Learning objectives for POD

The Passed-outwards Discussion (also known as the POD) is a teaching exercise to help trainees think about:

• the relationship between anxiety/stress and mentalizing
• the impact of this on our capacity to create a "coherent narrative" (a story of what's going on that makes sense)
• How the experience of being accurately-enough-mentalized helps us to recover our own mentalizing (this is nothing new: it is of course the main rationale for all supervision!)
• POD is a way to illustrate our Ripples in a Pond analogy
• It emphasises the importance of recognising who is where in relation to the anxiety in a help-seeking worker's story, with a help-offering colleague.
• Later in the training we will introduce Thinking Together which adapts some of the learning from this exercise.

Short Intro to POD by Liz Cracknell:

Another introductory film: how to set up the exercise:

Where to use the POD:

• "Clinical" applications: Although this is mainly a teaching exercise, many teams also use the POD as a technique in team meetings to help to facilitate Mentalization in a KeyWorker if they are overwhelmed or stuck.
• It can be performed in a number of different settings, any of which would represent the gathering of a Reflective Quorum:

1. As one of our Training exercises to develop our understanding of Mentalization and (via the Ripples in a Pond analogy) and support the core feature of developing the Keyworker well-connected to wider team.
2. Face to face in a team meeting
3. Via a formal telephone conference call
4. Using a mobile phone switched to "loudspeaker" to allow 'in-the-room' conferencing between more than two people.

In example 3, the KeyWorker might be standing outside a young person's home, having explained "What you have just told me seems very important, and there is obviously a LOT going on. I am not sure if I have got it all, but I'd like to take about 15 minutes break now if that is OK so that I can check in with my team-mates and get some help from them in thinking about all this. Does that sound OK? It may be that they will want to offer a message for both of us to think about. I'll go and phone them from the garden if that is OK..."

How to facilitate the POD exercise:

This exercise is designed to support or explain through experience the particular Rituals and Disciplines that are laid out in Thinking Together. It may conclude with the KeyWorker agreeing to deliver TakeHomeMessages from other members of the team.

The basic technique is as follows:

1. Set three "roles"

• person A
• person B
• person C

2. person A selects their story

• best to use a true story if this is a training exercise
• best to be a story that stirs emotions and is genuinely causing some upset for person A (a young person they are very worried about, a colleague they are in conflict with, another team that is proving very difficult to work with... some area of work where they feel things are NOT going well. "Don't choose a really tough case that - in truth - you are confident that no-one else could do better with, but which just shows how tough your work is!")
• agree boundaries of confidentiality and respect for material shared in the exercise.

3. person A tells their story to person B.

• person B can ask occasional questions to check details and understanding, using ordinary 'listening skills'.
• person C must remain silent, but can listen.

4. person B passes the story on to person C

• person B must retell the story to person C; they are not pretending to be person A, but they are trying to tell the story accurately from person A's perspective.
• they do not need to use exactly the same language, and can add their own observations if they mark these as such.
• person C can ask questions for clarification and as person B's account comes to an end, person C and person B can discuss the story briefly.
• person A must remain SILENT during this whole process (this can be hard!)
• person A is encouraged to be mindful of emotions, and thoughts as they have this experience of their story being re-told.
• what is my emotional reaction to hearing my story retold?
• were facts missed (in my account, or in their retelling of it?)
• do I become more aware of things in hearing the story?
• am I more or less able to think about this issue?
• are there any new insights?

What is this POD exercise about?

We are deliberately setting up a rather artificial process whereby a KeyWorker, having passed "hot" or disturbing information to one colleague, is then able to "sit back" rather artificially, and witness that colleague taking up their role (or burden) to passing on the same information to a third colleague (Person C), and to witness the discussion that they have (these might be in keeping with the boundaries of Thinking Together, but not necessarily.)

Why do this POD exercise?

By passing the information (and to a large extent the anxiety and affect) outwards (cf. Ripples in a Pond) the KeyWorker can temporarily create a marked "space" (the "POD") where he/she is able to make an imaginative leap from being in the midst of the chaos (and unable to activate his or her Mentalization), to being in an observing/reflecting position (we could call this a temporary "MetaTeam"), where stress is a bit less intense, and mentalizing is more possible.