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The system 

The system
Chapter:
The system
DOI:
10.1093/med/9780199608386.003.0010
Page of

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date: 22 February 2020

Chapter 10 describes the system through a detailed examination of different aspects of psychotherapeutic work in institutions and beyond in planning services in NHS settings, through service user involvement, understanding organizational processes, and investigating the challenges of the psychotherapeutic relationship with management. Therapeutic interventions which enhance the experience of patients and professionals are described in psychotherapy teaching, Balint groups, and reflective practice groups as different forms of therapeutic education and experience. The strata of primary, secondary, and tertiary levels of service and their historical and political origins provide a foundation for reflecting on empowering meaningful involvement of service users, a theme of power taken up in relation to the unconscious at work in organizational dynamics and in relation to distinctions between leadership and management. The different forms of therapeutic education offer diverse perspectives on developing psychotherapeutic thinking in the workforce, with vignettes highlighting the impact in the system through therapeutic impact on the individuals who work in the system.

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