Chapter 1 – the managers
Talk to any manager in treatment services and they will tell you very quietly of a secret wish, one morning they would like to come in to their office and find a solution rather than a problem. Talk to the drug services and they will say that there door is always open and they would love for someone to come and talk to them.
The trouble is everybody’s heard of recovery but no one has ever seen it – and if you talk to services and NTA/DATS they tell you they are confused. They know that services include hard working decent people including the managers, they also want more successful outcomes of which everyone can be proud.
Yet it still feels difficult to improve things, to change things and make things happen.
Managers often complain that all they do is wheelbarrow management, that is if they are not taking the strain and pushing like hell nothing moves – the higher up managers are the more they complain about this. But then if you talk to the people that work on the front line they will tell you a different story.
Chapter 2 – the workers
Staff often believe they are the helpless victim of change in the services, they think they aren’t listened to and they don’t think initative is a part of their job. This is not surprising – many services have taken a lot of costs out of the services, the biggest cost is always people and staff are reduced to the absolute minimum.
What is left are some very hard working and efficient staff who are slightly scared. Given enough time these staff would tell you what works within services and what does not work. But normally they won’t tell you because they are no longer inspired by their job.
They no longer feel engaged and don’t feel they have the power to change things for the better, they have survived by being efficient and they know that ideas generally look like costs, and that anything that looks like a cost has a very short life span. Even worse, they believe that having ideas will only increase their workload.
The relationship between staff and management has become ‘tell me what you want and I will do it’, which does not make either party happy. Management increasingly recognises this problem, which is good news. The bad news is they then make a big mistake – they call in the research consultants.
Chapter 3 – the evidence base experts
There are two types of experts. The first are the good experts that have the skills that you do not have in your workplace. And then there are the bad experts, who have skills you already have in the services but who claim to do things better than you. Calling in the first set of experts is good for the services, employing the second is normally bad.
Bad experts feed on ignorance and the insecurity of management. The worst experts know only two things, they know how to look clever and they know how to make the people who fund them look clever – such experts claim to add value.
This generally means that their research is not up to much and to get the money they want to do your thinking for you. These experts give the impression that they have better people, better clothes, better education, better cars, better offices and better danish pastries with their better coffee.
You can choose to be impressed by this or you could ask three simple questions:
Why can’t the staff do that thinking for themselves?
Do we have that kind of expertise in our service already?
If we haven’t, can we locate it ourselves?
What all experts know about is how to play the internal politics of the services, they know how decisions are made, they know how budgets are allocated, but most of all they know how senior management behave.
Bad experts wouldn’t exist if it wasn’t for senior mangers willing to pay for them, so what is wrong with senior managers?
Chapter 4 – the service directors
When people make it to the top they start thinking, because they are at the top, they must be in some way better than the people below them. In truth they are probably better at the kind of things that get you promotion. Sadly the skills that are needed to get you to the top are not always the ones needed when you are at the top.
One skill all managers have these days is the ability to speak fluent business jargon, so much so that words like communication and learning and recovery have become meaningless. In some services the secret to rapid promotion is to take the initiative and the credit and then move on before the consequences become clear.
It does not look good on your CV that you are responsible for slow and steady growth, bold high profile initiatives look better – especially if they include communication, learning and recovery. That’s why you should beware of people that change their tack with every political agenda, often they have got to the top by moving fast enough to keep ahead of their mistakes.
Once they are at the top they are in a position to make really big mistakes. People at the top forget that services like 12 step recovery generally looks after themselves. They think that they can improve on 12 step recovery and they wonder if it would be a good idea to change things.
Often they think change is expected of them and they can’t ask anyone below them, so ask someone who’s opinion they can respect, they ask experts in 12 step treatment – because 12 step treatment does not get paid for unless they find something that needs changing.
Chapter 5 – the big recovery plan
In a normal service you would have thought that the people at the bottom would look up and that the people at the top would look down. In fact the reverse is often true. People at the bottom sometimes never look up because they think their natural place is at the bottom.
At the other end of the services, people who made it to the top sometime can’t break their habit of looking upwards. They continually look up to polictians, media, funders, and other leaders. Even at the very top they still want approval – and when people need approval they start doing things to get attention.
Analysts and journalists don’t like small print, they like big stories, and that means big plans. This explains why big bosses jump to big solutions without clearly finding out what the big problem was – if indeed there was one at all.
Services reorganise, re-plan, restructure and engineer because they can and because they feel they should. All of these things are necessary sometimes, but they are the exception rather that the rule. Ocasionally the big plan is amazingly successful and become a case study of good practice or schools of training.
More often than not the plan fails and the services only survive by more blood letting and heavy handed butchery thinly disguised as restructuring. Two groups of people leave during these upheavals – your best people and the people that best use the services.
Chapter 6 – after the changes
Service cultures are stubborn things and you can’t change them overnight, but they can be changed! Service cultures can grow up in the same way people in 12 step treatment can grow up, a service or treatment will grow up in the same way as recovery communities grow up.
How it grows up depends on its role models, recovery communities and its environment. The role of the big bosses is absolutely critical, the big boss only has two vital functions, they must decide the vision and strategies for the services/recovery treatment then they must make sure the entire service delivers that vision.
The big boss must have two core skills – the ability to have a strategic vision and to deliver that vision and the ability to communicate that vision to those who make it happen! In short they need to direct and they need to manage, that’s why they are called managing directors.
If you want a grown up recovery service you need a grown up recovery managing director in charge of recovery grown management.
This requires less command and control and more boundary setting and facilitation. Ironically only a very strong, very confident, very disciplined manager can do this, for many managers this mean a very personal change which is a lot harder than having a big plan.
Chapter 7 – sweeping recovery
Getting people to take the initiative requires two essential elements – they need permission and then they need trust. Even when people are given permission to take the initiative and be creative and generally take responsibility for their actions they won’t do any of these things unless there is a basis of trust.
People must have trust that when they have a idea or take the initiative their actions will be welcomed, encouraged and supported by management – that trust needs to be earned!
It is trust that is not built by mission statements, experts or big speeches – it is a trust that is earned by a continual process of the right things done at the right time in the right way. It is the building of a pattern of trust until the work force understand and of course accept it without having to question it.
Sometimes when there is a history of mistrust there needs to be a clear signal that things have changed, but this signal must be a concrete management action. In services, as in politics, people have seen too many signals and not enough trains.
Investing money in the ideas and concerns of people is the clearest possible sign, trying to put everything right at once generally creates more problems than it solves, but putting a few small things right has very big impact!
Once you have straightened out the things that frustrate people you then can concentrate on the very things that inspire and engage people.
Chapter 8 – recovery landmarks
Healthy organic growth comes from a few fundamentals and one of them is that the whole organisation knows what they are doing and feel able to do it. Sadly mission statements are generally a collection of cliches that have had the meaning beaten out of them long ago.
People need two things in life to be happy, they need to have some sort of meaningful purpose and they need rules for what they can and can’t do. Services are no different, their goals should be very ambitious – so that they are a real challenge – but also very simple to understand. Naturally goals will change over time, but they should always be clear enough and far enough away to make the direction obvious.
Values have become even more hollow and meaningless than mission statements, real values are those that you are prepared to enforce, in other words they are the rules, just like rehab – break them and you’re out! This how recovery cultures are forged and maintained.
When the purpose is clear and the rules are straight, the effort and the initiative of everyone will naturally align. Processes, structures and habits inconsistent with this purpose and that break the rules will either be actively discarded or passively ignored.
Departments or team structures that make no sense will go, along with the silo or smoke stack mentally that they often breed
Chapter 9 – planting growth seeds
Sometimes it is hard to remember that the aim of recovery is people and to release their potential to grow recovering communities. There is a old saying from 2 step recovery – recovery talks, bullshit walks.
If you really trust the services and recovery treatment, if you really want them to take the initiative, if you really want them to take responsibility for growing their part of the deal then you need to trust them with something else – money.
You can tell a lot about a service by how far up or down the level of budgetary responsibility sits, if the purchase of a paper clip needs the approval of the managing director we are in trouble because the managing director is spending all their time signing off expenditure and not doing there two other vital tasks i.e managing and directing.
The lower down the budgeting responsibility lies the more responsible the services will be and services will know what things cost and where the money comes from. They will also be in the best position to decide where money should be best spent, or not spent!
When services know that they will be paid their worth for improving services and managing their budgets better, you will have the best of all possible services in the world. And what happens to management when their services are looking after themselves?
They get to spend less time controlling and more time to take the initiative and think creatively for themselves, so you also have management who are free to think, free to act and free to deliver recovery.
Chapter 10 – recovery roots in communities
A service with a productive recovery commnunity network is one where top down inspiration meets bottom up energy, people in this community find a greater individual sense of belonging and productivity, greater job satisfaction and greater pride in the unity of all our recovering communities. At the same time management are freed up to think about the community and to improve it.
If you want to start the change you need to start with communication, sharing is what human beings use to inform and, crucially, motivate. Sharing is successful when it changes the way people think, feel and act.
So first of all decide what you want services and treatment recovery to think, feel and do. Once the service as decided the purpose of recovery, the services/ treatment/recovery/NTA/DATS must put this in everything they think, feel and do in communities.
And the little things will count as much as the big things – the way a meeting is run is more important than the way conferences are run. The life of a small idea is as important as the big idea. Even the way a single member of staff is managed is as important as the way the services are managed.
No recovery movement is greater than the sum of its communities, and when you think of the huge consequences that come from the smallest events you will know that in reality there are no small events.