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lawyer and mental healthOver the past few years, following a number of high-profile attorney suicides, much more attention has focused on mental health needs of attorneys. The study we are featuring today was funded by the Hazelden Betty Ford Foundation and the ABA Commission on Lawyer Assistance Programs.

In short, the authors conclude we need to pay more attention to the mental health needs of attorneys in this country and we need to address the stigma and loneliness often experienced with these struggles. What we want to do with this blog post is display some of the numbers referenced in the article itself. If you are an attorney struggling with depression, anxiety, and/or excessive substance use (or know one who is)—you are very much not alone.

The authors of this study wanted to count the incidence of substance abuse and other mental health concerns and so they assessed alcohol use, drug use, and symptoms of depression, anxiety and stress in a group of 12,825 licensed and employed attorneys. To pull together a group of this size, “recruitment was coordinated through 19 states. Among them, 15 state bar associations and the 2 largest counties of 1 additional state emailed the survey to their members”. Participants were not asked for any identifying information (and IP addresses and geographic location data were not tracked).

In the group were roughly equal numbers of men (53.4%) and women (46.5%) and the most commonly reported age group was between 31 to 40 years of age while the sample included attorneys up to 71+ (as long as they were licensed and employed). Most of the participants (91.3%) identified as White. Private firms were the most common work environment (40.9%) with the most common positions listed as Senior Partner (25%), Junior Associate (20.5%), and Senior Associate (20.3%). Over 2/3 of the sample (67.2%) reported working 41 hours or more per week. In other words, this is a pretty representative sample of practicing attorneys.

Here are some of the numbers the authors reported on mental health and substance abuse issues in this large group of attorneys.

Alcohol use. Of the 11,278 participants who completed all ten questions on the measure of alcohol use, 20.6% scored at the level “consistent with problematic drinking”.

Men had higher levels of “problematic drinking” than women, younger participants had higher “problematic drinking” scores than older attorneys, and those who had been working as attorneys for shorter times were drinking more than those who’d worked in the field longer. Attorneys working in private firms or at bar associations had higher rates of drinking than those in other employment situations. Junior and senior associates drank more than those in other positions.

22.6% reported feeling alcohol use (or other substance use) had been a problem at some point in their lives. (27.6% said the problematic use was before law school, 14.2% during law school, 43.7% within 15 years of completing law school and 14.6% said their substance use had been a problem more than 15 years after completing law school. Age was the only significant predictor of alcohol use (with younger attorneys drinking more than older attorneys).

Drug Use. Participants also completed questions regarding substance use other than alcohol. Perhaps because many of these substances are illegal, there were not enough participants completing the questions to compare to national norms. However, the most common drugs in at least weekly usage were stimulants, sedatives, tobacco, marijuana and opioids.

Mental health issues. 11,516 participants completed the questions on mental health issues so we have good comparison numbers here. Men had higher levels of depression but women had higher levels of anxiety and stress. Older participants had higher levels of both stress and depression. Those who were classified as “non-problematic drinkers” on the earlier measure also reported lower levels of depression, anxiety and stress.

The most commonly reported mental health conditions were anxiety (61.1%), depression (45.7%), social anxiety (16.1%), attention deficit hyperactivity disorder (12.5%), panic disorder (8.0%), and bipolar disorder (2.4%) 11.5% reported having had suicidal thoughts during their career, 2.9% had “self-injured” in some way in the past and 0.7% reported at least one prior suicide attempt.

The authors express concerns that the high rate of problematic use of alcohol and the relatively high rate of anxiety, stress and depression among attorneys be addressed. They say that the level of problematic drinking is at a rate among lawyers that is much higher than other populations. Depression, stress, and anxiety are also significant issues and both substance use and mood disturbances are often effectively treated (and can be treated at the same time). The authors express hope that specialized treatment services and guidelines for attorney recovery will be developed similar to what has been done for impaired physicians.

For all of the talking about the universality of mental health issues (substance abuse, stress, anxiety, depression), it is difficult to admit it, or to seek support or assistance in coping with it. One of the issues not described in most of the article is whether the person reporting the history felt themselves to be a “problematic drinker”, or whether the mood and anxiety problems were brief or chronic. Those factors have a lot to do with whether people choose to seek help. Unfortunately, the social and professional stigma that causes people to deny problems and resist seeking help isn’t going to go away soon.

Krill PR, Johnson R, & Albert L (2016). The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys. Journal of Addiction Medicine, 10 (1), 46-52 PMID: 26825268

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We’re unsure if this strategy would work for women but it seems to work for men—at least in medical schools and teaching hospitals. We do presume those male leaders with mustaches do not have the sort of mustache illustrating this post but what do we know? We also tend to believe that if a woman were to grow this sort of mustache, she would also not be selected to advance as a leader. But, we digress. On to the real point of this blog post.

Each year, the British Medical Journal publishes a Christmas issue where they offer a more light-hearted look at important issues of the day. We posted about one of their articles on Christmas Day. Here is another important paper that (alas) reflects what women know all too well when it comes to women in leadership. These researchers (two medical residents, a professor of law ,and a professor of dermatology) examined (carefully and presumably visually) “clinical department leaders (n=1018) at the top 50 US medical schools funded by the National Institutes of Health (NIH)” to see if they were male or female and whether they had mustaches. None of the women in the sample had a mustache. The researchers defined a mustache in the following way: “the visible presence of hair on the upper cutaneous lip” and they included the presence of both standalone mustaches and mustaches in combination with other facial hair. They specifically did not include facial hair such as “mutton chops” or “chin curtains” as mustaches.

According to the researchers women accounted for only 13% of department leaders in the sample (137 women out of 1,018 department leaders).

Leaders with mustaches (none of them, as mentioned earlier, women) accounted for 19% of the sample (190/1,018 total leaders). And according to them, less than 15% of men in the country have mustaches so mustached men are over-represented among medical department leadership. .

The proportion of female leaders ranged from 0% to 26% across institutions and from 0% to 36% across specialties.

Only seven specific institutions and five specialties had more than 20% of female department leaders.

The researchers developed a novel unit of measure called the mustache index. (Essentially this is computed by looking at the number of mustached leaders versus the number of female leaders.) “The overall mustache index of all academic medical departments studied was 0.72 (p<.004). In other words, a medical department is much more likely to be led by a man with a mustache than by a woman. Only six of 20 separate medical specialties had “more women than mustaches” (for a mustache index > 1).

The researchers recommend that “mustachioed” individuals should number less than the number of women in medical department leadership (and they state they clearly do not mean a “no mustache” policy). They want to call attention to the disparity in these leadership positions between men and women—hence the tongue-in-cheek “mustache index”. They offer a number of suggestions to help increase the number of women in leadership positions that revolve around developing job criteria prior to evaluating candidates, flexible work schedules as well as increased personal control over work time and cite the high levels of satisfaction among women physicians in specialties that allow “controllable lifestyle” such as dermatology and anesthesiology.

From a litigation perspective, this really applies most to law office management and we’ve written before about the importance of hiring practices that do not discriminate against applicants by gender or race and ethnicity (as well as other descriptive characteristics). You can see all those posts by looking at our blog category on law office management. Do a quick count in your own office. Do leaders with mustaches outnumber leaders who are women?

Wehner MR, Nead KT, Linos K, & Linos E (2015). Plenty of moustaches but not enough women: cross sectional study of medical leaders. BMJ (Clinical research ed.), 351 PMID: 26673637

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We are now in ABA’s Blawg 100 Hall of Fame!

Monday, November 30, 2015
posted by Douglas Keene

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We’ve recently been informed that The Jury Room has been inducted into the ABA Journal Blawg 100 Hall of Fame! Okay, it’s not a Pulitzer, but we are wildly happy about it. To our way of thinking, it is the greatest honor The Jury Room could be given. We appreciate the recognition. Closer to truth, we are shocked. Every December from 2010-2014 we have been delighted to be included in the Blawg 100, but this was not even on our radar screen. Here’s a link to the 2015 ABA Blawg Hall of Fame and a link to the 2015 Blawg 100 honorees.

Here’s how the ABA describes the Blawg 100 Hall of Fame:

In 2012, we established the Blawg 100 Hall of Fame for those blogs which had consistently been outstanding throughout multiple Blawg 100 lists. The inaugural list contained 10 inductees; this year, we added 10 more, bringing the total to 40.

And here is how they described this blog on their roster:

Trial consultants Douglas Keene and Rita Handrich find the research to alternately back up what you think you already know about human psychology (Is rudeness contagious? Yes.) and alert you to the unexpected (Are “beer goggles” real? No.) Posts are both fascinating reads and lessons on how not to base your cases on stereotypical assumptions.

We were inspired to begin blogging by Anne Reed (formerly of Deliberations blog and now leading the charge at the Wisconsin Humane Society). Once we got started blogging, we realized it was a wonderful way to keep up with the changing literature and to share what we were learning along the way. Looking back over the 900+ posts, we still find it interesting to blog as well as a great impetus for our own continuing education. Thank you, ABA Journal, for your recognition of our work over the last 6-1/2 years.

Doug and Rita

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repeated-lie-becomes-truthWe often read articles that don’t have enough content to make us want to devote an entire blog post to them but that seem useful or intriguing or just plain fun. Here’s a few more of those tidbits.

“Illusory truth” and the repeated  falsehood

Back in 2009, we wrote a post called I never knew Hitler had three testicles which was all about how, if you hear something often enough, it begins to see true to you. It is sometimes called “familiarity breeds belief” and new research tells us it is still true in 2015. If something sounds plausible, most of us don’t want to do the work of considering whether it may be untrue (despite how familiar it seems). So—how do you make lies appear truthful? You repeat them repeatedly and voila! Truth becomes illusory. This truism is never more relevant than in the midst of an election cycle…

Web only surveys (whose responses are we missing?)

We like Pew Research Center’s no-nonsense approach to reporting poll and survey data. Internet surveys are becoming increasingly popular,and  there are times we need to think about how “doing it easier” can result in big holes in our data. Here’s a brief 4 point Pew summary of what you need to be concerned about and aware of as you ponder the costs and benefits of internet surveys.

There’s an evidence-based supplement for that…

Here’s a newly updated and visually impressive infographic on the ailments for which supplements and herbal products have been found useful. There is a filter you can use to search the database for specific medical conditions and you can see the data on which the decisions in the infographic are based with a single mouse click. While not perfect, it is a wonderfully easy tool to use to facilitate further research on alternative treatments for various medical conditions.

Did you hear about pig-to-human organ transplants?

It isn’t a joke—or one of those illusory truths written about earlier in this post. It’s true. Scientists have discovered that with gene editing using a new technique called CRISPR, they can make this far-fetched idea a reality: “Pigs and humans share a number of physiological and anatomical similarities, but pigs also carry harmful viruses in their genome making pig-to-human transplants dangerous. Now, researchers say, they can simply remove the viruses native to pig cells, reviving the idea of xenotransplantation — using animal organs in humans.”

Do you know what’s expected of you at work?

According to a new poll released by Gallup, many employees do not know what is expected of them at work! While it is a manager’s responsibility to communicate expectations, many do not “own” this task according to the Gallup people. They offer a plain language approach to how to help employees set and achieve performance goals and therefore, not only know what is expected of them but to actually meet those expectations.

Fazio LK, Brashier NM, Payne BK, & Marsh EJ (2015). Knowledge does not protect against illusory truth. Journal of Experimental Psychology. General, 144 (5), 993-1002 PMID: 26301795

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Perseverance-5While you may not have heard the term “counterproductive work behaviors” if you are not in the habit of reading organizational behavior research, you certainly will recognize the behaviors when you see them: absenteeism, lateness, rudeness and incivility. This is an interesting study because rather than studying counter-productive work behaviors (aka “bad behavior”) they wanted to see if there were character traits that were most correlated with good behavior and bad behavior in the workplace. And guess what? There are those traits and it would be pretty simple to assess them in an interview or while checking references. You will be happy to know that the assessment of perseverance requires neither a fMRI nor expensive administrations of tests to show unconscious bias. Instead, it’s a simple matter of questioning the candidate and former employers as we’ll specify later in this post.

First the researchers reviewed the literature on good and bad behavior at work as it relates to various personality characteristics. They touch briefly on the work that has shown (for years now) that conscientiousness is consistently associated with good work performance and good behavior at work. As it happens, say the researchers, perseverance and conscientiousness are highly correlated and so they wanted to see if perseverance was also a predictor of good work behavior and performance. They also thought that perseverance would be most strongly linked to good workplace behavior and performance when the work was seen as meaningful and as a career or a calling rather than “just a job”.

Participants were recruited at the Values In Action website where they completed a survey online [with perseverance being one of the assessed traits] and were then invited to participate in a study of the “character strengths of working individuals”. Participants included 686 working people (553 women, 133 men; 84.1% were full-time employed and 4.5% were employed part-time and 11.4% were self-employed; 82% had university degrees while 12% had completed some college coursework and 6% had high school educations; average age was 41.29 years; the majority were Caucasian (479), 58 were Latino, 58 were Asian, and 31 were African-American with fewer than 1% reporting other ethnic identification). The participants completed brief questionnaires on work performance, counterproductive work behaviors, meaningfulness of their work, and their sense of whether they saw their job as a job, a career or as a calling.

Overall, the researchers found that when you perceive your work to be meaningful and see it as a career or a calling—you are less likely to engage in negative work behaviors.

Perseverance was most indicative of good work performance and least indicative of engaging in counterproductive work behaviors (i.e., bad workplace behaviors).

The researchers say that perseverance plus the passion inherent in seeing one’s work as a calling or a career—is what one might call “grit”. They point to some research from 2007 coining the term “grit” and say grit is a “personal quality shared by the most prominent leaders in every field”. The researchers behind today’s work say that those with perseverance and “grit” are likely to work harder and longer without switching their objectives and goals.

From a hiring perspective, assessing perseverance during employment interviews (or reference checks) would be a relatively straightforward thing to do.

Simply ask the candidate during the interview how they demonstrated perseverance in past positions and ask references if they can give examples of the candidate showing perseverance during their employment.

After hiring, make sure your workplace offers meaningful work and that you model working with passion, purpose and a sense of meaning. And allow mistakes but learn from them. Perseverance doesn’t mean you get it right the first time. It just means you keep trying when it doesn’t work out by learning from past mistakes and getting it right next time. Allow your employees to make mistakes but create an environment where mistakes are discussed and where employee learning occurs so the same mistakes are not made repeatedly.

Littman-Ovadia, H., & Lavy, S. (2015). Going the Extra Mile: Perseverance as a Key Character Strength at Work Journal of Career Assessment DOI: 10.1177/1069072715580322

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