Concentric conversations.

Over the years, working in various roles, I have done quite a lot of work in the area of team facilitation and conflict resolution. Sometimes this has been with groups of doctors like general practitioners (GPs) who are not getting along with each other. These days, a lot of my work is with teams of hospital doctors who are having difficulty in balancing their clinical and training obligations. In all this work, I take an approach I describe as ‘concentric conversations’. This draws on a range of ideas from the world of organizational work, particularly from the psychologist David Campbell who was one of my own teachers 1 2 and from the work of Ralph Stacey, who looks at organizations in terms of the ‘complex responsive processes’ that happen there. 3 The approach is based on a belief that change in organizations generally takes place not through mission statements, action plans and restructuring, but by encouraging more open and attentive conversations, from moment to moment and day to day. In this article, I want to describe how such an approach works, and what team facilitation looks like in practice. Although every piece of organizational work is different, nearly all of them start in the same way—with an inquiry from an individual. Someone contacts a facilitator like myself with a concern about a team they belong to, or hold responsibility for. Often, this person starts off straight away with a request for a team ‘awayday’. They may say something like the following (and this is scarcely an exaggeration): ‘No-one in our team has spoken to each other for years, and we’d like you to come and meet us all for a day and make us all behave nicely’. Personally, I always decline. At best, an awayday in these circumstances will only get people to smile at each other and conceal the real problems. At worst, it will encourage everyone to haul skeletons out of every cupboard and start to hurl the bones at each other, without allowing time to nurse the resulting bruises. When a group of people have run into trouble, change takes time and it has to be brought about gradually and with diplomacy. Awaydays may be a useful option once communication has started to open up properly, but this takes patience and great deal of preparation.