Hello, and welcome to our audience. I'm Dr. Amy Cohen, a clinical psychologist and director of SMI Advisor. I am so pleased that you've joined us today to talk about a really hot topic. Today's SMI Advisor webinar is titled Strategies to Increase Staff Morale and Retention and Decrease Burnout. SMI Advisor, also known as the Clinical Support System for Serious Mental Illness, is an APA and SAMHSA initiative devoted to helping clinicians implement evidence-based care for those living with serious mental illness. Working with experts from across the SMI clinician community, our interdisciplinary effort has been designed to help you get the answers you need to care for your patients. Today's webinar has been designated for one AMA PRA Category 1 credit for physicians, one Continuing Education credit for psychologists, and one Continuing Education credit for social workers. Credit for participating in today's live webinar will be available until May 20, 2024. Next slide. Slides from the presentation today are available to download in the webinar chat. Select the link to view. Next slide. Captioning for today's presentation is also available. Click Show Captions at the bottom of your screen to enable and click the arrow and select View Full Transcript to open captions in a side window. Next slide. Please feel free to submit your questions throughout the presentation by typing them into the questionnaire found in the lower portion of your control panel. We're going to reserve 10 to 15 minutes at the end of the presentation for us to talk with our expert through a question and answer period. Next slide. Now it is my pleasure to introduce the faculty for today's webinar, Jose Verrett, who is a licensed clinical professional counselor and also the founder of Thrive for Wellness. He serves as the community care expert for SMI Advisor, and he has more than two decades of experience working with adolescents, young adults, and adults who have significant mental and behavioral health challenges. Mr. Verrett previously served as the clinical director of behavioral health at Erie Family Health Center in Illinois. Jose, it's a pleasure to have you today. Thank you for leading our webinar. Thank you for that introduction, Amy. I sound archaic after 20 years of experience, so I'll start off by saying that I have no relations or conduct of interest related to the subject matter of this presentation. So today's learning objectives are three. The first one is to highlight the day-to-day and long-term strategies that promote staff communication, ideas, interests, and professional goals. The second point is to promote trauma-informed practices that will enhance team cohesion and promote adherence to the agency's mission and vision. And the last one is to develop and apply practices that will help team members and supervisors become aware of the team's members' communication styles. As we all know, challenging and non-challenging to bring people on board has been an ordeal. Some people attribute all these changes to what's happened during the pandemic. Some people say that there's a sense of awareness of behavioral health services, and the stigma has been reduced. We need to be intentional in attracting really competent employees that can perform at high levels and are driven by the mission and vision of the agency. I personally say that the goal is to initiate, and for some folks, is to continue the process of helping people maximize their potential. There are some situations that people don't know how good they are, and sometimes they need encouragement. The other point is to help them reach their goals, and this may be a work goal that leads to the personal life and vice versa. And ultimately, I truly believe this is to fulfill their purpose. So one of the things that can potentially get in the way of those three goals is this notion of burnout. The APA defines burnout as an occupation-related syndrome resulting from chronic work stress that has not been successfully managed. Burnout can be measured and quantified using validated tools. So there is tools out there that can determine how intense is your symptoms of burnout and what things you can do eventually by seeking other resources. It involves ongoing exhaustion, psychological distance or negativity, or feelings of inefficacy. All adding up to the state where the job-related stresses are not being satisfied or managed by rest following breaks that usually take their work, long or short weekends, and time off. And when I talk about burnout, I'm not talking about the word we use and throw out there loosely that we say, okay, that person's burned out, they need to leave early on Friday, or that person's burned out, they need to take a long weekend. I'm talking about burnout that's specific to one's job and occupation. And it's not those conversations, it's not like those stresses that we can manage. It goes far beyond that. So I have three points that I want to highlight here, or three dimensions. Feelings of energy depletion or emotional exhaustion. You feel like you ran a marathon, or you can't give any more to anyone else regarding your emotions. There may be an increase of mental distance, like you're in the session or you're talking with someone where you're really not there, as well as negative or cynical feelings towards one's work. You still can believe in the mission, you still can believe in what the agency is doing, but for some certain state, you can't be there anymore. You have this negative emotion associated to the work. And the last one is reduced sense of efficacy at work. You're not doing the best you can do, not because you don't want to, because you're struggling with some issues related to burnout. So the AMA is responsible for sharing information pertaining to burnout, stress, and job dissatisfaction and job satisfaction. The AMA says that over 52% of respondents that they did a survey with were experiencing a great deal of stress. This is a 4% increase from previous benchmarks. They also say that the physician burnout rate spiked to 63% in 2021. And we're talking physicians, we're talking about the people that help us stay in our top shape or be well physically. So if they're not doing well, you may want to consider how they're doing work with us, right, in general, which is alarming. They say that the most recent study in the National Burnout Survey Series, co-authored by the AMA, shows how COVID-19 pandemic magnified longstanding issues that have accelerated the U.S. physician burnout rate. At the end of 2021, nearly 63% of physicians reported symptoms of burnout. That's a really big number. And they say up to 38% in 2020. So that went up 38% compared to the previous year. Now the APA is talking about burnout around behavioral health and mental health providers. They say, as in 2020, American workers across the board saw heightened rates of burnout in 2021. And according to the APA's 2021 work and well-being survey of 1,501 U.S. adult workers, 79% of employees have experienced work-related stress in the months before the survey, which is a really big number. Nearly three in five employees reported negative impacts of work-related stress, including lack of interest, motivation, and energy, and lack of efforts at work. Meanwhile, 36% reported cognitive weariness, 32% reported emotional exhaustion, and an astonishing 44% reported physical fatigue. That's basically saying that there's a lot going on within the body. A 38% increase since 2019. We all say, those who practice trauma-informed care, the body keeps the score. GALA statistic on job satisfaction, this specific area states that the recent GALA statistic on job satisfaction indicated that a very large portion of the world's 1 billion full-time workers are disengaged. That's huge. More precisely, only 15% of workers are happy and productive in their workplace. The remaining 47% of workers are not engaged and are psychologically unattached to their work and company. So that means that there's something that's getting in the way, right? Potentially, burnout is impacting our workforce, our talent, and how people are doing the work. And needless to say that the cost of turnover is a lot larger than just replacing staff. Oftentimes, I hear, well, if that person's not aligned with the mission and vision, that means they have to find a job somewhere else. And then we're not taking into account the impact of burnout. And here's a few examples. If the team has a lower morale, by someone leaving, that morale is going to get lowered even more. So lower morale on staff. Now there's going to be errors made by overburdened staff. And if someone leaves, the people who stay behind have to complete the work. Now supervisors and people who are responsible for training have to be spending time hiring, training, and onboarding new staff. And now we need to account for the time that these new employees have to adjust to the agency, the productivity markers, how to get there, the support that they need from supervisors, and a few other things. There's three other areas that we have to pay close attention to. The client and patient engagement. If a patient or a client comes into the site, and they're experiencing a high rate of turnover, and they're seeing different faces, their level of engagement may be off a little bit. And they may not want to disclose or share information. And this could be for all disciplines. This could be for social workers, for peer support service workers, or for therapists. On the other hand, if these clients and patients don't want to come into the clinic, don't want to come into the site, or don't want to see the person in the community, this potentially can impact sustainability. And there has to be a way for us to keep the lights on in order for us to continue providing this good care that we do. And one of the things that I get concerned the most is safety. If staff are stressed, because they're overburdened, and they're doing extra work, and the patients are not connected, they potentially can be causing each other stress, and lose the patient in the process. And I always say when I do my VOCs, the virtual learning collaborators around trauma, that if you're really stressed out, this may trigger your fight-or-flight-or-freeze responses. Your executive functioning is not online, so your ability to make the decisions from point A to point B, and point C to point C, are off. So now you're operating on defense mechanisms. So what do we do, and how do we consider the work, and how we work around colleagues? So the Boston Consulting Group identifies 10 factors that influence job satisfaction. Number one is appreciation for your work. I love when somebody says you did a fantastic job, that was well received, you spoke clearly. Point number two, the relationship of colleagues. How you get along with your colleagues means a lot. Number three, a good work-life balance. Four, your relationship with your supervisor. Do you have the opportunity to be transparent? Can you share your concerns? Can you share the ideas? And is that supervisor listening to you? The company's financial stability, the opportunity for you to learn and have career development, job security, and eight is attractive fixed salary. And I highlighted eight because oftentimes people feel like a big salary, or a fixed salary, or a very cush salary is the number one reason why people stay in their job. And according to this group, is the number eight reason. There's a lot of other things that we can do to ensure that people stay in their job, that they feel happy and connected. And then number nine is interesting job content. And 10 is company values. And by the way, this survey, they surveyed over 200,000 people around the world. So I have this belief that if you build it, they will come. If you believe, if you build these really good systems of care, you're going to have the ability to bring in good staff. And sometimes it means that you have to work with who you have in your insights. And some people who are not aligned with the mission vision, potentially have to go and explore other opportunities. Every slide that I'm going to share after this has to do with the compilation of my professional work experience. So in 2002, I started my career in Behavior Hub. I was a psych tech for a small little agency in the suburbs, where they provided services for juvenile justice program members. The first day that I was on site, I did the first portion. I did the new staff orientation. They shared some slides. These led us out for lunch. And when I was walking outside the site, I noticed that my supervisor was there. I thought he was going to come and share some documents that I needed to sign, or he was going to encourage me to attend some other training. To my surprise, he was taking me out for lunch. And I was a little starstruck because he was the director of the program. After I left the lunch, his name was Brian King, I felt this sense of being seen, of being heard. And I felt really good about working for the agency. And I remember telling myself, when I become a director, when I oversee programs, I want everyone to have this type of experience. The experience where you feel like you can relate to your supervisor and still have a professional relationship, but at the same time, be comfortable around their presence. So I'm going to be sharing information starting from the individual aspect. How do you start somebody on the right foot? And then I'm going to move in slowly into how to build team morale and team chemistry. So for me, the process doesn't start with the first day of work. For me, the process starts when you're posting the job. The job posting and blur has to demonstrate some indications of the agency's need. And you need to highlight the ideal candidate that you want. So what I have done in the past is there's three aspects of this that I do. I generate this general description. So maybe it's two or three paragraphs of the job description. And then the second portion is the qualifications for the job. And at the end, I'm going to highlight the benefits that the job has to offer. And occasionally, we can put the salary ranges in there. My objective is to recruit or grab the attention as many people as possible. Once we identify the top talents and we have the interview, then I can share the expectations of the role and what they're going to experience when they come to us. And at that point, if they really want their job description, we can share it. So if you're doing this practice, you really want to consider what are you saying about your role? What do you need to add or delete to attract top talent? In essence, that job poster blur has to be really clear, intentional, and concise. And by the way, in my previous roles, many of the high-performing employees were referred by other employees that were highly satisfied with their roles. So if you have a small group of people that are doing a good job, I encourage you to continue investing in them, for they can continue growing, and those folks potentially can bring other people in. And if there's people who potentially are not aligned with the mission and vision of the agency, this is your opportunity to encourage them to find and seek opportunities elsewhere. And it's part of the job, and just being transparent. Then we move into the interview. You need to be extremely intentional with a few things. Your energy has to be on 10. I call this having a positive vibe. You have to start the interview with a smile, demonstrate positivity, and even thank them for coming in and interviewing with you. A lot of people get shocked when I say that, and thank you for being here and taking the time to meet with me, because they're expecting me to just be grateful. They're expecting them to be grateful that I'm meeting with them, and it's the other way around. You want to hire people that are highly complementary to your team, even if your team is small. And I don't always hire the best talent. There's individuals that are really good, but don't necessarily work well with other team members. Within that, we want to hire people that are intrinsically motivated to learn and are interested in being part of the team. We also want to hire people for future positions of leadership. I always look in for the silver lining. If I'm hiring for a therapist, for a social worker, for a peer support specialist, I'm always looking for that nuance that can help this person move into an administrative role or into a clinical role, and the possibility of developing into a leader in the future. You also want to share the expectations of salary, if they ask the question, if they're going to be long hours, or any on-call expectations. And the last one is something that I evolved and I learned to do across my years of experience. During the interview process, you want to include other people that are not necessarily the supervisor of record. This means that other supervisors that report to other departments or other direct care staff that can be part of the process. If we're using trauma-informed language, this is basically talking about inclusion and belonging. Now we want to move into the formal interview. I have this sheet that I kind of put together that I work with other contributors, and I have questions I identified in specific areas. I have a portion of intrinsic motivation questions, I have other questions for skills and knowledge, and obviously when they apply, I use their resume to measure their experience. We use all this stuff to make sure that the person is aligned with the agency's mission and vision. For example, if I'm looking for a question that has to do with intrinsic motivation, I'm asking them, what gets you excited about this job? And if you look towards the bottom of the screen, you may want to ask them, if you didn't have to work for money, what occupation would you choose and why? So that's getting to the questions of more motivation. When we're talking about skills and knowledge, I ask the question about what are things that you do that you always have excel in? Is it looking at the details? Is it looking at the big idea? Is it creating consistency and predictability within your model of care? So there's a lot of things that you can do during the interview process to make sure that you are bringing in the right person onto the team. And towards the end of the interview or in the middle of the interview, according to how your style is, I encourage the candidate to ask me questions. And I'm looking for how they express themselves, how they're sharing information. I know they may be a little nervous, but I'm looking for statements like, as a part of a team, I did X, Y, and Z. I'm looking for us words. I'm looking for team building words. So that gives you insight in regards to their future goals and their motivations. So onboarding for me is one of the most important steps. Onboarding for me starts the before they get to their job, sending them a seven-day onboarding plan a week or two before they start. And this onboarding plan is basically indicating what site they're going to be attending, who they're going to be meeting, the contact information for colleagues or supervisors. And then after that, when they go into new staff orientation, obviously the agency has to share everything that has to do with the agency, the mission, the vision, and share what HIPAA is, but also share a little bit of information about the other roles that they're going to be working with. This leads to a sense of understanding, it's promoting inclusion and understanding, but also integration. So, for example, if I'm a behavioral health specialist and I understand what Dr. Cohen does on the psychology part, that helps me understand that we have different roles, but we're still connecting. And I also want to know what peer support specialists are doing. I also want to know what social workers are doing. So, it provides a sense of integration. And I always believe, and this is saying that a mentor of mine will always say, lo que empieza mal termina peor, meaning what starts bad finishes worse. So, we want to make sure that before they start, that they have a really good understanding of what the first seven days are going to be like. And when they're in new staff orientation, they understand how they fit into the agency's flow of the day. And this is a brief example of the first week of orientation. As you can see here with my cursor, it's the seven days, the five work days, then the site that they're going to be working on, the time that they need to arrive, who they're meeting with, the potential responsibility. And towards the end, you may plug in something like meet with Sylvia before leaving. This is the supervisor. So, day one is one of my favorite things. This is what I experienced with Brian King. You want them to feel welcome. You want them to feel like they belong as part of the agency. And some ideas is creating a sign. Welcome, Sammy. You can add more information. Welcome, Sammy, to Thrive for Wellness. Welcome, Sammy, to APA. Welcome, Sammy, to SMI Advisor. And if they label people's names and put them on the doors, you may want to do that too. You want to ensure that they have company swag. There's journals or sticky notes, a coffee team log, or anything that they mentioned during the interview. I find it really, really, really, really pleasurable to give somebody that they spoke about. So, if they spoke about coffee, leaving a little note and saying, here's a mug for your level of coffee. If they talked about plants, maybe a small little plant, some flowers on their desk. In addition, we want to include a printed copy of the week's schedule, what we already sent a week before, to make sure they have it in writing or in paper. We want to make sure they have access to folders or any chats or email groups. Print a copy of their organizational chart with their name and credentials on it. That helps them feel included. Then you want to print a copy and eventually customize the onboarding plan. We're looking at the first seven days, the first 30 days, and the next 90 days. And I encourage supervisors to review this information and both the new and employing supervisor sign the specific goal. And here's a quick example of an onboarding plan. As you notice in the column that is titled phase, it's the first week, first 30 days, the next 90 days. And then the second column is the objective, what we're trying to reach here. Moving into the next column, it's talking about the action items. So, these are the specific items that the individual is going to be targeting and completing. And next to the target item, that's when the supervisor can initial and the new staff can initial. And in the tool area, you can write questions that they have or they can identify tools to help them complete the specific task. And by the way, this is just the first sheet of an onboarding document that can be anywhere from 10 to 15 pages. Once the individual has completed the 90-day plan, they can sign it and date it, and their supervisor can also sign and date. So, the next seven days, you have to be very intentional and knowing that everyone works at their own pace and at their own pace. And you want to ensure that the individual is shadowing different team members. Everyone has a different style. Everyone has a different way of doing things. So, you want to give them the opportunity to test and see what style fits best for them. You want to focus on performing friendly staff. So, they can kind of teach them the ways, teach them little tricks, but also keep them encouraged in the process. Because some people have a hard time with learning more information at a fast pace, as long as we're taking that into consideration. I always encourage supervisors to shadow their employees to make sure that we can provide direction and provide feedback if needed, specifically in the last few days before they do work on their own. Setting the tone early on is extremely important. During those first seven days, I always encourage folks to have a one-on-one with their supervisor to make sure you're sitting with them. And during that time, they schedule the consecutive supervision. You want to do that depending on how you feel the support they need. It may be 30 days. It may be 30 minutes in the first week. It may be an hour. And then as the weeks pass by, you can increase or decrease the time. One thing that I use throughout my tenure in my positions is using the Strength Refiners book, which identifies the strengths of the individual, and also giving them the communication style inventory. This identifies their communication styles under favorable conditions and sometimes under stress. During the time that you're doing the one-on-one, you can create a plan rather than waiting for the yearly evaluation. You can do it from the very beginning, asking them what they're passionate about, what they love to do different, what initiatives they want to be part of, what are their general interests in regards to whether they want to coach interns, whether they want to work with children, and so forth and so on. So the next slide is going to share information on my communication style. And what I do with this, I usually have my communication style and my team members, the people that work really close next to me, they also share the communication style. So as you can see here in green, Thinker and Intuitor are my top two communication styles when I'm under favorable conditions, meaning when I'm not stressed. When I become a little stressed, my Feeder becomes my preferred method of communication and my Sensor becomes number two. So in this situation, if I know that I'm in my Feeding, so to speak, I take time to respond to employees, make sure that I'm grounded before I have those interactions. And the whole team can understand the communication styles of one another, and this can facilitate team cohesion and understanding when someone is not at their peak. So now we're going to move on to the team structure, team inclusion in general. So in the first meeting with this new employee, we want to make sure that they feel welcome to their team's meeting and supervision. I highlighted the words their team meetings because it's part of what they do daily, and I want this to feel connected. Rather than say that team meeting is their team meeting, I want to encourage the words of using us in conversation, our team, the things that we do together. And during the first team meeting, you want to be creative and generate fun icebreakers. I usually, I can, you can use, for example, what is your favorite childhood memory, your favorite cereal, and as a joking way, I say oatmeal doesn't count, you can't use oatmeal. So when it comes to the structure of the team, the same way we send the seven-day plan before they start it, we want to send out the agenda a few days before the meeting takes place. And we want to encourage those team members to add agenda items if they wish. There's going to be one administrator that's going to determine, okay, this agenda item can be an email, or this agenda item is too long, let's move it for next week, or this agenda item is perfect for the next meeting. You also want to encourage and explain that there's going to be different roles within this this meeting in order to stay organized and respect everyone's time. You want to start on time and finish on time. I don't know about the people on the call, but personally, if the meeting is 45 minutes, I want to end the meeting at 40 minutes and even give them five minutes to transition to their next meeting or to the rest part of the day. And make sure that the employees are aware that this is a process where everyone is going to be included. The notes of that meeting, you want to keep them in a folder. This validates the information, and it keeps track of what you discuss, and in the future, if you have to, if you get out of it, you have the notes available, and it serves as accountability for the employees. So when you're having a monthly staff meeting, if you have multiple teams, this is usually what I do. The meeting template is going to share information about the different roles, the facilitator, the coach, the note taker, and timekeeper. We, I traditionally want to start the meeting with something happy, something that promotes the people still feeling together, feeling seen and feeling heard. Birthdays, celebration, promotions, anniversary, pictures of cute little babies. And allow about five to ten minutes in the beginning of the meeting. This doesn't have to be a full drawn-out process. And then you can move into the bulk of the meeting, which can be special trainings, the review of policy, discussions on things that occurred, an incident that you want to debrief, allow some questions in between or towards the end, it depends on your preference. And one of the most important aspects of the meeting is celebrating team members that are excelling. You can call that a shining star, you can call that a rock star. And usually it's one person, the person that say, I was highlighted in February, the person who was highlighted in February is responsible for having the conversation with the person who's going to be highlighted during the next month. You can have a picture of them when they were a baby, their favorite meal, the things that they were really interested in when they were young. When you're presenting this in the team's meeting, you want to ask the team members to guess who is this person? And people are going to go crazy writing information in the chat. And towards the end, and you can say the shining star is Amy Corwin, for example. And the team is going to share positive words and encourage this person or share memories that they have. And towards the end, you can have this specific person share a few words. In my experience, people love this part of the meeting. And at the end, you want to make sure you give people, like I mentioned before, five to 10 minutes to transition into the next meeting. The way you select, the way we have done it in the past, select the shining star or the rock star is using their birthdays or anniversaries. If there was birthdays and anniversaries in February, let's say, for example, it was my birthday, it was Amy's birthday, or it was Peter's birthday. If we select Amy, we create a running list that she was selected during this month. And when it comes around, the next person will get selected. One thing I want to mention during meetings, there's going to be times that you're going to have meetings without an agenda. And the agenda is basically to team them. You want to create some kind of dynamic where people can connect. If you notice that the energy is off, or people need to reconnect. And some idea of activity is playing a group game. We did one during holiday, like a trivia. Another employee came in one day, she brought different essential oils. We got to mix them and create our own oil and take it with us. I usually have one on my desk. So this is an opportunity for you to create team building opportunities. This is a brief example of a meeting template. It starts with the date, the time, location, the title of the meeting, and the roles that I mentioned earlier. Facilitator, it's me facilitating the webinar. Dr. Coyne is the coach. The next step is Maggie, the person who makes all these things happen for us. And Shereen Khan could be the one taking the notes. When it comes to the coach report, it's all these descriptions down here. You're basically going to talk about what went well during the meeting. If anybody dominated the meeting, what do you enjoy, just to continue to encourage the attendees. The note taker is going to be obviously taking notes. And the person taking the next step is identifying the who, what, and where, just to make sure that we say we're going to do something, then we follow up on what we're going to do. That's talking about demonstrating consistency and predictability, and also follow through. And this is a good example to keep us on track. So there's going to be other monthly meetings that I highly encourage. There's one that has to do with group consultation or group supervision. And this is more peer-to-peer. This is where you can share concerns. You can discuss cases. You can talk about best practice, motivational interviewing techniques. Another meeting that I encourage is a supervisor meeting, where the supervisors are going to be sharing ideas of things that are going well for them, standard operating procedures that they implemented are going well in their sites, and even share challenges that they're experiencing. One of the cool things about developing a team by understanding their intrinsic motivations and what they want to do is developing strategic initiatives. As I mentioned, when you're doing the first interview, when you're doing the one-on-one, you're going to identify that people have certain things that they gravitate towards, things that they want to do. And this may be around quality, about developing EMR systems of care, clinical scope of care. And what I mean is, what do you do with peds? What do you do with adolescents? The desire to coach interns or develop an MAT program. So what I usually do when it comes to strategic initiative, I identify the folks who really want to do. One of them can volunteer to be the leader and have a co-leader. And you have one or two other folks that can help develop and move the strategic strategic initiative to make it a practice. And people find satisfaction in doing these things. Another aspect that could increase motivation in a sense of wellness is a fun and wellness committee. You can implement whatever you want. But if there's somebody intentionally looking at, okay, the next month's activity is going to be on engagement. So what can we do to help the staff feel connected? Or what can we do the last meeting of the month? Or what can we do during the holidays? So this committee can plan ahead of time to make sure that people have that sense of connection and the team stays healthy. The yearly award ceremony, I've been doing this for about 10 years. And when I talk about the yearly award ceremony, I'm talking about a small team celebration. It doesn't have to be the agency gala. This small celebration is to accentuate what your team is doing well. Make it a big deal. Allow people to leave an hour or two before. Allow them to get dressed and celebrate one another. When they walk in, you can have theme music and you can cater some food. It's not going to cost you a lot of money. You can cater out with a few hundred bucks. You can make this very special. And the agenda is to recognize the accomplishments of your small team or big team, depending on your size. You want to identify there's somebody that came in new or somebody who's been there for a long time. Acknowledge any work that's been doing, like there's new programs that are being fostered, new initiatives. We did really good with volume and we have new grants. And then towards the end, you can try to find ways of acknowledging specific people that are above and beyond. For example, three categories, the rookie of the year, visionary, and partner of the year. Rookie of the year can be somebody who's been in the role for about a year, year and a half. You want to give a little flexibility on that one. And then you create some kind of like poll where people can vote with the people that have been there during that time. Visionary, people who demonstrate vision and look beyond what they're naturally doing in the day-to-day. You can have a few people on the list and they can select. And then partner of the year is usually somebody outside the scope of your team. This can be a medical provider. This can be a front staff that's checking people in. And that's just basically going to demonstrate that there's some form of integration that you will appreciate what that person is doing and you see how they complement your team. In general, the celebration has to be creative. You have to have some form of fun when you're doing it. Other retention strategies that I highly encourage is team bonding and creating in-work opportunities. There's a running club, getting together to do the NAMI walk, Zumba classes, and escape rooms. And this is part of what the fun and wellness team does. An escape room falls within outside of the work, but you get the logistics of what I'm trying to convey here. Some people feel comfortable meeting outside of work and this is maybe dinner, hobbies, and fun activities. Again, the fun committee can be leading that. If your agency has funds, encourage the continual education credit time and money. If not, investigate certain grants, offer part-time positions, or be creative with the roles. Oftentimes I hear people say we don't have any part-time positions and they're firm on that. What we have done in the past in certain agencies is allow people to go part-time. And if there's somebody that's either applying from the outside or internally, we can offer the other .5 FTE. So now you have two part-time positions that are accumulating for one FTE. Or you can be creative with the role. If somebody wants to do clinical work for half of the time and do QI for the other half of the time, that promotes a sense of understanding what they're interested in, and therefore they can actually help you do other things within the scope of your team. Offering hiring bonus or incentives for quality and quantity, being flexible PTO, and you have to be intentional to cascade how people are providing care and make sure that you don't have any gaps in care. Completing a competitive market analysis for each role, making sure that you're at least staying competitive with other agencies, and sometimes by increasing staff's salary from a $1,000 to $2,000 a year can make a huge difference and it's not going to cost you as much as a person leaving. Supervisors need to create the foundation for the team's positivity. It doesn't mean that you are 100% responsible for that positivity. It means that you have to foster. I believe that everyone on the team has the opportunity to make the team dynamics good. As a supervisor, I was encouraged to be reliable, to be available, and be a good listener. And towards the end of when the person is leaving or moving on, you have to celebrate there's people on their way out. In my personal experience, when somebody leaves an agency and nobody knows what happens, it leaves a bad taste in my mouth. So I would encourage you if there's somebody leaving, I'm thankful for what they're doing, highlight them in the next meeting, and if potentially you can't, a lot of agencies don't do this, you may want to encourage the practice of having exit interviews. There's been so many times that I have an exit interview with employees, they told me I was leaving the agency because I need to reduce my time. Why am I leaving the agency? Because I don't like this practice. And during the exit interview, they can share what they were feeling and sometimes we can do something about it. And other times, we can learn what we can improve on and change it for the next person. So how do we do this and sustain productivity? I always start with the end in mind. In my job, across my team, I've been doing this for a long time. If I need to, if one person has one point on FTE, this means that they have to have 28 hours of billable time, then I create a schedule with that in mind, maybe add a little more hours, maybe somewhere between 32, to make sure that they're seeing that amount of patients. One week, they may see 28, the other week, they may see 36, and things are going to kind of bounce out. Once you create the schedule, you can give them the opportunity to do something different. One idea is giving them working four and a half days and giving them a block of four hours to complete their admin time. Maybe you've been doing this at home. People love the idea of doing that in their private time and the work is done. You also want to make sure that they understand that there are specific expectations and eventually, they're going to tell you that this is really good for the work-life balance. Other ideas are having five days, shorter hours, or maybe having a hybrid model where they can work a few days from home and a few days off-site. You want to make sure that in your state, the off-site billable encounters can be tracked and you can actually receive the revenue. Not every state has that opportunity. You want to, like I said before, encourage employees to go part-time and maybe adjust their administrative time based on the involvement in initiatives. Here's an example. If you have three employees that are leading an initiative on quality, those three employees are going to be using three hours of productive time a week. Over the month, that's 12 hours. Those folks can do really good work. Rather than hiring somebody for 40 hours, these folks can help you with quality and the resources that you're using for that person can be used in a different way. I'm not saying that you don't need a quality person. I'm saying if you're looking for opportunities for people to engage in things that they want to do and try different opportunities, this is a way of doing it. Also, it provides opportunities for funding in other areas and to apply for grants. This is all the information I have today. This is a complementing webinar that you can look into. There's other areas that you can look at how to address burnout and enhance well-being for providers in the work setting. These are some references that I used throughout my presentation. That's all I have for today. Back to you, Amy. Hi. When I listen to you, I just think of how many ways I can improve. That's why this conversation is so important today. Before we get into the Q&A, let me shift and let everybody know that they can download the SMI Advisor. It's accessible from your mobile device. It's accessible from your mobile device. Use the SMI Advisor app to access resources, education, and upcoming events, complete mental health rating scales, and even submit questions directly to our team of SMI experts. Download the app now at smiadvisor.org forward slash app. Let's go forward and we will go to the Q&A. We'll just go down to slide 38. Let's talk about our Q&A. When I listen to this, number one, I think, wow, I would love to come work for you because it sounds like it's amazing the way that you really onboard people. People do give short shrift to onboarding, unfortunately. A lot of people asked about salary transparency in job ads. While you were talking, I looked it up. There are eight states that have laws about salary transparencies as part of the job ads and an additional six local areas, cities that have it as a requirement. Is there any reason that you can think of not to have the salary range in the position description? There are probably people on this call who don't have a law about it and they can choose. Is there any reason not to put it in there? Honestly, I believe in full transparency. There's a few team members that I worked with in the past that know that I try my best to share as much as possible. If your agency feels comfortable doing so, I will post the salary range within the job description. If it's not being posted there during the last interview, I always ask people, what are your job expectations? I say, okay, we're within this range. We can make it happen. I say, unfortunately, you're way off. We can't afford you, but we have other things that we can offer. I talk about this total package. These are the benefits. I talk about CME time. I talk about hiring bonuses and all the other things that we have to offer. Someone also wrote in that they don't feel good in the interview if they ask the person, hey, what salary are you looking for? Can you talk a little bit about whether you think asking that question is important? If so, what kind of information does that tell you that you can then work with? So the question is, if the interviewee is asking or the interviewer is asking, what is the salary expectation? Yeah. They're saying, sometimes I'm an interviewer and I've been told by HR to ask them, what salary do they want? I feel like that's really stressful for the interviewee. What would be the reason to ask that of an interviewee, what salary they're looking for? As I mentioned before, I think it's really important that we both know the expectations. If they're expecting a specific number and we can't meet that, it saves us time, is number one. Number two, if we're really close, it gives us the opportunity to go back to HR and say, we're about $1,000 off or $2,000 off, and this person seems to be a really good fit. Is there something we can do about that? So it gives us the opportunity to have that conversation. But I truly understand and acknowledge 100% that being asked what salary expectation you have could be stressful. So sometimes you have to ease yourself into the question. And you can even say, I know this may be a little hard for you to answer. I just want to make sure we're on the same page. What salary expectations do you have to make sure that we meet it in a way that they feel like it's not invasive? I think a lot of people feel similar to someone who wrote in who said, at my place, it's often framed that burnout is the person's problem, that it's not a systems issue. Right? So the fact that Amy Cohen feels really burned out is, you know, maybe Amy Cohen's kind of weak. She can't handle things. She's this, she's that, right? Rather than reflecting back on the organization and saying, how did Amy get there? Are there things we can do? Are there things we can do to support them? Are we maybe giving her too much, too many, you know, this out of the oven? So if I'm a person like this person who wrote in, who is working at a place that makes burnout seem like it's the person's problem, how do they begin that conversation with maybe their supervisors, or how do they begin the conversation to help the system see it's a systems issue? That's a really good question. In my previous role as director, we were looking at at an overall arching approaches to make sure we were addressing that. And one of the things we talked about is that connection that the supervisor and supervisee have. Not intentionally about burnout, but having that sense of transparency that you can talk about anything, right? So if I'm meeting with you, you're my supervisor, you give me the opportunity to share and express how I feel, there you can identify what's going on with me. That conversation leads to the next line, which is the other line of supervisor. And when you're brainstorming as leaders of an agency, you can identify different practices to help people feel acquainted or comfortable within their site. And by the way, if your agency is practicing trauma informed care practices, this is one of the top things they should be looking at. What can we do different to make sure that everyone feels satisfied and that we meet the need of the patients that are coming across our doors? First of all, the questions are just lighting up because first of all, almost every third note is that you've done an amazing job. But I think there's so many questions because people are struggling or know that they have colleagues who are struggling and really are invested in making their home place of work better, right? Everybody's looking for ways to improve. One person said when posting goals, what kind of goals do you think about when you're moving somebody from a clinical role to a more administrative role? How is that change different? And so what are you kind of looking for? What kinds of skill sets are you trying to build in for that kind of transition? Yeah, that's a really good question. And sometimes the clinical role is always going to be connected with administrative roles or more like programmatic. So I'm really looking at people who can have a follow through, who can pay attention to the close details, who understand nuances that other people don't understand. For example, when I was working at Erie Family Health Services, I had a colleague, her name is Sylvia. And I understood that I wasn't good developing the system that we documented was called Epic, but I knew that she was. So my responsibility was to make sure that I hand it down to her, that she can do the work and I can support her while I do the other work. So it's recognizing talent and recognizing what it takes to actually complete certain tasks. A lot of people reacted to your... First of all, I loved the setup that you have for the meeting and this idea of starting with something positive. I really love that. A lot of people had some reactions to the prizes, the rock star, the whatever. Some people said, well, we got stuff like that at our place. And it's always the same four people that get them. The people who are kind of the top level and how can we change that? And one thing I was thinking about and kind of responded to that is, for example, having colleagues and staff be able to nominate people for rock star, not just having a CEO or the supervisors pick the rock stars. What do the colleagues say? Are they good to work with? And they nominate them. But some people also said, we've got these awards, we've got these stuff and still we're really struggling with burnout. Are there other ways? And you named a couple, but can we just kind of brainstorm a little bit here out loud? What are some other things we can do at our office to make people feel valued, that they're on a team, that we are all working and rowing in the same direction? What can we do? There's different ways. I mean, in the past, even it could be a very small thing. I try my best to put in my phone when somebody's, their birthday was coming up, their anniversary was coming up. And I know I was the director of the department, but I think it speaks volume when I can recognize that it's your birthday today, happy birthday, or identifying the certain things that they can do. Sometimes it's even the small details, bringing donuts to a team meeting. Sometimes it's a small detail to say, Noah, you guys had a long week, we're not having a meeting. And sometimes people feel relieved by not having those meetings that are necessary. And this is a funny one, but I'm trying to, I try to be intentional of not having a meeting where I could have sent an email. Because oftentimes there's all these meetings that we have and people said, people have transparency when we will say that could have been an email. So there's different things that we can do. But one of the most important things is listen to understand not to respond. So if somebody is telling you something, and this is something I'm still working on, listen to what they're saying, not necessarily how they're saying. So as a supervisor, absorb the information and give it time to respond. And feeling heard, being seen, speaks volumes in regards to how you feel part of the agency. And I think one of the things I often think about is you don't always have to have the answer right then. Just like you said about listening, sometimes you need to say to the person, this is really interesting what you brought up today. I'm going to sleep on it. I'm going to come back with a couple ideas tomorrow, right? Because it lets them know you're really thinking about it. And if there was a clear answer, they would already come up with it, right? And so you're kind of saying, listen, let me think about that. And so I do think, or even saying, if you were in my shoes, what do you think we should do? What are some ideas together we can brainstorm? I think this whole idea of de-emphasizing hierarchy, right? We're kind of all in this together, right? We're all trying to meet this mission, and we're all trying to bring everybody along in the boat. And so if anyone's struggling, that's not going to be good for anybody, right? And so that idea of kind of bringing them along, and I got that a lot in your talk today, this idea of looking to your neighbor, seeing how they're doing, remembering, do they have kids? Are they taking care of their elderly mother? Did they recently have COVID? Just remembering, like you said, when you gave them the mug on the first day, I remember in the interview that you said how much you love coffee. Just remembering these little things makes a real difference for all of us. It makes us feel part of something bigger, which is so important. And Amy, there's certain times that I don't have a good relationship, or maybe they're afraid to talk to me, but I know somebody else has a good relationship with somebody struggling. And I can say, you know, I noticed that Peter's a little off today. You mind checking in with him, make sure he's okay? Or you mind encouraging him to take a day off? There's even times where I see the physical fatigue in people's faces, and say, you know, you worked hard today. I think you should take a break. You take an extra hour today. So it's the little things that I think that people feel connected with. Not necessarily the big system approaches, which is really important, but as a supervisor, as a team member, as a colleague, just smiling sometimes, saying, hey, I notice you're not feeling your best. How can I support you? Those things really matter. Right. And just as a side note, of course, we have to take good care of ourselves so that we have the space to be able to look at our neighbors and see if they're doing okay. So it's self-care and looking at our neighbors. It's hard for me to smile every morning if I'm also feeling down and overworked, right? So we do have to do a lot of self-care or at least checking in with ourselves periodically. And sometimes you set up something with a partner, like, that you just, a person you feel safe with, that you can talk to at work when things are just not going your way. But overall, it's encouraging. Encouraging the share of ideas. When we're talking about team, everyone has a specific role in the team. My title can be the director. We can have managers. We can have supervisors. We can have front line staff. My job is not more important than anybody else's job. So everyone has the opportunity to share ideas. Everyone has the opportunity to hold everyone accountable. There's team members that I used to work with on this call right now that know that if I said something that made them feel bad or made them feel a certain way, they have the opportunity to come and talk to me and say, Jose, what you said hurt me. And I have to take a step back and listen to what they're saying. But at the same token, everyone can share ideas. Everyone's a part of the process. So that's another strategy that can highlight team chemistry and belonging. Right. I mean, everybody's an expert at this job that we're at. Right. We see it differently. We experience differently. And we all bring something to it. As a supervisor, you do have to get comfortable with people letting you know when you've messed up or when you've taken a misstep or when you've said something that they just didn't sit right with them. And instead of feeling as if that's a critique of you, think about the fact that, wow, they felt comfortable enough with me to tell me that. They felt comfortable and safe enough to say that to me. And that is kind of then you can work with it from there. And I think that's really important. Jose, I love working with you myself. So I'm glad that we got to do this together today. And let's roll through our last few slides. And so if there are any topics that we covered in this webinar that you'd like to discuss with your colleagues in the mental health field, please post a question or comment in our SMI Advisor Discussion Board. It's an easy way to network and share ideas with other clinicians who participated today. If you have questions about this webinar or any other topic related to evidence-based care for SMI, you can get an answer within one business day from one of our SMI Advisor National Experts on Serious Mental Illness, of which Jose is one of those individuals. This service is available to all mental health clinicians, peer support specialists, administrators, and anyone else in the mental health field who works with individuals who have SMI. It's completely free and confidential. SMI Advisor offers more evidence-based guidance on burnout, such as the webinar Evidence-Based Strategies for Addressing Burnout and Enhancing Well-Being for Mental Health Providers. This webinar presents an overview of research on burnout and points to strategies based on theory and empirical evidence that may be helpful in addressing burnout and enhancing well-being at work. Access the webinar by clicking on the link in the chat or by downloading the slides and linking there. To claim credit for participating in today's webinar, you need to meet the requisite attendance threshold for your profession. After the webinar ends, please click Continue to complete the program evaluation. The system then verifies your attendance for credit claim, and this may take up to one hour. It can vary based on local, regional, national web traffic and the usage of Zoom platform at the time that we're presenting today. So, be patient. It may take up to an hour, but you will be able to get your credit claim. Please join us in two weeks, on April 4th, as Kevin Martone, Vesper Moore, and Brenda Vezina present Expanding Peer Support Services in Rural, Remote, and Tribal Settings. Again, this free webinar will be April 4th, 2024, at 3 p.m. Eastern Time. That's a Thursday. Thank you for joining us today. Thank you, Jose, for being on a team with me and for being a wonderful faculty today. Until next time to our audience, take care, everybody. Bye-bye.

Dr. Amy Cohen

SMI Advisor

webinar

Strategies to Increase Staff Morale and Retention

Decrease Burnout

evidence-based care

staff well-being

team cohesion

Jose Verrett

Thrive for Wellness