‘Struggling well’

Abstract

Abstract Feeling and holding onto your self-worth when organizational change is constant; trying to implement a change process that you have not been consulted about; not knowing what is going on and feeling too insignificant to ask; watching effective systems be dismantled in the face of a new National Health Service (NHS) target or reorganization; being overwhelmed at work and feeling unsure how to cope; knowing when to get out when work has become too difficult or coping proactively when you feel you no longer have a valued place; making good decisions about whistleblowing when it all feels, and is, frightening. These are examples of emotional experiences embedded into the everyday psychosocial context of mental health work. Maintaining self-worth and self-efficacy in the face of service demands is key to well-being at work and is an enabling factor in supporting organizational change. The interrelationship between self and organization is therefore key to the delivery of effective and compassionate help-giving relationships. Drawing upon the mentalization literature cognitive analytic therapy (CAT) can help us maintain the focus on our primary work task of enabling and supporting positive change in the well-being and life chances of services users. This chapter explores using CAT organizationally to maintain the reflective capacities of the individual and the system through clinical and organizational supervision and by embedding CAT in wider system change.