Reality: What A Concept!
Ten Concepts from Human Services as Complex Organizations
What determines the nature of service delivery systems in the human services? In Human Services as Complex Organizations (1992), Yeheskel Hasenfeld presents 17 chapters which work towards an answer from the perspectives of power, ethnicity, leadership, ideology etc. Each chapter a introduces a myriad of ideas and concepts. This paper identifies 10 major concepts and relates their significance to my future career in social work. The concepts vary from specific, like "liability of newness" to general, as in the role of patriarchy in social work. For ease of understanding, the ten concepts are identified at the beginning of each section. There is no overall theme, but concepts are linked when transition is natural.
Hasenfeld begins his book by discussing the "Enigma of Human Services Organizations" (p. 3). On one hand human service organizations (HSOs) are supposed to provide for the needs of the clientele. At the same time they are obliged to follow rules which at times are contradictory to helping clients. Furthermore, the staff has as their charge to be supportive, yet much of their own efforts go unsupported by the organization and criticized by the clientele. The latter is particularly cogent to my future as an employee of HSOs.
Hasenfeld characterizes the staff's reactions to these contradictions in very helpful ways. The staff might capitulate, and feel good in that they are doing the best they can considering the circumstances. They might identify with the clients and recognize that the organization presents barriers to fulfilling needs. They might find a niche which would shelter them from the contradictions in their work. Some might withdraw and decide the work is not for them. The last reaction is where the staff feels victimization by the organization itself. The reactions go from happy to miserable, and provides a way of understanding how people cope with the contradictions.
These categories provide a good framework for understanding my reactions to the contradictions within social work. Of the five, I feel more comfortable with the second reaction. It appears to realistically assess the contradictions and frames them in terms of a problem to be solved. Identifying with the client also requires a degree of empathy that is important in individualizing the client. Knowing that there are different reactions to the work is empowering. If my actual reaction differs from my ideal reaction, I will be better able to successfully adjust. This will keep me from burning out and better serve the clients and organization. Furthermore, if I end up in administration I will be better able to identify workers reactions to the job. This would be useful in balancing dynamics and keeping them as positive and productive as possible.
The second concept is Hasenfeld's "moral entrepreneurship." (p. 11) Hasenfeld believes that HSOs influence the public's moral understanding of the client population. The staff-client relationship also adds to the moral perception. This can be beneficial and detrimental.
This is an important concept because it delineates the value-orientation of social work. If an organization and/or staff decides to label a population as part of the problem, it is likely that the label will be adopted by the society as a whole. Understanding the effects of such labeling will be important in measuring the communities determination of HSO effectiveness.
My goal as a social worker is to empower people. (This goal is further addressed in concepts six, nine, and ten). As a moral entrepreneur, my values will inform my concept of empowerment. For example, I believe that people should have freedom of choice until it imposes on somebody else's freedom. This is a value. This value will manifest itself in different ways working with disempowered populations than it would working with privileged college students. Labeling populations is inevitable. This concept will help me be more critical in looking at how that labeling will affect that population.
The third important concept for my social work practice is HSOs experience "cyclical legitimacy crises." (p. 11) Organizations are often created to adress a particular problem and is supported by the community because of shared values. As time passes, the community takes the organization for granted. The organization starts losing its legitimacy. When the community recognizes that the organization has not "solved" the social problem, the organization has reached a crisis point . To survives, the organization redefines its commitment to match the community's understanding of the social problem. If this is done successfully, the community re-legitimatize the organization and the cycle begins again.
This concept is very important in understanding the realities of HSOs. If the staff are unaware the community will begin to take the organization for granted and diminish the legitimacy they might lose faith in the organization and the goals, further eroding the positive effect that HSO has on the community. Knowing that this is a part of the life of an institution will help the staff maintain faith in their work. They know they need to work with the community to redefine the image or the actual goals of the organization to maintain the existence and legitimacy.
As an administrator, it would be very valuable to know where the organization was in the cycle. This would help in program implementation (more innovative and challenging programs during times of high legitimacy, more conservative programs during times of crisis) and staff-community-administration relationships. Staff relationships would play a large part in maintaining an organization during a period of low legitimacy. The staff reactions discussed in the first concept would be useful in determining internal strength in the organization. Familiarity with the concept of cycles would also help an administrator know whether the organization is in a period of low legitimacy or is actually dying. Organizational liabilities are discussed below.
In chapter three, Tucker, Baum and Singh discuss the reasons behind foundings and disbandings of populations of HSOs. One of the most important factors involved is how old or new is an organization. The term "liability of newness" describes the fact that "newer organizations tend to die more quickly than older organizations (Stinchcombe, 1965)." (p. 61) They found that new organizations which linked with established organizations disbanded less frequently that those with few or no links. I had never before thought about organizations coming and going.
As prospective staff this knowledge would help me assess the organization's potential lasting power, and provide a criterion to determine whether or not to work for a new organization. At the same time, the administration would know to actively seek links with existing organizations to prolong the life of the organization. This would help attract employees and enable the organization to develop long range goals for service implementation. Furthermore, as I integrate the previous concept of organizational legitimacy cycles, the new organization would need to link up with more established HSOs at the height of their legitimacy. As the executive of a new organization it would be important to see this. One way of "selling" this partnership to more established organizations is that this marriage would also help older HSOs maintain community support and prolong their legitimacy.
Chapter five provides a wealth of information about the nature of executive leadership. One of the most intriguing concepts is that an "executive's job is characterized by brevity, variety, and fragmentation." (p. 103) The executive spends relatively little time on any one task. The authors point out that this requires "proficient superficiality".
Knowing that the successful executive can be seen as superficial would prepare me to work with executives. I would know to prioritize in terms of an executives time frame (50% of all tasks are given less than 9 minutes). I could also better understand the amount and quality of attention my concerns are given. This would reduce the risk of unfairly judging an executive as uncaring or superficial.
These criteria would be important in selecting an executive to run the organization. An idealistic, unfocused, detailed- oriented person such as myself might not be the best choice for a CEO. However, if I ever do find myself in that position this information will help me do a better job. As staff I would need to err on the side of caution when judging an executive whose demands are different from mine. As an executive I would need to keep the staff's requirements in mind when assessing their performance.
Chapter Six focuses on woman-centered health clinics and introduces the idea that Human Service Organizations can be successful as agents of social change. In the mid-`70s, feminists organizaed health care clinics with the intention of empowering women through providing women-centered sevices. They developed new techniques and methods to help women learn about their own health. Empowering women learn about themselves threatened the traditional system. In the 1980's, feminist health clinics were the subjects of attack from the New Right. Despite this, the health clinics continued to be women-centered and successful service providers.
This was one of the most exciting concepts to me. History has shown us that all attempts to provide services have been value laden and often times part of an obvious or not so obvious social movement. The poorhouses, outdoor relief, and medicare are examples of services which were accompanied by an ideology. Cheryl Hide looks at the health care services provided by those espousing feminist ideology. The organization's ideology was their driving force for creating social change. This encourages me to think about service organizations in terms of their ideologies. Every ideology defines "good" and "bad" differently. Knowing the definitions will enable me to better understand the organization's impact in a community.
The author argues that the health clinics maintained their feminist ideology through time and changes. This inspires me to pursue my philosophy of social change within the context of social work. The thought that I can "change the world" even if it is just one client at a time is awesome. The article also indicates that it is necessary to break out of the establishment to realize these goals. I cannot imagine my vision of the future as being compatible with the policies of most HSOs with which I am familiar.
This chapter provides an excellent model for future endeavors. If the feminist movement could withstand their greatest fear, a mysoginistc patriarchal backlash, then an artistic revolution would certainly stand a chance. Radical and new organizations can survive. An earlier concept argued that an organization' newness could be a liability. The womens' health clinics needed to change in order to survive. Instead of linking with an established (and therefore non-revolutionary) HSO to survive, they relied on a strong sense of community which enabled them to maintain integrity and purpose. This is heartening.
The seventh concept is found in Andrew Abbot's discussion of the three acts of professional practice: diagnosis, inference and treatment. The concept of diagnosis is particularly intriguing. The author contends that the diagnostic process both determines which professional category is best for the client and also removes ambiguities once the category is determined. Once the problem has been diagnosed, ambiguities exist within the limits of what is known and workable to the professional. In Asylums (1961), Irving Goffman proposed a similar concept when he discussed the "process of mortification" clients go through when entering a total institution. The idea is that clients need to fit within workable categories in order for the professional to be effective.
The concept of diagnosis is important for a number of reasons. First, the categories set by the organization will affect how the client is diagnosed. Second, the diagnosis determines the treatment. Finally, how I understand those categories will personally involve me in a treatment which will either be empowering or disempowering. As Naomi Gottlieb discussed in her chapter "Empowerment, Politcal Analyses, and Services for Women", a profeminist diagnosis empowered the women involved. This included the workers and the clients. Because the diagnosis categorized the problem as environmental, not just personal, the treatment involved the environment. At this point the women clients were no longer blamed for their situation. The treatment empowered them to change the environment. These examples help me concieve of empowering my future clients based on the diagnosis.
Knowing the categories used in social work will also encourage critical thinking about how services are determined. If I am uncomfortable with a HSO, then Abbot's concept will help me look at what ambiguities are present in the organization based on the structure of the diagnostic categories. There might be issues which are not addressed in the framework which I feel are very important, such as the issue of empowerment as discussed above. Looking at how the organization structures diagnosis will help me think more critically about my role in the organization and how it can be improved.
Uncertainty and Mental Health Organizations (p. 164) is the eighth concept. The author argues that within the profession there is little agreement about when "disorders" differ from nondisorders. Even less agreement exists when disorders should be categorized as "mental" versus social, moral, physical or behavioral. This is complicated because the "raw materials" (the clients) are not a constant. Clients influence how the diagnosis is made and what the outcome of treatment can be. Furthermore, the clients' families, the communities, and other health professionals all have an interest in the diagnosis, treatment and outcome. Despite these uncertainties, MHOs work to give the appearance of order and certainty. This paradox will be important to remember in my social work career.
The first reason this is so important is because I will most likely spend time working for an agency. I could see myself getting frustrated by the uncertainty described above if I mistook uncertainty for disorganization and lack of purpose. Knowing the indeterminate nature of the work can help me evaluate how well I am doing. Am I reducing ambiguities, or merely covering them up? Am I helping clients understand the realities of an imprecise system, or promoting the fa‡ade of a well-run, purposeful machine? Ironically, the very knowledge that uncertainties exist reduces the number of uncertainties.
Another point is that, as much as I dislike the unknown, it forces me to think and conceptualize issues in a new way. This would be important in a MHO, where similar symptoms might be indicative of drastically different problems. The unknown motivates people to change. While direct practitioners expect clients to embrace change, the practitioners themselves often shun uncertainties that would encourage them to change.This would be the most difficult and rewarding work environment to create. As a manager, knowing that there are uncertainties would be an important tool in fostering a dynamic organization. In the same way that practitioners help clients better their lives by working through unknowns, a manager could encourage the practitioners' growth by helping them through the organizational unknowns.
The ninth concept is empowerment as the cornerstone of social work practice (p. 286). Hasenfeld believes that a major shift in theory and practice is necessary to create such a cornerstone. We need to "place client empowerment at the center of social work practice" (p. 269) Looking at the client as part of an environment shifts the blame from the client to the environment. This encourages empowerment in the client. Hasenfeld defines empowerment as a way that clients obtain resources and then use those resources to attain their goals. Within social work it is important that clients obtain resources. This requires that clients have a voice in the HSO. Social workers can work to get client representation on the decision-making body of a HSO which will start the empowerment process. Hasenfeld realizes that client empowerment will require transcending the traditional roles of the worker and the boundaries of the organization. Empowerment cannot happen without these changes.
The importance of this concept lies in the fact that it empowers me. The best way to learn is to teach. The best followers make the best leaders. The best way to empower clients is to be empowered. This article encourages me to start out my professional career with the thought in mind of empowering clients. It will affect the types of jobs I consider and the technologies I employ. As an administrator having the goal of empowering clients will help determine what groups should be considered when a decision is to be made. The realities of empowerment differ from the theory. Knowing this will motivate me to get up and go to work everyday to move closer to the ideal.
The final concept is extracted from Paula Dressel's chapter on Patriarchy and Social Welfare Work. The chapter states "welfare work is a female-dominated occupation undergirded by patriarchal ideologies." (p. 205) There are more women in lower paying direct practice jobs and more men in higher paying administrative jobs. This disparity has an historical basis rooted in the patriarchal origins of organized social work. The current system maintains the patriarchy by subordinating women economically and psychologically. The latter results from women adjusting to a situation rather than adjusting the situation itself. The system encourages such adjustments thereby maintaining the patriarchy.
The concept of patriarchy in social welfare work can be extended to the training ground for many social workers, the MSW program. While the author does not mention the role of school in oppression, it can be argued that the graduate program at the University of Texas is the last step in an educational system which contributes to the subordinate role that women play in the social work profession.
The school, like the profession itself is overwhelmingly female. As a tool of the patriarchal structure, it is in the school's best interest to graduate students who will perpetuate that structure. This means that the classes offered would discourage critical thinking and encourage a view of "the system" as beyond change. This is in fact the case. The ease by which students make top grades mirrors the trend of agencies to quickly move the clients through the system. Apparently in the first semester top grades do not require critical thinking. There are those who would argue that the first semester is used for an introduction to the profession of social work and that it is more important to focus on ideas related to social work than thinking critically about those ideas. This argument is not valid because critical thinking is a process that can be applied at all levels of comprehension. By not encouraging critical thinking, the graduate school sends the message that it is not necessary to think critically in order to succeed. Uncritical acceptance of the patriarchy will in fact be rewarded. But what a hollow reward! Naomi Gottlieb points out that most social work graduates enter the job force without an understanding of the patriarchy and the role of empowerment. (p. 305)
Dressel points out that in the patriarchal system women succeed by adapting to the oppression. By adapting, women reinforce the patriarchal assumptions and reproduce the subordination. The patriarchy socializes men to ignore their own problems and instead work to change the system. This does not pose a threat to the system because by the time they are powerful enough to change it, most men will have bought into the system. The task then, is to look at my future career in social work as starting today. I must promote change before an oppressive system has sucked out all of my revolutionary fervor. I will look at myself as an empowered client of the school and take my place at the decision making table. Ironically, as I fight against the evils of patriarchy, I engage in the very activities patriarchy proscribed for men; most of my energies, including much of this paper, are focused on changing the system without much attention paid to my own adaptation. Therefore, I end this paper with a final resolution to look more at the personal in answering this paper's original question; What determines the nature of service delivery systems in HSOs?
Hasenfeld, Y. (1992). Human Services as Complex Organizations. Newbury Park, CA: SAGE Publications.
Written By: Jonathan