they might discover how each system interacted with itself and with the other system. From the description offered it is

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evident that many of the skills involved in an interview of this nature are the general skills of family therapy.

Culbert and Renshaw (1972), and later Renshaw (1976), address them- selves to the problem of dealing with an organizational issue in such a way that home and work life hopefully improved. The workers came from an organization requiring them to undertake much travelling which was one of the most dissatisfying aspects of their work because of its disruptiveness on home and families. The authors arranged a workshop for the employee group together with their wives and they found there were some im- provements in both family and organizational effectiveness. They state that the techniques they utilized were derived from organizational develop- ment and were designed to improve the process of problem solving. ‘Gathering information, defining problems, identifying contributing forces, generating new alternatives, facilitating collaborative action, reflective current practices against longer term objectives’. These techniques were applied to both managerial and marital problem solving. Speck and Attneave (1973) in their descriptive account of network interventions of family systems make the point that professional associations and other institutions have many similarities to extended family network hierarchies and that ‘a combination of techniques in the context of social network intervention might offer something to improve the state of institutional health’. In particular they note two problems in organizations; the reluc- tance of older members to relinquish authority and the lack of awareness of options by the younger generation of members. Apart from a general comment on the applicability of network techniques they specifically men- tion sculpting ‘the history of the group’ in order that it may acquire a sense of its own interdependence and transgenerational qualities.

Even though the family therapy literature yields relatively little help there can be no doubt that many professional workers who engage in family therapy per se also become involved in some consultant/advisor r81e to care-giving establishments. I t has been noted by Sinclair (1975) that these establishments have a quasi-family nature and this point has also been made by Street (1979). Viewed in another way, Borowitz (1970) has noted that disturbed children in residential settings attempt to recreate those aspects of their previous life that they have internalized and adapted to, whether beneficial or otherwise. Consequently staff in children’s homes tend to take up responses to their charges that reflect processes in the children’s families of origin. This is similar to the process that Reder and Kraemer (1980) have commented on, which they label as ‘systems counter transference’, where care givers, because of their position in a professional network and to a lesser extent because of their personalities,

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are often cast in and act out the r6les of members of their clients’ families. One can expect therefore that within children’s homes there undoubtedly are many features with which the family therapist will be familiar. Not- withstanding this one must turn to the sociological knowledge on children’s residential provision, in order to have some background to involvement. Moss (1975), for example, has suggested that formal organizations that are involved in providing residential facilities to children can be subdivided into models based on the emphasis of the goals of the organizations, these being the educational, the childcare and the medical/nursing models. Millham et al. (1975) have provided possible tools for the sociological/ organizational analysis of residential organizations stressing the concepts of goals, formal versus informal systems, methods of social control and relationship to power structures. King et a€. (1971) in their influential work have looked at the determinants of care in residential establishments for handicapped children. The evidence that they present suggests that the r61e of the person in charge of each unit is critical for setting the pattern in that unit. This conclusion lends some weight to the Tavistock model of organizational change. However they go on to suggest that ‘the individual differences were outweighed by broader structural constraints, the adminis- trative organization with which staff operated and the training programmes which were designed to support their work’. This view is taken up later by Tizard et al. (1975) who note that even though there are different and opposing models in the care of children they do however share one basic assumption which is that variation in staff organization, building and the like have little importance on the nature of care. These authors, and the work they have generated, are clearly calling into question this assumption which must indicate that consultancy to these organizations should be directed towards the total environment rather than the particular person presenting with difficulties. Sinclair (1975) states emphatically his belief that the works in residential establishments need to be supported exten- sively, and this has been taken up by Walton (1979) in looking at the r61e of the residential care advisor who traditionally has provided support for children’s homes. He notes that ‘agencies need to look closely at the r6le to see whether other patterns of consultation are relevant, for example should each establishment have an external consultant whose sole action is to act as a resource for staff on a regular basis. There is no doubt that at present many homes are without adequate consultative resources. The agency’s internal problem is that residential care advisers are identified with organisation management which confuses their consultancy r61e. Properly managed external consultancy to particular homes can have direct effect on practice.’ The difXculty that is posed for all is that there are no

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guidelines for properly managed external consultancy and as can be seen from the very brief review above, the literature offers little in the way of aid for a developing consultant.

Over a period of several years this author has had involvement in children’s homes, particularly of the family groups variety. With a family therapy orientation of the structural/strategic approach particular common features have been noted and certain problems hopefully overcome. Essentially the first problem has been dealing with the invitation which can be seen in terms of the power of the individuals concerned and the power of the consultant, which in the last analysis must be of some high level. Children’s homes even though being somewhat self-contained and possible quasi-family units are usually however a part of a much larger organization in which someone who does not involve themselves in the day-to-day activity of the home is nevertheless in a superior position in the formal hierarchy. The consultant needs to deal with this fact in a way that validates the entity of the establishment whilst not undermining the r6le of the external superior. In other words, the consultant needs to treat the home/hierarchy boundary as a permeable one. The rule that has evolved is that the head of the unit must request the immediate supervisor (usually the residential care-adviser) to invite the consultant to attend a meeting at the unit. Therefore the line of communication to the consultant is at a level higher than that of the authority of the head of the unit. Many mis- takes were initially made from attending units after request from the residential care advisors themselves in which case the staff felt that some- thing was foisted upon them. The other situation was where a head of an establishment wodd issue an invitation without involvement of the resi- dential care advisor, who often felt that at that time they were dealing with the issues quite adequately and consequently felt threatened. It has been a practice that the immediate supervisor should be allowed to attend the meetings. Practically this is not always possible but the fact that it is possible makes it clearer to all concerned that there is an outside world that has to be negotiated with as well as making it easier to briefly exclude the superior if thought necessary at a later date. The date and time of the meeting is negotiated with the head of the unit, hopefully when all staff can be present and the responsibility for attendance (even of the superior) is left with the head of the unit. A contract for meetings is negotiated at the end of the first meeting with the whole of the group, and this contract may involve dealing with a particular child or a particular problem area, or even an attempt to look at the way the group communicates.

Even though time in the staff group itself is treated in the same way as time in psychotherapy it should be remembered that.the consultant as a

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visitor is likely to spend time in the unit outside of the group meeting. The consultant needs to plan in a strategic way how this time is to be spent for it too carries strong communications to the total staff group. Many mistakes were initially made following some staff group meetings by allowing the head of the unit the opportunity to re-negotiate any suggestion whilst the consultant was being given tea in the ‘ofice’.

It has proved important for the consultant to stress continually the status of any advice or suggestion that is given during a meeting, namely that it is up to the staff group by whatever means they chose to accept or reject any suggestion. This leaves the staff group with the responsibility for implementing any decision, hence the consultant is not placed in any managerial relationship to the group. It also requires the group to negotiate with outside individuals and agencies if any change impinges on them and thereby attempts to prevent a usual process of the group seeking to manipulate the consultant into being their negotiator with the outside world. This is particularly evident in the pressure on the consultant to see individual children and to become involved in the total management of the case. I t has become a strict rule that there is no involvement with individual cases as a ‘child guidance’ worker and if the child guidance team has received a referral of a child who lives in one of the establishments that is visited then it is passed to a team member who is unlikely to play a consultant r61e with that particular establishment. The staff group and the consultant discuss a particular child’s problem in almost an identical manner with which parents would discuss their child with a family therapist who believes there is no need to see the child. This bypassed any problems that may arise with regards to field social workers and other professionals. The ’Consultant is therefore not involved in the management of any case but is there to help solve problems, and in this respect opinions are transmitted to the staff group alone not to any case conference or any other worker that is involved with that child. If in the view of the staff group they wished to change any management decision relating to a par- ticular child they need to do so by negotiation with the other professional workers. Obviously the aim of consultancy in these circumstances is to clarify the group’s choices, and define alternative strategies. Experience suggests that in fact the most difficult issue in consultancy in children’s homes has been in dealing with these rules of the invitation and the non- involvement with individual cases.

With the orientation of family systems therapy and with some help from the literature on residential establishments for children particular features of their staff groups have been noted once consultancy meetings have begun.

(1) Each group has a primary task/goal that it must perform, i.e. the

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task a group must perform in order to survive. In many cases this is assumed and people react to it implicitly. Often however there are subtle, but nonetheless significant differences in the way in which group members perceive their primary task and this can be the cause of conflict. An initial phase of consultancy has been to make overt what the primary task is and to offer it as being something that can be continually re-negotiated. Some primary tasks have changed during discussion and those that have emerged for example is the wish to deal with a particular kind of child, the wish to deal with children who come into care immediately and particularly the wish to establish a particular type of care experience. In other words the area of explicit goal-planning is raised so that the staff can move from a ‘we are here to look after the children’ stance, which can engender conflict, to a more satisfying view of their own aims.

(2) The activity of staff groups is more overtly linked to decision making processes than families. In particular there is one useful dichotomy and that is between a programmed decision that is made in accord- ance with instructions from a hierarchy or existing precedence, and an unprogrammed decision which is made to meet a new situation with references to professional goals or ideals (see Heal and Cawson, 1975). Where the boundary falls between these two types of decisions, often reveals the nature of the power structure in any staff group and the extent to which the head of the unit wishes to exert their authority. Obviously the areas in which staff are allowed to make autonomous decisions needs to be clear and communicable.

(3) It is clear that as King, Raynes and Tizard (1971) state in their work that the r8le of the person in charge is critical for setting the pattern of that unit, and therefore the consultant needs to be very aware of the centrality of this r81e.

(4) Unlike families any staff group would seem to have a minimum of three hierarchies which can come into conflict, these being: (a) the authority (formal) hierarchy; (b) the expertise hierarchy-of which there can be several; (c) the length of service hierarchy, the person at the top holding their power by maintaining the myths and fantasies about the past. A typical problem is the formal hierarchy denying or over-controlling the expertise hierarchy with a usual process being for the formal hierarchy to ally with the length of service hierarchy in order to prevent expertise from introducing change. The consultant therefore needs to acknowledge the power or lack of it that each person holds in relation to each hierarchy.

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( 5 ) Sub-group activity applies to both the formal and informal struc- tures. There seems to be a tendency in staff groups to verbally emphasize either the formal or the informal structure even when both equally operate and it often takes some time for the consultant to work out the nature of both operating structures.

(6) There are a number of dimensions that appear to operate in terms of children’s homes. Firstly, the dimension which is created by the frequency of changes of staff. In homes where changes of personnel are frequent there tends to be an emphasis on d e s , communication patterns and the nature of leadership, whereas as one might expect the stable group has an emphasis on the actors themselves. Another dimension is in terms of overt communication. Where there is high overt communication with many meetings, triangulation and scape- goating towards the clients and/or the bureaucracy are the principal processes, whereas where overt communication is low, in terms of few formal group meetings, triangulation and scapegoating is towards members of the staff group itself. T o some extent some groups almost seem to spend too much time together possibly adopting a view that ‘we would have a much better group if it was not for these children/the bureaucracy’, whereas in some groups who meet very infrequently the rumours and stories that circulate about other group members seem to be quite high.

(7) The social network of any staff group must be defined in terms of the centrality of its client population, not its administrative structure. Unfortunately the system of case conferences can create the ten- dency to think of it as a network but it is in fact allied to adminis- trative structures and is not an actual social network in the terms that Speck and Attneave (1971) discuss. This has important bearings when a staff group is moving to seek changes in particular aspects of its work which may affect its network as well as its administrative structure.

Undoubtedly each consultant will bring different emphasis to bear in his work which will reflect his personality and therapeutic orientation. In these early days of describing consultancy a few points are worth making on techniques which have been found to be helpful. Initially, and con- tinually, the head of the unit has to be joined with by the consultant. He or she is the person who convenes the meeting and therefore the usual techniques of joining need to be consistent with this person. I t is however important to join with each member of the staff group individually and a topic which allows this without entering into conflict with too many

Staff-group consultancy 197 hierarchies is the topic of career and life development. It is quite acceptable to all staff members to hear a personal almost private conversation between the consultant and a group member on the issue of how they see their own professional and personal development. Strategies that have been evolved by Speck and Attneave (1971) are particularly useful notably their method of having the oldest member introduce chronologically ather staff mem- bers. This is helpful in that it does allow the staff to deal with the issue of the length of service hierarchy. Other hierarchies can be made overt by having group members line up in terms of their position in the adminis- trative structure or in terms of their ability to deal with particular problem behaviours. Very often conflicts become readily seen when the person who has the most status administratively has the least expertise in dealing with a certain situation. Of course these techniques can only be introduced at a time when some trust has developed between the consultant and the group itself. Other techniques that have developed in terms of subgroup and subsystem organization is to have the subgroups discuss some pertinent issues while the rest of the group watch. This allows for clarification of communication patterns ; decision making processes and subsystem internal relationships, it prevents boundaries from becoming too rigid for if this does happen it causes many feelings of exclusion and resentment. Unlike the marital subsystem in families staff groups do not require such firm rules about privacy, though the areas where decisions can be made and by whom need to be made quite explicit. Even though these techniques have proved of some use, most of the work in fact goes into creating the r81e of being a consultant and in dealing with the invitation and once this problem is overcome the consultant from a family therapy orientation needs just then to be a family therapist.

These few guidelines and impressions have merely evolved on a trial and error basis over time and in no sense do they carry the weight of any scientific evidence or of any other general experience save of this author. The work in this area however has already been noted as being up to this moment untheoretical and descriptive, and at present there is little to offer that makes it very different. Hopefully this contribution, however, will encourage more practitioners to become involved in this type of activity and once we have more involvement then we can develop a comprehensive approach to helping improve the effectiveness of caring organizations based on the framework of the values and aims of psycho- therapy.

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