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Well, within the trust I work in, only evidence based NICE recommended therapies can be delivered, so that's your person centred approaches out of the window. It narrows the scope of interventions to individualised ones only and you have to be given a label to get "treatment". Within IAPT, particularly low intensity work, it truly appears to be interventions by "battery therapists", see em' quick, briefly and directively, perhaps increasing burn out for therapists and an impersonal standardised McDonaldised type of intervention. I was amazed to read an article in last month's issue of Clinical Psychology Forum written by a Graduate mental health worker where she describes PWP workers as implementing common factors "through a series of empathy dots, these being marks placed into the margin of a pre designed psychotherapy interview schedule so that, the worker is reminded to say something warmly empathic and/or understanding at intervals within the interview". You couldn't make it up!!! Sent from my iPad On 5 Aug 2013, at 09:46, Chris Rossiter <[log in to unmask]> wrote: > The intersection between management, organisational practices and the services you all appear to be a part of is quite interesting. > > I'll admit to knowing very little about MH services, of any kind. Yet the model discussed seems like a rehash of Taylorism/Fordism, that even most Occ.Psychs would cringe at; and I can be sure you all know that's a fairly extreme position! Everything I've read speaks to authority, standardisation and bureaucracy; the bedfellows of the New Public Sector Paradigm. > > Public services are not a manufacturing business. It's incomprehensible to think that taking such a narrow view is justified, let alone practical. I wonder to what extent one has autonomy in the Lean Model, and if so how one can possible operate standardised practices with clients/patients who are anything but? > > > > > > Christopher J. Rossiter BSc MSc > Department of Psychology & Surrey Business School > 24 AC 04 University of Surrey, Guildford. GU2 7XH > [log in to unmask] > From: The UK Community Psychology Discussion List [[log in to unmask]] on behalf of Mark Burton [[log in to unmask]] > Sent: 04 August 2013 18:51 > To: [log in to unmask] > Subject: Re: Lean in mental health care > > Yes, I pretty much agree. My experience is more in so-called social care / long term support but supervision is another thing that you need 'slack resources'' for (in health and social support/care). > I'm maybe a bit more sceptical about the value of professionalised psy-services (can afford to be with a nice pension from years of doing just that) but am very clear that narrow managerialist (that is to say 'dirigiste') approaches will make the situation worse. > > > > ___________________ > Mark Burton > Scholar Activist; > Visiting Professor: Manchester Metropolitan University > http://steadystatemanchester.net > http://libpsy.org > http://www.compsy.org.uk > http://greendealmanchester.wordpress.com > http://uncommontater.net > > 37 Chandos Rd South, Chorlton, Manchester, M21 0TH, UK > > Telephones: +44 (0)161 881 6887 landline > +44 (0)777 594 9479 mobile > skype name: markburton52 > > -----Original Message----- > From: Jane Mitchell <[log in to unmask]> > To: [log in to unmask] > Sent: Sun, 04 Aug 2013 5:03 PM > Subject: Re: [COMMUNITYPSYCHUK] Lean in mental health care > > Some useful advice here to consider. Not sure that protecting my sectional interests at the expense of labelled people was the cause of my objections to lean, (consciously anyway), but more have been concerned that the effects of it in mental health care has been to demonstrate the unimpeded flow of a labelled person into and through a system supposedly to meet their needs. In practice this appears to be to get staff seeing as many people as possible in a day, to extract information from them to put on to the time consuming electronic recording system (thus to show productivity)to indicate by ticking electronic boxes that risk has been assessed, and that they are getting supposedly the right "interventions" for their assigned cluster in line with payment by results. > > Not included is the consideration that staff need supportive supervision rather than performance monitoring and management to be able to contain and manage difficult feelIngs in them evoked by being in touch with the distress of labelled people, in order to be able to interact with them compassionately and view them as humans in need of compassion. Staff also need some space and time to think about these people and plan how they can be helpful, (I know of the arguments that mental Heath care is never helpful). Lean is eroding working conditions to enable the above to occur, and one of the consequences I fear is that the consequent stress experienced by staff leads them to cope by emotionally cutting off and treating labelled people as objects, annoyances, diagnoses to an even greater degree than before, or by going off sick, or at worst losing their jobs, or positions in the organisation if they object. If mental health services were bad enough to warrant justified criticism before, this just seems to make a bad situation worse. > > Sent from my iPad > > On 3 Aug 2013, at 16:09, Mark Burton <[log in to unmask]> wrote: > >> I think the things to emphasise in any struggle about this are, >> 1) We do not endorse waste in human service systems. >> 2) But our services have been subject to (annual cuts usually called something ideologically appealing such as) efficiency savings. >> 3) There is positive value in having some 'slack resources' in a system - so in social care (where I've seen Lean tried) it allows adequate time for staff handovers, training, team working - and no doubt similar in mental health care. i.e. efficiency isn't necessarily a good thing. >> 4) Emphasise things like co-production of interventions, support by labelled people and staff - how do you model that in Lean? >> 5) Expose what this is really about - cutting people's jobs and rationalising support to a minimalist level. >> 6) So be careful not to accept the terms of the imposition of this kind of managerialism and rationalisation - wherever possible define the terms of the debate - go outside the imposed framing, frame of reference. >> 7) But try not to appear just defensive because then they say you are just protecting your sectional interests at the expense of the labelled people. (And you aren't are you?) >> >> >> ___________________ >> Mark Burton >> Scholar Activist; >> Visiting Professor: Manchester Metropolitan University >> http://steadystatemanchester.net >> http://libpsy.org >> http://www.compsy.org.uk >> ___________________________________ There is a twitter feed: http://twitter.com/CommPsychUK (to post contact Grant [log in to unmask] To unsubscribe or to change your details on this COMMUNITYPSYCHUK list, visit the website: http://www.jiscmail.ac.uk/cgi-bin/webadmin?A0=COMMUNITYPSYCHUK > ___________________________________ There is a twitter feed: http://twitter.com/CommPsychUK (to post contact Grant [log in to unmask] To unsubscribe or to change your details on this COMMUNITYPSYCHUK list, visit the website: http://www.jiscmail.ac.uk/cgi-bin/webadmin?A0=COMMUNITYPSYCHUK ___________________________________ There is a twitter feed: http://twitter.com/CommPsychUK (to post contact Grant [log in to unmask] To unsubscribe or to change your details on this COMMUNITYPSYCHUK list, visit the website: http://www.jiscmail.ac.uk/cgi-bin/webadmin?A0=COMMUNITYPSYCHUK