Leading Agendas for Behavioral

Health and Well-Being: The

Experience of an Internal
Integrated EAP/WORKlife Program
Kathleen Beauchesne, PhD, MBA, MSW, LCSW-C
Johns Hopkins Institutions
EASNA Annual Conference 2006
Toronto
 Goals and Objectives
 Discuss the critical leadership role that
integrated EAP and WORKlife programs
must achieve in work organizations
 Participants will learn:
 One tool for leading change
 How to develop Advisory Committees to
achieve strategic objectives; the value of
management committees and their importance
to program goals and objectives; the use of
leadership retreats; and
 The theoretical models used to guide
leadership on these issues
 Background Information
 Internal EAP, WORKlife and Student Assistance
Programs
 Johns Hopkins Institutions
 Johns Hopkins Hospital and Health System
 Johns Hopkins University
 Global organization
 55,000 faculty, staff, employees and students
 FASAP, WORKlife and Student Assistance
 The Challenge Facing
Academic Medical Centers
 Three lines of “business”
 Challenges
 Technology
 Changes in funding patterns
 Health care reform
 Diversity
 Corporate competition
 Critical Issues

 Adaptability and change

 Competition
 Recruitment and retention
 Productivity
 Benefits costs
 Value human resources
 Leading Agendas for
Change
 Integrated Human Services Model (IHS Model)
 Conceptual framework
 General systems theory
 Built on a systems model that reflects our view that universities
generally (and JHI specifically) is a network of communities
encompassing a complicated system of interrelated parts.
 Administrative Structure: Office of Human Services
 Mission: to support the fundamental purposes of the JHI to provide
cutting edge healthcare, education and research
 Career Management Program
 Center for Training and Education
 FASAP (EAP)
 Organizational Development and Diversity
 Office of WORKlife Programs
 IHS Model
 Model is consistent with a life-span human
development perspective for intervention; approach
emphasizes growth and change
 Incorporates statements about desirable goals
 Focuses on sequential change
 Emphasizes techniques of
optimization/empowerment rather than remediation
 Considers the individual or system as an integrated
bio/psychosocial unit amenable to a multi-
disciplinary approach to service delivery
 Views individuals as developing in a changing
cultural context
 Key Elements of the IHS
Model
 Systemic analysis
 facilitates the planning and delivery of our interventions
 Assessment
 most critical and valuable service that can be provided
 Timing of the intervention
 is important;
 evaluate every request with a review of the context of the situation that comes to our
attention as well as the impact of the problem on the person, their family, the work-team,
other related organizational units and the organization as a whole
 Interventions
 psychotherapeutic, family-centered, career oriented, organizational and directed at training
and development needs
 Design evaluation and research studies to assist in a formal assessment of the model
 Client management systems
 an integrated management information system that facilitates the gathering of compatible
utilization and evaluation data
 Human services delivery team meets regularly to discuss cases and consider
mechanisms for increased collaboration and integration
 The entire Human Services staff meets bimonthly to assure continuity
FASAP/WORKlife Integrated Infrastructure
Model
FASAP
WORKLIFE
  AA
 Early childhood education
Employed Adults INFRASTRUCTURE
Employees across the life span
MH and SA incidence and prevalence INTEGRATION
Demographics driven
driven Access
Licensed professionals Administrative Support Cognitive/psycho-educational approach
Intake Life cycle model
Clinical approach/medical model Client Services
Event Planning Utilizes national policy
Mandated drug testing /managed care
Data Management Support groups
Disciplinary process Financial Management
Risk Assessment Follow-up
Psycho-educational information
Databases of community resources
Credentialing of resources
Core consultation skills
Technology
Serve same clients
Supervisory training
Team practice
Advisory Board
SAP
Academic and social concerns
Rooted in K-12 programs
Safe, drug-free learning communities
Resilience and student success
Educational activities
Support groups
Integrated approach
 Theoretical Foundations
 Social exchange theory
 Social justice theory
 Role theory
 Life course/developmental perspectives
 Systems theory
 Leading Change
 Framework: (Kotter, JP. (March-
April,1995). Leading Change: Why
Transformation Efforts Fail. Harvard
Business Review)
 Eight Steps to Transforming Your
Organization
 Kotter’s 8
 Create a sense of urgency
 Form a powerful guiding coalition
 Create a succinct, compelling, noble vision
 Communicate the vision—do all you can
 Empower others to remove obstacles
 Create short-term wins
 Don’t declare victory too soon
 Anchor the change in the culture
Thoughts About Organizational
Change
 Must occur through a series of phases
 Stalled change efforts can be re-started and re-invigorated
 Requires a considerable length of time
 Find plenty of programs and plans—but no vision
 It’s not necessarily about the data
 Frequent communication is essential
 Must create a coherent, intellectual framework that reflects the
culture
 “Champion” models of change are not sufficient
 Coalitions are very powerful and can start small—but must grow
 Change must sink into the culture—a process that can take 5-10
years
 You must take care of the change effort and help people see the
right connections
Key Issues and Critical Events:
Opportunities for Organizational
Change
 FASAP started 1987
 Child care on campus defeated 1989
 Provost’s Committee on the Status of Women (WEFIS Committee)
 Women’s Forum
 WORKlife Programs 1993
 Aging Workforce Data 1993-1994
 Work Family Conference 1995
 Leadership Retreat
 Rex Chow Murder and the Campus Task Force on Violence 1996
 Work Family Task Force Report 1997
 Task Force with 4 subcommittees
 Matrixed the recommendations and completed in 5 years
 Proposal for Individualized Flexible Work Arrangements 1998
 FASAP Budget Cut 40% 1998
 Creation of the Management Committee
 Layoffs of EAP clinicians
 Workplace Violence—Risk Assessment Policies and Procedures 2000
 3 Committees
 Institution-wide retreat
Key Issues and Critical Events:
Opportunities for Organizational
Change
 Developed first Student Assistance Program
 September 11th: Mental Health Disaster Planning Report/Child Care
Disaster Planning 2002 and 2003
 Institution-wide Committee
 Steering Committee
 Child Care Disaster Planning/Gap Analysis
 FASAP/ WORKlife Advisory Committee 2003
 Aging Workforce Data
 Developed 2nd Student Assistance Program
 Advisory Committee
 Provost’s Committee on the Status of Women 2004
 Two students murdered off-campus in 2004/2005
 Domestic Violence Task Force 2005
 Flexibility Project of the Advisory Committee
 Workplace Violence Brochure: mailed to 55,000 faculty, staff and
students
 Organizational Structures
Used to Achieve Change
 Advisory Committees
 Think tank
 Management Committees
 Retreats
 Task Forces
 Work Groups
 FASAP/ WORKlife Advisory
Committee
 Charged by the Vice Presidents of HR
 Charge to FASAP and WORKlife
 Provide guidance and direction to the leadership of the
University and the Health System on how to update our
policies, practices, and procedures to keep abreast of the
changes in the nature of work, in the workforce, in our
institutions, and in the economy
 Think Tank
 Thought-leaders invited to be members
 Topical White Paper Reports Annually
 Form a coherent, intellectual framework for addressing
challenges facing the institutions
 Goals of the White Paper
 Recognize that the issues are social issues that require
Hopkins and other stakeholders working together
 Recognize the difference between policies and procedures
geared to a workforce that no longer exists and the current
realities facing Hopkins and its employees
 Reframe problems as systemic in the way the work gets done
 Develop institutional organizational support of work/life
integration, health and well-being
 Recommend new policies and arrangements that mesh with
current realities of Hopkins and its employees and families at
all stages of life
 The White Paper
 Survey of trends and impact on the institutions
 Integrated perspective
 Systems approach

 Life course/human development approach

 Capture knowledge
 Costs and investments
 Outcomes
 Bring the message home to Hopkins
 From the Committee
Meetings
 Describe the forces that will impact the workforce within
Hopkins.
 Address multiple types of workforces and the impact of the
shifting demographics. There are different businesses across
the institutions including health care, education and research.
However, there are common themes.
 Isolate the common themes across the institutions
including aging, diversity.
 The Committee believes there is enough commonality across the
institutions that the themes will speak to everyone—however,
there are trade-offs to this approach. The Committee will be
able to focus more directly on specific issues in future white
papers.
 Examine the data on part-time employees.
 We know very little about these employees, and they make up a
sizeable portion of our workforces.
 Organizing Themes
 Concept of “organizing themes” as central
driving points
 Example: threats to academic freedom,

shifting federal funding, current security

policies, shifting demographics, shifting
paradigms
 How do threats ripple through our workforce?
How are our employees affected?
 Threats to excellence/threats to quality?
 FASAP/WORKlife Advisory Committee
Trends
White Paper Project
Globalization
Technology
Economic Pressures
Cultural Issues Time Squeeze
Flexibility Financial Pressures
Spillover
Accomodating Work
Arrangements

Increasing Diversity
Government

Work Organizations
Work

Hopkins
Current Labor Force
Work and Changing Labor Force
Health Family
Personal Life
Recruit
Retain
Flexibilit
Future Laborforce Employee V
Benefits Red
Well-being Skills Prepa
Work Red
Community

Goals Theory Unions

Maximize human capital Role Theory
Minmize human resources costs Social Exchange
Improve organizational performance Social Justice
 Survey Results by Category:
Top 6
 Employment, wages and benefits
 Impact of increasing health care costs
 The workforce
 Increasing the diversity of our workforce
 Aging of our workforce
 Work conditions
 Addressing health and well-being of employees
 Addressing the need for flexibility
 Necessity of supervisors to acquire new skills to manage in today’s complex
environment
 Missing categories
 Work and family
 Working with other stakeholders
 Leadership Retreat
 60 leaders across the institutions
 Facilitated by OD
 Wrote goals statements
 Force field analysis
 Current and desired state
 Action steps on each trend
 Volunteers to work on committees
 Setting Up the Model for
Success: Flexibility Project
 Guided by the Advisory Committee
 Parts of this project are build on previous work
 Draws from the Retreat
 Examines the interrelationships between aging, health
and well-being, diversity, increasing health care costs
and supervisory training AND Flexibility
 Issue a report and recommendations to the committee
 Other Important Tools
 White Papers
 Annual Reports
 Organizational Assessments/Audits and
Gap Analysis
 Data
 Organizational demographics
 Benchmarking
 Trends
 Consultants and Vendors
 Managing Up
 Implications
 Our unique position in healthcare, education and research
provides us with the opportunity to be a national leader
 We must make the link between what we know about what
people need and our policies and practices
 Our traditional assumptions, values and beliefs about work
must be examined
 Breadwinner models of work and family are embedded in the way
we work today
 Adding additional hours to a person’s work day may lead to stress
and burnout in knowledge and service workers
 Our organizational strategies deal with those individual problems
brought to the office door
 In Summary: 3 Points
 Developing another program or another service is not the only
answer
 EAPS and WORKlife programs been privileged with a wide-ranging,
rare, and unusual view of the personal and work-related stresses
that a set of demographic, social, economic, political and cultural
changes have wrought on the workforce
 At Hopkins, EAP and WORKlife have had the unique opportunity to
assess the effects of these changes on employees of the Hospital and
the University from those barely getting by to the most privileged of
workers in healthcare, education and research.
 Among all our workers, reports of stress, overwork, job insecurity, and
difficult balancing the dual roles of work and family are common
 We have a responsibility to provide leadership and guidance on this
set of issues
 Questions

Kathi Beauchesne
kbeauchesne@jhu.edu