A Right v. Right Moment Squandered? A Teenager Forces Us to Think

The ethicist Joseph Badaracco wrote  short, wonderful book called Defining Moments.  In it he described defining moments as those choices one is forced to make between one potentially right thing to do and another right thing to do.  Right v. wrong is easy, he argues.  It’s those right v. right choices that define us; that define the quality of our characters.

Recently, a 17 year-old boy forced his school officials to make what looks like a right v. right decision.  On  school trip to Beijing he wrote in a Chinese student’s notebook, “Democracy is for cool kids. Don’t believe the lies your school and government tell you. It’s right to rebel.”

The lad’s messages proved deeply offensive to his Chinese hosts and violated the schools’ agreement about appropriate behavior in China.  As a punishment, the boy’s school system barred the boy from his prom.

I wonder what you think.  I think the boy both practiced free speech and violated protocol. Lodged in a 17 year-old boy’s skull his immature brain seems to have practiced intelligent thinking and lack of impulse control in the same act.   I am sure he in fact did, as the school system claims, jeopardize future exchanges.  But was the adult response correct?  I think not.  I think faced with a right v. right choice, the adults chose the lesser right.  However they spin it, it sounds like they are hypocritical about speech.  They revealed a principle of school rules, first, foremost and always.  Instead of a teachable moment they get an ill-defined controversy.

The better, albeit more laborious and scarier choice, might have been to see a teachable moment here.

The adults could have convened some interesting learning about balancing tests.  Every kid in the school must be talking about it.  It was a huge opportunity.  Here are some questions I thought would make great thinking material for workshops.

  • The boy’s speech rights v. the long-term value of the program to other students.
  • The American boy’s rights v. the danger in which he could have put the student in whose notebook, it appears without the Chinese student’s OK,  he wrote prohibited language.
  •  The right of all the students with him to benefit from their trip to China v. one person’s right to free expression.
  • The individual duty to stand up for the right v. the safety rights of others.
  • The inevitable fact that in life we all have to make right v. right decisions that leave us with dirty hands.  And adolescent brains do this differently than adult brains.


How often do we blow it like this in our leadership practices?  More often than we think we do, I’d wager.

Here is the story from today’s Boston Globe.


Newton North High School senior Henry DeGroot was visiting a school outside Beijing on a semester abroad this year when he decided to have some fun and also make a point by writing prodemocracy messages in the notebook of a Chinese student.

“Democracy is for cool kids,” he recalls writing. “Don’t believe the lies your school and government tell you,” said another message, and “It’s right to rebel.”

But when Chinese school officials found out, he had to serve five hours of detention. And when he returned home, it got worse: Newton school officials barred DeGroot from his prom.

Newton school officials say he violated semester abroad rules, embarrassed the principal of the Chinese school that was hosting Newton students, and showed so much disrespect for the Chinese that the longstanding relationship with the school may be harmed.

DeGroot sees it differently.

He says his rights were abridged by the Newton school system. The school system, he says, taught him the importance of civil disobedience and speaking his mind, but then punished him when he practiced what he learned.

Instead of the prom, DeGroot said he and his date, dressed in formal attire, went to Five Guys, the local burger restaurant. “I’m missing a lifetime of memories,’’ he said.

The controversy over free speech is taking place against the backdrop of the 25th anniversary of the events in Beijing’s Tiananmen Square, where Chinese government troops opened fire on student prodemocracy protesters who had occupied the area.

Newton School Superintendent David Fleishman said the problem is not that the 18-year-old expressed his opinions but that he did so on a school-sponsored semester in China, violating a code of conduct clearly spelled out to students before they left.

“We certainly want our students to be thoughtful and critical thinkers,” said Fleishman. “We encourage that, and we pride ourselves on giving students that opportunity. But this is not about free speech.”

DeGroot was among a group of eight Newton students on a four-month study abroad program, under a longstanding partnership between Newton and the Beijing Jingshan School. The episode happened when the Newton group visited another school, in a small town outside of Beijing.

At the end of a two-hour visit with the Chinese students, school officials asked the Newton group to write their e-mail addresses in the students’ notebooks so they could stay in touch. That’s when DeGroot said he wrote the prodemocracy phrases in one of the notebooks.

“It was definitely stupid, but I hoped the kids would read it and think about why this foreigner was writing this,” he said. “And hopefully they would be critical, or at least think about how their school and government interacts with them.”

But a Chinese teacher who reads English saw the phrases and told principal Fan Luyan of the Beijing Jingshan School, host to the Newton students.

The principal was highly insulted, according to DeGroot.

Fleishman said the phrases DeGroot wrote in the student’s notebook have nothing to do with speaking his mind or free speech.

“What he did chilled the rest of the entire trip. It put a strain on the visit,” Fleishman said. He said students are taught the intricacies of Chinese culture and social norms before they leave for the exchange, and they sign a detailed code of conduct, which he says DeGroot violated.

Consequences of students breaking the code can include being sent home from the student exchange at their own cost. Fleishman said that option was not considered for DeGroot because there were just two or three weeks left in the semester abroad when the controversy played out.

Fleishman said writing the phrases that insulted his Chinese hosts was a clear violation of the standards of behavior that DeGroot agreed to before leaving.

“It’s about adhering to the program standards,” he said.

While in China, Newton teachers had instructed DeGroot to write a letter of apology to Fan, principal of the Beijing Jingshan School.

He did, but he included an explanation of his reasons for writing the prodemocracy message. “I felt as a human being on this planet I have an inalienable right to free speech if I’m doing it in a non-vulgar, appropriate way, as this private conversation was,” DeGroot said in an interview.

He said he eventually agreed to rewrite the apology letter, but he refused to deliver it in person to the principal. “I wasn’t going to go out of my way to take a 30-minute train ride to deliver the letter,” he said.

Because of the prodemocracy note, he said, the US and Chinese school officials made him stay in detention for five hours while his classmates went on another trip. He was later told he could not attend the prom, a disciplinary action Fleishman said high school administrators chose because of the lateness of the school year.

Fleishman said he is concerned that DeGroot’s actions could have an impact on the entire exchange program. The Newton schools have had a relationship with Fan and his school since 1979, and have been involved in the school exchange since 1988.

“I applaud kids who want to be politically active, and I believe this program helps kids be active citizens of the world,” Fleishman said. “I don’t want to jeopardize that goal by one student doing something that could end one of the longest-running exchange programs with China.”

Ken Hamilton, chairman of the school exchange committee, said the Beijing Jingshan School is considered an elite institution.

“For something like this to happen, it’s embarrassing for principal Fan,” Hamilton said. “It’s losing face for him, and in Chinese culture that is like losing your reputation.”

Hamilton likened what DeGroot did to embarrassing someone in their own home, and then refusing to apologize.

“Had Henry apologized as he was requested to do, we easily could have repaired the problem. Now it is a little harder,” he said.

Hamilton said Fleishman and representatives of the Newton school exchange have a scheduled telephone meeting with Fan on June 12.

“I’m sure Henry’s behavior and the consequences will be discussed,” he said.

For DeGroot, who is heading to UCLA this fall, the incident left him with a feeling that the Newton school system he’s loved for the past 13 years has let him down.

“They refused to take any stand to support the principles they taught us,” he said.


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Valuable Resource for Officer Safety

Emotional and mental health are real issues in the overall question of protecting officer safety.  Every officer is subject to the effects of hypervigilance in which s/he spends a huge percentage of his/her waking adult hours in a heightened state of physiological and psychological vigilance.  As Dr. Kevin Gilmartin tells us, over a career these effects accumulate.  One horrible outcome of this is an increased incidence of suicide among law enforcement officers, in police, corrections and sheriff’s departments.

The IACP has just published some useful guidelines and information.  The work is summarized in the IACP blog posting below, which also provides links to the relevant documents.

Please take heed.

IACP Releases New Resource: Breaking the Silence: A National Symposium on Law Enforcement Officer Suicide and Mental Health
Posted on June 5, 2014 by iacpblog
According to a study conducted by the Center for Disease Control (CDC), in 2010, more than 38,000 people died by suicide. In 2011, more than 1 million adults reported making a suicide attempt and more than 8 million adults seriously thought about attempting suicide, according to studies conducted by Substance Abuse and Mental Health Services Administration (SAMHSA). Since 1999, the suicide rate nationwide for those 35-64 years-of-age has risen 28.4% (CDC).

Suicide within the ranks of law enforcement is of particular concern to the IACP. Annual estimates put the number of officer suicides at roughly double the number of officers killed in the line-of-duty each year by felonious assault or traffic-related injury. Unfortunately, even with greater awareness of mental health issues within the profession, there are no definitive statistics on law enforcement suicides, due to underreported and/or unknown data.

Due to the impact suicide can have on the law enforcement community, the IACP, along with the Office of Community Oriented Policing Services (COPS), convened a symposium in July of 2013, Breaking the Silence: A National Symposium on Law Enforcement Officer Suicide and Mental Health, with the purpose of creating a national action plan to curb officer suicide and increase awareness of mental wellness issues. The symposium brought together various law enforcement and mental health professionals to discuss innovative and real world strategies aimed to prevent, intervene, and present successful event response protocols for suicides within agencies.

The goals of the symposium were to:

Promote awareness for mental health issues and to shift towards a culture of receptiveness towards those struggling with such problems
Assess current resources and training mechanisms related to mental health issues
Create a national strategy with the intent of teaching agencies how to alleviate the risk of suicide
Promote officer mental wellness as a primary component of officer safety
The symposium also addressed four specific themes relating to law enforcement suicide:

Culture change – The intention of changing the negative culture regarding mental health issues. It is important for law enforcement officers to perform to the best of their abilities, and in order to do so, agencies must be supportive of officer’s struggling with mental health issues.
Early Warning and Prevention Protocols – Institutionalize resources in order to identify at-risk officers, such as using mental screenings to test for stressors and indicators of mental health issues.
Training – Provide more training for recognition of mental health issues for the individual officer and his/her peers.
Event Response Protocols – How does an agency deal with funeral arrangements for an officer who committed suicide and establish post-suicide protocols for both family members and fellow officers?
Symposium findings were formally released on June 5, 2014 jointly by the IACP, the COPS office, and the National Action Alliance for Suicide Prevention. A PDF copy of the Symposium Report can be accessed at http://www.iacp.org/Preventing-law-Enforcement-officer-suicide.

It is the IACP’s position that no injury to or death of a law enforcement professional is acceptable, and the IACP Center for Officer Safety and Wellness strives to improve awareness on all aspects of officer safety. To learn more and to share best practices pertaining to officer safety and wellness please visit http://www.iacp.org/CenterforOfficerSafetyandWellness or contact the Center staff at officersafety@theiacp.org.

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“…doing more things differently based on evidence and science.”

From the NIJ Journal.  Police chiefs, public health directors and researchers are establishing innovative public health/public safety collaborations to fight crime.

Healthy Communities May Make Safe Communities: Public Health Approaches to Violence Prevention
by Sarah Schweig

Most people may not think of jogging and biking as crime reduction strategies, but in neighborhoods in East Palo Alto, Calif., with the highest levels of shootings, law enforcement officers and residents are coming together and engaging in these types of outdoor activities to combat crime.

The East Palo Alto Police Department’s Fitness Improvement Training (FIT) Zones are part of an innovative initiative aimed at testing whether improvements in community health can help increase community safety in the city’s most dangerous neighborhoods. The FIT Zones implement health-related programs in public spaces that have been underused by residents and overtaken by gang members. The idea is that as residents increase outdoor physical activities like power walking, yoga and Zumba dancing, they will increase their presence in public spaces, improve their health, and regain control and ownership of their neighborhoods.

According to Ronald Davis, director of the U.S. Department of Justice’s Office of Community Oriented Policing Services (COPS) and former police chief of the East Palo Alto Police Department, “The greatest deterrent to crime and violence is not a community saturated with cops — it is a neighborhood alive with residents. The concept is that a healthy community would be, in fact, a safe community.”

“Whoever controls a neighborhood’s public spaces controls the quality of life in that neighborhood,” he added. “That control must rest with the residents.”
The FIT Zones are just one of a handful of new approaches that use public health strategies to solve community problems. These approaches tend to treat crime and violence like contagious diseases and look for innovative ways to prevent these “diseases” from spreading. Many involve partnerships between public health and public safety agencies and show promise in reducing and preventing crime and violence.
What Is the Public Health Approach?
The public health approach to solving problems consists of four basic elements:
Define and monitor the problem: The first step in preventing violence is to understand the “who,” “what,” “when,” “where” and “how” associated with it. This involves analyzing data from police reports, medical examiner files, vital records, hospital charts, registries, population-based surveys and other sources.

Identify risk and protective factors: Understanding what factors protect people or put them at risk for experiencing or perpetrating violence is also important. Risk and protective factors help identify where prevention efforts should be focused.
Develop and test prevention strategies: Research data and findings from needs assessments, community surveys, stakeholder interviews and focus groups are useful for designing prevention programs. Once programs are implemented, they are evaluated rigorously to determine their effectiveness.

Ensure widespread adoption: Once prevention programs have been proven effective, they must be implemented and adopted more broadly. Dissemination techniques to promote widespread adoption include training, networking, technical assistance and evaluation.

Public Health Approaches to Violence Prevention
A 1979 Surgeon General’s report made one of the first explicit links between public health and law enforcement: It identified violent behavior as a significant risk to health. Four years later, the Centers for Disease Control and Prevention (CDC) established the Violence Epidemiology Branch, which later became the Division of Violence Prevention.

Since then, law enforcement and public health agencies have increasingly recognized a shared interest in poverty, violence and other societal problems. Both fields respond to existing problems while also taking a preventive approach, stopping problems before they start. Public health and public safety agencies have started to adopt similar strategies and tools — many of which emphasize data analysis, collaboration, community engagement and problem solving — to combat problems facing communities. See “NIJ’s Investment in Public Safety and Public Health Partnerships”

Violence prevention lends itself to a public health approach for a number of reasons. Violence shares many of the “special characteristics of epidemics,” according to Gary Slutkin, an epidemiologist and the founder of the Chicago Project for Violence Prevention’s Cure Violence (formerly Chicago CeaseFire) program. For example, violence is said to be “infectious,” but rather than being transmitted by a vector, such as bacteria, it is transmitted through behavior, such as modeling (for example, a parent modeling behavior for a child) or social pressure. In addition, crime mapping uses many of the techniques originally developed to study disease patterns, and when researchers map incidents of violence, they often find that geographic clusters of crime closely match geographic clusters of disease.

Today, one of the most visible programs to take a stated epidemiological approach to violence is the Cure Violence model. This model enlists members of the community, including former gang members, to serve as “violence interrupters,” who hold community demonstrations and counsel those affected by gun violence in an effort to halt the cycle of violence and retaliation after a shooting occurs.

Other models, like the Cardiff Model for Violence Prevention and the Homicide Review Model, emphasize sharing data to identify opportunities for prevention efforts.

Sharing Data and Creating Solutions
Tight budgets make it necessary to maximize existing resources and share information across sectors. By analyzing data in new ways, overstressed police departments can target interventions more precisely.

For example, when Jonathan Shepherd, an emergency department physician, raised concerns that most assault-related injuries coming in for emergency services in Cardiff, Wales, were not reflected in crime data, the Cardiff Model for Violence Prevention was born. The Cardiff Model is a multiagency partnership that combines anonymous data from hospitals with law enforcement data to guide violence prevention. Reception staff in emergency departments are trained to ask basic questions about the nature and location of the violence, the date and time of the incident, and the weapon type. This information is stripped of identifiers, entered into a database and shared with a crime analyst, who then combines the information with police data to generate maps and summaries of violent incidents.

Sharing data can lead to strategic operational adjustments: In Cardiff, police can patrol routes and use closed-circuit television systems in the most problematic areas. Buses can make more frequent late-night stops to avoid overcrowding at certain locations. Local authorities can require a construction site near an alcohol outlet to secure pallets of building supplies that are being used as weapons. According to researchers, after implementing these relatively modest interventions, Cardiff saw a significant (32 percent) relative reduction in assault-related injuries recorded by police over the study period of more than four years when compared with 14 similar cities.[6] A recent cost-benefit analysis completed by the CDC and Shepherd further found that the Cardiff Model resulted in significant cost savings — substantially exceeding the costs of implementing the program — for the health services and criminal justice systems.

Bringing Two Fields Together
Police chiefs, public health directors and social science researchers are just beginning to truly understand the potential of public health-public safety partnerships. To further understand and encourage such collaborations, the COPS Office, The California Endowment and the Center for Court Innovation brought together police chiefs, public health experts, researchers and grant-makers from around the U.S. for two roundtable discussions. Roundtable participants agreed that, as budgets are tightening across sectors, the traditional ways of fighting crime are changing.

The first roundtable identified opportunities for collaborations between law enforcement and public health officials. Afterward, The California Endowment invited participants to apply for mini-grants of $10,000 for crime and violence prevention projects involving collaborations between the two fields; ultimately, nine programs were awarded funding.
The second roundtable was held to share some of the results of the nine mini-grant projects. Some projects partnered with researchers to document early results; others focused on creating new tools that precincts and health departments can use to analyze data across sectors. Below is a brief look at two of the projects.

Milwaukee, Wisconsin
According to Mallory O’Brien, a researcher and epidemiologist, the first step in public health and public safety collaborations is to get public health officials and law enforcement to agree that violence is preventable.

O’Brien is the founding director of the Milwaukee Homicide Review Commission, a collaboration of criminal justice professionals and community service providers that regularly exchanges information about the city’s homicides and other violent crimes to identify methods of prevention from both public health and criminal justice perspectives.[7] With funding from The California Endowment, the Wisconsin Office of Justice Assistance, and the University of Wisconsin–Madison School of Medicine and Public Health, the commission created a first-of-its-kind data hub where researchers and law enforcement can look holistically at individuals and neighborhoods that have frequent contact with the criminal justice system. The hub currently houses arrest, pretrial and health department data from the city of Milwaukee. Its design allows for regular feeds of updated data as well as new data sets, such as workforce development and department of corrections data.

“Once we have the data, we want to be able to share it with the community and with jurisdictions to help identify opportunities for interventions and then assess if they’re working,” O’Brien said.

Because one challenge to data sharing is ensuring individual privacy, all of the data are stripped of identifiers and made anonymous, as in the Cardiff Model’s approach. Each data provider sits on a governance committee that determines what kinds of data can be shared across sectors.

The Milwaukee Homicide Review Commission recently received a grant from the COPS Office to provide technical assistance to cities interested in implementing this collaborative approach, such as Chicago, New Orleans and Indianapolis.

East Palo Alto, California
In planning East Palo Alto’s FIT Zones, Davis brought in researcher Sarah Lawrence from the very beginning.

“One of the good things about this project is having a researcher at the table from the beginning, playing a role in shaping it and also an evaluative role in finding outcomes,” said Lawrence, director of policy analysis at the University of California (UC), Berkeley, Law School’s Warren Institute on Law and Social Policy.

“The FIT Zone project would not have been successful without having a research partner at the table during each stage of the project,” Davis said. “UC Berkeley’s involvement in the FIT Zones helped make the project successful and its results credible.”

East Palo Alto’s approach is both grounded in and continually shaped by research. In 2010, the city’s violent crime rate was nearly 80 percent higher than that of the state of California overall, and there was a large disparity between the number of shooting incidents and actual calls to police.

“If you live in a community where you’ve been hearing gunshots every day, at some point you just stop calling because from your perspective, nothing really happens, and it just becomes, unfortunately, part of life,” Davis said.

The East Palo Alto Police Department used a gunshot detection system to gain a more comprehensive understanding of the volume and nature of shootings, including the number of rounds fired, and the precise time and location of the incidents.[8] Using these data, the department worked with an epidemiologist from the local county public health agency to identify the areas with the most shootings. Ultimately, they chose two sites to pilot the project; 26 percent of the city’s population lives in these two sites.
Before the FIT Zones started, Lawrence conducted a telephone survey of residents to establish a baseline. The survey asked residents about their levels of fear, their confidence in the police in their neighborhood, their use of public space and their general thoughts about health. Additional rounds of surveys are being conducted to assess whether those perceptions and opinions have changed since implementation of the FIT Zones.

Nine months into a one-year study, the two FIT Zones are yielding promising results. Since activities began, shootings in the two FIT Zones are down 60 percent and 43 percent, compared with a decrease of 30 percent in other areas in the city.

Next Steps: Validating Results
Although some police departments and public health agencies have already partnered with researchers to show early results and successes when using public health strategies to solve community problems, others may need assistance to hone their approaches and document outcomes.
“Many of the community-based organizations we work with really don’t have the capacity to know whether their strategies are successful,” O’Brien said.
As Barbara Raymond of The California Endowment explained, research is key for these approaches to “make the leap into the mainstream and demonstrate that what makes us healthier also makes us safer.” Researchers can not only document the promising results of new approaches — they can also act as intermediaries, helping to bridge the worlds of public health and law enforcement so that all stakeholders can understand what is working, what is not and why.
However, validating innovation can be complex. Budget savings, for example, can be a huge selling point for state and federal policymakers, but proving that expenditures were spared because of prevention efforts can be hard. It can also be difficult to share innovative concepts across sectors. Even when public health and law enforcement agencies share the same goal, differing values and vocabularies can undermine partnerships.

“The challenge of policing in the new economy,” said Davis, “is not to do more of the same with less; it is doing more things differently based on evidence and science.”
Public health and public safety collaborations have shown promise in reducing crime and violence. More research about these strategies is a necessary next step. That way, effective prevention strategies — instead of violence — can spread.
NIJ Journal No. 273, posted March 2014
NCJ 244150
About the Author
Sarah Schweig is a senior writer at the Center for Court Innovation.

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Problem-Oriented Medicine in the Bronx

Here is an example of the medical field using, without knowing it, Herman Goldstein’s principles of Problem-Oriented Policing.  Medicine and Policing analogize closely.  Cops and Docs (and Nurses) are in similar businesses, both with powerful traditions that govern strategy.  They operate with powerful symbols: white coats/colorful scrubs, blue uniforms, stethoscopes and badges.  In my imagination I see an innovation conference keynoted by Dr. Atul Gawande and including line nurses, cops and docs in workshops looking for innovations inside the time-toughened shells of conventional practices.

What innovations are hiding inside conventional practices in your organization?


One Hospital Tells Bronx’s Sick: You Call Us, We’ll Call You

Tuesday, June 03, 2014
By Amanda Aronczyk, WNYC News

Stephen Esan is trying to decide if he should go to the emergency department. He’s 40 years old and suffers from congestive heart failure and end-stage renal disease. He has to go to dialysis three times a week until he can get a new kidney.

Today he’s in pain. The phone rings. It’s Maureen Patten, his “accountable care manager” from Montefiore Medical Center’s care management group.

Esan and Patten have never met. He lives in the Bronx; her office is up in Yonkers. Yet she, more than anyone else, is the person who coordinates his care, who knows his medical record, his medications and his hospital stays. They talk once or twice a month by phone.

Today, she asks him probing questions. Did he tell the dialysis nurse he wasn’t feeling well? Why doesn’t he show up to appointments with his doctor? Patten is part nurse, part advocate, part nagging mom. Every time Esan deals with the healthcare system, she knows, because it goes into his electronic medical record.

Patten’s work is part of the Affordable Care Act’s best guess for curbing ballooning healthcare costs. The particular program that Stephen Esan is part of is a “Pioneer ACO (Accountable Care Organization),” which attempts to improve how care is delivered to some of the most complex Medicare recipients. Montefiore’s is the most successful so far in terms of savings. The Pioneer ACO includes 26,000 patients, and is a sliver of the 265,000 patients, many of whom live in the Bronx, who are managed by almost 800 people — nurses, pharmacists, social workers, therapists and care managers — at a phone bank in Yonkers. They help patients with transportation, rent, food stamps. Basically, anything that affects their health.

The goal is to improve healthcare quality and lower costs. If Montefiore can keep people from getting sicker and from showing up in the emergency room, the hospital system will share the savings with Medicare.

“Patient sees a doctor, three specialists, who’s coordinating and talking to each other to make sure that everyone is on the same page?” asked Dr. Henry Chung, who is the chief medical officer for Montefiore’s ACO. This is particularly important with Medicare patients who are “fee for service,” he said — those whose care is paid for every time they show up in a medical office. Patients like Esan are found through data mining, which identifies Medicare patients with complex problems which are expensive to treat.

ACO’s prompt patients to fill prescriptions. To answer the door when a home healthcare practitioner visits. They help them figure out what federal and local aid programs they might qualify for and talk to them about modifying their behavior so that they stay healthy.

Esan couldn’t afford food when the program found him. He was $8,000 behind on rent after years of earning $60,000 a year. He kept going to the emergency room. But Patten worked with him to get on the transplant list; she and others at Montefiore helped him get food stamps and find a program that would assist with his rent, so he didn’t get evicted. He’s not well — but he’s doing better.

And Patten keeps calling.

“To this day, Stephen Esan has no idea what we look like… I can be right across the street from him and he would never have known,” said his social worker Norma Cruz, “But he knows that there’s someone out there helping him.”

But there are critics of the new ACO’s.

For Dominica Potenza and her husband Dr. Robert Potenza, their small private practice provides care that cannot be replaced by over-the-phone management.

“They don’t understand the dynamics of the family, of what’s going on at home,” explains Dominica Potenza. “We see it here. We see when the patient’s family members actually come in with them to an office visit. We know who’s present in the patient’s life.”

Their practice in the Throgs Neck neighborhood of the Bronx is staffed by just three people — the Potenzas and their receptionist. The only way they’re able to stay afloat now that Medicare is reducing reimbursements, is because Dominica doesn’t draw a salary. They have considered joining a hospital network, but fear they couldn’t provide the quality care they offer now.

“We love what we do and we want to continue to love what we do. So if we do it the way we want to do it, we know we’re doing it the right way,” she said.

Back at Stephen Esan’s parents’ place, Esan is feeling somewhat better. He doesn’t need to go to the emergency department. For now.

Additional reporting by Schuyler Swenson


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Sleep deprivation adds to the physical, emotional and spiritual havoc that police work wreaks on its practitioners.  This problem is part of the complex of issues that we as a service must begin to address systematically.  This blog has offered numerous entries about these issues. Here’s another, a report below from PBS radio station WNYC in NYC.

We have to help personnel learn how to look out for themselves and their brothers and sisters in these areas.  As Dr. Kevin Gilmartin might say, we need to have our comrade’s backs on emotional survival as well as street survival.

For managers or anyone who wants to learn more, check out a piece from the Journal of the American Medical Association (JAMA): December 21, 2011, Vol 306, No. 23,
Sleep Disorders, Health, and Safety in Police Officers.  Or just google “police and sleep deprivation.”

From WNYC News

Night Shift Making You Sick? Red Light Could Help
Tuesday, May 27, 2014
By Paige Cowett : Associate Producer, News/The Brian Lehrer Show

Fifteen percent of the American workforce are shift workers, and there are at least 600,000 of them in the New York City metropolitan area alone. They show up to work in the late afternoon or very early morning, and, not surprisingly, many of them are not getting enough sleep. But sleep deprivation and the off-hours are more than just a nuisance — shift work can be a major health threat.

Sleep deprivation, especially for shift workers, can increase your risk for obesity, hypertension, heart disease, cardiovascular disease, diabetes, even cancer. The World Health Organization has added shift work to the list of probable carcinogens. And in a 24-hour economy where the number of shift work jobs are on the rise, researchers are trying to understand why this work can be so harmful and what might help.

Dr. David Blask, a biologist at the Tulane University School of Medicine, is trying to figure out why shift workers have a higher risk of developing cancer. His lab has shown that the problem may have to do with light at night and the hormone we produce in darkness: melatonin. Blask says, “Melatonin actually has direct anti-cancer effects, in other words, it can directly inhibit the growth of breast cancer cells.” He says, “We will lose that cancer protection by being exposed to light at night and this is particularly troublesome we think for people who work night shifts.” But shift workers have to work at night and they need light to do their jobs.

Which is why Mariana Figueiro, associate professor at the Lighting Research Center at the Rensselaer Polytechnic Institute, is looking at whether different colors of lights can be a solution. Her research shows that while blue light keeps you alert, it also suppresses melatonin. But red light keeps you alert without suppressing melatonin. “We think that the red light has the potential to be the best of both worlds. It will not suppress melatonin, and it will give you that alerting effect that you can get say, with a cup of coffee, “ she says.

Figueiro imagines that shift workers could use red light goggles, red light boxes, or red lights around their computer monitors to “dose yourself at certain times of night. So I think break rooms would be an ideal place. You could have light boxes, they have blue light boxes for treating seasonal depression, you could have red light boxes.”

Red light does not solve all of the health issues related to sleep deprivation and shift work. But by allowing shift workers to stay alert without suppressing melatonin, red light could keep workers awake and still let them produce that hormone we know has direct anti-cancer effects.



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Leadership Matters: Transformational Leadership Can Enhance Emotional Health for Police Officers

Here is a new study that suggests a strong relationship between effective leadership and the long-term health and wellness of police personnel.

“An empirical investigation of high-risk occupations: Leader influence on employee stress and burnout among police,”  Lisa M. Russell, School of Business, Indiana University Southeast, New Albany, Indiana.


Purpose – The purpose of this study is to analyze the relationship between stress and burnout in high-risk occupations and how leadership moderates this relationship. Thus, the primary research question addressed within this study is: What is the relationship between stress and burnout in high-risk occupations as governed by transformational leadership behavior?

Design/methodology/approach – An analysis of primary data obtained by survey from 379 police officers from nine southern and southwestern agencies was conducted. Hierarchical regression analysis, multiple moderated hierarchical regression analysis, bivariate correlation analyses and other statistical methods are used.

Findings – Results indicate police stress exacerbates perceived burnout. Transformational leadership influences this relationship such that high levels of perceived transformational leadership attenuates the negative relationship between stress and burnout, but less so under highly stressful conditions. Findings have strong implications for leaders in high-risk occupations where bureaucracy, departmental policy, and life and death decision-making intersect.

Research limitations/implications – This study can be used as a basis for further inquiry into the effects of transformational leadership on individuals’ perceptions of performance, behavioral and psychological criterion variables in high-risk occupations.

Practical implications – The assessment of relationships among stress and burnout in high-risk occupational settings potentially allows managers to better understand how to structure supervisor-subordinate relationships in order to minimize the effects of stress on perceived burnout and provides a more realistic view of how individuals in high-risk occupations are influenced by leader behaviors under stressful conditions.

Originality/value – This study is thought to be the only one to evaluate the moderated relationships among stress, transformational leadership and burnout in high-risk occupations characterized by increasingly stressful circumstances. More specifically, the notion that individuals in high-risk occupations perceive burnout differently than those in less-risky occupations is not prevalent in the literature.

Journal: Management Research Review
Volume: 37
Number: 4
Year: 2014
pp: 367-384
Copyright © Emerald Group Publishing Limited
ISSN: 2040-8269


High-risk occupations present unique challenges because they are more dangerous and expose workers to different types of stress than less risky occupations. Organizations operating in dangerous or risky environments have higher costs (i.e. employee training and replacement, healthcare, and worker’s compensation insurance) than those operating in less risky environments (Deschamps et al., 2003). Because law enforcement is among the most stressful high-risk occupations (Dantzer, 1987) and officers suffer higher rates of illness, burnout, absenteeism, and premature retirement than other workers (Hart et al., 1996; Violanti and Aron, 1993) and face higher risk of increased rates heart disease and stomach disorder and higher rates of alcohol and drug abuse, divorce, and suicide (Lord et al., 1991; Rogers, 1976), it is important to study the relationships between stress and burnout among police.

There is considerable evidence documenting the effects of stress on individual well-being (Asterita, 1985; Bakker and Heuven, 2006; Jamal and Baba, 2000) and organizational performance (Bartone, 2006; Tang and Hammontree, 1992). While there is substantial research in the police and criminal justice literature examining how stress affects outcomes in high-risk occupations, there is a dearth of research centering on how leader behavior influences these relationships. The purpose of this study is to analyze the relationship between stress and burnout in high-risk occupations and how leadership moderates this relationship. Thus, the primary research question addressed within this study is:

RQ1. What is the relationship between stress and burnout in high-risk occupations as governed by transformational leadership behavior?

Theoretical framework and hypotheses

Stress and burnout

For the purpose of this study, stress is defined as a relationship between a person and the environment appraised as taxing or exceeding one’s resources and endangering his or her well being (Lazarus and Folkman, 1984). Factors contributing to stress in police work include tough physical demands and life threatening situations (Moon and Jonson, 2012). Moreover, economic, social, and technical changes are transforming societal expectations creating new work demands of police officers (Deschamps et al., 2003). Accordingly, police are an appropriate high-risk occupation to evaluate within the context of this study.

While organizational (i.e. administrative, departmental, etc.) and operational (i.e. tasks, events, etc.) factors contribute to police stress, organizational factors are repeatedly identified as the strongest police stressors (Shane, 2010; Violanti and Aron, 1995). Organizational stressors include interdepartmental practices (e.g. authoritarian structure; lack of participation in decision making which directly influence accomplishment of daily tasks; punishment-centered managerial philosophy; unfair discipline; and lack of administrative support), while operational stressors include job specific tasks (e.g. shift work, danger, apathetic public perceptions, boredom, and contending with suffering and death). Police face stressful events with the potential to encounter harm and organizational factors such as what they perceive as unfair workplace treatment like forced overtime, completing paperwork off the clock, and a general lack of support (Anshel, 2000; Anshel et al., 1997; Deschamps et al., 2003; He et al., 2002; Violanti and Aron, 1995). These factors result in higher levels of various outcomes among police than for workers in other professions including more stress-related complaints (Hart et al., 1996; Lobel and Dunkel-Schetter, 1990; Violanti and Aron, 1993); more illness, absenteeism, burnout, and premature retirement (Band and Manuele, 1987; Brown and Campbell, 1990, 1994; Burke, 1993); and increased rates of heart disease, stomach disorder, alcohol and drug abuse, divorce, and suicide (Lord et al., 1991; Rogers, 1976).

There is evidence showing the effects of stress on both individual well being of police and organizational performance (Asterita, 1985; Bakker and Heuven, 2006; Bartone, 2006; Jamal and Baba, 2000; Tang and Hammontree, 1992). More recently, researchers found that stressful shift work significantly increased sleep complaints and decreased use of primary health care among Swiss police (Gerber et al., 2010). The level of stress among police officers is not simply an inherent component of police work but results from a combination of situational factors including perceived levels of burnout.

Burnout is defined as a particular type of response among human service providers such as doctors, nurses, counselors, and police to occupational stress emanating from emotionally charged and demanding interactions with recipients (Bakker and Heuven, 2006; Maslach, 1982; Maslach and Schaufeli, 1993). Burnout, an extreme state of exhausted resources due to chronic exposure to occupational stress, represents a distinctive response to interactions between the provider and recipient of a service (Cordes and Dougherty, 1993; Lee and Ashforth, 1996; Maslach, 1982). It is largely accepted that individuals in a wide array of occupations involving a high degree of interpersonal interaction are prone to burnout (Cordes and Dougherty, 1993). Police officers represent one such occupational group.

Studies assessing relationships between stressors, leadership, and burnout among police (Densten, 2005; Thompson et al., 2005) are noteworthy because they evaluate how leadership and supervisory support influence the stress-burnout relationship. Researchers in one such study (Densten, 2005) evaluate how leaders’ visioning behaviors and follower burnout among 480 Australian law-enforcement senior managers are related. Densten (2005) found inspirational motivation (e.g. how leaders communicate bottom-line goals) reduced emotional exhaustion by clarifying roles followers are expected to play. Inspirational motivation was positively related to personal accomplishment (i.e. self-inefficacy or lack of ability) and negatively influenced depersonalization in this study, appearing to help burned out individuals cope by way of improving perceptions of personal accomplishment while simultaneously diminishing the need to emotionally distance themselves from recipients. Thus, the two facets of inspirational motivation exhibited by leaders in this police organization appeared to perform disparate roles in the decrease of burnout among followers. Indirect relationships between inspirational motivation and burnout were also evident in Densten’s study and he suggests inspirational motivation does not directly influence somatic feelings associated with emotional exhaustion; does not directly influence desires of providers to emotionally distance themselves from recipients; and does not directly affect success expectations or perceptions of learned helplessness of followers. Thus, effectiveness of inspirational leaders appears to be achieved through the pivotal role emotional exhaustion plays in burnout in this study.

Thompson et al. (2005) evaluated associations between leader support and burnout on crossover to the family environment and found supervisor support, but not coworker support, reduces role stressors among policewomen. Specifically, supervisor support reduces work stressors such as role overload and role ambiguity, which then influences emotional exhaustion. Emotional exhaustion differentially affects perceptions of both family cohesiveness and family conflict, such that policewomen who experience lower levels of emotional exhaustion report increased perceptions of both family cohesion and conflict. Thus, supervisor support indirectly affects the family environment through its impact on role stressors and emotional exhaustion.

Direct relationships between antecedents and burnout provide additional support for the contention that stressors influence burnout. Martinnussen et al. (2007) found that while the overall level of burnout was low among police officers compared to other occupational groups (i.e. health care workers) tested in Norway, job demands, especially work-family pressures, were important predictors for all dimensions of burnout among police officers. Lambert et al. (2010) found that social support could have positive effects on burnout. Specifically, these researchers found that although not all types of social support attenuated burnout, each dimension of burnout was affected by at least one type of social support (i.e. management, co-worker, supervisor, family-and-friends) among correctional staff in their study pointing to the important role social support (particularly supervisory and managerial) can play in reducing burnout among correctional staff.

While the Thompson et al. (2005) study provides evidence supporting the contention that leader behavior through supervisor support influences the relationship between work stressors and burnout, caution must be exercised when generalizing findings because this study evaluates only policewomen. Densten (2005) also provides evidence for the influence of leader behavior on the stress-burnout relationship among the 92 percent of male police respondents, but both studies (Densten, 2005; Thompson et al., 2005) evaluate different variables to address different research questions. In addition, these studies appear to use samples from outside the USA, limiting the ability to generalize findings. The country of origin of the Thompson et al. sample is not disclosed, but the academic affiliation of the authors and the language describing demographic characteristics of the sample hint an Australian sample was used.

Based on documented relationships between stressors and outcomes in the stress, police and correctional literature (Densten, 2005; Lambert et al., 2010; Martinnussen et al., 2007; Thompson et al., 2005) and in accordance with observed associations between work perceptions and burnout among police officers surveyed in this study (Bakker and Heuven, 2006; Maslach, 1982; Maslach and Schaufeli, 1993), increasing stress in police work is expected to increase perceived burnout. Thus:

H1. There is a positive relationship between stress and burnout.

Transformational leadership

Transformational leadership is defined as leader behavior influencing both values and aspirations of followers by activating higher-order needs and arousing followers to transcend self-interest for the benefit of the organization (Bass, 1985; Podsakoff et al., 1996, pp. 259-260; Rowold and Schlotz, 2009; Yukl, 1989). Transformational leaders influence the values and aspirations of followers (Bass, 1985). Moreover, transformational leaders are often credited with arousing followers to transcend self-interests for the sake of the organization. In effect, transformational leader behaviors influence followers’ values, activate followers higher-order needs, and motivate followers to self-less action on behalf of the leader’s organization (Bass, 1985; Podsakoff et al., 1996, pp. 259-260; Yukl, 1989).

Transformational leader behaviors are important to police organizations because of the trust between transformational leaders and their followers. Police officers must trust their partners with their lives. This same level of trust in leadership within police organizations allows police officers to perform their duties without worrying if they will get into trouble. In essence, transformational leaders are trusted to support officers when bureaucracy, departmental policy, and life and death decision-making intersect. Also, transformational leader behaviors can influence how officers react to stressful situations and encounters. Leaders in police organizations who articulate a clear vision and model behavior toward that vision, who provide individualized support for the followers, and who help officers accept group goals influence and change followers’ beliefs, attitudes, and core values and enhance performance beyond what is required by the organization (Podsakoff et al., 1996, 1990).

Evaluating transformational leaders serving at various levels of departments within the context of this study is both practical and beneficial. Indeed, Engel (2001) identified leader behaviors (e.g. traditional, innovative, supportive, and active) of patrol sergeants and lieutenants. Engel (2002) went on to identify specific follower behavior tied to lower level leader behavior. Specifically, he found that officers with active (i.e. get their hands dirty on the job) supervisors engaged in more self-initiated and community policing/problem-solving activities in a typical shift while those with innovative (i.e. transformational-style) supervisors spent more time with administrative tasks. Thus, leaders at higher and lower levels of the organization have the potential to influence officers with their respective leadership behaviors. Loon et al. (2012) argue that transformational leaders drive learning throughout organizations via shared vision and this translates to learning at all levels – including the individual level. This shared vision also translates to supervisors who have a direct impact on organizational members, and the potential outcomes associated with leader behaviors of these lower level supervisors is critically important. Moreover, direction from the top as an exemplar of model behavior is crucial in high-risk organizations because the consequence of failure can be loss of life (Weick et al., 1999, 2005).

Empirical findings support the proposition that transformational leadership behaviors moderate the relationship between police stress and burnout. Supervisor behavior such as leader-member exchange, participative decision-making, and supervisor-follower communication is found to moderate the relationship between perceptions of politics, a stressor, and outcomes such as job satisfaction and perceived strain such as anxiety among organizational members of highly bureaucratic organizations (Harris and Kacmar, 2005). In a study of 480 senior managers from an Australian law-enforcement organization, Densten (2005) investigated whether visioning leader behaviors (i.e. concept-based and image-based inspirational motivation) influenced the burnout process among followers. Results reveal inspirational motivation behaviors reduce feelings of emotional overextension and emotional exhaustion. Bartone (2006) found leaders in high-risk occupations, where individuals are routinely exposed to danger, hazards, and extreme work-related stressors, shape the sense-making process and interpretation of stressful circumstances through sharing positive construction or reconstruction of shared stressful experience.

Based upon theoretical and empirical findings associated with transformational leadership theory, transformational behavioral patterns of supervisors are expected to moderate the relationship between stress and criterion variable outcomes. Accordingly, the following hypotheses are associated with the influence of transformational leadership behavior on burnout in the present study:

H2. The relationship between stress and burnout is moderated by followers’ perception of leader behavior.

H2a. The relationship between police stress and burnout is moderated by followers’ perception of leader behavior such that when transformational leadership is perceived to be high the positive impact between police stress and burnout is lower than when transformational leadership is perceived to be low.



The paper-based survey, used as part of a larger study, consists of 15 sections, each containing multiple sections. Most of the 302 items, including 12 demographic questions in the survey require Likert-style responses. Two of the items are open-ended questions asking respondents to provide their thoughts and opinions about variables. A pilot study was used to assess the validity and reliability of the survey and the instrument was found to be reliable and valid with the pilot study data.

Sample and procedure

Multiple police departments in the southern and southwest US served as the sample for this study. This sample is well suited for study because officers in these departments are responsible for responding to multi-state natural disasters in addition to performing normal police activities (e.g. local, community and state policing, crime response and prevention, etc.). Moreover, the demanding nature of police work (e.g. unpleasant and even dangerous contacts and interactions with civilian and inmate populations), the fact that police face limited resources (particularly financial constraints) and the fact that leadership and stress-related and attitudinal outcomes are salient to this group make them a strong match to the target population.

To begin the data collection efforts, the Chiefs, Sheriffs, and Directors of nine departments were contacted and asked to participate. Researchers were given access to all officers (482) at daily briefings and shift changes where respondents were informed that participation was voluntary. Respondents were also informed that researchers would keep individual responses confidential and were told about the goals of the study and specifics of informed consent. Survey data were collected over a two-week period during shift changes and daily briefings by researchers on premises for all but two departments, where sealed surveys were collected by the watch sergeants and then sent to researchers. χ 2 tests revealed no differences among respondents where data were collected on premises by researchers and those that were collected internally and sent to researchers. A total of 379 respondents (78.6 percent response rate) completed the survey.

The majority of the respondents were non-Hispanic white men, between the ages of 32 and 45. Most officers were married with at least one child living at home and had at least some college experience. Just under half of those responding reported working in urban departments and equally classified their respective agencies as city, county, or state agencies with less than 100 officers. Over 40 percent of the respondents worked for agencies employing between 100 and 500 officers. The majority of respondents ranked themselves as either officers or deputies, having less than 15 years experience in police work, and as working in patrol capacity.


Measures for this paper are from a survey used as part of a larger study. Most of the 302 items in the larger survey required Likert-style responses and the survey instrument was found to be reliable and valid with pilot study data. Permission was obtained from the original authors to use all measures.


A 60-item previously validated measure (Spielberger et al., 1981) was used to assess the stress levels among police officers. The first event listed, assignment of disagreeable duties, was given a rating of 4, a moderate amount of stress, in the first column. Subsequent events such as disagreeable departmental regulations, ineffectiveness of the judicial system, making arrests alone and delivering a death notification are rated proportionately higher or lower in stress in comparison to being assigned disagreeable duties, which is generally considered moderately stressful by individuals in a variety of occupations (Spielberger et al., 1981). Officers indicated the number of times they personally experienced the event in the past six months by selecting the corresponding number in the second column. A stress index for the Police Stress Survey (PSS) was created by averaging the product of perceived stress (1 – no perceived stress to 7 – high amount of perceived stress) by frequency ratings (0 – never to 7 – 7+times), according to PSS instructions. Cronbach’s α for the present study is α=0.950.


The 24-item, previously validated Maslach Burnout Inventory (MBI) measure (permission granted by CPP, 2009) was used to assess burnout. Respondents read statements like “I feel burned out from my work” and rated how often an event occurred on a scale of zero to six (0 – never to 6 – everyday). Many researchers (Cordes and Dougherty, 1993; Densten, 2005; Maslach, 1982; Thompson et al., 2005) find emotional exhaustion fundamental, and the first step, to experiencing burnout; and that emotional exhaustion is consistently related to high levels of work demand. Thus, burnout in this study is comprised primarily of items from the emotional exhaustion dimension of the MBI. Cronbach’s α for the present study is α=0.873.

Transformational leadership

A 28-item, previously validated measure (Podsakoff et al., 1990) was used to assess transformational leadership. Respondents were instructed to rate how accurately statements like “Always gives me positive feedback when I perform well” describe their supervisor (Sergeant, Lieutenant, or higher) on a scale of one to five (1 – strongly disagree to 5 – strongly agree). Because global measures were used for both police stress and burnout, a global measure (rather than individual dimensions) of transformational leadership was also used to maintain consistency. Cronbach’s α for the present study is α=0.960.

Control variables

Based on a review of the extant literature (Kohan and Mazmanian, 2003; Liu et al., 2008; Violanti and Aron, 1993, 1995; Wolfgang, 1995) and to help minimize spurious relationships, controls for gender (male – 1, female – 2), ethnicity (white (non-Hispanic) – 1, African-American – 2; Asian-American – 3, Hispanic – 4, other – 5), age (18-24 years – 1, 25-31 years – 2, 32-38 years – 3, 39-45 years – 4, over 45 years – 5), current rank (officer/deputy – 1, sergeant – 2; lieutenant – 3, captain – 4, chief or higher – 5), and department size in number of sworn officers (500=5) were used. Ethnicity, organizational size, and age were coded in groupings to help respondents feel that their ratings were confidential and would not be easy to identify.

Analytical approach

Hierarchical multiple regression (HMR) analysis was used to test the direct hypothesis and hierarchical multiple moderated regression (HMMR) analysis was used to test the moderated hypothesis. HMR and HMMR are appropriate because it is important to determine any significant increase in predictive power beyond that of the control variables. Of equal importance is distinguishing between the main and interaction effects, given that moderating variables are investigated in this study. Moreover, the order in which the variables are entered into the regression is theoretically important. Tests of moderation were conducted in accordance with Baron and Kenny (1986). To avoid potential autocorrelation between the interaction effect of the independent and moderating variables, independent and moderating variables were centered for the HMMR analyses in this study (Aiken and West, 1991). In all analyses, statistical assumptions were tested and unless otherwise stated, data passed all tests or were successfully transformed.


The bivariate relationships among variables in this study were evaluated by analyzing the Pearson Product-Moment correlation coefficient. Means, standard deviations and intercorrelations are shown in Table I. Correlations between predictor and outcome variables are significant and in the expected direction. Correlations associated with the moderator variable are also as expected, and the highest correlation between the three variables is 0.439, which provides evidence, that although correlated, they are measuring different constructs.

With respect to the control variables, gender is positively correlated with age (p<0.05), indicating that women tend to be older than men in this study. Current rank is positively correlated with age (p<0.01) indicating that ranked officers are generally older than non-ranked officers. Department size is negatively correlated with current rank indicating that larger departments have fewer ranked officers as a percentage of total officers.

Police stress is negatively correlated with department size indicating that members of larger departments perceive lower levels of police stress. Police stress is positively correlated with transformational leadership and burnout indicating that higher levels of perceived stress are associated with higher levels of both transformational leadership and burnout among officers in this study. Transformational leadership is positively correlated with the size of a department indicating that officers in larger departments perceive higher levels of transformational leadership from supervisors. Finally, burnout is negatively associated with transformational leadership indicating that officers who perceive higher levels of transformational leadership report lower perceived burnout.

The effects of police stress on the dependent variable burnout was examined in a separate hierarchically arranged multiple regression analysis. Results are presented in Table II. Gender, age, ethnicity, current rank, and department size were used as control variables in this analysis.

H1 states there is a positive relationship between police stress and burnout. H1 is supported (β=0.442; p<0.01). The change in R 2 indicates police stress explains 11.8 percent of the variance beyond that explained by the control variables. Thus, for every 1 percent increase in perceived stress, respondents reported nearly 12 percent increase in perceived burnout.

H2 states that the relationship between police stress and burnout depends on followers’ perceptions of leaders transformational leader behaviors. H2a states that the transformational leadership influences this relationship such that perceptions of burnout diminish when high levels of transformational leadership are perceived. Results from HMMR analysis for H2 and H2a are also depicted in Table II. H2 is supported. Transformational leadership moderates the relationship between police stress and burnout (β=0.124; p<0.01) Transformational leadership explains an additional 1.4 percent of the variance beyond that of the control variables and the direct relationship between stress and burnout.

The moderated relationship of police stress on burnout by transformational leadership is shown in Figure 1. To the degree that leaders exhibit high levels of transformational leadership, followers perceive lower overall levels of burnout. It is interesting to note that followers perceive increasing levels of burnout as police stress intensifies, but the change occurs at a stronger rate as perceived levels transformational leadership increases.

The ordinal relationship shown in Figure 1 indicates that officers perceiving high levels of transformational leadership experience lower overall levels of burnout, and transformational leader behavior appears most effective in reducing burnout under low stress conditions. Thus, it appears that transformational leadership is less effective in reducing burnout under increasingly stressful circumstances and H2a is not supported.


Empirical and theoretical studies associated with stress (Anshel, 2000; Anshel et al., 1997; Deschamps et al., 2003; He et al., 2002; Lazarus and Folkman, 1984; Moon and Jonson, 2012; Shane, 2010; Violanti and Aron, 1995) and burnout (Bakker and Heuven, 2006; Maslach, 1982; Maslach and Jackson, 1984; Maslach et al., 1996; Maslach and Schaufeli, 1993) suggest that as stress increases, so to does burnout. Findings in this study support these conclusions. Specifically, the linear relationships between police stress and burnout was significant and in the hypothesized direction.

Social exchange theory (SET) (Blau, 1964) provides a conceptual framework for the argument that transformational leadership influences the direct relationship between stress and burnout. SET is centered on the idea that social behavior is based on exchanges between parties where individuals try to maximize pleasurable, and minimize less pleasurable, experiences (Cropanzano and Mitchell, 2005). In terms of transformational leadership among police, officers work to accomplish tasks and organizational goals in exchange for leader recognition (e.g. praise, acknowledgment, encouragement, consideration, and perhaps most importantly respect). Findings in this study support this conclusion, but results are more complex and specific than expected. Specifically, police officers perceive lower overall levels of burnout to the degree that leaders exhibit high levels of transformational leadership, but officers’ perceived burnout intensifies as perceived levels of transformational leadership increases. Thus, transformational leadership appears to be effective at mitigating burnout at lower levels of stress, but less so as stress levels increase for police in this study.

While results for both H1 and H2 are in line with SET, there appears to be a point where the positive benefits from the social exchange among police and their leaders no longer yield positive outcomes. It may be that transformational leader effects only have the desired outcomes up to a certain point for this high-risk occupational group, at which some of the benefit may actually be less effective. Indeed, Yukl (2012, p. 75) contends that moderate (amounts of) leader behavior (in terms of quantity exhibited) is optimal. Yukl’s contention is rarely empirically investigated, however.

Another possible explanation for why perceived burnout diminishes at lower but not higher levels of transformational leader behavior can be found in Hobföll’s conservation of resources (COR) theory (Hobföll, 1989; Hobföll and Shirom, 2000), which suggests that individuals work to accumulate, protect, and retain necessary resources, such as those required in stressful circumstances. Hobföll suggests that workers expend valued resources (i.e. those objects, personal characteristics, conditions, or energies valued by the individual). Hobföll suggests that individuals protect existing resource stores and expend them only when necessary to avoid re-accumulating them. The effectiveness of which transformational leadership reduces burnout appears to diminish as individuals are exposed to increasing levels of stress for which they must tap internal resource stores. Individuals may be less likely to recognize the benefit of transformational leader behavior until stress is reduced, at which time leaders are better able to help subordinates replenish vital resources. Thus, consistent with tenets of COR theory, transformational leadership is beneficial only up to a point. Needless to say, these are post hoc explanations beyond the scope of this data, but that I hope researchers will strive to answer in future empirical studies.


A potential limitation to this study is mono-method bias, a threat to construct validity due to the use of only one method of measurement (Trochim and Donnelly, 2007). Procedural and statistical remedies (e.g. use of previously validated measures, post hoc comparisons to archival demographic data, partial correlation procedure, scale trimming, the use of a panel of experts to determine appropriate exclusions, scale reordering, altering the design of the questionnaire such that the dependent and criterion variables are randomly placed throughout the questionnaire, etc.) were applied to minimize the effects of consistency artifacts (Podsakoff et al., 2003; Podsakoff and Organ, 1986). Moreover, Harmon’s one-factor test and confirmatory factor analysis revealed the presence of multiple factors, with eigenvalues greater than one, accounting for various levels of variance indicating less likelihood of a common factor (Podsakoff et al., 2003). Researchers recommend using structural equation modeling (SEM) to minimize the effects of common method variance (CMV) (Podsakoff et al., 2003). SEM was not the most suitable statistical analysis for assessing relationships in this study because tests of moderation were required.

Researchers recommend temporal separation of data collection between criterion and predictor variables to contend with another issue associated with CMV, in which CMV saturates higher order multidimensional constructs (Johnson et al., 2011). Various constraints (i.e. time, financial, etc.) prohibited temporal separation of data collection for the present study. Hence, while some researchers suggest that CMV presents less of a concern in some studies (Spector, 2006), correlations in the bivariate correlation analysis point to the notion that CMV may be present in this study. Thus, while every effort was used to minimize potential effects, it is impossible to rule out potential bias due to CMV, and results should be considered accordingly.

The sample in this study represents a variety of individuals from various agencies. Only one high-risk occupation, however, was examined in this study. Officers from multiple agencies from the city, county, and state level were surveyed representing a wide cross-section of police agencies. In addition, rural, suburban, and urban departments ranging in size from a few officers to well over 500 officers were included in this study. Nonetheless, external validity is limited and generalizing results from this study should be done with caution. It could be that police officers have differential needs for transformational leadership, so it will be important to investigate these relationships in a variety of high-risk and less-risky occupations to address this limitation.

Another limitation of this study pertains to the type of leaders assessed. Respondents were instructed to rate commanding superiors at the rank of sergeant, lieutenant, or above (or the nearest equivalent) to assess transformational leaders within respective units of command. Differences in department size, however, may affect the rank of leader being assessed with higher-ranking leaders being assessed in smaller departments and lower-ranking supervisors being assessed in larger departments. While differences in leadership styles certainly exist between top leaders and supervisors, top leaders set the tone and organizational culture, and create a climate in which supervisors must effectively work. Indeed, visioning of the top leaders of a department will effectively filter through the ranks to the supervisory ranks and be reflected in lower-level leadership styles. Nonetheless, future studies should investigate differences between upper-level and supervisory leaders.

Theoretical and managerial contributions

There is an abundance of research evaluating the relationship between stress and burnout among police (Bakker and Heuven, 2006; Densten, 2005; Maslach, 1982; Maslach and Schaufeli, 1993; Lambert et al., 2010; Martinnussen et al., 2007; Thompson et al., 2005). Few studies, however, evaluate how leadership influences this relationship; and of those evaluating the leadership-burnout relationship, most evaluate direct relationships (Bartone, 2006; Griffin et al., 2012; Lambert et al., 2012). This study provides a first step in addressing this important gap in the literature. As such, one of the major theoretical contributions of this study is the assessment of the moderating role of leadership on the relationship between stress and burnout.

Results from this study also have implications for managers and leaders. First and foremost, findings are in alignment with research in the area (Bakker and Heuven, 2006; Bartone, 2006; Densten, 2005; Lambert et al., 2010; Martinnussen et al., 2007; Thompson et al., 2005) that confirms that stress is positively associated with perceptions of burnout. Specifically, as police stress increases so to do perceptions of burnout among officers in this study. Moreover, leaders are able to mitigate perceived burnout when stress levels are low, but have less influence at increasing stress levels. Accordingly, the positive impacts of transformational leadership should be understood and encouraged, to the extent that it is effective in diminishing the negative effects of lower levels of stress. Managers and leaders need to be aware that providing transformational leadership is a good thing – under less stressful circumstances. Under highly stressful circumstances, a different leadership style (e.g. authentic leadership, inextremis leadership, participative, or supportive leadership) might be better suited to attenuate perceived burnout. Potentially these results allow managers and leaders to better understand how to structure supervisor-subordinate relationships in order to minimize the effects of stress on perceived burnout at varying levels of stress.

This work potentially provides a more realistic view of how individuals in one high-risk occupation are influenced by leader behaviors under stressful conditions and can potentially inform both researchers and practitioners. From a practical standpoint, the truth is that individuals in high-risk occupations do not always make rational choices when faced with stress despite organizational attempts to train them otherwise. This is particularly true for individuals providing service to, and engaging in, emotionally charged contacts with the public (Bakker and Heuven, 2006; Maslach, 1982; Maslach and Schaufeli, 1993).

Future research

Future research efforts investigating these hypotheses, with other samples from both high-risk and less risky occupations to determine the robustness of results is necessary. Additionally, studies with other consequences such as task performance, organizational behavior, job satisfaction, turnover and organizational commitment would help expand the nomological network related to this association. I encourage future studies that examine these outcomes, as well as research efforts with other, related consequences and longitudinal research designs as these types of investigations would be insightful.

Another area for future research would be to determine if transformational leadership has a curvilinear, as opposed to linear, relationship with various outcomes such as stress, burnout, and citizenship behavior. Specifically, do ever-increasing levels of transformational leadership lead to more and more desirable follower outcomes or is there a point of diminishing returns where followers feel “over valued”? It could be that police officers experience the too much of a good thing (TMGT) effect (Pierce and Aguinis, 2013). Perhaps followers value transformational leadership only up to a certain point after which the leader behaviors are no longer valued. This TMGT effect has been suggested in areas of leadership (Fleishman, 1998; Gebert et al., 2003) and researchers have found that leader-member exchange quality exhibits curvilinear relationships with stress, job tension, and turnover intensions (Harris and Kacmar, 2006; Harris et al., 2005; Hochwarter and Byrne, 2005) and assertiveness is nonlinearly related to leadership effectiveness ratings (Ames and Flynn, 2007). I encourage future studies that examine potential curvilinear associations, as these types of investigations would be insightful. A limitation of this study pertains to the type of leaders assessed. Respondents were instructed to rate commanding superiors at the rank of sergeant, lieutenant, or above (or the nearest equivalent) to assesse transformational leaders within respective units of command. Differences in department size, however, may affect the rank of leader being assessed with higher-ranking leaders being assessed in smaller departments and lower-ranking supervisors being assessed in larger departments. While differences in leadership styles certainly exist between top leaders and supervisors, top leaders set the tone and organizational culture, and create a climate in which supervisors must effectively work. Indeed, visioning of the top leaders of a department will effectively filter through the ranks to the supervisory ranks and be reflected in lower-level leadership styles. Nonetheless, future studies should investigate differences between upper-level and supervisory leaders.

Finally, only one high-risk occupation was investigated in this study – namely police. It is important that researchers work to confirm findings from this study not only among police, but also among workers from other occupations. Moreover, the type of stress may influence results. In addition to the type of stress, it is recommended that researchers study other high-risk occupations along with less risky occupations so that comparisons between levels of risk can be made.


An abundance of leadership research exists, with the large majority showing the positive associations with desired individual and organizational outcomes. Research and managerial recommendations about transformational leadership have implicitly stated that this type of leader behavior is beneficial. This study finds that although transformational leadership attenuates the relationship between stress and burnout, results only hold for lower levels of stress for police in this study. More specifically, results indicate that transformational leader behavior may actually augment burnout at higher stress levels. It may be that there is TMGT when it comes to transformational leader behavior – questions for further study. My hope is that this study will stimulate additional questions and that future investigations will further knowledge about the associations regarding transformational leadership behaviors and burnout in addition to other important variables.


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About the author

Lisa Russell is an Assistant Professor of strategic management and entrepreneurship at Indiana University Southeast. Her interests centre on high-risk occupations facing crisis and how stress influences individual and organizational outcomes. In addition to owing her own businesses, Dr Russell has worked in top management positions in corporate as well as in high-risk occupational settings. Lisa Russell can be contacted at: lismruss@ius.edu

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One Officer’s Moral Guidelines

A question posted recently on the website Quora asked, “What makes an officer more or less likely to issue a speeding ticket?” Former police officer Justin Freeman gave his opinion on the topic, below.

He also implicitly described his moral guidelines for the exercise of discretion.

“My gauge was always reasonableness.

If your license plate tags expired one month ago, I can see you not noticing and would probably cut you a break. If they expired one year ago, not so much.

If I pull you over for plates expired months ago, and you say, “I’ve been trying to get money together so I could renew them,” but there are $300 worth of cigarette butts in the ashtray and the backseat is full of bags from the mall, you’re getting a ticket.

If you don’t have insurance, you’re almost certainly getting a ticket. People who didn’t want to pay for insurance figured if they could get less than three tickets a year, they could get out of paying a premium and just pay their insurance fine, which would actually be less expensive since they were high risk. I never gave them the satisfaction.

I never really ran radar, so I didn’t write many speeding tickets – maybe four or five over three years. Even then, they were all for going at least twenty miles an hour over the limit (or speeding while they were drunk). Every officer has a magic number. One of my colleagues’ was, “Twelve [mph] over you’re fine, thirteen and you’re mine.” Now, some officers’ magic numbers may be one, so don’t bank on any kind of window. I never nailed one down, but probably would have if I ever did traffic enforcement.

If you’re driving drunk, you’re getting so many tickets. I’ve personally written as many as eight to one person after one incident, and a colleague in another agency (with a more permissive pursuit policy) once wrote 36 after a drunk driving pursuit. I have seen so many dead bodies lying on asphalt because of drunk drivers. No mercy.

Ladies, don’t count on sexing the situation up to dodge a ticket. I’ve written lots of citations to women with heaving cleavage who had obviously fussed with their blouse prior to my approach. What favor am I currying by not writing a ticket? There is absolutely nothing in it for me in that scenario. It’s not like just giving a warning is going to prompt her to go ahead and peel her top off. I’m not saying it would never work on anyone, but it didn’t go anywhere with me.

In any situation where a citation issuance was in the cards, I honestly tried to put myself in the shoes of the driver. Where are they coming from? Where are they going? Would I have noticed the same thing on my car? Would I go that fast off-duty? I tried to be very fair with my citations, and I like to think that if I ever gave you one, you could at least admit how I saw it was necessary. Some officers issued them indiscriminately, but I tried to, again, just be reasonable.”

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