Transforming a mental health care organisation with SF
Sieds Rienks leads a converstaion with Bjorn Ceresa
Sep 8, 2020
Introduced by John Brooker
Trust goes a long way. In this interview Bjorn describes how practicing the SF belief that professionals have all the skills they need to do their job, improved care and treatment at GGZ Oost Brabant despite severe budget-cuts, a shortage in health-care professionals and large reforms in the Dutch social health care system.
Please Bjorn, tell me a little bit about your new job
Starting this January, I will be member of the board of Proteion, an organisation that provides homecare for people living in the most southern part of the Netherlands. Proteion offers a wide range of care, ranging from specialised medical care to basic home care for people, so that they are able to stay in their own homes. Proteion also provides residential care, again ranging from basis care to specialised high-intensive medical care.
It is a wonderful step in a new organisation. How does that feel?
Over the last nine years I worked in a mental health care organisation that provides psychiatric care and treatment, so Proteion is a completely different organisation, although in the end the goals of both organisations are to support people. Moreover, over the last years I worked as a managing director, so starting as a member of the Board will be quite different, I can imagine. But I am really looking forward to starting at Proteion and getting to know the organisation and the people that work there!
I didn’t follow the standard route throughout my career. I actually studied International Business Studies at Maastricht University, but when I finished, I could not imagine myself working for a large multinational. So, I started working for a health insurance company as a contractor for health organisations. I loved this job as I had the position and possibility to improve health care. But after quite a few years I wanted my job to be closer to the care itself and then I had the possibility to start working at GGZ Oost Brabant, a mental health care organisation, where I worked as a managing director over the last nine years.
What were the things you were satisfied with ( in those GGZ years), what went well ?
That is a nice question, because just a few weeks ago I had my final working day at GGZ Oost Brabant before switching to my new job, so that is always a natural moment for reflection.
I think that one of the things I am most proud of is that over the last years we managed to keep our focus on improving the care and treatment. We succeeded in this, despite severe budget-cuts, a shortage in health-care professionals and large reforms in the Dutch social health care system.
If you want to provide really good care you will need good staff, good personnel to perform. How about that?
At GGZ Oost Brabant we supported the mental health care vision of Recovery. This was our main focus in our strategic objectives and in our daily work. As in all health care organisations, people from different disciplines with sometimes completely different expertise, all work together to provide the best care for our clients. But always with the focus on Recovery Oriented Mental Health Care. Staying focused on the care itself, respecting every individual’s expertise and knowledge and providing a good climate to work together is the key to good care.
Were you satisfied with the result?
I think we managed to create a common language that everybody, from psychiatrist to nurse, from facilitator to manager, understood. What really helped is that we introduced a way of translating the vision of Recovery Care to practice, by using a conceptual framework called the Service Outcome Scheme. This framework helps to focus on the care and support that truly supports Recovery as a goal.
It looks like you created a platform for care. Is that true?
Well, we did in the sense that we also introduced the Solution Focus (SF) approach as a ‘common language’. By using SF, we provided a useful way of translating the vision of Recovery into daily practice.
Were there particular things you provided in the process, or things you emphasised on?
I think the most important thing you can do is make sure that every professional in the organisation can use all of his skills and knowledge. SF makes this possible as it starts with the basic belief that every professional has the skills and competences to manage his or her work in the best possible way.
In the Netherlands we have a very well-known book (by Mathieu Weggeman: Managing professionals? Don’t!)[i] that describes that we should not minimise, but maximise professional space. Politics, government and insurance companies have a tendency to overregulate health care, sometimes barely leaving room for the professional to do his work.
I have always tried to provide as much room as possible, solely from the basic belief that most professionals are well educated and are eager to provide the best care. Management in general should be focused on supporting them and providing the room and climate that helps them to provide the best care as possible.
Language is vital, but how about listening?
Listening is vital. I think SF helped our management division to really listen to people. Listen to their need for professional space, for appreciation. One of my colleagues once said that being congruent or consistent is perhaps the most important aspect of any organisation. The way I approached my management team is important in the way they in their turn approach their professionals, which again is important for how the professionals approach clients.
Was it amazing for you, that you really saw this change happen?
Maybe not amazing in the sense that I already did have a focus on a human approach to management and care. But SF did create a common language, an approach and it gave us the means to really understand each other and start working together to make our care better! For instance, we changed from problem talk to solution talk. This alone makes so much difference! It really gave us more focus and purpose in our daily work.
We trained our complete management team quite intensively over the period of one year and provided them (and me) with the basic tools of SF. That was quite empowering as it provided them with practical tools to work with on a daily basis.
Would you say that Solution Focus itself is simple?
That is a good question. Maybe SF in itself is simple. The basic philosophy is simple, not rocket science, but in order to be able to work with SF on a daily basis, we had to learn about SF. And with the support of Ilfaro[ii], we provided our complete management team with a one year training on SF.
So, although SF in itself seems simple, using SF is NOT! The training provided us with the tools necessary to incorporate SF in all aspects of our daily work, from the basic way in which we organised meetings to the way in which we assessed development together with the professionals. Questions changed from ‘what did you do wrong?’ to ‘what are you most proud of?’
So, your department made a big change. How did the Board, Finance or HR react ?
One of the things that I regret is that we did not introduce SF simultaneously in all parts of the organisation. At times this made it difficult to create a common platform and we lost some of the momentum that we could have achieved. Having said that, the change in my department was significant and had great impact, and the rest of the organisation also shifted towards SF, but without the intensive training programme that was provided to my management team. Nonetheless, I think that in the coming years within GGZ Oost Brabant the Solution Focus approach will find its way throughout the whole organisation.
Could you cope with those differences yourself?
Sure. The Board at GGZ Oost Brabant always provided me enough space to do my work in the best possible way and for me that meant working with SF. And of course, I had to answer to the Board for my results, financial targets and other KPI’s, but there is no conflict with SF in this. I feel that sometimes SF is looked upon as more of a soft approach, but for me this is not the case. We still have to perform, achieve our results and make progress, using SF makes no difference to this.
Maybe the difference lies in the way you achieve these goals or targets. Using SF gives you a more open perspective and makes sure that you focus on the common achievement and development of the team. And again, perspective shifts from ‘what is going wrong?’ to ‘what is going well and what can we improve?’.
You left your organisation. What did people say to you?
I felt very proud that people recalled the space that I provided. Space for appreciation, development and respect for professional experience. People told me my management style was clear, to the point and based on trust. But I am most proud that a lot of people mentioned that I was able to understand the need of the professional and clients, even without an education in health care.
Are you confident that your approach will sustain past Christmas 2020 after you leave?
Oh yes. I think SF has become a real part of GGZ Oost Brabant and this is not reversible. But still it will be very important that other people within the organisation make sure that the focus on SF remains and the organisation continues to be challenged to include SF in every part within the organisation.
Thank you, Bjorn for this great interview.
[ii] Ilfaro is a Belgian training company. Website: https://www.ilfaro.be/en