Program Coordinators Retreat
Mary Yarbrough, MD, MPH
Jim Kendall, LCSW
Faculty and Physician Wellness Program
Your Role(s)
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Guide
Nurture
Direct
Lead
Coordinate
Mediate
Knowing the Resources
Mission: Helping Others Find Their Way
SUPPORT | HEALTH & PRODUCTIVITY | FACULTY & STAFF
Why Have an EAP?
Personal problems can have an impact on the workplace
“Well, it’s a delicate
situation sir…
Sophisticated firing
system, hair-trigger
mechanisms, and
Bob’s wife just left
him last night, so you
know his mind’s not
into this.”
The Far Side….Gary
Larson
The Faculty and Physician Wellness
Program
Began May 1999
Concerns during Training
• Stress, depression, and
grief.
• Career decisions
• Relationships,
pregnancy, and
families
• Time, money, and
lifestyle (lack of sleep,
personal time, etc)
Work/Life Connections-EAP
Continuum of Services
Skill Development
Training
Performance
Coaching
Assessment
Problems
and Needs
Plan for
Care
Solution-Focused
Counseling
Referrals for
Medication or
Psychotherapy
Accessing
Treatment or
Rehabilitation
Skill Development Training:
Encouraging stress resilience and life balance
Skill Development
• Goal: Improve abilities through development of skills.
• Common themes
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Stress Resilience
Seeking Work/Life Balance
Time management
Preventing Compassion Fatigue
Handling Change
Fatigue and Energy Level Management
• Desired outcomes:
– Improve the capacity to perform given certain environmental stimuli
and situations
– Orient Residents about other available services
Goal – Learn to
spot issues and
triage situations
First, let’s look at
some hypotheticals
Life
• One of the Resident’s just broke up with her
fiancé.
• She appears upset-like she has been crying
but it could also be that she is fatigued.
• She and the fiancé moved here from Iowa.
• You have heard rumors that he was having an affair and
broke off their engagement.
• This Resident stops by your desk having just
completed night call and looks exhausted.
What Should You Do?
• Ask her if she is depressed?
• Validate that she will be better off without
him?
• Tell her to forgive him?
• Should you contact anyone about your
observations?
Work/Life Connections-EAP
Easy Access: 936-1327
Confidentiality
Confidentiality
• Records separate from other systems
• Releases required except
– Concern for the safety of other specific persons
– Concern for public welfare
A Good Assessment is Key
“Struck from behind all
right…and from my first
examination of the
wound, I’d say this was
done by some kind of
heavy, blunt object.”
The Far Side…….. Gary Larson
Solutions-Focused Counseling
Addressing personal, relationship , and workplace
Referrals for
Psychotherapy or
Medication
Making the connection of
the past to unresolved
problems in the present.
(FPWP provides
assessment, stabilization
and referral.)
Overwhelmed Resident
• A Resident confides in you in a moment of
vulnerability that he is behind on his charting,
feels in over his head most of the time, and
fears that he is about to fail his Boards.
• He says that if things don’t improve, he might
as well leave the Program.
What Should You Tell Him?
• What are the issues?
• Are there any resources that can help?
• Does he need Counseling? Coaching? Career
Mentoring?
Performance Coaching
Enhancing an individual’s
performance to be more
effective and productive
at work.
Developing Skills
Performance Coaching
• Goal: Help achieve personal goals, overcome
barriers, and remain motivated.
• Common themes:
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Good physician but with patient complaints
Test taking anxiety
Trouble getting organized
Feeling socially isolated
Lacking communication skills
Desired outcome: Maximize personal and
professional potential.
Biswas- Diener, J Clin Psychol. 2009 May;65(5):544-53
The “Concerned” Spouse
• A spouse calls you to tell you that her husband ("your
resident") has had a problem with drug abuse in the past.
• She says he completed a drug treatment program and has
been "clean" for a number of years.
• The spouse feels that her husband may be relapsing and feels
that “you should know”.
• She suggests that you be particularly observant at work and
asks you to report any "unusual behavior" back to the her.
• She wants you to keep this “in confidence” since she doesn’t
want it to hurt his career.
What Should You Do?
• What are the issues?
• Should you contact anyone since she told you
in confidence?
• What are the resources?
Recovery Support Services
Promoting addiction recovery
and supporting a safe
workplace
Addictions
• Alcohol
• Drug: illegal and prescription
• Sex
• Others: Gambling, Shopping, Food, Smoking, Video games,
Internet, Work
The Impaired Physician
• Includes substance abuse, alcoholism,
depression or any medical condition (mental or
physical).
• The Faculty and Physician Wellness Program of
Work/Life Connections-EAP (Vanderbilt’s
Employee Assistance Program) can be of
assistance.
• Don’t make promises you can’t keep – no off
the record discussions.
• Ignoring a problem never works.
Best Practice Elements
Best Chance for Recovery Success
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Competent assessment
Quality treatment (life-saving not punishment)
Participation in professional advocacy TMF-PHP
Accountability: Formal Plans for Aftercare
12-Step Program Participation
Random UDS Monitoring
Consistent Messages
Supportive Workplace
Linking with More Intense
Treatment and Rehabilitation
Treatment and Rehabilitation
• Goal: Assessment, treatment, and rehabilitation based upon the stage
and type of each individual's disorder
• Common themes:
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Cycling of distress, denial, and anger: mood swings
Minimal acknowledgement of work impact until “the event”
Unexplained absences and erratic performance
Colleagues’ opinions vary: compassion to coldness to indifference
Past attempts to control behavior
DUI
Marital discord
• Desired Goal: Achieve and maintain the best possible functioning and
quality of life.
… like a travel agent for ‘psychological support’ services
Assessment
Brief Counseling
Performance
Coaching
Referrals to
Community
Resources
Stress
Depression
Workplace Issues
Addictions
Financial Problems
Relationship Concerns
Eldercare
Parenting
If You Need Help
Get It Sooner Rather than Later
936-1327
Mission
Supporting the health and productivity of the Vanderbilt
community.
Regularly Express Appreciation