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Creating Dialogic Contexts for Multidisciplinary Clinical Reviews: The Reflecting Team Process

Published online by Cambridge University Press:  02 March 2012

Roxanne Garven*
Affiliation:
Systemic Consultation Centre, Perth, Western Australia
*
Address for correspondence: Roxanne Garven, 203 Park Street, Subiaco W.A. 6008, Australia. E-mail: [email protected]
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Abstract

When multidisciplinary teams review their work, it is common for clinicians to hypothesise about their clients from the perspective of their role or theoretical model. The outcome of this review process may depend on the team's views. Here the epistemological position taken by team members about reality and objectivity can lead to starkly different pathways. There can either be a dialogue about different hypotheses, with the team jointly constructing new meanings; or, conversely, there can be a monologic exchange based on competition between different hypotheses. This paper explores why teams may struggle with coordinating different theoretical approaches and models. It suggests the dialogic nature of a reflecting team process offers one approach for helping teams to find ways of ‘putting their differences to work’. Ideas for implementing this process within multidisciplinary teams are illustrated with comments provided by teams who have begun to experiment with this approach.

Type
Articles
Copyright
Copyright © Cambridge University Press 2011

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References

Andersen, T. (1987). The reflecting team: Dialogue and meta- dialogue in clinical work. Family Process, 26, 415428.CrossRefGoogle ScholarPubMed
Anderson, H., & Goolishian, H.A., (1988). Human systems as linguistic systems: Preliminary and evolving ideas about the implications for clinical theory. Family Process, 27: 371393.CrossRefGoogle ScholarPubMed
Bateson, G. (1972). Steps to an ecology of mind. New York: Ballantine Books.Google Scholar
Bertrando, P. (2007). The dialogical therapist. London: Karnac.Google Scholar
Bertrando, P., & Gilli, G. (2010). Theories of change and the practice of systemic supervision. In Burck, C. & Daniel, G. (Eds.), Mirrors and reflections: Processes of systemic supervision. London: Karnac.Google Scholar
Boston, P. (2010). The three faces of supervision: Individual learning, group learning, and supervisor accountability. In Burk, C., and Daniel, G., (2010). Mirrors and Reflections: Processes of Systemic Supervision. London: Karnac.Google Scholar
Burck, C., and Daniel, G., (2010). Mirrors and Reflections: Processes of Systemic Supervision. London: Karnac.Google Scholar
Cecchin, G., Lane, R., & Ray, W. (1994). Irreverence: A strategy for therapist's survival. London: Karnac.Google Scholar
Cecchin, G. (1987). Hypothesising, circularity and neutrality revisited: An invitation to curiosity. Family Process, 26, 405414.CrossRefGoogle Scholar
de Shazer, S. (1991). Putting difference to work. New York: Norton.Google Scholar
Flaskas, C. (2011). Frameworks for practice in the systemic field: Part 2 - contemporary frameworks in family therapy. Australian and New Zealand Journal of Family Therapy, 32, 87108.CrossRefGoogle Scholar
Hoffman, L. (1985). Beyond power and control: Toward a second order family systems therapy. Family Systems Medicine, 3(4): 381396.CrossRefGoogle Scholar
Hoffman, L. (1990). Constructing realities: An art of lenses. Family Process, 29(1), 112.CrossRefGoogle ScholarPubMed
Keeney, B. (1983). Aesthetics of change. London: Guilford Press.Google Scholar
Koestler, A. (1964). The act of creation. United Kingdom: PenguinGoogle Scholar
Larner, G. (2003). Integrating family therapy in child and adolescent mental health practice: An ethic of hospitality. Australian and New Zealand Journal of Family Therapy, 24, 211219.CrossRefGoogle Scholar
Larner, G. (1994). Para modern family therapy: Deconstructing postmodernism. Australian and New Zealand Journal of Family Therapy, 15, 1116.CrossRefGoogle Scholar
Lowe, R. (2005). Structured methods and striking moments: Using question sequences in ‘living ways’. Family Process, 44(1), 6575.CrossRefGoogle ScholarPubMed
Mason, B. (1993). Towards positions of safe uncertainty. Human Systems, 4, 189200.Google Scholar
Maturana, H. R., & Varela, F.J. (1980). Autopoesis and cognition: The realisation of the living. Boston: Riedel.CrossRefGoogle Scholar
Minuchin, S., (1974). Families and family therapy. Cambridge, MA: Harvard University Press.CrossRefGoogle Scholar
Reder, P., & Fredman, G. (1996). The relationship to help: Interacting beliefs about the treatment process. Clinical Child Psychology and Psychiatry, 1, 457467.CrossRefGoogle Scholar
Rhodes, P., Whatson, L., Mora, L., Hansson, A., Brearley, K., & Dikian, J. (2011). Systemic hypothesising for challenging behaviour in intellectual disabilities: A reflecting team approach. Australian and New Zealand Journal of Family Therapy, 32, 7082.CrossRefGoogle Scholar
Seikkula, J. (2011). Becoming dialogical: Psychotherapy or a way of life? Australian and New Zealand Journal of Family Therapy, 32, 179193CrossRefGoogle Scholar
Seikkula, J. (2003). Dialogue is the change: Understanding psychotherapy as a semiotic process of Bakhtin, Voloshinov, and Vygotsky. Human Systems, 14, 8394.Google Scholar
Selvini Palazzoli, M., Boscolo, L., Cecchin, G., & Prata, G. (1980a). Hypothesising-circularity-neutrality: Three guidelines for the conductor of the session. Family Process, 19(1), 312.CrossRefGoogle Scholar
Shotter, J. (1993). Conversational realities: Constructing life through language. London: Sage.Google Scholar
Trimble, D. (2002) Listening with integrity: The dialogical stance of Jaakko Seikkula. Journal of Marital and Family Therapy, 28, 275277.CrossRefGoogle ScholarPubMed
White, M. (2007). Maps of narrative practice. New York: Norton.Google Scholar