LEADERSHIP

How do you handle the contradiction between professional expertise and interdisciplinary collaboration?

Being a specialised professional is culturally at odds with interdisciplinary collaboration. Dorte Hjortkjær sees this in her work as a leader at the Veteran Centre. Here are her 3 suggestions for points of focus in the management of these specialised professionals.

Master of Public Governance

Specialised professionals have great value in the Danish welfare society. They use their highly specialised knowledge to solve demanding tasks, and in return they enjoy a high degree of autonomy and control, for example when organising their work and making decisions in complex situations. But what happens when they have to work with others?

Crisis psychologist Dorte Hjortkjær is head of the Military Psychology Department at the Veterans Centre, which includes several different groups of professionals who all have to work together to provide veterans and their families the best help. She finds that this collaboration can be challenging. In fact, she concludes: being a specialised professional is culturally at odds with working interdisciplinarily.

Therefore, as part of her final master's project on the MPG programme, she investigated three managerial challenges of interdisciplinary collaboration among professionals. These challenges must be addressed to create more coherent and effective support for veterans. She won the award for the best project of the semester for this assignment.

Internal developments at the Veteran Centre have highlighted the difficulties in collaboration. The Veteran Centre was established in 2011, and with the wars in Iraq and Afghanistan, the number of veterans increased. So has the number of specialised employees at the Veterans Centre to best help veterans. 150 employees are currently located in 7 departments across the country and represent several different disciplines. For example, social workers, psychologists with various specialities, employment counsellors, family counsellors and physiotherapists.

‘We have professionalised and specialised our services. But there is a clash between our own idea of a good veteran programme and what we hear from some veterans. They experience a compartmentalisation,’ says Dorte Hjortkjær.

Veterans returning home with psychological injuries need a holistic approach, which requires the staff at the Veteran Centre to solve the task interdisciplinarily. However, it has been noticed that many do not receive the best treatment and several experience being left alone in the transitions between specialised interventions at the Veteran Center or transitions to, for example, municipalities and psychiatry.This is why Dorte Hjortkjær has investigated how the professional staff at the Veteran Centre can work better together.

Here are 3 key findings from her study:

Being a specialised professional is culturally at odds with working interdisciplinary

‘The professionals' reward comes from the recognition they get from the user they are with. It is a very strong value for them. But when I, as a leader and we, as an organisation ask professionals to think holistically, we are actually asking them to move into a space where they have to discuss and negotiate a common goal for a veteran with other professionals, and that common goal is not the same as it would be in a one-to-one relationship. It is not naturally motivating for them to spend time in meetings and coordination. Therefore, interdisciplinary collaboration is an uphill battle.

I can give you an example: exposure therapy is the primary treatment for veterans with PTSD. But the treatment itself is so stressful that everything else around the veteran needs to be in place before treatment. If you are not trained to think holistically, you might forget to ask: ‘Can you support yourself? Do you have a place to live? Do you have a job? How is your family doing?' Ultimately, it benefits users to have a plan that takes all factors into account, with each professional bringing their area of expertise to the table. And we are not good enough at creating a holistic plan for that.

In order to succeed with a holistic plan, professionals must compromise their own professional goals and recognise that right now, exposure therapy may not be beneficial. Perhaps supportive conversations are more effective while stability is being established around housing and finances.

My leadership task is to keep the long-term goal in front of everyone as a common benchmark. And that we as an organisation recognise and organise the work to support the interdisciplinary meetings so that they are just as important as the one-on-one meetings with the veteran.

Today, a specialised psychologist is the first person a veteran meets in the day shift. Internal discussions at our organisation have shown that this is not always the best solution. Maybe social workers are better at pre-visitation because they are trained to think more across the board?

It is also about me as a manager articulating that the closer you work with other disciplines, the clearer it becomes what you can and should do with your expertise and what I can and should do with mine. And where there are grey areas and overlaps. It helps to provide insight and build trust that other professionals also fulfil an important part of the task.

While focusing on the holistic approach, it is important that we do not compromise on specialisation. Specialisation is important for professionals and veterans in order to provide the best treatment and to attract skilled employees. So in the interdisciplinary approach, we need to work on several levels: we need to support the holistic approach with interdisciplinary collaboration, while not giving up on developing and recognising specialised professionals.’

"My leadership task is to keep the long-term goal in front of everyone as a common benchmark."

Dorte Hjortkjær, head of the Military Psychology Department at the Veterans Centre

When procedures change, there will be an organisational power shift

‘The longer the educational background, the more power you have in society in general. This is also seen in the Veteran Centre.

For example, we are currently investigating a redistribution of tasks so that new professional groups may have to solve new tasks to ensure a holistic approach, and this will affect familiar routines and processes.

Because in every task there is an inherent power that is hierarchically positioned. But it is not just about the power we attribute to people and tasks. The allocation of authority also comes from external sources. So, while one professional group may be ready to change their practice, when a veteran calls the day shift and requests contact with a specific professional group, this also involves an allocation of authority. If we believe that this professional group is not the best suited to help the veteran with their current issues, it is our responsibility at a managerial and communicative level to highlight other professional groups. This way, the veteran understands that they are receiving the best and most qualified assistance, even if it comes from a different specialty than expected.’

Professional leadership has changed significantly with the many new reforms in the public sector and requires new balances between, for example, professionalism, management and democracy.

This course at MPG looks at the role and practice of professions in organisations over time based on both classic and brand new professional theories. It also discusses the pros and cons of different leadership roles. It is taught in Danish 🇩🇰.

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MPG elective Ledelse Af Fagprofessionelle

The same factors are at play in the management team and in the employee group

‘By default, I thought that all managers are motivated for change and want to work holistically. So the following is also an interesting finding for me:

I found that the management team is exposed to the same factors as the employee group. They are managers of a specialised department and most managers are also professionals themselves. This means that in the management team, we also need to work on cross-functional and holistic thinking. Change requires motivation and trust in working towards a common goal. This development process requires psychological safety within the group. If this is compromised within the leadership team, both the leaders and the specialised professionals are likely to focus on their own departments and strengthen their own expertise, rather than thinking about the development of the whole.

In the leadership team, there is also the matter of delegating authority in interdisciplinary work. This could involve decisions about hiring a new colleague. Should it be someone from one section or another? Where is the need greatest? And how can we best strengthen the whole? It could also pertain to the priorities a leader sets.’

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Dorte Hjortkjær, leader at Veterancentret, has graduated from MPG, CBS

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How do you handle the contradiction between professional expertise and interdisciplinary collaboration?

"My leadership task is to keep the long-term goal in front of everyone as a common benchmark."

‘Management of Specialised Professionals’

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