On Being a Mentor

In my previous column “Looking Back, Looking Forward” I discussed the importance of reviewing the past year to make resolutions and set goals for the year. I mentioned that I enjoy mentoring young people and professionals as a way of “giving back” by sharing my experiences and ideas, and helping others tap into their abilities and strengths. In this column I will share ideas on ways to mentor professionals or take advantage of a mentor’s willingness to help. 

The late Dr. David J. Powell wrote several excellent columns on this topic and suggested that our treatment field needs to focus more on mentorship. I agree with him on this important, yet often neglected issue. Being a mentor has multiple benefits to those who are mentored, their mentors, and clients and students who benefit from educational or clinical services.

Mentorship refers to a voluntary formal or informal relationship in which a more knowledgeable and experienced person helps another grow professionally by providing help and support related to the needs and interests of the individual being mentored. An example of a formal mentor is the supervisor who assumes this as one of several roles when providing supervision. An example of an informal mentor is a person who takes time with a colleague who asks for help with a project, task or role based on their belief that this person has something to offer them in their growth as a professional. The time and effort put forth varies and depends on the circumstances of the relationship between the mentor and mentee. For example, some involve greater amounts of time and intellectual and emotional energy than others. In one case a mentor relationship may be brief and time-limited, whereas it may be long-term in another.

In this section I discuss three examples of mentoring young professionals. The first deals with a situation in which inpatient clinical staff initially had little interest in being mentored to work more effectively with psychiatric inpatients who had co-occurring substance use disorders (SUDs). Staff preference was to let other professionals trained in addiction medicine take care of these patients so they could focus on patients with psychiatric disorders only. As a result, patients with co-occurring psychiatric and SUDs (CODs) initially became “our” patients rather than patients that the unit was responsible for. One of three teams of nine patients each was designated as the COD treatment team to provide specialty integrated care.

This was a huge challenge as our colleagues, who were quite knowledgeable and experienced with psychiatric disorders, had limited knowledge, expertise, and in some cases little interest or desire to address SUDs with their patients. One of the most effective ways of mentoring some of the unit’s clinical staff was to provide in-service education while slowly integrating them into our group treatment program for patients. We invited select unit staff to observe experienced clinicians conduct COD groups followed by a discussion of clinical issues explored in these sessions. We then had unit staff assume the role of co-leader in group sessions, which was also followed by processing the session after it was over.  When unit staff felt ready, they assumed the primary role of group leader with experienced staff assuming a role as co-leader.  As unit staff became more experienced and competent conducting COD groups, we transitioned to the role of group observer and later to a group consultant who did not observe in vivo group sessions. The most significant outcome of being a mentor to these staff was watching their professional growth that led to eventual ownership of the group program and viewing patients with CODs as similar to other psychiatric patients on the unit, all of whom were people in the hospital in need of help for their disorders.  

A gratifying experience was being part of the process in which one of the psychiatric nurses on this unit moved from overt negativity and anger towards COD patients to being an excellent advocate and teacher for addressing SUDs among psychiatric patients, and accepting the need for a CODs program on the unit. Another gratifying experience was processing group with two co-leaders—my role at the time was that as an observer—and saying with great pride, “you do not need me to observe your groups, as you are doing an excellent job addressing COD issues with patients.” What was most striking was not their acquisition of knowledge or skills, but the positive change in attitudes in which patients were no longer judged in a negative light or seen as “unmotivated,” and developing a passion to work with patients with CODs.

Our Department of Psychiatry in the School of Medicine has a formal mentoring program for young faculty psychiatrists to aid their professional growth in a clinician-educator pathway.  Mentors are crucial to help faculty develop or improve skills, build a career-expanding network, and deal with the challenges of career advancement. The specific area of focus is determined by the psychiatrist being mentored, and it is usually a team, rather than a single mentor who works with the new psychiatrist. While senior faculty or staff are the usual mentors, peer mentors are also valuable resources.  

Several years ago, one of our new junior faculty psychiatrists asked me to serve as a mentor, which involved meeting regularly to discuss goals related to her clinical and teaching interests.  Later, we expanded our focus on issues related to supervision and consultation to therapists in the clinic as well as psychiatric residents and fellows. We planned and presented several one-day clinical workshops to professionals on integrated treatment of patients with CODs, and collaborated with the service line’s medical director on a group supervision program for residents and addiction fellows. Over time her role became more primary in these educational endeavors. Finally, I mentored her on the process of writing as opportunities came her way to publish.  

What was interesting to me was how my colleague became more comfortable and confident in both her teaching and supervision roles. I believe this lead her to feel more passionate about teaching. One of her goals was to be a more interactive educator to engage participants in active learning, whether this was an educational session with psychiatric residents or a clinical workshop with a diverse group of therapists. She made educational activities more interesting and relevant to participants. Of interest is that on several occasions she conducted presentations to psychiatric residents without using PowerPoint slides, which is almost unheard of in this current age of using technology in educational endeavors. To me, this showed that she wanted to do much more than simply share information with participants, but engage them in an active process of learning. Having co-led four different one-day clinical workshops with her, I saw her growth and her appreciation of the importance of engaging participants in the learning process.

My final example relates to mentoring professionals on writing and getting published.  I receive numerous inquiries from others interested in writing for professionals or individuals in treatment. Some send me copies of a draft of a specific writing. Additionally, I often offer colleagues the opportunity to coauthor a publication. Before getting into details of any specific proposed writing, I discuss the process of writing and try to get a sense of how the other person views it and what they need from me. The one concept I promote strongly is that “writers write.”

  

The responses to these writing opportunities have been highly variable. The majority do not follow through with their initial idea, usually because of the extensive amount of time, effort, and discipline involved in researching a topic, taking notes, writing and rewriting an outline, and writing, rewriting, and rewriting the draft. However, some invest the time and effort needed, and respond well to feedback on their approach to writing and the actual written product. For example, I invited a psychiatric resident to co-author two book chapters.  She did more than here share of work on the outlines, writing and rewriting, and accepted feedback graciously.  

These experiences have taught me that mentoring helps some get focused and engage in the process involved in writing while others learn they are not ready yet or unable to commit the time and effort needed, which is fine. I believe a good outcome of mentoring is helping a person realize and accept that they may not be able to reach one of their goals.

As I think about my experiences being mentored and mentoring others, a few key issues come to mind for both the mentor and the mentee. These include the following.

• Your degree of investment depends on your time, interest, and willingness to be part of the professional development of a colleague. You can help by face-to-face meetings, phone discussions, e-mails, and other forms of communication. If you cannot give adequate time, do not make the commitment as both you and the mentee may feel frustrated.
• The methods you use to facilitate professional growth should depend on the needs of the mentee and style of working collaboratively. For example, some seek guidance early while others try to problem solve on their own before seeking guidance from a mentor.
• Provide opportunities related to the goals and needs of the mentee that are appropriate to their skills, competencies, and interests. These opportunities can relate to clinical, teaching, education, writing, and research, supervisory or administrative activities. For example, a staff member may need mentored on how to relate to peers following a promotion to a supervisor.
• Self-disclose your own experiences, including failures as well as successes, as well as your insights and ideas related to the goals of the mentee.
• Provide resources or suggest ways to access other resources such as people, information, and/or organizations. You may recommend a specific reading, website or colleague with whom the mentee can consult with on a specific issue.  For example, if a mentee wants to learn about the impact of illness on the family, they can attend a mutual support program like Al-Anon, Nar-Anon or NAMI. Or, if you believe this person needs help with a personal problem, you can recommend a counselor or other professional.
• Promote self-reflection and self-evaluation. One of my colleagues has medical students at the end of their rotation on a CODs treatment unit write a personal reflection on work with one patient. This focuses on clinical interventions as well as personal reactions such as dealing with their own beliefs, feelings, challenges or perceived skill deficits. I have read many of these statements, which show impressive growth from anxiety and negativity to increased compassion, empathy, and confidence in their ability to reach patients.
• Check on how you are working together by asking questions such as, “How do you view our work together? “What do you find helpful or unhelpful?” “Are we meeting your goals?” and “What do you think we need to do differently?”

• Take an active role in determining your goals, the steps you need to take to reach these, and who may serve as a mentor.
• Seek out others you believe could help you reach your goals. Let each potential mentor know how you think they can help you and ask if he or she would be willing to work with you. Choose others you think will be a good fit for you. For example, one person may need a mentor who provides more structure and accountability in reaching specific goals.
• Follow through on the agreements you make to take specific actions related to your goals. This may mean working extra hours to accomplish something important to you.  It takes effort and action to achieve your goals so the work you put forth determines your degree of success.
• Be open and ask for feedback about your strengths and areas to improve upon. Although time intensive, if the focus is on improving your clinical skills, have your work observed in vivo or tape your session so you can get more specific feedback on your work.
• Complete your own self-assessment related to your goals with your mentor. Are you doing the work needed for your growth? If not, why? Are you taking advantage of the expertise of your mentor(s) to learn?
• Get out of your comfort zone and try something new. For example, if you want to be more effective in working with patients on trauma issues, consider learning a model of treatment that is evidenced-based.
• Strive for progress, not perfection. For example, if you are learning to conduct different types of treatment groups, do not expect to be as polished or competent as a senior clinician with years of experience. You get better from doing something over and over and learning new strategies to reach others.

There is much evidence that substance use, psychiatric or co-occurring disorders can cause or worsen problems in any area of life for the individual and the family. Engaging in treatment and long-term recovery are ways to deal with these effects and make positive changes in oneself. While professionals can help in many ways, recovery can be aided by others who experience similar problems or disorders. They can share their experiences, hope, and strength as well as provide specific ideas on how to use the tools of the specific recovery program.

Being open to receive help and support from others in recovery is a key issue for anyone dealing with any of these disorders. Mutual support programs like Alcoholics Anonymous (AA), Narcotics Anonymous (NA), other Twelve Step programs, and other mutual support programs can aid recovery.  Similarly, Al-Anon, Nar-Anon, NAMI, and other mutual support programs can aid recovery for the family member or person affected by a loved one’s disorders.

Individuals and family members in recovery can benefit from letting other members educate, support, guide, and mentor them. This can occur in many ways from sharing information, emotional support or guidance in dealing with a specific issue or problem. Connecting with a sponsor with a stable period of recovery is one of the best ways to engage in the process of recovery and deal with its many challenges.

Mentoring can be an important part of professional growth for those who are willing to take advantage of the experiences, skills, and expertise of colleagues who offer their help and support. Individuals and family members new in recovery can benefit from being mentored by others in recovery. Giving back through mentoring new members is one of the ways that mutual support programs continue to provide an excellent source of ongoing support as recovery is best viewed as a “we” program. Being a mentor can make a significant difference in the lives of others and, being mentored can improve the quality of life for those affected by a substance use, psychiatric or co-occurring disorders.