Emotional Intelligence

 Brain Circuitry plays a role

• Amygdala- seat of emotions (love, hate, grief, fear, etc.)

• ­Key part of the primitive “nose brain” along with the hippocampus

• Quick circuit to action, when impulse overrides everything

• Important in surviving in dangerous circumstances but can prove problematic in modern-day interactions

 Prefrontal lobes

• ­Stifles or controls feelings to deal with situation more effectively

• ­And yet….

  • ­Dr. Antonio Damasio- studied impairment in prefrontal-amygdala circuit

    • ­Decision-making flawed with no deterioration in IQ

    • ­Patients with brain injuries lost access to “emotional” learning

    • ­Individuals had difficulties with work, school, relationships, etc.

 Damasio authored “Descartes Error”

• ­“I think therefore I am” as per Descartes, perhaps not that accurate

• ­Emotional brain is as involved in reasoning as the thinking brain

  •  When two brains interact well-emotional intelligence rises and so does intellectual ability

• ­Emotions MATTER for rationality and they work hand in hand

• ­Thinking brain has the “executive” role with emotions except in those moments when emotions surge out of control and the emotional brain runs rampant

 IQ cannot be changed by experience or education

 EQ…may be changeable

• ­Emotional life has its own competencies

• ­Emotional aptitude: meta-ability determining how well we can use skills including “raw intellect”

• ­Emotionally-adept: know how to manage their own feelings well and read and deal effectively with other people’s feelings

 Howard Gardner-1983 “Frames of Mind”

• ­There are a wide spectrum of intelligences

• IQ and SAT testing capture a narrow range of intelligence; society places a high value on these, but things are beginning to be reconsidered

• ­However, Gardner contends that “we should spend less time ranking children and more time helping them identify their natural competencies and gifts and cultivate these”

• ­“Core of interpersonal intelligence includes the capacities to discern and respond appropriately to the moods, temperaments, motivations, and desires of others.”

• With intrapersonal intelligence, the key to self-knowledge, he included “access to one’s own feelings and the ability to discriminate among them and draw upon them to guide behavior.”

 Self-Awareness:

• ­Ongoing attention to one’s internal state

• Neutral mode that maintains self-reflectiveness even amidst stressful situations

• Parallel stream of consciousness

 Training in Emotional Intelligence now being incorporated into schools

Yale Center for Emotional Intelligence

• Connecticut-based program RULER

  • Recognizing emotions in self and others

  • Understanding the causes and consequences of emotions

  • Labeling emotions accurately

  • Expressing emotions appropriately

  • Regulating emotions effectively

 Emotions: Conscious and Unconscious

­Emotions simmering below the surface can have a powerful impact, but self-awareness can shake them off

• Self-mastery-temperance, appropriate emotion to circumstance

 Platinum Rule

­“Treat others the way they want to be treated”

• ­Coined by Dr. Tony Alessandra

• ­Developed a system for knowing the attributes of four main personality styles to guide understanding people better and being able to relate to them better.

  • ­Relators, Socializers, Thinkers, Directors

• problematic because we are all different from each other; it is not necessarily true that someone will want to be treated the way you want to be

  • know your patient!

 Communication is critical to every aspect of work as an Occupational Therapist

• ­Patients, Clients

• Their Families/S.O.s/Friends

• ­Colleague

• ­Professional Association

• ­Regulatory Agencies, Insurance Companies, Government, Other Stakeholders

Mentoring

• Mentor (Noun)- an experience or trusted adviser

• Mentor (Verb)- advise or train (someone, especially a younger colleague)

• Mentorship- personal developmental relationship in which a more experienced or more knowledgeable person helps to guide a less experienced or less knowledgeable person

•  Finding a mentor:

  • ­A) More experienced colleague in and out of the workplace

  • ­B) Supervisor or Manager at workplace

•  Engaging in a mentoring relationship:

  • ­Regular contact time-establishing how you best learn

  • ­Sharing of relevant information (self-reflection)

  • Accepting feedback­

  • ­Demonstrating understanding of what is learned (verbal, demonstration)

• Mentorship is often confused with supervision, although it can develop in this context

  • ­A mentor does not necessarily have to oversee the mentee’s work

• Mentor supports the mentee in their professional development and offers praise and encouragement

• Focus is on personal growth

• Mentors may change over the course of the career of the mentee for different needs and practice areas

• Key to mentoring relationship: Know Thyself!

  • ­Learning Styles:

    • ­Many learning style surveys to choose from

    • ­Many domains of learning: kinesthetic, tactile, visual, verbal/auditory

• Learning Styles change over time 

• Context is everything- where is learning occurring?

• Adaptation

  • Generational factors?

    • ­i.e., verbal/visual (e.g., as technology becomes more prevalent, more usage of online tools)

 Team Members in Hospital Settings

• ­MD

  • ­Attending MD or DO

    • ­Completed residency and practices in that specialty in a hospital or clinic

    • ­Supervises fellows, residents, and medical students

    • ­Professorship in academic medical settings

    • ­Have final responsibility, legally and otherwise, for patient care

  • ­Resident MD

    • ­Training-may be the first MD encountered for orders/questions/issues that arise

  • ­Fellow

    • ­Advanced training; completed basic residency in specialty area.

  • ­Hospitalist

    • ­Branch of Medicine or Internal Medicine

    • ­Deal with acutely ill hospitalized patients

    • ­Relatively new specialty organized around hospital care, not a disease, organ, or population

    • ­Assigned when the patient has no primary MD

• Physician Assistant

  • ­Mid-level health care provider

  • ­Diagnose illness, develop and manage treatment plans, prescribe medications, and serve as the principal health care provider

  • ­Required in many states to have a direct agreement with a physician

  • ­Complete less training and cost less than half as much as a fully qualified physician

• ­Nurse Practitioner

  • Mid-level practitioner

  • ­Advanced practice Registered Nurse

  • ­Trained to assess patient needs, order and interpret diagnostic and lab tests, diagnose disease, prescribe medications, and develop treatment plans

• ­Registered Nurse

  • ­Graduate from Nursing Programs

  • ­Work in a variety of healthcare settings and often specialize in a field of practice (Medicine, Surgical, Psychiatry, etc.)

  • ­Supervise other healthcare workers, student nurses, and licensed practical nurses.

• ­Certified Nursing Assistant (CNA)

  • Provide direct care to patients in hospitals, nursing homes, and home care

  • ­130 hours of programming approved by New York State, including classroom instruction and 30 hours of clinical internship.

  • ­Help with many tasks for patients, including eating, bathing, grooming, mobility, etc.

  • ­Take vital signs, monitor visually

• Physical Therapist

  • ­Allied Health Professional

  • ­Promote, maintain, or restore health.

  • ­Address illnesses and injuries limiting an individual’s abilities to move and perform functional activities.

  • ­DPT entry level, with some PTs still working with M.S. or even B.S. degrees.

  • ­Use patient history and physical exam to diagnose, establish a plan, and, as needed, incorporate lab and imaging studies to address treatment planning.

• Speech Language Pathologist

  • ­Allied Health Professional

  • ­Specialize in evaluation, diagnosis, treatment, and prevention of communication disorders, cognitive-communication disorders, voice disorders, and swallowing disorders.

  • ­Masters level education required

• Social Worker

  • ­Social work practice is often divided into three levels. Micro-work involves working directly with individuals and families, such as providing individual counseling/therapy or assisting a family in accessing services. Mezzo-work involves working with groups and communities, such as conducting group therapy or providing services for community agencies. Macro-work involves fostering change on a larger scale through advocacy, social policy research, development of non-profit organizations, and public service administration, or working with government agencies

  • The education of social workers begins with a bachelor's degree or diploma in social work or a Bachelor of Social Services. Some countries offer postgraduate degrees in social work, such as a master's degree or doctoral studies (Ph.D. and DSW (Doctor of Social Work). Increasingly, graduates of social work programs pursue post-masters and post-doctoral studies, including training in psychotherapy

• Case Manager/Care Coordinator

  • Case management is defined as the assessment, planning, and care coordination of services to meet a patient’s individual health care needs. Case managers often advocate for patients’ safety and positive health outcomes through appropriate care coordination and communication

  • Care Coordinators facilitate conversations between interdisciplinary Care Teams (including Patient Navigators, Care Coordinators, primary care physicians, and additional health care providers) and expedite client services referrals. Care coordinators work with and guide the team process and tasks while building collaboration with all parties and stakeholders

• Psychologist

  • ­PhD Clinical Psychology, or other specializations (Cognitive, Counseling, Developmental, Educational, Forensic, Neuropsychology, etc.)

• Creative Arts Therapists

  • ­Allied Health Profession

  • ­Use creative and expressive processes of art making to improve and enhance psychological, physical, and social well-being

  • ­Six specialties: Dance/Movement, Music, Art, Drama, Psychodrama, and Poetry

  • ­Masters-level education required

• Certified Therapeutic Recreation Specialist

  • Recreational Therapy, also known as Therapeutic Recreation, utilizes recreation and other activity-based interventions to address the assessed needs of individuals with illnesses and/or disabling conditions, as a means to psychological and physical health, recovery, and well-being

  • ­A Bachelor’s degree in Recreational Therapy is required for most entry-level positions

  • ­Most employers seek Certified Therapeutic Recreation Specialists (CTRS). They are required to submit an annual maintenance application and fee for each year of their five-year certification cycle

Generational Differences

• Other Considerations for Professionalism in the Work Environment-Generational Differences

• Understanding the different generations and how they relate to each other

• We have to be cognizant of the differences we encounter to be effective in  our profession (and life)

  • Silent Generation-Veterans (Traditionalists

  • ­Baby Boomer

  • ­Gen X-ers

  • Millennials (Generation Y

  • ­Generation Z-Digital Natives

• Generations and associated characteristics are only based on the United States, not other countries 

• Based on social/cultural/economic/political factors, etc. that impact their upbringing

 Veterans Generation (also known as Traditionalists)-Your Patients/Clients

• ­“The Greatest”- Depression, WWII

  • formative years were during The Great Depression and WW2

• ­Born between 1928-1945

• ­Described as loyal, formal

• ­Process-oriented learning style

• ­Goals: Build a legacy; feel personal responsibility for their organization

• ­Workplace values/ethics: Loyalty, dedication, sacrifice.

  • ­Hard work

  • ­Respect for authority, hierarchy, elders

  • ­Adhere to rules, “Duty First”

  • ­Conformity

Baby Boomers Generation (Sandwich generation)-your patients/clients/possibly colleagues or managers/director

• ­Born between 1946-1964

• ­Described as optimistic, tactful

• ­Learning styles derived from personal experiences, caring environment, handouts, and note-taking

• ­Goals: Build a stellar career; achievement-oriented; desire recognition, financial reward

• Workplace values/ethics: Dedication

  • Respect authority

  • ­Want “face time” (i.e., talking in-person > email)

  • Team oriented

  • ­Personal growth and gratification

  • ­Uncomfortable with conflict

  • Overly sensitive to feedback

  • ­Can be judgmental

  • Responds to directive leadership

 Gen-Xers Generation (Slacker generation, Me generation)

• ­Born between 1965-1980

• Described as skeptical, blunt, and even cynical

  • formative years were in a time when the economy was not as good

  • divorce rates were much higher

• ­Efficient learning style; study what is personally useful; own pace and time; like technology

  • technology boom

• ­Goals: “Build a portable career (career security vs. job security); freedom

• ­Workplace values/ethics: Work-life balance

  • ­Want autonomy

  • ­Accept diversity

  • ­Pragmatic/practical

  • ­Self-reliant

  • ­Reject rules

  • ­Mistrust institutions

  • ­Use technology

  • ­Multi-taskers

 Millenial Generation (Gen Y, Nexters, Trophy kids, Echo boomers)

• largely, children of boomers (product of their parents who wanted more)

• ­Born between 1981-1995

• Described as pragmatic, polite

• ­Collaborative learning styles; technology a ”must”; experiential; immediate feedback; Goals: “Build parallel careers”; Multitask at work; multiple careers in life; Seek personally meaningful work

• ­Workplace values/ethics: Need feedback and recognition

  • ­Nurtured

  • ­Seek fulfillment and fun

  • ­Celebrate diversity

  • ­Optimistic

  • ­Self-inventive

  • ­Rewrite rules

  • ­Institutions are irrelevant

  • ­Not impressed with hierarchy

  • ­Expect technology

  • ­Multi-task fast

Generation Z-coming up-born after 1996-2010 (Goodnight iPad). Children of Generation Xers.

• ­Parents are “fresh direct”

• ­Pragmatic, analytical, evaluate information quickly, review, through their own research

• Grew up completely with technology

  • ­Skype their grandparents (technology available at a very young age)

• ­Resurgence of physicality-cooking, sports, etc.

• ­A participation award is not a real award.

• ­Prioritize diversity- race, gender, orientation

• ­Flexible work environments

• ­Work-life balance

• ­Achievement and award focused

• ­Need constant feedback

• ­Entrepreneurial

• ­Expect clear goals

Shouldn’t “pigeonhole” anyone based on year born!

• Many influenced by more than one generation

• Individuals from two different generations may perceive behaviors in different ways

• Both come from their generational context

• When joining the workforce one must be aware of how they are perceived and learn to demonstrate professionalism that will earn respect with different generations

• Adaptive style will help one be most successful

• New staff enter a new world where they will be answering to an authority figure, typically a supervisor

• Sometimes new staff assigned to a mentor. On occasion the mentor is the supervisor, but not always

Demographic shift

half the workforce is millennials

• 2025-75% of the workforce are millennials

Cultural Humility vs. Cultural Competence

Cultural Competence

• Emphasizes knowing about cultures

• Expects providers to be adept and knowledgeable

• ­Focuses on differences between cultures

• Emphasizes personal culture and how it differs from others, but does not typically delve into prejudices and implicit bias

• Generally silent on issues of power, within and outside of health care

Cultural Humility

• Emphasizes a constant process of learning

• ­Recognizes gaps in knowledge without shame, and provides an opportunity for deeper engagement with patients

• Creates expectations for differentiation between and within cultures

• ­Acknowledges implicit and explicit bias and prejudice as a part of being human, and works toward the identification of bias to promote positive changes

• Recognizes power dynamics in health care and their effects on  patients and providers