Can the cost of sickness absence & stress be reduced by employing a business centred therapeutic approach?

I am a counsellor trained in person centred therapy. In 2003 whilst working in consultancy, I developed an outreach therapeutic model of working with substance misusing clients within the NHS. The client group was women who had withdrawn from using “treatment” services to support their drug and alcohol use, therefore were considered dis-engaging drug users.

These were chaotic women with a range of associated disturbances such as eating difficulties, deliberate self harming, often sex working, and many balancing social service and or criminal justice involvement. Hospital and G.P data informed us that these women existed, but how could we reach them and work with them positively?

Based strongly in Person Centred Psychology the components of my model gave the mental health professionals a radical alternative to working with clients and patients with mental health and dual diagnosis labels. The model acted as a platform for women’s experiences to be heard and used in furthering treatment plans and pathways. It was an individual way of working, but by experiential encounters and training professionals who also worked in differing capacities with these individuals, supported referrals and appointments could take place ensuring reaching the individual at ‘root cause’, by this I mean locating clients where they are in their locality, e.g. local day centers, drug services, hospitals, children’s and mother and toddler groups, seeing them locally and offering outreach counselling. Empowering clients to work on their own terms allowed them to process and speak about their experiences. It therefore aided re engagement of treatment and services.

Client Model Outline

1. Outreach Counselling & Psychotherapy
Go where your clients are – don’t wait for them to try and find you. Taking a proactive stance opposed to a reactive one.
2. Independent
Not aligned with any other services – completely impartial, safe & confidential.
3. Providing Supported Flexible & Portable Services
Covering Nottinghamshire County and ensuring service sustainable delivery by addressing clients’ needs in order to retain them in the helping relationship by providing, for example, bus fare, shoes, and childcare costs.
4. Bottom up Approach
Be informed at root cause(s) by the affected client group.

This model was specifically designed for hidden client group who reported in earlier surveys experiences of hopelessness and isolation, with no trusting accessible forum in which to talk. However, I do see this group as analogous to ‘stress sufferers’ who fall outside of existing measures in the workplace. My experience as a counsellor in occupational health departments informs me that there are hidden populations of personnel, struggling with stress, who are mistrustful of internal systems that are implemented to help with wellbeing.

Sickness Absence costs the UK £12 billion per year, or Employers £495 a year in direct costs for every worker employed. Indirect costs are probably considerably more than this (CBI 2005 statistics).

The (UK) Health and Safety Executive (HSE) together with the (UK) Health and Safety Laboratory have reacted by developing the six stress management standards, soon to be known as the management standards. These standards were conceived in 2001 after ‘Securing Health Together: a long term occupational health strategy for England Scotland and Wales’ (2001) was published. Latterly these standards were officially launched in 2004, and are now known as the Management Standards. Their aim is to help employers manage sickness absence effectively. http://www.hse.gov.uk/sicknessabsence/index.htm.

Issues have arisen in implementing these measures. Using an organisational ‘top down’ approach, The HSE are aware of this and have funded current research together with Goldsmiths College and supported by the Chartered Institute of Personnel and Development (CPID) to look at management competencies. (See attached PDF). As the HSE understands, in reality the responsibility for implementation of the standards fall on Human Resources managers, line managers and team leaders. Many of whom do not have any understanding of the complexities of stress and its related issues, yet are expected to manage it.

If an outreach model could be implemented in a business or workplace setting, which followed in principle the four point model above, but included research methods of employee wellbeing and engagement measures, the following questions arise:

1. Could this be an intervention which would prevent sickness absence?
2. Could this model facilitate absentees return to work?

Business Centred Therapy Stepped Approach

1. Observe and clean existing data utilizing information management systems
2. Interview a cross section of managers/team – Non directive/Engagement/Burnout Q’s
3. Interrogate data and report on findings
4. Prioritize a list of issues to be addressed
5. Identify and engage hidden populations at risk of absenting
6. Identify and engage middle managers and/or team members dealing with above threshold levels of absence
7. Run person centred applications individual and group
8. Coach and support line managers on how to manage the dynamic of absences within their teams and vice versa
9. Impartial absentee intervention, mediation or therapy where appropriate
10. Ongoing review and intervention
Optional integrative phases
11. Roll out specialists training where necessary utilising Business Centred Therapy’s virtual team of Employment lawyers, Bullying Training, Conflict Management. Coaching and supervision of new managers
12. Liaise with personnel to create a module for induction purposes
This week Business Centred Therapy Ltd launches the UK’s only Attendance Management blog we hope that it will act as an outreach provision for professionals working with those hidden populations silently suffering with stressful encounters, and at risk of absence.

Whatever your relationship to attendance or absence management, the blog aims to situate and share good practice. Please support me in following my journey in taking assertive outreach therapeutic practice into organisations. You or your colleagues are invited to use this virtual support creatively? I look forward to your feedback discussions common themes, practise based issues or theoretical insecurities. Let’s all have a crack at reducing the cost of isolation and disempowerment in and outside the workplace.