Sandy Roth and
Terry Goss
Who owns the problem?
This month, we want to provide a set of guidelines to help you determine what boundaries you are honoring with your patients. Each team member will present one patient as a case study. In preparation, the team member reviews the chart, focusing on the patient`s history with the practice, and outlining what was learned, recommended, and acted upon. You will also need a small ball to assist you during the role-playing exercise.
The accompanying checklist will be your guide through the process. For each patient, ask the seven questions listed below; then tally the results. After presenting each case, begin the role play. Select a team member to play the patient. If the problem is yours to solve, keep the ball. If the problem is not yours, toss it back to the "patient." Do not accept a return toss - unless you are acting as a facilitator. If so, you must be prepared to toss the ball back and forth, signifying an exploration of options and choices. Every time you toss the ball back to the "patient," ask a clarifying question. Facilitation opens many doors through clarifying questions. Use a clarifying question each time before returning the ball - the problem - to the patient.
When you have determined the problem is yours to solve, accept responsibility. That means you keep the "ball" within your boundary. If, however, you determine that the problem is not yours to either solve or facilitate, you must disengage and symbolically return the "ball" to the "patient."
1. What part, if any, did you play in creating the problem?
All _______ Some _______ None _______
2. What part, if any, did you play in perpetuating the problem?
All _______ Some _______ None _______
3. What control do you have over the variables (factors) related to a solution or solutions to the problem?
Major _______ Some _______ None _______
4. What expertise do you have which would contribute to a solution or solutions?
Significant _______ Some _______ None _______
5. What permission do you have to involve yourself in problem-solving?
Explicit _______ Implicit _______ None _______
6. What parts of the problem are highly personal to the patient and inappropriate for your involvement?
All _______ Some _______ None _______
7. What does your gut tell you about your involvement in this problem?
Rescuing _______ Helping _______
Now, add it up!
Based on the answers, the appropriate action is:
Accept responsibility _______ Facilitate _______ Disengage _______
