Meeting-The-Challenge-Making-a-Difference-Practitioner-Guide

PRACTICAL GUIDANCE
Common defences against the distress
stirred up by getting involved in the work
• Cutting off from service users and treating them in a distant,
superior or critical way.
• Retreating to the relative calm of paperwork or unnecessary
staff meetings.
• Getting promoted to management roles where there is less
contact with service users.
• Passing cases on to someone else when you feel hopeless
about being able to help.
• Becoming cynical about the work or resorting to ‘sick’ humour
with colleagues.
• Becoming very business-like and efficient but at the risk of
being insensitive.
When these defences get built into the culture of the
organisation, they can lead to rigid, distancing and inhuman
practices. There have been some very high-profile examples of
things going badly wrong in health service organizations and
care homes. But the factors that led to these and other
profound human service failures exist in embryo in every service.
Every service needs ways of supporting its staff to cope with
being exposed to human pain and distress, and without such
safeguards, unhelpful practices may develop.
STAFF TRAINING
One particular programme, the Personality Disorder Knowledge
and Understanding Framework (PDKUF) was commissioned by
the Department of Health and Ministry of Justice specifically to
help staff working with people with personality disorders. It is
worth finding out whether there are PD KUF courses available
to staff in your area. Individuals may access the PD KUF training
individually, or book a course for their whole team. Teams that
train together are more likely to develop helpful shared
working practices.
What do you
need in order to
do this work?
Work in this area is demanding,
and the business of providing
services is complicated. Frontline
staff and their managers
need to be working in teams
which are functioning well
enough to:
• Recognise (notice).
• Take in (digest).
• Make sense of (think about).
• Decide how to respond
(intervention decision).
Teams need to do this in
response to a variety of
challenging situations on a
daily, sometimes hourly, basis.
These are ordinary human
capacities but they can be
affected by the strains of
doing the work and by
problems within the
organisation. Organisations
can design clear structures
but if the team is not attended
to with the same degree of
care, it will be difficult to get
the work done well.
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