The most important person in an orchestra does not play a single note. The conductor conceives and produces the sound of the orchestra. Players are guided to understand their role in each work and follow the conductor’s lead. Executive leadership bears some similarities. Leaders articulate their vision and strategy for a business, and they provide all participants with direction and support.
Every conductor is a trained musician, while executives often have little training in their industry. Behavioral healthcare leaders need not be clinicians. Yet all must be well educated about the business since certain decisions rely on specialized knowledge. They should know their field and their competitors. Ideally, they are advocates both for their businesses and their industry.
An executive needs orientation amid competing interests and priorities. It is difficult to keep a balanced perspective when pressured by proponents of specific viewpoints. One excellent source of orientation discussed previously is the biopsychosocial model. Another to be examined here, the concept of psychosocial assets, is a multi-dimensional goal focused on the resources people have at their disposal.
Why is any of this important? Healthcare is big business. Marketing drives it, and it is complicated. A scan of public media might suggest gigantic strides against cancer. Yet roughly 600,000 people will die from cancer this year. How does our field function in this environment? Our only clear message today relates to medications. People want hope, clarity and honesty. We can deliver on each count.
We can understand a clinical specialty with an emphasis on its problems, solutions or goals. We want and need information on each, but the question is how to prioritize messaging. Business leaders might prefer the image of achieving lofty goals. Technical details about problems and solutions can be overly complex. Embracing an emphasis on goals is fine, but which goals merit top focus?
Behavioral healthcare companies should prioritize the clinical outcomes they achieve. New companies, many with a technology component, embrace this focus today. Most established companies achieved dominance at a time when financial goals largely populated lexicons. However, the clinical outcomes reported today are incomplete. Improvement in symptoms is only part of the picture.
Attention to resiliency and psychological strength is familiar to clinicians. A conceptual focus on the positive aspects of human functioning has been labelled positive psychology. An emphasis on increasing strengths along with decreasing symptoms helps complete the picture, but this is still unidimensional. Our programs build more than psychological resources. Social resources are as vital as internal ones.
A new concept: psychosocial assets
It is time for our field to embrace a new, more comprehensive idea, namely, psychosocial assets. We are familiar with the idea of financial assets or capital. Positive psychology borrows from the concept of assets. Sociologists discuss the importance of social capital, the critical relationships and social support in one’s life. We achieve a two-dimensional goal for our field with the concept of psychosocial assets.
Growing one’s assets is non-stigmatizing, and we have good psychometrics for this. There is a deep literature on wellbeing, as well as one devoted to social connection based on measures for loneliness and social isolation. We can orient people to our field as one that helps people pursue universal, positive goals. This is not a rejection of the medical model, but it is a refusal to let it dominate our field.
The biopsychosocial model ensures that we are not abandoning the medical model. We urgently need effective biological solutions. Yet our field is not like the rest of medicine. The psychosocial focus is not ancillary to the biological. It is coequal. It produces one of our best solutions, psychotherapy. In any case, a focus on goals subsumes the clinical dimensions of the biopsychosocial model within it.
We typically describe a program as having treatments for specific diagnoses. A focus on goals provides an alternative framework. Problems and solutions do not dominate the discussion. Patients have many problems, and we have many biopsychosocial solutions. This becomes secondary messaging. A focus on goals prioritizes changes in domains such as resiliency, wellbeing and social connection.
This orientation for our field is versatile. Every program can be situated within its continuum. The medical model gets its due, as does the psychosocial. Severe behavioral health disorders are reframed. The most vulnerable are portrayed as not only coping with exceptional disorders, but as pursuing universal goals like everyone else. Whatever your background, people want greater psychosocial assets.
We might even imagine this orientation being musical. Might someone with creativity craft an inspiring tune for the growth of psychosocial assets? Can we expect a dominant theme with distinct melodies for important clinical subgroups? Will there be an uplifting chorus that celebrates our common strivings? Each conductor will gladly convey this powerful message to the public. Messaging is part of the job.
Ed Jones, PhD, is senior vice president for the Institute for Health and Productivity Management.