Consultation to the Workplace:
Thoughts for Family Therapists*
The number of organizations calling on therapists for help
is increasing. I think that there are several reasons for
this phenomenon: a level of trust in the therapeutic model
coinciding with a growing frustration with the content experts
(Hilburt-Davis and Senturia, 1995); a heightened awareness
of the 'human side of business' (Kanter, 1985); and the growing
number of therapists, frustrated with managed care and the
changing mental health field, expanding their knowledge and
practices to consult to larger systems. This article will
offer some background information about the field of organization
development (known as 'OD' ); how the therapeutic and consultation
roles differ; and how family therapists' knowledge of systems
can be a valuable contribution*.
II. Organization Development
OD has evolved from several roots: (1) National Training
Laboratory (NTL ) and T-Groups (or sensitivity training);
(2) human resources, personnel & industrial relations,
including ideas about professional management practices; compensations
and career paths for employees; (3) survey feedback, an orderly
and formulaic method assessing the organization from the viewpoints
of the employees ; (4) sociotechnical and socioclinical systems,
an approach pioneered by Tavistock consultants based on the
premise that an organization is both a social and technical
system; (5) the group as a focus of change, including ideas
about behavior (Lewin, 1958), interpersonal dynamics and learning
(Argyris, 1971), psychodynamics of social defenses (Hirschorn,
1988,1993) and the group's unconscious (Bion, 1975), connecting
the individual with transpersonal functioning.
Models of Intervention
Although there are several models described in the OD literature,
most practitioners agree that the generic model of intervention
looks something like this: (1) contracting for the work to
be done; (2) gathering of information from the client system;
(3) reporting the information back to the client in order
to make an action plan; (4) collaborative planning between
the change agent and the client; (5) implementation of the
plan; (6) institutionalizing the change; (7) evaluation. This
is often referred to as action research and is an iterative,
III. Therapists in the Workplace
Parallels exist between the history of family systems and
the history of organization development; both are relatively
new fields with no one single theory, but an emerging set
of assumptions. The effectiveness of each field is being examined.
(Burke,1995; Pinsof and Wynne,1995). A useful way I have of
conceptualizing each is that the model of organization development
is practical, a way of doing; the systemic framework is theoretical,
a way of thinking.
In considering the similarities in working with families
and the workplace family, it's important not to forget the
differences. (Wynne, 1986) These vary, obviously, with the
size and structure of the organization and the contact person
but in general the following apply: The presenting problems
in consulting work are usually around transitions, such as
downsizing and mergers, crises of leadership, and lack of
direction, no articulated short or long term goals. The work
or tasks within the work place is to improve the bottom line
and be more productive and efficient. It is not overtly around
pain or suffering, only how these feelings get expressed in
the work. Leaders want to hear, whether they address it overtly
or not, how this will affect productivity. The contract is
explicit usually specifying the 'deliverables', and an estimated
cost and time for the job. The consultant works within the
hierarchy and the higher up in the chain of command the contract
is made, the greater the chances of success.
The professional relationship in a consultation is collegial
with the motivation coming from the boss and not primarily
from the relationship with the consultant. The language and
vocabulary of the consultant describes interpersonal dynamics
in less clinical terms. For example, assessment in place of
diagnosis; issue, problem or concern in stead of symptom;
old baggage instead of transference. The paper work in consultation
is a major part of the work. There is an emphasis on written
materials and hard copies of instructions and advice that
can be left behind. I spend alot of time at the computer preparing
worksheets, training manuals, and psychoeducational material
for my clients.
Challenges for Therapists
The client is a colleague; for example, at the Family Firm
Institute dinner programs, it is expected that consultants
will bring a client as their guests. Can you imagine as
a family therapist taking a client to dinner? This requires
careful boundary work on the part of the consultant. The
work that therapists have done on themselves is invaluable
once they get used to the change in the type of relationship.
- Culture of Business
The focus is on the bottom line. The work is not directly
around pain but around getting the work done more effectively;
creating more productive employees. The move is toward changes
in observable behavior rather than changes in subjective
experience. As consultants, we must remember that we are
not hired as psychotherapists. The changes that are requested
are not intrapsychic but are at an interactional level.
It is here that systems therapists have a distinct advantage;
change happens as the systems change. Intrapsychic changes
may happen but only as a result of changes in the interactions,
the processes, the system.
- Giving advice
The consultant takes a leadership position/role of the change
agent . You are paid to have an opinion, to give advice.
The consultant is active, direct; His/her personality is
often a commodity. The expectations are that the consultant
takes more responsibility than in the clinical setting for
making changes happen and, then, institutionalizing them.
There is a paradox in being the expert and the facilitator
that can be used effectively by systems trained consultants
who can move in and out of the system.
The consultant gathers information and makes decisions about
how and what gets 'fed back' into the system. Not all information,
such as personal histories, is shared with the work group
or the leader. The consultant makes clear at the beginning
of the work that, although all information gathered will
be used in the assessment, only themes relevant to the work
will be discussed and individuals' anonymity respected.
Therapists are generally terrible business people. Somehow
business is a nasty word. There is no other way to get the
word out that what we do really works and is essential in
the work setting.
IV. Nothing is so Practical as a Good Theory
The phone call was from a physician at a local hospital
and the request was for a "Retreat" since
two hospitals were merging and the this section was
the first to be merged. I explained that I would want
to get some information; and always urge a follow-up
in about 6 months. The fee was settled on and I made
an appointment to talk with the Chair of the department.
The work involved several information gathering formats:
individual interviews, focus groups, and a questionnaire
asking each person to prioritize the issues they wanted
to be addressed at the Retreat. This information was
feedback to the work group in a mini-seminar we called
"Introduction to the Retreat".
After the Retreat, I was asked to conduct one educational
meeting about teams and communication. The four newly
formed teams began their work. Two of the teams proceeded
without major problems; two experienced conflict right
at the start. And I was called to help them deal with
the conflict. My systemic thinking was invaluable in
managing the conflict and facilitating lasting changes.
- Knowing where to look and what to do when you find
From a systems perspective, the consultant gathers information
from all involved, takes a meta position and carefully looks
at patterns and processes. I conducted individual interviews
and focus groups. As one name kept coming up as the 'troublemaker',
I was able to see the usefulness of this scapegoating to
the department. I was not lead off the track by red herrings,
could hold the multiple realities offered and understand
the forces working against change. I could understand the
function of the symptoms (conflict, anger and anxiety) and
this lead me down the critical information paths.
- Systems theory as change technique
My own experience is that most consultants pay lip service
to the words 'whole system' and do not understand or apply
the fundamental concepts of systems but are generally
referring to the whole department, section, or organization,
not individuals. One consultant told me that he did 'systems
work' since he worked with the whole department and not
I use a lot of psychoeducational and experiential material
to ready a group for change and help them through it.
Depending on the sophistication of the work group, I will
teach about the differences between process and content,
effective and congruent communication, systems terms (such
as scapegoating, boundaries, symptoms vs. problems and
effect of change on a system). Before this group got to
the Retreat, they had a working vocabulary of these useful
concepts. I think that this training accomplishes several
goals: the training itself is a group process and I can
give hands-on suggestions as they work on exercises and
role playing; the work teams generally feel 'given to'
by the larger agency; it enables them to step back and
look at the process with a new lens, and gives them knowledge
to use in future changes
- Planning change: homeostatic forces
The merger was not the choice of either department. There
would be powerful homeostatic forces (resistance ) at work.
The technique of reframing was useful for everyone to understand
how difficult this would be, give emphasis to health, strengths,
resources to empower Another effective systems concept was
being able to assess who had the power and who had the control
in this system. Organizational hierarchies, both formal
and informal are necessary pieces of information. In this
case, I was also able to understand the role that this department
(sub system) had in the larger picture of the merger. Two
cultures were becoming one; this process included loses
and gains. There was a push- pull for change.
- Use of Self: as a transitional object.
The work we've done on ourselves is priceless as a consultant
in being able to provide a holding environment for the
consultee as it goes through the painful and exciting
process of planned change and to deal with dependency
issues. As the groups struggled with the integration process,
I received many panicked phone calls to help with what
was happening. Countertransferential material provides
a wealth of information for the systems consultant, especially
to feedback into the system in ways appropriate to the
workplace. I was able to provide reassurance, normalization
and specific tips for dealing with the difficult process.
After the major part of the consultation is over, I think
it is crucial to help the clients set up a container for
themselves. This can be in the form of structured meetings,
exercises, regular communication and/or team meetings,
and helping them think in systemic ways.
- After the action plan: what to expect
As the new work teams were formed, the conflict in one
was chronic and complex. In the other, it was new , with
no complicated history. From a systems perspective, I
could reframe the new conflict as anxiety being expressed
in reaction to the massive and unwanted changes. This
reframe helped the work group handle the conflict and
establish rules for dealing with conflicts as the arise
in the work team. In the other group, I help individual
and the a joint meeting with the two warring parties.
This conflict was long standing; simple rules of communication
would not have even touched the issues, My experience
as a systems therapist allowed me to see the conflict
from a meta position and dig a little deeper to see where
it started, what kept it going ; how to manage it; and
how to affect a second order change.
Both the fields of family therapy and organization development
are changing. Increasing numbers of therapists are consulting
to the work place; systems thinking is finding its way into
the organization development field. Systems therapists have
distinct advantages in consulting to the work place. They
bring special skills and a unique perspective that can deepen
the work as needed to create lasting changes. The challenges
for the therapist are in the nature of the work; the nature
of the relationship where the rules and boundaries are different
from the therapy relationship; and the culture of the business
*My thanks to Mary F. Whiteside for helpful comments and suggestions.
Argyris, C. Management and Organizational Development, NY.,
Bion, W. "Selections from Experiences in Groups,"
in Colman and Braxton, ed. Group Relations Reader 1, London:
A.K. Rice Institute, 1975.
Burke, W. Organization Development: A Process of Learning
and Changing, Reading, MA: Addison-Wesley, 1994.
Hilburt-Davis, J. and P. Senturia. "Using the Process/Content
Framework: Guidelines for the Content Expert", Family
Business Review, VIII, 3 (Fall 1995), 189-199.
Hirschorn, L. The Workplace Within: Psychodynamics of Organizational
Life, Cambridge, MA MIT Press, 1988.
Hirscholrn, L. and C. Barnett. The Psychodynamics of Organizations,
Philadelphia: Temple University Press, 1993.
Kanter, R. "Managing the Human Side of Change",
Management Review, 1985, 52-56.
Lewin, K. "Group Decision and Social Change," in
Maccoby, Newcomb, and Hartley, eds. MY: Hold, Rinehart &
Pinsof, W> and L.Wynne, "The Efficacy of Marital
and Family Therapy: An Empirical Overview, Conclusions, and
Recommendations." Journal of Marital and Family Therapy,
NY: Guilford, 21,4 (October 1995), 585-613.
Wynne, L. S. McDaniel, and T.Weber. Systems Consultation:
A New Perspective for Family Therapy, NY: Guilford, 1986.
*Originally in AFTA Newsletter, Spring, 1996.
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