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Can you afford to ignore generational differences?
At any given moment, a member of any of four distinct generations of adult consumers-The Matures/Silent Generation, Baby Boomers, Generation Xers, and the Millennials (or Gen Yers)-may knock on the door of your facility.
And, at any moment thereafter, cross-generational dynamics between a provider staff member and a consumer could generate resistance, compromise a treatment outcome, or end a therapeutic relationship altogether.
Later, I'll discuss three practical ways that you can “tune up” the generational understanding and rapport-building skills of staff, skills that build more positive consumer relationships and foster better outcomes. But for now, let me define what I'm talking about.
Cross-generational differences-differences that arise from the experiences, assumptions, and beliefs of succeeding generations of people-often arise between individual clinicians and consumers. Such differences can easily fork into mental and emotional detours that result in undue tension and conflict that, whether spoken or unspoken, disturbs the building of rapport, trust, and respect essential to a therapeutic relationship.
Cross-generational differences can contribute to a higher rate of no-shows, cancellations, and drop outs, or to low consumer satisfaction results. All of these are signs of consumer disappointment, resistance, or passive aggressive participation. Like a bus rattled and slowed by winter potholes, a bumpy generational split disrupts and damages the service provider's helping process with the consumer, making it difficult, uncomfortable, or impossible to achieve the desired treatment outcome.
Here are two examples of how cross-generational differences can compromise bottom-line goals:
Example 1: Stand on your own two feet
Joan, a 57-year-old Boomer clinician, spoke with Megan, a 26-year-old GenY client over the phone prior to the initial session. Megan says she is overwhelmed, extremely anxious, and unable to sleep. Joan enters the initial session with a judgmental curiosity and predetermined agenda to find out why Megan still lives at home with her parents.
Megan, who is not financially self-supporting, increasingly resents her parents when they offer advice, ask questions, or impose rules. Through early sessions with Megan, Joan comes to believe that, if Megan is so dissatisfied and argumentative with her parents, the solution is simple: Megan should move out and stand on her own two feet. But, Megan has missed two of the last four sessions. And, Joan's comments to staff suggest that her client is irresponsible and lazy and needs to be more mature.
Joan's background? She was financially self-sufficient and living on her own since age 21. Is it likely that her biases, beliefs, and sentiments were reflected to her client. Is it possible that these affected Joan's ability to establish a meaningful connection?
If Joan reflected more deeply, through an understanding of the cultural lens of Gen Yers, she might realize that Megan's circumstances fit the profile for this population. Studies show that Generation Yers look to parents for emotional and financial support until late in their 20s and make major life decisions seven or eight years later than their boomer parents did.
Typically, Gen Yers also have financially generous parents, who tend to be more engaged in the affairs of their children than were parents of previous generations. In fact, one source says that significant numbers of Gen Yers expect to live at home with parents after college-rent-free.
Example Two: A lack of commitment
Mason, a Gen Y PhD-track psychology student, resigned an internship that required him to drive 70 miles each way in winter weather. His Boomer supervisor, Mary, expressed shock and resentment at Mason's decision, saying that he “backed out mid-assignment” and “defaulted” on what she maintains was an important and binding commitment. Her organization finds itself in a tough spot, being forced to reassign Mason's clients and psychological testing responsibilities to an already overburdened staff.
To more effectively recruit and supervise future interns, Mary must learn to understand Mason's choice in light of his Gen Y values. Surveys show that Gen Yers may average eight or more jobs by age 32. They tend to be:
highly ambitious and optimistic about life, job, and career;
less likely to stay with an organization when they perceive that it's not in their immediate best interest;
more likely to make decisions without considering potential future costs or impacts.
To members of the Silent or Boomer generations, such behavior is shocking, but there's a reason: Many GenYers never saw their parents' loyalty to job and company pay off. Their parents instead appeared naïve and powerless as they became statistics of globalization. Despite their loyalty and years of service, Gen Y children saw their parents victimized by widespread layoffs and long-term unemployment.
So, the question is important: How capable and sensitive are agency staff when they must work with generationally diverse individuals from ages 20 to 80? Even more important: How comfortable are consumers and clients in these four generations when they must work with your staff? Or, is a 30-year-old clinician really tuned into the needs of a 75-year-old client?
In a faltering economy marked by financial uncertainty, improving the ability of your staff to understand and manage the dynamics of cross-generational relationships opens a tremendous window of opportunity. Managing these obstacles and potential costs is a must for leaders who are serious about improving outcomes for all, as well as financial performance.
So, how can you give your understanding of cross-generational differences in treatment a quick tune-up? Here are three steps I often suggest:
Adjust your “generational lens”
This suggestion is based on an Arabian proverb that says, ““We resemble our times more than we resemble our families.” Ask yourself, “What generational lens am I looking through, and what does it say about the assumptions that I'm making right now?”
Assume that, as a service provider, you see your client through your own generational lens, a lens that includes some degree of skew or bias based on your age group. Consider this: In a workshop, an eager and assuming Baby Boomer workshop participant says, “We are all professionals and trained to work with everyone. I don't have a problem with the 25-year-old Gen Xer with pierced face and tattooed body.”
Across the room, another participant frowns and replies, “That doesn't mean he feels comfortable working with us.” While it's true that Boomers may respond neutrally to nose rings, body tattoos, or exposed belly buttons, it's also wise for any provider or counselor to consider other issues or lifestyle choices that may trigger a recognizable and negative reaction.
Because we're molded by historical, political, social, and technological events in our formative years, we must recognize that our values, assumptions, and world views are more generation-centric than many of us would acknowledge. As individuals, we live, work, and interact most easily with those who share the events, fads, music, technology, and styles of our own times. But what about those in other generations who share other views and values? Clearly, our work in the continuum of healthcare is strongly influenced by the generational lens we peer through each day.
Exercise the Platinum Rule
The Golden Rule admonishes us to “do unto others as you would have them do unto you.” But this is the wrong advice when you're working across generations-it just doesn't work. For example, a Gen X or Gen Y clinician might think nothing of assigning a computer- or internet-based assignment to an older boomer. It's convenient for the clinician, but the client feels technologically inept.
Here's where the Platinum Rule comes in: “Treat others as they want to be treated.” Even a bit of thought or a moment of discussion with the client may identify better and more comfortable ways (for them) of working on a therapeutic goal.
Watch your language
When working across generations, it's also wise to consider how you use language, since ideas of what constitutes formal, slang, or offensive language differ widely by age. This is based, once again, on what we all learned early in life about words that could be used in earshot of adults. This Boomer author grew up in a family the word “butt” was a “bad word” that we dared not use, for example. The term “ass” was unthinkable.
Today, many Gen Xers and Gen Yers use the “f word” much more openly. Other once-offensive terms are widely used in TV sitcoms and movies, while on cell phones, “that sucks” goes right along with “lol” and “wtf?” To older ears, such language may transmit an inappropriately friendly or casual tone at best, or at worst a tone of disrespect or contempt. These are hardly the ingredients for a trusting relationship. With language, perhaps a variation of the Platinum Rule is best: “speak to others the way they want to be spoken to.”
A sound understanding of the fund-amental differences across generations has never been more central to the therapeutic and financial success of behavioral healthcare organizations. First, it is essential in building the personal rapport needed to drive positive provider-consumer relationships and healing outcomes across four generations. Second, it is essential to building the sense of openness, understanding, and comfort that is needed to make all clients feel that their visits are warmly welcomed-or deeply missed.
Investing in generational “tune up” time and education for staff members and programs is a smart and cost-effective way to look after both your consumers and your finances.
Debra Neal, LSC, CSAC II is a consultant and trainer on stress hardiness and resiliency in the workplace, cultural proficiency, and motivational interviewing and president of Pathways to Empowerment. For more information, visit www.pathwaystoempowerment.net.
