Post University Conflict & Disagreements in The Workplace Discussion Responses

Question Description

D#1 Case Vignette

Liz P

Conflict and disagreements occur in the workplace. When co-leaders disagree, it can happen in their workplace, the group. This can certainly have negative consequences, including: patient transference, dissatisfaction, triggering negative behavior, cause group dysfunction, and create conflict within the group context. This can cause group division and split members amongst themselves and create alignment, identification with one of the co-leaders, and isolation. Some group members may feel threatened. The group can also interpret that the group setting is no longer a safe place, disagreement and discord are triggers for many clients causing relapse or continued engagement in unsafe behavior practices in response to feeling unsafe (Cullati, Bochatay, Maitre, & et al., 2019).

One way that the co-leaders, Robert and Susan, could turn this disagreement into a therapeutic moment, is by processing their disagreement with the group. This could become their topic for the session: conflict resolution and flexibility. They could discuss how and what their conflict was about with the group and how that made the group feel. This shows the group that conflict is real and experienced by everybody, and demonstrating how this can be resolved in a healthy way through active communication and ultimately serve as a teachable moment. The goal – “to be competent in having a difficult conversation” (Overton, & Lowry, 2013, p. 261). The leaders can serve as a model for how healthy strategies are used and actively shows flexibility and respect through empathic listening. These “real life examples of conflict management” can teach empowerment and advocacy if the co-leaders managed to turn this into a lesson (Overton, & Lowry, 2013, p. 261).

As a supervisor, I would process the conflict itself, and the ethical implications of the disagreement in front of the members of the group with Robert and Susan. I would seek to help them explore why this occurred, much less during a group session. And, perhaps ask them why they did not turn this into a teachable moment? I would ask questions and prompt some individual reflections and continue to monitor this dynamic because my ultimate concerns are the patients in the group. As a supervisor I would need to ensure safety. Therefore, I would challenge my clinicians to be mindful and aware of their own issues and question whether they have done this before unknowingly or not. A supervisor would be negligent if this was not addressed, because the lack of action “could be interpreted as negligent or as condoning a hostile work environment” (Ramsay, 2001, p. 139). Each incident should be documented as well as the plan moving forward to ensure patient safety.

A disagreement with a co-leader can trigger feelings of insecurity and lead to questioning. This scene could play over and over, what could I have done differently? How? When did this disagreement really start? Can I work with this person again? How will I face the group and what will I (we) say?

References

Cullati, S., Bochatay, N., Maître, F., Laroche, T., Muller-Juge, V., Blondon, K. S., Junod Perron,

N., Bajwa, N. M., Viet Vu, N., Kim, S., Savoldelli, G. L., Hudelson, P., Chopard, P., & Nendaz, M. R. (2019). When team conflicts threaten quality of care: A study of health care professionals’ experiences and perceptions. Mayo Clinic Proceedings. Innovations, Quality & Outcomes, 3(1), 43–51. https://doi.org/10.1016/j.mayocpiqo.2018.11.003

Overton, A. R., & Lowry, A. C. (2013). Conflict management: difficult conversations with

difficult people. Clinics in Colon and Rectal Surgery, 26(4), 259–264. https://doi.org/10.1055/s-0033-1356728

Ramsay M. A. (2001). Conflict in the health care workplace. Proceedings (Baylor University.

Medical Center), 14(2), 138–139. https://doi.org/10.1080/08998280.2001.11927749

Michael B

As Robert and Susan’s direct supervisor, I would observe the overall group structure, the disagreement, and the group’s response to the interaction in a curious way instead of one of judgment. Understanding that the disagreement in front of the group presents a learning opportunity for everyone is critical in turning this potentially upsetting scenario into growth for the co-facilitators and group members. According to Berg, Landreth, & Fall (2013), co-facilitators have a distinct opportunity to model healthy relationships by demonstrating mutual respect and problem-solving skills with one another. This respect is displayed to group members through proper listening skills, trust in the partnership, and conflict management in a healthy way (Berg, Landreth, & Fall, 2013). As Robert and Susan’s supervisor, these would be things that I would make a note to discuss later in supervision. I would also be interested in observing the co-leaders to see how they effectively utilize each other throughout the group session. Co-leadership of a group offers the benefits of extra attention to the group’s needs and requirements while attending to the crucial components of the group interaction and providing a higher level of insight than possible with a solo-facilitator (Berg, Landreth, & Fall, 2013). For example, one leader may facilitate the dialogue between group members, while the second facilitator focuses on process observation (Berg, Landreth, & Fall, 2013).

One of the key observations that I would want to note for follow up supervision with the two co-leaders would be my observation of the group members and how they responded to the disagreement. Many group members have family experiences of dysfunction due to poor communication skills or non-communicative family members or grew up in chaotic environments where arguments and violence was the norm (Berg, Landreth, & Fall, 2013). When a group member witnesses a debate between the leaders of their group, their initial reaction may be to retreat emotionally or withdraw due to an immediate increase in anxiety; however, when the disagreement is resolved healthily, and group members can witness the resolution, it provides a significant learning opportunity for the clients in the group (Berg, Landreth, & Fall, 2013).

If I found myself in Robert or Susan’s spot, a one-time disagreement over a specific topic would not bother me and should be easy enough to resolve healthily. If these disagreements were ongoing or hinted at a larger issue such as incompatibility due to personality, interpersonal style, or a conflict over theoretical approach, then it would require a more in-depth discussion between myself and my group partner or potentially getting our clinical supervisor involved to work out the differences (Berg, Landreth, & Fall, 2013). Yalom and Leszcz (2005) assert that the outcome of the group’s success or failure depends heavily on the co-therapy relationship that emphasizes complementary personalities (Bridbord & DeLucia-Waack, 2011). For this reason, Rosenbaum (1983) suggests that careful consideration be paid to each of the therapists’ personality characteristics and temperament (Bridbord & DeLucia-Waack, 2011). According to Bernard et al. (1987) and Paulson et al. (1976), theoretical orientation can also be a predictor of co-facilitator satisfaction (Bridbord & DeLucia-Waack, 2011). Even with co-leaders with the same amount of experience, differences in style and skill were among the main problems cited by co-leaders of different theoretical orientations (Bridbord & DeLucia-Waack, 2011). For these reasons, I would ensure that before beginning a group with another therapist, I would make a significant effort to learn about that person’s style, theoretical orientation, and interpersonal style (Bridbord & DeLucia-Waack, 2011).

References

Berg, R., Landreth, G. L., & Fall, K. A. (2013). Group counseling: Concepts and procedures. New York: Routledge.

Bridbord, K., & DeLucia-Waack, J. (2011). Personality, leadership style, and theoretical orientation as predictors of group co-leadership satisfaction. Journal For Specialists In Group Work, 36(3), 202-221 20p. doi:10.1080/01933922.2011.578117

D#2 Professional Characteristics

Liz P

Competence is vital in delivering therapeutic treatment to clients. This encompasses training, knowledge, and awareness. Competence refers to “the extent to which a therapist has the knowledge and skill required to deliver a treatment to the standard needed for it to achieve its expected effects.” (Fairburn, & Cooper, 2011, p. 373). The therapist must have the knowledge base and skill set to perform, strategize, and deliver treatment. It is important to continue learning and engage in classes towards degrees and licensure as it is to learn about topics and further develop skills through continuing education and trainings. Counselors should be engaged in this continuously throughout their careers. I am currently seeking additional licensure and would like to take additional trainings in REBT. This furthers our competence and deepens our awareness about ourselves – what we know and do not know – as it helps us deliver a treatment to clients – do no harm. I will continue to seek additional trainings to help broaded my interests and gain expertise. As I am doing now, engaged in additional education through POST, I will continue my professional growth.

The competent therapist will also have an awareness of themselves, ethical practice, and cultural awareness. The therapist should be mindful of their own biases and self-process in order to “effectively modulate one’s behavior and understand their own conditions that cause or distort biases” (Vago, & Silbersweig, 2012, p. 1). And, the personality to “be meaningfully associated with the psychotherapy working alliance” (Chapman, Talbot, Tatman, & Brition, 2009, p. 1). The personality characteristics associated with stronger alliances are: “flexibility, honesty, respectfulness, trustworthiness, confidence, interest, alertness, friendliness, warmth, and openness versus exploitiveness, criticalness, distance, aloofness, and rigidity” (Chapman, & et al., 2009, p. 2). Counselors should be engaged in supervision to help them grow professionally and get an outside perspective on how they present to others. This process helps identify potential biases and/or ethical practice issues. Those working in the clinical field should be engaged in clinical team meetings, which involve a licensed therapist and a medical director. Ethical practice should be assessed on an on-going basis. This includes daily case by case practice, as it also means engaging in discussion through clinical reviews and professional training workshops. Counselors should be aware of their professional organization code of ethics as well. My organization reviews ethical practice daily, and reviews practice weekly in team meetings. This counts towards supervision and staff can use these hours towards their own certification/licensure hours.

The culturally competent therapist is also following professional guidelines like that of the American Counseling Association or the American Psychological Association (2002, pp. 1062-1063):

Psychologists recognize that fairness and justice entitle all persons to access to and benefit from the contributions of psychology and to equal quality in the process, procedures, and services being conducted by psychologists. Psychologists exercise reasonable judgment and take precautions to ensure that their potential biases, the boundaries of their competence, and the limitations of their expertise do not lead to or condone unjust practices.

References

American Psychological Association. (2002). Ethical principles of psychologists and code of

conduct. American Psychological Association. 57(12):1060–1073.

Chapman, B. P., Talbot, N., Tatman, A. W., & Brition, P. C. (2009). Personality traits and the

working alliance in psychotherapy trainees: An organizing role for the five factor model?. Journal of Social and Clinical Psychology, 28(5), 10.1521/jscp.2009.28.5.577. https://doi.org/10.1521/jscp.2009.28.5.577

Fairburn, C. G., & Cooper, Z. (2011). Therapist competence, therapy quality, and therapist

training. Behaviour Research and Therapy, 49(6-7), 373–378. https://doi.org/10.1016/j.brat.2011.03.005

Sue, S., Zane, N., Nagayama Hall, G. C., & Berger, L. K. (2009). The case for cultural

competency in psychotherapeutic interventions. Annual review of Psychology, 60, 525–548. https://doi.org/10.1146/annurev.psych.60.110707.16…

Vago, D. R., & Silbersweig, D. A. (2012). Self-awareness, self-regulation, and self-

transcendence (S-ART): a framework for understanding the neurobiological mechanisms of mindfulness. Frontiers in Human Neuroscience, 6, 296. https://doi.org/10.3389/fnhum.2012.00296

Michael B

Numerous professional qualities make up an effective group counselor, such as attention to detail, the ability to quickly process what the client is telling you about their thoughts and emotions, and the ability to process these thoughts effectively with each group member (Berg, Landreth, & Fall, 2013). One professional characteristic that I feel I possess right now is a firm grasp on the proper use of Motivation Interviewing. I received both individual and group supervision over the course of five years in the use of MI, and I feel that this education has served me well in various roles in human services. According to Miller and Rose (2009), there are two components to counselor characteristics regarding motivational interviewing: relational and technical (Berman et al., 2019). The relational component is essential and sets the tone for the counselor-client work (Berman, et al., 2019). The technical component is rooted in the counselor-client interrelationship and is concerned with verbal behavior and client responses (Berman, et al., 2019). The other characteristic that I feel I currently possess is an interpersonal style that allows for establishing a strong therapeutic alliance. Again, I go back to motivational interviewing and emphasize my instructors (both MI national trainers) placed on developing the “spirit of MI.” According to Miller and Rolnick (2013), Motivational Interviewing originated from Rogers’ person-centered therapy that emphasizes engaging with others through acceptance, empathy, and compassion (Mallisham & Sherrod, 2017).

The first area that I will need to continue to develop is establishing my group leadership style and becoming more comfortable with it. My preferred theoretical orientation is cognitive-behavioral therapy, which can be more authoritarian than other approaches. Because I’ve really only facilitated groups from written curriculums, my current style may be too authoritarian (Berg, Landreth, & Fall, 2013). According to Berg, Landreth, and Fall (2013), authoritarian groups rely heavily on the group leaders, were more discontented, were more critical, and were prone to more aggressive demands. This is NOT the type of group leader I want to be, so I will need to develop my skills to become more of a democratic leader. The group members reported friendliness and cooperation as the main attributes (Berg, Landreth, & Fall, 2013). Another professional characteristic that I will need to develop is self-care. Skovholt (2001) suggests that counseling is an emotionally demanding profession and many counselors experience compassion fatigue and burnout (Browning et al., 2019). Admittedly, I am not currently good at self-care and will need to become better to make a career out of counseling. According to Stamm (2010), burnout can happen at any point in a counselor’s career and can reduce productivity, creativity, and compassion for clients (Browning et al., 2019). The professional counselor’s professional quality of life is not something we speak much about at work or in class but is an important skill to master. Burnout can be caused by the work environment, caseload, individual characteristics, exposure to primary and secondary trauma in the workplace, poor counselor self-care, and the inability to control work stressors (Browning et al., 2019).

References

Berg, R., Landreth, G. L., & Fall, K. A. (2013). Group counseling: Concepts and procedures. New York: Routledge.

Berman, A. H., Lindqvist, H., Källmén, H., Durbeej, N., Hermansson, U., & Forsberg, L. (2019). Counselor and drug detox inpatient verbal behaviors in a single motivational interviewing session and subsequent substance use-related patient outcomes. International Journal of Mental Health & Addiction, 17(1), 73. https://doi-org.postu.idm.oclc.org/10.1007/s11469-017-9866-4

Browning, B. R., McDermott, R. C., & Scaffa, M. E. (2019). Transcendent characteristics as predictors of counselor professional quality of life. Journal of Mental Health Counseling, 41(1), 51–64. https://doi-org.postu.idm.oclc.org/10.17744/mehc.41.1.05

Mallisham, S. L., & Sherrod, B. (2017). The spirit and intent of motivational interviewing. Perspectives in Psychiatric Care, 4, 226. https://doi-org.postu.idm.oclc.org/10.1111/ppc.12161

D#3 Co-Leaders When considering the use of co-leaders for a therapeutic group, several considerations should be made before convening the group. There are several reasons why co-facilitating groups make sense, including a greater ability to tend to the multiple dynamics occurring at any one time and providing for the accurate collection of each group interaction (Berg, Landreth, & Fall, 2013). Group leaders benefit by having one leader who can facilitate the group discussion while the other leader can serve as a process observer (Berg, Landreth, & Fall, 2013). In this way, the group’s effectiveness can be improved upon, and the group members benefit directly (Berg, Landreth, & Fall, 2013). Another benefit of co-facilitating groups is that it creates continuity of treatment when responsibilities outside of the group interfere with group time (Berg, Landreth, & Fall, 2013). Instead of having to cancel the group when emergencies occur, the other group leader can step in to facilitate the group alone (Berg, Landreth, & Fall, 2013). Perhaps one of the most valuable reasons to consider co-leadership of a group is to model healthy relationships with group members (Berg, Landreth, & Fall, 2013). Many individuals enter groups struggling with relationships in their lives or having a past dysfunctional relationship that did not allow healthy interpersonal interactions (Berg, Landreth, & Fall, 2013). Co-leaders who demonstrate respect towards one another allow group members the opportunity to observe healthy, positive interactions and problem-solving skills (Berg, Landreth, & Fall, 2013).

Unfortunately, not all co-facilitators can model good interpersonal skills, and conflicts between group leaders erode group effectiveness and the group process for the members (Berg, Landreth, & Fall, 2013). This valuable component of the group is lost when co-leader conflicts do not allow the modeling of healthy interpersonal skills (Berg, Landreth, & Fall, 2013). Power struggles between leaders can lead to verbal responses that undermine the leaders and cause group members to take sides with the facilitator they connect with (Berg, Landreth, & Fall, 2013). The most common incompatibility sources are found in personality differences and therapeutic orientation, and incompatible group leaders will struggle to grow their relationship. The value of the two leaders diminishes (Berg, Landreth, & Fall, 2013).

References

Berg, R., Landreth, G. L., & Fall, K. A. (2013). Group counseling: Concepts and procedures. New York: Routledge.

Gloria M

Hello Instructor and All

Having a second professional assistance is key for various reasons. Likewise this addition to a therapeutic setting can become overbearing or even hindering at times (Berg, Landreth, & Fall, 2013). One specific benefit of co-leadership is the access to an immediate professional opinion as well as additional supervision/assistance with analysing each individual in the group. In terms of group therapy there is obvious much opportunity for multiple things to be taking place at once. This scenario can prove to be overwhelming for any single individual. Additionally, throughout therapy there are often stages each individual must attend to, and essentially overcome. In the event that each participating member is at a different stage in their journey throughout the progression of therapy, co-leadership allows for continual and shared responsibility of keeping up with those aspects of each individual (Berg, Landreth, & Fall, 2013). One of my main concerns as an aspiring counselor is that when utilizing group therapy, it will become easy to disregard one member’s progress considering all of the different aspects I will be obligated and motivated to get through in such little time. Co-leadership is also beneficial in the fact that it allows the leading analysts some time to be human. For instance, I’ve experienced a personal recount of his sessions with his therapists who were extremely sick towards the end of her life, as well as towards the end of her counseling journey. This woman was treating his clinical depression for more than two decades and therefore it is understandable why he would not want to see anyone other than her after her passing. Nevertheless, when she did pass, he had an extremely difficult time finding and gaining comfortability/trust with a new provider. I believe his struggles in finding a new provider was due to a lack of experiencing therapy outside of her doors. While he’s dealt with depression for a very long time, he has never been counseled by anyone but her even towards the end of her career and life, she felt so obligated to him that she literally met with him weekly up until the last week of her existence. Before then, she refused to miss a meeting if humanly possible. Altogether, having a co-leader could’ve provided the client in this case with the much needed security and the counselor with the peace that her client was in good hands so that she could take a sick day or two (Berg, Landreth, & Fall, 2013).
Nevertheless, there are also some difficulties which can arise in a scenario where a co-leader is present. For instance, especially when dealing with professionals there are possibilities where one’s opinion on a subject may drastically differ from the others opinion. While both people could be absolutely correct in their statements, the issue may fall down to perspectives and how each counselor perceives the other professionals advice to be applicable in a particular setting. Disagreeing in life is what helps foster diversity and much needed progression. However, in the counseling world two professionals disagreeing pertaining to one situation can appear as if they both are not competent or that one is less competent than the others. Both perceptions from a client’s perspective are unfavorable. As explained by the text this issue can easily be amended by both leaders respectfully announcing when they view an issue differently and this process can also show the clients how they should interact with adversity in their everyday lives. Overall, many of the disadvantages consist of the level of functioning within a dynamic of two or more people in general. While we don’t always have to agree, conscious awareness and appreciation of different opinions helps improve collaboration skills with others (Berg, Landreth, & Fall, 2013). On the other hand, co-leadership involves having an actual leader. As seen in many of the occupations within the professional world, power can be an addictive disease. Some people want to always be the best at what they do, meaning that prior to consenting to co-leadership a clear consensus of who’s in higher authority is key for the sole reason of allowing the second individual to know how much leeway they have to assist these clients. At the end of the day it is the clients wellbeing that should be in the best interest of everyone in the group, but especially the analysts. Ensuring roles are established before going into therapy just allows for less conflict to arise and more cohesiveness. Lastly, finances when working with other professionals can be a hindering aspect as well. There are various issues of how to split the workload, payment and even clients progress which will arise in these situations and can either cause dysfunction between client and counselors or counselor and counselor.
References
Berg, R., Landreth, G. L., & Fall, K. A. (2013). Group counseling: Concepts and procedures. New York: Routledge.
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