1. Closing the health gap through resource management: A workplace attachment perspective
Michael Clarkson-Hendrix, PhD LCSW-R
John Carroll-Barbuto, PhD MPA LCSW-R
Network for Social Work Management 28th Annual Management Conference
June 16, 2017

2. Background Health inequities continue to exist (Walters et al., 2016)
At the same time, the health care workforce is being challenged in retaining workers who are competent and proficient in addressing these injustices (Hyde, 2013)
Could a worker’s attachment to their workplace lead to new ideas and change their likelihood of staying?

3. Purpose
Expand the application of attachment theory through the perspective of a workplace-based attachment system
View the workplace as a multidimensional attachment figure
Relational, Social & Physical Aspects
Identify types of workplace attachment
Secure, Insecure: Anxious, Insecure: Ambivalent, Insecure: Avoidant (Ainsworth & Bell, 1970; Bowlby, 1988)

4. Methods
In-depth, semi-structured interviews with Veteran health care sector social workers
Purposive and snowball sampling (N=13)
Mostly female (77% female, 23% male)
Worked primarily in behavioral health (77% behavioral health; 23% medical/surgical)
Vast majority were direct practitioners (85% direct practitioners, 15% supervisors)
Ages ranged from young to middle adulthood

5. Data collection and analysis
Interviews with social workers elicited perceptions of:
Connection with their work
Motivation to work with Veterans
What made them feel secure in their work
Times they felt particularly attached to their job
Recorded and transcribed verbatim
Combination of thematic (Braun & Clarke, 2006; Lofland, Snow, Anderson & Lofland, 2006) and deductive qualitative analysis (Fortune, Reid, & Miller, 2013)

6. Overall results
Three workplace attachment types occurred, which were thematically related and categorized using foundational interpersonal attachment styles (Ainsworth & Bell, 1970; Bowlby, 1988):
Secure
Insecure: Anxious
Insecure: Ambivalent
One type was not found to be occurring:
Insecure: Avoidant

7. Results
Secure – Affective tie characterized by the worker feeling safe within the workplace
Workforce-related meaning and purpose
Felt competence
Trust
Empathy
Reward
Trust:
“I’m in an environment where it’s okay if I get it wrong the first time around, or I take the long way around to get there. But, so basically that it’s okay to fail to a certain extent; that there’s going to be a learning curve for me, and that I don’t lack the insight to know that, but that I promise I will get there.”

8. Results
Insecure: Anxious – Affective tie characterized by worker anxiety about the workplace
Concerned about performance
Questioning self-confidence
Concerned about performance:
“I know that I’m a hard worker so nobody can argue that, and I think I’m pretty good at what I do. The part that makes me feel insecure is that I am notoriously late with notes and treatment plans. It just takes me forever.”

9. Results
Insecure: Ambivalent – Affective tie characterized by worker ambivalence about their workplace
Questioning personal and organizational investments
Wondering about other patient populations or work settings
Wondering about other populations and settings:
“I don’t see my career at the VA necessarily being forever. I’ve got a lot of other things I can be getting into at some point”

10. Results Insecure: Avoidant
Themes inducted were unrelated to this type of workplace attachment
This may have been due to the nature of this type of attachment, in which workers may have avoided participation in the study since they would need to present themselves as a prospective participant

11. Limitations Non-random and non-stratified sample Single coder
Single sector of social workers

12. Conclusion Three workplace attachment types occurred Secure
Insecure: Anxious
Insecure: Ambivalent

13. Implications for managers and leaders
Assess the attachment style of staff
For workers who demonstrate insecure attachments, reallocate resources to engender security

14. Implications for managers and leaders
Target supportive supervision
Assist them in finding meaning and purpose in their job tasks
Rekindle memories of rewarding workplace experiences (Mikulincer & Shaver, 2007)
Distribute reasonably challenging projects
Build their confidence and re-engage them
Conduct activities that enroll all team social workers to identify agency missions and renew these commitments publically and routinely
Use active listening skills in interactions
Develop capacity for empathy for service participants and colleagues

15. Contact Information
Michael Clarkson-Hendrix John Carroll-Barbuto

16. References
Ainsworth, M. D., & Bell, S. M. (1970). Attachment, exploration, and separation: Illustrated by the behavior of one-year-olds in a strange situation. Child Development, 41(1), 49–67. doi: /
Bowlby, J. (1988). A Secure Base: Parent-Child Attachment and Healthy Human Development. Basic Books.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. doi: / qp063oa.
Fortune, A., Reid, W., & Miller, R. (Eds.). (2013). Qualitative Research in Social Work(2nd ed.). New York, NY: Columbia University Press.
Hyde, P. S. (2013). Report to congress on the nation’s substance abuse and mental health workforce issues.
Lofland, J., Snow, D., Anderson, L., & Lofland, L. (2006). Analyzing Social Settings: A Guide to Qualitative Observation and Analysis(4th ed.). Belmont, CA: Wadsworth.
Mikulincer, M., & Shaver, P. R. (2007). Boosting attachment security to promote mental health, prosocial values, and inter-group tolerance. Psychological Inquiry, 18(3),
Walters, K., Browne, T., Spencer, M., Maramaldi, P., Smukler, M., Wheeler, D., … Uehara, E. (2016). Health Equity: Eradicating Health Inequalities for Future Generations (Grand Challenge: Close the health gap No. 19).
*This research was conducted at Stratton VA Medical Center, in Albany, NY. The opinions and findings expressed here are not those of SVAMC or the VHA. Michael Clarkson-Hendrix had a VA appointment at SVAMC at the time of this study. John Carroll-Barbuto is an employee of SVAMC at the time of this study. The study was approved by the SVAMC IRB.