Psychotherapy and social action model

Domain V · Systemic, relational, group & community · Sue Holland · 1980 · West London, England

What it is

This is not a manualised therapy. It is a community mental-health model and project. Sue Holland, an NHS clinical psychologist with a background in community action, set it up in 1980 on the White City council estate in West London. She worked with very depressed women and their families. The…

Format

• The four stages below follow Holland (1992) as summarised by Wikipedia. Holland mapped them onto Burrell and Morgan's (1979) four sociological paradigms, the "square". Its outer rows contrast changing individuals to fit social convention with changing social structures.
• Individual work comes first for severely depressed women, because severe depression prevents attending groups or taking action.

Who practises it, and how they are trained or regulated

• What it is. This is not a manualised therapy. It is a community mental-health model and project. Sue Holland, an NHS clinical psychologist with a background in community action, set it up in 1980 on the White City council estate in West London. She worked with very depressed women and their families. The project was later known as the Bridge Project and as Women's Action for Mental Health (WAMH). There is no…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Using the square to push clients along against their wishes.
• The boundaries of a dual role. Agree how this affects therapy confidentiality. Her capacity to self-advocate growing.
• Pressure on members to conform to a group line about their partners. Domestic-abuse disclosures that need individual follow-up.
• Withdrawal symptoms, a return of severe depression, and rising risk. Any sense that she must give up medication to be accepted for therapy.
• Relief at being less to blame: a sign it is working. Your political frame being imposed on her. If she rejects the social reading, return to her own meaning.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.