By Sarah Phillips, Founder and CEO of VeinTrain - Systems Psychodynamics 

Most organisations do not have a training problem. They have a problem with what happens before and after the training, and that is why the same issue keeps returning.

I was recently prompted to think about this after reading Professor Manfred Kets de Vries’ essay, Peanuts: the playground as psychoanalytic couch. He uses Charles M. Schulz’s familiar characters to explore the patterns people repeat, even when they know how the story usually ends.

This article is inspired by those reflections, but the question it raises for me comes from healthcare education and organisational change: why do capable people and committed organisations keep running towards the same football?

What Manfred was saying

Manfred’s essay is an enjoyable read whether you are interested in the deeper workings of organisations or simply enjoy recognising human behaviour in a comic strip. Charlie Brown endures, Lucy dominates, Linus clings, Schroeder retreats into art and Snoopy escapes into fantasy. Manfred treats each response as a defence against vulnerability rather than merely a personality quirk.

His argument is not that people learn nothing. It is that insight alone does not necessarily free us from familiar patterns. As he puts it:

“We are not necessarily saved from our repetitions; we may be revealed by them.”

That sentence stayed with me. It is a useful way to think about organisations too. A repeated problem may reveal more than a gap in a process. It may show us how the organisation manages anxiety, distributes authority, avoids conflict or protects an established way of working.

This is where Manfred’s psychodynamic-systemic approach becomes especially relevant. It asks us to pay attention not only to what people say and do, but also to what they avoid saying, unconsciously repeat or defend against. His recent book, The Path to Individual and Organizational Transformation: Confronting the Elephant in the Room, develops the same invitation to look beneath the polished surface of plans, strategies and performance.

A project plan or Gantt chart can show tasks, owners and deadlines. It cannot, by itself, show the fear of losing status, the informal loyalties, the unspoken rivalry, the anxiety about competence or the history that makes one team distrust another. Those dynamics may be less visible, but they can be more powerful than the formal plan.

Charlie Brown and the repeated training intervention

The pattern is familiar.

An incident, audit or concern identifies a gap. Training is commissioned. Staff attend. Completion is recorded. Everyone is relieved that action has been taken.

Then the same problem returns.

The natural response is often to run the training again. Sometimes that is necessary. Knowledge changes, skills fade and people need opportunities to practise. But repeated training can also become a substitute for examining the conditions in which people are expected to work.

If staff return from a course to the same workload, unclear responsibilities, inconsistent supervision, outdated local processes or a culture that rewards shortcuts, the organisation has changed the individual learning event without changing the system around performance.

That does not mean the training failed. It may mean the training was asked to solve a problem it could never solve alone.

Charlie Brown keeps approaching the football because the ritual offers the possibility that this time the result will be different. Organisations can fall into a similar rhythm: identify the gap, commission a course, record attendance and hope for a lasting change. When the wider conditions remain untouched, the cycle begins again.

The more useful question is not simply, “Have we delivered the training?” It is, “What needs to be different when people return to work?”

Lucy and the danger of confident diagnosis

Lucy is wonderfully certain. She has an answer, a booth and a fee. What she does not always have is curiosity.

There is a lesson here for anyone who supports organisational change, including training providers and consultants. A confident diagnosis can feel reassuring, particularly when leaders are under pressure to act. Yet a quick answer offered without listening can mistake the visible symptom for the underlying problem.

Low compliance may be described as a motivation issue when staff cannot access the right equipment. Variation in practice may be labelled a competence issue when different teams are working to conflicting policies. Poor uptake may be blamed on resistance when the intervention was designed without the people expected to use it.

Good organisational work begins with curiosity. What is happening in practice? What are people being asked to do? What makes the safer behaviour easier or harder? Where do policy, supervision, equipment, workload and accountability support one another, and where do they pull in different directions?

The aim is not to avoid expertise. It is to use expertise with enough humility to test the diagnosis, understand the context and remain involved after the recommendation has been made.

When leadership becomes trombone noise

In the animated Peanuts stories, adults are present but their voices arrive as indistinct trombone sounds. The children know authority is speaking, but the message itself is difficult to hear.

Something similar can happen inside organisations. Leaders may communicate frequently, but repetition is not the same as connection. A message about standards, safety or improvement can become background noise when it does not match what staff experience each day.

People notice when leaders say that learning matters but do not protect time for it. They notice when a new process is announced but managers reinforce the old one. They notice when feedback is invited but nothing visible follows. Eventually, another email, briefing or mandatory module can sound like one more instruction from a system that is speaking at people rather than working with them.

Communication becomes meaningful when it is supported by action. Staff need to see what is changing, who owns the next step, how concerns will be handled and what leaders will reinforce when operational pressure rises.

Culture is not created by the message alone. It is created by the pattern between what an organisation says, what it enables and what it tolerates.

Training is an event. Learning is a system.

Training still matters. A well-designed course can build knowledge, strengthen practical skills and give people a safer way to approach their work. But lasting change depends on the environment into which that learning returns.

For organisations, that wider picture can include:

• clear expectations and local policy
• trainer preparation and ongoing support
• opportunities to practise and receive feedback
• appropriate equipment and protected learning time
• supervision and employer-led competency assurance
• consistent messages from leaders and managers
• evidence that shows where implementation is working and where it is not
• a route for updating learning when practice, standards or local needs change

This is where organisational transformation becomes practical. It is not an abstract culture programme added above the real work. It is the deliberate effort to connect learning, leadership, governance and day-to-day conditions so that the desired behaviour has somewhere to take root.

The work beneath the work

The systems-psychodynamic perspective has become an important part of how I think about VeinTrain’s own transformation. On the surface, we can map programmes, partnerships, products, timelines and responsibilities. Beneath that sits another system made up of trust, identity, power, anxiety, hope and the meanings people attach to change.

Following those deeper threads has often helped me understand why a technically sound plan is moving well, why it is becoming stuck or why the same difficulty keeps returning in a different form. In many ways, this has been part of VeinTrain’s secret sauce. Once you learn to notice what is happening beneath the surface, it is difficult to switch that awareness off.

It also affects how I choose to work with partners. A brilliant project is not enough on its own. The people and organisations around it need values that can withstand pressure, honest conversations and the inevitable uncertainty of change. Expertise matters, delivery matters and commercial reality matters. So do integrity, respect and the way people behave when the plan stops being easy.

That is why VeinTrain’s healthcare centres and partners are not selected only because an opportunity looks impressive. We look for people whose values fit the work and whose approach supports safe, respectful and sustainable progress. The relationship beneath the project is part of the project.

Where HALO fits

HALO is VeinTrain’s organisational deployment model for practical venepuncture, phlebotomy and IV Cannulation training. It is being developed and used as a structured way to connect training delivery with trainer capability, local implementation, governance and progression over time.

We should be careful not to claim that any single model can transform a culture. Culture change is shared work, and responsibility remains with the organisation, its leaders, its policies and the people delivering care. HALO does not replace local employer competency sign-off, supervision, scope of practice or assurance.

What HALO can do is help organisations look beyond an isolated course. It provides a framework for asking how training will be delivered consistently, how local capacity will grow, what support trainers need and how learning can remain connected to the organisation around it.

That is an important shift. The question moves from “How many people completed the course?” to “What needs to be in place for this learning to change practice safely and sustainably?”

Before running at the football again

When a problem returns, more training may be part of the answer. Before commissioning it, however, leaders can ask:

1. Is this primarily a knowledge or skills gap, or is the system making the right action difficult?
2. What will staff return to after the training?
3. Who will reinforce, supervise and model the expected practice?
4. How will we know whether behaviour has changed, not just whether attendance was recorded?
5. What are we prepared to change if the same problem appears again?

Charlie Brown’s persistence is part of his appeal. In organisations, persistence matters too. But persistence without reflection can become repetition.

The goal is not to stop running. It is to look carefully at who is holding the football, what keeps pulling it away and what must change around the next attempt.

If your organisation is looking beyond one-off training and wants to explore a more structured approach to workforce learning, trainer development and local implementation, learn more about HALO or speak to the VeinTrain team about your starting point.