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March 2010 – Tips &Topics

TIPS & TOPICS from David Mee-Lee, M.D.
Volume 7, No.11
March 2010

In this issue

— SAVVY   – Staff Morale and What’s Bugging You?

— SKILLS   – How to Express Powerful Appreciations

— SOUL – Singapore, China and AA
— SUCCESS STORIES  – Conflict: The Benefits of a Policy
— Until Next Time

Welcome to the many new subscribers to TIPS and TOPICS.  Accessing TNT issues just got easier. Look for the button on the right hand side of the home page of The Change Companies


Massive State budget deficits are leading to severe cuts in many mental health and addiction services. Hiring freezes increase caseloads and stretch people and programs to the breaking point. Staff morale is taking a beating. If this is not your work reality, count your blessings. Even if your team is not experiencing budget cuts, the almost universal morale-buster is “too much paperwork”.


–> Ask yourself and your team members how you feel about your job and what frustrates you most.

Earlier this month a small article in the American Medical Association News caught my eye: “Want to boost morale? Ask workers what’s bugging them?” (March 8, 2010, pages 35-36). It’s not likely any time soon that budgets, salaries and hiring are going to dramatically increase. So, is your work environment and personal job satisfaction doomed to be in the depressing doldrums for a long time?  Not necessarily.

Here are some tips I gleaned from the article, tips deceptively simple and surprisingly effective:

  • Pay attention to the little things and give more recognition – this can make a big difference in helping improve performance and attitude. Employees at a medical practice struggling with high staff turnover revealed, when asked, that the manager never gave compliments, but regularly and publicly pointed out people’s flaws.  Training was given to the manager and a recognition program instituted.  Turnover started to slow. (page 36)
  • “When it comes to employees being engaged and staying with a job, the compensation doesn’t hit the top five.  You have to really be able to listen to your people.  If they don’t have enough blood pressure cuffs or the other tools they need, they are going to get really frustrated.” (Kristin Baird, RN, President, Baird Consulting, Fort Atkinson, Wisconsin.) – Where you work, it might not be blood pressure cuffs, but it might the molasses-pace computer system; or the overly cold or hot cooling/heating system, or the printer forever breaking down.
  • Ask people how they feel about their jobs via one-on-one interviews or larger meetings, formal focus groups, and/or anonymous online surveys. These can be set up free through a variety of web sites like Survey Monkey – e.g. How is everything going today?  Do you have what you need to do your job? What do you feel happy about?  What are you not so happy about? Such questions can unearth all sorts of issues with the job culture like how team members treat each other poorly or what is frustrating the staff.  Administration may be totally unaware of these.
  • Authentically address the issues which arise from meetings or surveys.  This will be far more effective than typical “morale boosters” like one-time parties which “might seem insincere and fall flat “(page 35).  Or paying for incentives or gifts that an employee doesn’t really value.
  • An example: Nurses in a neonatal intensive care unit were asked what bothered them.  The director knew more staff was needed, but budgets precluded hiring for now. It turned out that what the nurses needed (besides more staff) was a good, clean place to hang their coats.  Providing a new location improved the mood.  However a convenient coat closet was not even something the director would have thought of without asking for input, because she did not hang her coat there.
  • Ask people what they value in terms of recognition and appreciation – How would you like to be recognized?  Are timely, sincere and specific words of appreciation about what you have done well meaningful?  Is an “Employee of the Month” parking space or certificate a valued recognition or not? Would you rather receive a low-key recognition or a more public team recognition event?

On January 5, the Conference Board released data that only 45.3% of employed people were satisfied with their jobs in 2009.  This is the lowest number since 1987 when the survey began with 61.1% satisfied. Another survey released in November 2009 found that 20% of health care workers rated morale as low. Approximately 38% said they had difficulty staying motivated and 23% did not feel loyal to their employers.

How is your job satisfaction and motivation going?  Getting enough appreciation and recognition for the hard work you do?


1. Victoria Stagg Elliott: “Want to boost morale? Ask workers what’s bugging them” American Medical News pp 35-36. Posted March 1, 2010 at

2.  Press Release: “U.S. Job Satisfaction at Lowest Level in Two Decades” Jan. 5, 2010

Author:  John M. Gibbons
Publication Date:  January 2010
Report Number:  R-1459-09-RR

In the 2009 edition of an annual job satisfaction survey conducted for The Conference Board, only 45 percent of Americans said they were satisfied with their jobs, which is a marked drop from the more than 61 percent who said they were satisfied in 1987, the first year the survey was conducted. While some may wish to blame the most recent survey’s low satisfaction numbers on the current economic downturn, such an easy answer would be inaccurate. An analysis of the job satisfaction data produced by The Conference Board finds that, unlike the economy, this increasing worker unhappiness is not cyclical. I Can’t Get No…Job Satisfaction, That Is examines how, through both the booms and the busts of the past two decades, job satisfaction numbers have shown a consistent downward trend.

3.  “Nearly a Quarter of Employers Rate Their Organization’s Employee Morale as Low, Finds New CareerBuilder Survey” November 17, 2009. ( is the largest online employment website in the USA with more than 23 million unique visitors each month and a 34% market share of help-wanted web sites in the USA)


In the February 2007 edition of TIPS and TOPICS, I wrote about work of Marshall Rosenberg, Ph.D. and his four step process of Nonviolent Communication (NVC).
It guides people to practice (and it does take practice and commitment) to reframe how we express ourselves and hear others by focusing on what we are observing, feeling, needing, and requesting.

Here is the NVC four step process:

1.   Observing means to state what you are seeing, hearing, remembering, imagining so that it is clear what issue we are talking about e.g., “When I see you come in late without calling ahead….”

2.   Feeling means to state how you feel in one word about that observation e.g., “When I see you come in late without calling ahead, I feel frustrated….”

3.   Needing means to then state what human need(s) is not being fulfilled by the situation e.g., ., “When I see you come in late without calling ahead, I feel frustrated because I need consistency and reassurance that we will have staff to cover client needs ….”

4.  Requesting means to end the dialogue with a specific request that the person can either agree with or not e.g.,  “When I see you come in late without calling ahead, I feel frustrated because I need consistency and reassurance that we will have staff to cover client needs.  So would you be willing to call ahead next time if you are going to be late, so that I will have time to arrange for other staff coverage?”

You can read more at this link


In expressing appreciation be more specific than “Good job.”

Marshall Rosenberg points out that expressing appreciation is more powerful and meaningful to the person you are recognizing if you use the same principles that work in nonviolent communication about conflicts.  When you tune into a person’s feelings and needs, you are more likely to empathize, really understand each other and resolve conflicts.

The same makes expressions of appreciation powerful.

So here is the parallel process if you want to show appreciation to a person that really communicates:

1.   Observing means to state what you are seeing, hearing, experiencing that you appreciate.

(a) “When I saw how you worked with that angry client….”
(b) “When I listened to your in-service training….”
(c) “When you understood and supported me in the the staff meeting when everyone else was crticizing me…….”

2.   Feeling means to state how you feel succinctly about that observation.

(a) “When I saw how you worked with that angry client,  I was so impressed and grateful….”
(b) “When I listened to your in-service training I felt inspired and excited….”
(c) “When you understood and supported me in the staff meeting when everyone else was criticizing me, I felt so touched and reassured…”

3. Needing means to then state what human need(s) was fulfilled by the situation.

(a) “When I saw how you worked with that angry client, I was so impressedand grateful because you met my need for competence, compassion and safety. Your good work made this happen.”
(b) “When I heard your in-service training I felt inspired and excited because I really needed relief and new ideas to cope with my frustration and burn-out.”
(c) “When you spoke up and supported me in the staff meeting when everyone else was criticizing me, I felt so touched and reassured because I need understanding and appreciation for how hard it is to manage such a budget”

This may all sound a bit stilted and formulaic however heart-felt expressions of appreciation will communicate no matter how you say it.  And I’m not suggesting that every appreciation has to be a long, drawn-out, deep and meaningful communication. 

There’s nothing wrong with:

  • “Nice work”
  • “Great!”
  • “Thanks a lot”
  • “You rocked!”
  • “Good job”
  • “Really appreciate it”
  • “You’re the best”

But if you want to make a more powerful recognition, think first about your feelings and needs that were met.  And then share your more in-depth appreciation with this person.


This month, I visited Singapore to attend, and speak at, the first Asia-Pacific Behavioral and Addiction Medicine Conference (APBAM). Dr. Muni Winslow, an influential psychiatrist and addiction specialist in Singapore and his team had assembled speakers and attendees from 11 Asian-Pacific countries such as Australia, Hong Kong, Singapore of course, the Philippines, Vietnam, Indonesia, China etc.  It was a fascinating experience to meet people from some of the most populous countries in the world and to hear how addiction is treated or not treated. In some countries it is a crime to just use illicit substances.

We have court-ordered treatment in the USA, but an offender could, if he really wanted to, refuse treatment and take the consequences of his drug-related offence.  Not so in some Asian countries where a user can be imprisoned in a “treatment” program for months and years.

Singapore was interesting on many levels (if you ever get there, spend a day at the Singapore Zoo!) because I got a little in touch with my roots since Singapore’s population is 75% Chinese I’m told.  But even better for me, English is spoken by 99% of the population making getting around very easy. While there, David Powell, Ph.D., President of the International Center for Health Concerns based in East Granby Connecticut, introduced me to a very significant person…………

David Powell is someone you may know as a leading expert on Clinical Supervision and longtime CEO of ETP, a training company for many years.  David first went to China thirty years ago, the beginning of a labor of love to raise awareness about addiction, treatment and Alcoholics Anonymous (AA).  His work established AA in China and that particular day in Singapore, he introduced me to the first person in China to get sober in AA.  I smiled and nodded and shook hands.  He did the same.  He spoke little or no English; and all I speak is English.  But it was impressive to see this smiling man celebrating ten years of sobriety in AA.

Those are some of the sweetest fruits of one’s labor.

In April I will be in China, the first time since my trip there in 1979 soon after China opened up more to the West. I’m anticipating culture shock as I am told it won’t look much different from modern Japan or Hong Kong. When last there, you could only buy Coca Cola at the foreign embassies.  Now you can go to one of over 2,000 McDonald’s in China and order your fries and a coke.

I will really be surrounded by my “roots” in China.  But unlike Singapore, there will be 99% Chinese everywhere but nowhere close to 99% spoken English. I’m curious to see how my Power Point slides look translated into Chinese characters.  Even more fascinating will be training an audience with a translator.  I only have to plan for half of my usual material to allow time for translation; plus I have to practice how to talk in bite-sizeable sound bites that the translator can understand.  This will be no sophisticated United Nations, simultaneous translation through fancy earphones. This is a labor of love.

And I’ll get to meet, again, the first person in China to get sober in AA.


A Story of Success….or, How to Improve Morale via Conflict Resolution

Recently a workshop participant related to me a gratifying success story. I asked her to write up so I could share it with you.  Here is what she wrote:

“As the Program Director of Pathway House, a residential treatment facility operated by Pathway Society, Inc. in San Jose, California, I attend many trainings sponsored by Santa Clara County’s Department of Alcohol and Drug Services (i.e. DADS). And as the director, I am frequently thinking about issues of morale and the treatment team’s functioning and level of team cohesiveness.  I’m always looking for ways I can help improve morale and maintain a level of team cohesiveness that optimizes effectiveness.  I read, subscribe to newsletters and I think.  Like Pooh says, “Think, think, think!”

So, one day I found myself attending one of Dr. Mee-Lee’s trainings when a simple, very Pooh-like solution presented itself.  Though the exact topic of that day eludes me now, I do remember he asked the audience, “How many of you, at your agencies, have a conflict resolution policy?”  A handful of hands went up.  Dr. Mee-Lee proceeded to talk about the importance of conflict resolution in the context of being a ‘helping professional.’  He indicated that there was a direct correlation between an agency’s policies regarding managing conflict and the degree of ‘healthiness’ that agency possessed.  More importantly as helping professionals we had an ethical obligation to operate within our agencies in a manner that supported healthy communication.  He stated that the best way to ensure this occurs consistently is to have a written policy.

During the break I approached him and talked about this idea of having such a policy.  He had shared with the audience that he had information about a conflict resolution policy on his website.  I asked him if I could use part and parcel what he had on his website and he graciously agreed.

I went back to my office, logged onto his website and began modifying what he had posted in his February 2007 edition of “Tips and Topics”.  I decided that we needed to have a written policy to ensure everyone adhered to the procedure to resolve conflict.  Although it is a requirement and part of each staff members’ annual evaluation, it has become a tool of empowerment.  Previous to implementing the policy I sometimes became triangulated into staff conflicts and felt frequently frustrated at how I could help them get along better.  This often took precious energy and time from me that precluded me from addressing and moving on with other obligations and tasks I had.

Though I could not have predicted the result it would yield it had an amazing effect on the staff and morale.  Notably, the number of staff coming to me to mediate their conflicts decreased, but more importantly staff morale began to improve.  Occasionally staff would spontaneously share with me that they felt “thankful” that I had implemented the policy.  They even expressed relief and feeling more at peace while at work.

Like staff, I am grateful that the policy exists and it continues to help us all in our daily work together.  Tensions are down, spirits are up and a healthy team endures. 

With gratitude,
Christine Tronge, MSW, ACSW
Program Director
 Pathway Society, Inc.-Pathway House
San Jose, California

Until Next Time

Thanks for reading.  Join us again in late April.


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