Cathie O'Brien OD Consultant, Psychotherapist, Supervisor & Trainer 

  Specialising in organisations who work with vulnerable people in challenging environments 

Organisational Therapeutic Approach

A whole service/systems approach to emotion-regulation

Cathie develops, within organisations, a whole service/systems therapeutic approach,which is based in Attachment Theory and Gestalt Therapy; both are regulatory theories and recognised by recent research in Trauma and the Neurosciences, in particular working in the here and now and a relational approach.             

Cathie helps professionals to understand and assess relationship (attachment) styles in the adults and young people they work with and their ability to regulate their emotions/nervous system in relation to others and the environment. This informs professionals about the individuals particular rhythm of relationship and therefore 'how' to be in relationship with them. It also helps the teams to consider interventions that are best suited to the individual's needs. 

Teams also learn about their own relationship style and to monitor their own nervous system in relation to distressed adults and young people who they maybe working with. Teamwork is also important here and reflective practice at a team level is encouraged.

Cathie believes that a whole service approach is key when working with very distressed people and the main emphasis is on developing safety and a secure base for service users and staff, as well as compassionate team work, respect, and developing the professional team into a emotion-regulating collective. There will be little change through individual therapy if the environment (meaning professional teams, families and context) remains the same.  This concept lies in ‘field theory’ and believes that one action has a reaction, causing a knock on effect. For instance, if someone is absent from work the whole service has to adjust itself to accommodate this. With distressed service users, if the system does not work together the system has little impact and often, unintentionally, can create greater chaos and disharmony. If the system works well together it can develop the person’s capacity to regulate emotion and this is a physiological change. This can be measured through practice based evidence i.e. decrease in dangerous behaviours, self-harm etc.

Through affect (emotion) regulation, which is a relational approach, the individual develops their ego strength, their sense of self and their sense of difference. The person can internalise their own sense of home which can help to shift chronic presentations and behaviour strategies developed, learning to self-regulate in a more helpful manner.

Cathie believes that it is not the model of work a practitioner is trained in but their ability to engage very distressed and vulnerable people, in a safe working relationship, as well as having a sound understanding of working with interpersonal trauma and the ability to integrate trauma theory into practice.