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Two approaches to organizational consultation — psychodynamic systems and socio-technical systems theories — originally developed at the Tavistock Institute for Human Relations but diverged several decades ago. We describe each approach and analyze its effectiveness in a community consultation in which the presence of social hierarchies presented a considerable challenge. We then discuss a consultation in which both approaches were combined, and argue for the benefits of this joint technique. Copyright © 2013 John Wiley & Sons, Ltd.