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TIPS & TOPICS from David Mee-Lee, M.D.
Volume 4, No.9
February 2007
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In this issue
-- SAVVY
-- SKILLS
-- SOUL
-- Until Next Time

Thanks for joining us this month. Have you ever worked where there are disagreements and conflict? You might want to read on.

SAVVY
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In the December 2004 edition SKILLS section, I talked about creating a culture where conflict is seen as normal- especially as teams integrate services for people with co-occurring mental and substance disorders. (December 2004 Tips & Topics)
In my workshops I often inquire whether participants have a conflict resolution policy or not at their workplace. And if they do have one, do they know where to find it and what it says. Quite often no one raises their hand. They either don’t have a policy or never use it. I am certain that is not because there is no conflict where they work! A recent reader requested a conflict resolution policy and procedure from me. Here is an example for your consideration

Tips:

Multidisciplinary teams are made up of clinicians, counselors and consumers often culturally, vocationally and educationally diverse. It would be quite surprising if disagreements did not arise, especially when rapid change creates a lot of stress. Team members have the right and responsibility to resolve conflicts as soon as possible. Resolving conflicts helps you stay centered, and helps the team to work together better. As a result, our clients receive higher-quality care.

Conflict Resolution Policy and Procedure

Policy Rationale:

Disagreements, differences of opinion, varying clinical perspectives on assessment and treatment, and interpersonal conflicts are inevitable among interdisciplinary team members. Because of different life experiences, training, theoretical orientations and familiarity with recovery, personnel can be expected to encounter clinical, administrative and team- functioning conflicts. If conflicts are not evident from time to time, it is likely that one or more members of the team is not speaking up assertively for what they believe in. They may not be advocating for their perspective, to the possible detriment of the people served, and also the health of the team.

Given all this, disagreements and conflict are normal. The following procedures will ensure safe and effective care for the people served, and promote healthy team functioning. Faithful adherence to these procedures is a performance expectation of all staff.

Procedure:

1. Each team member has the right and obligation to ask for clarification and discussion about any behavior, decision or treatment intervention that could compromise high quality care.

2. If the question arises as a result of an individual team member’s behavior, decision or treatment intervention, then the discussion should occur at the lowest level possible, directly face-to-face.

3. If resolution is not achieved, either person has the right and obligation to seek consultation from a team member who is next higher in the organizational structure. However this is openly suggested and discussed together before calling in such a person. Sometimes such discussion finally resolves the conflict; while at other times, seeking such consultation will be necessary.

4. If resolution is not achieved even with this consultation and three-way discussion, each person has the right and obligation to seek consultation from a team member who is now next higher in the organizational structure. This again is openly discussed together before calling in such a person. This process of consultation moving up the organizational structure continues until the conflict is resolved, even to the point of a calling in a consultant outside of the organization, if necessary.

5. If there is a question or conflict about administrative, clinical, or other issues that affect the whole team or agency, then it is the person’s right and obligation to bring the concern to group supervision or an equivalent team meeting.

6. The group supervision or team meeting addresses the concern in a timely fashion so as to maintain the healthy functioning of the team for the good of the people served. If the issue is unresolved, any team member has the right and obligation to openly suggest consultation from a person who is next higher n the organizational structure. As before, this process of consultation moving up the organizational structure continues until the conflict is resolved, even to the point of a calling in a consultant outside of the organization if necessary.

7. A team member may require supervision to assist in resolving conflicts at the lowest level possible. However, supervision is not a substitute for open discussion of the conflict between or amongst team members. Follow-through on these conflict resolution policies is a performance expectation, and will be included in areas monitored in employee evaluations.

SKILLS
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When you sit down with the person with whom you are in conflict, what you say and how you say it makes a big difference in the outcome. Here are a couple of tips from the work of Marshall Rosenberg, Ph.D. and his years of experience with Nonviolent Communication (NVC). It is sometimes referred to as compassionate communication. Its purpose is to strengthen our ability to inspire compassion from others, and to respond compassionately to others and to ourselves.

Tips:

Here are some meaningful quotes from Rosenberg’s “Nonviolent Communication – A Language of Compassion”:

--> “Empathize, rather than put your “but” in the face of an angry person” (P.96)

In any conflict it is easy to zero straight in on asserting your opinion and meeting every opposing opinion with a “but”--- "But if you had just asked me, it wouldn’t have been such a big deal.” Or: “But what about you? You weren’t any more logical than I was.” Or: “That’s fine for you, but it isn’t fair to me.” A good place to start any conflict resolution process is to bite your tongue. Actually try to tune into what was happening for the other person. Someone once said that whoever feels they are a more right in an argument should be the first one to reach out to the other person.

--> “When we listen for their feelings and needs, we no longer see people as monsters.”

The universal human experience is that we all have feelings and needs. Even the most obnoxious behavior and aggressive language arises from feelings and needs we have all experienced. The recognition of these feelings and the fulfilling of these needs is what all people crave.

--> “Listen to what people are needing rather than what they are thinking about us.”

It is not easy, when under verbal or even physical attack, to focus on the other person. It is a natural impulse to defend ourselves. But a way to do that is to actually believe in your integrity, and then focus your energy on what universal needs are unfulfilled for this person right now? Can you see the “monstrous” behavior as if it comes from a helpless child crying out for help to get their needs met?

--> “Violence in any form is the tragic expression of our unmet needs” (P.78)

The tragedy of verbal or physical violence is that it usually induces a violent reaction in the other person. He/she is now sadly even less likely to want to resolve disagreements, let alone reach out to help fulfill the unmet universal human needs of the attacking person. Yet it is these needs that fuels the violence in the first place. If these could only be acknowledged, appreciated and addressed, the power of the conflict would dissipate.

Just to make sure we are on the same page, a brief review of feelings and needs is in order. Feelings and needs are one-word universal human experiences. Feelings like: joyful, happy, sad, frightened, satisfied, excited, anxious, scared, angry, hurt, reassured etc.
Needs like the universal human need for: love, acceptance, appreciation, safety, security, peace, serenity, excitement, novelty, stimulation, nurturance, recognition etc.

Feelings are not: “I feel you are the most arrogant person I know.” That is actually an opinion or a judgment. Or: “You feel like you are a bit scattered and disorganized to me.” That’s another judgment. Judgments turn people off and away from conflict resolution.

Needs are not: “I need you to be more responsible.” That is a request or desire or directive. Or: “You need to slow down and think before you act. You’re too impulsive.” That is a judgment again.

So what to do?

If you already have good success in resolving conflicts, then there’s no need to focus on the following NVC steps. If you run into a sticky situation where your usual methods are not working, take note of the NVC four step process. It guides people to practice (and it does take practice and commitment) to reframe how we express ourselves and hear others by focusing our consciousness on what we are observing, feeling, needing, and requesting.

--> Here is the NVC four step process:

1. Observing means to state what you are seeing, hearing, remembering, imagining so that it is clear what issue we are talking about e.g., “When I see you come in late without calling ahead---”
2. Feeling means to state how you feel in one word about that observation e.g., “When I see you come in late without calling ahead, I feel frustrated---”
3. Needing means to then state what human need(s) is not being fulfilled by the situation e.g., “When I see you come in late without calling ahead, I feel frustrated because I need consistency and reassurance that we will have staff to cover client needs ---”
4. Requesting means to end the dialogue with a specific request that the person can either agree with or not e.g., “When I see you come in late without calling ahead, I feel frustrated because I need consistency and reassurance that we will have staff to cover client needs. So would you be willing to call ahead next time if you are going to be late, so that I will have time to arrange for other staff coverage?”

This may not seem very revolutionary. But if you are stuck in a conflict with a person, this is a useful structure to increase understanding of your own feelings and needs, and also the other person’s. The example above provides the “I” statement version where you are honestly expressing your viewpoint. Sometimes the situation is more volatile and tense. You may need to start with an empathy statement; you are the first to engage with the person as they may be too upset to hear what you have to say or to consider your request.

-->So the empathy version of this incident may be like this:

“When I scolded you for coming in late without calling ahead (observing), were you feeling angry or scared (feeling)because you need understanding about what happened? (needing) And would you like me to be quiet for a moment to hear what happened at your end to be coming in late?" (requesting)

You will still get to the request for behavior change, but it will be heard and responded to perhaps only after the person has their need for understanding fully appreciated.

“Well yeah, you don’t know what happened. I was about to leave when my child fell and scraped her knee and was crying. The babysitter was late and my cell phone battery was dead. I rushed out the door intent on getting to work as soon as possible, knowing how important it is to you to have consistency for the program and the clients.”

There is a lot more to compassionate communication than this. But I hope this brief glimpse into NVC will pique your interest to try some different conflict resolution methods. The stuffing-feelings, bite-my-tongue, gossip-behind-their-back, resentment methods don’t really work.

(Center for Nonviolent Communication Website: www.cnvc.org)

 

SOUL
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Movies are a bit like a Rorschach test. We view the film through our “lens” and glean lessons that are personal, and may be quite idiosyncratic. I am amazed by the skill of filmmakers and actors. They capture our attention. They get us thinking about major life issues - all in two hours of entertainment. How do you, for example, get people to examine their attitudes and values about marriage, divorce, parenting, family, sex offenders, pornography, love, hate, death, honesty, community action, career, feminism, self-esteem and more - all in one film?
“Little Children” features two actors nominated for an Academy Award. This film could generate discussion content for a semester college course. I like movies with socially redeeming messages. I left the cinema reminded of the importance of loving and caring for our children; turning hate into compassion for the seemingly unlovable; balancing individual freedom with group and family cohesiveness.

You may think I am pushing this particular film. My Rorschach test gave it four stars. Yours may give it one and a half. But my point is not just about this movie.

It is about my wonderment and admiration for the variety of human talents and avenues for expression. People’s creativity, intelligence, communication, perceptiveness, insight, influence, and inspiration produce a thousand ways for shared human, uplifting experiences. Some people write books. Others are community activists, and transform whole neighborhoods. Still others bring passion to counseling or teaching. Some excel in sports or coach their local kids’ soccer team. The ways are endless.

Each of us “creates” in our preferred and personal style. We may not receive accolades or Academy Awards. But when you find and embrace your own path to inspire and positively impact others, it is a “movie” worth making.

Until Next Time
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Thanks for joining us. See you in March.
David

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