Sunday, July 18, 2010

Sunday Musing on Meetings, Team Form and Function

I went to a meeting the other day. It was a meeting of minds. There were some extraordinary minds in the room and I have to admit that I developed a case of imposter syndrome that kept my usual disregard for the rules of engagement in check. Reflecting on the meeting, the agenda and the recorded notes (along with several other meetings of late), I find myself wondering about the meeting and team building process.

The reason for this particular meeting was to bring together a group of people who were interested in research and program development in a specific area. That area being to “help” a group of folks that traditionally struggle with education and training; the multi-barriered, the difficult to engage; those in recovery; the round peg people who don’t fit into the square peg classroom.

The other criterion, for invitation to this meeting, was an investment in creativity, working outside the box. It’s this second part that I’m reflecting on. It’s this second part that won’t leave me alone, it’s bugging me, irritating the inside of my skull and I know from experience that the irritation will not stop until I fully explore it and find some kind of solution at best, closure at worst. So here goes.

The meeting started pretty much like all meetings. After a bit of shuffling rooms we each introduced ourselves, in the usual meeting type way of reciting our business cards. This was an initial meeting so we spent most of our time very respectfully trying to articulate our purpose. I had a great, unshared, epiphany during this time. There are educators that do not Twitter, Facebook or wiki. I had managed to remain blissfully blind to that. It was a rude awakening.

Technology related differences aside the strand of thought that keeps running through my mind is a quote from Einstein. He said “We can't solve problems by using the same kind of thinking we used when we created them.”

If we want to do something creative, outside the box, innovative and un-traditional I am doubtful that sitting in a traditional meeting room, have a traditional meeting and following a traditional meeting script is going to move us toward that vision. There are too many mental models that get set to auto- play mode when we enter any kind of traditional space. It’s like we are all actors on a stage with a pre-defined script (nods to Shakespeare). If we are to do something different we need to stage it differently. To get people thinking outside the box you have to take the box away, shake them (us) up a bit so that the script they came in with gets lost or at least helps them forget their lines.

Interestingly we talked about doing that at a later date by staging an un-conference that includes the folks we are trying to provide the net for. I say “net” because in a way that is exactly what we are trying to do. We want to capture these folks in a net that can gently hold them long enough to allow them to create their own nets, be it a safety net, network of support or personal learning network.

For this to work well I think we need to use and model the same process. We need to have un-meetings, and by that I don’t mean we have to enter a state of complete chaos. I do think that we can look to leaders in the field of meeting and mental models for some ideas on how to do things a bit differently.

Patrick Lencioni author of Death by Meeting, The Five Dysfunctions of Teams and other great guides provides some usable ideas around having great meetings and building functional teams. He provides a model of the five dysfunctions of teams that begins with trust as the foundation. The absence of trust, emotional trust, and fear of being vulnerable has to be resolved so that the fear of open conflict doesn’t stall the team’s efforts. He goes on to suggest that teams that don’t embrace unfiltered conflict risk lack of commitment. Genuine buy-in only occurs when every possible dissention is voiced and worked through.

With these three foundational stones in place accountability and attention to results are more likely. Lencioni says “teams that trust one another, engage in conflict, commit to decisions, and hold one another accountable are very likely to set aside their individual needs and agendas and focus almost exclusively on what is best for the team”. In addition to the model he provides lots of exercises that can get any team to the alignment stage quickly and relatively painlessly.

Alignment is a word I associate with Peter Senge. In his book The Fifth Discipline: The art and practice of the learning organization he covers a massive range of thinking and process around using systems thinking to create organizations that embrace and manifest generative learning. His focus tends toward the Vision being the guide and he includes a discussion about attitudes toward vision that makes the distinction between commitment, enrollment and compliance. On the committed person he says, “The committed person brings energy, passion, and excitement that cannot be generated by someone who is only compliant. The committed person doesn’t play by the rules of the game. He is responsible for the game. If the rules of the game stand in the way of achieving the vision, he will find ways to change the rules. A group of people truly committed to a common vision is an awesome force” (p. 205).

Senge goes on the discuss alignment saying that alignment is the “necessary condition before empowering the individual will empower the whole team” (p.218). The easiest way to understand what he means by alignment is to think of great jazz musicians or winning basketball teams. There is a state of flow or a “groove” that happens on occasion that exemplifies true alignment. With jazz musicians and basketball players there is a set of skills that they need to master before they, as a group, can find flow. The same can be said about other kinds of teams.

The mastery of four skills- inquiry, reflection, dialogue and discussion - are the requisite skills of the types of teams I’m writing about. Chris Agyris, like Lencioni points to barriers that keep teams from reaching the critical level needed to achieve alignment and full functionality. Argyris talks about an internal script called “defensive routines” as being one of the chief barriers to learning and creating effective teams. Agyris teamed up with Donald Schön in the early 70’s and suggested that:

“...people have mental maps with regard to how to act in situations. This involves the way they plan, implement and review their actions. Furthermore, they assert that it is these maps that guide people’s actions rather than the theories they explicitly espouse. What is more, fewer people are aware of the maps or theories they do use (Argyris, 1980). One way of making sense of this is to say that there is split between theory and action.(http://www.infed.org/thinkers/argyris.htm)

The skills of inquiry and reflection can go a long way in exposing our own internal maps. However it’s usually through dialogue and discussion with others, ideally with those who are also skilled in these areas, that our hidden and often self and team-limiting mental maps can be more fully examined. To do this kind of work however begins with a team that has built the necessary foundation of trust, so they can embrace open conflict… and we’re back to Lencioni again.

Perhaps the best article I’ve read that relates to this is Dialogic Leadership by William Issacs. In this paper he outlines four actions that can and should take place in a team conversation. Issacs references David Kantor, a well-known family systems therapist saying that “Kantor suggests that some people move—they initiate ideas and offer direction. Other people follow—they complete what is said, help others clarify their thoughts, and support what is happening. Still others oppose—they challenge what is being said and question its validity. And others bystand—they actively notice what is going on and provide perspective on what is happening.”

He goes on to say that, “in a dialogic system, any person may take any of the four actions at any time. Although people may have a preferred position, each individual is able to move and initiate, to follow and complete things, to oppose, and to observe and provide perspective. None of these roles is better or worse than the others. They are all necessary for the system to function properly. As people recognize these different roles and can act on this recognition, they begin to create a sequence of interactions that keeps the conversation moving toward balance.”

By integrating the concepts of inquiry and advocacy to the 4-player model you get a fuller picture of the route to effective dialogue and discussion that can keep teams moving in the direction they want to go.

This is turning into a very long blog and I haven't even gotten to bio-teams and community as curriculum so I think I will end this here and continue in the next blog.

Saturday, July 03, 2010

Substance abuse and unemployment - literature review

Apologies ahead of time for the odd citation scheme...

This is a result of a brief survey designed to determine the percentage of unemployed individuals who are substance abusers. The survey was conducted over a three day period and is in no way an exhaustive or thorough treatment of the subject. The survey included a phone interview with a representative of the Chilliwack office of the Human Resources and Skills Development Canada (HRSDC) and a literature review.

The HRDC representative indicated that he could not locate any data that identified those with substance abuse disorders who were accessing assistance under the Persons with Disabilities (PWD) or the Persons with Persistent Multiple Barriers (PPMB) programs. He did acknowledge that there were probably many unemployed persons who would be considered “substance abusers” currently accessing these programs. The lack of easily accessible data around this does not necessarily mean that the HRDC data base could not yield this type of data, only that is was not accessible through that office at that time.

In reviewing the literature I found that there is substantial research that supports the theory that there is a positive correlation between substance abuse and unemployment. However quantitative data that would provide statistical information about individual’s concurrently experiencing unemployment and substance abuse was scant with only one major research study found that focused on Canadian data.

The Canadian Center on Substance Abuse published The Costs of Substance Abuse in Canada 2002 as an aid to understanding and interpreting the original report of the same name, written under contract by Rehm et al., (2002, 2006). This document and the original report focused on the costs of substance abuse with one of the costs being the indirect costs associated with loss of productivity. “By comparing average income levels reported by those with a substance abuse problem and those without a substance abuse problem, it is possible to calculate the difference, which becomes an economic cost attached to illness and injury linked to substance abuse” (Rehm et al., 2006). Productivity loss was further defined as short and long term disability attributed to substance abuse.

In 2003 the productivity loss due to substance abuse overall was calculated to be $24 billion or 61% of the total social costs. The cost of loss of productivity, due to long-term disability was calculated to be approx. $6 billion due to alcohol abuse and 4.4 billion due to illegal drug use. (Rehm et al., 2006).

Following are excerpts that pertain to the question of - What percentage of unemployed individuals also abuse substances?

According to a 2002 United Nations report … there is a correlation between unemployment and prevalence of substance use in many countries; and prevalence of illicit drug use is higher among younger age groups (18-25 years of age) in practically all countries.1

Goodman and Hankin presented their research findings that examined “both direct and indirect impacts of alcohol consumption on labor force participation and income, with controls for drug abuse and smoking (2006).

… study uses the recently collected National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), designed to be the primary source for information and data on the U.S. population for alcohol and drug use. The NESARC provides multi-dimensional information on alcoholism, drug abuse, and cigarette smoking, as well as excellent individual and labor market information.

Separate analyses by gender show that alcohol use significantly impacts the choice between part-time and full-time employment. Heavy drinkers are more likely to be unemployed or part-time workers compared to lighter drinkers or abstainers. In contrast, alcohol use has an insignificant impact on income conditional on employment.

Conclusions: The labor force impacts of alcohol and substance abuse are complex. The alcohol impacts are most pronounced with respect to labor force participation, and full- v. part-time employment. Drug use has its major impact on men with respect to labor force participation (less likely to be full-time) and health (worse health). Women who use drugs are also less likely to work full-time and will have worse health. 2

Renwick and Krywonis (1992) suggest that unemployment for substance abusing individuals is “much higher” than the averages for unemployment rates in North America citing statistics by the Addiction Research Foundation which produced a mean annual rate of 36.9%. However these statistics were from data collected from 1986-89.

It is a recurrent and well-documented theme in the addiction literature that unemployment and vocational instability are serious problems among persons who abuse substances (Gardiner, 1978; Peachey, & Franklin, 1985; Waldo, & Gardiner, 1984).

Annual intake records between 1985 and 1989 for the Addiction Research Foundation (Clinical Institute) in Toronto, Ontario indicate that unemployment for this population is much higher than the current average rates for North America (Addiction Research Foundation [ARF], 1986, 1987, 1988, 1989). For the 14,659 substance abuse clients reporting their employment status during this period, the mean annual rate of unemployment was 36.9% (ARF, 1986, 1987, 1988, 1989).

Employment difficulties for individuals who abuse substances are related to both obtaining and maintaining work (Renwick & Krywonis, 1988; Yates et al., 1988).

A retrospective interview study of clients admitted to a treatment facility for substance abuse intervention demonstrates drastic declines in vocational productivity over the year prior to their treatment (Gardiner, 1978). This research also indicates that vocational stability, measured in terms of the number of jobs held, is generally poor during this period.

Another study focused on maintaining employment following residential treatment for addiction suggests that employment stability deteriorates markedly from one month post-discharge and onwards (Waldo & Gardiner, 1984). This research underscores the need for particular attention to "job survival" (Gardiner, 1978, p. 502) skills.3

Dooley and Prause measured the impact of unemployment and underemployment on alcohol misuse in the National Longitudinal Survey of Youth concluding that job loss increased risk of alcohol misuse.

… these results confirm previous findings that job loss can increase the risk of alcohol misuse, provide new evidence that two types of underemployment (involuntary part-time and poverty-level wage) can also increase this risk and suggest that these effects vary over time.4


In the Journal of Health Economics, MacDonald and Pudney published results of their research on Illicit drug use, unemployment and occupational attainment (2000).

… we find compelling evidence to suggest that drug use, particularly the use of opiates, cocaine, and crack cocaine, is associated with an increased risk of unemployment, regardless of age or gender.5

In a study titled, Barriers to Employability Among Women on TANF With a Substance Abuse Problem researchers found that women who abused substances spent more time on welfare that non-substance abusing women.

In a comparison of cumulative total years receiving welfare benefits for the substance abuse and non-affected samples. The substance abuse sample spent significantly more total time on welfare than the non-affected sample.
On average the substance abuse sample spent 12 years (SD=8.5) versus 5.8 years (SD=5.5) for the non-affected sample. Research also indicates that groups differed for long and short stays on welfare. About 36% of substance abusers received welfare benefits for more than 15 years versus only 7% of the comparison sample. Conversely, 66% of the non-affected sample received welfare benefits less than six years versus 28% of the substance abuse sample. (see here for full report)

In the 2002 National Survey on Drug Use and Health, Substance Abuse and Mental Health Services Administration (SAMHSA) reported the following:

• Current employment status was highly correlated with rates of illicit drug use in 2002.
o An estimated 17.4 percent of unemployed adults aged 18 or older were current illicit drug users compared with 8.2 percent of those employed full time and 10.5 percent of those employed part time.
o Of the 16.6 million illicit drug users aged 18 or older in 2002, 12.4 million (74.6 percent) were employed either full or part time.
o Most binge and heavy alcohol users were employed. Among the 51.1 million adult binge drinkers in 2002, 40.8 million (80 percent) were employed either full or part time.
o 12 million (79 percent) of the 15.2 million adult heavy drinkers were employed.

• Among Unemployed Adults the rate of drug use was higher among unemployed persons compared with those from other employment groups.
o 17.4 percent of unemployed adults (18 and over) reported current drug use.
o Binge and heavy alcohol use rates were higher for unemployed persons (34.7 and 13.3 percent, respectively, for binge and heavy use) than for full-time employed persons (29.0 and 8.4 percent, respectively).6

References

J. Rehm, D. Baliunas, S. Brochu, B. Fischer, W. Gnam, J. Patra, S. Popova, A. Sarnocinska-Hart, B. Taylor. In collaboration with E. Adlaf, M. Recel, E. Single
The Costs of Substance Abuse in Canada 2002 March 2006 http://www.ccsa.ca/2006%20CCSA%20Documents/ccsa-011332-2006.pdf

Single, E., Robson, L., Xie, X., and Rehm, J. (1996). The Costs of Substance Abuse in Canada. Canadian Center on Substance Abuse, 75 Albert Street, Suite 300, Ottawa, Ontario, Canada K1P 5E7.

1. United Nations Office for Drug Control and Crime Prevention, Global Illicit Drug Trends 2002, New York, 2002, p. 213-14. As cited in The Policy for the New Millennium: Working together to redefine Canada’s drug strategy interim report of the special committee on non-medical use of drugs. Paddy Torsney, M.P. Chair December 2002

2. Goodman, A. C. and Hankin, J. R. , 2006-06-04 "Employment and Income Effects Related to Drinking with Controls for Drug Abuse and Smoking: Analysis Using the NESARC Database" Paper presented at the annual meeting of the Economics of Population Health: Inaugural Conference of the American Society of Health Economists, TBA, Madison, WI, USA . 2009-05-25 from http://www.allacademic.com/meta/p89538_index.html

3. Renwick, R M., Krywonis M., 1992. Personal and Environmental Factors Related to Employment: Implications for Substance Abuse Intervention. The Journal of Rehabilitation, Vol. 58

4. Dooley D, Prause J. (1998) Underemployment and alcohol misuse in the National Longitudinal Survey of Youth. J Stud Alcohol. 1998 Nov;59(6):669-80.
Department of Psychology and Social Behavior, University of California, Irvine 92697, USA

5. MacDonald, Z, Pudney, S., Illicit drug use, unemployment, and occupational attainment, Journal of Health Economics, Volume 19, Issue 6, November 2000, Pp.1089-1115, ISSN 0167-6296, DOI: 10.1016/S0167-6296(00)00056-4. (http://www.sciencedirect.com/science/article/B6V8K-415RGRX-D/2/25325048818b5f76c2b2b0bcc6bc56de)

6. Substance Abuse and Mental Health Services Administration, Results from the 2002 National Survey on Drug Use and Health: National Findings, September 2003.