Effective places
Effective addiction practitioners working in effective places are the most potent means of improving addiction outcomes, particularly for those with more severe problems. Help seekers are likely to be the more troubled individuals. Practitioners need to understand the mix of service users catered for by their service and create an operational culture in tune with service user needs.
The characteristics of effective places…
A positive operational culture
Managing a helping organisation requires nurturing a set of principles that can work for all the service users and for all of the helpers...
First contact is important - make sure help seekers feel they will get the help they need
Treat people as unique individuals
Giving take-home tasks and feedback to create an expectation of continuity
Fanny Duckert about these and other operational issues ➜
Fanny Duckert, Professor of Psychology, University of Oslo
Organisational constraints
The seminal work of Max Weber held bureaucracy as a rational organising principle: there is a clear hierarchy of authority, and rules and policies govern operations. He also anticipated that ‘bad bureaucracy’ would be an ‘iron cage’ for employees. Libertarians warn that power corrupts and bureaucracies have a habit of becoming self-serving, self-perpetuating, and stifling productivity and creativity. Centralised efforts to promote values have a tendency to infantilise adults and impose one group's beliefs on others. In short, decentralised, evidence driven services will deliver the best treatment outcomes. Some organisations understand how to be ‘good bureaucracies’ - many do not.
Health and social care in the UK is beset by a poverty of leadership and a culture of blame and negativity. Leaders are prone to arrogance, an inflated sense of self-importance and a sense of righteousness from which flows bullying, secretiveness, and centralisation of power, which, in turn, leads to practitioner disengagement and a demoralised staff group. Change is difficult but an emblematic indication of a right-thinking leadership would be one that replaced high-flown titles with modest ones that suggest a collegiate approach to service delivery and a progressive organisational culture.
A healthy organisational climate, the conditions under which practitioners work, is a prerequisite of being able to deliver best practice and achieve the best outcomes.
Ingredients of effective teamwork...
① Everybody understands their role in the team and has a commitment to the way the team works and its objectives
② There is mutual trust and respect with open discussion of mistakes and how to learn from them
③ There is an informal atmosphere where conflicts are dealt with quickly and openly and everyone looks out for each other
④ Everybody helps to squash sexist, racist and pompous behaviours when they see or experience them
⑤ The team has regular self-critical meetings to review how well they are doing and where things could be better
⑥ Communication is good and discussions involve the whole team especially regarding how to respond to new challenges or major change
⑦ In emergencies anybody near the scene will move quickly to help out however they can
⑧ The team is composed of competent individuals possessing both technical and interpersonal skills
