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Managing Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1By Robert Norton

Enhancing Personal Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8By Robert Norton

Grief in the Workplace: Suggestions for Colleagues and Managers . . . . . 15By Eileen Grady

Stress in the Workplace: Causes and Solutions . . . . . . . . . . . . . . . . . . . . . . 20By Eileen Grady and Ed Neunlist

Domestic Violence in the Workplace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26By Ed Neunlist

Navigating the Mental Healthcare System: Lessons Learned from the FrontLines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

By Mark A. Blair

The Challenges of Work/Life Balance: Finding Creative Solutions . . . . . 37By Debbie Triviso

Introduction to The Lie Is Over—We Do Recover . . . . . . . . . . . . . . . . . . . 42By Eileen Grady

The Lie Is Over—We Do Recover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43By Myer J. Cohen, Charles O. Hagan, Jr., and Harry G. Goodheart, III

November2005

Volume 53Number 6

United StatesDepartment of JusticeExecutive Office for

United States AttorneysWashington, DC

20535

Michael A. BattleDirector

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In This Issue

NOVEMBER 2005 UNITED STATES ATTORNEYS ' BULLETIN 1

Managing ChangeRobert NortonCertified Employment Assistance CounselorEmployee Assistance Program AdministratorEmployee Assistance ProgramExecutive Office for United States Attorneys

I. Change

The expression that change is a constant ringstrue. We are always confronted with change in ourlives, in the form of the physical, emotional,cognitive, and spiritual dimensions that weexperience. Moreover, our beliefs, philosophies,or outlooks undergo subtle changes. Thesechanges are often taken in stride, with occasionalangst as one navigates these challenges.

Psychologists have codified such changes inthe form of a developmental construct whereineach life stage contains unique tasks or transitionsone must make in adapting to and moving on tothe next stage. Certainly, as one moves throughthese changes, the uniqueness of each humanbeing, coupled with societal, nurturing, andenvironmental influences, will play a role in howsmoothly the changes are made. FRANCES

HOROWITZ, EXPLORING DEVELOPMENTAL

THEORIES: TOWARD A STRUCTURAL/BEHAVIORAL

MODEL OF DEVELOPMENT 1(Lawrence ErlbaumAssociates 1987). Available at http://www.questia.com/PM.qst?a=o&d=27730225.

How does this translate to change in theworkplace? The focus of this article is to present adevelopmental paradigm of change and transitionemphasizing three main points.

• How to deal with change by engaging in aprocess of transition.

• How to use change organizationally orpersonally as a positive opportunity.

• How to successfully transition in the wake ofchange in the context of the workplace.

Implied here is that as change occurs, transitionfollows. William Bridges commentslightheartedly that it is the transition that does youin, not the change. In other words, change is anevent and transition is a process which, byimplication, has a course and therefore takes time.

W ILLIAM BRIDGES, MANAGING TRANSITIONS 3(Addison Wesley Publishing Company 1991).

The U.S. Attorneys' Offices are not immuneto change, especially in the wake of differentpresidential administrations. In addition, theeconomics of running government agencies andthe vigilance against terrorist attacks changed thepriorities of the U.S. Attorneys' Offices. Formany, such changes can be agonizing, while forothers it can be a welcome challenge. The pace ofchange has increased and the pressure hasintensified. There is much written today aboutchange and its effects on the workforce. Theliterature consistently suggests similar approachesto effectively dealing with change and transition,keeping in mind that some will experience angstresulting in resistance to change, while others willembrace change openly with a sense of adventure.Available at http://www.tbs-sct.gc.ca/cmo_mfc/resources2/review-revue/11_e.asp. This is thereality facing our workforce in both private andpublic sectors. Focusing attention on keeping theU.S. Attorneys' Offices' workforce strong,resilient, and engaged in its mission, is imperativeif leadership is to effectively navigate thechallenges of change.

Organizations do not change, people do.Because of this reality, the focus needs to beunderstanding the impact of change on the peopleaffected and the processes of adjustment. Thereare a few basic principles to apply before wemove on. Transition has a process. Change can beexpected or unexpected, but either way, there willbe an adjustment period. People transitiondifferently. Some people will transition smoothlywhile for others it will be a struggle. There is notimetable.

People grieve differently and at differingpaces. Awareness of the grief process and what toexpect can make the transition to the new situationeasier. No matter what the change may be or theseverity of the change, there is loss associatedwith it. The loss of the old way of conductingbusiness, a change of coworkers and in coworkerrelationships, adjusting to a new coworker ormanager, and dealing with a philosophical change,carries with it a process of adjustment that forsome has a great emotional impact. Grieving is theloss of the "old" and reinvesting in the "new" to

2 UNITED STATES ATTORNEYS ' BULLETIN NOVEMBER 2005

bring about the opportunity for growth. Thedevelopmental model of transition provides thefoundation for understanding and effectivelynavigating the impact of organizational change.W ILLIAM BRIDGES, MANAGING TRANSITIONS 6(Addison Wesley Publishing Company 1991).

William Bridges states that transition inresponse to change can be broken down into threestages.

• An Ending.

• A Neutral Zone.

• A New Beginning.

Any change signifies the ending of somethingfamiliar. This can be an emotional roller-coasterfor some as they deal with a variety of emotions,from fear of the unknown, anger, worry,excitement, and anticipation at venturing into anew situation. A common change we allexperience is the end of a relationship, alterationof a relationship, or the beginning of a newrelationship. Once a couple that has been in achildless relationship decides to have a child, theintroduction of this new life changes thedynamics, expectations, and in most cases thelifestyle, which might have been morespontaneous and carefree. There is a grievingprocess that occurs as the couple adjusts to thisnew phase of their life and the relationshipchanges that come with the addition of a newfamily member. Moving to a new neighborhood isanother example. In this situation one has to notonly adjust to making new friends, but mustfamiliarize themselves with school systems,churches, and social groups. One may reflect onthe comfort of the familiar as they make their waytoward establishing new relationships within thecommunity. This is not uncommon and should beexpected of any change.

II. Endings and "letting go"

The beginning of a transitional process isrecognizing the ending of what has changed andits meaning to the stakeholders. The process of"letting go" of the old involves understanding andworking through the grief process. Letting goinvolves navigating through several psychologicalphases.

• Denial.

• Anger.

• Fear/Bargaining.

• Sadness or Depression.

• Acceptance and Integration.

The grief process is unique to each individualand for some it is marked by resistance to the newchange. The challenge is to assist the individualthrough encouragement and honestcommunication so that he or she can successfullymake the transition. Shakespeare once said; "Hethat lacks time to mourn lacks time to mend."W ILLIAM BRIDGES, supra at 25. It is important tohonor the grief process because it is a healingprocess.

For many, change or the prospect of changecan be painful and fearful. Denial of painfulfeelings is the normal course of action(psychologically) and pretending these feelings donot exist is part of the first phase of grief. If it isnot acknowledged, it does not exist. Typicalresponses might be "It will all blow over," "It isjust a matter of time," or "I do not think my jobwill be affected by these changes." This might becoupled with absorbing oneself in work, andignoring or not acknowledging the impendingchange.

Once people move through the numbness ofdenial, anger toward the organization may set in.If anger is allowed to fester, resentment can buildand inappropriate blaming and resistance tochange takes place. Unchecked anger andresentment can cloud one's vision of realityallowing misconceptions to dictate responses. It isnormal to be angry at these situations, but theanger needs to be effectively acknowledged anddealt with before moving forward.

Change brings about a period of uncertaintyregarding the future of the organization and one'sviability in the organization. Fear and anxiety arethe emotions most commonly experienced duringthis time. Doubts about one's ability to deal withchange sneak up and can result in an increase inmistakes and missed deadlines. Keeping a lowprofile is often the strategy accompanied bythoughts such as: "What if I get fired?" or "Howam I supposed to get my work done with all thesechanges?"

Depression and sadness are to be expected atsome point in the process, especially in responseto a major change. Again, these responses arenormal and are within one's control. If depressionand feelings of helplessness or hopelessness are


left unchecked, they can serve to magnify thediscouraging aspects of change. It is common todwell on the negative possibilities and distort thechallenges involved in dealing with change.

As a supervisor and a coworker/colleague,recognition of these signs as part of the normalgrieving process, and finding the appropriatesupportive venues to express one's feelings andthoughts, will typically serve to facilitate aquicker and smoother adjustment to new changesand challenges. Ignoring these signs will prolongthe process, add to resistance, and bring onadditional stress.

Dealing with transitions can be influenced bymany variables.

• Expectations, either realistic or unrealistic,will influence one's ability to navigate theirtransition.

• Stage of life can alter one's perspective.

A single employee in their twenties or thirties mayhave a different perspective on change as opposedto an employee in their forties or fifties with afamily. These two separate circumstances will, nodoubt, have an impact on the emotional responseof these employees. The family man or woman ismore likely to experience angst and worry as theyhave more at stake, such as a family to feed and amortgage to pay. Multiple changes occurring atthe same time can increase the level of stress inone's life and give rise to several questions.

• What are the time limits on effecting thechange?

• Is there a strategic plan in place to navigateand prepare for the change?

• Is there enough time to prepare for changeand transition?

Self-awareness plays a critical role in how onedeals with change. One who has a high level ofself-awareness will know his/her strengths andweaknesses and will use strengths to embrace thechange and will address weaknesses by seekingout appropriate help.

Lastly, communication will have the greatestinfluence on transition. If communication isevasive or ambiguous, it will give rise to anxiety,worry, and anger. Effective, open, and honestcommunication will have a better payoff in termsof easing the transition for individuals and theorganization.

Change and transition can influence peopleprofessionally (career), personally (relationships),and psychologically (self-esteem). Professionally,one is affected in terms of job security, career,professional status, and sense of belonging.Organizational change can have a profoundimpact in these areas. A negative by-product ofany organizational change, no matter howprofessionally and sensitively it is handled, is theeffect on one's self-esteem. Regardless of therationale in making difficult financial decisionssuch as outsourcing or eliminating jobs, theemployee often finds himself with questions abouthis value or skills. Given help and encouragement,the employee can overcome these feelings. Thisblow to his self-esteem, however, can spill overinto the personal arena and cause relationshipswith family, friends, and status in the community,to be altered. Additionally, lifestyles, priorities,and future plans can also be changed.

It is important for managers, who often are thebearer of the news of impending change, to beaware of the many workplace grief reactions theycan expect to witness. We have mentioned a fewof the more common reactions above. Added tothose may be an increase in physical complaints,sick leave, apathy, tearfulness, silence, agitation, adecrease in enthusiasm, denial/avoidance,panic/anxiety, isolation, anger, fatigue, self doubt,and fear of the unknown. All of these canadversely affect performance, slow downproduction, and in some cases, lead to disruptiveconduct, as people work to come to terms with thestated change. Associated feelings can range fromanger to excitement at the prospect of change.Other feelings include pain, fear, guilt, shame (myfault), dread and disappointment, disillusionment,curiosity, hopefulness, happiness, and eagerness.

Understanding that those feelings andbehaviors mentioned above are all normal andexpected will enable managers to effectivelyinstitute some useful strategies in helpingemployees adjust. Accept the reality of subjectivelosses. Loss associated with organizational changeis unique to each person. Listen and learn whatthose losses mean and represent to the people withwhom you work. Arguing or debating withemployees will end the conversation and mostlikely stir resentment, rather than pave the way toacceptance and commitment to the new change.Expect overreaction. It is not the change thatpeople are reacting to, but most likely theanticipated loss associated with the change.


Recognizing that it is a part of their world that islost may assist managers in understandingoverreaction. Acknowledge the losses openly andwith empathy. Simply and directly acknowledginglosses will more likely win over employees' trust,as opposed to paying little or no attention to theemotional impact. Research has demonstratedrecovery from loss happens much quicker ifconcerns are expressed openly. Available athttp://www.ncsconline.org/D_Tech/CTC/CTC5/209.HTM.

Defining what is over and what is not iscritical in facilitating a clear understanding ofwhat the new change will look like. Speaking invague terms such as "we are going to be lean andmean" or "we are going to be 50 percent moreefficient" can lead to confusion,misunderstanding, duplication of effort, orindependent thinking that, without clearexpectations, typically leads to chaos. Givingexplicit information again and again will reducethe risk of chaos and reinforce consistency ofexpectations and information flow necessary inmaking a smooth and successful transition.Employees need and deserve to know what isexpected of them and what to expect frommanagement during times of change. Providingclear information with the opportunity forquestions and answers can significantly reduce therisk of rumors and misinformation. Additionally,continued honest and open communication, be itgood news or bad, will serve to win the trust ofemployees and allow them the chance to examinetheir options.

Treating the days gone by with respectconveys respect for those employees who identifywith the past or with how things used to be.Managers who, in their enthusiasm to embrace thenew change, belittle the past may be seen asattacking those who hold an allegiance to it.William Bridges cites an example of an executivewho was brought in to reorganize a division intobusiness units. The executive did not attack theold functional organization as inefficient andarchaic. Rather, he pointed out that the old waysof doing things brought the company to the brinkof an important new development. He went on toemphasize the continuity he felt with hispredecessor and talked about the new challengesthat called for new responses. One will greatlylessen the chances of alienation by honoring thepast for what it has accomplished and recognizingthat the past innovations were once new and

contributed to the new organization's presentposition. W ILLIAM BRIDGES, supra at 30.

To prevent the failure of an organizationalchange, it is important to anticipate and plan forthe endings, the impact on employees, and theprocess of letting go. Although there is adestination, attention to the journey necessary toreach it is what will lead to personal acceptance,integration, and a successful transition.

III. The neutral zone

William Bridges introduces the concept of theneutral zone as the middle phase of the transitionprocess. In any transition, once the loss has beenreconciled and the change has been accepted, thesense of "now what?" sets in. The neutral zone isbest described as that point in time after thetrapeze artist lets go of the old trapeze and iswaiting to grab the new trapeze with the hope thatit is flying toward him. While in midair the artistis in the neutral zone with nothing to hold on to.This is a time characterized by hope, fear,excitement, and anticipation. Id. at 34.

The neutral zone is a very difficult anduncomfortable time and poses the greatestchallenge in the transition process. Marked withambiguities of direction, expectations, andinadequate communication, the neutral zonetypically gives rise to anxiety and a decrease inproductivity. There are several additional realdangers that managers and supervisors need to beaware of and sensitive to. Because the neutralzone is a time of uncertainty, employees willtypically experience loss of focus and confusionover unclear directions and expectations.Unanswered questions, mixed signals, unreliableinformation about mission critical issues, jobretention, or reassignment provoke high levels ofanxiety with the usual by-products of missedworkdays, increased sick leave, and an increasedexodus to other jobs.

As communication remains mixed and/orinadequate, the ground is fertile for rumors, oftenuntrue, which add to the increasing level ofanxiety and mistrust of coworkers andmanagement. In times of confusion andambiguity, it is observed that some employeesrace to move ahead while others revert to the oldways of doing business, creating a breakdown incohesiveness. Under these conditions, it can beexpected that a polarization and breakdown of


consensus building and teamwork will occur. Ifmanaged properly, this is only temporary. If leftunmanaged, the resulting chaos can be permanentand the desired outcome will most likely fail. Id.

While the neutral zone provides anopportunity for negative outcomes, it alsoprovides the opportunity to employ creativemanagement techniques aimed at effectivelyconfronting the issues characteristic of this phase.Of course, this is largely dependent on howmanagement navigates itself and employeesthrough this difficult time. Managing and guidingstaff through this crucial phase is the most criticalassignment for supervisors and managementbecause their success in doing so will clearlydefine the success or failure of the desired change.The following are proven tools in assistingmanagement to successfully help employees andthemselves effectively deal with the challenges ofthe neutral zone.

Normalizing the situation openly and honestlyis the first and simplest way to begin to navigatethis journey. First, accept the fact that transition isa process. Understand that the neutral zone is notsimply a place of waiting, but a time whenreorientation and redefinition are taking place.People need to know it is natural to feelfrightened, confused, and anxious. Even the mostardent supporters of the organization's decisionsoften make the journey with a degree oftrepidation. Validating these responses is typicallywelcomed by employees and can promote buy-in.Redefining the situation can cast a meaning ofhope and opportunity as opposed to a sense ofhopelessness and survival of the fittest mentality.

The middle phase of transition ischaracterized by loss of structure, which can bedeadly to the organization. The creation oftemporary systems will lend structure and providethe opportunity for employees to becomestakeholders in the new change even if thetemporary system is a bridge to the newbeginning. Refinement of existing policies to fitthe situation and defining new roles and reportingrelationships are essential to get through theneutral zone. This can provide opportunity forappointment of acting managers andestablishment of project teams where theemployees are encouraged to brainstorm newideas and innovations and actively contribute tothe mission at hand.

Setting short term goals to ensure success willset a foundation for further success. Be wary ofsetting targets that are too lofty during this time.Embrace the losses and setbacks as opportunitiesto learn and move forward. Mistakes may be madeduring this time, but doing nothing or stiflingcreativity will typically have far-reaching negativeconsequences for the organization. Settingrealistic achievable goals will reinforce workerparticipation and output while having the addedbenefit of making upper management look good.Managers and supervisors should look to identifywhat they need to know in order to functionsuccessfully in the neutral zone. This mightinclude seminars on team building, problemsolving, and understanding transition.Strengthening intra-group connections promotesteamwork, trust, innovative thinking, and thesharing of ideas.

As mentioned above, one of the salientnegative aspects of the neutral zone is its tendencyto promote isolation and mistrust. Communicationis the key to surviving the neutral zone. Far toooften managers do the wrong thing for the rightreason. In other words, their desire to protectpeople from the harsh realities of the truth,evidenced by withholding valuable information,fosters mistrust, confusion, and gives rise todamaging rumors and innuendo. People want anddeserve to learn first hand the truth of thesituation. Honest and ongoing communication willdispel rumors and keep employees abreast of whatis expected of them.

Knowing what they can expect ofmanagement will encourage participation fromemployees who are experiencing the changepersonally. It is also important to give employeesthe correct information so they can make aninformed decision regarding their own future. Ifpossible, it is recommended that decisions arekept to a minimum to prevent overload andconfusion. Schedule weekly meetings or dailybriefings to keep staff appraised of the latest newsrelated to the change. This will provide structure,as well as a clear and concise flow of informationthat employees can depend on. This strategy has avalue-added component in that it taps into themost important resource of the organization, thestaff. Wise management will look to theiremployees for answers concerning best practices,which will lead to a smooth transition. Availableat http://humanresources.about.com/od/changemanagement/a/change_lessons.htm.


In order to manage the stress thataccompanies organizational change, it is vitallyimportant to take care of oneself. When it appearsthat a loss of control and feelings of helplessnessoccur, there are things that one can do to restoreand maintain control. Keeping a routine at homeor in the workplace can provide a sense ofcomfort during uncertain times. Examining andmaintaining one's routine outside of the workplaceis an essential element in managing one's stresslevel.

Remaining involved in health-centeredactivities such as an exercise routine, limitedalcohol intake, elimination of nicotine, gettingenough rest, and maintaining a nutritious diet areessential in managing the stress of ongoingchange. During stressful periods, it is easy toisolate from friends, colleagues, and family. Theloss of structure and cohesion in the workplacecan be made up in the world outside of work.Remaining socially active and connected helps tomaintain routine and structure, personal contacts,and psychological buoyancy. Seeking outoptimistic people and avoiding complainers willfurther ones success in managing stress. It is atthis time that one needs to be surrounded bypositive influences. Save time for leisureactivities. They can be both relaxing andenergizing.

The belief that opportunity follows changecan be a formula for personal development andthe exploration of new challenges. Stories andliterature abound about people who, because ofdownsizing or reorganization, have gone on tofind a greater level of personal and professionalfulfillment. Having an updated resume orStandard Form 171 on hand can prepare one forthe exploration of other employment options.Stephen Covey refers to "sharpening the saw" as ametaphor in self exploration. STEPHEN COVEY,FIRST THINGS FIRST, 84-85 (Simon and Shuster1995). One can take a professional, mental,emotional, and spiritual inventory leading to thesharpening of any of these areas, with the goal ofachieving a higher level of personal andprofessional awareness. This can serve to enhanceone's ability and confidence to face newchallenges and seize the opportunities born out ofchange.

It is also important to maintain a sense ofhumor. The use of humor will be a buffer throughthe rough spots. It is vital to our well-being andour ability to adapt to change. It has been shown

that humor and laughter can facilitatecommunication, boost morale, place things inproper perspective, and increase flexibility. Whenused appropriately, humor makes people feelbetter about themselves. Laughter is veryliberating and can give one a sense of power whenthings seem out of control. If we can learn tolaugh at ourselves, we are less rigid and morespontaneous, and rebound when faced withdifficult challenges. We are less fearful of makingmistakes and know how to cope with setbacks.Management can set a tone by modeling a senseof humor, even at their own expense, and canbring cohesion and a sense of team during timesof change. Begin meetings by sharing somethingfunny that happened in the past week and offerstaff the opportunity to share any humorousexperiences they had. Organizing spontaneousinformal gatherings outside of work can also builda sense of unity.

Emerging from the neutral zone can beexhausting and enervating. It can be a challenge toone's self confidence. Building a new structurewith staff participation requires a degree ofpatience and care. Setting clear, definable,immediately achievable goals will serve to buildconfidence, build morale, and pave the way forbuilding the new organization. Recognition ofthese achievements is important. Hold a weeklymeeting where problems are identified and plansof action are discussed and implemented. Eachpassing week the team can track the progressmade in the resolution of identified problems. Theweekly meeting provides the forum where suchissues can be addressed and progress can bemeasured. This process typically reveals thatproblems are being solved, or are in the process ofbeing solved, and forward progress is being made.Celebrating the successes, both big and small,reinforces individual and team investment andcommitment to the new order. As this processcontinues, the investment in the old way tends todissolve as the new becomes comfortable andrewarding for all.

IV. New beginnings

The last phase of transition is new beginnings.Here the new organization starts to take ondefinition. This phase is marked by new visions,new plans, and new energy. This is realized bymaking employees part of the change. This phaseis a process within a process, where all employeesare encouraged to examine their role and


participate in the formation and implementation ofthe new organization. William Bridges states thatin order for there to be a New Beginning, youneed to have the "Four P's," a purpose, a picture, aplan, and a part to play. W ILLIAM BRIDGES, supraat 52.

When we are confronted with any change,especially if the change is imposed, the firstresponse is "why?" People typically will want,and at times demand, an explanation orjustification. In order for change to be accepted, ithas to make sense to those affected. Clarifying thepurpose is a reasonable necessity to affect thedesired outcome. This is accomplished bypromoting an understanding of the reasons for thechange. Managers and supervisors often are awareof problems that the front-line workers are not.Because of this, the change makers need to sellthe problems before they can sell the solutions.

• What are the problems leading to the need forchange?

• What will occur if these problems are notaddressed?

• What will happen to employees if that wereallowed to occur?

By answering these or similar questions,employees will begin to understand the rationalefor change. Having an understanding of theidentified problems leading to the need for a newdirection, employees will be less resistant. Usingclichés such as "we are shooting for excellence,"or "we are going to be value added in ourcustomer service" is not recommended. Clichéstend to lack substance and are a poor substitute forcommon sense and honest rationale.

After the reasons for change have beenexplained and clarified, the matter of what formthe change will take is the next question. Peoplewant to see, or at least imagine, what the changewill look like, and where they will fit in the neworganization. Creating a picture will allow peopleto envision what the new world of work will looklike, begin to understand how the work will getdone and how people will be interacting with eachother, and see the new spatial layout. Having apreview of things to come can ease the journeyand foster enthusiasm for the new beginning.

Development and implementation oftransition plans leads the way to the desireddestination. The transition plan is focused on apersonal level. It will lay out the details for each

individual to demonstrate how the world willchange. It also helps workers focus their energyon the process by letting them know when theycan expect to receive information and training,and how and when they will have input in theplanning process. The ground work is laid forparticipation. To succeed, it is essential thatpeople become a part of the process and not apartfrom the process. This is best accomplished bygiving affected employees a part to play in theplanning and implementation. This accomplishestwo important things. It brings people into theprocess and makes them a true stakeholder. Ithonors and values their expertise, professionalism,and insight by allowing them the chance tocontribute their personal touch to the outcome.Lastly, who are better consultants than those whodo the work?

Reinforcing the new beginning can be done inseveral ways. Be consistent. Many managersmake the fatal mistake of implementing a newprocess or procedure, but rewarding the old. Thissends a mixed message. For instance, askingpeople to buy supplies with their own moneywhile executives are flying first class sends amixed message. Managers can gain a lot ofpersonal credibility and win staff over bydemonstrating consistency in their actions. Forinstance, if you preach teamwork and reward onlyindividual accomplishment, the stage for a newbeginning will not last. Actions speak louder thanwords. The simple act of taking accountability formaking a mistake, especially in light of a newchange, can have a huge payoff in terms of respectgained and trust established. In launching a newbeginning, the reward system should be consistentwith the new management philosophy.

Rewards can be monetary, recognition, timeoff, additional perks, praise, and awards.Certainly, a new beginning can give rise tocreative acknowledgement of a job well done.

V. Conclusion

With every change, whether minor, major,personal, or organizational, there will be someform of transitional process that, in most cases,leads to the eventual acceptance and integrationinto the new condition. The transitional model ofchange can be applied to the organizational andpersonal worlds of individuals. Change canhappen in an instant, whether by design or fiat.People have to transition to that change.


Transition is a process and takes time. Transitionis not the same for everyone. Understand thattransition involves acknowledging the ending,where letting go is the focus; moving through thethe neutral zone marked by chaos, fear, andresolution; and new beginnings marked byunderstanding, commitment, and collaborativeaction.

Change is forever with us and we can notescape it. We grow old and we have to makeadjustments. Aging athletes may not be able tocompete professionally and will have to come toterms with their physical decline. As they grievefor that which gave them so much, new horizonsawait. Some find it in continued involvement inathletics on a different level. Some move on tonew ventures. It is inevitable, however, that wewill have the opportunity to say good-bye to theold and embrace the new. The adage "this tooshall pass" always comes in to play.�

ABOUT THE AUTHOR

�Robert "Bob" Norton is a LicensedProfessional Counselor, Certified EmployeeAssistance Counselor, and is the ProgramAdministrator for the Executive Office for U.S.Attorney's/United States Attorney's EmployeeAssistance Program. He has over twenty-sevenyears post graduate experience in the fields ofmental health, substance abuse, employeeassistance counseling, and program management.In addition to having worked in several mentalhealth and substance abuse treatment settings,Bob has worked as an employee assistancecounselor and program coordinator for the Officeof Personnel Management, U.S. Marshal'sService, and the Library of Congress.a

Enhancing InterpersonalCommunication Robert NortonCertified Employment Assistance CounselorEmployee Assistance Program AdministratorEmployee Assistance ProgramExecutive Office for United States Attorneys

I. Introduction

Supervisors, managers, and employees oftenconsult with the Employee Assistance Programabout conflicts, clashes, confusion, diminishedmorale, hostility, and overall discomfort with thepeople in the workplace. Our collectiveexperience points to communication as being themain source of the problem. How and why this isso is as varied as there are people in anorganization. Since human beings and, as somewould argue, other animal forms have inhabitedthe earth, communication has been essential in thesurvival of the species. The survival of anorganization is a matter that rests oncommunication of policies, procedures, andorganizational needs to deal with changes and

competition. When there is a breakdown incommunication, a host of problems is certain tofollow.

This article will address the essence ofcommunication and its importance in theworkplace. We will define communication andexplore its components; identify factors thatinfluence communication both positively andnegatively; discuss the message behind themessage observed in nonverbal communication;contrast communication styles, and explore usefultools to enhance interpersonal communication thatcan reduce misunderstandings, conflict, and stress.

First and foremost, it is important to acceptthat we are communicating even when we do notintend to do so. For example, while at theshopping mall or a public park, people mayengage in people watching. As they observepeople walking, talking, or running, they have onething in common. They are communicating. Tothe people watcher, messages are being conveyed


that can give the observer some insight into theworld of the one observed.

II. Components of communication

Communication is defined as an act wherebyone or more persons are sending and/or receivingmessages; can be distorted by noise (anything thatdistorts or interferes with communication); occurswithin a context; has some effect; and hasopportunity for feedback. Available at http://www.mindtools.com/CommSkll/CommunicationIntro.html.

The definition of communication incorporatesseveral components based on information theory.Available at http://www.cultsock.ndirect.co.uk/MUHome/cshtml/index.html. According tothis construct, communication involves severalaspects.

• A source or sender of messages.

• A receiver of those messages.

• A message or information that is transmitted.

• Channels in which the messages aretransmitted (visual, auditory, or tactilemodes).

• An opportunity for feedback (response by selfor others).

• Some desired effect or intentional outcome.

Communication occurs within a context.Context can directly influence the modes,transmission, and reception of communication.One will communicate much differently whilegreeting people at a funeral than during a nightout at the baseball park. The environment andsituation defines the behavior and tone of theinterpersonal interaction that occurs in diversesituations.

Perhaps one of the biggest obstacles forsomeone in management is to transition from acoworker relationship, which defines the worksituation in one way, to becoming that person'sboss. The relationship is altered since the powerstructure has changed and communication willoccur within a new context. An additional factorto consider is that people have unique ways ofcommunicating, given their background, culture,temperament, genetic makeup, life experience,and grasp of the language.

That being said, we come to the concept ofnoise which is anything that interferes with ordistorts communication. Available at http://www.pc.cc.ca.us/pinewood/Module1sprg05.htm. Noise can consist of any one or combinationof the following influences.

• One's cultural background, beliefs systems,experiences, and temperament can have aprofound influence over how onecommunicates.

• Outside influences such as auditoryinterference (for example, telephones ringing,interruptions from coworkers, radio, orgeneral background noise).

• Visual distractions.

• One's psychological state of mind (elated,depressed, angered, or preoccupied withpersonal matters).

• One's state of physical health (bad case of fluor chronic illness).

• Attitudes (preconceived) and biases,experiences, command of the language, and asmentioned earlier, context.

Added together with nonverbal cues andstyles of communication, especially when dealingwith differences and conflict, these distractionscan easily lead to miscommunication,misunderstanding, and conflict. Awareness ofthese influences and their significance inimpacting how one communicates is the first steptoward improving communication.

III. Styles of communication

The exciting thing about working with peopleis that each individual brings his or her ownunique style of communicating to the table. Forsome interpersonal communication, varying stylesof communication influence how one deals withissues from conflict to harmony. There are severalcommon types of problem-solving techniques thatare alternatives to collaborative problem solving.JOHN BOLTON, PEOPLE SKILLS: HOW TO ASSERT

YOURSELF, LISTEN TO OTHERS AND RESOLVE

CONFLICTS 233-39 (Simon and Shuster 1979).The following are communication styles thattypically facilitate, rather than resolve, conflict.

• Denial. For some the conflict is so painful orthreatening that they will deny the existenceof the problem.


• Avoidance. People will acknowledge aproblem, but will go out of their way to avoidconflict or the source of the conflict. Theywill typically withdraw when strife exists.

• Capitulation. This style is marked by fulfillingother's needs when in conflict with their ownneeds—usually without a struggle. Habitualcapitulation can easily lead to resentment.

• Domination. This style is demonstrated byimposing one's own views and solutions onanother. The solution is designed to meethis/her needs at the expense of others. Theneed may be partially met, but the relationshipsuffers.

• Collaboration. Collaboration is the most idealmode of communication. Collaboration is amode that is direct, open, and honest. Theoutcome is designed to be mutually beneficialto all parties—a win-win outcome.Collaboration promotes an awareness ofinterdependence, achievement of commongoals, mutual support and understanding,keeps lines of communication open, facilitatestrust, and promotes teamwork where allindividuals can contribute and be recognized.

IV. Elements of communication

The most important communication skill islistening. It stands to reason, that in order to getone's needs met, one has to convey those needs.The receiver (second component) has theimportant job of listening and hearing what issaid. Effective listening involves the entireattention of the receiver. If the conversation iscasual or serious, business or personal, listeningeffectively will give an understanding of what issaid.

To be an effective listener, the followingskills have been proven to be helpful. Choose atime and place to talk where neither party will beinterrupted or distracted. Nonverbal cues willdefinitely convey whether there is interest ordisinterest. Ideal listening involves beingphysically attentive by sitting quietly facing theperson and maintaining eye contact. Givingundivided attention to what is said involveslistening to the verbal content and watchingnonverbal cues (posture, tone, gestures, spatialrelationships, eye contact, and facial expressions).Typically, nonverbal cues will reveal consistencyor inconsistency with verbal content.

Inconsistency with verbal content conveys amixed message which necessitates clarification (tobe discussed later). While engaging inconversations, especially concerning workplaceissues, people often bring to the table biases,opinions, and preconceived ideas about the issuesor the person with whom they are speaking. Tooptimize listening, it is important to suspendjudgments and interpretations and focus onunderstanding what the person is saying. Toensure that you understand what is being said,periodic paraphrasing or requests for clarificationare recommended.

A. Active listening

Active listening includes a host ofcommunication techniques designed to enhanceunderstanding and facilitate honestcommunication. Five basic techniques areparaphrasing, empathizing, clarification, pacing(nonverbal), and giving and receiving feedback.

Paraphrasing is simply restating what hasbeen said either in the receiver's words orparroting back the statement. For instance, onemight state; "what I heard you say is…", "so, inyour case…" or "if I understand you correctly,you think that. . . ." Paraphrasing can be apowerful tool in that you let the other party knowthat you have indeed heard what they said and thatthey have your attention. It can also be used as abasis for clarifying questions.

Empathizing can be a challenge if one doesnot share the same experiences or perceptions ofthe sender. However, empathizing with thespeaker will work toward facilitatingcommunication and information sharing. Feelingempathy does not mean one has to agree withwhat is said. Taking a moment to examine theissue from the sender's point of view allows thereceiver to have empathy and to glean a clearerunderstanding of the matter at hand.

Clarification is a technique in which thereceiver may ask for more information, or askwhat the sender meant by what he or shesaid. Clarification techniques, such asparaphrasing, demonstrate that the receiver islistening and following what is being said, butlacks understanding or needs more information.


B. Nonverbal communication

Pacing is a nonverbal technique used by thereceiver to send a message that he/she is listening.Pacing is a measured response where a blend oftiming and action are employed to let the senderknow the listener has his undivided attention. Forinstance, a slight tilt of the head, a slight leanforward, or a friendly gesture, will typicallyconvey openness and receptivity to the sender,which will facilitate further communication. Adiscussion of nonverbal communication could filla separate article since so much has been studiedand documented on this subject.

Human beings are separated from the rest ofthe animal kingdom because of their ability toverbally communicate. What is also evident fromboth animal and human studies is that what is notsaid can often disclose the truth. Followinglistening, nonverbal communication is the mostcritical element in communication, whether it bein a dyad or within a larger group. Nonverbalcommunication is a part of all conversation.Certainly, nonverbal communication is subject tothe receiver's biases and particular sensitivities.Nonverbal behavior that might trigger a negativeresponse from one person may hold an entirelydifferent meaning to another.

When the discussion of nonverbalcommunication comes up, most people think ofbody language, which includes physical posture,facial expressions, hand gestures, and eye contact.The most important aspect of communication iseye contact. People speak of solid eye contactwhether engaged in a one-to-one conversation orwhen speaking to an audience. Two waycommunication is occurring when the sender isreceiving messages (nonverbal acknowledgement)that he is connecting with his/her receiver(s). It isalways a dialogue even if the receiver is notspeaking. Available at http://www.humorpower.com/art-connecting.html.

Establishing and maintaining eye contactcoupled with a firm handshake can be seen as asign of confidence and interest. Lack of eyecontact and a weak handshake can send thenonverbal message that the individual lacksconfidence. Skilled communicators know how touse all these components in concert to effectivelymake a point, especially in instances where onemay issue a directive or apply a persuasiveargument.

An individual is also capable of sending amessage by doing or saying nothing. Factors toconsider in working with people, especially in anincreasingly diverse workplace, are culture andethnicity. Familiarization with the nuances ofnonverbal communication, as it applies to peopleof diverse and familiar cultures and ethnicities,assists in communication. Speakers must be awarethat nonverbal communciations may beinterpreted differently by members of diversecultures.

C. Tone and inflection

Tone and inflection are often overlooked, butboth have an effect on communication. A deepcommanding voice may yield different resultsthan a softer, meeker tone, although they may beconveying the same message. By changing thetone or inflection, one can use the same words toconvey different meanings. For instance, whenasked how one is doing and the direct response is"fine," with little change in tone or inflection, oneis left to believe that the person is truly fine.Changing the tone or inflection, however, can takeon the sound of sarcasm or hostility that isincongruent with the word, fine. Used incombination, voice, content, body language, andappearance will influence the receiver'sinterpretation of the message.

D. Open and closed questions

Clarifying statements and questions willtypically yield an answer. Asking open questionsis the ideal way of gathering necessaryinformation, especially in clarifyingmisunderstandings or ferreting out additionalinformation. An open question will invite asentence or paragraph response. For example,"Describe for me please ..." "Tell me what youmean when you say…" or "Please help meunderstand ..." are excellent questions designed toelicit further information. Open questions beginwith "how," "what," "when," "where," and "who,"and encourage elaboration.

Closed questions begin with "do" or "are" andinvite "yes" or "no" answers that can kill theopportunity for elaboration.

Using the open question technique will yieldinformation that can reduce the incidence ofmaking costly assumptions and will lend moreclarity to the conversation. Think of the attorney


who comes to his legal assistant and tells her thathe needs several documents sent to anotherdepartment or district ASAP. One reaction is forthe legal assistant to go on stress autopilot andbecome overwhelmed at having to perform thistask. The legal assistant's definition of ASAP maydiffer from the attorney's. The assistant should asksome open questions.

• How soon is as soon as possible?

• When exactly do you need this?

• To whom am I to send it?

• How many copies do you need?

• Where should I send it?

• Is there some particular routing you require?

The legal assistant may find that as soon aspossible means by three o'clock this afternoon orthat it is indeed a rush job. Either way, having aclear idea of exactly what is needed and when it isneeded will aid in reducing the stress reaction tothis type of situation. Use of these questions willlend more clarity to what is being asked and willreduce the risk of making incorrect assumptionsbased on a subjective interpretation of a vagueconcept.

E. Spatial relationships

Spatial relationships or "proxemics" are a veryrevealing and fascinating aspect of nonverbalcommunication and greatly influence our dailyencounters. There has been a great deal of studyand research devoted to this aspect of nonverbalcommunication. Research supports the hypothesisthat intrusion into one's personal space can haveadverse effects on communication. Informal spaceis characterized by a personal zone that varies forindividuals and circumstances. The study ofspatial territory for the purpose of communicationuses four categories for informal space.

• The intimate distance for embracing orwhispering (six to eighteen inches).

• The personal distance for conversationsamong good friends (one and one-half to fourfeet).

• The social distance for conversations amongacquaintances (four to twelve feet).

• The public distance used for public speaking(twelve feet or more).

Available at http://members.aol.com/katydidit/bodylang.htm.

In the work world, spatial relationships takeon a more formal tone, especially when dealingwith management/employee relationships. Thearrangement of office furniture usually leads to adefinitive spatial relationship between the bossand the employee. In this situation, navigating theseas of spatial relationships can reveal the truenature of the relationship. A coworker may stepbehind the desk of an associate, but does he or shehave this leeway with the boss? Perhaps, if theyare good friends. A general rule is to observe andask permission to move into someone else'spersonal space.

Changing the distance between two peoplecan convey a desire for intimacy, declare a lack ofinterest, communicate discomfort, orincrease/decrease domination. Whatever the case,the research strongly indicates that the violation ofpersonal space can have serious adverse effects oncommunication. Thus, if there is to be mutualsatisfaction in a communication encounter, mutualpersonal space must be respected.

F. Giving and receiving feedback

Perhaps one of the most challenging tasks ofmanagement is giving and receiving feedback. Forsome, receiving constructive feedback orconstructive criticism can be a dauntingexperience, even when the feedback is designed toassist the recipient in improving a targeted aspectof their performance or conduct. This also poses achallenge for the sender of the feedback. Mostpeople will want to avoid giving negativefeedback and risk the incidence of potentialconflict. It is important for people in anyorganization, however, to learn and becomeresponsible for what is expected of them in thecommission of their duties. A few rules to helpguide those giving feedback are as follows.

• State the purpose of the meeting beforehandso that the recipient will know what to expect.

• Outline an agenda for the meeting to promotebuy-in.

• Describe and define the situation objectivelyand clearly, rather than evaluate it.

Evaluating lends itself to subjective interpretationthat may be a set up for debate. What you aretrying to accomplish is to share with the recipient


information that can help them succeed on the job.Although giving feedback can grant some neededrelief to the presenter, focus on the value it mayhave for the recipient. Even if the feedback is notpositive, being honest and direct will facilitatereceptivity.

• Treat the person to whom you are givingfeedback with respect and dignity.

When receiving feedback, much of what wasdiscussed on active listening applies. First,suspend judgment and interpretations. Ask forclarification if you do not understand what isbeing said. Maintain solid eye contact andprofessional posture, and take notes where andwhen you can for clarification purposes. If it getstoo uncomfortable, it is appropriate to ask for atime out to compose oneself and reconvene themeeting. If this is the case, chances are bothparties could use a break.

• Use of "I" statements when giving feedbackwill convey personal ownership of theconcern while at the same time softening thedefensiveness of the recipient and serving asan appropriate introduction to the matter ofconcern.

Questions such as "Peter, I am concerned that… ,"or "I was disappointed at the results of… " aregood approaches. The initial reaction of therecipient when informed that improvement isneeded in conduct or work performance isdefensiveness. This is a normal reaction for mostpeople, yet it can detract from the recipient'sability to receive the necessary information. Adefensive posture can be exacerbated if the senderdecides to point a finger (typically an accusatory,judgmental, and aggressive gesture) citing "youdid this… you did that ... or you aren't doing...."This approach conveys a disrespectful tone to thereceiver. This does not mean that the sender maynot be angered or disappointed regarding thematter at hand, however this approach will dolittle to achieve the desired results. An effectiveand positive approach will include incorporatingthe following techniques in your delivery.

• Be supportive by delivering the message in anonthreatening manner.

• Make sure the message is clearly stated toinclude specific references to behavior andperformance with a focus on behaviors (notpersonality) that can be changed to improvethe situation.

Helpful feedback is intended to have constructivevalue to the recipient. Incorporating a considerate(not insulting or demeaning) and thoughtful(organized) approach to presenting feedback willmost likely yield the desired results.

The same formula applies to the receiver offeedback. An open and responsive position willenhance listening and receptivity. The receivershould engage the sender and use active listeningfor clarification and understanding the meaning ofthe message. Suspend judgment until you havehad time to think and digest what has beenpresented. Lastly, ask for guidance and clarify theexpectations of the sender, if necessary.

V. Management tools

Creating a healthy work environment involvesestablishing a trusting relationship with the peoplewith whom and for whom one works. The basisfor trust is open and honest communication. Inmost relationships that sour over time, thecommon denominator is negative communication.Laying blame for communication problems iscounterproductive in resolving workplaceinterpersonal difficulties. Management can takethe lead by establishing a few basic principles thatwill make the workplace a healthier place andadvise employees what to do when it looks likethere are impending problems that may requireguidance. Employees should try to resolve theirown problems first, before coming to theirmanager.

Management's intention to solve employees'problems may be good, but it is often the wrongthing to do. It is better to establish the expectationthat employees are adults who should work thingsout with their coworkers. If employees are notencouraged to solve their problems with others,they will be more than happy to let managementtake the responsibility for resolving all personnelissues. They will also watch and critique thesupervisor's performance. Further consequencesmay include an increase in intensity of the conflictbecause the coworker believes they have been"tattled" on. Once management becomes involvedin the first situation, they will find employeeslined up at their doors expecting management to"fix" the problem. Frankly, this is an inefficientuse of precious time.

Managers can use complaints as anopportunity to teach their employees how tohandle conflicts, rather than jump in and do it for


them. Teach employees by asking the followingquestions.

• What have you said or done thus far?

• Why do you think he is angry with you?

• How has it affected the customer?

• What do you think you could do that wouldhelp solve this?

• What could you say to him?

Guide employees through the thought processof accepting their responsibility, their approach toconflicts, and what they said to the other person.Role playing may help the employee to verbalizethoughts and feelings. Ask the person to reportback once they have completed the conversation.This guarantees that they follow through andprovides another opportunity to help them withthe next step.

Do not choose sides in a conflict. If it isdiscovered that the complainer played a part in theconflict, the next step would be to determine ifthat person takes responsibility for his or heractions. The best strategy is to get out of the officeand actually observe the climate of theorganization. Secondary complaints are usually asign that you are too removed from what is goingon.

Employee complaints to managementrequesting action against a coworker, but askingfor anonymity, may set management up forsplitting and triangulation. This can put thesupervisor at odds with both parties and in a no-win situation. If management takes responsibilityfor the anonymous complainer, the situation ismade worse. The offending party will want toknow which employee complained and what wassaid. It is human nature to want to know whocomplained and to confront them. The employeewill be suspicious, distrustful, resentful, andhostile toward the team and management.

If this situation arises in your organization,suggest that the offended party make the firstattempt to discuss the problem directly with theother employee(s). Let him know he can count onhelp and support in resolving the issue. If thesituation does not improve, management mayneed to step in. If they do not feel abandoned, thecomplainers may be more willing to take steps toresolve the problem on their own. Typically, theywill feel better for taking the responsibilitythemselves.

VI. Conclusion

Effective communication can be summed upby the following behavioral skills that can easilybe employed.

• Solid eye contact.

• Good posture.

• Natural gestures.

• Appropriate dress and appearance.

• Voice and vocal variety.

• Effective use of language and pauses.

• Active listening.

• Effective use of humor.

• Being receiver centered.

• Checking perceptions with trusted colleagues.

• Avoiding absolutes (black/white thinking).

• Knowing and being one's natural self.

Good communication skills require a highlevel of self-awareness. Understanding personalstyles of communicating will go a long waytoward helping to create good and lastingimpressions on others. Available at http://www.mindtools.com/CommSkll/ActiveListening.htm.

Understanding other's perception allowspeople to more readily adapt to other styles ofcommunication. Additionally, knowing what youwant is one of several key steps toward enhancingeffective communication. This will be defined bythe context (formal/informal, work/recreation/home, for example). Speakers should pay closeattention to their behavior, as well as that of thepeople to whom they are speaking. Be aware ofthe spatial relations and boundaries as they candefine the nonverbal tone of interaction. Beflexible in communication and response. Selfexamination and feedback from trusted colleaguesand friends may give valuable information thatwill enhance communication skills. In addition,suspension of judgment will increase the chancethat the desired message will be heard.

Making the personal commitment to improvecommunication will require one to examine allelements of communication and be open tomaking changes where needed. Lastly, studieshave shown that when communicating,approximately 55 percent of people respond to


what they see, 35 percent respond to the sound ofthe voice, and 7 percent respond to what isactually said. Available at http://www.minoritycareernet.com/newsltrs/95q3nonver.html.We cannot ignore the impact and influence ofnonverbal communication. It is evident that theact of communication involves a complexintegration of spoken words and a host ofnonverbal behaviors and cues that conveymessages to one another.�

ABOUT THE AUTHOR

�Robert "Bob" Norton is a LicensedProfessional Counselor, Certified EmployeeAssistance Counselor, and is the ProgramAdministrator for the Executive Office for U.S.Attorney's/United States Attorney's EmployeeAssistance Program. He has over twenty-sevenyears post graduate experience in the fields ofmental health, substance abuse, employeeassistance counseling, and program management.In addition to having worked in several mentalhealth and substance abuse treatment settings,Bob has worked as an employee assistancecounselor and program coordinator for the Officeof Personnel Management, U.S. Marshal'sService, and the Library of Congress.a

Grief in the Workplace: Suggestionsfor Colleagues and ManagersEileen Grady, LICSWDeputy AdministratorEmployee Assistance ProgramExecutive Office for United States Attorneys

I. Introduction

Why do bad things happen to good people?That is the central question addressed by HaroldKushner in his 1981 book which he wrotefollowing the illness and death of his young son,Aaron. HAROLD S. KUSHNER, WHEN BAD THINGS

HAPPEN TO GOOD PEOPLE (Anchor Books 1981).It is the same question we often ask ourselves andeach other following the death of a beloved familymember, friend, or colleague. With any loss, griefcan hit us like a sucker punch, taking our breathaway as we strive to acknowledge what hashappened. When loss occurs in the workplace, theblow can be particularly acute because it feels sovery out of context. Work is generally thought ofas somewhat predictable chaos–a place where wedo not expect an emotional onslaught. This articleaddresses some of the effects of experiencing loss

at work and offers suggestions for regaining officeand individual equilibrium.

II. Grief as a process

The words grief, mourning, and bereavementare often used interchangeably. Bereavement isexperienced as the condition of having beenrobbed, of having lost. Grief is the emotionalresponse to that loss. It involves a process ofrealization. Mourning is that realization coupledwith one's adaptation to it. The words themselvesare not as important as the recognition that allinvolve a process that follows the initial assault toour senses, to our world.

Although loss is intrinsically a part of the lifecycle, it sneaks up on us and catches us unaware.This is often the case when we experience grief atwork. Work involves skills, functions, mission,and routine. We get a large portion of our self-esteem at work by utilizing our strengths. Becauseof this, many workers check emotions at the door.At the same time, many spend more hours of theday and week at work than at home andcolleagues often become one's second family.


When a colleague dies, particularly if his or herdeath is sudden, we feel especially shocked andvery vulnerable. It may feel as if there is no whereto go to escape.

Grief is a natural process, a fact, and anecessity rather than a weakness or a luxury. It iscomplex and mystifying, an issue which societies(particularly western societies) have struggled torealize throughout the ages. It is a relatively recenttopic of discussion in the health care and mentalhealth arenas. Elisabeth Kübler-Ross' 1969 book,ON DEATH AND DYING, was the seminal work onthe stages of the grief cycle. According to theKübler-Ross model, those who are grievingexperience five stages.

• Denial.

• Anger.

• Bargaining.

• Depression

• Acceptance.

ELIZABETH KUBLER-ROSS, ON DEATH AND DYING

(Scribner 1969).

John Bowlby developed a similar grief modelusing four stages.

• Initial numbing (that usually lasts from a fewhours to a week and may be interrupted byoutbursts of extremely intense distress and/oranger).

• Yearning.

• Disorganization and despair.

• Reintegration or organization.

1 JOHN BOWLBY, ATTACHMENT AND LOSS (2d ed.1982).

Many similar models exist, and they can givethe false impression that the transition throughgrief is smooth and fits predictable patterns.Discussions with grieving individuals have helpedus to better appreciate that grief feels more likethe ebb and flow of a violent surf. Waves of griefcrash down before there is a chance to recoverfrom the previous onslaught. Over time those joltsbecome more manageable, but people do not cyclethrough grief as we previously imagined. Grief isa process that, at the very least, takes time. Sometry to deny or escape the process, but it catches upwith them eventually, often resurfacing in morecomplicated and troubling ways.

III. Grief reactions

Grief reactions vary from person to person.How one grieves is affected by many things,including the following factors.

• Your relationship with the deceased.

• Other losses you have experienced.

• Your cultural/family practices.

• Your religious/spiritual beliefs.

• Other stresses in your life.

• How you cope with things in general.

It is imperative to remember that no two griefreactions are the same. Because we often do notknow the full extent of another's grief experience,we should be careful not to judge whether anotheris grieving enough, too much, or as we think theyshould. We each grieve for whom we have lost,what we have lost, and what we have lost for thefuture.

People who have lost colleagues experiencegrief in many ways. Available at http://www.lib.law.washington.edu/hazelton/article-grieving.doc.Most grief reactions start with denial, shock, ordisbelief–coping mechanisms which help prepareus to absorb the unimaginable reality with whichwe have been faced. When that initial shock wearsoff, reactions include behavioral, cognitive,spiritual, emotional, and physical realms.

A. Behavioral

Common experiences of people who haveencountered a loss include how they act orbehave.

• Low self-confidence.

• Lack of energy.

• Little social interest.

• Diminished interest in communicating.

• Decreased ability to make plans or decisions,or to act.

B. Cognitive

Cognitively, people find themselves makingmore mistakes, such as locking oneself out of thecar or misspelling one's own name. Cognitiveexpressions of loss reflect a temporarily altered


use of our analytical abilities. Commonexperiences include the following.

• Decreased ability to concentrate.

• Difficulty imagining the future.

• Concerns of forgetting the past.

• Sense of triviality about everyday life.

• Absorption with the finality of loss.

• Inability to understand why or what happened.

• Focus on the consequences of the loss.

C. Spiritual

Additionally, grief is often experienced on aspiritual level. Our soul or spirit is deeply affectedby loss, which may result in a number ofsymptoms.

• Feelings of emptiness/meaninglessness.

• Loss of faith or questioning of beliefs.

• Need to reassess life's significance.

• Loss of sense of self.

• Inability to see positives.

• Awareness of life's fragility.

• Profound feelings of aloneness or despair.

D. Emotional

"No one ever told me that grief felt so likefear. I am not afraid, but the sensation is likebeing afraid." C.S. LEWIS, A GRIEF OBSERVED

(Harper 1961).

In addition to a sense of fear or anxiety,emotional reactions commonly associated withloss are numerous.

• Numbness.

• Sadness.

• Longing/yearning.

• Apathy.

• Helplessness.

• Agitation.

• Emptiness/loneliness.

• Disconnectedness to anyone/thing.

• Anger (at oneself, at the deceased, atmanagement, at the world for not stopping).

• Guilt or shame associated with feelings ofpowerlessness.

E. Physical

Our physical self is not immune from loss.Physically, people describe feeling worn out,wrung out, sluggish (as if they were wadingthrough jello or peanut butter), and nauseous, aswell as numerous other afflictions.

• Chest pains.

• Headaches.

• Fatigue/exhaustion.

• Restlessness.

• Numbness.

• Crying, sobbing, sighing.

• Eating and sleep disturbances.

Grief does not occur in each of these realmsindependently. We experience many of these areassimultaneously. This can lead to periods ofexhaustion and self-doubt. It is important to notethat, at the same time, the initial denial mayresurface. When we hear the deceased's voice inthe hallway or are sure we recognize theirfootsteps, our brain and heart are still strugglingwith the finality of our loss. This is a very normalreaction, which can feel both disturbing andcomforting. Also, it is not uncommon to hear thatthose grieving experience anxiety about thedeceased being forgotten. They are sometimesworried that they will forget the face or the voiceof their friend or family member. They may feelresentful that others are moving on too soon.Working through the process of grief does notmean we no longer love the person who died orthat we no longer care. It can mean that we aretrying our best to honor their memory so that wecan continue our lives with what we have learnedfrom them.

IV. Suggestions for coping with grief atwork

In the workplace loss is experienced in manyways.

• The death of a coworker after a long illness.


• The sudden death of a coworker.

• Sudden catastrophic death caused by theterrorist attacks of September 11th.

All of these losses have a consequence in aworkplace and need the attention of everymember of the organization. Available at http://www.lib.law.washington.edu/hazelton/article-grieving.doc.

The following suggestions have beencompiled by the author in working withemployees in the United States Attorneys' Officecommunity following the tragic losses of manyesteemed colleagues.

A. Do not second guess yourself. Try not tojudge your past interactions with your colleaguebased on what you know now. If you feel thereare conversations to be remedied or things leftunsaid, consider writing them down or writingyour friend a letter. Tell him or her what is in yourmind and heart. This is often a useful tool forforgiving oneself.

B. Do what gives you comfort. Some will feeltheir way through grief, others will think theirway through it, others will "busy" (activity isoften helpful to men when they are grieving) theirway through it. Find what works for you.

C. Support each other–talk and listen. Talkingwill release the adrenaline surges your body hasexperienced vis-à-vis the trauma of losing yourcolleague. Talking provides a means fororganizing your emotions and regaining a sense ofcontrol over them. Recognize, though, that talkingwill not feel comfortable for all. Give thosearound you the room to grieve in their own ways.

D. Defer to your colleague's family. One personin your office (or a few) may act as a point ofcontact. Follow the family's lead about how muchcontact they want. Give them time to decide whatthey want to do about funeral or memorialservices before moving forward with an officememorial. Remember, though, nobody complainsof having received too many sympathy cards orcondolences.

E. Offer logistical assistance. It helps to feeluseful. Talk with each other about what you cando for the family. Bring food? Take care of yardwork? Assist with funeral preparations? Rather

than ask generally what you can do, offersuggestions while being mindful of the above.

F. Watch platitudes. Give advice to others whoare grieving very cautiously. If you are not surewhat to say, offer condolences. Say "I'm sorry"and let others know how much you cared for oradmired your colleague and how much they willbe missed.

G. Write to your colleague's family and toyourself. Family members cherish books ofletters, notes, and photos sharing fond memoriesand touching anecdotes. These can be particularlymeaningful for children. In addition, journaling isemotionally and physically cathartic.

H. Take care of yourself physically. Grief isextremely taxing physically and suppresses theimmune system. Remember to eat. Drink lots ofwater. Watch caffeine, nicotine, and alcoholintake.

I. Continue your routine. This can help regainyour identity, your role, and your sense of safetyand normalcy.

J. Be gentle with yourselves and with eachother. Do not judge how others are reacting.Some will show their emotions, others will not.Some will attend services, others will not. Again,we all react in different ways and there is no rightor wrong way.

K. Cry or laugh. Both provide the samephysiological release. We all need to provide ourbodies that kind of momentary respite.

L. Pray. Meditate. Read. Do what brings you amoment of peace.

M. Focus on what you want to remember aboutyour colleague. Write it down. Post it somewherevisible in your work space.

N. Allow yourself to slow down. Grief takesmore energy than we would ever have imaginedand the need to recharge one's battery is universal.

O. Watch for unguarded moments. Grief oftensneaks up on people while driving, or at thegrocery store, while completing mundane tasks, orearly in the morning. All of these reactions arevery normal, but can be startling.


P. Watch the "whys." Try to ask yourselves"what" or "how" instead. How can we get throughthis? What can we do to honor our colleague?What do we want to ensure that this communityremembers about him or her?

Q. Ask for help. This can come from friends,colleagues, family, the clergy, or mental healthprofessionals.

V. The role of managers in griefresponse and recovery

In addition to working through their owngrief, managers have the added concerns of caringfor their grieving employees. The following,compiled by Mary Tyler are recommendations formanagers in assisting their staffs to navigatethrough the loss of a beloved colleague. MARY

TYLER, UNITED STATES OFFICE OF PERS. MGMT.,HANDLING TRAUMATIC EVENTS: A MANAGER’S

HANDBOOK (1996).

A. Stay firmly in charge. Let all employeesknow that you are concerned and doing all youcan to help them. You represent the organizationto your employees and your caring presence canmean a great deal in helping them feel supported.

B. Ask for support from higher management.Relief from deadlines can help make it easier foryou to focus on helping your employees and yourorganization return to normal functioning.

C. Don't keep a stiff upper lip or advise anyoneelse to do so. Let people know, in whatever wayis normal for you, what you are feeling. Since youcan function rationally in spite of your strongfeelings, they know they can do likewise.

D. Share information as soon as it is available.Do not be afraid to say I do not know. It will showthat you care and that you are paying attention. Asa result, it will lessen others' anxiety.

E. Reach out to family members. As notedearlier, designate a point of contact so the familyis not overwhelmed with calls.

F. Contact all employees. Reach out to thosewho are on leave or on travel.

G. Give people a private place to mourn. Leavethe deceased's office or work space as much intact

as possible and consult with staff before turning itover.

H. Ask for support from your EmployeeAssistance Program (EAP). Bring them on site.Also, encourage your employees to accessservices as a way of preserving health.

I. Encourage employees to talk about theirpainful experiences. Again, set a positiveexample by expressing your feelings openly.

J. Build on the strengths of the group. The moreyou have done to build a cohesive work group andto foster self-confidence in your employees, themore your staff can help one another in a crisis.

K. Get back to the work routine in a way thatshows respect for the deceased. Be aware of thehealing value of work. Getting back to the dailyroutine can be a comforting experience. However,the process of getting a staff back to work is onewhich must be approached with great care andsensitivity. The process must be handled in a waythat shows appropriate respect.

L. Honor the deceased. After the family has hadan opportunity to organize a funeral or memorialservice, consider a district ceremony to honoryour colleague. Again, involve those closest to thedeceased and ask for everyone's input. Amemorial service, dedication of a conferenceroom or a park bench, planting of a tree, anddevelopment of a scholarship fund or award, areexamples of ways to honor and preserve thememory of a beloved colleague.

VI. Conclusion

"I think of Aaron and all that he has taughtme, and I realize how much I have lost and howmuch I have gained. Yesterday seems less painful,and I am not afraid of tomorrow." In a time ofgrief, we all struggle with unanswerablequestions. Our hope in the face of tragedy is howwe struggle together. HAROLD S. KUSHNER,WHEN BAD THINGS HAPPEN TO GOOD PEOPLE 162(Anchor Books 1981).�


ABOUT THE AUTHOR

�Eileen Grady is a Licensed Clinical SocialWorker, as well as the Deputy Administrator ofthe Executive Office for United States AttorneysEmployee Assistance Program (EAP). She cameto the Justice Department in 1998 following tenyears as a social worker for the Unites StatesNavy, Marine Corps, and Army, providing mentalhealth services for military personnel and theirfamilies in the areas of domestic violence, childabuse and neglect, rape and sexual assault, andaddictions. She started EOUSA's EAP in 1999and has extensive experience in trauma and griefresponse.a

Stress in the Workplace: Causes andSolutionsEileen GradyLicensed Clinical Social WorkerDeputy AdministratorEmployee Assistance ProgramExecutive Office for United States Attorneys

Ed NeunlistLicensed Clinical Social WorkerEmployee Assistance ProgramExecutive Office for United States Attorneys

I. Introduction

Stress is a universal condition. We have allexperienced it. An anonymous quote sums upcommon feelings about stress: "Stress is when youwake up screaming and realize you haven't fallenasleep yet." Dr. Hans Selye (1926) formulated thefirst clinical definition of stress as "the non-specific response of the body to any demand madeupon it." HANS SELYE, THE STRESS OF LIFE 1(McGraw-Hill 1956).

Stress can occur as a result of positive andnegative experiences. The joy you experiencewhen you win a trial or see a loved one, the

excitement you feel when watching a favoritesporting event, or the happiness from a visit withan old friend are all stress reactions. In each ofthese situations your heart beats faster, youremotions peak, and you experience a surge inadrenalin, all of which are normal symptoms.Because these are positive situations, you may notthink of them as stressful. Without some degree ofstress, to either motivate or activate your self-protection instinct, you could not survive. Whenfeelings of stress become chronic, you begin tofeel anxious, may become irritable or moody, andcan develop physical symptoms.

II. Eustress versus distress

Eustress, often referred to as "good stress," isthe stress which everyone needs to functionproperly on both emotional and physical levels.Eustress provides the shot of adrenalin needed tofinish a project at work or motivates you toperform a task you dislike. In these situations,when something is viewed as manageable, thebody reacts accordingly and keeps the personalert, rather than alarmed. Eustress is regulated byboth emotional and situational processes. Byevaluating the potential benefit of a given task or


situation, emotional regulation provides thepassion or energy needed. Situational regulationinvolves breaking the task or situation intomanageable steps, and providing internal feedbackin order to stay on task, evaluate progress, andinstill confidence. Relying on past experience,both positive and negative, assists in both types ofregulation. Available at http://www.Eustress.org.

Distress, often thought of as "bad stress," canbe triggered whenever life's demands exceed theperceived ability to cope with them. In a situationof distress, the activation of the sympatheticnervous system (a critical part of the generalnervous system) mobilizes a person for quickaction. The more an individual senses danger(social or physical), the more the body reacts.Distress triggers what has been called a "fight orflight" reaction. This reaction was very importantin past times when our ancestors were frequentlyfaced with life or death situations. In currenttimes, such life and death scenarios are not ascommon. Yet an individual may react to manydaily situations as if they were life or death issues.The human body does not know the differencebetween a saber-toothed tiger and an employercorrecting our work. It is how the events of lifeare perceived and interpreted that dictate how thebody reacts. If we think something is very scary orworrisome, our bodies react accordingly. Distressis often what people are experiencing when theytalk of feeling stressed at work.

There is a third type of stress called Post-Traumatic Stress that can result following theexperience or witnessing of life-threatening eventssuch as terrorist attacks, military combat, naturaldisasters, serious accidents, or violent personalassaults. Post-Traumatic Stress is beyond thescope of this article, but additional information onPost-Traumatic Stress and Post-Traumatic StressDisorder (PTSD) is available by contacting theauthors.

III. Stages of stress reactions

The way we react to stress is very predictable.In 1936, Selye identified what has becomeuniversally known as the General AdaptationSyndrome (GAS). The GAS describes the body'sresponse (particularly that of the hypothalamic-pituitary-adrenal axis) to emotionally challengingstimuli (perceived stressors) and includes threephases.

• Alarm—Once confronted with an initialstimulus, or stress-producing situation, thebody reacts automatically and decideswhether to fight or to flee. As we move intothe "fight or flight" mode, the respiration rateincreases, shallow breathing ensues, the heartbeats faster, stomach muscles releaseadditional stress hormones, pupils dilate,perspiration increases, capillaries constrict,and the individual may begin to experiencerestlessness, anxiety, fear, and anger.

• Adaptation—In full "fight or flight" mode, thebody tries to cope, adapts to stress and beginsthe process of repairing any damage caused. Ifthe stress can be overcome (for example, thethreat withdraws or is scared away) or isdetermined to be eustress, the biologicalreactions begin to diminish and the emotionalresistance to the stressor is increased. If thethreat remains, or if the body remains in astate of distress, we may begin to deny ourfeelings of fear and anxiety, suffer emotionalisolation, and experience a narrowing ofinterests (for example, pinpoint focus on thesituation at hand).

• Exhaustion—If there is no relief from stressand the body and mind cannot repair thedamage, emotional and physical symptomsmay include chronic frustration, anger,depression, interpersonal problems(coworkers, friends, and family), healthproblems, declining performance, substanceabuse, and feelings of meaninglessness. Atthis stage, it can be very helpful to seekprofessional counseling.

If the experience of stress continues throughand beyond the exhaustion stage, burnout mayresult, characterized by psychosomatic illnesses(psychological/emotional distress which ismanifested physically), fatigue, digestiveproblems, headaches, teeth grinding, high bloodpressure, heart attacks, and strokes. At this point,counseling and medical assessment are stronglyrecommended.

IV. Stress at work

Although we experience stress in all aspectsof our life, the stress we experience at work isunique in that it happens when there is a conflictbetween job demands on the employee and theamount of control the employee has over meetingthese demands. In other words, the combination of


high demands in a job and a low amount ofcontrol over the situation can lead to feelingdistressed.

L.R. Murphy reported that workplace stresscan result from a number of situations, eitherindividually or in combination. 2 L.R. MURPHY,OCCUPATIONAL STRESS MANAGEMENT: CURRENT

STATUS AND FUTURE DIRECTION IN TRENDS IN

ORGANIZATIONAL BEHAVIOR 1-14 (1995).

• Factors unique to the job—workload(overload and underload), pace/variety/meaningfulness of work, autonomy (forexample, the ability to make your owndecisions about your job or specific tasks),shift work/hours of work, physicalenvironment (such as noise or air quality),isolation at the workplace (emotional orworking alone).

• Role in the organization—role conflict(conflicting job demands, multiplesupervisors/managers), role ambiguity (suchas lack of clarity about responsibilities orexpectations), level of responsibility.

• Career development—under/over-promotion,job security (lack of job security either fromthe economy or a lack of tasks or work to do),career development opportunities, overall jobsatisfaction.

• Relationships at work—with supervisorsand/or coworkers and subordinates, threats ofviolence or harassment (threats to personalsafety).

• Organizational structure/climate—participation (or non-participation) indecision-making, management style,communication patterns.

V. Surveys of workplace stress

The National Institute for Occupational Safetyand Health (NIOSH), the federal agencyresponsible for conducting research and makingrecommendations for the prevention of work-related illness and injury, summarized findingsobtained in the 1990's in large surveys byNorthwestern National Life Insurance Co.,Princeton Survey Research Associates, St. PaulFire and Marine Insurance Co., Yale University,and The Families and Work Institute and reportedthe following.

• 40 percent of workers reported their job wasvery or extremely stressful.

• 25 percent viewed their jobs as the numberone stressor in their lives.

• 75 percent of employees believed thatworkers have more on-the-job stress than ageneration ago.

• 29 percent of workers felt quite a bit orextremely stressed at work.

• 26 percent of workers said they were "often orvery often burned out or stressed by theirwork." Available at http://www.cdc.gov/niosh/stresswk.html.

More recently, in 2000, the annual "Attitudesin the American Workplace VI" Gallup Pollsponsored by the Marlin Company resulted insimilar findings.

• 80 percent of workers felt stress on the job,nearly half said they need help in learninghow to manage stress, and 42 percent say theircoworkers need such help.

• 14 percent of respondents had felt like strikinga coworker in the past year, but did not.

• 25 percent have felt like screaming orshouting because of job stress. Available athttp://www.stress.org/job.htm.

VI. Effects of workplace stress

In September 2003, The Center for theAdvancement of Health in "Facts of Life: IssueBriefings for Health Reporters" reported a numberof interesting conclusions. Available athttp://www.cfah.org.htm.

• Workplace stresses can double the rate ofdeath from heart disease, according to a 2002study of 812 healthy employees.

• Workers who have little control over theirjobs are up to 50 percent more likely to dieduring a period of five to ten years thanworkers who have high-stress jobs, but moredecision-making responsibilities.

• Office workers, who are exposed to low-leveloffice noises, including quiet conversations,have higher levels of the stress hormoneepinephrine than those working in silentoffices.


• Clerical workers show more signs ofbiological stress during the workday thanthose in executive or more senior positions.

• Work-related stress (including job insecurity)and fatigue may increase the risk of cold, flu,and stomach inflammation. In one study,employees in demanding jobs developed colds20 percent more often than those in lessdemanding positions.

What about the economic cost of stress in theworkplace? The American Institute of Stress(AIS) estimates that up to a million workers in theUnited States are absent daily due to stress, andAIS president Dr. Paul Rosch states, "We estimateit costs American industry $300 billion a year interms of diminished productivity, employeeturnover and insurance." Available at www.stress.org/job.htm. One of the biggest expenses anorganization has is the cost of health care, and jobstress is a key driver of health care costs.According to the Journal of Occupational andEnvironmental Medicine, health care expendituresare nearly 50 percent greater for workers reportinghigh levels of stress. Available athttp://www.cdc.gov/niosh/stresswk.html.

VII. Identifying stress

As stated previously, the human body'sbiological reaction to perceived stressors is anautomatic response designed to protect andsupport it. In order to maintain both a physicaland emotional sense of stability, an individual'sbody is constantly adjusting to his or hersurroundings. When a physical or psychologicalevent threatens this equilibrium, the human bodyreacts to it. These reactions can be seenphysically, via emotions and behavior, and incognitive functioning. The following are possiblereactions to stressful situations.

• Physical—pounding heart, headaches, sweatypalms, indigestion, skin rashes, shortness ofbreath, holding breath, cold hands,sleeplessness, oversleeping, fatigue, nausea,diarrhea, gastrointestinal distress, tightmuscles, and pain.

• Emotional—moodiness, irritability,depression, anxiety, lack of sense of humor,abrasiveness, hostility, nervousness, andemotional volatility.

• Cognitive—forgetfulness, loss ofconcentration, poor judgment,

disorganization, fuzzy perception, confusion,lack of interest, and negative self-talk.

• Behavioral—increased smoking, aggressivebehaviors (such as road rage), increasedalcohol or drug use, carelessness, undereating,overeating, withdrawal, listlessness, hostility,accident proneness, nervous laughter,compulsive behavior, and impatience.

If these symptoms seem familiar to you it maybe time to take a personal stress inventory andconsider developing a new stress managementplan.

VIII. Optimizing stress

A very simplistic approach to optimizingstress might be to "tough it out" and march on. Itis certainly understandable to think of stress as areason for not pushing harder. High performanceat work, however, may require continued hardwork in the face of high levels of sustained stress.The strongest and most flexible position in thesesituations is to actively optimize stress so as toproduce high quality work over a long period oftime in a reliable manner. If this is the case, it isessential to identify the type of stress beingexperienced and implement effective strategies foroptimizing the positive benefits of the stress,while at the same time minimizing the negativeconsequences resulting from too much stress.

If the stress is short term, such as thatassociated with a trial, a deadline, a difficultmeeting, a sporting event or other typeperformance, or a confrontational situation, theemphasis is on short-term management ofadrenaline to maximize performance. In thesesituations, the level of stress under which a personoperates is important. If an individual is not underenough stress, he or she may find that theirperformance suffers because of boredom or lackor motivation. If an employee is under too muchstress, they may find that their results suffer asstress-related problems interfere with theirperformance. In the middle, at a moderate level ofstress, there is a zone of best performance. If it ispossible to stay within this zone, the employeewill be sufficiently aroused to perform wellwithout being overstressed and unhappy.

The zone of best performance is different fordifferent people. Some people may operate mosteffectively at a level of stress that would leaveother people either bored or in pieces. It is


possible that someone who functions superbly at alow level might experience difficulties at a higherlevel. Alternatively, someone who performs onlymoderately at a low level might performexceptionally well under extreme pressure.

If the stress is long term, and fatigue and highadrenaline levels are maintained over a longperiod of time, it can lead to degradedperformance. Optimizing stress should focus onthe management of fatigue, health, energy, andmorale. This includes three phases. During thefirst phase, the level of stress and the time understress are increasing, but the individual is able toface challenges with plenty of energy. Theperson's response will probably be positive andeffective. During the second phase, the level ofstress continues to increase as the time understress increases, but the quality of work begins todecrease. The employee begins to feel seriouslytired, anxious, frustrated, and upset. During thethird phase, a point is reached where functioningand performance drop dramatically. Theindividual will ultimately experience depression,burnout, and other serious stress-related illness. Inorder to optimize the stress in an increasinglystressful situation for long periods of time, makesure appropriate steps are taken to keep healthy,be aware of morale, and seek assistance frommental health professionals, if needed.

People move between stages at differentspeeds and under different stress conditions. Inaddition to paying attention to stress levels, payattention to the stress under which other peopleoperate. As a manager seeking to improveproductivity, failing to monitor stress may meanthat employees are driven into depression orburnout. If this is a danger, reduce stress longenough for them to recover and reconsider thepace management is setting.

IX. Managing stress and buildingresiliency

We think of stress and the need for aneffective way of managing stress as a result of thetrials and tribulations of modern times. The Greekphilosopher Epictetus, however, showed greatinsight into stress and stress management a very,very long time ago when he observed that "Menare disturbed not by things but by the views theytake of them." Available at http://www.cdc.gov/niosh/stresswk.html.

Stress is the body's response to a perceivedthreat to well-being. It is not the event itself whichis stressful, but the body's response to the event.The manner in which we perceive an event, or ourperspective, is the primary factor in how we reactto a given situation and how we cope once webegin to experience a stress-related reaction. Forexample, if we perceive a particular person orsituation as dangerous, harmful, or threatening,we will respond by mobilizing our stress responsesystem (GAS). If, on the other hand, we view thesame person or situation in a nonthreatening way,we may have a positive outlook and not activateour GAS in the same way. We often findourselves in situations where we have very littleor no control over events, but we do have controlover how we perceive or interpret those events.

Our system of beliefs will also generallyaffect the emphasis we put on a potential stressorand may dictate what we feel are appropriateresponses to the situation. We generally form ourbelief systems at a young age. Some people maybelieve that they are quite good at handling smallhassles and major stressors. Others may believethat they are quick learners who can improve theirstress management skills. These beliefs contributeto one's temperament or constitution and play asignificant role in how one views, is affected by,and copes with difficult situations.

Because there are numerous situations both atwork and in life which are beyond control, andbecause we can not make stressors disappear,building resiliency is a critical component insteeling one's self for the impact of chronicallystressful challenges. The following are offered aspractical suggestions for managing stress,strengthening resiliency, and improvingperformance.

• Develop awareness of the stressors in life andthe methods used to react to stressfulsituations. Take control.

• Plan the day. How do you spend your timeand how do you want to spend it? What isurgent and what is important? Prioritize actionitems and assess your high and lowproductivity times. Next, be prepared for thatplan to change. STEVEN COVEY, FIRST THINGS

FIRST (Free Press 1994).

• Evaluate the work space. Organize existingclutter and make it a physically comfortableplace to work.


• Exercise is one of the most effective stressmanagement tools in behavioral medicine.Find something enjoyable and make it apriority. Run, walk, swim, lift weights, hike,play tennis, golf, or a team sport, take martialarts and exercise classes. Yoga provides theadded benefit of relaxation, visualization, andmeditation.

• Practice good nutrition. Lighter, healthiermeals yield excess energy. Increaseconsumption of fruits and vegetables–even byone serving per day. Watch caffeine intakeand drink lots of water.

• Take a real lunch break. Where lunch is eatenis sometimes as important as what is eaten.Productivity studies show that taking a onehour lunch break results in sustained qualitywork.

• Sleep. Take an active role in developing anew sleep strategy, if problems exist in thisarea.

• Limit consumption of alcohol and other drugs.Alcohol, although viewed by many as a greatstress reliever, charges high interest rates.Sleep disturbances, fatigue, irritability, andmalaise are only the beginnings of the pricepaid the next day. Also, review all medicationwith a physician on a regular basis to ensurethat maximum benefit is achieved withminimal side effects.

• Identify strategies for dealing positively withnegative situations (what is learned from thissituation, this encounter, this mistake?).

• Do not "catastrophize." Keep challenges andpressures in perspective. Remember, thoughtscontrol feelings rather than the reverse.

• Surround yourself with positive people. Resistthe temptation to participate in office gossip.This contributes to feelings of chronic stressand resentment.

• Delegate one task a day whenever possible.

• Keep a calendar. In addition to prioritizingwork tasks, projects, and deadlines, scheduletime for exercise, leisure, and life outside theoffice. In today's busy world, what is notwritten down is not viewed as important and,as such, does not get done.

• "Just say no." Too many commitments lead tostress overload, resentment, and burnout.

Reduce stress by learning to gauge thenumber of commitments that are comfortablyhandled.

• Impose a quitting time. It is commonly heardthat no one says on their death bed that "Iwish I had spent more time at the office."Plus, productivity drops to levels ofdiminishing returns at the end of the day.

• Seek progress, not perfection. Avoid blame ofothers and self.

• Remember the healing power of humor. Donot take yourself too seriously. Laugh atyourself and with others.

• Read, write, meditate, or pray. Find thatwhich helps you breathe more comfortably.

• Ask for help from colleagues, supervisors,family, friends, clergy, and mental healthprofessionals. Call your Employee AssistanceProgram for confidential assistance indeveloping a personalized stress inventoryand stress management plan.�

ABOUT THE AUTHORS

�Eileen Grady is a Licensed Clinical SocialWorker, as well as the Deputy Administrator ofthe Executive Office for United States AttorneysEmployee Assistance Program (EAP). She cameto the Justice Department in 1998 following tenyears as a social worker for the Unites StatesNavy, Marine Corps, and Army, providing mentalhealth services for military personnel and theirfamilies in the areas of domestic violence, childabuse and neglect, rape and sexual assault, andaddictions. She started EOUSA's EAP in 1999and has extensive experience in trauma and griefresponse.

�Ed Neunlist is a Licensed Clinical SocialWorker. He joined the Executive Office forUnited States Attorneys Employee AssistanceProgram (EAP) as an EAP Counselor inSeptember 2003 after almost ten years workingfor the Navy as part of its Family AdvocacyProgram. He has worked in the United States andoverseas in the field of domestic violence.a


Domestic Violence in the WorkplaceEd NeunlistLicensed Clinical Social WorkerEmployee Assistance ProgramExecutive Office for United States Attorneys

Domestic violence is not a "gender neutral"issue. While it is true that men can be, and arevictims of domestic violence, it is noteworthy thatin 2001 the U.S. Department of Justice's Bureauof Justice Statistics reported that 85 percent of allsurveyed victims of intimate partner violence werewomen, domestic violence is the leading cause ofinjury to women, and three in four homicidevictims who were murdered by their intimatepartners were women. The research and statisticssadly show that the clear majority of victims arewomen and the clear majority of offenders aremen. Although there is no desire to deny orminimize the pain male victims of domesticviolence experience, it would be disingenuous,inaccurate, and overly cumbersome to use"he/she" for both victims and offenders ofdomestic violence throughout this article. Forthose reasons, victims will be referred to as "she"and offenders as "he."

I. Introduction

Domestic violence is most often portrayed inour society as taking place in the bedrooms, livingrooms, and kitchens of our homes. However,domestic violence does not stay at home when thevictim goes to work and, as a result, domesticviolence has begun showing up more frequently inthe workplace. Domestic violence enters theworkplace via unwanted or threatening phonecalls, unwanted and unexpected visits from theoffender, and actual incidents of violence.

Lethality of domestic violence is difficult topredict, but there is general consensus that theviolence increases when the victim leaves orattempts to leave the relationship. Once a coupleseparates, or the offender is forced from the homeby legal means, the workplace becomes the easiestplace to locate and access the victim. Domesticviolence may also enter in less direct ways such asloss of productivity and the arrest and/orhospitalization of employees.

According to research conducted by EDKAssociates and reported in The Many Faces ofDomestic Violence and Its Impact on theWorkplace (1997), a survey of 7,000 womenshows that 37 percent said domestic violence hada negative impact on their job performance.Available at http://www.endabuse.org/resources/facts/Workplace.pdf. A 2000 report by B. Y.Urban of the University of Illinois at Chicagoshows that among a group of abused employeesreceiving workplace counseling, the averageabsenteeism rate of the group at the time ofbeginning counseling was about 30 percent higherthan the average employee. Available at http://www.endabuse.org/resources/facts/Workplace.pdf. As the potential for violence spills from homeinto the workplace and as productivity isadversely affected, it is no longer sufficient foremployers to lend a sympathetic ear andencourage either the victim or the offender to getoutside help. It is imperative that employers, bothprivate and public, learn to recognize the signs ofdomestic violence and include domestic violenceas a central part of their workplace violenceprevention program.

Irene met Randy shortly after ending a verypainful relationship. Although Irene stated shewas not interested in a relationship at the time,Randy came on like gangbusters and would nottake no for an answer. Randy showered Irene'sson with attention and became very important inhis life. Randy would call Irene once in themorning and once in the afternoon to see how herday was going and tell her he was thinking abouther. Randy courted Irene's friends and family asmuch as he courted her and it was not long beforeeveryone saw them as a couple. After they hadbeen dating about two months, the couplereturned to Irene's following a date, and Randysuggested that he spend the night as it was toolate to drive home. Although her son was thereand she wanted to protect her son from getting tooattached to Randy, Irene reluctantly agreed.Gradually Randy would forget clothes, leavepersonal effects at her house, or find otherreasons to spend the night at Irene's. Withinanother month Randy had moved in and wasdominating Irene's time and attention.


II. Impact of domestic violence on theworkplace and scope of the problem

The American Institute of Domestic Violencereports that of battered workers, 96 percentexperience problems at work due to abuse, 74percent are harassed while at work by their abuser,56 percent are late to work, 28 percent leave workearly, and 54 percent miss entire days of work. Inother terms, employers lose between $3 and $5billion every year in absenteeism, lowerproductivity, higher turnover, and health andsafety costs associated with battered workers.Additionally, The American Institute of DomesticViolence reports that businesses lose an additional$100 million in lost wages, sick leave, andabsenteeism annually. Over 1,750,000 workdaysare lost each year in the United States due todomestic violence, which costs an estimated $67billion annually. Several other findings areinformative.

• Sixty-six percent of senior executivessurveyed agreed that their company's financialperformance would benefit from addressingthe issue of domestic violence among itsemployees.

• Ninety-four percent of corporate securitydirectors rank domestic violence as a highsecurity risk.

• Seventy-eight percent of Human ResourceDirectors identify domestic violence as asubstantial employee problem.

• Forty percent of corporate leaders arepersonally aware of specific employees whoare affected by domestic violence.

• Forty-nine percent of senior executives saidthat domestic violence has a harmful effect ontheir company's productivity.

• Forty-seven percent of senior executivesadmit partner violence negatively impactsemployee attendance.

Available at http://www.aidv-usa.com/Statistics.htm.

In October 2002, Patrice Tanaka & Company,Inc. issued a news release citing results of asurvey of corporate leaders on the effects ofdomestic violence. The survey showed that two inthree (66 percent) corporate leaders identifieddomestic violence as a major social issue. Only 33percent of those sampled said that domestic

violence has a negligible impact on the "bottomline," indicating that two-thirds believed it affectsbusiness functioning. Available at http://www.home.cybergrrl.com/dv/orgs/wworkspr.html.

In 2002, Partnership for Prevention reportedthat twenty-five health benefit managers fromsmall and large businesses around the countrydescribed the effects of domestic violence in theworkplace as absenteeism, inability to focus, poorself-esteem, low productivity, and low morale.Available at http://www.aidv-usa.com/Statistics.htm. These same managers noted that employerswho take steps to prevent domestic violence seeimprovements in performance, productivity,health, work-site safety, job retention, and otheroutcomes related to employee well-being.

In an unpublished report, twenty-nineemployers who had implemented a response toviolence against women said that their motives forresponding included "making the workplace safer,expressing concern for the personal needs of ouremployees, and being part of the solution todomestic violence or sexual assault." B.Y.URBAN, FAMILY VIOLENCE AGAINST WOMEN, TheAttorney General's Report to Congress:Workplace Responses to Violence Against Women(2003).

In addition to costs associated withproductivity, there are potential liability costs aswell. The American Institute of DomesticViolence reports that homicide is the leadingcause of death of women in the workplace.Partners and boyfriends commit 13,000 acts ofviolence against women in the workplace everyyear. Available at http://www.aidv-usa.com/Statistics.htm. As employers are becomingrequired to maintain a safe work environment fortheir employees, these statistics can become verycostly. D.F. Burke reported in January 2000 inThe National Law Journal that a wrongful deathaction cost an employer $850,000 for failing tohelp an employee who was at risk for domesticviolence on the job. D.F. BURKE, WhenEmployees are Vulnerable, Employers are TooTHE NAT'L L.J. (2000), available at http://www.endabuse.org/resources/facts/Workplace.pdf.

It surprised Irene the first time Randy madenegative comments about her friends. Randy hadalways been very supportive of her friendshipsand his sudden anger at the time she wasspending with her friends seemed out of


character. Irene knew some of her friends couldbe a bit tiresome, but over time Randy becameresentful of all of her friends, as well as the timeshe spent with her family. Randy began keepingclose tabs on Irene when she left the house and onwhat time she returned. If Irene went to visit herfamily, Randy would insist he accompany her.Randy also became resentful of the time Irenespent on the phone and began to monitor hercalls. Randy began calling Irene more frequentlyand would become angry if he could not reach herimmediately or she did not return his callsimmediately.

III. What is domestic violence?

Whether it is referred to as domestic violence,spouse abuse, intimate partner abuse, or domesticabuse, at the most basic level it is behavior used toexercise power and control over an intimatepartner. The Centers for Disease Control andPrevention, National Center for Injury Preventionand Control defines domestic violence as "violentbehavior that is controlling, coercive, and/orabusive, including physical, sexual, psychological,and economic abuse; it is committed by oneindividual against another in a domestic/intimaterelationship." Available at http://www.cdc.gov/ncipc/factsheets/ipvfacts.htm.

Although we initially think of physicalviolence, all domestic violence is not physical.Emotional abuse—putting her down, calling hernames, playing mind-games, humiliating her—canbe as devastating to the spirit as physical abuse isto the body. Domestic violence can consist of thefollowing.

• Coercion.

• Threats.

• Intimidating looks and actions to make herafraid and control her behavior.

• Isolating someone economically and sociallyby refusing to contribute income to basicexpenses or preventing her from getting orkeeping a job.

• Controlling whom she sees and talks to.

• Controlling what she reads.

• Controlling where she goes.

• Limiting her outside involvement.

• Treating her like a servant.

• Making all the big decisions.

• Acting like the "master of the castle."

• Alienating children from her.

• Using visitation to harass her.

• Threatening to take the children away.

• Making light of the abuse and not taking herconcerns about it seriously.

• Saying the abuse did not happen, saying shedeserved it, saying she caused it, or saying itwas the only way she would pay attention.

Because the purpose of domestic violence isto control behavior, spouse abusers will often usethe amount of force required to get what theywant as long that level of force continues to beeffective. For example, if a threatening look getsthe desired response, there may be no "need" tothreaten or strike the victim. But as time goes by,a threatening look may escalate to threats ofviolence and other forms of verbal abuse. Whenname-calling and verbal threats are no longereffective, the abuse will escalate to pushing,shoving, slapping, and other forms of physicalabuse. When these forms of abuse are no longereffective in controlling the victim, an abuser willresort to more extreme physical and sexualviolence to get the power and control back. Overthe life of an abusive relationship, the frequencyand magnitude of the abusive behavior willincrease in order to maintain control.

Randy slapped Irene when she got home anhour late from work. Irene and her friends hadstopped off for a drink and she did not tell Randywhere she was going. When she got home Randymet her at the front door and demanded to knowwhere she had been. When Irene happily told himabout her time with her friends Randy slappedIrene and called her friend bitches and sluts andforbade Irene to go out with them after work.Later that night Randy apologized to Irene andsaid he behaved that way because he loved her somuch and he was jealous. Although Randypromised nothing like that would ever happenagain, the next day he told Irene she had to callhim when she left work and she had a half an hourto get home. Over the next couple of weeks Randyinsisted that he answer the phone and beganlistening to Irene's conversations. When Randythought Irene had been on the phone long enough


he would interrupt her calls by asking questionsor gesturing for her to end the call. Gradually hebegan to listen to her calls on the extensionupstairs and refused to allow her to speak tocertain friends and family. Eventually, Irene'sfriends began to withdraw and quit calling her.Irene's family began to express their concerns toIrene, but she dismissed them as notunderstanding her situation and how much Randycared for her and her son.

IV. Signs of domestic violence

Unless someone discloses that they are beingabused, or are being abusive, there is no way toclearly identify victims and/or abusers. Allbattered women are not passive with low self-esteem, and most batterers are not violent in frontof other people. Both victims and offenders comefrom all ethnic groups, professions, andsocioeconomic backgrounds. While there is nochecklist to identify victims and offenders, thereare some telltale signs.

A. Victims

• Bruises/injuries she may try to explain asbeing caused by an accident.

• Frequent or unexplained absences ortardiness.

• Frequent personal phone calls that leave herupset.

• Personality change from very outgoing towithdrawn.

• Fear of conflict resulting from being battered.

• A decline in job performance—difficultyconcentrating or working effectively.

• Withdrawal from coworkers.

B. Offenders

• Obsessed with partner.

• Excessively jealous.

• Blames others for his faults.

• Blames circumstances for his problems.

• His way is the only way.

• Others are responsible for his feelings.

• Rigid gender roles.

V. How to talk to someone in an abusivesituation

Talking about domestic violence is anemotionally-charged event for both the personbeing abused and the confidante and needs to behandled with sensitivity. If you suspect someoneis being abused, consider the following guidelines.

• Let the employee know what you haveobserved, "I noticed the bruises you had lastweek and you look upset and worried today."

• Express concern that the employee might beabused, "I thought it was possible that you arebeing hurt by someone and I am concernedabout you."

• Make a statement of support, "No onedeserves to be hit."

• If the employee still chooses not to disclose,no further questions or speculations should bemade.

• Refer the employee to the EmployeeAssistance Program (EAP).

If an employee chooses to disclose that she isbeing abused, your reaction to the disclosure isvery important. You may want to consider thefollowing list of "do's" and "do nots" once abuseis disclosed.

• Do believe her.

• Do respect her need for privacy.

• Do listen to her and support her withoutjudging.

• Do let her know that she is not alone.

• Do reassure her that the abuse is not her fault.

• Do emphasize that physical safety is the firstpriority.

• Do refer her to the EAP.

• Do not tell her what to do, when to leave, ornot to leave (potentially very dangerous).

• Do not tell her to go back and try a littleharder (also potentially very dangerous).

• Do not rescue her by trying to make decisionsfor her.


• Do not encourage marriage counseling(Research shows that couples counseling,anger management, and individualpsychotherapy are not effective forperpetrators and may even put the victim inmore danger).

• Do not offer to try to talk to her partner tostraighten things out.

• Do not tell her to stay because of the children.

Four million women are battered every year,therefore, it is likely that some employees in anyorganization will be batterers. The batterer needsto be challenged to recognize his or her ownbehavior and requires support and assistance inaddressing it. Abusers tend to minimize theirbehavior. Holding an employee accountable forhis actions is the first step toward ending theviolence. Below are some suggestions forsupervisors when talking to an employee who hasbeen identified as a perpetrator of domesticviolence.

• Do not approach perpetrators if your solesource of knowledge of the abuse is from thevictim. Doing so could put the victim in evengreater danger. If you learned about the abuseby observing the abuse or through theperpetrator's self-disclosure, responding to theinformation in a matter-of-fact manner is themost effective method and is safest for thevictim.

• There may be situations in which you need toshare information with security or the policeto protect the victim and others. If there is adangerous situation in your workplace,contact the police, security, and/or the DistrictOffice Security Manager (DOSM)immediately.

• Encourage the perpetrator to acceptresponsibility. Perpetrators often justify theirconduct by blaming someone or somethingother than themselves, such as the victim, thejob, their drinking, or stress.

• Let him know that you will not condone hisviolent behavior.

• Refer the employee to the EAP.

Gradually Irene realized that no matter whatshe did Randy would always find a reason to beather. Sometimes all it took was a look from Irenethat Randy did not like and he would slap her.

Other times Randy would verbally denigrate Irenein front of her son for infractions real orimagined. Irene was aware that she was no longerthe person she had worked so hard to become. Shefrequently missed work, her performance at workhad fallen dramatically, and she was isolatedfrom her friends and family. Irene only confrontedRandy about his behavior after she saw the impactRandy's behavior was having on her son. Irenewas called by the school after her son called alittle girl a bitch and slapped her for disrespectinghim. When Irene tried to talk to Randy he becameenraged and beat her so badly that the neighborscalled 911.

VI. Developing a domestic violencepolicy for the workplace

Robin H. Thompson of the American BarAssociation Commission on Domestic Violencehas developed nine "Nuts and Bolts" steps foremployers to address domestic violence in theworkplace. Available at http://www.abanet.org/domviol/workviolence.html.

• Adopt a policy that specifically addressesdomestic violence. General workplaceviolence policies do not address the uniqueaspects of this kind of violence.

• Train all employees on the policy. A domesticviolence policy can only be effective if it isunderstood by all employees. Additionaltraining may be in order for managers andsupervisors, human resources, legal, andsecurity staff.

• Be consistent and vigilant. Consistent anddiligent implementation of the domesticviolence policy reduces employer liability andhelps to prevent violence. If a policysupporting victim safety and holding allperpetrators fully accountable is notconsistently enforced, the policy will be littlemore than feel-good window dressing.

• Comply with all local, state, and federallaws–this is particularly important formultijurisdictional offices or in areas whereemployees work in one jurisdiction, but livein another. Be aware that federal laws such asthe Family Medical Leave Act, the Americanswith Disabilities Act, and the OccupationalSafety Health Act can be applicable indomestic violence cases. More than forty


states and locales have enacted legislationspecifically directed to domestic violence inthe workplace. Maintain a safe and secureworkplace, including data systems. Victimsknow too well the tactics abusers use andabusers often act predictably, thus aidingemployers in preventing workplace violence.Abusers may threaten an employee at work ormay use office e-mail and other systems tostalk and harass victims. Managers shouldwork closely with employees who are victimsof domestic violence, EAP, security, and locallaw enforcement to create safe environmentsand to be able to respond quickly to a violentincident or threat.

• Audit your personnel policies. Make sure thatthe domestic violence policy is consistentwith other personnel policies. For instance, inaccordance with existing leave policies,victims should be allowed time off to seekhelp in the justice system, meet with herlawyer, go to court to obtain a protectionorder, and assist in the prosecution of herabuser.

• Refer employees to the Employee AssistanceProgram. Although the primary role ofEmployee Assistance Programs is notdomestic violence intervention, prevention,and education, EAPs are staffed by trainedpersonnel who can assist both victims andoffenders. The manager should referemployees to the EAP and allow the EAP andlocal domestic violence programs toundertake the responsibility of safety planningand victim advocacy. A supervisor orcoworker's best-intentioned advice can bedangerous and advice coming from a managermay appear to be coercive. The manager's rolein safety planning should be limited toconsidering ways of enhancing the victim'ssense of security at work, for example,providing a different parking space, installinglocks or changing office location. Allow thestaff of the EAP to be the liaison between theworkplace and the treatment providers ratherthan managers assuming that role. Work withand use your EAP effectively.

• Make benefits and policies that arevictim/employee friendly. Managers shouldactively strategize with individual employeeswho are victims of domestic violence, as wellas with human resources, security, and EAPon how they can make employee benefits,

including leave, insurance, and transferpolicies, easily accessible and applicable tovictims.

• Protect confidentiality. Employees may notcome forward and talk to their supervisorsabout abuse unless they understand the limitsof confidentiality. The domestic violenceworkplace policy and related guidelinesshould detail the path information will takewhen a victim tells her supervisor or acoworker about her situation and seeks help.The victim should also be told who will beinformed (for example, security, supervisors,EAP) if someone is making threats to her atthe workplace or may show up there.

• Link with community programs. A significantpart of the domestic violence workplacepolicy should be liaison between the EAP andlocal domestic violence programs. Localprograms exist to advocate and supportvictims of domestic violence. They are thelocal experts who can help victims exploreoptions for safety for herself and her children.Local programs also provide services foroffenders including treatment and aftercare.

Randy was arrested for domestic violence andIrene went to court and asked for a protectionorder. Irene's visible injuries convinced the judgethat a "cooling off period" was in order, and thejudge issued an order barring Randy from thehouse for three days and ordering him to ceasehis abusive behavior. The police advised Irene notto go home for several hours so they could servethe order on Randy and give him time to get somebelongings from the house. When Irene got homethat evening all of her clothes had been pulledfrom the closet and had bleach poured on them.All of her pictures had been torn up and theframes broken, her most prized mementos fromher family had been broken, and her son's mostrecent Mother's Day gift to her had beendestroyed. Randy was arrested for violating theprotection order, and the police report said thatRandy had lost control and destroyed everythingin sight. In court, Irene testified that it was onlyher stuff, and only the things she valued the most,that had been destroyed. She said it looked to herlike Randy had been in complete control andpointed out that none of his things, or her son'sthings had been damaged. Irene asked that therestraining order be extended for 180 days, butthe judge did not think she was in any serious


danger so he just extended the order for thirtymore days. On the way out of the courtroomRandy told Irene he would kill her before he lether leave him.

VII. Efficacy of workplace domesticviolence policies and awarenessprograms

Harman International Industries, Inc.instituted a workplace domestic violenceawareness program in 2001, after a Harmanemployee of twenty-four years was killed by herex-husband one block from her home. Thedomestic violence training sessions for employeeslasted one hour and the sessions for managerslasted two hours. An evaluation of Harman'sworkplace domestic violence program conductedby B.Y. Urban found that the company's domesticviolence training produced the following results.

• Ninety-one percent of employees said theywere now more likely to know where to refersomeone who is abused for help.

• Eighty-nine percent said they were now morelikely to be supportive of a colleague who isabused.

• Eighty-six percent said they were now moreaware of what to do if there is a threat ofdomestic violence at work.

• The training caused a "highly significantincrease" in the number of employees whosaid they know the signs of abuse, where torefer a victim to get help, and who to contactif they know an employee who might beattacked at work.

• Employees' attitudes about domestic violencewere more supportive of victims after thetraining than before it.

• Approximately 20 percent more employeeshad highly supportive answers after thetraining.

• Approximately 75 percent of Harmanemployees agreed that the training sessionsincreased their awareness and readiness torespond to domestic violence. Available athttp://endabuse.org/workplace/display.php?DocID=33013.

Randy killed Irene on the day after Christmas.Court records show that Randy had violated courtorders and had been arrested four additionaltimes for assaulting Irene, and that Irene hadbeen to court an equal number of times seekingprotection. Two weeks before Thanksgiving Randywas ordered to stay away from Irene and to ceasehis abusive behavior after he was again arrestedfor assaulting Irene. Irene's injuries were severeenough to require surgery and an extendedhospitalization. When she was discharged, Irenewent immediately to court and got anotherprotection order. A few days later she and Randyboth appeared in court and the order wasextended for 365 days. In the courtroom, Randyreminded Irene of what he told her last time theywere in court and promised her that if he couldnot have her, no one would. The witnessesdismissed Randy's threats as him being hurt andangry. Irene knew he was serious and madearrangements for her son to spend the holidayswith her parents. Neighbors later reportedhearing Randy shouting for Irene to open the doorso he could drop off a Christmas present for herson and also reported hearing Randy breakthrough the door after Irene shouted that she wasgoing to call the police. The police reported thatRandy shot Irene multiple times, and as he wasbeing led from the house he was heard to havesaid, "This was her fault … I guess I loved her toomuch."

VIII. Conclusion

The duty of an employer to provide areasonably safe workplace may arise from avariety of federal or state statutes, regulations, orjudicial decisions, and many state courts haveruled that an employer is liable for the dangerousacts of employees if such acts were foreseeable.

Domestic violence has clearly become aworkplace issue and one that needs to beaddressed at all levels of the organization. Doingso is more than cost-effective. It is the right thingto do. None of us can afford to turn a blind eye tothis very real problem.

If you or someone you know is being abusedor behaving in an abusive manner, please do nothesitate to call the Executive Office forUnited States Attorneys Employee Assistanceprogram at 202-514-1036 or 888-271-0381 forassistance.�


ABOUT THE AUTHOR

�Ed Neunlist is a Licensed Clinical SocialWorker. He joined the Executive Office forUnited States Attorneys Employee AssistanceProgram (EAP) as an EAP Counselor inSeptember 2003 after almost ten years workingfor the Navy as part of its Family AdvocacyProgram. He has worked in the United States andoverseas in the field of domestic violence.a

Navigating the Mental HealthcareSystem: Lessons Learned from theFront LinesMark A. Blair, Master of DivinityEmployee Assistance Program Specialist Employee Assistance ProgramExecutive Office for United States Attorneys

I. Introduction

Looking for the right mental health providercan be a very daunting task. A person who hasgone through a difficult or trying time andinitiated a search for a counselor or other mentalhealth provider may become more confused andfrustrated as the search progresses. Going througha stressful time in life can be exacerbated bytrying to navigate the mental healthcare systemalone. Contacting your Employee AssistanceProgram (EAP) is the first step in seeking help fora stressful or troublesome period in life. Trainedclinicians who are experienced in handling amyriad of mental health issues staff the EAP.

One of my responsibilities as an EAPSpecialist is to find mental health resources forEOUSA and USAO's staff who may contact EAPduring a difficult time. I have personallyexperienced the cacophony of questions and termsthrown at clients by insurance companyrepresentatives. Unless the client has extensiveexperience utilizing the mental health option of

his health plan, it is easy to get confused. It isEAP's responsibility to help not only clarify theissues but also to find dependable resources tomeet the clients' needs.

Buoys are often used to assist the watertraveler as he or she navigates a channel or river.They can be used to warn of impending danger ormark a safe passage and can, at times, be alifesaver to a distraught or weary voyager. Thereare also several buoys or markers which will helpa person as he or she seeks to navigate through thewaters of mental health options and resources. II. Buoy #1-General considerations

There are some general considerations tothink about as the search for a provider isundertaken. The following are some topics toconsider.

• The type of therapist needed or desired (seebelow).

• The specialized experience and training of thepotential provider. For example, a client whomight be experiencing obesity issues wouldnot want to see a clinician who specializesonly in marital counseling.


• The gender of the provider. Oftentimes aclient feels more comfortable with a same-sexprovider. Consider what the client'spreference is before starting the search.

• Is the provider covered by the client'sinsurance? If not, then the client can expect topay higher out-of-network expenses with amuch larger annual deductible fee than if aPreferred Provider Organization (in-network) is used.

• Is the provider's office convenient to theclient's home or office? Driving an extremedistance to meet with a provider on a weeklybasis can add stress to an already difficulttime. Generally, it is a good idea to findpotential providers within a ten-mile radius ofthe client's home or office to alleviate unduestress and anxiety.

• Are the provider's office hours andavailability suitable for the client's needs?Some clients prefer to be seen only duringtheir lunch hour or on weekends, therefore, itis extremely important to be able to see atherapist who can accommodate the desiredschedule.

• Is the therapist available in emergencysituations? Is there a plan in place if the clientneeds to contact the therapist or his/her officeafter hours?

• Should the client ask questions of the therapistor therapist's staff? The client should feel freeto ask questions of the therapist at any timeregarding issues related to therapy. Irecommend writing down questions for thetherapist in advance. If the client is made tofeel uncomfortable by asking questions of thetherapist or the office staff, this should serveas a "red flag," and a search for anotherprovider should be initiated. The client has aright to know not only what the charges willbe for each session, but also what to expectduring therapy. A provider who is trulyconcerned about the patient will be more thanhappy to field questions.

• Is the client comfortable seeing the therapistchosen? It is often difficult for a client todetermine if they will feel relaxed seeing aparticular therapist by simply speaking withthat therapist over the phone. If the client feelsreasonably comfortable with the therapistafter speaking with him or her, then consider

scheduling an appointment. After severalsessions with a therapist, the client will likelyhave a general impression of that person'sability to assist with therapy. It all comesdown to personal comfort level with thetherapist. The client should be wary of atherapist who does all of the talking andseldom listens. If the client does not feel thatthe therapist is a good match for him or her,then the search for a compatible therapistneeds to begin again.

• What are the insurance company's benefits?There are many questions that need to beasked regarding the benefits the client'sinsurance company provides through themental health option. Is there a deductible forin-network providers?

• What is the co-pay per session?

• How many sessions are allowed under theplan per calendar year?

• Is pre-certification required for thesesessions?

• Is there a phone number to call to verifyprovider status and client's coverage in thenetwork? Even though a provider may belisted as a provider on the insurancecompany's Web site provider listing, verifythis personally with the representative.Frequently when clients call to verify aprovider's status in the network, they find thatthey no longer are actual providers. It istypically the provider's responsibility to notifythe insurance company if they no longer wantto be considered as a provider, but often thereis a lack of communication ormiscommunication between providers andinsurance companies. A word ofcaution–verify, verify, verify!

As with the medical portion of the client'sinsurance company's provisions, options andbenefits vary with plans. Make sure you have allquestions answered before ending the call with theinsurance company representative, and do nothesitate to call them back for clarification or withfurther questions.

III. Buoy #2-Types of providers

Although most clinicians provide therapy, notall do. For example, a psychiatrist, who may nottypically conduct therapy sessions, may want a


client to see a therapist in conjunction withmedication management. The many differenttypes of therapists and the services they offer arediscussed below.

• Marriage and Family Therapist or LicensedMarriage and Family Therapist (MFT orLMFT). According to The AmericanAssociation for Marriage and FamilyTherapy, LMFT's or MFT's are

mental health professionals trained inpsychotherapy and family systems, andlicensed to diagnose and treat mental andemotional disorders within the context ofmarriage, couples and family systems.Marriage and family therapists are ahighly experienced group of practitioners,with an average of thirteen years ofclinical practice in the field of marriageand family therapy. They evaluate andtreat mental and emotional disorders,other health and behavioral problems, andaddress a wide array of relationship issueswithin the context of the family system.

Available at http://www.aamft.org/faqs/index_nm.asp#what. These are clinicians who hold at least amaster's degree in psychology, psychology withan emphasis in counseling, or marriage and familytherapy. They usually work with all age groups.To find a Marriage and Family Therapist nearyou, go to the AAMFT website at http://www.aamft.org/TherapistLocator/index.asp.

• Licensed Professional Counselor or MentalHealth Counselor (LPC or MHC). The Officeof Public Policy & Legislation of TheAmerican Mental Health CounselorsAssociation, defines LPC's as,

professionals with master's or doctoraldegrees in counseling or relateddisciplines who provide counselingservices along a continuum of care, fromdiagnosis and treatment of mental illness,to educational and preventative services,to long-term care. Mental healthcounselors practice in a variety of settings, including mental health centers,hospitals, managed behavioral health careorganizations, substance abuse treatmentcenters, and private practice.

Beth Powell, Education, Training, andSupervision Requirements for Mental Health

Counselors, AMERICAN MENTAL HEALTH

COUNSELOR 'S ASSOCIATION 1 (2005).

An LPC usually holds at least a master'sdegree in counseling or psychology, has twoto four years of supervised clinical experienceand has met the necessary requirements forlicensure. For the location of an LPC log onto: http://www.find-a-counselor.net/default.htm.

• Licensed Clinical Social Worker (LCSW),Licensed Independent Clinical Social Worker(LICSW), or Licensed Social Worker (LSW).According to The Mayo Clinic, clinical socialworkers are clinicians that have, at aminimum, a master's degree in social work(MSW), three years experience, and meetcertain stringent training stipulations asdetermined by their state, includingsupervised clinical experience, to enable themto provide mental health and psychologicalservices as licensed providers. Social workersparticipate in the assessment, diagnosis, andtreatment of a variety of individual and familyissues and are often involved in client supportand advocacy. For further information on thelocation of social workers in your area, youcan visit the Web site of The NationalAssociation of Social Workers at http://search.socialworkers.org/default.asp?df=CSW&fn =. Go to NASW's homepage at http://www.socialworkers.org. to access furtherinformation on the web.

• Ph.D., Psy.D. Psychologist, or Doctor ofPsychology. The Mayo Clinic definespsychologists as,

specialists in psychology, the branch ofscience that deals with the mind, mentalprocesses and behaviors. There are manytypes. Those who treat mental illnessesare generally clinical or counselingpsychologists. The title psychologist isusually reserved for those who have adoctoral degree (Psy.D. or Ph.D.),advanced training, and certain licensingand certification.... Psychologists providepsychotherapy for a range of problems,from marital discord to personalitydisorders....

Available at http://www.mayoclinic.com/invoke.cfm?objectid=549B34CB-C4FD-45AB-8616378D0AB4F56B&locID =. Theseclinicians often have experience in advanced


treatment methodology. They also providepsychological examination and evaluation.For a listing of links to state board offices goto http://www.apa.org/practice/refer.html.

• Psychiatrist (MD). According to the MayoClinic, psychiatrists are those, "who specializein the diagnosis, treatment and prevention ofmental illnesses." Available at http://www.mayoclinic.com/invoke.cfm?objectid=549B34CB-C4FD-45AB-8616378D0AB4F56B&locID =. They are licensed physicians whohave advanced training that permits them toprescribe medications to aid in the treatmentof mental or emotional problems. They canalso order specific laboratory tests, X-rays,and other studies as part of client treatment.To find a psychiatrist go to the state boardlocator of the American PsychiatricAssociation, and click on the appropriate e-mail or Web link for your state. It is found athttp://www.psych.org/dbs_state_soc/db_list/db_info_dyn.cfm.

• Pastoral Counselors. Defined as counselorswho are, "trained mental health providers whoalso have in-depth religious or theologicaltraining. They provide psychotherapy andother support in a spiritual context…. Pastoralcounselors provide a variety of services, suchas treatment of mental illnesses, wellnessprograms, spiritual direction, group therapy,and family and couples therapy." Available athttp://www.mayoclinic.com/invoke.cfm?objectid=549B34CB-C4FD-45AB-8616378D0AB4F56B&locID =. To find a pastoralcounselor in your area, go to the AmericanAssociation of Pastoral Counselors at:http://www.aapc.org/. It is important to notethat not all pastoral counselors are listed onthis Web site.

IV. Buoy #3-Safe passage home

In navigating any unusual or unfamiliarwaters, it is always important to follow guidelinesand directions carefully to arrive safely at yourdestination. It is no different in navigating themental healthcare system. To find the righttherapist, consider following some simple, time-saving steps.

In the search for a counselor, there is animportant item to consider. Although someonemight be listed as a clinician, always check tomake sure they are a licensed clinician. For

instance, if the assistance of a pastoral counseloris sought, ask whether he or she is affiliated withthe American Association of Pastoral Counselors.To find out, go to the AAPC Web site listedabove. Ask the insurance company if they have alisting of pastoral counselors, and also verify theirprovider status and coverage in the insurancenetwork.

Another issue that often produces addedanxiety to an already stressful situation is trying tofind the most appropriate therapist. To minimizethis stress, clients should contact an EAPCounselor as soon as it is recognized that therapymay be a necessary step in the resolution of theproblem(s). After consulting with an EAPCounselor, clinicians may be located by using theclient's insurance company's provider listing. EAPstaff help to take the confusion out of cliniciansearches and it is our goal to find severalclinicians that would be responsive to the client'sneeds. We go a step further by obtainingcounselor resumes or curriculum vitaes to find agood "match" between the client's needs and theskills and training of the counselor. This assures amuch better fit than just going to the firstcounselor who agrees to see the client.

If the client is trying to find an appropriatetherapist on his or her own, there are severalavenues to consider. Recommendations from afamily physician, a trusted friend, a familymember, a member of the clergy, or by calling aprofessional therapist organization, are some waysto find a therapist.

Again, unless the client consults his insurancecompany's provider listing and goes with an in-network provider, out-of-pocket expenses can besubstantial. Therefore, if the client has mentalhealth coverage, I highly recommend utilizingtheir services.

This is a service where the EAP can help. Ourdedicated staff is committed to finding the mostappropriate resources as quickly as possible, andwe will do a thorough search based on thepresenting issues and match clients and cliniciansfor the best outcome. Do not wait until theproblem has escalated or the situation worsens.Contact the EAP staff at the first sign of difficulty.We are always here to assist the JusticeDepartment community, and it is our goal tolessen stress and find resolutions. You do not haveto navigate the mental healthcare system alone.


Please call (888) 271-0381 for fast, friendlyservice and attention.�

ABOUT THE AUTHOR

�Mark Blair is the EAP Specialist for theExecutive Office for United States Attorneys(EOUSA) Employee Assistance Program. He hasfour years experience working as intakecoordinator and resource manager for the office.Prior to his arrival in EOUSA, Mark, an ordainedminister, was a full-time pastor of five churches inKentucky and Virginia.a

The Challenges of Work/Life Balance:Finding Creative Solutions Debbie TrivisoLicensed Clinical Social WorkerEmployee Assistance ProgramExecutive Office for United States Attorneys

How does one manage to find balancebetween the demands of work and those that areplaced on the rest our lives? Is it possible to carefor yourself, both in and out of work, and care foranother outside of work? What if that other personis an ill or elderly parent or relative or a dependentchild? What then? How do you find balance?

Both men and women are living longer, and itis more likely that employees will be faced withcare demands for aging parents and relatives, aswell as their children. Women are now havingchildren later in life, which means that they mayface caretaking responsibilities for both ends ofthe age spectrum.

Without question, in American society today,there are more dual wage earners, more singleparent households, and more elderly who dependupon family members to provide their care andsupport. Two-thirds of adult caregivers in theUnited States are employed outside the home, andmore than 22.4 million U.S. households areserving in family caregiving roles for persons overthe age of fifty, according to the U.S. Department

of Health and Human Services Administration onAging. Available at http://www.aoa.gov.

Working caregivers are under tremendousstress as a result of attempting to maintain balancebetween the multiple roles they are juggling. As aresult, many caregivers suffer significant financiallosses as they strive to meet their obligations.Employers also face the costs of excessiveabsenteeism, partial absenteeism—arriving latefor work or leaving early, extended lunch breaks,replacement costs when employees leave theirjobs, and the costs of "presenteeism" (the notionthat employees may physically be present at theirjobs, but are essentially unproductive orinefficient in the workplace for a variety ofreasons). Presenteeism may account for as muchas $44 billion a year in losses to employers acrossthe United States. Walter F. Steward, et al.,JOURNAL OF THE AMERICAN MEDICAL

ASSOCIATION, June 18, 2003, at 3135-44. A 2004study completed by National Alliance forCaregiving and American Association of RetiredPersons (AARP)® and funded by MetLife®revealed that a majority of caregivers reportedhaving made work-related adjustments in the formof leaving work early, coming in late, or takingtime off in order to provide care for a familymember. Available at http://assets.aarp.org/rgcenter/il/us_caregiving.pdf.


These findings are significant for a variety ofreasons. First, family caregiving has become asocial enigma in the United States with therecognition that tens of millions of workingAmericans are family caregivers, but, to date,these workers have been virtually invisible in theworkforce. Second, elder-oriented programs thatare in place in many work settings are designed toprovide clinical assistance to the elderly, but oftenmiss their target population since they are notdesigned to support the caregiver. Third,AdvancePCS®, a healthcare leader that studiesthe connection between health and workperformance through its Center for Work andHealth, surveyed 25,000 American workers whoreported the following top five health complaints:headache/pain, cold/flu, fatigue/depression,digestive problems, and arthritis. Interestingly,these complaints bear a striking resemblance tothe physical and emotional stressors cited byfamily caregivers: anxiety, depression, irritability,sleeplessness, and fatigue. See Robert Del Campo,Diana Del Campo, and Marcilla DeLeon, Caringfor Aging Family Members: Implications andResources for Family Practitioners. THE FORUM

FOR FAMILY AND CONSUMER ISSUES 5.2 (July2000). Available at http://www.ces.ncsu.edu/depts/fcs/pub/2000/caregiving.html.

Caregiving can be an overwhelmingexperience—emotionally demanding, time-consuming, and often intensive. Americans areliving longer than ever before as a result ofmedical progress, therefore, more working adultswill, of necessity, assume elder care duties.Consider the following statistics compiled by theAdministration on Aging.

• The number of Americans age 65+ in 2002was 35.6 million, representing an increase of3.3 million or 10.2% since 1992.

• Approximately one of every eight (12.3%)people is an older American.

• Those reaching age 65 have an average lifeexpectancy of 18.1 additional years (19.4years for women; 16.4 years for men).

• The older population is expected to more thandouble to 71.5 million by the year 2030.

• The number of people aged 85 and older isprojected to increase from 4.6 million in 2002to 9.6 million in 2030.

Available at http://www.aoa.gov/prof/Statistics/profile/2003/2_pf.asp.

Due to the intensity of care recipients require,and the competing family pressures of caregivers,outside help is often needed to supplement familycare. Costs vary with need, but even part-timecustodial care in many cities can cost well over$20,000 annually. Some elderly people needround-the-clock care. Twenty-four hour homecare in some areas is almost as expensive asnursing home care. Nursing homes, which average$50,000 per year nationwide, can run as high as$100,000. Private long-term care insurance canhelp cover these costs, but presently only sixmillion people have purchased it and, as anunderwritten product, people need to buy it whilein relatively good health. Toward a NationalCaregiving Agenda: Empowering FamilyCaregivers in America, convened by The NationalAlliance for Caregiving® in collaboration withPartnership for Caring®, July 2001. Available athttp://www.metlife.com/WPSAssets/12303959231018861971V1Fempowering.pdf.

Employee productivity in the workplace issignificantly hampered by both general andpersonal elder care. Personal elder careencompasses such activities as assisting an elderwith taking medications, dressing, bathing, eatingor toileting, and providing transportation tomedical appointments. Other activities of dailyliving include financial management, shopping,and meal preparation.

MetLife® conservatively reports that greaterthan $11.4 billion every year is spent on lostproductivity to U.S. business as a result of theaggregate costs of caregiving. This estimatereflects those costs that are not easily quantifiable.The costs of a nonproductive workforce due tomental and physical health issues that are directlyrelated to the stress of caregiving often do notcome with a price tag. A large proportion ofworkers do not participate in surveys, and thus arenot represented in large scale research studies.These unrepresented or underrepresented workersfail to give voice to our workplace culture.

In addition to dollars lost by industry everyday due to reduced worker productivity and theincreased costs of health care and mental healthcare, caregiver demands are likely to disruptattempts at achieving work/life balance. The 2004MetLife® study showed that caregivers havepronounced unmet needs, such as not havingenough information to feel adequately informedabout their role as caregiver, finding time for


oneself, managing physical and emotional stress,and balancing work and family responsibilities.

Meeting the psychosocial needs of caregiversis vitally important in maintaining a productivework force. Caregivers can empower themselvesby becoming knowledgeable about caregiving ingeneral, as well as the particular illness orcondition from which the recipient of the caresuffers. Caregivers can also seek out the supportof other caregivers and utilize peer support, learnfrom others' experiences, and cooperativelydevelop means for sharing various sources ofinformation.

Caregiving is a unique and often challengingexperience, but it certainly can be rewarding.Without the opportunity to share the experience,the difficulties may become magnified, while thepleasures of the experience may become diluted.There exists an abundance of resources that caneasily be acquired from the many associations andorganizations that specialize in caregiving, serviceprovision, and research related to olderAmericans.

Finding time for oneself can be challenging inmodern society under the best of circumstancesand is a frequent complaint made by those strivingto achieve a work/life balance. In terms of caringfor an ill or elderly family member however,caregivers can start by acknowledging that, inmost cases, they do not have to manage the entireburden of responsibility alone. Creative solutionsfor sharing responsibility can often be achieved byinvolving other family members, trustedneighbors, and friends, to assist in some aspects ofthe caregiving. The art of delegating tasks mayneed to be learned by some who are used to takingcare of business themselves. A Geriatric CareManager can be employed to assist the ill orelderly and their families with a variety of tasksincluding problem identification and solutions,counseling and support, financial management,and the myriad tasks that often make up a largepart of the duties of the caregiver. Likewise,respite care is available in most communities toenable a caregiver to take a much needed breakfrom their often tiring and stressful duties. TheRespite Care Act of 2003 was unanimouslypassed by the United States Senate and provided$90 million in grants for states and localorganizations to increase the availability of respitecare in their regions in order to help familycaregivers. Available at http://www.clinton.senate.gov/~clinton/news/2003/2003411A09.html.

Other ways of meeting one's needs areinvolvement in some form of support, such as asupport group, a church or spiritual-based support,an on-line chat group, or individual counselingwith a trained professional. The value of this formof psychosocial support for a caregiver cannot beoverstated. Support is beneficial for themanagement of stress. It encourages socialinteraction and it can be a forum for learning fromothers who are in a like situation.

Taking time out from the routine ofcaregiving is vitally important. How that time isspent can be decided by the individual based uponassessing what sort of activities or pastimes arerelaxing and rejuvenating.

Prolonged caregiving can adversely affectone's health both physically and psychologically,resulting in consequences to every aspect of life.Particular attention must be paid to managingstress and promoting mental health, as well asoptimal physical health. A 2002 study of olderadults discovered that men who report chronicstress resulting from providing care for an ailingspouse were more than twice as likely to developheart disease than other men in the study. Peter P.Vitalizano, et al., A Path Model of Chronic Stress,the Metabolic Syndrome, and Coronary HeartDisease, PSYCHOSOMATIC MEDICINE, 2002 at418-35. Available at http://www.psychosomaticmedicine.org. By the same token, a 2002 studyconducted by Kansas State University found thatstaying stressed for a long period of time canimpair both the immune system of the humanbody and its cardiovascular functions, thusindicating that stress, as well as negative emotionssuch as anger and depression, can literally makepeople ill. Available at http://www.mediarelations.ksu.edu.

While the focus of much discourse on thesubject of work/life balance is on elder care,issues related to the care of children and theimpact that has on work/life balance cannot beignored, and certainly ought not to be minimized.Many of the issues cited above are applicable tothe care of dependent children as well. More than15 percent of working adults ages 40 to 65surveyed by Nichols and Junk had primarycaretaking responsibilities for aging parents andfinancially dependent children. This so-called"sandwich generation" makes up a vital portion oftoday's workforce. The long term implications onfamily structure, workplace productivity, andsociety in general, are phenomenal. Laurie S.


Nichols & Virginia W. Junk, The SandwichGeneration: Dependency, Proximity, and TaskAssistance Needs of Patients, JOURNAL OF FAMILY

AND ECONOMIC ISSUES, 1997 at 299-326.

In addition, there are a number of gender-specific issues to consider.

• The combined work hours of dual-incomecouples have increased significantly over thepast twenty-five years. From 1992 to 2002,men in dual-earner couples with childrenappear to have taken increased responsibilityfor managing family work—chores, cooking,and child care. Women, however, are stillmuch more likely to shoulder greaterresponsibility. From 1977 to 2002, men indual-earner couples with children reportedspending more time actually doing familywork than comparable men twenty-five yearsago, whether or not they assume overallresponsibility for these tasks. Family andWork Life Institute 2002 National Study.Available at http://www.familiesandwork.org/summary/nscw2002.pdf.

• Sixty percent of working parents (from bothgenders) felt significant conflict betweenwork demands and time spent at home.

• For 2004, the Bureau of Labor Statisticsreported that there were 35.4 million familieswith children under age 18. Of these, 90.5percent had at least one employed parent.Both parents were employed in 60.6 percentof two-parent families. Available at http://www.bls.gov/news.release/famee.nr0.htm.

• The Bureau of Labor Statistics reports that thenumber of households where a working fatheris the sole parent has more than doubled in thelast two decades from 569,000 in 1975 to 2.1million in 1998. The media almost alwaysfocus on mothers when portraying singleparents, but 27 percent of working singleparents are men. Demographically, singlefathers are the fastest-growing populationsegment in the workforce. This growth meansthat fathers need help finding and paying forchildcare.

• Employees with families report significantlyhigher levels of interference between theirjobs and their family lives than employeestwenty-five years ago (45 percent vs. 34percent report this some or a lot). Men withfamilies report higher levels of interference

between their jobs and their family lives thanwomen in the same situation according to theFamily and Work Life Institute. Available athttp://www.familiesandwork.org/summary/nscw2002.pdf.

• As the population ages, more and moreemployees are providing elder care forrelatives. In 2002, 35 percent of workers, menand women alike, say they provided regularcare for a parent or in-law over 65 years ofage in the past year, helping them do thingsthat they could not otherwise do themselves.Available at http://www.familiesandworkorg.summary/nscw2002.pdf.

We all have a number of roles which we holdover the course of our life: spouse, parent,employee, sibling, friend, caregiver, andcommunity member. Work-life conflict occurs

when the time and energy demands imposed by allthese roles are incompatible, so that participationin one role is compromised to varying degrees byparticipation in another role. Work-life conflicthas several basic components.

• Too much to accomplish and not enough timein which to do it.

• Work demands that interfere with life includelong hours, heavy workloads, and inflexiblework schedules which limit an employee'sability to participate in family roles andfunctions.

• Family demands that impose upon theworkplace may include caring for a sick childor elderly parent or relative which causes anemployee to be late or miss work, inability totravel for work due to such demands, inabilityto stay late for work, and the aforementionedpresenteeism.

This is not a new phenomenon. In 400 B.C.Euripedes wrote: "The best and safest thing is tokeep a balance in your life, acknowledge the greatpowers around us and in us." Available athttp://www.geocities.com/wisdomforthesoul/authors/euripides.html.

In seeking a balance in work and life, it maybe helpful to consider that we own theresponsibility for making decisions and choosinghow we conduct ourselves and what we do withour time. Values clarification exercises can aid inan exploration of such issues as: What isimportant in my life right now? Am I being true tomy value system(s)? to myself? and to my beliefs?


Equally important, am I being true to others in mylife?

The Family and Work Life Institute reportsthat work-life supports on the job, includingbenefit entitlements and less formal policies andpractices, have increased modestly in the pastdecade. Employees exhibit more positive workoutcomes in job satisfaction, commitment toemployer, and retention, when more supportivework-life policies and practices are available.They also exhibit more positive life outcomes,such as less interference between job and familylife, less negative spillover from job to home,greater life satisfaction, and better mental health.

The Office of Personnel Management (OPM)provides federal agencies with guidance,direction, and leadership, to manage humancapital by providing tools, resources, andexpertise. OPM has devised the "Healthier Feds"campaign in an effort to support the President'sHealthierUS initiative to encourage daily physicalactivity, a nutritious diet, preventative healthscreenings, and making healthy choices. Availableat http://www. opm.gov/healthierfeds/. Theprogram is aimed at educating the federalworkforce to take greater responsibility for theirpersonal health. They also offer suchinformational brochures as the Handbook of ElderCare Resources for the Federal Workplace, on-line resources for child care, kinship care,fatherhood, and parenting support. Available at http:www. opm.gov/wrkfam/Elder01.asp.

Most federal agencies offer some form ofemployee wellness program in order to promotethe mental health of the workforce, maintainproductivity, and assure that the workplacefunctions at an optimal level. This is frequentlyaccomplished via an Employee AssistanceProgram (EAP), and may include individualservices to employees, education and trainingopportunities, mediation, organizationaldevelopment, and executive coaching.

Although not everyone who is attempting tojuggle multiple roles finds themselves out ofbalance or in conflict, many employees do. Peoplewith many responsibilities often feel guilty abouttaking time out for themselves. Taking care ofone's self is imperative in order to care for anotherand is a prerequisite for achieving a work/lifebalance. Basic self-care, such as eating well,getting adequate sleep, enjoying recreation, andrelaxing, are often neglected when an adult ispreoccupied with his or her role as a caregiver.Without adequate attention to managing all ofthese dimensions and keeping a focus on awork/life balance, the situation can often spiralout of control with harmful consequences.Attempting to manage all aspects of caregiving byone's self may seem to be a daunting, if notimpossible, task. Given the complexity of thistopic, it may be beneficial to have a social worker,your EAP, or another trained professional assist insorting out the issues and developing creativesolutions to restore balance to an often difficultand stressful situation.�

ABOUT THE AUTHOR

�Debbie Triviso is a Licensed Clinical SocialWorker who has been working with the EmployeeAssistance Program at EOUSA since September2003. Her professional background includessignificant experience working with theDepartment of the Navy in a hospital setting anddealing with issues related to substance abuse,stress, grief and loss, trauma, child abuse, anddomestic violence. Prior to joining the EAP team,she was involved with a special projectestablished after 9/11 by the Army's Office of theSurgeon General to provide emotional andbehavioral services to the Pentagon population.a


Introduction to The Lie Is Over—WeDo RecoverEileen GradyDeputy AdministratorEmployee Assistance ProgramExecutive Office for United States Attorneys

The legal profession is inherently stressful. Asmentioned in other articles in this Bulletin,chronic stress can contribute to depression,marital and health problems, and alcoholism. In1988 the American Bar Association created theCommission on Impaired Attorneys (renamed theCommission on Lawyers Assistance Programs in1996) to respond to those stressors. Today,Lawyers Assistance Programs (LAP) exist in moststates throughout the country (part of state barassociations) and offer confidential services toattorneys impacted by alcoholism and otherpersonal challenges. The following article, fromFlorida’s LAP, provides an excellent overview ofthe support available to members of the legalcommunity throughout the country. For moreinformation about your state bar’s LAP, go to http://www.abanet.org/legalservices/colap/lapdirectory.html.


The Lie Is Over—We Do RecoverMyer J. CohenExecutive DirectorFlorida Lawyers Assistance, Inc.

Charles O. Hagan, Jr.Founder and First Executive Director Florida Lawyers Assistance, Inc.

Harry G. Goodheart IIIPresidentMediation Resources, Inc.

A network of recovering attorneys and judgescarries the message to fellow members of theirprofession that recovery is possible.

"Once a drunk, always a drunk." How manytimes have we heard colleagues say this aboutanother attorney after his or her latest escapade,brush with the law, or embarrassing scene at theoffice party?

Unfortunately, in many segments of society,including the law, this belief is stated as a fact,despite evidence compiled over the past sixdecades that recovery from alcoholism and drugaddiction is possible.

Before describing Florida LawyersAssistance, Inc., the Bar's program to helpimpaired attorneys, one must first review some ofthe attitudes, behaviors, and preconceptions heldby attorneys and judges.

To begin with, the legal profession clearlyqualifies as a high-stress occupation. Beginning inlaw school, the attorney is taught that he or she isa problem-solver whose opinions are sought andvalued not only by clients, but by the public aswell. Lawyers are regarded as learned individualswho possess knowledge in nonlegal as well aslegal matters. Attorneys have historicallycomprised the majority of federal and statelegislators, and are consistently elected by thegeneral public as the individuals most qualified toanalyze and decide the important political,economic, and financial problems of the day.

The medical field has long recognized that theuse of drugs, including alcohol, increasesproportionally with the degree of stress andpressure in one's life. Attorneys tend to take their1

role as problem-solvers seriously, and believe

there is little they cannot handle by using effortand concentration.

All too often, though, the use of alcohol andother drugs becomes a primary relief mechanismto deal with the strain of constantly having tocome up with the right answer to other people'sproblems. In many other instances, having a fewdrinks with one's colleagues at "the other bar" isthe acceptable and expected means of celebratinga victory or dulling the pain of a defeat. Attorneysare taught that no problem is insurmountable, thatno challenge cannot be overcome by the use ofone's keen intellect and training. Taking a fewdrinks, doing a little cocaine, or taking a few pillsonly enhances this belief.

This thought process represents the greatestimpediment to a lawyer's recovery from chemicaldependency. Trying to think one's way out ofaddiction is as effective as believing that a personcan use willpower to cure herself of diabetes,heart disease, or cancer.

The disease model of alcoholism was firstproposed by Alcoholics Anonymous in 1935 and2

has been accepted by the American MedicalAssociation since 1953. This model of addictionrecognizes that the compulsive use of mood-altering chemicals is not a question of morality,weakness of character, or lack of willpower. Inrecent years, medical studies have confirmed thatthe prevailing characteristic of addiction isbiochemical, i.e., that measurable differences inthe action of neurotransmitters can be found in thebrains of addicts. These biochemical differences3

appear to be genetic, although the onset andprogression of the disease can be affected,positively or negatively, by environmental andpsychological factors. Addiction is characterizedas chronic (an addict is never "cured"),progressive (the illness always gets worse ifignored), and invariably fatal if left untreated. Thesymptoms and effects of the illness are well-documented and recognizable to the trainedprofessional, but the progression of the illness canbe arrested at any point with proper treatment andinstitution of a daily recovery program.

Faced with their own or another's alcoholismor addiction, the attorney's initial reaction isalmost always, "I can handle it myself." Such anattitude is akin to saying, "I can self-treat these


pains I'm having in my chest." By training,lawyers become to a greater or lesser degree thecreatures of their own image or persona. How canthey ask for help when they have been told theyare society's problem-solvers? They tellthemselves that they are the experts at everything,that no one could provide better counsel. Ifunchecked, the end results of such impairedthinking and denial are always medical, legal, anddisciplinary problems, eventually leading to lossof one's license, career, and life. Historical Perspective

In 1976 the Florida Supreme Courtspecifically recognized the disease concept ofalcoholism and ruled that the presence of theillness could be taken into consideration whendetermining sanctions to be imposed on anattorney. Following this decision, the court in4

1979 directed The Florida Bar to establish acommission on alcohol and drug abuse, chargingthe commission with assisting and monitoringchemically dependent attorneys during and afterthe grievance process. The court also expressed itshope that the commission would be able toidentify and assist affected lawyers prior todisciplinary proceedings being filed. Thecommission eventually evolved into the SpecialCommittee on Alcohol and Drug Abuse (thecommittee).

In 1981 the committee issued a reportcontaining the following recommendations:

1) Establishment of a statewide, toll-freehotline through which chemically dependentattorneys could obtain help.

2) Establishment of an independent AlcoholAdvisory Committee to assist the court andthe Bar in disciplinary cases where chemicaldependency was involved.

3) Establishment of an educational program,including speakers to appear at local barmeetings, to inform attorneys of the problem,and to let chemically dependent attorneysknow that help was available.

In 1985 the Rules Regulating The Florida Barwere amended to provide that the Bar was to"create or fund a program for the identification ofits members who are addicted to or dependentupon chemicals and the assistance of thosemembers in overcoming such addictions or

dependencies." The rationale for implementing5

the rule was the court's determination that aprogram designed to intervene before achemically dependent attorney entered thedisciplinary system could result in substantialsavings of funds, client harm, and devastatedlives, as well as acting as a resource to grievancecommittees in cases where alcohol or drugs wereinvolved. In that same year, the Bar was, for thefirst time, given the responsibility of monitoringthe probation of an attorney disciplined by thecourt. 6

Both the Bar and the committee perceived thata major impediment to the objective of reachingattorneys before they became involved indiscipline was the issue of confidentiality ofinformation provided by lawyers voluntarilyseeking help. In order to provide the necessarysafeguards, 25 active members of The Florida Barpetitioned the court for an amendment providingfor such confidentiality. In 1985 the courtauthorized Rule 3-7.1(o), providing "that anattorney has voluntarily sought, received, oraccepted treatment for alcoholism or alcohol ordrug abuse shall be confidential and shall not beadmitted as evidence in disciplinary proceedingsunder these rules unless agreed to by the attorneywho sought the treatment."

In carrying out the court's mandate to createor fund a lawyer assistance program, the Board ofGovernors decided that in order to assureconfidentiality and provide maximum separationbetween the Bar and the LAP, a new corporationindependent of the Bar should be created. This ledto the formation of Florida Lawyers Assistance,Inc., in February 1986.

FLA functions through a 15-member board ofdirectors (at least three of whom are nonlawyers)appointed by the Board of Governors. In addition,FLA receives approximately 60 percent of itsfunding through an annual allocation from theBar. Beyond that, FLA operates independently ofthe Bar, judiciary, or Board of Bar Examiners.

As stated in FLA's mission statement, theprogram is designed to provide services to assistattorneys, judges, law students, and other legalprofessionals who may be impaired in their abilityto function in a legal setting. The backbone ofFLA is a support network of recovering attorneysand judges who wish to carry the message tofellow members of their profession that recoveryis possible.


FLA concentrates on assisting legalprofessionals with chemical dependency orpsychological problems, providing evaluation,assessment and referral services, peer andfacilitated support, aftercare programs, andmonitoring services. In addition, FLA engages inpreventive services through educational outreachprograms, including mailings, literaturedistribution, and presentations to the judiciary,law schools, law firms, bar associations, FloridaBar seminars, and other professional entities.FLA's services are available for problemsassociated with drug, alcohol, gambling, food, andsexual addictions, as well as problems resultingfrom depression, stress, finances, and other areasthat might affect an attorney's ability to functioncompetently in a legal setting.

FLA is not a 12-step program, although incases of chemical dependency it relies onparticipation in the programs of AlcoholicsAnonymous and Narcotics Anonymous as theprimary resource in an attorney's recovery.Neither is FLA a treatment program, counselingcenter, employment agency, legal referral center,or employee assistance program, although all ofthese services can be accessed through FLA'sresources.

FLA works independently of, butcooperatively with, The Florida Bar, the FloridaBoard of Bar Examiners, the JudicialQualifications Commission, local bar associations,and the Bar at large.

From its inception, FLA has been anorganization of lawyers helping lawyers.Although it maintains its primary office in Ft.Lauderdale, with a staff composed of an executivedirector, an assistant director, and twoadministrative assistants, its daily operations arecarried out by a network of more than 300attorneys, judges, law students, lay persons, andmedical personnel, most of whom are themselvesin recovery from chemical dependency orpsychological impairments, who volunteer theirtime to help others.

One of the primary purposes of any peerassistance program is the early identification ofimpaired individuals. Very often in the practice oflaw, the first signs of trouble come through thedisciplinary system. At early stages of the illness,typical grievances include allegations that alawyer has failed to respond to calls from clients,has not kept his or her clients properly informed

about the status of a file or case, or has beenarrested for DUI. Unfortunately, due to thechemically dependent attorney's denial regardingthe root of such complaints, combined with manygrievance committees' lack of understandingabout chemical dependency and perhaps someskillful (although perhaps misguided) advocacyon behalf of the respondent, the majority of suchminor grievances result in a finding of noprobable cause to proceed.

If the disease is not caught at this point, it isalmost certain that the attorney will be backbefore the grievance committee on more seriouscharges, such as appearing at client meetings orcourt hearings under the influence, failing toappear at all, missing deadlines and statute oflimitations dates, acting in a bizarre manner,abandoning his or her practice, further DUI orcontrolled substance arrests, or trust accountviolations.

It has been documented that between 50percent and 80 percent of all cases beforegrievance committees, including minor matters,have as their cause some form of chemical orpsychological impairment. 7

In cases where chemical dependency issuspected, FLA has urged the grievancecommittees to refer the subject attorney to FLAfor an evaluation, which the committee canfacilitate through a recommendation fordiversion. If chemical dependency or some other8

identifiable impairment is found after theassessment and evaluation process, the attorney isrequested to enter into a written rehabilitationcontract with FLA. The contract generally has athree-year term, and requires the attorney tocomply with a structured rehabilitation programdesigned for the particular individual. Mostsubstance abuse contracts are 12-step oriented,requiring the attorney to attend a specified numberof AA or NA meetings per week, obtain asponsor, and follow the 12-step program. Inaddition, the attorney is assigned a recoveringattorney monitor with whom they are required tomeet on at least a monthly basis, is required toattend an attorney support meeting each week ifone is available in their area, agrees to submit torandom urinalysis, and may be required toparticipate in group or individual therapy.

The monitoring system and attorney supportmeetings are vital parts of the program, madepossible by the volunteers throughout Florida who


devote time to FLA. The monitoring and attorneysupport meetings are really what make the FLAprogram unique, and which no doubt contributesignificantly to the extremely high recovery rateshown by FLA participants.

Written monitor reports are filed with FLAeach month and constitute evidence of recoverythat would be otherwise difficult or impossible toprove. When possible, a monitor is assigned whoattends the same attorney support group as thesubject lawyer, so the monitor can assess theattorney's rehabilitation in a group setting on aweekly basis.

The attorney support groups currently meetweekly in more than 20 cities. The groups, whichare completely confidential, meet for an hour.Members support each other through an exchangeand sharing of their experience, strength, andhope. Particular emphasis is placed on voicingthose concerns arising out of the participants'practice of law, admissions process, ordisciplinary problems, so that other members ofthe group with experience in such areas can sharehow they made it without the need to resort tousing chemicals. The support meetings also arethe primary vehicle for introducing new membersto the AA and NA fellowships; by first attending asupport meeting with their colleagues, with whomthey feel comfortable, new members find it easierto make the transition to community based 12-stepmeetings. Being in a room of other recoveringattorneys goes a long way toward ridding theaddicted lawyer of the feeling of isolation, guilt,and shame which are the hallmarks of chemicaldependency. A listing of the attorney supportmeetings can be found on the FLA web page atwww.fla-lap.org.

The advantage of the FLA program tochemically dependent lawyers, in addition toproviding a peer support system uniquelydesigned for the legal community, is that theyhave a means of documenting their ongoingrecovery efforts and successes through highlycredible evidence. The Bar's Standards forImposing Lawyer Sanctions state that ongoing,supervised rehabilitation with FLA will beconsidered as mitigation when determiningsanctions to be imposed. Likewise, evaluation9

reports from FLA and from qualified healthcareprofessionals certified by FLA are often used toestablish that the behavior leading to disciplinewas in fact drug- or alcohol-related. The FLAprogram has been used successfully to supervise

probation of attorneys ordered by the SupremeCourt. Regular reports are made to The FloridaBar outlining the attorney's progress or lack ofprogress in recovery. In such cases, the costs ofFLA's services are partially defrayed by an initialregistration/evaluation fee, monthly monitoringfees, and fees charged for appearances by staffpersonnel at hearings. Intervention Services

FLA also performs intervention services involuntary and mandatory cases, provided thecircumstances meet certain criteria. Intervention isa means by which the attorney can be confrontedin the hope of dismantling the denial system andallowing the addict to acknowledge he or sheneeds help. Initial contact with FLA is usually10

made by a family member, colleague, or closefriend who is aware of the addiction. An FLAstaff member will assemble an intervention groupcomposed of five to 10 people who have personalknowledge of the illness' effect on the attorney.Those participating in the intervention arerehearsed by the FLA facilitator prior to theintervention, which takes place without priorwarning to the attorney. The ultimate result is tohave the attorney agree to go directly from theintervention to chemical dependency treatment.Interventions, if performed carefully and out of asense of caring rather than accusation, have anextremely high rate of success.

The services provided by FLA are equallyavailable to law students and other applicants toThe Florida Bar. In cases where an application foradmission reveals a history of alcohol or drugabuse, chemical dependency treatment, ordrug/alcohol related offenses, the Florida Board ofBar Examiners understandably must determine ifthe applicant has in fact reached a point in his orher recovery which would permit the competentpractice of law. In cases where such a point hasnot been reached, the potential danger to thepublic and The Florida Bar is obvious. FLAendeavors to provide the Board of Bar Examinerswith evidence of rehabilitation, using theevaluation, contract, and monitoring provisionsdescribed above. Experience has demonstratedthat in certain circumstances, a period ofmonitoring after admission is appropriate.

In such cases, applicants are often admitted ona conditional basis for one to three years, with theconditions removed upon successful completion


of the FLA contract. While no restrictions areplaced on the applicant's actual practice of law,they are required to remain under contract for theprobationary period. In the event of a materialviolation of the contract the FLA staff consultswith the Bar's Lawyer Regulation Department torecommend appropriate measures. In some cases,an extension of the probationary period may besought or, if warranted, a petition to show causefor termination of the conditional admission maybe filed by the Bar. FLA may recommendresidential or outpatient treatment, individualcounseling, or another alternative in lieu ofsuspension. ABA Commission

FLA is a longstanding participant in theAmerican Bar Association's Commission onLawyer Assistance Programs. The commissionprovides education and prevention services to theABA and coordinates the lawyer assistanceprograms which now exist in some form in everystate, Canadian province, and other countries.

Each year, the commission holds a workshopwhere representatives meet to exchangeinformation concerning their respective programs.The workshop consistently includesrepresentatives from the state programs, as well aslawyer assistance programs from Canada, GreatBritain, Mexico, and other countries. The meetingis followed by the three- day annual meeting ofInternational Lawyers in AA, which is attended byrecovering attorneys from all over the world.CoLAP has an extensive internet presence(www.abanet.org/legalservices/colap), providing alisting of lawyer assistance programs around thecountry, recovery related resources, news articles,and annual workshop information. FLA'sexecutive director was appointed to thecommission in 1997 to serve a three-year termwith responsibility for Florida, Georgia, Alabama,North and South Carolina, and Tennessee.

Since the commission's formation in 1988,FLA has been considered to be one of the mostcomprehensive programs in the United States.Florida has an advantage in that a unified bar candevelop and support a uniform policy forevaluation, treatment, and monitoring ofchemically dependent attorneys. Recently, inrecognition of the direction in which the stateprograms, including FLA, are heading, thecommission has expanded its role to deal with

attorney impairments other than those causedsolely by chemical dependency.

Other Impairments

Over the past several years it has becomeapparent that conditions other than chemicaldependency can also adversely affect an attorney'sability to practice law. Those conditions, whichare likely more prevalent within the legalcommunity than is chemical dependency, includedepression, stress, bi-polar disorders, personalitydisorders, financial and family problems, andother addictions such as gambling, sex, or food.11

Failure to address and treat these conditions canresult in consequences just as severe as drugaddiction or alcoholism. In recognition of this12

fact, the Supreme Court in 1998 expanded Rule13

2-9.11 to provide that the program of assistancefor addicted and chemically dependent memberswould include those suffering psychologicalproblems affecting their professional performance.The rule now reads:

The Florida Bar shall create or fund aprogram for the identification of its memberswho suffer from impairment related tochemical dependency or psychologicalproblems which affect their professionalperformance or practice of law, and theassistance of those members in overcomingsuch dependency or problems.

When such cases are brought to FLA'sattention, either voluntarily or through the Bar,FLA and a mental health professional willevaluate the attorney and develop a rehabilitationprogram. In disciplinary cases, FLA enters into amodified rehabilitation contract with the attorney,acting primarily as liaison between the attorney,the attorney's therapist, and The Florida Bar.

FLA is also developing a system of facilitatedsupport meetings, led by FLA-certified therapists,for legal professionals suffering frompsychological impairments. The first meetingstarted in April 1999 in Ft. Lauderdale, and fivegroups should be operating by the end of thisyear.

Every July FLA sponsors a workshop forattorneys, law students, and judges interested inlawyer impairment, as well as the disciplinary andadmissions processes. Presenters include expertsin the field of addictionology, representativesfrom the Lawyer Regulation Department, the


Board of Bar Examiners, attorneys specializing inrepresentation in disciplinary and admissionsmatters, criminal and family law practitioners, andrecovering attorneys themselves. Substance abuseCLE credits are awarded for attendance at theworkshop, which not only provides substantiveinformation, but also allows the volunteers fromaround the state, the FLA staff, and otherinterested parties the chance to meet on a socialbasis. Conclusion

Although not every judge, lawyer, or lawstudent who takes a drink, uses a drug, or has adepressive episode can be considered to beimpaired, continuing the behavior despiteincreasingly severe consequences can generally beregarded as evidence of an illness.

FLA estimates that of the more than 65,000attorneys admitted in Florida, between 5,000 and10,000 have had or will have a problem withdrugs or alcohol during their careers (using 50years as an average career). Some 10,000 to18,000 Florida attorneys will experiencedebilitating short-term or full-blown clinicaldepression while in practice. In response to theseproblems, FLA has assisted almost 2,000attorneys, law students, and judges since itscreation in 1986, with approximately 200currently under contract, of which more than 100are being monitored for disciplinary or conditionaladmission purposes. In follow-up studiesperformed for peer assistance programs, it wasdetermined that over 90 percent of participantswho successfully completed their contractsremained chemically free and most weresuccessfully practicing. Clearly, the reduction inharm and suffering to the impaired individuals,their families, and the public as a result of theseprofessionals' participation is immeasurable. Ashas been said by one member of the Board ofGovernors, FLA is the only Bar funded programwhich works directly to save lawyers' lives.

Future plans for FLA include attempts toobtain statutory confidentiality of information andimmunity for staff members and volunteers,recognition by the court and the Bar of theexpanded role FLA is playing in the area of otherimpairments, continuing efforts at publicizingFLA's existence and function, increased educationof the bench and bar regarding impairment andrecovery, and development of a revolving loan

fund to assist indigent attorneys to obtaintreatment and counseling. Whether such goals arereached will depend on continued cooperationfrom the Supreme Court and the Bar in terms offunding and support, as well as the ongoing andexpanding efforts of FLA's network ofvolunteers.�

Coombs, R.H., Drug-Impaired Professionals,1

Harvard University Press, Cambridge (1997).

Alcoholics Anonymous, AA World Services, Inc.,2

New York, NY (1935).

Erickson, C.K., Review of neurotransmitters and3

their role in alcoholism treatment, Alcohol &Alcoholism 31 (Suppl. 1): 5-11 (1996).

The Florida Bar v. Blalock, 325 So.2d 1014

(1976).

Rule 2-9.11. 5

The Florida Bar v. Headley, So.2d (1985). 6

Nace, E.P., Achievement and Addiction: A Guide7

to the Treatment of Professionals, Brunner/Mazel,Inc., New York, NY (1995).

See Rule 3-5.3, Rules Regulating The Florida8

Bar.

Florida Standards for Imposing Lawyer9

Sanctions 10 and 11.

Johnson, V.E., Intervention: How to Help10

Someone Who Doesn't Want Help, JohnsonInstitute Books, Minneapolis, MN (1986).

Beck, C., Sales, B., Benjamin, G.A., Lawyer11

Distress: Alcohol Related Problems and OtherPsychological Concerns Among a Sample ofPracticing Lawyers, 10 J.L. & Health, Cleveland-Marshall College of Law (1996).

Nace, E.P., Achievement and Addiction: A12

Guide to the Treatment of Professionals,Brunner/Mazel, Inc., New York, NY (1995).

Case No. 92,841 September 24, 1998.13

ABOUT THE AUTHORS

�Myer J. (Michael) Cohen is the executivedirector of Florida Lawyers Assistance, Inc., andsits on the ABA Commission on LawyerAssistance Programs, with responsibility for thesoutheast region. He received his B.A. fromBoston University in 1972, and his J.D. from


Suffolk University Law School in 1980. He hasbeen in recovery since 1986.

Charles O. Hagan, Jr., is the founder and wasthe first executive director of FLA. He receivedhis B.S. from the University of Pennsylvania andhis J.D. from Temple University School of Law.Mr. Hagan has his masters in sociology, andserves on the board of directors of the SouthwestAlcoholism Council of Florida. He has been inrecovery since 1969.

Harry G. Goodheart III has been mediatingthroughout the Southeast since 1989, and ispresident of Mediation Resources, Inc., inBradenton. As a member of the Board ofGovernors of The Florida Bar he was instrumentalin the early development of Florida LawyersAssistance, and served on its board of directorsfor five years. He has been in recovery since1990.a

Reprinted with permission from the authors.Printed previously in the Florida Bar Journal,December 1999 at page 26..


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