System Enactment: An Individual, Interpersonal, and Organizational Perspective

ABSTRACT Enactment is primarily conceptualized as a phenomenon occurring in the therapeutic dyad. This paper presents a relational construct of enactment as it manifests in the individual, interpersonal and organizational matrix of a clinical system. System enactments are ubiquitous phenomena that emerge with clients and staff in the relational field of a system that involves multiple participants with mutual and intersecting subjectivities; yet, there is little information about this type of enactment in the literature. This phenomenon often occurs in the context of power struggles and ruptures in the alliance with the client, and difficulties in the working relationships between treatment staff, which if not engaged, can result in negative therapeutic outcomes. A fictionalized case example demonstrates how this construct guides systems-based clinical practice. Implications for social work education, practice and training, and suggestions for future research are discussed.