Own-Tax-2811

By "people who have been traumatised respond to a system around them and how the trauma influences the system too" do you mean that people working in Health & Social Care have often had difficult life experiences which affect how they respond & that can also feed back into a vicious cycle?

I was wondering about a more straightforward or prosaic effect of uncaring/abusive management>systems which reward suboptimal care>having to switch off to avoid moral injury>high likelihood of being uncaring and increased likelihood of being abusive.

I worked for a while in a social care dept where the criteria for receiving social care were being revised. I was an assistant OT, trained in equipment provision only to help make tasks easier where people were struggling (not where they had stopped altogether), but would get referrals like "Due to changes Mrs X is losing her lunchtime meal prep visit, please work with her on food preparation, she hasn't done this for 5 years". I asked for supervision from a qualified OT, which was refused. Management cared mainly about throughput. I left. The only way I could have stayed and not had a breakdown would have been to disengage from caring about the people we worked with.

I hope you & Lucy don't mind if I jump in here with my own 2p worth! I had Compassion Focused Therapy (CFT) for several years & found it of very limited effectiveness. Some techniques e.g. imagining looking at your ideal compassionate self from the outside were actively unhelpful. Eventually I received a diagnosis of OCD and had OCD specific CBT. Made more progress in 20 sessions than in years of CFT.

My sense, from personal experience, hearing other people's experiences, studying psychology and working for a short time in mental health research is that different things work for different conditions & people. Usually there will be evidence pointing towards a particular treatment for the person's diagnosis, which is where treatment should start. If it doesn't help then need to give careful thought as to why before next steps.

How do you respond if someone tells you things aren't going well? Are therapists taught how to do this? Does the response affect therapy going forward?