Leading Agendas for Behavioral Health and Well-Being

8/14/2019 Leading Agendas for Behavioral Health and Well-Being

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Leading Agendas for BehavioralLeading Agendas for BehavioralHealth and Well-Being: TheHealth and Well-Being: TheExperience of an InternalExperience of an Internal

Integrated EAP/WORKlife ProgramIntegrated EAP/WORKlife Program Kathleen Beauchesne, PhD, MBA, MSW, LCSW-CKathleen Beauchesne, PhD, MBA, MSW, LCSW-C

Johns Hopkins Institutions Johns Hopkins InstitutionsEASNA Annual Conference 2006EASNA Annual Conference 2006

Toronto Toronto


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Goals and ObjectivesGoals and Objectives

Discuss the critical leadership role thatDiscuss the critical leadership role thatintegrated EAP and WORKlife programsintegrated EAP and WORKlife programsmust achieve in work organizationsmust achieve in work organizationsParticipants will learn:Participants will learn:

One tool for leading changeOne tool for leading changeHow to develop Advisory Committees toHow to develop Advisory Committees toachieve strategic objectives; the value of achieve strategic objectives; the value of

management committees and their importancemanagement committees and their importanceto program goals and objectives; the use of to program goals and objectives; the use of leadership retreats; andleadership retreats; and

The theoretical models used to guide The theoretical models used to guideleadership on these issuesleadership on these issues


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Background InformationBackground Information

Internal EAP, WORKlife and Student AssistanceInternal EAP, WORKlife and Student AssistanceProgramsPrograms

Johns Hopkins Institutions Johns Hopkins Institutions Johns Hopkins Hospital and Health System Johns Hopkins Hospital and Health System Johns Hopkins University Johns Hopkins University

Global organizationGlobal organization55,000 faculty, staff, employees and students55,000 faculty, staff, employees and students

FASAP, WORKlife and Student AssistanceFASAP, WORKlife and Student Assistance


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The Challenge Facing The Challenge FacingAcademic Medical CentersAcademic Medical Centers

Three lines of business Three lines of businessChallengesChallenges

Technology TechnologyChanges in funding patternsChanges in funding patternsHealth care reformHealth care reformDiversityDiversityCorporate competitionCorporate competition


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Critical IssuesCritical Issues

Adaptability and changeAdaptability and changeCompetitionCompetitionRecruitment and retentionRecruitment and retentionProductivityProductivity

Benefits costsBenefits costsValue human resourcesValue human resources


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Leading Agendas forLeading Agendas for

ChangeChangeIntegrated Human Services Model (IHS Model)Integrated Human Services Model (IHS Model)

Conceptual frameworkConceptual frameworkGeneral systems theoryGeneral systems theoryBuilt on a systems model that reflects our view that universitiesBuilt on a systems model that reflects our view that universitiesgenerally (and JHI specifically) is a network of communitiesgenerally (and JHI specifically) is a network of communitiesencompassing a complicated system of interrelated parts.encompassing a complicated system of interrelated parts.

Administrative Structure: Office of Human ServicesAdministrative Structure: Office of Human ServicesMission: to support the fundamental purposes of the JHI to provideMission: to support the fundamental purposes of the JHI to providecutting edge healthcare, education and researchcutting edge healthcare, education and research

Career Management ProgramCareer Management ProgramCenter for Training and EducationCenter for Training and EducationFASAP (EAP)FASAP (EAP)Organizational Development and DiversityOrganizational Development and DiversityOffice of WORKlife ProgramsOffice of WORKlife Programs


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IHS ModelIHS Model

Model is consistent with a life-span humanModel is consistent with a life-span humandevelopment perspective for intervention; approachdevelopment perspective for intervention; approachemphasizes growth and changeemphasizes growth and change

Incorporates statements about desirable goalsIncorporates statements about desirable goalsFocuses on sequential changeFocuses on sequential changeEmphasizes techniques of Emphasizes techniques of optimization/empowerment rather than remediationoptimization/empowerment rather than remediationConsiders the individual or system as an integratedConsiders the individual or system as an integrated

bio/psychosocial unit amenable to a multi-bio/psychosocial unit amenable to a multi-disciplinary approach to service deliverydisciplinary approach to service deliveryViews individuals as developing in a changingViews individuals as developing in a changingcultural contextcultural context


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Key Elements of the IHSKey Elements of the IHS

ModelModelSystemic analysisSystemic analysisfacilitates the planning and delivery of our interventionsfacilitates the planning and delivery of our interventions

AssessmentAssessmentmost critical and valuable service that can be providedmost critical and valuable service that can be provided

Timing of the intervention Timing of the interventionis important;is important;evaluate every request with a review of the context of the situation that comes to ourevaluate every request with a review of the context of the situation that comes to ourattention as well as the impact of the problem on the person, their family, the work-team,attention as well as the impact of the problem on the person, their family, the work-team,other related organizational units and the organization as a wholeother related organizational units and the organization as a whole

InterventionsInterventionspsychotherapeutic, family-centered, career oriented, organizational and directed at trainingpsychotherapeutic, family-centered, career oriented, organizational and directed at trainingand development needsand development needs

Design evaluation and research studies to assist in a formal assessment of the modelDesign evaluation and research studies to assist in a formal assessment of the modelClient management systemsClient management systems

an integrated management information system that facilitates the gathering of compatiblean integrated management information system that facilitates the gathering of compatibleutilization and evaluation datautilization and evaluation data

Human services delivery team meets regularly to discuss cases and considerHuman services delivery team meets regularly to discuss cases and considermechanisms for increased collaboration and integrationmechanisms for increased collaboration and integration

The entire Human Services staff meets bimonthly to assure continuity The entire Human Services staff meets bimonthly to assure continuity


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FASAP

AA

Employed Adults

MH and SA incidence and prevalencedriven

Licensed professionals

Clinical approach/medical model

Mandated drug testing /managed care

Disciplinary process

Risk Assessment

INFRASTRUCTURE

INTEGRATIONAccess

Administrative SupportIntake

Client ServicesEvent Planning

Data ManagementFinancial Management

Follow-upPsycho-educational information

Databases of community resourcesCredentialing of resources

Core consultation skillsTechnology

Serve same clients

Supervisory trainingTeam practiceAdvisory Board

WORKLIFE Early childhood education

Employees across the life span

Demographics driven

Cognitive/psycho-educational approach

Life cycle model

Utilizes national policy

Support groups

FASAP/WORKlife Integrated InfrastructureModel

SAPAcademic and social concerns

Rooted in K-12 programsSafe, drug-free learning communities

Resilience and student successEducational activities

Support groups

Integrated approach


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Theoretical FoundationsTheoretical Foundations

Social exchange theorySocial exchange theorySocial justice theorySocial justice theoryRole theoryRole theoryLife course/developmental perspectivesLife course/developmental perspectives

Systems theorySystems theory


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Leading ChangeLeading Change

Framework: (Kotter, JP. (March-Framework: (Kotter, JP. (March-April,1995).April,1995). Leading Change: Why Leading Change: Why Transformation Efforts Fail.Transformation Efforts Fail. HarvardHarvardBusiness Review)Business Review)

Eight Steps to Transforming YourEight Steps to Transforming Your

OrganizationOrganization


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Kotters 8Kotters 8

Create a sense of urgencyCreate a sense of urgencyForm a powerful guiding coalitionForm a powerful guiding coalition

Create a succinct, compelling, noble visionCreate a succinct, compelling, noble visionCommunicate the visiondo all you canCommunicate the visiondo all you canEmpower others to remove obstaclesEmpower others to remove obstacles

Create short-term winsCreate short-term winsDont declare victory too soonDont declare victory too soonAnchor the change in the cultureAnchor the change in the culture


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Thoughts About Organizational Thoughts About Organizational

ChangeChangeMust occur through a series of phasesMust occur through a series of phasesStalled change efforts can be re-started and re-invigoratedStalled change efforts can be re-started and re-invigoratedRequires a considerable length of timeRequires a considerable length of timeFind plenty of programs and plansbut no visionFind plenty of programs and plansbut no vision

Its not necessarily about the dataIts not necessarily about the dataFrequent communication is essentialFrequent communication is essentialMust create a coherent, intellectual framework that reflects theMust create a coherent, intellectual framework that reflects thecultureculture Champion models of change are not sufficientChampion models of change are not sufficientCoalitions are very powerful and can start smallbut must growCoalitions are very powerful and can start smallbut must grow

Change must sink into the culturea process that can take 5-10Change must sink into the culturea process that can take 5-10yearsyears You must take care of the change effort and help people see the You must take care of the change effort and help people see theright connectionsright connections


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Key Issues and Critical Events:Key Issues and Critical Events:Opportunities for OrganizationalOpportunities for Organizational

ChangeChangeFASAP started 1987FASAP started 1987Child care on campus defeated 1989Child care on campus defeated 1989

Provosts Committee on the Status of Women (WEFIS Committee)Provosts Committee on the Status of Women (WEFIS Committee)Womens ForumWomens Forum

WORKlife Programs 1993WORKlife Programs 1993Aging Workforce Data 1993-1994Aging Workforce Data 1993-1994

Work Family Conference 1995Work Family Conference 1995Leadership RetreatLeadership Retreat

Rex Chow Murder and the Campus Task Force on Violence 1996Rex Chow Murder and the Campus Task Force on Violence 1996Work Family Task Force Report 1997Work Family Task Force Report 1997

Task Force with 4 subcommittees Task Force with 4 subcommitteesMatrixed the recommendations and completed in 5 yearsMatrixed the recommendations and completed in 5 years

Proposal for Individualized Flexible Work Arrangements 1998Proposal for Individualized Flexible Work Arrangements 1998FASAP Budget Cut 40% 1998FASAP Budget Cut 40% 1998

Creation of the Management CommitteeCreation of the Management CommitteeLayoffs of EAP cliniciansLayoffs of EAP clinicians

Workplace ViolenceRisk Assessment Policies and Procedures 2000Workplace ViolenceRisk Assessment Policies and Procedures 20003 Committees3 CommitteesInstitution-wide retreatInstitution-wide retreat


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Key Issues and Critical Events:Key Issues and Critical Events:Opportunities for OrganizationalOpportunities for Organizational

ChangeChangeDeveloped first Student Assistance ProgramDeveloped first Student Assistance ProgramSeptember 11th: Mental Health Disaster Planning Report/Child CareSeptember 11th: Mental Health Disaster Planning Report/Child CareDisaster Planning 2002 and 2003Disaster Planning 2002 and 2003

Institution-wide CommitteeInstitution-wide CommitteeSteering CommitteeSteering Committee

Child Care Disaster Planning/Gap AnalysisChild Care Disaster Planning/Gap AnalysisFASAP/ WORKlife Advisory Committee 2003FASAP/ WORKlife Advisory Committee 2003

Aging Workforce DataAging Workforce DataDeveloped 2Developed 2 ndnd Student Assistance ProgramStudent Assistance Program

Advisory CommitteeAdvisory CommitteeProvosts Committee on the Status of Women 2004Provosts Committee on the Status of Women 2004

Two students murdered off-campus in 2004/2005 Two students murdered off-campus in 2004/2005Domestic Violence Task Force 2005Domestic Violence Task Force 2005Flexibility Project of the Advisory CommitteeFlexibility Project of the Advisory CommitteeWorkplace Violence Brochure: mailed to 55,000 faculty, staff andWorkplace Violence Brochure: mailed to 55,000 faculty, staff andstudentsstudents


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Organizational StructuresOrganizational Structures

Used to Achieve ChangeUsed to Achieve ChangeAdvisory CommitteesAdvisory Committees

Think tank Think tank

Management CommitteesManagement CommitteesRetreatsRetreats

Task Forces Task ForcesWork GroupsWork Groups


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FASAP/ WORKlife AdvisoryFASAP/ WORKlife Advisory

CommitteeCommitteeCharged by the Vice Presidents of HRCharged by the Vice Presidents of HRCharge to FASAP and WORKlifeCharge to FASAP and WORKlife

Provide guidance and direction to the leadership of theProvide guidance and direction to the leadership of the

University and the Health System on how to update our University and the Health System on how to update our policies, practices, and procedures to keep abreast of thepolicies, practices, and procedures to keep abreast of thechanges in the nature of work, in the workforce, in our changes in the nature of work, in the workforce, in our institutions, and in the economyinstitutions, and in the economy

Think TankThink TankThought-leaders invited to be membersThought-leaders invited to be members

Topical White Paper Reports AnnuallyTopical White Paper Reports AnnuallyForm a coherent, intellectual framework for addressingForm a coherent, intellectual framework for addressingchallenges facing the institutionschallenges facing the institutions


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Goals of the White PaperGoals of the White Paper

Recognize that the issues are social issues that requireRecognize that the issues are social issues that requireHopkins and other stakeholders working togetherHopkins and other stakeholders working togetherRecognize the difference between policies and proceduresRecognize the difference between policies and proceduresgeared to a workforce that no longer exists and the currentgeared to a workforce that no longer exists and the currentrealities facing Hopkins and its employeesrealities facing Hopkins and its employeesReframe problems as systemic in the way the work gets doneReframe problems as systemic in the way the work gets doneDevelop institutional organizational support of work/lifeDevelop institutional organizational support of work/lifeintegration, health and well-beingintegration, health and well-beingRecommend new policies and arrangements that mesh withRecommend new policies and arrangements that mesh with

current realities of Hopkins and its employees and families atcurrent realities of Hopkins and its employees and families atall stages of lifeall stages of life


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The White Paper The White Paper

Survey of trends and impact on the institutionsSurvey of trends and impact on the institutionsIntegrated perspectiveIntegrated perspective

Systems approachSystems approachLife course/human development approachLife course/human development approach

Capture knowledgeCapture knowledgeCosts and investmentsCosts and investments

OutcomesOutcomesBring the message home to HopkinsBring the message home to Hopkins


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From the CommitteeFrom the Committee

MeetingsMeetingsDescribe the forces that will impact the workforce withinDescribe the forces that will impact the workforce withinHopkins.Hopkins.

Address multiple types of workforces and the impact of theAddress multiple types of workforces and the impact of theshifting demographics. There are different businesses acrossshifting demographics. There are different businesses across

the institutions including health care, education and research.the institutions including health care, education and research.However, there are common themes.However, there are common themes.Isolate the common themes across the institutionsIsolate the common themes across the institutionsincluding aging, diversity.including aging, diversity.

The Committee believes there is enough commonality across the The Committee believes there is enough commonality across theinstitutions that the themes will speak to everyonehowever,institutions that the themes will speak to everyonehowever,there are trade-offs to this approach. The Committee will bethere are trade-offs to this approach. The Committee will beable to focus more directly on specific issues in future whiteable to focus more directly on specific issues in future whitepapers.papers.

Examine the data on part-time employees.Examine the data on part-time employees.We know very little about these employees, and they make up aWe know very little about these employees, and they make up asizeable portion of our workforces.sizeable portion of our workforces.


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Organizing ThemesOrganizing Themes

Concept of organizing themes as centralConcept of organizing themes as centraldriving pointsdriving points

Example: threats to academic freedom,Example: threats to academic freedom,shifting federal funding, current securityshifting federal funding, current securitypolicies, shifting demographics, shiftingpolicies, shifting demographics, shiftingparadigmsparadigms

How do threats ripple through our workforce?How do threats ripple through our workforce?How are our employees affected?How are our employees affected?

Threats to excellence/threats to quality? Threats to excellence/threats to quality?


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HopkinsCurrent Labor Force

Changing Labor ForceWork andPersonal Life

TrendsGlobalizationTechnology

Economic Pressures

Cultural IssuesFlexibilityTime Squeeze

Financial PressuresSpillover

Accomodating WorkArrangements

Work Re

FlexibiliBenefits Re

Employee

Increasing Diversity

Skills Prep

RecruitRetain

Future Laborforce

Government

Community

Unions

Work Organizations

TheoryRole Theory

Social ExchangeSocial Justice

GoalsMaximize human capitalMinmize human resources costsImprove organizational performance

Work

Family

Well-being

Health

FASAP/WORKlife Advisory CommitteeWhite Paper Project


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Survey Results by Category:Survey Results by Category:

Top 6 Top 6Employment, wages and benefitsEmployment, wages and benefits

Impact of increasing health care costsImpact of increasing health care costs The workforce The workforce

Increasing the diversity of our workforceIncreasing the diversity of our workforce

Aging of our workforceAging of our workforce

Work conditionsWork conditionsAddressing health and well-being of employeesAddressing health and well-being of employeesAddressing the need for flexibilityAddressing the need for flexibilityNecessity of supervisors to acquire new skills to manage in todays complexNecessity of supervisors to acquire new skills to manage in todays complexenvironmentenvironment

Missing categoriesMissing categoriesWork and familyWork and familyWorking with other stakeholdersWorking with other stakeholders


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Leadership RetreatLeadership Retreat

60 leaders across the institutions60 leaders across the institutionsFacilitated by ODFacilitated by ODWrote goals statementsWrote goals statementsForce field analysisForce field analysis

Current and desired stateCurrent and desired stateAction steps on each trendAction steps on each trendVolunteers to work on committeesVolunteers to work on committees


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Setting Up the Model forSetting Up the Model for

Success: Flexibility ProjectSuccess: Flexibility ProjectGuided by the Advisory CommitteeGuided by the Advisory CommitteeParts of this project are build on previous workParts of this project are build on previous work

Draws from the RetreatDraws from the RetreatExamines the interrelationships between aging, healthExamines the interrelationships between aging, healthand well-being, diversity, increasing health care costsand well-being, diversity, increasing health care costsand supervisory trainingand supervisory training ANDAND FlexibilityFlexibilityIssue a report and recommendations to the committeeIssue a report and recommendations to the committee


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Other Important ToolsOther Important Tools

White PapersWhite PapersAnnual ReportsAnnual ReportsOrganizational Assessments/Audits andOrganizational Assessments/Audits andGap AnalysisGap AnalysisDataData

Organizational demographicsOrganizational demographicsBenchmarkingBenchmarking

Trends TrendsConsultants and VendorsConsultants and VendorsManaging UpManaging Up


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ImplicationsImplications

Our unique position in healthcare, education and researchOur unique position in healthcare, education and researchprovides us with the opportunity to be a national leaderprovides us with the opportunity to be a national leaderWe must make the link between what we know about whatWe must make the link between what we know about whatpeople need and our policies and practicespeople need and our policies and practices

Our traditional assumptions, values and beliefs about workOur traditional assumptions, values and beliefs about workmust be examinedmust be examinedBreadwinner models of work and family are embedded in the wayBreadwinner models of work and family are embedded in the waywe work todaywe work todayAdding additional hours to a persons work day may lead to stressAdding additional hours to a persons work day may lead to stressand burnout in knowledge and service workersand burnout in knowledge and service workersOur organizational strategies deal with those individual problemsOur organizational strategies deal with those individual problemsbrought to the office doorbrought to the office door


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In Summary: 3 PointsIn Summary: 3 Points

Developing another program or another service is not the onlyDeveloping another program or another service is not the onlyansweranswerEAPS and WORKlife programs been privileged with a wide-ranging,EAPS and WORKlife programs been privileged with a wide-ranging,rare, and unusual view of the personal and work-related stressesrare, and unusual view of the personal and work-related stressesthat a set of demographic, social, economic, political and culturalthat a set of demographic, social, economic, political and culturalchanges have wrought on the workforcechanges have wrought on the workforce

At Hopkins, EAP and WORKlife have had the unique opportunity toAt Hopkins, EAP and WORKlife have had the unique opportunity toassess the effects of these changes on employees of the Hospital andassess the effects of these changes on employees of the Hospital andthe University from those barely getting by to the most privileged of the University from those barely getting by to the most privileged of workers in healthcare, education and research.workers in healthcare, education and research.Among all our workers, reports of stress, overwork, job insecurity, andAmong all our workers, reports of stress, overwork, job insecurity, anddifficult balancing the dual roles of work and family are commondifficult balancing the dual roles of work and family are common

We have a responsibility to provide leadership and guidance on thisWe have a responsibility to provide leadership and guidance on thisset of issuesset of issues


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QuestionsQuestions

Kathi BeauchesneKathi [email protected]@jhu.edu

Leading Agendas for Behavioral Health and Well-Being

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