Resilience Reconsidered

by Michael Cull, PhD, Associate Director for Safe Systems, University of Kentucky’s Center for Innovation in Population Health

No doubt our resilience as a nation is being tested by current events.  We’re facing significant uncertainty at home and at work. How will we accomplish home visits? How do we ensure child safety? How can we use technology to help those we serve? How will we address our own and our family’s needs? In the face of growing personal and professional stress, there may be no better time to re-visit how we think about workforce resilience in the helping professions.

We generally understand resilience to be one’s ability to bounce back from adversity. We work to help children, families, and adults as they build resilience. We understand that whatever challenges bring us into someone’s life, our goals in being truly person-centered require us to identify and expand on their strengths. This may, in fact, be our primary function as we support those we help as they go from where they are now to where they want to be.

Of course, to continue to be helpful, we must also focus efforts on our own resilience. Helpers are at high risk for burnout, chronic fatigue, the lack of psychological safety at work, and symptoms related to both direct and vicarious trauma exposure. And while exposure to trauma may be unavoidable in some settings, the systems influences that contribute to high-levels of burnout, unaddressed unprofessional behavior, and work design issues that allow for things such as late nights and sleep deprived professionals only compound the effects of trauma. No doubt, all of these factors overload personal resilience.

Workforce resilience is a well-documented challenge to helping systems. Although some good strategies have been developed to support individuals, very little real progress has been made. Documented high rates of burnout, secondary trauma, and turnover persist. It begs the question, have we framed the problem correctly? Should our primary goal be to build a new capacity into helping professionals that allows them bounce back and survive another day? Or should our goal be different?

Engineers use a slightly different definition of resilience. In engineering, resilience is the property of a system that allows it to “stretch” in the face of increased demands and then return to normal operations. Think of a rubber band. It doesn’t bounce. It’s designed to stretch when it works. A resilient system is one that is not brittle in the face of increased demand. Instead, it stretches.

Perhaps the helping professions would benefit from a new frame in the discussion about workforce resilience. Too often what we describe as interventions designed to support resilience in our professionals is actually a response to adversity and exposures. It’s not prevention. It’s reaction. We would benefit from an engineering approach that shifts the responsibility from the professional – to the system. If we view resilience as a property of our systems it requires us to consider different approaches to building resilience.  We must take an approach that predicts adversities and designs effective solutions to manage them. We don’t assume normal work. We assume things can go wrong. Our approach shifts from responding to the needs of professionals and providing them with tools to be more resilient, to designing a system that anticipates their needs and builds in protective solutions.

The critical component in a more resilient, better engineered, helping system is the team. Designing collaborative work in professional teams has the potential to transform our work and support a safer, more effective, and more engaged workforce. Not only are collaborative decisions of teams known to be more effective, the social connectedness that emerges from what the military calls unit cohesion may be our most effective buffer against the effects of burnout and work-related stress (including traumatic stress).  

Steps to engineering a more resilient system through collaborative work:

  1. Spend time identifying what could go wrong.
  2. Talk openly about mistakes and ways to learn from them.
  3. Test change in everyday work activities.
  4. Develop an understanding of “who knows what” and communicate it clearly.
  5. Appreciate colleagues and their unique skills.
  6. Make candor, transparency, and respect a precondition to teamwork.

For more TCOM tools for engineering safe, reliable, and effective teams check out TeamFirst: A Field Guide

You can reach Michael Cull at michael.cull@uky.edu

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