Therapeutic Communities and other residential placements for children and young people are expensive resources that are usually only used when other community or family -based placements have failed repeatedly. These failures are usually due to behaviour from the child that prevent their carers from functioning as carers, and can often be linked back to early and extreme disruptions in parenting in the child’s family of origin which cause the child severe trauma.
The primary task of therapeutic communities for children and young people therefore, is to address and mitigate the traumatic consequences of severe early maternal deprivation. D W Winnicott traces the roots of anti-social behaviour in children, delinquency in adolescents and criminality and psychological problems in adults back to the failure in infancy of the mother/infant relationship. He uses the term ‘maternal’ because he is referring specifically to the first few weeks and months of life when the infant expects and requires the thoughtful presence of the biological mother. Substitute carers, however well attuned they are to the baby’s needs, are experienced as ‘not mother’ and therefore there is a sense of loss involved. Subsequent adverse childhood experiences will be experienced and responded to by the child through the prism of this primary deprivation.
Traumatic levels of maternal deprivation result in the child unconsciously seeking restitution for this failure by any means possible including violence, theft and disruption. Traumatised children have a limited capacity to manage their feelings and struggle to distinguish unconscious phantasy from reality. They project unwanted feelings into others, particularly the adults who are caring for them. Some children can only relate to others by means of projective processes because their emotional development has been frozen in infancy. They relate non-verbally, communicating their feelings and needs through actions which result in the adult being made to feel the child’s distress. The child hopes that the adult will hold these feelings and transform them into a more bearable experience. This is the same process that takes place in the relationship between the mother and the infant.
It follows that the intensity of the transference from the child group to the adult group in the residential setting will have a primitive, disturbing quality with the potential to disrupt normal adult psychological functioning. These unconscious processes operate at individual, group and organisational levels and must be consciously addressed in the design and implementation of an organisation’s therapeutic culture and practice. If the adult team is unable and/or unwilling to address the full consequences of their transference and management and institutional dynamics and be acted out at all these levels. I will give some examples of this later.
This paper explores some of these issues as they arise in the consultancy groups and individual sessions which I have facilitated for staff teams and managers in therapeutic community, children’s home and special school settings. I use a systems psychodynamic approach which draws heavily on group relations thinking and practice. The consultant’s role is to observe and draw the group’s attention to possible unconscious processes affecting the group task. The task is explicitly stated as being to explore relationships between group members, and to consider possible links to relationships with the children at individual, group and organisational levels. I draw on a number of theoretical frameworks to help me in my consultant role: Melanie Klein and DW Winnicott to understand personal and interpersonal relationships at the unconscious level; Wilfred Bion and SH Foulkes to understand group processes; and group relations thinkers including Isabelle Menzies-Lyth, David Armstrong and Eric Miller to make sense of unconscious dynamics at the organisational level.
Some Key Features of Organisational Dynamics in Therapeutic Communities for Children and Young People
In my experience it is an inevitable and necessary element of therapeutic community practice that the staff team holds the unconscious projections of the child group. The therapeutic task at both individual and group levels, is to receive these projections, bring them to consciousness and transform them on behalf of the children, who are unable to do this for themselves. To put it another way it is not a question of if the staff team is the receptacle of anti-social dynamics, but to what degree the staff team is affected. It is the responsibility of the adults – managers, staff members and consultants – to raise these elements to conscious thought in order to understand the nature of the communication from child to adult.
This is an extremely difficult, exhausting and complex task. In order to understand anti-social behaviour as a symbolic communication as well as an emotional expulsion of unbearable feelings, it requires effort and psychological knowledge by the adults. A therapeutically effective staff team will respond to anti-social behaviour by attempting to understand what the behaviour means to the child, to transform these understandings into words, and to think of ways of communicating these thoughts back to the children in a way that they might understand.
When the staff team is unable to do this, there may be a defensive response to the projected traumatic experiences of the children. Although staff team members may not have suffered the extreme levels of maternal deprivation of the children, nevertheless all of us can be gripped by infantile and primitive levels of thinking and feeling. These damaged primitive parts of the adults are evoked in the transference in the form of countertransference feelings which are themselves primitive in origin – rage, greed, envy, revenge, abandonment. Such primitive transference feelings can generate high levels of anxiety in the adults, leading to a loss of capacity to process and make sense of them. It becomes harder for the adults (both individually and collectively) to distinguish objective reality from primitive unconscious perceptions of reality. The unwanted feelings are defended against by being denied, split off and projected into others. Such defences manifest themselves at the individual, group and organisational levels and must be addressed at each of these levels. (Klein, Bion, Menzies -Lyth)
In therapeutic communities the whole community is the holding environment (Winnicott) within which unconscious processes can be revealed and made available for analytic understanding and transformation. The staff consultancy group is one of the places where adults can consciously think about these unconscious processes. For example, anger or hatred towards the children is frequently experienced unconsciously in the staff team. These feelings are experienced as unacceptable and are given conscious expression in the form of displaced anger towards managers. (Collie) It is often felt to be socially unacceptable to feel anger or hatred towards the children even though it is the children who have evoked this anger through the projection of their own deprivation experiences. Managers are experienced as depriving parents who do not pay enough, expect too much, or are persecuting their staff. They are too intrusive of too absent. Or the deprivation anger may be displaced onto colleagues who are felt to be ‘too harsh’ or ‘too soft’ depending which side of the split in the team they happen to be on. The children may be thought to get ‘too much’ when ‘primary provision’ (Dockar Drysdale) evokes envy in the adult. In the residential setting this dynamic often appears around Christmas and birthday times and on summer holidays, when the children receive presents and treats.
These dynamics are more clearly visible in the child group where they are often the root of rivalries and fights between children. A child who is at risk of losing his place due to persistent extreme behaviour may be ‘helped on his way’ by his friend who encourages him to more anti-social acts. It is common for extremely deprived children to phantasise ‘killing off’ all the other children so that they have all the adults all to themselves, all the time. These dynamics in the child group may be mirrored in the adult group and vice versa. The consultant’s task is to help the group to identify these issues as unconscious processes to be considered rather than denied, split off and projected in the defensive patterns described below.
The Consultancy Task
The ‘anti-social tendency’ (Winnicott) if left as unchallenged phantasy, will achieve its aim – the destruction of the social. Under pressure from projections from the child group, the team will lose sight of the complexity of their roles and adopt primitive forms of thinking that seek overly simplified ways of understanding the professional task. Splitting (between ‘good’ and ‘bad’), projection of unwanted feelings into others and denial of reality dominate team functioning. Staff relationships may begin to break down, the team may fail to function effectively, and the children may re-experience something of the toxic environment of their families of origin. An example of a team attempting to simplify the professional task is when the complex tension between the boundary holding and nurturing aspects of the task are denied in the team by splitting along gender lines. The nurturing element, experienced as the idealised ‘good breast’ (Klein) is located primarily in the female staff and the boundary holding experienced as the denigrated ‘bad breast’ aspects are located in the men. The member of the team with most valency for expressing an extreme form of punitive boundary holding is chosen, and chooses, to take on a role which embodies the aggressive aspects of the group as a whole. This person takes on the characteristics of the ‘bad breast’ and is denigrated by the others. (Bion) If the team cannot work through the defensive nature of the fight/flight mechanism it inevitably progresses to the ‘angry member’ being expelled from the team. The group behaves as if all the aggression is located in that person and that once he has gone the nurturing breast will be safe from attack. The next scapegoat will then be sought.
The first case study is an example of the denigration of the person who has been elected and has chosen to embody aspects of the ‘bad breast’.
Case Study One
The staff team of a therapeutic community school had become increasingly subdued and defensive over several months. The team comprised school managers, teachers, learning support staff and administrators. There appeared to be friction particularly between Stan, a male teacher and his female colleague who had recently been promoted. Despite attempts to open up a dialogue about these tensions, the group had become stuck and lethargic.
It appeared that Stan controlled the group by unspoken threats of violence. He was like a smouldering volcano, and quite intimidating. No-one was willing to confront him and his brooding anger held sway over the group. To be more precise, the group had given him the role of holding all the group’s anger whilst denying him or anyone else the opportunity to express their own anger. His narcissistic wound at being passed over for promotion was not open for exploration.
As consultant, this left me in a difficult position, since it seemed that no matter how often I drew attention to these defensive patterns he continued to intimidate the group into silence. Finally, after several frustrating meetings over a four month period, I addressed him directly and asked him what he was feeling and was he willing to talk about it. His aggressive response alarmed me, and I understood the fear that he had engendered in his colleagues. I said that he seemed determined to sit on his anger. No-one else spoke. I was no longer sure that I could help the group to get beyond this impasse.
A week later Stan was suspended for aggression towards one of the children and was subsequently dismissed. In the following consultancy meetings it emerged that he had bullied and demeaned junior colleagues on a daily basis. The team was now able to begin to think about his coercive control of the team but could not easily engage with the idea that this was a group phenomenon. The group was unwilling to acknowledge that it suited everyone for Stan to hold all the anger. The similarities between these dynamics and the dynamics of domestic abuse were clear.
Some weeks after these events the group appeared to have moved on, but another male member of staff (this time Barry, a learning support worker) took on the smouldering volcano role. Rather than confront him directly I observed that the group as a whole was engaged in a hostile resistance to the consultancy task of exploring relationships in the here and now. Eventually Barry erupted in fury about a perceived injustice by managers over his sick leave arrangements. Once again the group had elected a male staff member to express collective anger towards a manager who was seen as being depriving and persecutory. The manager, who was present, was able to dispel Barry’s belief that he had been unjustly treated and that actually he (the manager) had extended Barry’s sick payments beyond what he was entitled to.
The scapegoating dynamic is a defence in which the group externalises unconscious phantasies of the bad breast (the depriving and persecuting mother), projects them into a member of staff with a particular valency for this projection (Bion) and then attempts to expel that person from the group.
Case Study Two
In the second case study the group attempts to deal with the problem of a staff member being idealised by a child. The unconscious good breast phantasy is just as problematic as bad breast phantasies because we are still dealing with a primitive flight from reality. The problem for the adult group arises from the children’s propensity to idealise certain members of staff whilst denigrating others through splitting mechanisms. The idealised member of staff (an embodiment of the good breast) may be seduced into believing that they are indeed perfect, and that they are the only answer to the child’s needs. They welcome the child’s apparent attachment to them and attempt to live up to the child’s expectations. In doing so they can become detached from the rest of the team (who resent them for their special status in the child’s eyes) and can become impervious to challenges about the danger of the situation. The danger is that the child will inevitably at some point switch from idealisation to denigration without warning and become vehemently hostile towards the adult.
Jill was a member of staff in her twenties who had taken on particular responsibility for an extremely disturbed nine year old boy. He was violent to every member of staff except Jill, whom he apparently adored. He was always with her when she was on duty and hated other children wanting to spend time with her. In a consultancy meeting Jill said that she had a really good relationship with the boy and felt that she was making a real difference to him. Her comments were met with silence by the rest of the team and I (in my consultant role) suggested that not everyone agreed with Jill’s assessment. When there was still no response from the others, I said to Jill that her relationship with the boy was not ‘good’ but an idealisation, and that sooner or later she would be transformed in his mind into the bad object and he would hate her. He was not relating to her as a real person but as an imagined ideal mother.
Senior managers had decided to intervene in the relationship by ensuring other adults than Jill were involved with the boy in order to try to protect Jill from his powerful projections. The boy did indeed turn against Jill and began to physically attack her on a regular basis. She was shocked and disturbed by this turn of events but was unable to use supervision and support to understand what was happening between the two of them. Soon after this Jill stole some money from the community and like Stan in the example above, was dismissed.
In the following consultancy meeting a shocked team attempted to make sense of what had happened and what the theft of money meant in terms of Jill’s relationship with the boy and with her colleagues. It was hypothesised that Jill felt betrayed by the boy and her colleagues when he turned on her, and that these experiences may have triggered her own powerful unconscious feelings of deprivation. The theft may have been an attempt by Jill to compensate for these unbearable feelings of deprivation and abandonment. It was also clear that the team had initially colluded with her identification with the idealisation and had allowed her to lose her boundaries by not challenging her enough.
New and enthusiastic staff members often have an unconscious rescue phantasy which involve the adult offering love and compassion to the child in deprived of such love. By meeting the unmet need to be loved, the child will be saved from their unhappy past. Through a process of over-identification with the child the adult will also imagine that they will be healed themselves. This belief is doomed to failure for several reasons, primarily because the child knows that the adult is not seeing them for who they really are. The child’s rage and hatred of adults for having let them down is denied by the rescuer, and the child retaliates. The child was ‘teaching Jill a lesson’ about her delusions, which every adult must learn if they are to be effective therapeutic practitioners. The adult feels profound disappointment with the child and with themselves, but this is a necessary process of disillusionment. In this context disillusionment leads to a healthier relationship with reality and it is only then that trust between adult and child can start to develop. (Welldon) Jill failed to learn this lesson partly because she was unable to make any links between her feelings about the child and her own childhood deprivation. She was unable to recognise her own feelings as countertransference and instead acted them out in the theft.
The task of the group (with the assistance of the group consultant/facilitator) in these circumstances is to undertake the difficult work of distinguishing phantasy from reality. In the examples of scapegoating and idealisation given above, the evidence of phantasy thinking is clear when similar group dynamics recur but with different actors. Therapeutic childcare roles require an ability to hold both the nurturing and the boundary holding aspects of the task at the same time regardless of gender, and in the face of powerful projective processes to take up an either/or position -the paranoid-schizoid state of mind. (Klein) The task is complex and challenging as the individual worker has to hold these two aspects in an internal tension whilst the child is attempting to push the adult into extreme positions of either love or hate. When an adult says ‘no’ to a child appropriately, the child may react as if the adult hates them and may even become violent towards the adult. The adult may respond with anger towards or withdrawal from the child (countertransference response) rather than maintain the neutral adult role. Or the child may idealise a particular adult (‘you are better than all the other staff. You are the only one who understands me.’) The adult may feel gratified by this and believe they have a special relationship with the child. Both these responses are a regression in the adult to a primitive level of functioning induced by the behaviour of the child, the unconscious process of projective identification. (Klein)
The Consultant/Facilitator Role
The consultancy task is to represent and model the capacity to maintain complex roles under pressure, by resisting projections from the group to enter a defensive ‘as if’ state of mind, and by pointing up the unreality in the group functioning, as it arises in the ‘here and now’. When a deprivation dynamic underpins the group defence the consultant’s comments are likely to be perceived as demeaning to the good opinion the group has of itself. The good breast is experienced as being within the group, and the bad breast is located in the consultant. Managers and more sophisticated team members in the group may find themselves torn between loyalty to their team and an awareness that the team is acting defensively. It can be tempting to leave the difficult interpretations to the consultant.
Teams can become stuck in ‘basic assumption’ defensive patterns (Bion) if there is a strong enough collusion against reality testing. In a ‘fight flight’ group, anyone who attempts to challenge unreality is likely to be treated with hostility or be ignored. Eventually a team member may find the unreality unbearable and provide evidence that the team is indeed in denial. Hostility shifts away from the consultant or manager to the scapegoated staff member and their flaws are presented for consideration as if this was the real problem. The group becomes more overtly anxious as it moves towards a realistic appraisal of the situation it finds itself in. Individual members begin to talk to each other more openly about their relationships and anger is replaced by thoughtfulness and a degree of sadness.
In Kleinian terms the group begins to operate from the ‘depressive position’ where reality testing and ‘linking thinking’ become possible. Once the group begins to function in less defensive ways and engages with the task, new information begins to emerge about the nature of the relationships between the adult members and between the adult group and the child group. It is a significant part of the consultant role that they set the standard for working towards reality testing by resisting the temptation to accept simplistic solutions to the group’s difficulties, and by pointing out their defensive nature.
Agency Structures and Agency Dynamics
Individual members of the child or young person group in a therapeutic community share similar backgrounds in that they all come from dysfunctional or chaotic families. They unconsciously attempt to recreate these family dynamics within the TC setting, where they dramatize what has happened to them in the past. (Hinshelwood) It is not surprising therefore that characteristics of domestic violence, neglect, chaos or sexual abuse appear in some form in the community. In recognition of the power of the projections from the child/young person group into the adult group, therapeutic communities must have layers of protection to assist the adults to process these potentially destructive dynamics. A sophisticate staff support network of individual supervision and team consultancy within a framework of clear boundaries and procedures, is essential. These frameworks will all be subject to attack by the children as they attempt to recreate the familiar world of their chaotic and abusive backgrounds. No single person can work with severely traumatised children without the support of a strong and sophisticated agency framework around them. The adults work as a team for the furtherance of the therapeutic task because the work is so challenging and emotionally exhausting, and because it is almost impossible not to become caught up in transference and countertransference states of mind. Colleagues, supervisors and managers at all levels of the organisation are involved in the process of containing the projected feelings and phantasies of the children, and to a lesser extent other adults. Each level of the hierarchy acts as a layer of containment beginning with the individual supervisor, extending to team managers and culminating in the director of the community each playing a role in the therapeutic management of the child group.
To assist the staff in the therapeutic management task two additional elements are necessary at an agency level. Consultants must not only be concerned with individual and group dynamic aspects of the task but also with the organisational framework within which these dynamics are explored. A systems psychodynamic approach works well in addressing this task. Professional roles, organisational boundaries, the professional task and how authority is dispersed throughout the organisation are the systems elements of the consultancy role.
Case Study Three – Boundary
An example of how insufficient attention to the systems aspect of therapeutic community practice can subvert the psychotherapeutic task, is seen in the following example. A fourteen year old boy was in a foster family placement which was rapidly failing. In collusion with his aggressive mother, the children’s department social work team were under enormous pressure from the boy to find alternative accommodation quickly. There was insufficient time to complete the referral process, which involved assessing the boy’s suitability for a therapeutic placement and gaining his agreement to the requirements of the therapeutic community. This involved gaining some indication from him that he had problems that he needed help with, and that he would attend school, group sessions and individual therapy.
The referral became an emergency placement (engineered by him and his mother) where normal procedures were ignored and anxiety to place him quickly disrupted the thinking of the professionals from the referring agency and the therapeutic community. He arrived with no therapeutic contract agreed.
Unsurprisingly (with hindsight) he refused to go to school, refused to attend group meetings, and denied that he needed any help or had any problems. Having arrived in an unboundaried way, he defied every boundary that he was presented with in the community. The staff had little authority to enforce norms of behaviour and were rendered helpless. He quickly became the leader of a delinquent subgroup which threatened the therapeutic culture. There was thus no framework within which a therapeutic process could even begin, and the situation presented a serious threat to the effective functioning of the organisation. The placement broke down quickly.
Case Study Four – Task
An old model of residential care in local authorities was the ‘Community Home with Education’. There were residential units and a dedicated school on the same campus, in order to accommodate adolescents who could not be placed in foster care and could not attend mainstream school, usually for behavioural reasons. I was the new manager of the whole campus with a brief to institute a therapeutic culture. I was struck by how dysfunctional the school was, even compared to the residential side of the organisation. There appeared to be no actual education taking place, and the residential staff were frequently called upon to remove students for what appeared to be trivial incidences of anti-social behaviour.
I called a meeting of the school team – a head teacher and six teachers. I asked them to tell me what they thought their primary task was. One said ‘counsellor’, one said ‘supervisor’, another said ‘friend’. I asked if there were any other suggestions and was meant with blank stares. How about ‘teaching’ I asked. Their astonished response was that these young people were unteachable and that the best the school could do for them was to keep them occupied. I responded that they were failing in their responsibilities as teachers and suggested that they think of ways of adapting their teaching methods to fit the special needs of the students.
The team now became quite angry, saying that I was asking the impossible and that they would have to take the issue up with their union. I said that they were right to do that, as the union needed to be informed of any possible changes in working practice, but that I would be contacting Ofsted to ask them to inspect the school and make recommendations about how the service could be improved. They were alarmed. The head teacher agreed that they would look closely at how they could address the educational needs of the children. The results were mixed, but there was a move towards more creative approaches to their primary task after this meeting.
Case Study Five – Role
Maureen was the recently appointed care manager in a private company which provided residential care for teenagers. Her role was to manage the registered managers of the four residential homes, and to act as liaison between the houses and the leadership team at head office. She was finding the role difficult, and the senior leaders asked me to provide role consultation for her as they were finding her difficult to work with. She could not bear criticism of any kind and reacted as if she was being persecuted. Her managers did not know how to help her without being persecutors.
Role consultancy focusses on the person in role within the wider organisational setting, with the emphasis on the organisational dynamics that might be affecting the person’s performance in the role. The presenting problem as Maureen saw it was that she could not work with one of the managers who was older that her and resented her being his boss. She suggested that there was a degree of misogyny involved. She also felt misunderstood and unsupported by her (male) boss.
What was striking about this scenario was the way that organisational problems were reframed by all those involved, as interpersonal problems or problems of individual pathology. Her manager found it difficult to help her with her role because he felt personally critical of her and because she felt he did not like her. The consultancy work concentrated on helping Maureen and her boss to explore what these difficulties said about the organisation as a whole and to regard the conflict as a source of information which would help them understand the underlying organisational problems. By reinterpreting Maureen’s difficulties as an enactment of something below the surface in the organisation rather than a personal failing in her, Maureen’s boss was able to help her work more effectively with the house manager and all three developed a more constructive and less persecutory working relationship.
A working hypothesis about the ‘organisation in the mind’ (Armstrong) that underpinned these working relationships, was that some aspects of dysfunctional family dynamics projected mainly by the young people were being enacted by the adults. In particular, gender role stereotypes and parental conflict were evident in the manager/managed dynamic.
Case Study Six – Authority
The way that authority is dispersed through an organisation, and how this dispersal is appropriate to the task, are a key management and leadership issues for all organisations. As Bion noted, the armed forces primary task requires a top down, hierarchical authority structure in order to ensure rapid decision-making in times of conflict or other emergencies. Avery different authority style in appropriate to the primary task of therapeutic communities for children and young people. Children benefit from living with adults who are authorised to function as mature, thoughtful and autonomous parent figures and present as good role models. The process of ‘introjective identification’ (Klein) by which the child takes into their ego structure positive aspects of the parental adult, is an essential part of child and adolescent development both in family and institutional settings.
In a therapeutic children’s home the therapy team operated separately from the care staff in the residential setting. They worked individually with the children and communications with the care team were erratic. It had become a taken for granted assumption that they were the ‘experts’ carrying out the real therapeutic work, and that the care staff were child minding. Morale in the care team was low and staff turnover was high. The children’s day-to-day experience of adults was of a group of people who did not stay long and did not appear to be very interested in children.
The consultancy involved working with both teams to redistribute ownership of professional authority so that the care staff could work in partnership with the therapy team in furtherance of the therapeutic task. The therapists now joined the care staff in case discussions in order to draw up shared care plans. The majority of care staff felt that their role had become more meaningful and there was a reduction in staff turnover whilst the therapy team began to see that ‘therapy’ had a much wider meaning than their own individual sessions with children. Both teams were empowered by these developments.
In writing this paper I have been formulating thoughts about therapeutic communities as psycho-social systems in which children and young people who are severely traumatised, anti-social and resistant to offers of help, come together in a physical and psychological environment which is designed to meet their profound emotional, social and educational needs. I am struck by the fit between the design and day to day functioning of therapeutic communities, and the contribution to our understanding of wider organisational life offered by the systems -psychodynamic approach of the Tavistock tradition of organisational consultancy.
It seems to me that the psychodynamic therapeutic community is a laboratory where Tavistock thinking can be tested in the real world against which other organisations can be analysed and understood. It is central to the task of both therapeutic communities and systems-psychodynamic theory that they explore the tensions between the personal, the interpersonal, the group and the organisational levels of existence at both the conscious and unconscious levels. It is through these efforts that new paradigms of group, organisation, and social meaning can emerge.
Armstrong D (2005) ‘Organisation in the Mind’ (Tavistock)
Bettelheim B (1974) ‘Home for the Heart’ (Alfred A. Knopf Publishers Inc. New York).
Bettelheim B. (1950) ‘Love is not Enough’ (The Free Press),
Bion W. (1961) ‘Experiences in Groups’ (Tavistock)
Collie A. (1996) ‘The Institute as a container of unconscious feelings: the therapeutic challenge of adolescents in residential care’. (Journal of Social Work Practice Volume 10 No. 2).
Fahlberg V. (1990) ‘Residential Treatment: A Tapestry of Many Therapies’. Perspective Press, Indianapolis).
Hinshelwood R.D.(1987) ‘What Happens in Groups’ (Free Association Books).
Hinshelwood R.D. (1989) ‘A Dictionary of Kleinian Thought’ (Free Association Books).
Huffington C et al, eds (2004) ‘Working Below the Surface’ (Tavistock)
Kreeger L. (ed.) (1994) ‘The Large Group: Dynamics and Therapy’ ( Karnac Books).
Menzies – Lyth I (1989)‘The Dynamics of the Social’ (Free Association Books).
Menzies- Lyth (1988) ‘Containing Anxiety in Institutions’ (Free Association Books).
Miller E. (1993) ‘From Dependency to Autonomy: studies in Organisation and Change’ (Free Association Books).
Obholzer A. and Zagier Roberts V. (eds) (1993)‘The Unconscious at Work: Individual and Organisational Stress in the Human Services’ (Routledge).
Ogden T. (1992) ‘The Matrix of the Mind’ (Karnac)
Rose M. (1990) ‘Healing Hurt Minds: the Peper Harow Experience’ (Routledge, London).
Rustin M. & Bradley J. (2008) ‘Work Discussion’ (Tavistock)
Segal H. (1988) ‘Introduction to the Work of Melanie Klein’ Karnac
Stapley L.(1996) ‘The Personality of the Organisation’ (Free Association Books).
Ward A. et al (Eds) (2003) ‘Therapeutic Communities for Children and Young People’ (JKP)
Welldon E. (2011) ‘Playing with Dynamite’ (Karnac)
Winnicott D. W.(1986) ‘Home is Where we Start From’. (Pelican Books).
(1990) ‘The Maturational Process and the Facilitating Environment’ (Karnac)
Worthington A . ‘The function of the community meeting in a therapeutic for pre – adolescents’ (1990 International Journal of Therapeutic Communities).