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Psychology of Interdependence

“Regardless of the type of aggression, self-injury or withdrawal, we assume that a hunger for being-with-others rests in the human spirit, longs to be fulfilled, and , in many instances, needs to be uncovered. We struggle to uncover and fulfill this need in ourselves and others. We are often pushed by the fear of giving ourselves to others and pulled by the hope that such feeling give rise to. Our fear can lead us to lord over others in order to gain a false sense of power. But, the more we question our values, our hope can lead us to feelings of companionship. This pushing and pulling leaves us in a quandary–to reach out toward others or to preside over them. The desire to affirm the other is often buried in us by years of training that have taught us that independence is the central goal of life, and, for those who are on the fringes of community, compliance is the pathway to success.

Yet, self-reliance and blind obedience are lonely conditions that lock us and others out of the embrace of human warmth and affection. Those who are committed to care giving often do not recognize this struggle within themselves, let alone in the marginalized people whom they serve, So the first place to start in the psychology of interdependence is with ourselves, our values, and how we translate these into reality.”

John McGee

A culture of gentleness is also about being able to be vulnerable

“When I first heard about creating a culture of gentleness I had no idea what that meant.

After going to trainings, learning about gentle teaching, and seeing a culture of gentleness through the people around me in an organization that seemed so alien, I finally understood what it was. Talking about a culture of gentleness isn’t enough. You don’t really understand what it is until you start partaking in the movement of gentleness that has spread across Canada. It really is a powerful thing.

I learned that creating a culture of gentleness doesn’t just mean serving the people that we support, but serving every person you meet on the street and at home.

It is a way of life. I had to change my mind set and mold my thinking to something completely different and something unnatural to a lot of people. Growing up the way I did, I learned what it meant to love unconditionally and to care for people in a way that was personal. Maintaining a culture of gentleness is very personal. In order to have gentleness, I needed to care about another person more than myself and take their limitations and physical or mental state away from how I viewed them. I have come to do this everyday with the people I support. I see them more than just someone I look out for and someone I spend a lot of time with: I see them as friends and as a huge part of my life, because to them sometimes you are their family.

The way I create a culture of gentleness is finding a balance between being firm and being personal with each person I serve. The definition of gentle is to be kind and mild temperament; I have found that being that understanding person that will listen and care in a more personal way has created this culture of gentleness for our team. The more bonded we are on a personal level and the more we listen and show kindness to each other the more gentleness has spread.

In my team, I have had to hold team members accountable and have had to have some tough conversations, but at the same time, building each person  up and showing them that I care for them. In order to create a culture of gentleness, I needed to gain trust. In going out of my way to make team members feel comfortable with me, I demonstrated that I genuinely care for them and their life situations. I try and make the people that I serve feel appreciated and loved, I have written personal cards to each and every one of them praising them for things that I have seen them do well. To maintain a culture of gentleness, I have realized that taking the times is very important… A culture of gentleness is also about being able to be vulnerable with both the people that we support and those who we serve with. It has helped us grow individually, as well as grow as one.”

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Krystel, Team Leader

See Worthy

At the age of eighteen I had applied for a job at a coffee shop in the city that I had been living in. I had visited this establishment numerous times and fell in love with it; at the time I had seen it as a place that screamed adulthood, something that I was craving in my life. To my surprise, I had been asked to come in for an interview; I was ecstatic! As I entered the meeting I was greeted by the manager. He asked me a few questions about my work experience, desire for growth and future plans that I had for myself. The overall interview didn’t span more than ten minutes before the manager offered me a position at his coffee shop; My teenage dream came true! For the next few minutes he talked to me about work expectations (what I should wear and when I would be trained). For the next twenty minutes the manager began to blast me with statements such as,

“I know people like your kind–you better not disappoint.”

“All you teenagers are the same.”

” If you ever dare to call in sick because you are hungover, you can guarantee yourself an early retirement from this job!”

Your boss woud never yell at you at COR

I left the interview feeling deflated and heart-broken. ‘How could I be treated like this?’ I thought to myself. I wasn’t seen as the person I am, but seen as a stereotype. In that moment any worth that I had was extinguished with a swift blow and no filter on a over opinionated mouth.

In the world today, the idea of worth is something that doesn’t go unnoticed. A person is able to see the value of ‘worth’ on a daily basis. Whether it is the constantly changing stock market which drives the worth of our currency, the title that falls before the name of a person, or the color of robe that is worn at graduation ceremonies; a person’s worth is often built upon standards that society has crafted over time. While economics, academics and professional titles are not the problem, we need to work hard at challenging our perspective. Think with me for a moment: When a baby is born there is something magical about the community that seemingly appears out of no-where to celebrate this thing we call life. As quick as we take a breathe, this baby has been given value and worth–yet as the child changes and grows into an adolescent and then an adult so does the societal view of worth. Choices are made; some good and some bad. As much as we hate to admit it, we are capable of becoming hardened towards people and deflating a sense of worth.

Our role as part of humanity, friends and supports in building the worth of another person can be viewed through the  lens of a child’s building block set; we have three options: We can either stand idly by and do nothing, which is of little value, we can build the tower of worth up, or we tear the tower of worth down. In his book, ‘Mending Broken Hearts’, Dr. John McGee says, “The self is seen not so much as independent or self-determining, but as connected with others who help the person feel worthy because he/she is safe and loved.” The choice is yours– but I would challenge you to build.

Ben, Director of Culture and Mentorship

 

Our hope is…

“As care givers, we need to be well grounded. Our hope is not in independence, but interdependence. Our primary task is not to control others or force others to be what we want them to be or do what we want them to do. It is to bring a deep unconditional love to those whom we serve. Our central purpose is not self-determination or self-reliance; it is a feeling of connectedness between those whom we serve and ourselves. Our central role is to express a profound sense of companionship and community. What we often think are our primary tasks will come in due course if those whom we serve feel safe, loved, loving and engaged.

We are community makers. Community is a gathering of gifts. Our gift in the act of care giving is the creation of companionship and the formation of community. Those whom we serve bring their mind-body-spirit, their dreams denied, and their hunger for love. They bring their troubles and sorrows, their life story, and their broken hearts. We are to bring a spirit of gentleness to mend their hearts.”

John McGee
‘Mending Broken Hearts: Companionship and Community’

Why a Culture of Gentleness Makes Good Business Sense

The following article addresses the culture found in residential settings where the quality of life is shaped by the multiple relationships between residents and direct care support staff. I was struck by the correlation between the elements of a culture of gentleness and what LaLoux has described in “Reinventing Organizations” as new level of organization emerging that holds great promise. (see “Book Corner”) The organizing principle in this new tier is the constellation of the deep values individuals are liberated to express in their work. – Clint Galloway, Editor

Those of us in the business of providing care for others often find ourselves trying to balance sound financial decisions with decisions that directly impact the quality of care provided. Tipping the balance negatively on the economic side (we can refer to them as “scale tippers”) include staff turnover, worker’s compensation claims, unemployment claims and the cost of training new staff, all of which can lead to increased anxiety for those we support, lower staff morale, reduced quality of care and increased expenses. If we can agree that the scale tippers attribute to a majority of the increased costs then we can agree that by reducing the incidents of scale tipping we will be making decisions that can lead to expansion, fewer vacancies and other business opportunities. Fortunately, we are learning that the same things attributed to reducing expenses are also attributed to increasing the quality of care for the individuals we support.

The ever changing landscape of our system of care pales in comparison to the changes experienced by those receiving care due to staff turnover. I recently went to my dentist and was informed that I would have a different dental hygienist. “What…no Dena?” I thought, “she’s been my hygienist for many years and suddenly they expect me to have my teeth cleaned by someone else?” (Maybe if I’d flossed regularly I’d be less concerned). The care that the new hygienist provided for me and my teeth was more aggressive than I’m used to, leaving me wanting Dena back. After my initial disappointment, I’m okay now with the notion of waiting six months to find out who will do my cleaning next. But I would be much less settled if I was to experience this uncertainty with every shift change, 547 times over the next six months. This uncertainty about whom we will be interacting with in a face-to-face relationship makes us feel less safe and precipitates negative feelings and actions. It invades the entire culture of care. It is an expensive drain on our resources as well as the peace of mind of those that we support.

Providers report an average turnover rate of 49% among frontline direct caregivers. For agencies that experience high annual turnover rates (hopefully you’ve calculated your annual rate, if not this would be a good first step to take), it is likely staff will leave within the first six months of employment. This is the period in which the initial, comprehensive training will occur for new staff. At an average replacement cost of approximately $3,500 per employee, these costs weigh heavily on the economic scale.

Other scale tippers that often appear in a workplace with excessive rates of turnover include worker’s compensation, health insurance premiums and unemployment claims. Worker’s compensation claims tend to increase when the people in our care feel unsafe and are more likely to be aggressive towards staff, resulting in injury. Insurance rates increase when claims expense increases, and conversely, rates remain more stable when claims expense decrease; in some cases refund checks are cut to providers when there is a well-established “culture of gentleness.” When excessive scale tipping is present we are more likely to find frivolous worker’s compensation claims. This can reduce morale, as well as your bottom line, due to time spent resolving the issues. Another hidden cost of high turnover is health insurance premiums. Decreased turnover means that a large health insurance claim can be absorbed over time if staff continues to be employed after the claim has been paid. Unemployment claims, whether you are reimbursing or a contributing provider can be incredibly time consuming and expensive, costing up to $10,000 a claim in some cases.

Not to be forgotten in the discussion are wages and benefits. These are significant factors in finding and retaining qualified staff. According to the Michigan Assisted Living Association’s (MALA) 2009 Strategies for Improving Wages, Benefits, and Training to Staff Providing Community Mental Health Funded Residential Services, “Wages for direct care workers among the providers responding to this survey are as much as $3.25 per hour less than wages in other similar sectors of long-term care.” Although it will not bring parity to our Medicaid reimbursement rates, an established culture of gentleness will increase our ability to offer more attractive incentives for our employees.

Now that we’ve identified the scale tippers, how do we begin to tip them in more favorable directions? We cannot support the people we support without feeling supported by the people who support us.

That sentence will gain few points from English teachers, but it does offer insight into what our focus must be if we want to create a culture that is conducive for healthy bottom lines and healthy hearts alike.

Have you ever heard of “seagull management?” This philosophy is indicative of a culture that offers little or no proactive support, and when things are not going well—for example, if a group home is in chronic upheaval—management (the seagulls) intervenes by providing plenty of white droppings to go around. The flock then flies off, leaving those covered in white droppings to rectify the scale tippers. So where do we need to focus if we want to prevent the seagulls from disrupting our day at the beach?

Creating a culture of gentleness starts with the leaders of organizations recognizing that the way we train, support, and maintain our employees ultimately has a direct effect on both the quality of care provided and staff retention. Just as those we support in our system of care strive for unconditional valuing, uplifting interactions, and encouragement so do our employees. We all do. It is imperative that all levels of management have an understanding of the six elements (safe, valued, praise, demand, structure, and transitions) that lead to a culture of gentleness. The key to higher quality training includes finding quality trainers and materials. The Center for Positive Living Supports (the Center) has been involved with supporting staff in numerous Mobile Response Training Unit deployments. Overall, we find that without understanding, commitment, and congruent behavior from the host provider and CMH staff, we often find an increased amount of scale tipping.

For example, our home managers play a vital role. Staff often quit a direct care position, not because of the people they support in the home, but rather the way they feel devalued by management. Many home managers also feel devalued from lack of support from above. One way in which we demonstrate our appreciation of the value of employees is by providing tools that give them the confidence to help create a supportive culture under complex circumstances. These tools come in the form of training and gaining a basic understanding of what we can do. In a best case scenario, it is estimated that 2% of annual budgets are earmarked for training. To use this effectively we need to incorporate ongoing support within the day-to-day culture and focus less on the external classroom. This requires developing trainers and recognizing that mentors play a vital role in creating and sustaining a culture of gentleness.

When the going gets tough, the mentors get going. Not exactly the adage with which we are all familiar, but a culture of gentleness requires us to invest in some of the more skilled staff, enabling them to become mentors. They are able to assist in some of our more difficult situations that traditionally may have escalated into scale tipping events. If you can build a capacity of at least one mentor for every 50 staff you will be investing in someone who has the skill set to assist in our most complex situations. The goal of mentoring is to create a sustained environment that will begin to make everyone that lives and works in the setting feel safer, more valued and less volatile. MALA’s findings, from their aforementioned 2009 study, concluded, “Education related to this culture of “gentleness” should be broadened throughout the state.”

According to projections from Michigan’s Department of Labor and Economic Growth (DLEG), employment in the state’s long term care industry is projected to grow by 20 % over the decade from 2006-2016, adding nearly 25,000 new positions. May I take you back to the dentist chair experience for a moment? When it’s time to see your dental hygienist wouldn’t you rather have Dena, whom you have grown to trust and respect? Me too, and for the same reasons the people receiving our care and those we employ will look to you, and want to stay with you. We need entire organizations that embody the elements that constitute a culture of gentleness. Working within an organization built on trust, mutual respect and valuing, dedicated to quality service, is like a sunny day at the beach engaging in experiences that can be meaningful and fun without worrying about Seagulls hovering overhead. They have also learned the prerequisites for landing and being warmly welcomed on the beach.

Example: Ayanna is extremely bright, has a wonderful sense of humour, likes to shop, and cares deeply about her family. She has had over 15 different placements over the past several years and more recently spent two-thirds of a year in psychiatric hospitals. Ayanna spent 45 days at the Transition Home and her future caregivers attended the preliminary training offered by The Center. When Ayanna moved to her new home, our staff worked for approximately three weeks with her caregivers during which time the six elements were demonstrated, coached, and observed by the Mobile Response Team Mentor. Her current provider remains committed to supporting her in her home and for the past year she has lived successfully in her home having only been hospitalized for a week.

Ed Kiefer, B.S., L.B.S.W
The Center for Positive Living Supports, an affiliate of Macomb-Oakland Regional Center.

 

Download the PDF version of the article here: Why a Culture of Gentleness Makes Good Business Sense

 

It’s all about your pace.

Have you ever stopped to think about the way that you walk?

I know that it is a strange question and if you chose to stop reading here I would likely understand. But  I promise you, I’m on to something. Now I am not talking about the physicality of your walk: do hips sway with a hoola-hoop like action, or is one leg shorter than the other causing a noticeable limp. More so, when you walk with a friend or companion, do you walk as if it is the end of the world and speed to wherever your destination may be or do you walk intentionally taking in your surroundings and the conversation that you may be having.

For the past three years I have been married to the love of my life. It has been an incredible adventure and we have enjoyed every minute of it: including the bountiful walks that we have taken. However one of the things that I noticed early on into our marriage is that my wife walks as if she is an Olympian speed walker–it eventually got to the point where I had to tenderly grab her hand and ask her to slow down. To ally my naysayers out there, it wasn’t because I couldn’t keep up to her, rather I didn’t like the feeling of being rushed in moments where I felt like I could relax.

I have been thinking about this idea of “pace” for a long time and it finally struck me: the way we pace ourselves not only determines when we finish the proverbial race, but also how we finish it.  As supports, friends, family and others associated with COR and the Gentle Teaching movement has this idea fully penetrated our hearts and minds, thus being embodied in our words and actions?  I ask this because I was convicted about it in my own heart, when I began noticing the young man that I support was always a few steps behind me. At first I didn’t think much of it, but as time passed I was frustrated: not at him, but myself. I had become the ‘Olympian’, though accomplishing much, missing the view.

So do me a favor, after reading this blog: stop whatever you are doing and ask yourself a few questions:

  1. What is the pace you are moving at?
  2. Are you noticing the ‘view’ and slowing down to assist others?
  3. Take a few moments to review the four tools of Gentle Teaching  and honestly ask yourself how you are doing in each of the following areas.

a)Loving Eyes/Gaze

b) Hands

c) Loving Words

d) Loving Presence

 

Ben, COR Support

Overflowing Gratuity

The first image that is most likely to come to mind when I say ‘gratuity’ is that of a monetary tip at a restaurant. While in one sense, this is the very definition of the word; I believe that there is more to it than that. If you were too look up the definition of the word, you would first find:

1. a gift or reward, usually of money, for services rendered; tip quickly followed by;

2. to give something freely without claim or obligation.

As a former waiter I loved my job and the tips were amazing. But all too often that small (or large) monetary tip became an expectation. Fellow co-workers would often be found cursing out guests who didn’t leave anything; going so far as asking guests for tips. I found this strange and semi-disturbing.

This post isn’t to blab on and on about my past work experience, rather to challenge those in COR, and those reading, to make a conscious effort of living a life that is overflowing with gratuity. To clarify, I am not referring to tipping waiters and waitresses, rather to live life as an active giver. To the clerk at the grocery store give your smile. To the homeless man asking for money, give your time (and maybe a cup of coffee too!). To the sad and broken-hearted, lend your ear. To the stranger you just met who is cursing you out, be kind, compassionate and hold your words carefully.

The majority of us out there have heard the famous phrase by Mahatma Ghandi, “Be the change you want to see in the world.” While this isn’t an earth-shaking challenge, it is a world changing one! What will it take for the person looking back at you in the mirror to take the plunge, go all in and risk it all? When you give generously and graciously the world around your starts to change — and it’s a beautiful view!

Ben, COR Support

 

Refuting the Bystander Effect

Kitty GenoveseIn 1964 a woman by the name of ‘Kitty Genovese’ was murdered but was not found out for two or three weeks later. When her death was later published in a local newspaper, numerous neighbors came forward telling the police of  their accounts of the murder. When questioned why they didn’t come forward sooner, the majority of the neighbours claimed that they didn’t feel like it was their place or responsibility. This became known as the bystander effect.

The bystander effect is a phenomenon that refers to cases in which individuals do not offer any means of help to persons in need, when others are present. The probability of help is inversely related to the number of bystanders. In other words, the greater the number of bystanders, the less likely it is that any one of them will help. Why is this?  Some say it is because of self-apathy, others argue personal boundaries, but I wonder whether or not it could be that we (as a society) have forgotten or neglected how to live in human relationship. Believe me, I am all for my own space but I wonder if we use that as an excuse sometimes to keep us from real, honest and true relationships.

Within the Gentle Teaching model, I believe that the four pillars of SAFE, LOVED, LOVING and ENGAGE, equip people with the  ability to refute the bystander effect: calling us as individuals to first and foremost work on our hearts, while we turn towards serving and caring for others.

Ben, COR Support