It’s About Respect

Showing respect and appreciation for the team can go such a long way. When I have been on teams that showed respect and gratitude, I worked hard, maintained a better attitude, and felt a sense of ownership. But this respect had to be shown. If leadership was telling me how much they appreciated me but did nothing to help me save time and work more efficiently, or worse, implemented policies that made my job harder, the words of appreciation meant little. In fact, it can feel insulting and erode trust in leadership.

Communicating respect to a team means demonstrating it by choices. It’s essential to communicate with the team and determine their needs, then strategize to provide them. This can be challenging due to the inherent tensions found in the behavioral health industry. However, by employing creative problem-solving, we can explore options that may not be immediately apparent.

Inherent Tensions:

Time - Employees often feel pulled in too many directions with never enough time to get everything done and do things well. This occurs when policies and requirements are implemented without conducting a workflow analysis to determine their impact on the workload of each department.

Finances vs. Clinical Care - We often pretend that these two aspects are in alignment, but upon analysis, this is an inherent tension. For example, decisions regarding admission criteria, the number and speed of admissions, staffing requirements, supply needs, training allocations, and other related matters are areas where these tensions often come to light. This occurs because running a successful business in a capitalist economy is dependent on spending as little as possible and charging as much as possible. At the same time, the ethical obligations of the therapist, nursing, and medical teams are aimed at a quality of care and safety.

Differing views on client care - I will discuss this further in the Unity section. It’s often the case that therapy and medical teams have different and sometimes opposing views on client care, from diagnosis to expectations within the milieu, to consequence structures, the gap can be broad. Challenges with conflict and/or resentment between teams occur when each team is not educated on the fundamental principles of the other teams. For example, a nursing team is inherently more directive than a therapy team. This makes sense for their role. If these teams don’t understand one another, it’s tough to negotiate or ethically compromise on client care.

Hospitality vs. Clinical - Hospitality usually covers admissions teams, community relations teams, and marketing teams. This tension can be seen as a subset of the inherent tension of finance. This tension arises when the treatment team’s recommendations, boundaries, ethics, or requirements are not well-received by individuals who are not part of these teams. For example, a client referral source might want X, Y, Z for the client, and the treatment team believes X, Y, Z is not appropriate. Or a member of the CR team might want daily updates from the treatment team on a client, which activates the inherent tension of time. Depending on how much revenue these folks bring to the facility, there might be a very real tension around what to do from a business standpoint.

These are a few of the tensions I have observed in facilities. There will likely be additional inherent tensions that are specific to each facility. In my experience, it works better to address them head-on, rather than deny the reality of them or try to avoid them coming up.