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This paper explores why leadership, especially senior leadership in British organizations, is persistently nearly always white. The paper contends that beneath the veneer of our apparent commitment to equal opportunities, primitive often unconscious factors operate to ensure that leadership remains white, thus reproducing a racial hierarchy in the workplace. It argues that the barriers to black and minority ethnic people getting appointed to leadership positions in organizations today are largely invisible and are hidden within the psyches of decision makers, the cultures of white organizations, and their combined impact on the confidence of black and minority ethnic staff. [ABSTRACT FROM PUBLISHER]

Never before have public sector jobs been so threatened. Fear and anxiety have shifted their focus, from performance to survival. With reference to immediately contemporary works on the NHS in particular, such as Mandelstam (2011) and Leys and Player (2011), the paper establishes the factual validity of the crisis. The authors conducted a series of workshops for public sector staff to enable them to explore their reactions to the current situation. It is possible to identify increasing levels of denial and other forms of resistance to change similar to those first identified by Menzies' (1959). Drawing on the work of Bion (cited Obholzer & Roberts, 1994) the paper considers the dangers of a retreat to the paranoid schizoid position, and identifies a theoretical clue in Halton (2004) for turning the trauma of change into a creative opportunity. Art has access to emotional, spiritual and creative facets of the human mind that science cannot explore. Klein's (1975) consideration of the infantile and regressive aspect of art is acknowledged. The paper then considers what is revealed by a study of specific works of art which were presented in the workshops; including paintings by Bosch, Rousseau, Breughel and Goya. The work of Zagier-Roberts (1998) and Winnicott (1971) is called upon to endorse the usefulness of such a playful collage of responses. Art can be used to help people move through Kubler Ross' stages of bereavement (1997); not to acceptance but out of the paranoid schizoid position into the depressive position (Klein 1975). Revisiting the work of Halton (2004) and the concept of evolutionary creativity, a move on from the depressive position can begin. Collective validation can be affirmed through a rebooting of the essential public sector values while a radical turning away from organisational priorities, to face the service user, provides a more far reaching optimism than any envisaged by an essentially limited demand for modernisation. In conclusion the paper considers the recent contributions of Dienst (2011) and Dumenil and Levy (2011) to advocate tactical resistance to the denigration of the public sphere. [ABSTRACT FROM PUBLISHER]

The concern of this study is a blindness to risk assessment of mental health and safety issues for children and young people by Child and Adolescent Mental Health Services (CAMHS) teams when they are insufficiently emotionally contained. The need for social worker membership of CAMHS teams is suggested but not developed, as the focus is unconscious processes that debilitate required thinking by CAMHS about risk. A case example allows discussion of various ways in which primitive anxieties within CAMHS teams lead to paucity in thinking about risks. Located at the beginning of life, primitive anxieties are contained through nourishment. It is suggested without nourishment, and its consequent provision of a containing boundary for these anxieties, teams can dangerously dysfunction in primitive infantile states. These persecutory mental states are traced as the cause of a depleted thinking capacity, which may inadvertently place patients at increased risk through errors and oversights. [ABSTRACT FROM AUTHOR]

This article discusses the impact of a 'life-story film' - co-created with a person with dementia - on NHS staff's perceptions of the person, and by implication, their wider perceptions of people living with dementia. The study used an innovative research method, the visual matrix, to encourage hidden images, feelings and ideas to emerge. A complex, multi-layered experience emerged through rich metaphorical language, encompassing both personal and broader sociocultural understanding of dementia. An unexpected outcome was the quasitherapeutic effect of the visual matrix on staff. The study suggests that the visual matrix may have potential to be adapted as a training tool in dementia care and that the fluid, associative and non-linear qualities of the visual matrix may prove an effective method for gathering the views of people with dementia, whose authentic voices are under-represented and difficult to gather using traditional research methods. [ABSTRACT FROM AUTHOR]

This qualitative study explores the experiences of five primary care counsellors working in the NHS with clients identified as diagnosable with borderline personality disorder (BPD). Participants completed a semi-structured interview about their experiences of clinical work with BPD clients. Interview transcripts were analysed via Interpretative Phenomenological Analysis (IPA) and three master-themes were identified: recognition and implications; managing feelings of inadequacy; and managing dilemmas in the primary care context. Despite struggling to manage feelings of failure evoked by these clients, counsellors described feeling a sense of ethical responsibility, and adapted the traditional short-term model of counselling to ensure clients received ongoing, supportive work. Whilst NHS guidelines propose that BPD is best managed and treated in secondary care and specialist services, this study found that counsellors are working with this complex group of clients in primary care and require specialist supervision and support in managing unconscious process issues emerging from the work. [ABSTRACT FROM AUTHOR]