‘The Way to Well - Being’

A Wellbeing Strategy for Staff Working

with an Acquired Brain Injury Population

Brain Injury Specialism programme provides services through the below:

Brain Injury Specialism Programme

06/03/15

Meet Lars....

Outcomes

“The hospital fixed my body but this

service brought normality back to my life”

-Anto, ex Headway Service User

Returning to work allowed me to reach my

main goal and objectives. With the

assistance of this service, I was able to make

my dream a reality. I could not have done it

alone.”

- Mario, Service User

Implications for staff

Clients presentation:

Broad range of cognitive, behavioural, emotional and interpersonal difficulties

Intensive interventions are often required, often extended and repetitive

Frequently clients have limited awareness of the nature of the difficulties, the

impact on everyday life or the need for rehabilitation

Persistent anger, frustration and aggression particularly difficult to manage

(Witting, Tilton-Weaver, Patry and Mateer 2003)

High degree involvement:

Clients with dual diagnosis, cognitively impaired older adults

Frequent contact often with resistant clients with reduced insight into their

difficulties and rehabilitation needs

Associated with: Greater emotional exhaustion, Depersonalisation, Decreased sense

of competence or that work is significant (Witting et al, 2003)

Complex relationship within ‘Helping Professions’ (Stamm, 2005)

Formulation of questions

Critical Incident technique (Flanagan, 1954)

Used within qualitative health care research (Perry, 1997,Crouch, 1991),

Specifically used with staff working with ABI population effective and

ineffective team work (Suddick and De Souza, 2007)

Interview format

Semi Structure interviews x 3

2 questions based on CIT

Followed by series of open ended questions on

General well being

Physical health

Rewards and recognition

Stress management

Uncovered themes: Making a difference through work

Extra roles

Relationship with manager

Appreciation of the work itself

Stress

Resource Management

Feedback

Job Demands-Resources Model (Baker & Demerouti,

2007)

Mental

Emotional

Physical

Etc.

Support

Autonomy

Feedback

Etc

Job Demands Strain

Job Resources Motivation

OrganizationalOutcomes

Bakker & Demerouti, 2007

The Job Demands-Resources Model

This model can be applied to many organisational settings regardless of the specific demands and resources

Job Demands

Examples: Time pressure, heavy workload,

Stress, role ambiguity, emotional labour, poor relationships

Job Demands

Physical, psychological,

social or organisational

features related to

psychologist cost

Themes

Additional

roles

Relationship

with manager

Stress

Lack of

feedback

Employees Examples

Emotional nature of the job taken for granted. Lack of support and understanding frommanagement. Important workundermined by pettyadministrative tasks/problems.

Job Resources

Examples: Autonomy, strong work relationships

opportunities for advancement.

Job

Resources

Physical, psychological, social or

organisational features of a job

that help achieve work goals,

reduce job demand and

stimulates personal growth

learning

Themes

Appreciation

of the work

itself

Positive

Feedback

Meaningful

work.

Employees Examples

Relationships with colleagues Supportive team Doing things

outside of work that help them relax Being organised.

Job Demands- Resources Model (Bakker &

Demerouti, 2007)

Two psychological processes play a part in the development

of motivation and job strain

Job Strain – health impairment process: Chronic job

demands and poorly designed jobs – can lead to exhaustion.

Motivation- Adequate resources have motivational potential

– can lead to high work engagement and excellent

performance.

Job Demands-Resources Model

The relationship between job demands and resources is also

important

The model suggests that job resources may act as a buffer for job

demands.

In terms of the staff at Headway, although their job demands are

high, they also have considerable resources that help to balance

their feelings of well-being at work.

HIGH MOTIVATIONLOW STRAIN

HIGH MOTIVATIONHIGH STRAIN

LOW MOTIVATIONLOW STRAIN

LOW MOTIVATIONHIGH STRAIN

JOB RESOURCES

LOW HIGHJOB DEMANDS

LOW

Interventions on the basis of the JD-R Model

Job Crafting

Job Redesign Training

Strengths Based

Personal Resources

Org

anis

ati

on

Level

Intervention Target

Inte

rventi

on L

evel

Job Demands/Job

Resources

Bakker &

Demerouti (2014)

The most effective interventions combine specific measures at the organisational and individual levels (Kompier, Cooper & Geurts, 2000)

Indiv

idual

Level

Job Demand: Issues with Management

Unfair treatment and negative communication

by managers

Shift from employee production to:

Employees finding ways to control their emotion

Finding ways to diffuse the current situation with their superiors

Hirigoyen (1998) as cited in Sandvik, 2003

Reason : If employees cannot advise their superiors of issues that may arise, the company is left without an initial warning system (Beer & Eisenstat, 2000) that may lead to loss of capital.

Recommendation:Ensuring that manager are aware of the effects of managing personnel within the workplace, or training managers in effective communication and consultation.

Proposed result: When managers develop a relationship-focused approach to their interaction with

employees, it is evident that employee satisfaction in the workplace increases, and the possibility

of employees resigning decreases (Atwater & Brett, 2006).

Organisational Level Intervention - Modify Management Practices

Job Demand: Stress

Defined as : The perception that one cannot cope with their current situation, or cope with an imminent decline in their well-being.

Lazarus, R.S. (1966). Psychological stress and the coping process. New York: McGraw- Hill.

Employees’ current way of dealing with stress

Walking

Aqua Fit

Comedy gigs

Colleagues

Mindfulness:

Being fully aware in the present moment,non-judgmentally

– Be aware of actions andemotions

– Increases our ability to prioritize, focus,and make life choices that are

consistent with our values

• Associated with decreased stress andimproved mental & physical health

Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: A metaanalysis. Journal of

Psychosomatic Research, 57, 35-43

Recommendation:

Individual Level Intervention – Mindfulness (Formal or Informal)

Reason : At times, managers and subordinates perceive their tasks to be separate and leading to independent goals (Tjosvold, 1989). When goals are definite and seen as a challenge to be faced as a united front, managers and subordinates develop relationships that create cohesion and thus success for the organization (Tjosvold, 1981 as cited in Tjosvold, 1989).

Proposed result: Cooperation rather than competition leads to collaboration. It is the result of reciprocated support and direct communication between the members which instills a sense of camaraderie among employees. This cooperation creates a culture that encourages the circulation of resources, and advocates for a mutual direction to be withheld within the workplace (Beer & Eisenstat, 2000).

Create a shared vision with the mind set of leading by example through all behaviors and actions at work.

Further recommendation:

Job Demand: Extra roles

Extra rolesUnpredictable and

outside job description

Need to anticipate what might happen within the structure of the organisation, and clearly understand role within it - Environmental clarity

Uncertainty leads to discomfort particularly

when related to decision makers

Warr (2007)Lack of sense of control

Detrimental to performance which impacts in turn on

wellbeing

Numerous studies show positive associations between aspects of environmental clarity and well being

‘when you have your own set

program for the day and then

something kind of comes in out of

the blue, it’s an extra thing that

can be difficult or stressful at times

to manage that’

Recommendation: Optimise job demands by increasing environment clarity. Roles and

expectations should be clearly defined, discussed and formalised as roles are assigned and

adapted over time. Incorporate an update of employees job roles into regular appraisals

including

Proposed result

Increased clarity of job expectations and development of achievable jobs with clear goals

Increased level of communication and information sharing which are both shown to

correlate positively with eudemonic and evaluative wellbeing (NEF, 2014)

Conflicting tasks or unclear

information regarding work related

explanations, rules and policies

High demand jobs Considerable effort

Sense of constant uncertainty

and experience higher levels

of burnout (Witting et al,

2003)

Importance of

examining

possible ways to

reduce demands

such as role

ambiguity (Bakker

et al, 2014).

Organisational Level Intervention - Environmental clarity

Organisational Level Intervention - Increase Sense of Control

Recommendation: Encourage employee sense of control and autonomy. Staff

should be afforded and encouraged to exercise control in carrying out their roles

Managers should work to foster trusting relationships between themselves and

their employees, and support staff to exercise control over their own roles

(Through job crafting and use of strengths)

Encourage employees to contribute to the wider organisation by requesting and

seriously considering feedback

Proposed result: If implemented well this could ultimately free up time for

managers and the potential impact in terms of job satisfaction are significant

Autonomy Positively associated with

wellbeing

Capabilities more visible

When employees are able to

organise their own work, apply

own ideas and able to influence

decisions around them

Individual Level: Job Crafting

Recommendation: Provide Job crafting training in which employees learn to proactively

change their own work environment (Tims , Bakker & Derks, 2012) using the Job Crafting

questionnaire (Slemp& Vella-Brodrick , 2013)

Proposed results: This will facilitate the following (Tims et al, 2012)

Increasing structural job resources

Increasing social resources

Increasing (challenging) job demands

Decreasing (hindrance) job demands

Well designed jobs and working

conditions have been shown to

facilitate employee motivation and

reduce stress.

Increased in structural and social

resources

Increased work engagement and job

satisfaction

Job crafting

Job Resource: Appreciation

What is it?

“An emotion which occurs after

people receive aid which is

perceived as costly, valuable,

and altruistic.”

Why is it important to show

appreciation?

A study of over 1,700 people

found that more than half of all

employees intended to search for

new jobs because they felt

underappreciated and

undervalued. (APA, 2012)

“I think this is me being really honest about it, because if it is not being recognised and this is what I’m

doing, then how long is that sustainable for? And is this something I can do for the rest of my life?”-

Interview

Benefits of

Appreciation

• Increased productivity

• Increased engagement among

colleagues

• Loyalty to organisation

• Higher loyalty and satisfaction rates

from clients

• Positive organisational attitude and

relationships

Tower Watson- “the single highest determinant for engagement is whether or not employees feel that their manager is genuinely interested in their wellbeing.”

“More consistent acknowledgement and a kind approach” would make workplace wellbeing better.-Interview

It’s the little things…• Say thanks to clients, co-workers, and senior staff

• Change your attitude

• Learn to give and receive compliments

• Learn to show gratitude

• Deliberately infuse culture from top to bottom with an ‘attitude of gratitude.’

• Remember, this is a two way street.

Organisational & Individual Intervention – Increase levels of appreciation

Job Resource: Meaningful work

• Individual Level intervention: acknowledging making a difference through your work.

• Csikszentmihalyi (1990) attempted to define meaning by coming up with three concepts:

• Having a purpose or the significance of something

• The intentions one holds• Identifying or clarifying the term in context.

(Chalofsky, N. (2003). An emerging construct for meaningful work. Human Resource Development International, 6(1), 69-83.)

Individual Level Intervention – Acknowledging

Making a difference through your work

At Headway all of our interviewees believed that their

work with this client group was meaningful

Gayle (1997) stated that both humanistic psychologists

and motivation theorists believed that individuals need a

work life they think is meaningful

Shamir (1991) suggested that a task can be motivating

depending on its meaning to the individual, rather than

for any rewards associated with it.

(Chalofsky, N. (2003). An emerging construct for meaningful work. Human Resource Development International, 6(1), 69-

83.)

What is

feedback?

Types of Feedback

Formative

Summative

Positive

Constructive

Who can give feedback?

Direct management/supervisors

Customers/clients

Co-workers/peers

The organisation as a whole

Helpful information or criticism

that is given to someone to

say what can be done to

improve a product, service,

performance, etc. (Webster

Dictionary)

Organisational & Individual Intervention – Increase mechanisms for feedback

What happens when people don’t get feedback

1. Tend to either be overly critical or self- congratulatory

2. Lack of self-awareness

3. Reduced well-being

Benefits of feedback

• Manager feedback leads to:

• Increased feelings of employee motivation and energy

• Employee satisfaction

• Employees identifying with the organisation

• Increased employee loyalty

• Improved performance and productivity

• Promotion of professional and personal growth

• Decrease in organisational costs

• Client feedback leads to:

• A significant increase in employee morale and motivation

• Experience and education of employees

“So that can be very rewarding- that immediate feedback you get.”- Interview

06/03/

15

Our Well-Being Strategy

Summary of Interventions on the basis of the JD-R

Model

Job Crafting

-Use of job crafting

-Increase means of finding

meaning in work

-Increase means of giving

feedback

Job Redesign- Modify Management

Practices

-Environmental Clarity

-Increase sense of control

-Increase means of feedback

Training

-Mindfulness

-RD-M training for Management

-Wellbeing Psycho education

Strengths Based-Working with Strenghts

Personal Resources

Org

anis

ati

on

Level

Indiv

idual

Level

Intervention Target

Inte

rventi

on L

evel

Job Demands/Job

Resources

Bakker &

Demerouti (2014)

Limitations

1. It is difficult to control for all of the variables within the organisation when using the JD-R model.

2. Our sample size was small, and the three members of staff that we interviewed each had different roles within the organisation, therefore limiting our access to the overall employee sample.

3. Interviewees were aware that the results from the study were being fed back to the organisation.

4. The use of strengths based interventions have not yet been scientifically validated, despite its contribution to wellbeing research, resulting in promising findings. (Bakker & Demerouti, 2014)

How this could look in practice..

Training Access to advice In company routines

• Job Demands –Resource

Model Awareness Training for

Management team

• Increased promotion of Employee

Assistance Programme

• Wellbeing as a standing agenda

item (both management and

team level)

• Wellbeing Psycho – education

including awareness of JD-R

model

• Mindfulness (formal/informal)

• Development of Informal Peer

Support Networks (increase sense

of meaning in work)

• Regular Performance Reviews

(increased environmental

clarity, feedback, appreciation,

sense of control)

• - Incorporate use of strengths

• Job Craft awareness training

• Strengths use awareness

training

Positive Psychology Intervention

and ongoing promotion (NEF

postcards promotion – ‘Have you

tried a way today?’) (not found in

study but recommended)

Pre and post measure

Perfect Timing!

March 27th Irelands First National Workplace Well Being Day