Transforming Practice in Developmental Disability Services Through Systemic and Dialogical Practice

Abstract

The aim of this article is to tell a story of organizational change in a large government developmental disability service responsible for working with multistressed families. Over a 10-year period, case management and clinical methods were significantly enhanced, to include systemic and dialogical practices. Many disempowered and stressed staff members were able to develop leadership roles, some seeding local teams or learning to work with families differently. Factors that allowed for this change included conducting research to establish the trustworthiness of innovation, a focus on emergent and local change rather than an establishment in organizational policy frameworks, an appreciative stance toward staff and families, and the circulation of healing stories from systemic interviews to senior management. In the end, after 10 years work, six systemic consultation teams were developed and a further four family support clinics. Initially these teams were based on post-Milan systemic family therapy but later came to be integrated with network or Open Dialogue therapy. While these initiatives will not have changed organizational culture as a whole, local transformation of practice was possible, providing a safe refuge

Family‐systems interventions for families of people with an intellectual disability or who are autistic: a systematic review

“…Nevertheless, clinicians may wish to explore the use of interventions such as MST for which there is preliminary evidence for potential positive effects. Alternatively, clinicians may consider integrating systemic techniques and ideas with other methods such as those from behavioural interventions (Rhodes et al 2014). Where clinicians do use family-systems approaches, other research has highlighted the importance of interventions being adapted appropriately for people with an ID or who are autistic (e.g.…”