Building a resilient organization

 By any measure, these are stressful times for helping organizations. Budgets are being cut, we are operating short-staffed, and more clients need intensive services. Increasing pressure on addiction treatment programs to serve more people with fewer resources means an epidemic of burnout, staff turnover, dissatisfaction and internal conflict. In 2009, organizational psychology expert Lillian Eby, PhD, found in Project MERITS that the majority of staff in addiction treatment systems intended to quit their jobs in the next year but were not optimistic about finding another job in the field.

The key to survival in the coming years will be to develop resilient organizations. Individuals in the workplace vary in how resilient they are, but it is their collective resilience that should be of concern here. Collective resilience occurs when those in caregiving organizations join together in meaningful ways to share information, solve problems, make sense of what they are going through, and support one another. This collaboration and support will determine which organizations thrive and which barely survive.

What is needed now is not simply strategic leadership, although that surely helps. Effective managers enable staff to join together to reflect on their experiences in their roles, to express rather than act out, to protect against strong negative emotions and anxiety, and to develop productive mechanisms for managing stressors.

Management through engagement

The first step is to create the conditions for engagement. Ask yourself: How safe is my workplace? Stephen Covey’s 2005 book The Speed of Trust emphasizes the importance of safety and trust in a workplace. Is yours a high- or low-trust organization?

Resilience is created when individuals absorb, express, reflect on and learn from their emotions at work. A sense of safety allows people to be vulnerable and to take risks in exploring their emotions.

Engagement happens in various forums: clinical supervision, team meetings, management staffing, case management, etc. Three conditions are required to have an engaged staff: clear task assignments, appropriate roles and use of authority, and boundary setting. When these conditions are met, staff will engage with one another in examining the emotional undercurrents at work and in rendering negative emotions ineffective.

Defining roles

In the second step, supervisors and managers need to monitor the staff’s primary tasks, consistently examining the extent to which members’ efforts are on task. This is a time, as never before, for clinical supervisors’ direct observation of counselors in action with clients. Supervisors need to teach staff about the reasonable limits to what the agency might accomplish with the populations served, while still retaining hope on clients’ behalf.

Roles need to be clearly delineated. A first-rate supervisor hires first-rate people and lets them do their job. A second-rate supervisor hires third-rate people and micromanages them. Rather than blame staff when they are off task, an effective leader examines why this is occurring and how the agency was unable to remain on task.

Convening for resilience

Third, effective leaders convene various forums to create resilience. Such gatherings have many purposes, the most obvious of which is to get the work itself done. Case management, rounds, and staff meetings are all examples of venues in which organizations focus on the tasks at hand. However, effective leaders also convene staff for more complicated purposes. They create a culture of inquiry that allows system-level resilience to be created and maintained.

Cultures of inquiry address the raw emotions of work, where people feel free to express their emotional experiences in order to improve their work. They are able to express anger, resentment, longing, fear, sadness, or whatever else they might feel. This sharing links up staff through the exchanging and interpreting of emotions.

Some might say that the workplace is not therapy for staff, that people should “check their emotions at the door” and just do their job. With patients, we say we are only as sick as our secrets. With caregiving organizations, I say we are only as sick as our inability to express emotions to one another. Given the stressors we are operating under, the concept of isomorphism is critical: What exists in one aspect of life exists in another. If I come to work angry, resentful, fearful and anxious, I cannot check those emotions at the door. They will bleed out into my relationships with clients and other staff.

Venues for resilience

Clinical supervision needs to be the primary forum by which resilience is created. Group supervision is an ideal venue for caregivers to be care seekers. It offers an opportunity for supervisors to relieve anxiety and to learn something of value about the organization.

Supervision provides reflective space, to convert anxiety and emotions into something than can be communicated. The effective supervisor absorbs, digests, and then provides for supervisees in the way that caregivers work with patients, with the aim of enhancing staff’s capacity for resilience.

Another venue for resilience is staff meetings where meaningful attachments are created. When counselors are able to speak of their actual experiences of their work and interactions, they form attachments that over time translate into the relationship networks underlying cultures of inquiry. As a group they can absorb the distress that may be felt by staff, disperse it among one another, and work with it rather than be disabled by it.

Staff needs to feel free to speak candidly of their experiences and emotions without risk of isolation or scapegoating. The supervisor needs to monitor this process to prevent any staff member from committing “social suicide,” through too much candor. Regular staff meetings should provide the time and space for frustrations, concerns, ideas, enthusiasms, and questions to be raised. Over time, led correctly, staff meetings can offer a regular place for staff to join together to deal with work’s stressors.

Holding down the fort

Psychiatrist and Harvard Medical School professor George Vaillant, MD, wrote, “Maturity is many things. Maturity includes having appropriate expectations and goals for oneself and finding a major source of fulfillment in productive work. Maturity includes the capacity to love and to hope. It includes the ability to discharge hostility without harming others or oneself. … Finally, maturity includes the capacity to adapt to change, to endure frustrations and loss, and to maintain an altruistic concern for human beings outside one’s own group and beyond one’s own time and place.”

This definition can apply to the maturity needed from our social services in these times of reduced funding and staffing shortages. Organizations need to help staff find fulfillment in productive work, to experience hope and hostility without harm, to play, to adapt, to experience loss, and to forge altruistic connections to others, both patients and staff.

The way we will thrive through these difficult times is in finding transformational change within organizations. We must disperse the pain of staff, seek to find hope, establish mature defenses, engage in change, diagnose problems early, engage staff in conversations, contain conflicts, create the capacity for hope, and hold authority courageously. This requires a love of the tasks that drew us to our work and our organizations. It requires commitment to one another. It requires holding fast in the struggle to care well for others.

David J. Powell, PhD, is President of the International Center for Health Concerns, Inc. (www.ichc-us.org). His e-mail address is djpowell2@yahoo.com.