Transactional Analysis in Social Care and Health Management

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An introduction to
Transactional Analysis
Applied to Managing
Social Care and Health
 
Transactional analysis
 
Objectives
 
Understand the basic principles of the PAC model of
transactional analysis
 
Gain an insight into how we communicate with one
another and what relevance this has to managing
relationships within teams in social care and health
 
Key authors
 
Berne, E., (1961)
 
Lapworth, P & Sills, C. (2011)
 
Transactional analysis
 
The model of transactional analysis has been widely
applied to:
 
Psychology
Counselling
Leadership and management
Social care and health
 
What is transactional analysis?
 
It is a model which helps us to make sense of how we act, interact
and react with one another.
 
A transaction is an exchange of words, expressed feeling, physical
behaviour, shared thoughts, stated opinion or belief.
 
What is transactional analysis?
 
It is based on the idea that some of our transactions are based on
our childhood experiences and later become patterns of behaviour
in our adult lives.
 
 Eric Berne’s (1961) model consists of three ‘ego states’
The 
P
arent
The 
A
dult
The 
C
hild
 
The PAC model
 
The theory states that an individual consistently uses three ego states to
express their personality.
P
arent: is an unconscious mimicking of how your parents acted or an
interpretation of the parental action - so we can be nurturing or critical.
 
A
dult: this is a logical state without major emotion which is objective,
thoughtful, uses evidence and fact. We behave in a respectful, equal and
open-minded way
 
C
hild: is a state in which we reacted as a child, either adapting or acting
freely, for example uninhibited or silly.
(Phillips, 2013)
 
The PAC model
 
Harris (1973); Lapworth & Sills (2011)
 
Adult 
– being appropriate
to the situation, in the here
and now
 
Parent 
– originates not from
our own direct experiences
but those of our parents or
others who had power over
us which we have
internalised
 
Child 
– a fixed state which
has its origins in our own
emotional childhood
experiences. It has become
stylised and repetitive over
the years
 
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Let’s consider three work based examples:
 
1.
Your manager is angry with you because you were late for a meeting. They shout at you and
tell you that they can’t trust you any more.
 
2.
You have a phone call, email or conversation that something has
          gone wrong today, your staff member says 
‘Please please help me
          I’m really really struggling
’. Your immediate reaction is to immerse yourself
          into the situation.
 
3.      A new member of staff is very keen and is taking extra time with individuals.
         This was great at first but he is now slowing down the work timetable. The
         individuals using services love him but the staff are complaining that things
         are not getting done. The team is unhappy
 
How do you react? How should you react? Let’s work through each example in turn.
 
 
 
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Lets apply the PAC model to the first work based example:
 
 Your manager is angry with you because you were late for a meeting. They
shout at you and tell you that they can’t trust you any more.
 
Your manager’s critical parent ego has responded by shouting at you,
demonstrating anger and frustration (P).
 
If you respond by leaving the room then the act itself demonstrates a child
ego response (C). Continuing in a parent – child interaction could
perpetuate a conflict situation.
(Lapworth & Sills, 2011
; Jones, L., Bennett, CL., 2012)
 
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Resolving the conflict situation could be achieved in two different ways by
moving towards an adult state:
 
An adult response from your manager would have been an acknowledgment
such as ‘lets look at what’s making you late’.
 
An adult response from you, would have been in the form of an apology ‘yes, I
can only apologise…. [Giving a reason… for example…. ‘We are going through
an unusually high level of activity at the moment’].
(Lapworth & Sills, 2011
; Jones, L., Bennett, CL., 2012)
 
For example P-C response
 
(Harris, 1973)
 
Manager
 
Employee
 
An alternative adult response by either would resolve the  conflict
 
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t
h
?
 
Transactional analysis is relevant to managing
relationships in social care and health because it
can help us understand the different transactions
(the acts of behaviour) that staff portray when we
communicate in different circumstances.
 
It can help us to build resilient teams by steering
individuals to find the ‘
A
dult’ within ourselves and
behave in a respectful, analytical, conscious,
relaxed and attentive state.
 
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c
a
r
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a
n
d
 
h
e
a
l
t
h
?
 
Lets apply the PAC model to the second work based example:
 
You have a phone call, email or conversation that something has gone wrong
today, your staff member says ‘
Please please help me I’m really really
struggling’.
 Your immediate reaction is to immerse yourself into the situation.
 
Your staff member has used a ‘child’ ego state (C). This has resulted in a
parental response feeling wanted, immersing yourself in the problem and
taking over the situation or assuming a staff dependency (P).
 
If this Child –Parent interaction persists then the member of staff will continue  to
call every time there is a problem and does not develop appropriate decision
making skills.
                                                                                     
(Lapworth & Sills, 2011)
 
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Resolving this situation could be achieved in two different ways:
 
As a manager you could respond with ‘how can I help’ or ‘what kind of help do
you need?’ or ‘who do you think could best help you in this situation?’ this
immediately invokes the individual’s adult ego to think about the situation and
available resources objectively and thoughtfully.
 
 In a supervision session you may wish to suggest that your staff member need only
say ‘can you help with this a moment?’ when requesting help.
 
Again the aim of moving the interactions to the adult state is achieved.
(Lapworth & Sills, 2011)
 
For example C-P transactions
 
Employee
 
Manager
 
An alternative adult response by either would resolve the potential of
dependency and promote self development.
              
(Harris, 1973)
Child-Help me I can’t
do it
.
Parent –I’ll take over and do it for
you
 
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a
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a
r
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a
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d
 
h
e
a
l
t
h
?
 
Let’s apply the PAC model to the third work based example:
 
A new member of staff is very keen and is taking extra time with
individuals. This was great at first but he is now slowing down the work
schedule. The individuals using services  love him but the staff are
complaining that things are not getting done and they are refusing to
work with him.
 
Your team are responding in their collective child state (C). They are
frustrated and angry.
 
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h
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a
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t
h
?
 
How do you respond to this situation?
 
If you respond using your child ego state and ignore the situation for fear of
making it worse, then they will continue to work in this way possibly until the new
member of staff leaves. This is a Child-Child interaction.
 
If you respond using your critical parent ego state and interact with the new
member of staff saying something like ‘do you realise you’re making a mess of the
work schedule?’ Then you are likely to create further conflict (P).
 
Again moving the interactions to the adult ego state may be achieved
through acknowledging and addressing the situation through individual
supervision and team meetings asking staff members how they think the
situation could be resolved through objective appraisal of the situation.
                                                        
(Lapworth & Sills, 2011)
 
For example C-C-P transactions
 
(Harris, 1973)
 
Team
 
Manager
 
An alternative adult response by the manager would
demand an adult response from the team and from the
employee and so resolve any potential isolation or
conflict.
 
Employee
We’re not working with
 him!
I’m ignoring you
I don’t care what people
think, I’m doing my job
Do you realise you’re
making a mess of
things?’
 
Let’s think about this for a
moment
 
If we can identify which ego state we are in then it will help us
increase our responses in any given situation. Reflecting on past
responses will help us.
So, think about events in the past and ask yourself the following
questions:
Did I think, feel and behave in ways my parents (or other adult) used to
when I was little? (P)
Did I think, feel and behave in ways that were appropriate and direct here
and now response to what was going on? (A)
Did I think, feel and behave as I did at some time in my recent, mid or
distant past?(C)
Knowing this now how could I have behaved differently?
 
(Lapworth & Sills, 2011)
 
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?
 
Relationships are central to the work of managing a
successful team. They require mutual respect and
empathy as well as a shared vision and goals.
 
Transactional analysis believes that people are
generally good, those who have emotional difficulties
are whole human individuals who can take
responsibility for themselves.
 
Finally, all emotional and behavioural problems can be
changed with the right resource and knowledge.
undefined
 
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References
 
Berne, E., (1961) Transactional Analysis in Psychotherapy: a
systematic individual and social psychiatry. Grove Press.
Pp232-46
Harris, TA., (1973) Transactional analysis- I’m ok, you’re ok.
Arrow Books.
Jones, L., Bennett, CL., (2012) Leadership in Health and
Social Care: An introduction for emerging leaders.
Banbury. Lantern Publishing. p39
Lapworth, P., Sills, C., (2011) An introduction to
Transactional Analysis. London. Sage Publications.p25-38
Phillips, A., (2013) Developing Assertiveness Skills for Health
and Social Care Professionals. London. Radcliffe
Publishing. p 78-92
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Explore the basics of Transactional Analysis (TA) and its application in social care and health management. Discover the PAC model, key authors, and how TA helps us understand communication and behavior patterns. Learn about the three ego states - Parent, Adult, and Child - and their impact on relationships within teams. Gain insights into how childhood experiences shape our interactions and reactions.

  • Transactional Analysis
  • Social Care
  • Health Management
  • Communication
  • Relationship Dynamics

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  1. An introduction to Transactional Analysis Applied to Managing Social Care and Health

  2. Transactional analysis Objectives Understand the basic principles of the PAC model of transactional analysis Gain an insight into how we communicate with one another and what relevance this has to managing relationships within teams in social care and health

  3. Key authors Berne, E., (1961) Lapworth, P & Sills, C. (2011)

  4. Transactional analysis The model of transactional analysis has been widely applied to: Psychology Counselling Leadership and management Social care and health

  5. What is transactional analysis? It is a model which helps us to make sense of how we act, interact and react with one another. A transaction is an exchange of words, expressed feeling, physical behaviour, shared thoughts, stated opinion or belief.

  6. What is transactional analysis? It is based on the idea that some of our transactions are based on our childhood experiences and later become patterns of behaviour in our adult lives. Eric Berne s (1961) model consists of three ego states The Parent The Adult The Child

  7. The PAC model The theory states that an individual consistently uses three ego states to express their personality. Parent: is an unconscious mimicking of how your parents acted or an interpretation of the parental action - so we can be nurturing or critical. Adult: this is a logical state without major emotion which is objective, thoughtful, uses evidence and fact. We behave in a respectful, equal and open-minded way Child: is a state in which we reacted as a child, either adapting or acting freely, for example uninhibited or silly. (Phillips, 2013)

  8. The PAC model Parent originates not from our own direct experiences but those of our parents or others who had power over us which we have internalised Adult being appropriate to the situation, in the here and now Child a fixed state which has its origins in our own emotional childhood experiences. It has become stylised and repetitive over the years Harris (1973); Lapworth & Sills (2011)

  9. How is transactional analysis relevant to managing relationships in social care and health? Let s consider three work based examples: Your manager is angry with you because you were late for a meeting. They shout at you and tell you that they can t trust you any more. 1. You have a phone call, email or conversation that something has 2. gone wrong today, your staff member says Please please help me I m really really struggling . Your immediate reaction is to immerse yourself into the situation. 3. A new member of staff is very keen and is taking extra time with individuals. This was great at first but he is now slowing down the work timetable. The individuals using services love him but the staff are complaining that things are not getting done. The team is unhappy How do you react? How should you react? Let s work through each example in turn.

  10. How is transactional analysis relevant to managing relationships in social care and health? Lets apply the PAC model to the first work based example: Your manager is angry with you because you were late for a meeting. They shout at you and tell you that they can t trust you any more. Your manager s critical parent ego has responded by shouting at you, demonstrating anger and frustration (P). If you respond by leaving the room then the act itself demonstrates a child ego response (C). Continuing in a parent child interaction could perpetuate a conflict situation. (Lapworth & Sills, 2011; Jones, L., Bennett, CL., 2012)

  11. How is transactional analysis relevant to managing relationships in social care and health? Resolving the conflict situation could be achieved in two different ways by moving towards an adult state: An adult response from your manager would have been an acknowledgment such as lets look at what s making you late . An adult response from you, would have been in the form of an apology yes, I can only apologise . [Giving a reason for example . We are going through an unusually high level of activity at the moment ]. (Lapworth & Sills, 2011; Jones, L., Bennett, CL., 2012)

  12. For example P-C response Manager Employee An alternative adult response by either would resolve the conflict (Harris, 1973)

  13. Why is transactional analysis relevant to managing relationships in social care and health? Transactional analysis is relevant to managing relationships in social care and health because it can help us understand the different transactions (the acts of behaviour) that staff portray when we communicate in different circumstances. It can help us to build resilient teams by steering individuals to find the Adult within ourselves and behave in a respectful, analytical, conscious, relaxed and attentive state.

  14. How is transactional analysis relevant to managing relationships in social care and health? Lets apply the PAC model to the second work based example: You have a phone call, email or conversation that something has gone wrong today, your staff member says Please please help me I m really really struggling . Your immediate reaction is to immerse yourself into the situation. Your staff member has used a child ego state (C). This has resulted in a parental response feeling wanted, immersing yourself in the problem and taking over the situation or assuming a staff dependency (P). If this Child Parent interaction persists then the member of staff will continue to call every time there is a problem and does not develop appropriate decision making skills. (Lapworth & Sills, 2011)

  15. How is transactional analysis relevant to managing relationships in social care and health? Resolving this situation could be achieved in two different ways: As a manager you could respond with how can I help or what kind of help do you need? or who do you think could best help you in this situation? this immediately invokes the individual s adult ego to think about the situation and available resources objectively and thoughtfully. In a supervision session you may wish to suggest that your staff member need only say can you help with this a moment? when requesting help. Again the aim of moving the interactions to the adult state is achieved. (Lapworth & Sills, 2011)

  16. For example C-P transactions Employee Manager An alternative adult response by either would resolve the potential of dependency and promote self development. (Harris, 1973)

  17. How is transactional analysis relevant to managing relationships in social care and health? Let s apply the PAC model to the third work based example: A new member of staff is very keen and is taking extra time with individuals. This was great at first but he is now slowing down the work schedule. The individuals using services love him but the staff are complaining that things are not getting done and they are refusing to work with him. Your team are responding in their collective child state (C). They are frustrated and angry.

  18. How is transactional analysis relevant to managing relationships in social care and health? How do you respond to this situation? If you respond using your child ego state and ignore the situation for fear of making it worse, then they will continue to work in this way possibly until the new member of staff leaves. This is a Child-Child interaction. If you respond using your critical parent ego state and interact with the new member of staff saying something like do you realise you re making a mess of the work schedule? Then you are likely to create further conflict (P). Again moving the interactions to the adult ego state may be achieved through acknowledging and addressing the situation through individual supervision and team meetings asking staff members how they think the situation could be resolved through objective appraisal of the situation. (Lapworth & Sills, 2011)

  19. For example C-C-P transactions Team Employee Manager Do you realise you re making a mess of things? I m ignoring you I don t care what people think, I m doing my job We re not working with him! An alternative adult response by the manager would demand an adult response from the team and from the employee and so resolve any potential isolation or conflict. (Harris, 1973)

  20. Lets think about this for a moment If we can identify which ego state we are in then it will help us increase our responses in any given situation. Reflecting on past responses will help us. So, think about events in the past and ask yourself the following questions: Did I think, feel and behave in ways my parents (or other adult) used to when I was little? (P) Did I think, feel and behave in ways that were appropriate and direct here and now response to what was going on? (A) Did I think, feel and behave as I did at some time in my recent, mid or distant past?(C) Knowing this now how could I have behaved differently? (Lapworth & Sills, 2011)

  21. How is transactional analysis relevant to managing relationships in social care and health? Relationships are central to the work of managing a successful team. They require mutual respect and empathy as well as a shared vision and goals. Transactional analysis believes that people are generally good, those who have emotional difficulties are whole human individuals who can take responsibility for themselves. Finally, all emotional and behavioural problems can be changed with the right resource and knowledge.

  22. We hope that you have gained some understanding of transactional analysis

  23. References Berne, E., (1961) Transactional Analysis in Psychotherapy: a systematic individual and social psychiatry. Grove Press. Pp232-46 Harris, TA., (1973) Transactional analysis- I m ok, you re ok. Arrow Books. Jones, L., Bennett, CL., (2012) Leadership in Health and Social Care: An introduction for emerging leaders. Banbury. Lantern Publishing. p39 Lapworth, P., Sills, C., (2011) An introduction to Transactional Analysis. London. Sage Publications.p25-38 Phillips, A., (2013) Developing Assertiveness Skills for Health and Social Care Professionals. London. Radcliffe Publishing. p 78-92

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