The ‘Narcissistic‐We’ model: A conceptual framework for multidisciplinary team working, researching and decision‐making with traumatised individuals

Abstract

Greater emphasis is being placed on multidisciplinary team (MDT) working for complex clinical presentations in the NHS. Whilst such integrated working has the potential for considerable benefits for clients, it also raises the issue of constructive and destructive decision-making within teams that bring together different individuals and professional groupings. This paper outlines a model which attempts to address how individuals in a MDT can hold onto their own personal and professional identity whilst simultaneously adopting a team identity. Thus how the 'me' and the 'we' operate to assist the client. The model, termed the 'Narcissistic-We', was developed out of multidisciplinary team working with traumatised individuals in Belfast and has particular relevance for decision-making in MDTs. The model argues that MDTs operate along two continua, the first running from 'me' to 'team' and the second running from 'me' to 'client'. When overlaid these continua create four quadrants. It is suggested that no clinical decisions should be made in the 'Me-Me' quadrant and most decisions should come from the 'Client-Team' quadrant. However, there are times when decisions are required from the 'Me-Client' and 'Me-Team' quadrants. The development, practical implications and research possibilities of this model are discussed.

Integrative Clinical Social Work Practice

“…Although the data to date on the impact of teamwork on mental health is somewhat limited, what has been done suggests that teamwork in this fi eld can improve client care as well (Brown, Crawford, & Darongkamas, 2000 ;Dorahy & Hamilton, 2009 ).…”

Holistic and team approach in health care

“…This suggests that effective multidisciplinary teams incorporate dynamics that work towards a team approach to client problems but maintain the right of individual members of the team (professional or clients) to operate independent of "groupthink" when required. (26,15) Forming the multidisciplinary team is only one aspect of providing a multidisciplinary health care service. Developing systems and resources that ensure the team functions effectively is also essential.…”