Clinical Practice in Treatment Systems: A Psychodynamic Systems Approach
Clinical practice in treatment systems is complex and challenging. Effective clinical practice is contingent on knowledge and skills that are particular for systems-based work involving multiple mental health practitioners and clients interacting in a relational matrix. Yet, not all clinical theories and constructs that were developed for application in individual, group, and family modalities are directly transferable to the practice setting of a treatment system. In this seminar, Cathleen Morey, Ph.D., LICSW, outlines a conceptual framework that synthesizes contemporary psychodynamic principles with systems theory – referred to as a psychodynamic systems approach – to inform and advance knowledge of systems-based clinical practice. This approach considers the interplay of dynamic processes among the four levels of the socially co-constructed system, as well as patient, staff and organizational factors that uniquely impact clinical processes in systems of care. Five key clinical phenomena are frequently actualized in systems work: transference, countertransference, splitting, projective identification and enactment. Definitions of these phenomena formulated from a dyadic perspective and a contemporary psychodynamic systems approach will be offered, and their similarities and differences will be discussed.
Based on Morey’s empirical research, she will describe the construct of system enactment and its relevance for clinicians practicing in treatment systems. She will outline a four-step framework for engaging system enactments to repair alliance ruptures with patients, restore intra-staff functioning and address problematic organizational dynamics. Throughout the seminar, Morey will highlight social justice and anti-oppressive elements of a psychodynamic systems approach. Case discussions will illustrate the application of concepts in ways that are clinically relevant for participants.
CEs: 3 CEs are available