Clinical social work practice in organizational settings: a psychodynamic systems approach

Abstract

ABSTRACT Clinical social work practice in organisational settings is complex and challenging. Effective practice is contingent on knowledge and skills that are particular for systems-based work involving multiple interprofessional mental health practitioners and clients interacting in a relational matrix. Yet, not all social work theories and constructs that were developed for application in individual, group, and family modalities are directly transferable to the practice environment of a treatment system. This paper offers a conceptual framework that synthesises contemporary psychodynamic theory with systems theory – referred to as a psychodynamic systems approach – to inform and advance knowledge of systems-based social work practice. This approach considers the interplay of dynamic processes among the four levels of the socially co-constructed system which constitute the system as a whole. It examines how five key clinical phenomena – transference, countertransference, splitting, projective identification and enactment – are actualised in systems. Definitions of these phenomena formulated from a dyadic perspective and a contemporary psychodynamic systems approach are offered, and their similarities and differences are discussed. A composite case example is provided to illustrate how several of these phenomena manifest in clinical practice.