The document outlines a strategy to promote well-being for staff working with acquired brain injury patients. It analyzes job demands and resources using the Job Demands-Resources model. It identifies common job demands such as stress, extra roles, and lack of appreciation. Resources include meaningful work and feedback. The strategy proposes interventions targeting both job demands and resources at the individual and organizational level. This includes job crafting, increasing feedback, appreciation, and control. Training in mindfulness, strengths use, and the JD-R model is also recommended. Regular reviews and promoting employee assistance aims to support well-being in a sustainable way. Limitations in generalizing from a small sample are noted.

1. ‘The Way to Well - Being’
A Wellbeing Strategy for Staff Working
with an Acquired Brain Injury Population

2.  Brain Injury Specialism programme provides services through the below:
Brain Injury Specialism Programme

3. 06/03/15
Meet Lars....

4. Outcomes
“The hospital fixed my body but this
service brought normality back to my life”
-Anto, ex Headway Service User
Returning to work allowed me to reach my
main goal and objectives. With the
assistance of this service, I was able to make
my dream a reality. I could not have done it
alone.”
- Mario, Service User

5. Implications for staff
 Clients presentation:
 Broad range of cognitive, behavioural, emotional and interpersonal difficulties
 Intensive interventions are often required, often extended and repetitive
 Frequently clients have limited awareness of the nature of the difficulties, the
impact on everyday life or the need for rehabilitation
 Persistent anger, frustration and aggression particularly difficult to manage
(Witting, Tilton-Weaver, Patry and Mateer 2003)
 High degree involvement:
 Clients with dual diagnosis, cognitively impaired older adults
 Frequent contact often with resistant clients with reduced insight into their
difficulties and rehabilitation needs
 Associated with: Greater emotional exhaustion, Depersonalisation, Decreased sense
of competence or that work is significant (Witting et al, 2003)
 Complex relationship within ‘Helping Professions’ (Stamm, 2005)

6. Formulation of questions
 Critical Incident technique (Flanagan, 1954)
 Used within qualitative health care research (Perry, 1997,Crouch, 1991),
 Specifically used with staff working with ABI population effective and
ineffective team work (Suddick and De Souza, 2007)

7. Interview format
 Semi Structure interviews x 3
 2 questions based on CIT
 Followed by series of open ended questions on
 General well being
 Physical health
 Rewards and recognition
 Stress management
Uncovered themes:
 Making a difference through work
 Extra roles
 Relationship with manager
 Appreciation of the work itself
 Stress
 Resource Management
 Feedback

8. Job Demands-Resources Model (Baker & Demerouti,
2007)
Mental
Emotion
al
Physical
Etc.
Support
Autonom
y
Feedbac
k
Etc
Job
Demands Strain
Job
Resources Motivation
Organizational
Outcomes
Bakker & Demerouti, 2007
The Job Demands-Resources Model
This model can be
applied to many
organisational settings
regardless of the specific
demands and resources

9. Job Demands
Examples: Time pressure, heavy workload,
Stress, role ambiguity, emotional labour, poor relationships
Job Demands
Physical, psychological,
social or organisational
features related to
psychologist cost
Themes
 Additional
roles
 Relationship
with manager
 Stress
 Lack of
feedback
Employees Examples
 Emotional nature of
the job taken for
granted.
 Lack of support and
understanding from
management.
 Important work
undermined by petty
administrative tasks/
problems.

10. Job Resources
Examples: Autonomy, strong work relationships
opportunities for advancement.
Job
Resources
Physical, psychological, social or
organisational features of a job
that help achieve work goals,
reduce job demand and
stimulates personal growth
learning
Themes
 Appreciation
of the work
itself
 Positive
Feedback
 Meaningful
work.
Employees
Examples
 Relationships with
colleagues
 Supportive team
 Doing things
outside
of work that help
them relax
 Being organised.

11. Job Demands- Resources Model (Bakker &
Demerouti, 2007)
 Two psychological processes play a part in the development
of motivation and job strain
 Job Strain – health impairment process: Chronic job
demands and poorly designed jobs – can lead to exhaustion.
 Motivation- Adequate resources have motivational potential
– can lead to high work engagement and excellent
performance.

12. Job Demands-Resources Model
 The relationship between job demands and resources is also
important
 The model suggests that job resources may act as a buffer for job
demands.
 In terms of the staff at Headway, although their job demands are
high, they also have considerable resources that help to balance
their feelings of well-being at work.
HIGH MOTIVATION
LOW STRAIN
HIGH MOTIVATION
HIGH STRAIN
LOW MOTIVATION
LOW STRAIN
LOW MOTIVATION
HIGH STRAIN
JOB
RESOURCES
LOW HIGH
JOB DEMANDS
LOW

13. Interventions on the basis of the JD-R Model
Job Crafting
Job Redesign Training
Strengths Based
Personal Resources
Organisation
Level
Intervention Target
InterventionLevel
Job Demands/Job
Resources
Bakker &
Demerouti (2014)
The most effective
interventions combine specific
measures at the
organisational and individual
levels (Kompier, Cooper &
Geurts, 2000)
Individual
Level

14. Job Demand: Issues with Management
Unfair treatment and
negative communication
by managers
Shift from employee production to:
Employees finding ways
to control their emotion
Finding ways to diffuse the
current situation with their
superiors
Hirigoyen (1998) as cited in Sandvik, 2003

15. Reason : If employees cannot advise their superiors of issues that may arise, the company is left
without an initial warning system (Beer & Eisenstat, 2000) that may lead to loss of capital.
Recommendation:
Ensuring that manager are aware of the effects of managing personnel within the
workplace, or training managers in effective communication and consultation.
Proposed result: When managers develop a relationship-focused approach to their interaction with
employees, it is evident that employee satisfaction in the workplace increases, and the possibility
of employees resigning decreases (Atwater & Brett, 2006).
Organisational Level Intervention - Modify Management Practices

16. Job Demand: Stress
Defined as : The perception that one cannot cope with their
current situation, or cope with an imminent decline in their well-
being.
Lazarus, R.S. (1966). Psychological stress and the coping process. New York: McGraw- Hill.
Employees’
current way of
dealing with stress
Walking
Aqua Fit
Comedy gigs
Colleagues

17. Mindfulness:
Being fully aware in the present moment,
non-judgmentally
– Be aware of actions and
emotions
– Increases our ability to prioritize, focus,
and make life choices that are
consistent with our values
• Associated with decreased stress and
improved mental & physical health
Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: A metaanalysis. Journal of
Psychosomatic Research, 57, 35-43
Recommendation:
Individual Level Intervention – Mindfulness (Formal or Informal)

18. Reason : At times, managers and subordinates perceive their tasks to be separate and leading to
independent goals (Tjosvold, 1989). When goals are definite and seen as a challenge to be faced
as a united front, managers and subordinates develop relationships that create cohesion and
thus success for the organization (Tjosvold, 1981 as cited in Tjosvold, 1989).
Proposed result: Cooperation rather than competition leads to collaboration. It is the result of
reciprocated support and direct communication between the members which instills a sense of
camaraderie among employees. This cooperation creates a culture that encourages the
circulation of resources, and advocates for a mutual direction to be withheld within the
workplace (Beer & Eisenstat, 2000).
Create a shared vision with the mind set of leading by example
through all behaviors and actions at work.
Further recommendation:

19. Job Demand: Extra roles
Extra roles
Unpredictable and
outside job description
Need to anticipate what might happen within the
structure of the organisation, and clearly understand
role within it - Environmental clarity
Uncertainty leads to
discomfort particularly
when related to decision
makers
Warr (2007)
Lack of sense of control
Detrimental to performance
which impacts in turn on
wellbeing
Numerous studies show positive associations
between aspects of environmental clarity and well
being
‘when you have your own set
program for the day and then
something kind of comes in out of
the blue, it’s an extra thing that
can be difficult or stressful at times
to manage that’

20. Recommendation: Optimise job demands by increasing environment clarity. Roles and
expectations should be clearly defined, discussed and formalised as roles are assigned and
adapted over time. Incorporate an update of employees job roles into regular appraisals
including
Proposed result
 Increased clarity of job expectations and development of achievable jobs with clear goals
 Increased level of communication and information sharing which are both shown to
correlate positively with eudemonic and evaluative wellbeing (NEF, 2014)
Conflicting tasks or unclear
information regarding work related
explanations, rules and policies
High demand jobs Considerable effort
Sense of constant uncertainty
and experience higher levels
of burnout (Witting et al,
2003)
Importance of
examining
possible ways to
reduce demands
such as role
ambiguity (Bakker
et al, 2014).
Organisational Level Intervention - Environmental clarity

21. Organisational Level Intervention - Increase Sense of Control
Recommendation: Encourage employee sense of control and autonomy. Staff
should be afforded and encouraged to exercise control in carrying out their roles
Managers should work to foster trusting relationships between themselves and
their employees, and support staff to exercise control over their own roles
(Through job crafting and use of strengths)
Encourage employees to contribute to the wider organisation by requesting and
seriously considering feedback
Proposed result: If implemented well this could ultimately free up time for
managers and the potential impact in terms of job satisfaction are significant
Autonomy
Positively associated with
wellbeing
Capabilities more visible
When employees are able to
organise their own work, apply
own ideas and able to influence
decisions around them

22. Individual Level: Job Crafting
Recommendation: Provide Job crafting training in which employees learn to proactively
change their own work environment (Tims , Bakker & Derks, 2012) using the Job Crafting
questionnaire (Slemp& Vella-Brodrick , 2013)
Proposed results: This will facilitate the following (Tims et al, 2012)
 Increasing structural job resources
 Increasing social resources
 Increasing (challenging) job demands
 Decreasing (hindrance) job demands
Well designed jobs and working
conditions have been shown to
facilitate employee motivation and
reduce stress.
Increased in structural and social
resources
Increased work engagement and job
satisfaction
Job crafting

23. Job Resource: Appreciation
What is it?
“An emotion which occurs after
people receive aid which is
perceived as costly, valuable,
and altruistic.”
Why is it important to show
appreciation?
A study of over 1,700 people
found that more than half of all
employees intended to search for
new jobs because they felt
underappreciated and
undervalued. (APA, 2012)
“I think this is me being really honest about it, because if it is not being recognised and this is what I’m
doing, then how long is that sustainable for? And is this something I can do for the rest of my life?”-
Interview

24. Benefits of
Appreciation
• Increased productivity
• Increased engagement among
colleagues
• Loyalty to organisation
• Higher loyalty and satisfaction rates
from clients
• Positive organisational attitude and
relationships
Tower Watson- “the single highest
determinant for engagement is whether or
not employees feel that their manager is
genuinely interested in their wellbeing.”
“More consistent acknowledgement and a kind
approach” would make workplace wellbeing better.-
Interview

25. It’s the little things…
• Say thanks to clients, co-workers, and senior staff
• Change your attitude
• Learn to give and receive compliments
• Learn to show gratitude
• Deliberately infuse culture from top to bottom with an ‘attitude of gratitude.’
• Remember, this is a two way street.
Organisational & Individual Intervention – Increase levels of
appreciation

26. Job Resource: Meaningful work
• Individual Level intervention: acknowledging making a
difference through your work.
• Csikszentmihalyi (1990) attempted to define meaning
by coming up with three concepts:
• Having a purpose or the significance of
something
• The intentions one holds
• Identifying or clarifying the term in context.
(Chalofsky, N. (2003). An emerging construct for meaningful work. Human Resource Development International,
6(1), 69-83.)

27. Individual Level Intervention – Acknowledging
Making a difference through your work
 At Headway all of our interviewees believed that their
work with this client group was meaningful
 Gayle (1997) stated that both humanistic psychologists
and motivation theorists believed that individuals need a
work life they think is meaningful
 Shamir (1991) suggested that a task can be motivating
depending on its meaning to the individual, rather than
for any rewards associated with it.
(Chalofsky, N. (2003). An emerging construct for meaningful work. Human Resource Development International, 6(1), 69-
83.)

28. What is
feedback?
Types of Feedback
 Formative
 Summative
 Positive
 Constructive
Who can give feedback?
 Direct management/supervisors
 Customers/clients
 Co-workers/peers
 The organisation as a whole
Helpful information or criticism
that is given to someone to
say what can be done to
improve a product, service,
performance, etc. (Webster
Dictionary)
Organisational & Individual Intervention – Increase mechanisms for
feedback

29. What happens when people don’t get feedback
1. Tend to either be overly critical or self- congratulatory
2. Lack of self-awareness
3. Reduced well-being

30. Benefits of feedback
• Manager feedback leads to:
• Increased feelings of employee motivation and energy
• Employee satisfaction
• Employees identifying with the organisation
• Increased employee loyalty
• Improved performance and productivity
• Promotion of professional and personal growth
• Decrease in organisational costs
• Client feedback leads to:
• A significant increase in employee morale
and motivation
• Experience and education of employees
“So that can be very rewarding- that
immediate feedback you get.”- Interview

31. 06/03/
15
Our Well-Being Strategy

32. Summary of Interventions on the basis of the JD-R
Model
Job Crafting
-Use of job crafting
-Increase means of finding
meaning in work
-Increase means of giving
feedback
Job Redesign
- Modify Management
Practices
-Environmental Clarity
-Increase sense of control
-Increase means of feedback
Training
-Mindfulness
-RD-M training for Management
-Wellbeing Psycho education
Strengths Based
-Working with Strenghts
Personal Resources
Organisation
Level
Individual
Level
Intervention Target
InterventionLevel
Job Demands/Job
Resources
Bakker &
Demerouti (2014)

33. Limitations
1. It is difficult to control for all of the variables within the organisation when using
the JD-R model.
2. Our sample size was small, and the three members of staff that we interviewed
each had different roles within the organisation, therefore limiting our access to
the overall employee sample.
3. Interviewees were aware that the results from the study were being fed back to
the organisation.
4. The use of strengths based interventions have not yet been scientifically
validated, despite its contribution to wellbeing research, resulting in promising
findings. (Bakker & Demerouti, 2014)

34. How this could look in practice..
Training Access to advice In company routines
• Job Demands –Resource
Model Awareness Training for
Management team
• Increased promotion of Employee
Assistance Programme
• Wellbeing as a standing agenda
item (both management and
team level)
• Wellbeing Psycho – education
including awareness of JD-R
model
• Mindfulness (formal/informal)
• Development of Informal Peer
Support Networks (increase sense
of meaning in work)
• Regular Performance Reviews
(increased environmental
clarity, feedback, appreciation,
sense of control)
• - Incorporate use of strengths
• Job Craft awareness training
• Strengths use awareness
training
Positive Psychology Intervention
and ongoing promotion (NEF
postcards promotion – ‘Have you
tried a way today?’) (not found in
study but recommended)

35. Pre and post measure

36. Perfect Timing!
March 27th Irelands First National Workplace Well Being Day