Module Seven: The Parallel Process and Team Meetings

The organization is a living, growing, changing system with its own unique biology. It is therefore every bit as susceptible to stress, strain & trauma as the individuals who live and work in the organization. Complex interaction between traumatized clients, stressed staff, pressured organizations, and oppressive social and economic environment. Parallel Process

Organizations, like individuals, are living, complex, adaptive systems and that being alive, they are vulnerable to stress, particularly chronic and repetitive stress. Organizations, like individuals, can be traumatized and the result of traumatic experience can be as devastating for organizations as it is for individuals. ©Sandra L. Bloom, M.D., 2009

Organizational Stress Changes in financing Decreases in training, more paperwork, More surveillance Fewer staff, rapid turnover Less professionally developed staff Aggressive children & adults adapted to violent norms Organizational trauma ©CommunityWorks, 2008

PARALLEL PROCESS Feelings Behaviors Thoughts When two or more systems – whether these consist of individuals, groups, or organizations – have significant relationships with one another, they tend to develop similar: K. K. Smith, V.M. Simmons, and T.B. Thames, The journal of applied behavioral science, 1989. 25(1): p. 11-29. Feelings Behaviors Thoughts Smith, K.K., V.M. Simmons, and T.B. Thames, "Fix the Women": An intervention into an organizational conflict based on parallel process thinking. The Journal of Applied Behavioral Science, 1989. 25(1): p. 11-29. ©Sandra L. Bloom, M.D., 2009

Organizational Stress as a Barrier To Change Treatment programs today experience significant and CHRONIC STRESS Many exist within a context of constant or CHRONIC CRISIS This results in CHRONIC HYPERAROUSAL Results in LACK OF SAFETY and BASIC TRUST © Sandra L. Bloom, M.D. CommunityWorks, 2008

Organizational Stress as a Barrier To Change Lack of organizational EMOTIONAL MANAGEMENT Communication networks breakdown under stress COMMUNICATION FAILURE Important topics become “undiscussables” ORGANIZATIONAL ALEXITHYMIA Organization stops learning from itself DISSOCIATION © Sandra L. Bloom, M.D. CommunityWorks, 2008

Organizational Stress as a Barrier To Change Organizational memory is lost ORGANIZATIONAL AMNESIA Feedback loops breakdown & failure is repeated SYSTEMATIC ERROR REENACTMENT Poor decisions, problem solving LOSS OF DEMOCRACY & LOSS OF COMPLEXITY Helplessness about problems LEARNED HELPLESSNESS © Sandra L. Bloom, M.D. CommunityWorks, 2008

Organizational Stress as a Barrier To Change Staff increasingly powerless DISEMPOWERMENT Conflicts increase and are not resolved IMPOVERISHED RELATIONSHIPS Leaders use formal authority to respond INCREASED AUTHORITARIANISM “Dumbing down” of staff LOSS OF CRITICAL THINKING SKILLS © Sandra L. Bloom, M.D. CommunityWorks, 2008

Organizational Stress as a Barrier To Change Punitive measures to effect change make things worse SELF DESTRUCTIVE BEHAVIOR Staff respond with increased passive aggressive , punitive behavior INCREASED AGGRESSION Everyone feels loss of purpose, meaning, opportunity UNRESOLVED GRIEF Ultimately, ORGANIZATIONAL DECLINE ; FORE-SHORTENED FUTURE; FAILURE OF IMAGINATION © Sandra L. Bloom, M.D. CommunityWorks, 2008

Parallel Process Clients Feel unsafe Angry/aggressive Helpless Hopeless Hyperaroused Fragmented Overwhelmed Confused Depressed Staff Demoralized Organization Is unsafe Punitive Stuck Missionless Crisis Driven Valueless Directionless © Sandra L. Bloom, CommunityWorks, 2005

As a result, our systems frequently replicate the very experiences of abusive power that have proven to be toxic and traumatic for the children and families we are supposed to treat and educate. ©CommunityWorks, 2008

Deeply rooted change in clients, staff AND in Systems Changing Mental Models Changing Basic Beliefs

Changing the Culture Safety plans Organization identifies norms to be established Sanctuary commitments Sanctuary staff training Safety plans Universal training Create mechanism to regularly familiarize all members with the norms Community Meetings S.E.L.F. Team meetings Red flag reviews S.E.L.F. Psychoed The community as a therapeutic agent of change Sanctuary Implementation Guide Sanctuary Core Team Sanctuary technical assistance ©CommunityWorks, 2008

Practice Talking about power

Reenactment in Your Workplace Discussion Reenactment in Your Workplace Victim Rescuer Persecutor

Discussion Questions What are some examples of reenactments you have seen between the staff at your setting? Are certain groups, departments, divisions more likely to fall into certain roles of the reenactment triangle? If so, why might that be? How do issues of power or perceived power contribute to reenactments among the staff or with the clients?

The Sanctuary Toolkit Team Meetings Community Meetings Safety Plans S.E.L.F. Psychoeducation Red Flag Meetings Team Meetings S.E.L.F. Treatment Planning Sanctuary Toolkit ©Sandra L. Bloom, M.D., 2008

Team Meeting: What is it? Active, focused meeting where every member Feels comfortable talking and listening Is engaged and contributes Shares insights and generates new ideas Team Meetings may be taken for granted, and when we do that we Often end up with lists of announcements, only a few people talking, Unclear information, and fuzzy decisions. Ask the group what makes a Team Meeting useful, meaningful, And welcoming.

Team Meeting: Why Do It? The benefits of an effective Team Meeting include: Opportunity to discuss client issues… Ideas for working with individual clients or the whole group… New initiatives to improve the activities or events on the horizon. Open forum for addressing staff concerns, communication, and teamwork. Review the benefits of the Team Meeting.

Team Meeting: How To Lead It Ask for (and accept) feedback Set a clear agenda, preferably available in advance Everyone on staff should have the opportunity to put items on the agenda. These are some basic considerations for leading a team meeting. Every Member of the team, whether they’re the leader or a staff member, Has responsibility for making the Team Meeting work.

Team Meeting: How To Lead It Look for ways to delegate responsibility for aspects of the meeting to staff. Note: Announcements are sometimes necessary, but they should be kept to a minimum at Team Meetings. These are some basic considerations for leading a team meeting. Every Member of the team, whether they’re the leader or a staff member, Has responsibility for making the Team Meeting work.

Team Meeting Checklist Yes No Somewhat Democratic decision making Team refrains from blaming/shaming Youth and each other All levels of staff participating Community Issues discussed S.E.L.F. discussed in relation to community During rounds, team balances time spent on discussing youth’s problems with creating a shared treatment plan