Case Study 

Consultancy to a Senior Management Team working in community mental health  

A large, busy senior management team sought external support to help it think through how it could use valuable meeting time more effectively.

The team’s context

Targets: 

• In the face of ever-increasing patient demand targets were about to be missed for the local mental health service the team managed. This meant it was under pressure from the external organisation monitoring performance.

• Targets and immediate operational issues seemed to squeeze out all else: the team’s weekly business meetings focused on ‘firefighting’ and solving here and now problems. This meant the group was finding it difficult to think creatively or collaborate on longer-term planning/strategic issues. 

Morale: 

• The senior management team led, and supported, several frontline mental health service teams. Pressure of targets, as well as recent changes in the senior team's own membership, was impacting staff morale within these frontline teams. 

• These changes in membership were also influencing the senior team's sense of cohesion. 

Time to reflect: 

• Against the backdrop of these challenges the team was finding it difficult to find space to reflect on emotional and psychological aspects of its work in the mental health field.

My approach 

Structured discussions:

Over several consultancy sessions I facilitated structured discussions using themes and questions key to the team’s work and tensions faced. 

...this allowed the group to explore core team purpose and identity as well as issues related to time and task. The group was able to freely share, and listen to, a range of views and perspectives from individuals within the team. 

Tools:

My engagement with the team kept the wider organisation in mind: I used an action learning tool and image/drawing exercises to help the group get in touch with deeper pressures from the organisational context and system within which it worked.

...this allowed individuals to share different perceptions and experiences of ‘below the surface’ dynamics which had previously been hard to articulate and acknowledge. This helped the team create a collective sense of particular pressures they were working under.   

Facilitating using observational material:

Feedback from my observations helped the team highlight and talk about its informal patterns of behaviour and routines i.e. team culture. 

Responding flexibly to client needs:

The COVID crisis brought sudden and unexpected changes to the way local services were delivered for patients needing mental health support, including a total shift to online service provision. 

The crisis also brought immediate changes to the team’s work patterns and to how decisions were made in the wider organisational hierarchy. 

The group needed a structured time and space to process these significant changes which later sessions of the consultancy provided. 

...my careful facilitation of group discussions meant team members could share differing opinions and feelings about the challenges these changes had brought. This helped individuals make sense of their experiences at a critical time and begin to build an integrated picture of what had happened.

Impact 

Structure and facilitation of the consultancy sessions allowed greater openness and discussion on core tensions, dilemmas and frustrations facing the team than had previously been possible. 

Managers were able to listen to each other - and be listened to - in new ways. 

This helped the team:

Strengthen relationships and communication: 

• Feedback from the group was very positive, emphasising a high level of engagement from all team members and strengthened relationships within the team. 

• Individuals said they had more empathy and sense of connection with others in the group and were able to see things differently and from the perspective of other team members. People could communicate better, talk about things and knew each other better. 

• It was clear the work had increased trust within the group, helping provide a basis for future collaboration and shared decision-making. 

• It had also strengthened the group as a potential place of mutual support for individual managers in their work. 

Clarify choices: 

• The group was able to frame and articulate more clearly choices about how it prioritised its valuable time - including time for reflection. 

• The consultancy also helped the group reconnect with its sense of agency in making those choices. 

Gain deeper insight into system pressures: 

• The team was able to acknowledge deeper pressures at play relating to the context within which it worked - that might be influencing team mindset, leadership dynamics and pull to focus on the short-term here and now.

• This helped the group shift focus, developing new thinking: the group was able to recognise how it might be 'blocking' itself from certain choices, thus helping in its determination to avoid the pull of old habits. 

Manage change and uncertainty: 

• Later consultancy sessions helped the group reconnect after the sudden loss of regular face-to-face meetings and work structures due to the pandemic. 

• The group could begin to develop a collective response on the huge changes brought by the COVID crisis and their meaning. This helped it process these changes and so move forward as a team.