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Home » Health Professionals » General Information » Difficult Clients » Conflict avoidance and resolution

Conflict avoidance and resolution

 

 

What is Conflict?


  • Disagreement
  • Clash
  • Divergence
  • Difference
  • Argument
  • Discourse

 

The Oxford Dictionary defines conflict as:   The opposition of incompatible wishes”

 

What are its Causes?

 

A: With Injured Workers

 

Conflict is the result of stress – perceived or real, of rehabilitation or treatment providergined or predicted loss (e.g. loss of money, status, health, faith, power). Workers who have experienced injuries have to deal with numerous changes in their life and circumstances that are frequently perceived as threatening and likely to result in loss or losses. These include:

 

1. Reduced income – Most workers who are off work for anything other a few days will find their income reduced. The reduced income from loss of overtime, penalty rates reduces further in time if they do not return to work. As a result many have problems meeting financial commitments.

 

2. Loss of job – for some injured workers injury means loss of capacity to work pre-injury duties and sometimes unable to work in the pre-injury job at all. A reduction or loss of status, financial prosperity, capacity to fulfill talents and exercise skills is common to any person who is unable to work.. A lower status of physical and psychological health is frequently experienced by injured workers who are unable to return to pre-injury work. Many are reliant upon medication, have poor fitness and experience chronic pain.

 

3. Lack of information and poor communication by treating professionals – can lead to poor knowledge of diagnosis, prognosis of what treatments will or will not work. Unrealistic expectations can follow.


4. Lack of coordination of services – by treating professionals can lead to frustration.

 

5. Slow process of injury management, treatment and rehabilitation – can lead to considerable frustration, particularly when other difficulties are being encountered.

 

6. Individual characteristics of workers – can determine their response to treatment, frustration and taking the initiative to manage their own situation and injury as much as possible within the current workers compensation system.

 

The issues and difficulties outlined result in many workers who are injured feeling out of their depth, frustrated, anxious, angry and at times depressed. They are often less able to deal with frustrations and setbacks than normally and may be ready to “explode” if their needs and wants aren’t acknowledged. Poor communication and lack of reliable follow up and confidence with injury management guidance, rehabilitation and treatment can be a trigger point for major conflicts occurring.

 

B: With Employers

 

Conflict can develop with employers in the following situations:

  • When they believe the workers injury is not genuine
  • When they believe the injury didn’t happen at work
  • When they believe the injury is not as severe as the worker is making out
  • When they have a poor relationship and lack of respect for the worker prior to injury
  • When they have had bad experiences with prior claims
  • When they are fearful of higher premiums and the impact on their “bottom line”
  • When they do not acknowledge and accept the importance of WH&S
  • When they have a “challenging personality”


C: Treating Professionals

 

Some treating professionals are difficult to deal with and it will take considerable skill to avoid potential disagreement and conflict resulting in a standstill with the injury management plan going ahead. Common difficulties occur when they:

 

  • Won’t speak to you
  • Don’t understand the concept of injury management
  • Are arrogant - not willing to accept other views
  • Don’t understand a particular workplace
  • Have stereotypical attitude of insurers as being solely money motivated at all levels with no regard for clarehabilitation or treatment providernt’s welfare whatsoever
  • Have concern that their patient’s welfare will be compromised with a proposed strategy

 

D: The Rehabilitation Provider

 

Conflict can escalate when the rehabilitation or treatment provider:

  • Does not have the knowledge or skills to manage a case and does not have available supervision
  • When the rehabilitation or treatment provider is one of many rehabilitation or treatment provider’s in a situation of rapid staff turnover
  • When he or she is so goal or task focused that they don’t listen to the needs and concerns of the various parties involved
  • When he or she has poor communication skills
  • When promised follow up does not occur
  • When a heavy-handed approach to differences of opinion is the usual way of dealing with differences of opinion.

 

How to Prevent and Resolve Conflict

 

Three models of conflict resolutions and behaviour change are outlined in the following section.

 

1. Model of Stages of Change

 

For the vast majority of injured workers an injury is something that they would prefer not to have had. When an injury does not resolve many changes are frequently required that can be perceived as extremely threatening and require major adjustments in nearly all aspects of their life. An injury that does not resolve may require a change in career, a new employer with the threat of unemployment, the taking up of new hobbies and interests, and changed dynamics with family members and spouses because of a shift in roles that must occur.

 

As a rehabilitation or treatment provider of workers compensation benefits the injured worker loses some of their autonomy and independence and is accountable to an insurer and an employer in a way they were not prior to injury. For major adjustments to take place in the areas outlined to accommodate an injury a series of steps needs to be worked through (even if these are not done consciously). They are as follows:

 

1.  PROCESS OF CHANGE MODEL

 

The stages

1. Precontemplation

 

The person is not even considering change as he/she doesn’t feel they have a problem or need to change. Many injured workers do not make changes to their lifestyle in early stages of an injury, not accepting that change is necessary and remaining hopeful that they will return to normal.

 

2. Contemplation

 

During the contemplation process the injured worker is ambivalent but at this stage recognizes that change may be necessary and that they may need to explore options.

 

3. Determination

 

At this stage the injured worker decides they want to change and accepts the need for change.

 

4. Action

 

The injured worker chooses the strategy for change and pursues it.

 

5. Maintenance

 

The injured worker’s challenge is to continue strategies of change. In relapse the person resorts back to old negative self defeating behaviours.

 

This model although developed in context of alcohol, drugs and gambling problems is also applicable for professionals working with injured workers who have to make significant changes in their life as a result of injury. By acknowledging that the injured worker may not yet have accepted the need for change and even be aware of areas where change is required, potential conflict can be avoided. Tact and skill in broaching sensitive issues can help in bringing the injured worker on side to participate in change initiatives that are required e.g. rehabilitation, new work goals, etc.

 

2. DEBONO'S CONFLICT RESOLUTION APPROACH 

 

Edward Debono, philosopher and thinker has suggested that there is a dominant way western democratic society tends to deal with conflict situations that is inherently flawed and destined to failure when resolving conflict. It is enshrined in our democratic processes and can be seen in most parliamentary democracies where two parties oppose each other’s view and systematically criticize each other until one party wins and their views dominate. This model can be summarised as follows.

 

The Argument Model of Conflict Resolution

 

Objective: To win the argument and have your idea accepted.

 

Assumption: Your ideas are right; theirs are wrong and need changing.

 

 

Features:

 

1. Each side gets more rigid.

2. Neither side makes an attempt to develop an idea different from the two that are clashing.

3. An infinite amount of time, energy and cost are locked up in standoffs which may continue for a long time.

4. Creativity and ingenuity of each side is not directed at improving the idea but in securing defeat of the opposing idea.

5. At the end the idea which triumphs is the stronger but not necessarily the better idea.

 

In contrast Edward Debono’s conflict resolution model is as follows.

 

Debono’s Conflict Resolution Model

 

Objective: To develop creatively a solution based on common ground.

 

Assumption: No one party or idea is right or wrong. Both parties have ideas and potential to develop and evaluate workable solutions.

Features:

1. The existing idea is not attacked and may be returned to later without having suffered any discredit or damage.

2. In the beginning both parties are involved in the creative exploration and design rather than criticism (in practice if only one skilled party is active with this it will engender the other party to become involved during the process).

3. The whole time is taken up in a positive and creative manner.

4. Since there is no need to show fault it is possible to set out to modify an idea which is already good

5. The idea is jointly designed and then jointly evaluated.

6. There are not the problems of ownership e.g. your idea against mine.

 

3. Fears/Needs Model

This model is based upon the idea that each opposing party has particular needs and fears that they may or may not have expressed or even acknowledged themselves. This model is often applied when there is conflict between groups of individuals and mediation is required. The theory and approach however can be applied to assisting individuals deal with another individual or organisation when a conflict situation arises.

 

A. Needs

In any situation where there is conflict an individual or group will have certain core needs that must be met. These may be such things as enough income and reliability of income to pay the rent or mortgage, access to reliable medical care and continuing social support. In situations where tension is high the individuals who are in a conflict situation may not express their needs accurately or precisely but be more interested in venting their frustrations and placing blame upon the party or individuals that it perceives to be blocking them having their needs met. Understanding the likely needs of an injured worker is a first step to resolving any conflict. Basic counseling skills including empathy, active and reflective listening can help in gathering additional information about the core needs being expressed.

 

B. Fears

Often driving conflict and the expression of intense emotion is fear of the consequence of what will happen if a particular need is not met. Fear can be concerned with issues such as whether an individual will by “thrown onto the street” if they cannot pay their rent, starvation and being a failure as a provider if there is not enough money coming in.

 

Fear can also concern issues of self esteem e.g. being out of work for a long period may symbolize being a failure. Alternatively being forced into an area of work or training that is of little interest can create fear that work will be meaningless, boring and frustrating for an infinite period of time. What is a source of concern of fear for one individual may be quite different for another.

 

For the REHABILITATION OR TREATMENT PROVIDER working with an injured worker predicting likely sources of fear and addressing them in communication is a first step. Other essential skills required are as follows.

 

Skill Base Needed For Successful Conflict Resolution

 

  • Reflective Listening – the ability to reflect back the essential features of what your client or injured worker is saying encompassing their statements, and underlying thoughts and emotions.

  • Empathy – the ability to feel some compassion and understanding of their situation from their standpoint.

  • Assertiveness – the skill required to acknowledge and demonstrate that that both you and the client are important and have rights (as opposed to aggressive where you get your way and they don’t; or passive where they get their way at the expense of your rights.

  • Knowledge – the knowledge of your job, your professional discipline and of various aspects of your job required for good injury management.

  • Communication – skills to articulate and express yourself in a way that is clear and unambiguous.

 

  • Timing – the skill to know when it is appropriate or not appropriate to deliver information and to attempt to direct change in a way that will enhance motivation rather than resistance.

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