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Research & Evidence

Dialogue as a Whole-System Healthcare Intervention - Beth Macy

Beth Macy

A year-long dialogue intervention in a healthcare facility with toxic culture produced unexpected results: buried traumas surfaced, staff lined up for counselling, and the facilitator's own life transformed. Beth Macy documents dialogue's power to reach beneath the surface.

This paper documents an intensive, whole-system dialogue intervention at a long-term healthcare facility plagued by chronic absenteeism and toxic culture. Beth Macy and her co-facilitator trained the entire staff in dialogue, hoping to build resilience for coming changes. What emerged was unexpected. As sessions deepened, participants began seeking out the co-facilitator, a therapist; because buried memories were surfacing: an abusive husband, childhood trauma, sexual abuse never before recalled. The facilitators were shocked: what had they unleashed? The paper honestly addresses structural traps; participants expected problem-solving even as facilitators insisted dialogue wasn't about that, and the emotional toll on facilitators who absorbed the organisation's shadow. By the intervention's end, Macy had left her partner, her profession, and moved states. Twenty-five years later, she remains 'compelled' by dialogue. Though conducted over two decades ago, the insights on embedding dialogue throughout an entire organisation remain directly applicable today.

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Research & Evidence

Topics

Dialogue in organisations and systems

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