Playing Well With Others — Interdisciplinary Collaboration at a Center on Aging
By Lenard W. Kaye, DSW, and Jennifer A. Crittenden
Social Work Today
Vol. No. Page 34

True interdisciplinary collaboration is hard work. But the payoff is big: better client services.

We are living in a professional climate ripe for interdisciplinary collaboration. Collaboration is a particularly timely topic in the context of today’s social issues where multiple interests are set against the backdrop of shaky budgets and looming cuts. One thing certain in times of scarce resources is that collective efforts with your neighbors, colleagues, other professionals, and a variety of organizations and agencies can often buffer the effects of stretching too few resources too thin. In a time when issues affect communities and agencies in big ways, social workers cannot truly serve a population or address a social issue as effectively and efficiently as they might have had they partnered with others.

Taking Risks
Collaboration is a term that is often misused and misunderstood by professionals. Many practitioners claim to participate in collaboration but may not give much thought to the application of this practice or the implications of its use. True interdisciplinary collaboration requires crossing professional boundaries into what is often unfamiliar territory. Interdisciplinary collaboration also challenges us to drop preconceived notions of other professions, learn new languages, and also see a problem through a new lens.

Interdisciplinary collaboration differs from many popular practices in the field such as team work, coalitions, and partnerships. By its very nature, the interdisciplinary component means searching out those in other disciplines and fields. So, for example, work teams within an agency may not necessarily push through the boundaries of one particular profession.

Not Just Going Through the Motions
Collaboration will not reap benefits if it is merely a ritualistic exercise. Meaningful collaboration is a curious combination of blood, sweat, and tears combined with a consistent philosophy and set of personal and professional values. You must believe that more can be accomplished when you work with others than alone and that even more can be accomplished if those you work with are able to offer diverse perspectives, expertise, and resources.

Many social workers are tempted to believe that as long as they are working together with other agencies they are participating in interdisciplinary collaboration. However, the key is to fundamentally understand the boundaries of your profession. Many examples of interdisciplinary collaboration have been described in the health professions. Treatment teams typically consist of a diverse group of individuals, each with different orientations to the same problem, including physicians, nurses, nutritionists, activities staff, physical and occupational therapists, social workers, and chaplains. Such teams gather many professions around a table to share perspectives about each patient within their care. That diversity of perspective is further ensured when representatives of the community and patient and client groups and their caregivers are also invited to the table.

Alter (2000) suggests another useful framework for defining collaboration. Partnerships often involve joint projects with fewer players. Networks, another popular term, should be considered partnerships with more stakeholders involved. However, it is the collaborative process that must occur in genuine fashion prior to the creation of entities such as partnerships, networks, and coalitions.

Benefits
The benefits of collaboration are numerous. First, collaborating with key professionals and agencies in your region can legitimize an issue. For example, at the Center on Aging at the University of Maine, we work with the Eastern Maine Transportation Collaborative, a diverse group of professionals that represent roughly 30 organizations that have come together to address transportation issues for rural older adults in Maine.
With the backing of so many organizations and stakeholders, we are able to collectively capture the ears of key policymakers in the state. Would this have happened if the University of Maine Center on Aging or another organization had decided to go it alone? Possibly. But it is doubtful we would have received much more than a passing glance from policymakers in Maine.

Another benefit of collaboration is the synergy that occurs through participating in a group that is invested in the issues it is addressing (Alter, 2000). During many brainstorming sessions of our transportation collaboration, we have found the ideas and energy to expand exponentially. Why is this? Because each person at the table has a vested interest in seeing the transportation challenges of older adults met. Along with this synergy comes the additional resources and ideas that are brought to the table by each person and agency.

Not only does your organization stand to gain resources from other agencies in collaboration, but in a time when grant monies are essential for many organizations, collaboration can also convince granting sources that your agency is not only committed to the population you serve and the issues you address but that you realize making inroads into solving the problem cannot be accomplished on your own. Collaboration also ensures that redundancies across programs, especially in rural areas, are reduced. It can be seen as a vital cost-saving technique for federally funded programs. At the University of Maine Center on Aging, we have been awarded grants based on the magnitude of the collaborations we have formed. On the other side of the coin, we have also been cautioned by granting sources to expand those collaborations so as to include all stakeholders involved. As we quickly discovered, collaboration usually means partnering with more than one or two other organizations.

Challenges
You may be hard pressed to find a professional who admits to being against collaboration. However, the devil is indeed in the details. Often, it is the challenges of implementing collaborative relationships that may hold some agencies and organizations back from engaging in this practice. One challenge is the expenditure of time, money, and information that comes from planning and executing the collaborative process (Alter, 2000). Anyone who has been involved in collaboration understands the time inevitably invested in meetings, the money expended for employees to participate in collaborations, and the information required to share with others at the table.

Collaboration also means having the ability to relinquish control of a project. This too can be intimidating for some administrators and professionals who have grown accustomed to wielding complete power and having the authority to direct project efforts. Trust is an important part of the equation because professionals and organizations put their name on the line for a new initiative. Trust can often be a challenge in rural areas where politics and history shape the interactions that occur in each community. Trust, too, takes time to build.

Other Barriers
Other barriers to effective collaboration can include factors such as professional misinterpretation, conflict over goals and objectives, and problems with communication and coordination. One way to avoid these problems is to involve a third-party facilitator who is seen as being impartial, such as the United Way. This facilitator or facilitating entity can be involved in the collaboration process by keeping records, clarifying goals, organizing work sessions, and facilitating discussions. Another approach is to encourage collaborating organizations to send designees to special trainings on conflict management, group process, and facilitation.

In more rural areas of the country, the collaborative process may be negatively impacted by the lack of community resources, long travel distances, and smaller population bases served. New technologies are arising that are now able to bring professionals together who would otherwise not be able to meet in person through teleconferencing and the Internet. The Maine Benzodiazepine Study Group is a diverse group of professionals comprised of social workers, physicians, epidemiologists, nurse practitioners, drug abuse specialists, healthcare providers, payors, advocates, and other interested parties in the United States and Canada looking at issues related to benzodiazepine use. As a member of this group, we often meet via teleconference with colleagues across the state and country with whom we would otherwise not have the opportunity to collaborate. In addition, many communities are developing methods to share resources through selected resource directories, in both print and Web format, bringing together and integrating an otherwise limited resource base.

Principles of Practice
The following are some principles that can help guide the process of collaborating effectively and efficiently with others. First, identify an issue or area of concern that is both relevant and attractive to other organizations and professionals. Secondly, identify and then invite stakeholders to engage in discussion. This means including not only top-ranking professionals but also direct service workers and, when appropriate, consumers or those directly affected by the problem (Morreale & Howery, 2002). Wall and Luther (2001), of the Heartland Center in Lincoln, NE, suggest the following steps to recruiting stakeholders and gathering them around the table:

1. Ask the question: Who’s not here?

2. Look for skills, not names.

3. Try involvement by degrees.

4. Appeal to the self-interests of stakeholders.

5. Use a wide-angle lens: Look outside your profession.

6. Define the task clearly.

7. Use current leaders and members to recruit new members.

8. Create a reputation for using time efficiently.

9. If possible, offer incentives for joining.

Third, after successfully recruiting your partners in collaboration, negotiate the roles and responsibilities of participating members (Morreale & Howery, 2002). Lay this groundwork up front because this foundation will guide subsequent meetings and communications among group members. Fourth, develop what can be described as win-win outcomes. That is, when identifying goals and outcomes, ensure that all collaborators feel like “winners” (Morreale & Howery, 2002). Morreale and Howery (2002) further caution against working for a “lowest common denominator goal,” which will ultimately make group members feel as though nothing has been accomplished. The final principle that guides this process is minimizing competition whenever possible. Competition among group members can best be controlled through a strong commitment to win-win solutions.

Time, Trust, and Change
Collaboration takes time and energy and at best moves slowly. As such, allow the process time to unfold. It takes time to build the foundation of trust between agencies and professionals. This trust is the backbone upon which successful collaborations are built. Another point we cannot emphasize enough is that the actions and relationships we have today with other organizations and agencies are sure to affect the quality of the collaborations that occur in the future. Remember that the costs that accrue in the collaborative processes are greatest at the outset. Staying the course allows for cost savings (not to mention greater effectiveness and impact) in the longer term.

Be mindful of the likelihood that certain players and organizations may withdraw from collaborative initiatives as their interests and goals naturally evolve and change over time. Similarly, be aware of and receptive to the emergence of new stakeholders over time in terms of the issue or problem you may be addressing. As a result, collaboratives can be expected to both expand and shrink over time depending on the roster of players. Healthy collaborations should have an open-door mentality. They should not succumb to what can be an inclination to close ranks and establish unduly restrictive membership criteria.

Collaboration in Your Practice or Agency
A commitment to a philosophy of collaboration must be nurtured early on. Mitchell and Crittenden (2000) emphasize the importance of learning and practicing interdisciplinary collaboration early on in one’s education. The value and positive outcomes that come from interdisciplinary units in healthcare are often the reason that many health professions programs require students to participate in collaborative work. Student learning should include practice-based opportunities for collaboration across disciplines; guidance on interprofessional conflict resolution; division of labor; and the effective use of time and resources. These learning components can also be applied to social service settings that provide student internship opportunities. You can enhance student learning in your own agency or organization by providing an opportunity for students to participate in work that exposes them to the perspectives of other professions, as well as the opportunity to negotiate the rich group experiences that collaboration provides.

Your agency can further extend its commitment to interdisciplinary work by encouraging staff to attend interprofessional continuing education programs hosted by a wide range of allied health professional associations. If you are providing trainings and continuing education for your staff, invite staff members from other agencies and professions to attend. Continuing education opportunities can and should facilitate interprofessional networking and discussion and foster the possibilities of future collaborative relationships.

Whenever possible, integrate other disciplines into administrative aspects of your agency through recruiting diverse professionals to sit on special project advisory boards and your agency’s board of directors. Our work at the center is greatly enriched by the diversity of professions represented on our numerous advisory boards, planning committees, and board of directors. Such involvement enriches our discussions and work sessions and continually challenges agency practice and procedures to stay in touch with professional standards and the diverse needs of our state and local community.

— Lenard W. Kaye, DSW, is director of the Center on Aging and professor in the School of Social Work at the University of Maine.

— Jennifer A. Crittenden is a graduate research assistant at the Center on Aging at the University of Maine.

References
Alter, C. F. (2000). Interorganizational collaboration in the task environment. In R. J. Patti (Ed.), The handbook of social welfare management, (pp. 283-302). Thousand Oaks, CA: SAGE.

Mitchell, P. H., & Crittenden, R. A. (2000, Fall). Interdisciplinary collaboration: Old ideas with new urgency. Washington Public Health, 1-3.

Morreale, S. P., & Howery, C. B. (2002). Interdisciplinary collaboration: Down with the silos and up with engagement. Retrieved February 1, 2005, from http://www.aahe.org/interdisciplinary.pdf.

Wall, M., & Luther, V. (2001). 10 ideas for recruiting new leaders. Lincoln, NE: Heartland Center for Leadership Development. For more information, contact: info@heartlandcenter.info.

Resources

Books
Hardcastle, D. A. (1997). Community practice: Theories and skills for social workers. New York: Oxford University Press.

Straus, D. (2002). How to make collaboration work: Powerful ways to build consensus, solve problems, and make decisions. San Francisco, CA: Berrett-Koehler Publishers.

Weinstein, J., Whittington, C., & Leiba, T. (Eds.). (2003). Collaboration in social work practice. London: Jessica Kingsley Publishers.

Winer, M., & Ray, K. (1994). Collaboration handbook: Creating, sustaining and enjoying the journey. St. Paul, MN: Wilder Publishing.

Web Sites
Florida Conflict Resolution Consortium’s Practitioners Resource Center
http://consensus.fsu.edu/resourcectr.html

Northwest Regional Educational Laboratory’s “Making Collaborations Successful” Web site
www.nwrel.org/cfc/frc/collabindex.html

Northeast CAPT — Collaboration: A Strategy for Prevention Practitioners
www.northeastcapt.org/products/strategies/collaboration/collaborationpaper.html

Articles
Reilly, T. (2001). Collaboration in action: An uncertain process. Administration in Social Work, 25(1), 53-74.