Janice is a home visitor working with highly stressed parents and their young children. Her program’s mission, the prevention of child maltreatment, aligns with her sense of purpose, which is what made her decide to apply for this job four years ago.

This is work she feels called to do. She is great at building relationships with difficult to reach families, supporting their engagement and successful goal attainment. Her work brings her into close, empathic contact with parents who experience serious adversity as adults. Like Janice herself, many of her clients were abused as young children. While the work is stressful and can stir up a lot of strong feelings, Janice has been driven by her passion to make a meaningful difference in the lives of young children and their families.

But now Janice is starting to struggle. Her caseload keeps growing, and seems to be filled with families experiencing such severe stress and difficulty that they need the most intensive level of support.

Recent policy and practice changes meant to increase staff accountability have reduced the scheduling flexibility she once had.

A new online data collection program has been hard to learn and has been hard for her to keep up with. Similarly, an electronic expense voucher system is unwieldy and takes more of her time than the former reimbursement system took.

It’s so hard keeping up with everything that Janice has been taking very little time off. If she doesn’t take some vacation time soon, she’ll have to forfeit it. She doesn’t see hows she can take time off right now. In addition to her own caseload, she’s also serving participants normally seen by a colleague who is out on maternity leave.

These days, Janice is feeling exhausted and ineffective. Her rate of completed home visits is declining because she can’t find time to reschedule when families miss an appointment. Her once accurate and up-to-date participant records are now in bad shape. Last week, her supervisor threatened to put her on probation for these issues if she didn’t start showing immediate improvement.

On the Path to Burnout

Janice is on the path to burnout – the experience of utter depletion that negatively affects physical and emotional well-being. Burnout has great personal and organizational costs. It results in declines in morale, job performance, and staff retention.

This impacts an agency’s bottom line. Poor quality services threaten program outcomes and can create problems in relationships with funders. Turnover is costly in human and fiscal terms. Relationships with co-workers and participants are disrupted, and organizational history can be lost. Replacing a staff member is time-consuming and can cost double or more  their annual salary.

Supporting Individual and Organizational Resilience

The changes that are challenging to Janice’s resilience and leading her (and other staff) toward burnout reflect the organization’s efforts to cope with changes in technology and in the funding and policy environment. Such changes are challenging and seldom can they be negotiated with perfection. Yet, it is possible to proactively strengthen  both the organization’s resilience, defined as the capacity to adapt positively to change, and that of the people within it (Glasgow Centre for Population Health, 2014). This is discussed further below.

Resilient individuals promote and require reliable networks of trust and support. Resilient communities include individuals who are trusting and supportive. ~GCPH, 2014, p 10.

Resilience is the capacity for communities and individuals to adapt positively and successfully the face of change, uncertainty or adversity . Nonprofit agencies are a community, made up of those who work within it and are served by it. Individual and community resilience are interconnected and mutually reinforcing (GCPH, 2014).

Creating and Strengthening a Relationship-Based Culture

At its heart, a relationship-based and reflective organization recognizes the power of one relationship to powerfully and positively affect other relationships.

The core of relationship-based work is creating and maintaining a network of trusting, supportive relationships. Trust implies that all involved experience a sense of safety and security within the organization’s interconnected relationships.

As senior program leaders note, this is no easy process, as at times relationship-strengthening and trust-building may seem to be in conflict with other organizational commitments.

Consider the bind that can arise when, for example, the relationship-based principle of open communication comes up against the legal necessity to protect employee privacy and confidentiality. Another area of potential conflict is the one between the need for rapid decision making in urgent situations and the principle of creating collaboratively agreed upon goals and decisions.

While there are no formulas for resolving these conflicts, there are some guidelines that can help:

• Be proactive in building an organization guided by the principles of relationship-based practice, so that  there is “money in the bank;” a fund of trust and support to draw upon in managing difficult situations.
• Identify  what can be done, said or shared, even when there are constraints.
• Be transparent about those constraints.

Placing a high value on using the principles of relationship-based organizations to guide policy and practice can help organizations pro-actively build trust. This develops the resilience that helps the organization, and those within it, to collaboratively weather the inevitable changes and challenges that leaders and staff will face together.

A relationship-based and reflective organization recognizes the power of one relationship to powerfully and positively affect a network of other, connected relationships. This understanding helps us realize that building trusting relationships has an  exponential impact, increasing the organization’s capacity to achieve its goals and meet its objectives.

The way relationships impact other relationships, or what is termed the parallel process in relationships, means that each person in the organization who experiences trusting, supportive relationships is in turn able to create such relationships with others.

Staff members benefit from having the resources they need to cope with the stresses inherent in their work. The organization benefits from the input of motivated, trustworthy and engaged staff members. Participants benefit from their contact with providers who are fully present for them and who help build their resilience and coping capacity.

Relationship-based, reflective practice builds networks of support for programs, professionals and participants, building resilience and supporting the creation of the world we want to live in!

It’s A Process

Implementing relationship-based, reflective practice is a process that happens through continuous cycles of reflection, action and learning. If I had some quick-fix tips for transforming quickly into a relationship-based organization, I’d be thrilled to offer them!  Does this mean it will require months of contemplation and study before your organization can do anything to become more relationship based?

Not necessarily! Implementing the immediately do-able steps to become more relationship-based makes a positive impact while engaged in the long-term and ongoing process.

Getting Started

Here are three different starting points three Baltimore child and family serving agencies used. After participating in a 2013 training on relationship-based practices and reflective supervision:

1. Agency A’s child care program, which was part of a shelter for women and children affected by domestic violence, wanted to implement reflective supervision. The program supervisor began working one-on-one with the child care program’s manager, providing her with reflective supervision and having her begin offering it to staff. They invited me onsite to  facilitate two training workshops for the child care program staff, to give them the opportunity to explore what relationship-based practice meant to them. This was done as part of a larger, agency-wide effort to become a trauma-informed organization. Later, this program was the one found to most fully engaged and successful in implementing trauma-informed practices.
2.  Agency B, a children’s outpatient mental health unit within a large hospital facility. decided to hold reflective peer support meetings for supervisors. These meetings, which I facilitated, created a safe space for  sharing thoughts, feelings, observations and hopes about the work. Sometimes action steps emerged from these meetings. Other times, the chance to listen and to be heard provided the needed support.
3. Agency C, a small mental health clinic serving traumatized young children and their families made several changes, with it’s director and two lead staff members implementing these changes over time, openly communicating about the changes with the rest of the staff. First, the group reviewed it’s hiring practices, and enlisted my consultation in making these more more relationship-based. Then, looking at their monthly staff and training meetings, they identified what was working well and what could be improved, in order to make these meetings more relationship-based and reflective. Additionally, the program director, who supervised the clinic staff, reviewed her own practices to increase the relationship-based and reflective aspects of her supervisory approach.

At the end of our funded project all three had notable accomplishments, and things wished to continue working on.

As in implementing reflective supervision, which is one aspect of relationship-based practice,

…the transition [to becoming a more relationship-based organization consist[s] of a series of incremental changes as each supervisor and staff member ma[kes] small modifications in practice and personal style…”

~Parlakian, 2002

Many programs and organizations find it helpful to engage an expert consultant to provide relationship-based, reflective support the organization’s leaders, and guiding them in the process of becoming a relationship-based, reflective organization.

Questions about implementing relationship-based practice in your organization?  Contact me here!

Resources and References

• Glasgow Center for Population Health (2014). Resilience for public health: Supporting transformation in people and communities. Briefing paper 12 concept series.
• Heffron, M.C., & Murch, Trudi (2010). Reflective supervision and leadership. Washington, DC: ZERO TO THREE.
• Kansas Workforce Initiative (2010). How supervision relates to workforce outcomes.
• Multiplying Connections (nd). What is reflective supervision?
• Pawl, J. & St. John, M. (1995). How you are is as important as what you do. Washington, DC: ZERO TO THREE. Scott Heller, S. & Gilkerson, L.,Eds.(2000). A practical guide to reflective supervision. Washington, DC: ZERO TO THREE.

Photo Credit: Nancy L. Seibel

Originally published 11-5-16. Revised 1-23-18.