This paper presents an exploratory qualitative study which draws upon cognitive analytic therapy (CAT) as part of an organizational assessment of a dysfunctional and disharmonious staff group. The remit of the research was to explore why relationships between nursing staff and management employed in a surgical theatre unit in a District General Hospital had disintegrated. Using the information generated from semi‐structured interviews a sequential diagrammatic reformulation was created which identified the object relational core of the work group and the consequent sabotaging cognitions and behaviours that emerged. The strengths and limitations of the use of therapeutic approaches for the psychologist interested in working with organizational change processes is discusse