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I; I? r I, I. '~ l.‘ [I .Im J! ‘1; J,” 3 1293 10432 9044 M LIBRARY Michigan Stan University This is to certify that the thesis entitled ORGANIZATIONAL CLIMATE APPLIED TO THE PROCESS OF EVALUATING ORGANIZATIONAL EFFECTIVENESS: ASSESSMENT OF A CHILDREN'S PARTIAL HOSPITALIZATION PROGRAM IN COMMUNITY MENTAL HEALTH presented by Kenneth Grey has been accepted towards fulfillment of the requirements for Ph. D. degree in Manaqement p 3, fl ‘1 \ \f‘ I Major rofessor Date June 6, 1979 0-7639 OVERDUE FINES ARE 25¢ PER DAY PER ITEM Return to book drop to remove this checkout from your record. @ Copyright by KENNETH GREY 1979 ORGANIZATIONAL CLIMATE APPLIED TO THE PROCESS OF EVALUATING ORGANIZATIONAL EFFECTIVENESS: ASSESSMENT OF A CHILDREN'S PARTIAL HOSPITALIZATION PROGRAM IN COMMUNITY MENTAL HEALTH By Kenneth Grey A DISSERTATION Submitted to Michigan State University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY Department of Management 1979 ABSTRACT ORGANIZATIONAL CLIMATE APPLIED TO THE PROCESS OF EVALUATING ORGANIZATIONAL EFFECTIVENESS: ASSESSMENT OF A CHILDREN'S PARTIAL HOSPITALIZATION PROGRAM IN COMMUNITY MENTAL HEALTH By Kenneth Grey Organizational effectiveness is not a clear and unified concept and the process of its determination is much less clear. This statement has even more force when public sector social service organizations are concerned, where there are fewer generally accepted standards of effectiveness. The purpose of this study is to supplement the rather sparse literature on the evaluation of the effectiveness of children's partial hospitalization programs. This is accomplished by estab- lishing base-line levels of environmental and therapeutic percep- tions of a program, by studying individual's differential perceptions of their work milieu as professionals and as employees, and by study- ing differential perceptions of effectiveness criteria as seen by various groups associated with the program. An open system approach is used. The program studied is a children's partial hospitalization program in the Lansing, Michigan area. It is one of the programs Kenneth Grey administered by the Tri-County Community Mental Health Board. The program employs a multi-disciplinary staff of twelve persons, and serves 30 children ranging in age from 5 to 17. There were 12 respondents from the program staff, 10 from the organization line, 6 from the organization staff, 7 clients, 9 parents of clients, 20 from agencies who refer clients to the program, and 8 from formal consumer advisory committees attached to the Community Mental Health Board. The total number of respondents is 72. Three instruments were used. The Community Oriented Program Environment Scale (COPES) was used to measure respondents' percep- tions of the therapeutic environment; the Work Environment Scale (WES) to measure perceptions of the program staff's work environment; and two Critical Incident questions to develop effectiveness and ineffectiveness criteria. COPES and WES were used in two forms, Form R (real) to measure current perceptions of the therapeutic and work environments, and Form I (ideal) to define some character- istics of what respondents consider to be ideal environments; thus giving an indirect measure of their goals and values with respect to the program. Data were analyzed descriptively and statistically, using univariate and multivariate analysis of variance for COPES and WES, 2 statistic for the Critical Incident results. Overall and the Chi results were analyzed,as well as groupings by organizational posi— tion, and professional training. Independent variables were as follows: Internal (to the program) vs. external, program staff vs. Kenneth Grey line, line vs. organization staff, program staff vs. referral agencies, program staff vs. clients, and program staff vs. parents of clients. Overall results are within the norm groups on which the COPES and WES instruments were standardized. Organizational posi— tion overshadows professional training in all three instruments. Internal vs. external groups show differences in COPES Real results, and in effectiveness and ineffectiveness criteria. Different hier- archial levels show no significant differences in the therapeutic or work environment instruments, but do show differences in ineffec- tiveness criteria. The line and organizational staff groups show no differences in either form of COPES, nor in effectiveness criteria. The program staff and referral agencies show no differences in COPES responses, and some barely significant differences in effectiveness criteria. Program staff and clients show significantly different responses to COPES, both real and ideal forms. Clients did not complete the critical incident questions. Program staff and parents of clients show barely significant differences in COPES responses and in ineffectiveness criteria. To Myrtle and in loving memory of Barbara Gallant and Annie Wool ii ACKNOWLEDGMENTS I would like to acknowledge the enthusiastic cooperation of the Tri-County Community Mental Health Board and its employees during the entire project. In particular, Dr. Myrtle Yoshinaga, the program supervisor, who smoothed the way for data gathering, was herself a respondent, and was constantly available as a sounding board at all stages of the work. Dr. Judith Taylor, Director of Evaluation for the Board and a member of my committee, was indispensable. She accepted the pro- ject initially, arranged for its acceptance by the board, advised as to both statistical and descriptive data analysis, and was finally a respondent herself. The staff of the program extended themselves by completing the instruments twice; once for the pilot study, and again for the study itself. In addition, they arranged for and assisted in data gathering with clients and their parents. Drs. Lawrence H. Foster and Stanley Bryan served as chairman and committee member. Their willingness to accept the project ini- tially, and their prompt and clear critiques, are greatly appreciated and gratefully acknowledged. The children in the Program's Home Base III served as client respondents. I wish to thank them fbr agreeing to participate, and iii for their cooperation during the actual test administration. Similar thanks go to those parents who volunteered to serve as respondents. Finally, I would like to thank my mother and sister for their unfailing support over the years. This work could not have been completed without them. iv LIST OF LIST OF Chapter I. II. III. IV. TABLE OF CONTENTS TABLES FIGURES . REVIEW OF THE LITERATURE Purpose of the Study . . Organizational Effectiveness . Organizational Climate . Program Evaluation and Evaluation Research DESIGN AND METHODOLOGY . Program Description . Design . Instruments . Selection of Respondents Administration of Instruments Hypotheses . . . Analysis of Data . RESULTS . Overall . . . Hypothesis A: Internal vs. External . . Hypothesis B: Low vs. High Hierarchial Levels . Hypothesis C: Line vs. Organization Staff . . Hypothesis D: Program Staff vs. Referral Agencies Hypothesis E: Program Staff vs. Clients . . Hypothesis F: Program Staff vs. Parents of Clients DISCUSSION . General . Effectiveness Criteria : Social Climate Instruments Overall Results Effect of Organizational Structure vs. Training Page vii Chapter Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis 71MDOCD3> Internal vs. External . . . . Low vs. High Levels in the Hierarchy Line vs. Organizational Staff Program Staff vs. Referral Agencies Program Staff vs. Clients . Program Staff vs. Parents . V. SUMMARY AND CONCLUSIONS Summary . ConclUsions REFERENCES vi Page I25 I30 I33 I33 I34 I36 I39 I39 I41 I46 Table I0. II. 12. I3. I4. I5. LIST OF TABLES Synthesized List of Possible Indicators of Organiza- tional Effectiveness . . . . . . . Synthesized List of End States Specified by DD that Define a Healthy System . . . COPES Subscales and Definitions Internal Consistencies and Average Item-Subscale Correlations for Form R Subscales . Form R Subscale Intercorrelations for Members and Staff . . . . . Work Environment Scale Subscale Descriptions . Internal Consistencies and Average ItemrSubscale Correlations for WES Form R Subscales WES Form R Subscale Intercorrelations Classification of Critical Incident Responses: Organi- zational Function . , , . . . . Structural Classification of Critical Incident Responses . . . . Critical Incident Response Classification: Nature of Response . Classification of Respondents by Organizational Structure . . . . . . . . . . Classification of Respondents by Professional Training. Critical Incident Responses: Functional References Critical Incident Responses: Structural References vii Page l3 l8 44 46 48 49 SI 52 54 55 56 64 65 66 67 Table Page 16. Critical Incident Responses: Nature of Response . . 68 l7. Hypothesis A: Results and Analysis of Variance COPES Form R (Real) . . . . . . . . . . . . . . 73 I8. Hypothesis A: Results and Analysis of Variance COPES Form I (Ideal) . 74 19. Hypothesis A: Internal vs. External. Chi2 Tests on Group Differences . . . . . . . . . . . . . 76 20. Summary of Critical Incident Responses. Hypothesis A: Internal vs. External . . . . . . . . 77 2l. Hypothesis B: Results and Analysis of Variance COPES Form R (Real) . . . . . . . . . . . 78 22. Hypothesis B: Results and Analysis of Variance COPES Form I (Ideal) . . . . . . . . . . . . 8l 23. Hypothesis B: Results and Analysis of Variance: WES Form R . . . . . . . . . . . . . . . . 83 24. Hypothesis B: Results and Analysis of Variance WES Form I . . . . . . . . . . . . . . . . 85 25. Hypothesis B: Critical Incident Responses. Chi2 Tests on Group Differences . . . . . . . . . . 87 26. Summary of Critical Incident Responses. Hypothesis B: Program Staff vs. Line . . . . . . . 88 27. Hypothesis C: Results and Analysis of Variance COPES Form R (Real) . . . . . . . . . . . 89 28. Hypothesis C: Results and Analysis of Variance COPES Form I (Ideal) . . . . . . . . . . . . . 91 29. Hypothesis C: Critical Incident Results. Chi2 Tests on Group Differences . . . . . . . . . . . . 93 30. Hypothesis D: Results and Analysis of Variance COPES Form R (Real) . . . . . . . . . . . 95 3l. Hypothesis D: Results and Analysis of Variance COPES Form I (Ideal) . . . . . . . . . . . . . 97 viii Table Page 32. Hypothesis D: Critical Incident Results. Chiz Tests on Group Differences . . . . . . . . . . . . 99 33. Summary of Critical Incident Responses. Hypothesis D: Program Staff vs. Referral Agencies . . . . lOO 34. Hypothesis E: Results and Analysis of Variance COPES Form R (Real) . . . . . . . . . . . lOl 35. Hypothesis E: Results and Analysis of Variance COPES Form I (Ideal) . . . . . . . . . . . . 103 36. Hypothesis F: Results and Analysis of Variance COPES Form R (Real) . . . . . . . .’ . . . l06 37. Hypothesis F: Results and Analysis of Variance COPES Form I (Ideal) . . . . . . . . . . . . 108 38. Hypothesis F: Critical Incident Results. Chi2 Tests on Group Differences . . . . . . . . . . . . llO 39. Summary of Critical Incident Responses. Hypothesis F: Program Staff vs. Parents 111 40. Effect of Organization Structure vs. Professional Training . . . . . . . . . . . . . . . . 122 4l. Effect of Organization Structure vs. Professional Training on Critical Incident Results . . . . . . 123 ix Figure IO. II. 12. I3. l4. I5. 16. LIST OF FIGURES COPES Profiles: Form R vs. Form I, All Respondents Work Environment Scale Profiles: Form R vs. Form I, All Respondents Hypothesis A: Profiles. COPES: Form R (Real) . Hypothesis A Profiles. COPES: Form I (Ideal) Hypothesis B: Profiles. COPES: Form R (Real) . Hypothesis B Profiles. COPES: Form I (Ideal) Hypothesis B: Profiles. Work Environment Scale: Form R (Real) Hypothesis B: Profiles. Work Environment Scale: Form I (Ideal) . Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis C: m 'fll'l'lrfiDCJn Profiles. Profiles. Profiles. Profiles. Profiles. Profiles. Profiles. Profiles. COPES: COPES: COPES: COPES: COPES: COPES: COPES: COPES: Form R (Real) . Form I (Real) . Form R (Real) . Form I (Ideal) Form R (Real) . Form I (Ideal) Form R (Real) . Form I (Ideal) Page 69 70 7] 75 79 82 84 86 90 92 96 98 I02 104 I07 I09 CHAPTER I REVIEW OF THE LITERATURE Organizational effectiveness is not a clear and unified concept, and the process of its determination is much less clear. If this is true generally for organizations, the statement has even more force when public sector social service organizations are considered, where there are fewer generally accepted measures of effectiveness. The social service organization may be viewed as providing a process which involves operations on people. An effectiveness evaluation would thus include definition of the people entering, what happens during the process, and definition of the people leaving. If the evaluation is to be useful in making the organiza- tion more effective, then the process must be addressed in terms that encompass the technology employed and in terms that are related logically to the state of the person before, during and after the operation of the process. This will permit organization change efforts to be designed using the outcome of the evaluation process. This study is concerned with establishing a baseline level of the current state of effectiveness of a children's partial hospitalization program. This will be done by examining the concomitant organizational climate in terms which will permit desired changes to be planned both organizationally (organizational structure, manning levels, etc.) and technically (development of outcome measures, staff training, etc.). Purpose of the Study The purpose of the study is: a. To establish baseline levels of environmental- therapeutic perception in and of the program. b. To study individual's differential perceptions of their work milieu as professionals and as employees. c. To study differential perceptions of effectiveness criteria as seen by various groups associated with the program. d. To apply the Systems Approach to the evaluation of organizational effectiveness. e. To supplement the rather sparse literature on the evaluation of children's partial hospitalization programs. The justification for this study is that a literature review shows that the literature is sparse concerning applications of open- systems theory to organizational effectiveness. The approach has not been used in evaluating children's partial hospitalization programs. Organizational Effectiveness Organizational effectiveness is, in many ways, a rather diffuse concept. Criteria that are regularly used for business organizations include such common accounting/financial measures as sales, profit, return on investment, current ratio, ratio of debt 3 to equity capital, etc. Also regularly used are the year to year changes in some of these indicators. Analysis often involves a comparison of the changes in indicators to the general economy (e.g., cost increase compared to inflation rate). This latter comparison implies that there is really an external basis for com- parison in addition to comparing the organization's own performance for the prior period. This exemplifies that environmental factors have some part in the evaluation of effectiveness. One does not do an evaluation in a vacuum. Such factors as inflation rates, general sales level in the industry, technological innovation, and financial performance of competitors all have some bearing on the evaluation of effective- ness in business organizations. Internally, many organizations may take a narrower view; narrower in the sense of excluding consideration of external factors. Commonly, these measures may include unit costs of production; subdivided into material, direct and indirect labor. In addition, such measures as turnover, absenteeism, inventory levels, safety records, grievance activity and performance versus budget may be used. One sees that any attempt to combine measures meets with two problems. First, what measures should be used; and second, how does one combine unlike indicators into a measure of effective- ness? In public organizations the problem is compounded because there is no analogy to the profit criterion. Yet, in the final analysis, profit in a business organization means survival of the organization. What determines the long-term survival of a public organization? ‘ There is a commonality if one views the survival of both business and public orgnaizations as a societal statement of need for the organization's services. In turn, this indicates a need to turn to the external environment of the public organization for a statement of its value. Now, consider Community Mental Health organizations. Many internal measures are available that are analogous to the internal measures used by business organizations. Such information as client attendance and turnover, cost per client, employee attendance and turnover, ratio of employee-client contract hours to non-contract hours, cost per contact hour, and client waiting period between initial call and initial appointment are all essentially internal measures of effectiveness. These internal measures are currently in existence and are not the subject of this proposal. Organizationally, such a broad view of effectiveness generates many other questions which grow smaller and more specific in focus. A statement of effectiveness must have arisen through information feedback, and then been applied against criteria held by an individual or collection of individuals. Should the organiza- tion strive to evaluate its effectiveness, the individuals, the criteria, and the information must be identified; and this data integrated with the organization's internal functioning. Organizational behavior has been split generally into molar and molecular views. The former encompasses such variables as size, structure and technology; the latter such variables as individual satisfaction, motivation, and leadership. All of the organizational variables (molar and molecular) combine and interact to determine the effectiveness of the organization. The concept of climate can be viewed as a mediator between molar and molecular variables. This leads to an approach which consists of obtaining general ideas of effectiveness from both the internal and external environ- ment, then examining in some detail the perceptions of those within the organization, followed by causal hypotheses of the relationships involved. This, in turn, leads to attempts at organization change, followed by evaluation of effectiveness and climate. The literature on organizational effectiveness has taken three fundamental views, one is that of organizational effectiveness as goal attainment (Barnard, l938). In this approach, one discovers the relevant organizational goals from the significant individuals within the organization and then obtains outcome measures to match. However, it is difficult to ascertain whether the outcome (attain- ment or non-attainment) is the result of inappropriate goal selec- tion or inappropriate efforts on the part of the organization. A second approach is viewing organizational effectiveness as the ability to attract resources (Katz and Kahn, 1966). This approach may be highly relevant for business organizations, but it seems of questionable utility in approaching.some public sector organizations. The public sector organization exists because some authority has deemed its services necessary--and the organization receives what it needs to attract the needed resources. In addition, use of resources is essentially a measure of efficiency--and efficiency (accomplishing a task with minimum resources) does not become a pertinent question until one knows where the organization wants to go. In other words, efficiency may be viewed as a secon- dary measure--albeit an important one. Katz and Kahn's (I966) open systems concept is one that fits the evaluation of social service organizations well. The open systems view sees an organization as part of a larger environ- ment, embodying technical knowledge and resources in order to create some product or service desired by society. In Katz and Kahn's approach, internal and external elements (individuals, groups, organizations) may be defined arbitrarily--but should include all elements having interchanges with that defined as internal. In other words, the unit to be analyzed may be chosen flexibly, but once chosen all outside units that interface must be identified and taken into account. Only in this way can a true systems approach be taken, and changes in one part of a system be related to changes in other parts. One consequence of choosing a systems view is that one accepts that there is no "one best way" of achieving desired results. This follows from the principle of equifinality which states that if a system moves from an initial state to a final state, an infinite number of paths exists. In other words, if one studies an organization and finds it in an undesired initial state, and one can determine the desired final state, there is nothing in systems theory pg; sg that will define the path to be followed. One must turn to other concepts and areas of organizational study. The concept of effectiveness changes depending upon whether one takes an internal or external viewpoint. The internal view- point is concerned principally with efficient use of resources. Return on investment is a typical measure. The external question is whether a significant contribution is made to the larger society by the organization. A typical measure for this question is cost/benefit ratio. This measure, particularly for investment questions, is analogous to return on investment in the private sector. Its advantage is that it can be used in public sector organizations where there is no profit as such. Dubin (I976), points out that efficiency of resource use is not necessarily related to effectiveness. An organization may use resources very efficiently, but toward the wrong ends. This leads to a dilemma: as operating efficiency increases, social utility of the organization's output may decrease. Dubin hypothesizes that a strategic choice must be made between efficiency and satis- faction of societal needs when evaluating effectiveness. Katz and Kahn (l966) take an external view, or an open systems approach to organization effectiveness. They define organization efficiency as the ratio of "energic" output to "energic" input. Physical inputs and outputs as well as "human energy" are considered. Their concept also includes such intangibles as societal goodwill to the organization. They define organizational effectiveness as "the maximization of return to the organization by all means" (Katz and Kahn, 1966, p. 161). Effectiveness is seen as having two components: economic, and non-economic or political. The latter may increase effectiveness without affecting efficiency. Increases of effectiveness by both means are observable as storage of energy, organizational growth, organizational survival, and organizational control of the surrounding environment. These authors also point out that definitions of effectiveness involve some assumptions with regard to frames of reference. One assumption would be to consider the organization itself; another the larger society of which it is a part. J. D. Thompson develops a theoretical approach which provides criteria which an organization may use in practice to choose between an internal and an external approach. Organizations are seen as taking a "satisficing" approach to effectiveness. Results and goals are seen as a dichotomy with some organizations concentrat- ing on one, some on the other. Goals are defined as motivation, i.e., towards what is the organization moving? The principal variables of assessment are seen as: stand- ards of desirability, and understanding ny cause-effect relation- ships. In a closed system approach there are clear cause-effect relationships; in an open system such relationships become much less clear. Thompson theorizes then, that beliefs about cause- effect relationships may be classified as complete or incomplete; and standards of social desirability may be classified as clear or ambiguous. Since these two classifications may be taken to be independent, this means that any specific organizational situation may be classified into one of four categories. Should the belief about cause-effect relationships be com- plete and standards of desirability be clear, then Thompson reasons that a classical maximizing approach would be taken to effective- ness. Should beliefs about cause-effect relationships be incomplete and standards of desirability clear, then Thompson theorizes that instrumental tests of efficiency will be used. One such test might be to measure past performance against goal achievements. The third and fourth situations are those in which standards of desir- ability are ambiguous, and beliefs about cause-effect relationships may be either complete or incomplete. Under these circumstances, Thompson suggests that organizations will turn to social reference groups. These groups exist in the environment, outside of the organization. One would expect environmental social reference groups to be especially interested in the organization's ability to satisfy their needs. The organization, then, may be viewed as though it were constantly being assessed by a variety of external organizations, each inclined to employ a different kind of yard- stick. It would follow that since these external organizations have different needs, they will use different criteria in their IO evaluations and these criteria may be incompatible. This study is concerned with an organization where standards of desirability may be ambiguous. John P. Campbell (1976) pursues the problem of criteria development. Criteria are viewed as guides to decision making. This raises three questions: what decisions are to be made; what is the identity of the decision makers; and under what conditions must the decisions be made? There are three broad areas of decision making for which criterion data could be used: to describe whether some aspect of a system is in an effective or ineffective state; to diagnose or to decide why the system is in the state that it is in; and finally to determine what actions should be taken to change the state of the system. Since organizational decisions rarely use a single criterion, it follows that a single criterion will seldom be appropriate for evaluating organizational effective- ness. This apparently has become reasonably well accepted, but the emphasis is mostly on the decision of whethera system is in an effective or ineffective state, with the other two decisions left to speculation and follow up. Campbell develops the point that organization effectiveness has no operational definition, but constitutes a model or theory of what organizational effectiveness is. The functions of such a model would be to identify the kinds of variables we should be measuring, and to specify how these variables, or components of effectiveness, are interrelated or should be interrelated. One 11 must have a theory (private or public) in order to select variables for effectiveness, or in order to plan organizational changes. Two general models of the effectiveness construct are a goal-centered model, and a natural systems model. The goal-centered view is that there exists a set of influential decision makers whose personal goals are also the organization's goals. This view holds that the goals are few enough to be manageable and well enough defined to be understood. The final assumption is that once the goals are known, it is possible to plan the best management strategies for achieving them. It follows that within the goal- centered orientation, the way to assess organizational effective- ness would be to develop criterion measures to assess how well goals are being achieved. The natural systems model takes the viewpoint that the 'organization's complexity precludes determination of specific goals and that the overall goal of viability without resource depletion is taken. Effectiveness is evaluated by examining whether the organization is internally consistent, whether its resources are distributed judiciously over a wide variety of coping mechanisms, and whether it is using up resources faster than it should (Ghorpade, 1971; Price, 1972). The organization also needs some theory or model that specifies the kinds of coping mechanisms it must have. Likert (1961), and Taylor and Barnes (1972) have each presented a_prigri notions of which systems variable should be assessed. Campbell (1976) 12 has summarized a number of empirical studies which have used different criteria for the evaluation of effectiveness. These are shown in Table l. Proponents of organizational development have used various intervention techniques borrowed from behavioral science. Beckhard (1969) presents a summary of what organizational development practitioners see as a healthy organization. These concepts are shown in Table 2. There are, then, a number of variables. Most of them arise from a particular construct of effectiveness. There is some over- lap and different degrees of specificity. Little attempt has been made to develop core variables. Indeed, it looks impossible to develop core variables unless one adheres to one particular construct. These constructs also vary on a continuum that might be called "closeness to the final payoff." For example, is job satisfaction the continuum on which the real payoffs are made, or is it a means to an end? Is satisfaction important because it's related to some more central variable which is the organization's real concern? Which are means and which are ends is a value judg- ment on someone's part. Should the variable be a means, is it necessary to demon- strate an empirical relationship between that variable and the outcomes of real interest, or can a relationship be assumed? Most 13 TABLE l.--Synthesized List of Possible Indicators of Organizational Effectiveness. 1. Overall Effectiveness: which is a general evaluation that takes in as many single criteria as possible and results in a single judgment about the effectiveness of the organization. It has been measured primarily by two methods: archival performance records, either singly or in some combined form, and overall ratings or judgments obtained from persons thought to be knowledgeable about the organization. 2. Productivity: which is usually defined as the quantity or volume of the major product or service that the organization provides and can be measured at three levels, individual, group, and total organization. Both archival records and ratings have been used, and in at least one case, independent observation of ongoing work was used to obtain a measure of production. 3. Efficiency: usually thought of in terms of a ratio that reflects a comparison of some aspect of unit performance to the costs incurred for that performance. There have been relatively few attempts to operationalize this concept, and all but one of these is a measure taken directly from organization records or a factor derived from such records. 4. Profit: the amount of revenue from sales left after all costs and obligations are met. Percent return on investment or percent return on total sales are sometimes used as alternative defini- tions. 5. Quality: the quality of the primary service or product provided by the organization may take many operational forms, which are largely determined by the kind of product or service provided by the organization. They are too numerous to mention here. 6. Accidents: or the frequency of on-the-job accidents resulting in lost time. Only two examples of accident rates being used as a measure of organizational effectiveness were found. 7. Growth: or an increase in such variables as total manpower, plant capacity, assets, sales, profits, market share, and number of innovations. It implies a comparison of an organization's present state with its own past state. Only four studies attempted to use measures of growth. 8. Absenteeism: or the relative frequency with which people are absent from work. The usual definition stipulates unexcused absences but even within this constraint there are a number of alternative definitions. 14 TABLE l.--Continued. 10. 11. 12. 13. 14. Turnover: this is usually some measure of the frequency and amount of voluntary terminations and refers to a change in actual personnel within the organization, however that change occurs. All but one of the turnover measures reviewed are archival, but even with this constraint there are a surprising number of variations and few studies used directly comparable measures. Satisfaction: Satisfaction has been defined many ways (e.g., see Wanous & Lawler, 1972) but perhaps the modal view references satisfaction to the achievement or possession of certain out- comes provided by the organization and defines it as an individual's perception of the degree to which he or she has received an equitable amount of the outcomes. That is, satis- faction is the degree to which individuals perceive they are equitably rewarded by various aspects of their job situation and the organization to which they belong. Motivation: In our present context this is the strength of the predisposition of an individual to engage in goal-directed action or activity on-the-job. It is not a feeling of relative contentment with various job outcomes as is satisfaction, but more akin to a feeling of readiness or willingness to work at accomplishing the job's goals. As an organizational index, it must be "summed" across people. Morale: This is an often used variable that is difficult to define or even to understand how organizational theorists and researchers are using it. The modal definition seems to view morale as a predisposition in organization members to put forth extra effort in achieving organizational goals and objectives. It includes feelings of commitment and is a group phenomena involving extra effort, goal communality, and feel- ings of belonging. Groups have some degree of morale while individuals have some degree of motivation (and satisfaction). By implication, morale is inferred from group phenomena. Control: refers to the degree of, and distribution of manage- ment control that exists within an organization for influencing and directing the behavior of organization members. Conflict/Cohesion: a bipolar dimension defined at the cohesion end by an organization in which the members like one another, work well together, communicate fully and openly, and coordinate their work efforts. At the other end lies the organization with verbal and physical clashes, poor coordina- tion, and ineffective communication. 15 TABLE l.--Continued. 15. 16. 17. 18. 19. 20. 21. Flexibility/Adaptation (Adaptation/Innovation): refers to the ability of an organization to change its standard operating procedures in response to environmental changes. Many people have written about this dimension (Benedict, Calder, Callahan, Hornstein, and Miles, 1967; Burns, 1961; Gomson, 1968; Hall, 1972; Henry, 1968; Humber, 1960; Utterback, 1971; Indik, 1970; Bennis, 1971; Price, 1968; Korman, 1971), but relatively few have made attempts to measure it. Planninggand Goal Setting: or the degree to which the organiza- tion systematically plans its future steps and engages in explicit goal setting behavior. Goal Consensus: refers to the degree to which all individuals perceive the same goals for the organization, which is distinct from actual commitment to those goals. Role and Norm Congruence: the degree to which the members of an organization are in agreement on such things as what kinds of supervisory attitudes are best, performance expectations, morale, role requirements, etc. Managerial Interpersonal Skills: or the level of skill and efficiency with which the management deals with superiors, sub- ordinates, and peers and includes the extent to which managers give support, facilitate constructive interaction, and generate enthusiasm for meeting goals and achieving excellent performance. It is meant to include such things as consideration, employee centeredness, etc. We realize that this variable is often used as a "predictor" of other variables. However, within some models of organizational effectiveness it has the character of a systemic variable which is indicative of an organization's health. Managerial Task Skills: or the overall level of skills the organizationTs managers, Commanding Officers, or group leaders possess for performing tasks centered on work to be done, and not the skills employed when interacting with other organiza- tional members. Information Management and Communication: refers to the collection, analysis, and distribution of information critical to organizational effectiveness. 16 TABLE l.--Continued. 22. 23. 24. 25. 26. 27. 28. Readiness: the usual definition of this variable is in terms of an overall judgment concerning the probability that the organization could successfully perform some specified task if asked to do so. Work on measuring this variable has been largely confined to military settings. Utilization of Environment: The extent to which the organiza- tion successfully interacts with its environment and acquires scarce, valued resources necessary to its effective operation. For example, it includes the degree to which it acquires a steady supply of manpower and financial resources. Evaluations by External Entities: such evaluations refer to evaluations of the organization or organizational unit by those individuals and organizations in its environment with which it interacts. Loyalty to, confidence in, and support given the organization by such groups as suppliers, customers, stock- holders, enforcement agencies, and the general public would fall under this label. Stability: as per Stogdill's (1971) definition, stability refers to the maintenance of structure, function, and resources through time, and more particularly through periods of stress (Stogdill, 1971). Internalization of Organizational Goals: or the acceptance or internalization of organizational goals within that organiza- tion. It includes their belief that the organization's goals are right and proper. This is not the extent to which goals are clear or agreed upon by the organization members (goal consensus and goal clarity, respectively). Thus, it refers to the acceptance, not the understanding of the organization's goals. Value of Human Resources: which is a composite criterion, where the components refer to measures of individuals. It refers to the total value or total worth of the individual members of an organization, in an accounting or balance sheet sense, to the organization. It is another way of combining many of the variables discussed so far but it deals only with the role of human resources, not other kinds of assets, in organizational effectiveness. Participation and Shared Influence: or the degree to which individuals in the organization participate in making the decisions which directly affect them. 17 TABLE l.--Continued. 29. Training and Development Emphasis: or the amount of effort the organization devotes to developing its human resources. 30. Achievement Emphasis: almost an analog to the individual need for achievement, this refers to the degree to which the organization appears to place a high value on achieving major new goals. SOURCE: J. P. Campbell, “Contributions Research Can Make in Under- standing Organizational Effectiveness," in Organizational Effectiveness, edited by S. L. Spray (Kent, Ohio: Kent State University, 1976), pp. 36-38. 18 TABLE 2.--Synthesized List of End States Specified by DD that Define a Healthy System.a 10. "The total organization, the significant subparts, and indi- viduals manage their work against goals and plans for achievement of these goals. "Form follows function (the problem, or task, or project determines how the human resources are organized). "Decisions are made by and near the sources of information regardless of where these sources are located on the organizational chart. "The reward system is such that managers and supervisors are rewarded (and punished) comparably for: - short-term profit or production performance. - growth and development of their subordinates. - creating a viable working group. "Communication laterally and vertically is relatively undis- torted. People are generally open and confronting. They share all the relevant facts including feelings. "There is a minimum amount of inappropriate win/lose activities between individuals and groups. Constant effort exists at all levels to treat conflict and conflict situations as prob- lems subject to problem solving methods. "There is high 'conflict' (clash of ideas) about tasks and projects, and relatively little energy spent in clashing over interpersonal difficulties because they have been generally worked through. "The organization and its parts see themselves as interacting with each other and with a larger environment. The organization is an 'open system.’ "There is a shared value, and management strategy to support it, of trying to help each person (or unit) in the organization maintain his (or its) integrity and uniqueness in an inter- dependent environment. "The organization and its members operate in an 'action- research' way. General practice is to build in feedback mechanisms so that individuals and groups can learn from their own experience." aThis table originally appeared in R. Beckhard, Organizational Development Strategies and Models (Reading, Mass.: Addison-Wesley, 969). 19 natural systems theorists would say it can be assumed, but goal theorists would say data must be provided. Campbell draws a number of tentative conclusions from previous research concerning methods to be used in studying organi- zational effectiveness. If large numbers of organizations are included in one study, it is probably counterproductive to follow the multivariate approach in the development of effectiveness measures. The reason for this is that archival measures between organizations are different. "Searching for objective measures is a thankless task, and virtually preordained to fail in the end" (Campbell, 1976). The reason is that no measure really stands alone: for example, if quantity produced is considered, then quality should be considered. Thus the most objective measure calls for the need for some subjective judgments. It may be a mistake to focus on the organization's terminal efforts. Measures such as productivity and return on investment are functions of many other things the organization does. Teasing out those parts which are under the control of the organization is a difficult task. A large number of variables presented are aggregated percep- tions of individuals' job satisfaction, morale and climate. Most organizations are so complex that averaging over everyone covers up so many individual differences that it renders the indicator useless. As far as research that should be done, Campbell feels that scientists might achieve more by studying the process by which 20 people in organizations resolve the question of effectiveness. The distinction between operative goals and formal goals may be signifi- cant. Campbell suggests that a determination of how much commonality there is in operative goals across groups in the organization should not be overlooked, nor should the commonality of these goals over time. As far as research methods are concerned, he suggests that asking a panel to judge the importance of different factors to effectiveness, and asking judges to rate similarity among measures may be appropriate. In addition, a panel could be asked to rate the extent to which each variable is a consequence of each other variable. Campbell also sees a gap that could be filled by what he calls nonjudgmental research. He would consider that carefully conducted simulation studies would be one type of research that could fill this gap; very intensive and very thorough case studies or pilot studies would be another. This latter technique could serve to identify significant variables for a particular organiza- tion. He goes on to state: By case study, I refer to a very intensive longitudinal monitoring of each relevant variable using a variety of observational and data collection techniques. For example, behavior observation interviews, questionnaires, and archival records all could be used to monitor changes in supervisory practices and changes in productivity (Campbell in Spray, 1976). Organizational Climate Evan (1968) sets forth two tests for the concept, organiza- tional climate: first, does it help us perceive phenomena hitherto 21 not perceived or identify problems hitherto not identified? Second, does it link up with other concepts in organizational analysis, thereby generating empirically testable propositions and contribut- ing to the development of theory? According to Evan, the concept suggests a union between an individual and an aggregate level of analysis. Chris Argyris (1958) equates organizational climate with “organizational culture." This would appear to be quite broad if one takes culture to mean the set of beliefs, values, and norms that constitute a blue print for behavior. Perrow (1961), speaks of "organizational prestige." This concept relates to the public image of the product or services of an organization and deals with the image that nonmembers have of an organization. It does not include the image that the members themselves may have of the organization. Margulies (1965) uses the concept of organizational culture which he defines as the degree to which the organization is capable of adapting to its dynamic environment. Evan points out that his conception does not capture the subjective or perceptual dimension conveyed by the term. Halpin and Croft (1963) used the metaphor of personality in their study of the organizational climate of schools. Their explanation of Halpin's metaphorical definition of organizational climate is as follows: Anyone who visits more than a few schools notes quickly how schools differ from each other in their "feel." In one school the teachers and the principal are zestful and exude confidence in what they are doing. They find pleasure in working with each other; this pleasure is transmitted to the students, who thus are given a fighting 22 chance to discover that school can be a happy experience. In a second school the brooding discontent of the teachers is palpable; the principal tries to hide his incompetence and his lack of a sense of direction behind the cloak of authority, and yet he wears this cloak poorly because the attitude he displays to others vacillates randomly between the obsequious and the officious. And the psychological sickness of such a faculty spills over on the students who in their own frustration, feed back to the teachers a mood of despair . . . and so, too, as one moves to other schools, one finds that each appears to have a "personality" of its own. It is the "personality" that we describe here as the "organizational climate" of the school. Analogously, personality is to the individual what organizational climate is to the organization (Halpin, 1966, in Evan, 1968, p. 109). Evan himself follows this with a definition of organizational climate which states that it is a multidimensional perception of the essential attributes or character of an organizational system. There are two points that could be made about this defini- tion: first, it does not limit the concept to perceptions of members, since nonmembers may also perceive the climate of an organization; and secondly, it does not incorporate the effect of organizational climate on behavior, which can be conceived as the dependent variable in any empirical research on organizational climate. Evan also sets forth some assumptions about organizational climate: 1) Members as well as nonmembers have perceptions of the climate of the organization. 2) Organizational members tend to perceive the climate differently from nonmembers because of the prevalence of different frames of reference and different criteria for evaluating an organization. 23 3) Perceptions of organizational climate, whether real or unreal, have behavioral consequences for the organization as well as for elements of the organization-set. The organization-set is that complement of organizations with which the focal organization interacts. 4) Organizational members performing different roles tend to have different perceptions of the climate if only because of a lack of role concensus, a lack of uniformity in role socialization, and a diversity in patterns of role—set interactions. 5) Members of different organizational sub-units tend to have different perceptions of the climate because of different role-set configuration, different sub-goals, and a differential commitment to the goals of sub-units compared to the goals of the organization as a whole (Evan, in Tagiuri, 1968, pp. 113-114). Evan also makes some hypotheses which may be applicable to the present study. One of these is that if the climate as perceived by members of the organization is more favorable than the climate perceived by members of the organization-set, there will be a lower rate of innovation because of a reduced motivation to change. He believes the converse also holds that is, if the climate as perceived by members of the organization is less favorable then the climate perceived by members of other elements then there will be a higher rate of innovation. Another hypothesis is that organization climate is more susceptible to deliberate efforts to modify it when there is a low degree of concensus regarding it. Another is that as differences in sub-unit climates of an organization increase, there is a tendency for greater conflict to arise concerning proposals for innovation, and for a discrepancy to occur in the rate of technical and administrative innovation. Sells (in Tagiuri, 1968) makes use of a systems approach. He makes the point that objectively measureable aspects of the 24 environment alone, or the subjective perceptions of participants alone, are insufficient to account for the behavior of the system or any of its components; a frame of reference must be the total system. He refers to Parsons (1959) for some definitions. Parsons separated personality systems, social systems, and cultural systems. All these systems involve the relation of one or more persons to situations which involve actors and objects, both social and non-social. In Parsons' framework a social system is a unit involving two or more actors, while a personality system is defined by the behavior universe of one individual. A cultural system defines and maintains patterns of meanings of objects and symbols, which function in the orientations of actors in personality and social systems. In this context, Parsons defined orientations as: patterned relationships of actors to other actors and social objects, acquired through learning. Cultural patterns are defined as generalized patterns of orientation that are internalized in the case of the individual, and institutionalized, in the case of the social system. Sells (1968) then defines organizational climate in Parsons' terms. The definition is that organizational climate is a function of the culture patterns of organizations and include those generalized orientations of members which are (a) shared by a majority of members of an organization unit and (b) acquired in relation to factors specific to the organizational situation. 25 This definition comes closest to that favored by the author, namely that organizational climate is the common perceptions of the members of an organization and that these common perceptions arise through properties of the organizational setting. Should one attempt to put organizational climate in perspective with the traditional kinds of organizational behavior variables, one finds that climate would appear to be a mediator between the macro or gross structural variables such as size and structure; and the micro variables such as individual behavior, motivation, job satis- faction, and leadership behavior. This leads to the conclusion that if organizational climate can be operationalized, then changes made in the design of the organization which affect variables such as job satisfaction should be reflected in the operationalized con- cept. An ancillary assumption is that changes in the organization's structure will result in changes in climate and in individual behavior and attitude variables. Rudolf Moos (1976) reviews and extends the concepts of social environment, which subsumes organization climate. There are a few points made in the preface of his book which are relevant to the approach taken here. One point that Moos makes is that he. has emphasized environmental impact, when he knows that people shape environments as much as environments shape people. His defense is that most of us cannot shape our environment as it is. He goes on to say that his initial concern was with the social climate or what he calls the "personality" of the environment. 26 As he worked, it became clear that one could not fully understand the social climate of an environment without focusing on the types of people in that environment and on the organizational structure within which they function. He also makes the point that one must take what is essentially a systems approach to these problems since such factors as architectural environment, social climate, organizational structure, and behavior settings will all have effects on the other parts of the system. In his first chapter Moos develops conceptualizations of human environments. He reviews what he sees as seven major trends that underlie the upsurge of interest in man's surroundings. The seven trands are as follows. First is a broad historical and geographic perspective that attempts to explain the rise and fall of entire civilizations. One major example is Arnold Toynbee's notion that men need stimuli and challenge from the environment to develop advanced societies. The second trend is the development of ecology and the associated outgrowth of human ecology and cultural ecology. These developments are linked to conceptions of the environment as currently used in anthropology. sociology, and epidemiology . . . The third trend, the notion that environmental factors influence health and disease, has an old tradition beginning with the ancient Greeks. . . . the study of organizations, the fourth trend, emerged from the industrial revolution and the rise of the bureaucratic society. This trend (is) historically represented by Carl Marx and Max Weber . . . . The fifth trend is due mainly to experimental psychology and personality theory. Personality theorists and mental health practitioners ahve found that personality traits do not explain as much about individual behavior as these investigators had originally thought. This has led to important shifts in emphasis in these fields and to the development of community-oriented and environmental perspectives . . . . 27 The sixth trend stems from the architectural and building design profession. Architects conceive of buildings as actively shaping the behavior that occurs in them. Build- ings and the spaces in them encourage some behaviors and inhibit others. . . . we consider how environmental psychology has arisen partly from this development and partly from the increased emphasis on environmental varia- bles in personality theory and social psychology. The seventh trend is represented by recent interest in conservation and the quality of life. . . . the quality of the environment, especially as it effects individual human beings, is of serious concern. A review of all seven trends provides a broad introduction to the major ways in which human environments have been characterized (Moos, 1976. PP. 3-5). Moos combines these seven trends of thought into what he calls a social ecological approach. In effect, he takes a set of concepts and assumptions from the topics discussed above and com- bines them into an approach to the study of organization effective- ness. This approach studies the impact of the environment from the perspective of the individual. It attempts to synthesize the study of the physical and social environments. This latter means that the approach is concerned with the basic units of the milieu. An example that he gives is that absenteeism is generally higher in larger work groups, but this may be modified by conditions of high cohesiveness and autonomy. He is really saying that elements of the physical and social environments interact and must be studied together. The approach emphasized individual adaptation, adjustment, and coping mechanisms. One must recognize that the environment, to a certain extent at least, also adapts to the individual. This means simply that the individual has some effect 28 on the environment. It appears that most of the effect may go from the environment to the individual, but this is a simplifying assumption. Environments are seen as ranging along a scale that can be actively stressful to those that can be stimulating and challenging, thus bringing out the best performance of which an individual is capable. This can lead to the hypothesis that organizational decisions (e.g., structure, technology, physical environment) may, in and of themselves, affect such micro-organizational variables as productivity, job satisfaction, and absenteeism. In other words, the organization's environment may be conceptualized as the link between macro-organizational variables and the micro-organizational variables. Barker (1963) is an ecological psychologist who has done considerable work on behavior settings over a twenty year period. This work has been done in units generally larger than an organiza- tion, i.e., a unit the size of a small town has been taken as a unit of analysis. Within this setting, Barker has identified some twelve behavior settings, e.g., elementary school settings, high school settings, adult settings, local business settings, family oriented settings, and large membership settings such as street fairs and parades. Under local business settings, he includes what we would consider to be business organizations; for example service stations, banks, barber shops, grocery stores, and lumber yards. It seems obvious that had some larger industries existed 29 within this community they would have been included under this classification. The relevant point for organizational behavior is not so much Barker's taxonomy of behavior settings in a community, as it is the attributes of behavior settings and the methods of observa- tion that he has used. These concepts can lead to a different view of organizations and a different way of studying them. Barker describes some essential attributes of behavior settings. There are one or more standing patterns of behavior involved. These patterns are not the behavior of individuals but of people as a whole. As an example, in a classroom, lecturing and note-taking might be two of the behavior patterns observed. Another characteristic of behavior settings is that they involve the physical milieu. Continuing the classroom example, there are chairs, tables, and a lectern. In many classrooms, these objects are fixed. This lends itself well to the lecture method of instruction, but may not be nearly as suitable for discussions, where it may be most effective for class members to face each other. Barker would say that the conventional classsroom was synomorphic with the lecture method, but not with the discussion method of instruction. This concept has not yet been widely applied to organizations. Its consequences are that certain physical settings may lead to certain patterns of behavior. It follows that if cer- tain patterns of behavior are desired by the organization, then some physical settings may lend themselves to promoting the desired behavior patterns and other settings to actually suppressing them. 30 The milieu surrounds or encloses the behavior both in temporal and physical terms. Continuing the classroom example, if it's Tuesday morning between 8:00 a.m. and 9:50 a.m. in a particu- lar room, then one would expect a particular class to be there. In other words, it might be appropriate to discuss accounting at a particular time in that room, and not human relations in business. The point is that the people entering that setting at that particu- lar time will come to expect a particular topic to be dissussed. The method that has been used by Barker in his studies is naturalistic observation. He recognized that in some ways this method is opposed to an experimental one. Yet, he feels that both have their place and that naturalistic observation is the most suitable for this particular problem. Again, in an organizational setting it may be possible to do both. Perhaps this is best illustrated by organizational development methods, where survey feedback followed by change efforts may be made. Moos (1976) sees organizational factors as an independent variable and organizational impact (or outcome measures) as the dependent variable with three mediating variables. These mediating variables are role and role concomitants, social climate, and the average background and personality characteristics of employees. The structural factors discussed are those of organization and work group size, and organizational shape, e.g., supervisor-employee ratios. Ullmann (1967) investigated the effect of size and staff- patient ratio at 30 VA Psychiatric Hospitals. The outcome measures 31 used were release and turnover rates. Release rate was defined as the number of patients leaving the hopsital within nine months of admission and remaining in the community for at least ninety days. Several different measures of patient turnover were used including: the number of patients discharged divided by the total patient population, and the portion of patients who had lived in the hospital two years or more. Ullmann found that patients in the smaller hospitals were more likely to be released early, and the occurrencetrfthis effect was independent of how well the hospital was staffed. He also concluded that patient turnover was more rapid in the better staffed hospitals, independently of size. Thus it would appear that both small size and high staffing had independent positive effects on release and turnover rate. Linn (1970) did a rather large study using twelve state mental hospitals which varied in size from seven hundred to more than twelve thousand patients. He was testing the hypotheses that the crucial determinants of hospital effectiveness are the kinds of patients admitted, the facilities available to patients, and hospital policy regarding discharge. He found that hospital turn- over was not related to the average background and personality characteristics of the patients, and that discharge rates were also unrelated to the quality of the hospital living conditions. Furthermore, discharge rates were not related to hospital rules and policies regarding patients' freedom of movement or work activities. Two structural characteristics that were related to 32 the rate of patient discharge were size and staff/patient ratios. Linn did not test to see whether average background characteristics mediated the relationship between structural factors and effective- ness. Moos (1974) studied 143 American and 36 British psychiatric wards. The question that he addressed was: how are size and staff/patient ratios related to the social climate or treatment environment of psychiatric wards? He measured the environments with the Ward Atmosphere Scale which assesses ten dimensions of the social environment of psychiatric treatment programs. The results showed that with greater numbers of patients in a program and lower staff/parient ratios, there was less supportiveness from the staff and among the patients themselves. Moreover, patients were less strongly encouraged to act openly and to express their feelings freely. Larger size or poor staffing also meant greater staff control. In addition, the degree of agreement between patient and staff about what their program was like was significantly higher in programs with higher staff/patient ratios. This raises the question of which social climates benefit patients more than others. Cohen and Struening (1964) related the social atmospheres of psychiatric hospitals to the length of time patients spent in the community after discharge. They found the hospitals with authoritarian and restrictive social atmospheres were less effective at keeping patients out in the community. On 33 the other hand, hospitals with benevolent, humanistic, or religious atmospheres were more successful. Ullmann (1967) argued that these results could be explained by differences in size and staffing among the hosptials studied. In response to this Cohen stated that size and staffing were not psychological variables and could not directly effect patients. He believed that the importance of a structural variable derived from their effects on staff attitudes and values, which in turn influenced patients. In Moos' terms, social climate was viewed as mediating the impact of size and staffing ratios. Moos concludes that there is considerable evidence from psychiatric settings that size and staffing ratios influence treatment outcomes and that this effect is mediated by social climates. This raises the question of how does this mediating effect occur? Knight (1971) discussed several mechanisms by which increased size and decreased staffing might operate. Large living units will reduce the proportion of intimate relationships. Group cohesion tends to decrease as group size increases. Large living units limit the time available per event and per group member, while simultaneously providing an impetus for greater control and reducing the opportunity for personal intimacy. Wider social distance between residents and staff in larger units facilitates the development of separate resident and staff sub-groups. Knight sees that shared misunderstandings may occur among residents as a result of the reduced intimacy, decreased group cohesion, and increased distance between residence and staff. People in large 34 groups have less information and are especially susceptible to misinterpreting other's real feelings and intentions. He also feels that increasing regimentation leads to restriction of the personal satisfactions and social rewards of residents. Moos points out that it may be possible to attenuate some of the apparently negative effects of larger size by changing the organization's internal structure to make more and smaller treat- ment units within the large organization. As examples, he points out that the Veterans Administration has tried to deal with this problem by decentralizing some large hospitals into separate units that admit and discharge their own patients. In one study, Ellsworth et a1. (1972) examined the relationship of size and staff/patient ratios to the effectiveness of these decentralized units. The definition of effectiveness was a rise in patient turnover and a reduction of a hospital's long-term patient popula- tion (those hospitalized two years or more). Those results show that hospitals with the smallest units and with the most favorable doctor-patient ratios tended to have the highest increase in patient turnover and the greatest reduction in long-term residence. The average number of patients per unit in the more effective settings was about half that found in the less effective settings. Moos discusses the specific measurement of the social climate. He considers that the work of Murray was the base from which many current empirical studies have sprung. Murray (1938) pointed out that the concept of personality needs could describe 35 the general course of individual behavior but that this omitted the nature of the environment, which he felt to be an important source of variation in human behavior. This position would be consistent with that of the behavioral school in such writers as Hull, Spence, and Skinner. Murray classified environments in terms of the benefits or satisfactions they provided. He coined the term "press" to designate a directional tendency in an object or situation. He concluded that: One can profitably analyze an environment, a social group or an institution from the point of what press it applies or offers to the individuals that live within or belong to it . . . Furthermore, human beings in general and in particular can be studied from the standpoint of what beneficial press are available to them and what harmful press they customarily encounter (Moos, 1976, p. 120). Pace and Stern (1958) extended the concept of environmental press by studying the atmosphere at colleges and universities. They constructed the college characteristics index to measure the global college environment by asking students to act as reporters. The students answered true or false to items covering a wide range of topics about the college. Moos and his colleagues built upon this concept in developing environmental scales for ten different settings. Separate item pools were developed for each setting and were reduced in size by surveys and factor analyses. Three general dimensions emerged from each study. Each dimension is composed of one or more factors, generally at least two and as many as five factors. The three dimensions are: relationship dimensions, personal growth dimensions, and system maintenance and 36 system change dimensions. The precise dimensions developed for their work environment scale and a therapeutic environment scale will be discussed in detail in another section. Program Evaluation and Evaluation Research The terms "program evaluation" and "evaluation research" can be viewed as special extensions of existing parts of the field of organizational behavior. Evaluation research is basically research which is concerned with the effectiveness of given mental health and medical programs. In other words, it is the process of evaluating the effectiveness of a program. A program, however, is always provided by an organization. This organization may or may not be exclusively devoted to providing that program. A systems approach concerned with a particular program would simply view that program as a sub-system surrounded by other environmental systems. The evaluation of a program, then can be viewed as the evaluation of the effectiveness of that organization which provides the program. Coursey (1977) considers that the earliest efforts at program evaluation were made in the medical field, particularly in epidemology. This represents one extreme of well defined, quantifiable outcome measures. One can gather statistics on the incidence of a particular disease and evaluate the effects of public health measures to combat it. The processinvolved can be studied with rather strict application of scientific method, including the 37 full range of statistical, experimental design, and research techniques. Mental health programs present a different set of problems. First, outcome measures are not well defined. A person may be very difficult to classify as either "sick" or "cured." There are extremes that are measurable, e.g., a person who is unable to function outside an institution on the one hand, and one who is able to participate in work, family life, and social functions on the other hand. Between these extremes however, there is a large undefined area. The program considered in this proposal, is one such program. Precise outcome measures are difficult to define, the process of moving from a "sick" to a "cured" state is also not well defined. This poses a particular challenge to those who would evaluate a mental health program. An overview of the field shows that it deals with such concepts as community assessment, program goals, data systems, fiscal monitoring, and outcome evaluation. Some of the models of evaluation that are used are: outcome models, goal attainment models, systems analysis, cost analytic models, descriptive and quality assurance models, planning and management methodologies, and a legal model. Some of the evaluation procedures which are followed are those of needs assessment, output value analysis (using a cost- benefit model), management by objectives, and factor analysis of survey, questionnaire, and interview results. 38 The ways in which these various techniques are implemented bear a remarkable similarity to organization development, and organizational change techniques. Investigators discuss administra- tive decisions, acquiring manpower assistance, professional inter- change, aspirations of a program,participatory techniques, feedback, and open system perspectives. The uses of outside evaluators (i.e., consultants) are discussed, patient rights, and evaluations made by citizen groups are all part of this field of community mental health program evaluation. It is now generally recognized in the field that there is not only no single criteria for program effectiveness, there is also no agreed combination of criteria that can be used between programs. This has validity because the population served, the capabilities of the staff involved, and the desirability of needs for various outcomes is different for different programs. In all of this there is the obvious need of tying in the process of psychotherapy with whatever criteria or outcome measures are chosen so that appropriate changes can be made. CHAPTER II DESIGN AND METHODOLOGY Program Description The program to be studied is a children's partial hospitali- zation program in the Lansing, Michigan area. It is one of the programs administered by the Tri-County Community Mental Health Board, who provides funding, fourth level supervision, and various organizational staff services such as personnel, accounting, and program evaluation. The Board functions similarly to a corporate board of directors. The program uses a multi-disciplinary staff of eleven persons and one supervisor and one secretary. The staff includes two recreational therapists, one occupational therapist, one art therapist, four social workers, one clinical psychologist, and two elementary school teachers qualified in special education. A partial hospitalization program (or a day treatment program, the names are used interchangeably) is called such because clients spend weekdays in the program and nights and weekends at home. Such programs are seen as alternatives to total institutionaliza- tion. In the case of disturbed children, they are, generally, those that cannot be handled by regular or special education programs in the schools. 39 40 Such clients may or may not suffer some degree of mental impairment or learning disability (most currently do not) but this is not their primary problem--the primary problem is some degree of emotional disturbance. Clients are referred to this program through their schools, almost exclusively. The program handled thirty children ranging in age from 5 to 17 at the time of the study. The children spend two hours of their day in a formal class- room with one of the two teachers. The balanceof their time is devoted to treatment of their primary problem. The techniques employed include recreational, occupational, and art therapy; individual and group psychotherapy; and (for some) participation in family psychotherapy with their parents and siblings. Most of the individual, group, and family psychotherapy is done by the program staff. Some of this work (e.g., family therapy) must be done outside of normal program hours. Additional staff functions are preparation of treatment reports, participation in admission procedures (called intake procedures), and consultation with school personnel on matters where the staff's expertise can prove useful. Staff are encouraged, but not required, to seek regular conferences concerning their progress with their individual clients. Such conferences are called clinical supervision and are focused on both therapeutic techniques and the therapists' personal effectiveness. This function may be performed by the staff members' administrative supervisor, or by other supervisors, or by qualified personnel who hold organizational staff positions. Such 41 arrangements are made by the individual staff member. A frequency of once weekly is considered desirable. Design The study is concerned with establishing a baseline level of process parameters and effectiveness criteria that can be used in program evaluation and organizational change efforts. This was done by examining the organizational climate and the therapeutic environment, both in terms of respondent's current perceptions, and the way they would like the program to be. The latter is a reflection of the respondent's goals and values with respect to the program. Effectiveness criteria are developed, and criteria differences between groups are studied. The experimental design, then, is to sample a universe of organizational climate, therapeutic environment, and effectiveness criteria. A modified form of an equivalent materials design is used (Campbell and Stanley, 1963, p. 64). The modification was that different treatments were not used. The design may be diagrammed as: Each group: A1 A2 A3 ... An X Oi; where A symbolizes components of each observation (either subscales or categories of effectiveness criteria), X represents the real or ideal work or therapeutic environment or the effectiveness criteria employed, and 0i symbolizes each individual instrument used. The assumption is made that intergroup differences in these measures represent indicators of possible organizational 42 problems in at least three areas. These areas are effectiveness of supervision or leadership, intergroup cooperation or conflict. and effectiveness or ineffectiveness of communications between various organizational components. This design is subject to the full range of internal sources of invalidity. However, history, testing, maturation, and regres- sion are ameliorated since only one observation is taken. External invalidity is a moot question, since the process of investigation itself is the point of the study. One would not expect the specific results of the testing to be generalizable to other organizations, but the process of climate and effectiveness criteria determination and comparison between groups and subsequent conclusions about a state of effectiveness will generalize. Instruments The principal instruments used in this investigation are two of nine social environment scales developed by Rudolf H. Moos and his associates (Moos, 1974a, 1975, 1976). Nine scales have been developed, and are in various stages of validation. None have been developed specifically for a children's partial hospitalization program, although a children's scale is now receiving attention. The scales selected for use in this study are the Community Oriented Program Environment Scale (COPES), and the Work Environment Scale (WES). COPES consists of one hundred items which define a treatment environment. There are ten subscales, each of which is 43 composed of ten true/false questions. Certain subscales combine to form relevant environmental dimensions as follows: Relationship Dimension: Involvement, Support and Spontaneity subscales; Treatment Program Dimensions: Autonomy, Practical Orientation, PersonalTProblem Orientation, and Anger and Agression subscales; Systems Maintenance Dimension: Order and Organization, Program Clarity, and Staff Control subscales. Definitions of each subscale may be found in Table 3. COPES is available in three forms. Form R is used to measure the real, or current environment and is appropriate for these familiar with the program. Form I measures the ideal environ- ment or the way the subject would like the program to be, and is appropriate for those familiar or unfamiliar with the program. Form E is similar to Form R (the items are identical, only the instructions differ). Respondents are asked what they would expect the program to be like. The latter is appropriate for those not familiar with the program. A short form (Form S) is also available, and consists of the first four items from each scale--for a total of forty items. COPES was developed from the Ward Atmosphere Scale (WAS), which is a 130 item instrument developed for adult inpatients. The dimensions and scale nomenclature are the same, and many items were carried over directly, while others were modified as appropriate for differences in the programs studied. COPES was validated using 44 TABLE 3.--COPES Subscales and Definitions. l. Involvement: measures how active members are in the day-to-day functioning of their programs, i.e., spending time construc- tively, being enthusiastic, doing things on their own initiative. 2. Support: Measures the extent to which members are encouraged to be helpful and supportive towards other members, and how supportive the staff is towards members. 3. Spontaneity: measures the extent to which the program encourages members to act openly and express their feelings openly. 4. Autonomy: Assess how self-sufficient and independent members are encouraged to be in making their own decisions about their personal affairs (what they wear, where they go) and in their relationships with the staff. 5. Practical Orientation: assesses the extent to which the member's environment orients him towards preparing himself for release from the program. Such things as training for new kinds of jobs, looking to the future, and setting and working toward goals are considered. 6. Personal Problem Orientation: measures the extent to which members are encouraged to be concerned with their personal problems and feelings and to seek to understand them. 7. [Agger and Agression: measures the extent to which a member is allowed and encouraged to argue with members and staff, to become openly angry and to display other agressive behavior. 8. Order and Organization: measures how important order and organization isTin the program, in terms of members (how do they look), staff (what they do to encourage order), and the house (how well it is kept). 9. Prggram Clarity: measures the extent to which the member knows What to expect in the day-to-day routine of his program and how explicit the program rules and procedures are. 10. Staff Control: assesses the extent to which the staff use measures to keep members under necessary controls, i.e., in the formulation of rules, the scheduling of activities, and in the relationships between members and staff. SOURCE: R. H. Moos, Community Oriented Prggrams Environment Scale Manual (Palo Alto: Consulting Psychologisth Press, 1974), p. 3. 45 for differences in the programs studied. COPES was validated using a sample of forty-four programs. Both members and staff were tested in 32 of these programs; which included two rehabilitation workshops, two partial hospitalization programs, eleven halfway houses, and 17 day care centers. Members only were tested in 22 programs; which included 20 foster homes, an outpatient support group, and a patient run self-help unit. A total of 779 members and 357 staff were included. Means and standard deviations are available for members and staff for each subscale, as are standard scores for Forms R and S (Moos, 1974b, pp. 4, 19). Subscale internal consistencies were obtained for the initial group of 21 programs using Kuder-Richardson Formula 20, with average item-subscale correlations obtained for the same programs. The internal consistency results range from .62 to .82 for members, with a mean of .79; and from .64 to .89 for staff, with a mean of .78. The average item/subscale correlations range from .38 to .52; with a mean of .41 for members; and .42 to .52 for staff, with a mean of .47 (Moos, 1974b, p. 6). The investi- gators consider that the subscales have acceptable internal consis- tency and moderate to high average item to subscale correlations. See Table 4 for results of these tests for each subscale. Test- retest reliabilities are not published. The authors state that the Ward Atmosphere Scale reliabilities are satisfactory, and some data shows that the Community Oriented Programs Environment Scale profiles "are highly stable over relatively short periods of time (2 to 6 months)" (Moos, 1974a, p. 246). 46 TABLE 4.--Internal Consistencies and Average Item-Subscale Correlations for Form R Subscales. Internal Average Item-Subscale Consistency Correlation Subscales Members Staff Members Staff Involvement .79 .82 .48 .46 Support .67 .64 .44 .42 Spontaneity .63 .75 .43 .46 Autonomy .62 .89 .38 .49 Practical Orientation .64 .64 .44 .43 Personal Problem .78 .84 .52 .50 Orientation Anger and Aggression .82 .86 .51 .52 Order and Organization .81 .87 .53 .53 Program Clarity .68 .77 .45 .44 Staff Control L§Z_ ;Z§. ng_ :45 MEAN .79 .78 .41 .47 SOURCE: Moos, 1974(b), p. 6. 47 Subscale intercorrelations were run. These values range from -.47 to .5 for members; and -.49 to .46 for staff. The com- plete intercorrelation table is shown in Table 5 (Moos, 1974b, p. 7). The investigators concluded that: ". . . the only cluster of sub- scales which show even moderate intercorrelations . . . was composed of the Relationship dimensions of Involvement, Support, and Sponta- neity. It thus appears that the ten dimensions measure distinct, albeit correlated characteristics of member and staff perceptions of program atmosphere" (Moos, 1974b, p. 7). Normative data are also available for Form I (ideal). These norms were obtained from 47 programs for members (N = 618), and 26 programs for staff (N = 252). Average item to subscale correlations, and subscale internal consistency were run. The investigator's conclusion is that Form I also has adequate psychometric character- istics. The Work Environment Scale (WES) is in a somewhat earlier stage of development than either COPES or WAS. Dimension nomencla- ture is identical with COPES. Subscale names and definitions are given in Table 6. There are nine items in each of ten subscales. Normative data were obtained from 624 individuals in 44 work groups. Supervisors were included, but not differentiated in the data analysis. The sample was quite broad in scope, ranging in skill level from nursing school professors to fork lift operators and including some proportion of mental health professionals who were not differentiated in the published data analysis. 48 .e .a .Aeveeap .mooz "muezom .Aeeee_ee mFmewumuv 3o_mn mcowuepmccou wwmum new .Pmcommwu mcu m>onm mew mcoepm—occou cease: "whoz No mm me Om we 04 mm mp N_ _oeeeeu ccepm Po em .N so mN om mm mm mm speeapu seemosa op mm as am we om Po am No eeeea~weameo new Levee co m_ Re me me am F_ NF o_ eecmmesmm< nee Lem=< :owumucmwco oo mp mo om «N we we em on aepeosa _aeoWLee eo RN om _o e_ m_ e, em on eo_eeeeeeso _aemeuase em em co 00 mm mp em mm m_ ssocee=< KN em KP mp mm _N mm as me seeeeepeeam mo Ne ee NF KN mm pm 44 mm eeoaasm mo Nm me we em as m_ em om eeeee>Po>eH 38 3d 00 Vuv Odd 0d V S S I 01.. ILJ JJ 6U JJB JJ n d n U Up. 90 Up 65 [.0J L.D.. 1+ 0 d A .44. JD 93 J3 30.5 33 0 U .0 0 JI: LJ UJ SJ ULO U1 U .4 O I. O 1.9 L. S 13D 1L. 0 n. J A .1. KW ZD. SD. END. 93 m U 1.. a EU I.U 1. I. 1.9 ..A a w 1p 0p L. Irl I: a .L. u 0 o «I? U W U U ..A 1. .Amom u zv wwmpm ucm Amnm u zv mcmnEmz Low mcovumpmccoocmucm mpmumnam a EcouII.m m4m, r— -p m L.) O O D. 4-, O (U U ‘0- : 't- L > 0!- L 1+- O .2 x S. 4-? O m 0.1 CB 4-, U) S— I'U : C >3 G) -l--1 3 n: O t— O c .c D. (I) < I— 3 U U H O- Involvement 59 52 52 54 -08 44 -09 58 26 Peer Cohesion 55 45 38 -21 43 -O8 43 23 Staff Support 51 27 -31 48 -21 47 20 Autonomy 23 -17 32 -26 53 16 Task Orientation ll 48 26 34 20 Work Pressure -15 23 -05 -34 Clarity 18 27 42 Control -18 12 Innovation 20 aDecimals Omitted 53 in three ways: by the functional area of the program referred to, by the structural area, and by the nature of the response. Response classifications for the three categories were defined as shown in Tables 9, 10, and 11 respectively. Following initial classification by the author, a second judge was asked to classify the responses, with unsatisfactory results. The classifications were revised and a random sample of six respondents were selected. Six respondents involved twelve responses and 36 classification decisions. There was agreement between the two judges on 31 of the 36 decisions (86%), and this was considered adequate for the purposes of this study. Selection of RespOndents The program participants; staff, supervisor, and clients; were considered to be a functional and organizational unit. All other functional and organizational units with whom these partici— pants had contact were identified and every effort made to include them in this study. The groups so identified and included are: the Community Mental Health Board organizational line, the CMHB organizational staff, parents of clients, referral agencies, and formal consumer advisory committees attached to CMHB who are con- cerned with children's programs. Respondents were self-selected to a degree, since participa- tion was voluntary. Internally, however, supervisor and peer pressure probably offset this, i.e., some participants probably felt that they were volunteered, rather than volunteering themselves. 54 TABLE 9.--Classification of Critical Incident Responses: Organizational Function. 10. Testing, Intake, Referrals in. Therapy and therapeutic activities. Includes individual, group, and family therapy. In case of doubt, this response is preferred to Number 8. Case reviews, other joint planning and evaantion activities. This classification includes consultation. Aftercare, termination, referrals out. Personnel, finance, program evaluation functions. Includes recruiting, training, and development. Administration as a function. This function may be performed by anyone in the organization, if authority is delegated. Clinical supervision. Other or general program. Respondent could not think of a critical incident. Education or academic. 55 TABLE lO.--Structura1 Classification of Critical Incident Responses. 1. Clients 2. Staff and supervisor 3. Supervisor alone 4. Administration, i.e., second, third and fourth levels of supervision; Organizational staff (personnel, finance, program planning, program evaluation). 5. Parents of clients 6. Outside agencies (including schools). This classification includes other Community Mental Health Board programs. 7. Community advisory council, other formal consumer group advisory committees. 8. General program, other. Note: Any ambiguity regarding this classification and another is to be resolved in favor of the other classification. 9. Respondent could not think of a critical incident. 56 TABLE ll.--Critical Incident Response Classification: Nature of Response. 1. Client behavior, attitude, level of functioning. 2. Competence, skill, state of training, or qualifications; primarily in reference to the program staff and supervisor. 3. Group cohesiveness, concern, motivation, morale, attitude; primarily applied to program staff and supervisor. 4. The availability of resources; e.g., people, materials, space, money. 5. Cooperation or conflict, communication and coordination within the Day Treatment Program. 6. Cooperation or conflict, communication and coordination with other programs or agencies. 7. The efficiency or effectiveness of organization or procedures. 8. Other. 9. Respondent could not think of a critical incident. 57 As distance from the program increased, this pressure probably became smaller. All respondents did not complete all of the five instruments administered. Some were simply not in a position to give any sort of opinion due to unfamiliarity with this particular program. The Critical Incident technique was considered inappropriate for the clients. Administration of Instruments The author administered all instruments to all subjects. Group administration was done whenever possible. When individual administration was done, the Critical Incident question was answered orally and summarized by the author. This was not possible during group administration, and respondents answered in writing. Oral administration was preferred due to large individual differences in respondent's abilities to express themselves in writing. In addition, it afforded an opportunity to seek clarification of a narrative when necessary. Administration of the COPES and WES instruments was done in as standardized and consistent a manner as possible, using written instructions which were read aloud when appropriate. The author preferred to be present during completion of the instruments, but if this was precluded by a respondent's schedule they completed the instrument on their own. In all cases the purpose of the study was explained and assurance was given that individual results would remain confidential since only group results would be published. 58 Any questions concerning test items were answered by first repeating and paraphrasing the instructions. If doubt still existed concerning the meaning of an item, the item itself was paraphrased. In the case of one client with a reading disability, all questions had to be administered orally and paraphrased, with the author marking the answer sheet. These procedures were considered prefer- able to no response, since the instruments were validated with the assumption that all items would be answered. Hypotheses Results will be arranged in the form of profiles for each instrument administered. Each profile is composed of 10 separately scored subscales. A full administration to one respondent would involve four instruments, COPES Form R and Form 1, and WES Form R and Form 1, yielding four profiles. When studying one group, a group profile was obtained by taking the group mean raw score for each subscale separately, thus yielding one group profile for each instrument adminstered to that group. Analysis involves differences between the 10 subscales taken together and taken one at a time. Critical incident results are presented as the percentage of a group responding to each classification of each of the three response categories (functional, structural, and nature of the response). Responses for effectiveness and ineffectiveness are tabulated separately. Using this data, a descriptive analysis of scale differences between profiles, and of effectiveness criteria will be made. 59 Statistical tests will highlight significant differences between and within groups, but intra-profile relationships and the choice of effectiveness criteria is descriptively analyzed as well. This will suggest areas of strength and weakness within the program, conceptual inconsistencies in perception and goals and values, areas of inter-group conflict, and differences in effectiveness criteria. The development of hypotheses flows from certain assumptions about the nature of the data. The "real" form of the instruments reflect perceptions of the program and of the work environment. The "ideal" forms reflect the values of the respondents with respect to these environments, and also reflect their goals for the program. Large inter-group differences would indicate the possi- bility of dysfunctional conflict or poor communication. Yet, differences would be expected due to differential familiarity with the program, different organizational roles with respect to the program, and differences in education and training of the respon- dents. The data is analyzed by organizational structure and training of the respondents in an attempt to better define the relative magnitude of these effects, but no formal hypothesis concerning their relationship is made. Differences would, therefore, be expected in all of the formal hypotheses. Further, as distance from the program increases, greater differences would be expected. Large Real-Ideal differences could indicate dissatisfaction with the program and motivation to effect changes. 60 Hypothesis A: Internal vs. External There will be significant differences between internal and external group responses of: l. The real (or expected) treatment environment as reflected in COPES Form R. 2. The Ideal treatment environment as reflected in COPES Form I. 3. Effectiveness and ineffectiveness criteria as reflected in the Critical Incident results. Hypothesis B: Low vs. High Levels in the Hierarchy (Program Staff vs. Line) There will be significant differences between the program staff and line groups in: 1. COPES Real results. 2. COPES Ideal results. 3. The real work environment as reflected in the WES Form R results. 4. The ideal work environment as reflected in WES Form I results. 5. Effectiveness and ineffectiveness criteria as reflected in the Critical Incident results. Hypothesis C: Line vs. Organization Staff There will be significant differences between line and organization staff in: 1. COPES real responses. 2. COPES ideal responses. 3. Critical incident results. 61 Hypothesis 0: Program Staff vs. Referral Agencies There will be significant differences between program staff and referral agencies in: l. COPES real responses. 2. COPES ideal responses. 3. Responses to the Critical Incident questions. Hypothesis E: Program Staff vs. Clients There will be significant differences between program staff and clients in: l. COPES real responses 2. COPES ideal responses. Hypothesis F: Program Staff vs. Parents of Clients There will be significant differences between program staff and parents of clients in: l. COPES real responses. 2. COPES ideal responses. 3. Responses to the Critical Incident questions. Analysis of Data Two statistical procedures are run on COPES and WES profiles. These are a multivariate analysis of variance on each profile pair tested, and univariate analysis of variance on each subscale pair within those profiles. The independent variable is group membership, 62 the dependent variable is the response to the instruments. Wilk's Lambda statistic is used to estimate F in the multivariate analysis, although other methods available give virtually identical results in this particular application (Cohen, 1976, p. 32). The threshold significance level is conventionally chosen at p = .05 for the multivariate tests. A lower probability level was chosen as the threshold for the univariate tests since ten tests are run on each profile pair studied. To minimize the probability of making a difference determination when one did not exist, a significance level of p = .005 (.05 divided by 10, the number of tests run) was used. The Critical Incident results are tested for inter-group differences by category (functional, structural, and nature of response) and by responses to the effectiveness and ineffectiveness 2 questions separately. The Chi statistic was then used to test for significant differences in the percentages so obtained. CHAPTER III RESULTS Overall Seventy-two respondents completed all or part of the instruments administered. Classification of respondents by organiza— tional structure is given in Table 12, and by professional training is given in Table 13. Critical Incident results are given for all respondents in Tables 14, 15 and 16. Effectiveness and ineffectiveness criteria given by all respondents are presented, as well as a combined percentage. The three tables contain the three categories of the functional area referenced, the structural area referenced, and the nature of the response. Standard score plots of Forms R and I of the Community Oriented Programs Environment Scale (COPES) are presented in Figure l, and the Work Environment Scale (WES) overall results for both forms are presented in Figure 2. All 72 respondents completed both COPES instruments, 24 completed WES Form 1, and 16 completed WES Form R. Hypothesis A: Internal vs. External The internal group is composed of the program staff, the program supervisor and the clients tested (N = 19). The external 63 64 TABLE 12.--Classification of Respondents by Organizational Structure. Number Program Staff and Supervisor 12 Line 10 Organization Staff 6 Clients 7 Parents of Clients 9 Referral Agencies 20 Consumer Advisory Committees .__8 TOTAL 72 65 TABLE l3.--Classification of Respondents by Professional Training. Number No Professional Training 17 Special Education (Teacher) 10 Recreational, Art, and Occupational Therapy 4 Social Work 19 Clinical, Counseling, or Educational Psychology and Psychiatry 13 Other Mental Health Training 4 Professional Training, Non Mental Health 5 TOTAL 72 66 TABLE l4.--Critical Incident Responses: Functional References (Percent of Total Responses). Effective- Ineffective- Combined ness ness Education and Academic 3.1 3.1 3.1 Testing, Intake, Referrals In 15.6 14.1 14.8 Therapy and Therapeutic Activity 32.8 29.7 31.2 Case Reviews, Planning 12.5 9.4 10.9 Termination, Aftercare, Referrals Out 4.7 4.7 4.7 Organizational Staff Function 4.7 7.8 6.3 Administration (as a function) 9.4 12.5 10.9 Clinical Supervision 1.6 O .8 General Program, Other 7.8 6.3 7.0 Couldn't Think of an Incident 7.8 12.5 10.2 67 TABLE 15.--Critical Incident Responses: Structural References. Percent of Total Responsesa Effective- Ineffective- Combined ness ness Client 23.4 6.3 14.8 Program Staff and Supervisor 45.3 57.8 51.6 Supervisor Alone 18.8 3.1 10.9 2nd, 3rd, 4th Levels of Supervision and Original Staff 0 9.4 4.7 Outside Agencies 0 4.7 2.3 General Program 4.7 6.3 5.5 Could not Think of an Incident 7.8 12.5 10.2 aColumn totals may not add to 100% due to rounding errors. 68 TABLE l6.--Critica1 Incident Responses: Nature of Response. Percent of Total Responsesa Effective- Ineffective- Combined ness ness Client Behavior, Functioning, 26.6 6.3 16.4 Attitude Staff Competence, Skill, 26.6 23.4 25.0 Training Staff Attitude, Motivation 14.1 6.3 10.2 Resource Availability 0 7.8 3.9 Cooperation, Communication 6.3 14.1 10.2 within the Program C00peration, Communication 9.4 17.2 13.3 with Outside Agencies Efficiency or Effectiveness 9.4 12.5 10.9 of the Organization (including Procedures) Couldn't Think of an Incident 7.8 12.5 10.2 aColumns may not add to 100% due to rounding errors. 69 0—4 Real A-..-.b Ideal ‘ — .1.-- -..--- .. .. -- - '7 P--.-.-...-..—— -----1.-- -- 100 90 - 80 - 7o --- 60 - 50 30 mwcoum ocmucmum 20 - 10 - Foeeeou cceem »u_cmpu Emcmocm cowum~wcmmco a sauce :owmmmcmm< a cmmc< cowumucmwco empnoca Fccomcmg cowumucwwco quwuumca xsocoua< auwmzmuconm ucoagsm u=m5m>~o>cH Form 1, All Respondents. Form R vs. Figure l.--COPES Profiles: 7O A—--b Ideal \. Ik. I. C VI \ 4 ‘ _ Y 100 90 e- b 0 8 . . . b 0 7 n O 6 50 40 mmcoom ccevcmpm 3O .- ------------ ..- ..-- ...- --- -- 20 - IO - ucomeou Pmuwmxsa cowum>occH Pocgcou apwcmpu acammmca xcoz cowomu:m_co xmep xsocouz< ugoaazm wwmum commence some acmem>Fo>:H Form 1, Form R vs. Figure 2.--Work Environment Scale Profiles: All Respondents. 71 H Internal A. - -A External - p - 100 lr 0 00 54 o_ x mmcoom 2mm 0 3 O 2 10 0 pocpcou eemum xpwcmpu Ensues; =o_um~wcmmco a tango :owmmmcmm< a cmmc< cowpmucmwco Em_noca chomcma cowumpcwwco .mu_uumcq xsocouz< zuwmcmacoqm acoaazm ucmsm>po>2H Form R (Real). COPES: Profiles. Figure 3.--Hypothesis A: 72 group consists of all others completing the instruments, giving a sample size of 53 for COPES and the Critical Incident questions. The Critical Incident Question was not considered appropriate for the clients, giving an internal sample size of 12 for this instrument. Results for Hypothesis A1 are as follows: COPES Form R profiles are shown in Figure 3. The raw scores for each subscale, together with results of the multivariate and univariate tests are shown in Table 17. The multivariate F test shows that the profiles are signifi— cantly different. The univariate F tests show the Support subscale significantly different with the external group higher. The results for Hypothesis A2, COPES Form 1, are shown in Table 18 and Figure 4. Significant differences are found between the profiles, and the univariate tests show significant differences between involvement, support, practical orientation, and problem clarity subscales. The results for Hypothesis A3, effectiveness and ineffective- ness criteria are given in Table 19 and 20. Significant differences are found in effectiveness criteria in the functional area cited and in both effectiveness criteria in the nature of the response. Hypothesis B: Low vs. High Hierarchial Levels (Program staff vs. lineT' Hypothesis Bl results are shown in Table 21 and Figure 5. No significant differences are found between the COPES Form R profiles. 73 moo..w a Po..w a see.~ u a Po.o_ u .J.a ”emoe-e ooe_ea>wepsz ... ooeaoccceaem N.e o. o._ N. m._ m._ m. m.m o.e_ o.m L oe._ I .L.o ”pmmpum mpmwcm>wcz m.m e.m m.m N.w o.m N.m m.¢ m.o v.w n.n mm Pmccmuxm m.m e.n m.m o.m m.c ~.m m.e o.m «.0 o.o or chcmch ”museum 3mm oF m m N m m e m N — z 35 3d 00 WW Odd 0d V S S I 01.. |.J JJ 5U JJB JJ 0 d n u Up. 90 50. 55 I..OJ [.9 1+ 0 d A 1.1. JD 23 J3 30.5 33 O U .0 O JI: L.J UJ SJ ulO U1. U 1. 0 I. O 1.9 I. S 1.8U 1...... O D. J A I. Am Zn. Sp. Emu. 93 m U 1. a EU L.U 1. I. 1.9 A 3 w 1p Up I.. ......IL I... a l. U 0 0 1. U 0 U U ..A 1. U i l l l l l l l l i l .Apmmmv m Econ m—mom pcmscocw>cu mamcmoca nmucwwco xpwczeeou .mucmwcm> *o mwmapmc< new mppzmmm u< mpmmgpoaszI.u_ m4mwupzz are k: «if: «:3. wucmu 7+ _. co _. m o. ¢.m o. o.m ¢._ o.op m. o.~ o.o~ m.m m ou.p u .u.a ”pmwh u mumwcm>w=2 m.m ¢.m m.n _.~ P.w o.m o.o on. m.m m.m mm pmcgmuxm w.m N.m 5.5 o.m m.n F.“ n.m ¢.m e.“ N.m mp pmcgmuca ”museum 3mm op m w n o m e m N F z 35 3d 00 Vuv Odd 0d V S S I 01. LJ JJ ..DU JJB JJ n d n U Up. 90 SD. 56 L.OJ [.9 ...... 0 d A .41. JD 93 J3 30.5 33 0 U .0 0 J1... L.J UJ aJ UlO U1. U ..+ O I. O .49 L. S lau ....L. O E J A I. Am 29 SD. new? 93 m U .4 a EU ID 1. I. 1.9 .A I. m 1p UP I: l.|. a a l. U 0 0 1.. U 0 U U 0A 1+ U .Apmmcfiv H Eco; mpmom newscocw>cm mangoes; umpcwmco zuw=255ou .mucmwcm> we mwmxpoc< new mppammm u< mmmwzuoaAIII.mp m4mu_cmpu Emsmoca cowum~_:mmco a canto :owmmmcmm< a cmmc< :owpm~_:mmco Empnocm _m:omcma cowumacmwco qu_uomca xsocouz< Xpwmcmucoqm “coaazm acmem>po>cm Form I (Ideal). COPES: Profiles. Figure 4.--Hypothesis A: 76 TABLE l9.--Hypothesis A: Internal vs Externala Chi2 Tests on Group Differences. Chi? D.F. Functional Area Cited: Effectiveness 19.9 9* Ineffectiveness 14.6 6 Structural Area Cited Effectiveness 1.4 4 Ineffectiveness 5.7 6 Nature of Response Effectiveness 21.3 6** Ineffectiveness 21.1 7** aClients did not respond. 77 TABLE 20.--Summary of Critical Incident Responses. Hypothesis A: Internal vs External (percent of group responses by category). Effectiveness Ineffectiveness Internal External Internal External Functional Area Cited: Education and Academic O 3.8 O 3.8 Testing, Intake 0 19.2 8.3 15.4 Therapy 33.3 32.7 41.7 26.9 Case Reviews, Planning 33.3 7.7 16.7 7.7 Termination, Aftercare 16.7 1.9 9 5.8 Organizational Staff 0 5.8 O 9.6 Function Administration (as a O 11.5 8.3 13.5 (as a function) Clinical Supervision 8.3 O O 0 General Program, Other 0 9.6 25.0 1.9 Couldn't Think of an 8.3 7.7 O 15.4 Incident Nature of Response: Client Behavior, 33.3 25.0 8.3 5.8 Functioning Staff Competence, Skill 16.7 28.8 8.3 26.9 Staff Attitude, Motivation 8.3 15.4 8.3 5.8 Resource Availability 9 9 16.7 5.8 Cooperation, Communication 33.3 0 50.0 5.8 within the Program Cooperation, Communication 0 11.5 8.3 19.2 with Outside Agencies Efficiency, Effectiveness O 11.5 0 15.4 of Organization, Procedures Couldn't Think of an 8.3 7.7 O 15.4 Incident 78 .ucmom supmm: peace: apwcsseoo .couumcmo m>Fu=umxu .copumcwa smcmocmn .comw>cmnam mwuzpoxmm mm._ u c o_.oP u .J.o ”emoe-u oeaeeasee_=z mucmowwwcmwm o.o o. N.e N. m. u mP.P u .m.o ”mpmmth mummgm>wca o.m F.m m.n m.o m.m OP none; m.n N.m m.m N.~ 0.0 FF mwwmum Emcmoga "mmgoum 3mm op w m m m e m N P 2 03¢. fiuAu nunu uvuv nuauAu AU.d Hy Q. AS .1 O 1. ILJ J J ,D U .J.Jqu J J n .0 n U U P P O .D D. .D.D .Inu.J 1.? 1+ 0 .0 A 1+I: J.D P a J a .d.ugs a 3 0 U .0 O J I. I.J U J a J “u.l;u U 1. U 1. O .L O 1.9 I. S .+.unu 1.L. 0 P J A II .A w 2 P .3“: P m.e E D m U 1. a D U [.0 .4 .L 1.8 .A a w “I.- p 0 p IL. L. l L. 9 IL. u 0 o «I? u W U U .A 1. mangoes; umucmwgo xuwcassou .Apmmmv m Eco; "mpmum newscosw>cm .mucmwcm> we mwmemc< ucm mupzmmm ”m mwmmguoaazII.Fm u4mPo>:H Form R (Real). COPES: Profiles. Figure 5.--Hypothesis B: 80 Hypothesis 82 results are shown in Table 22 and Figure 6. No significant differences are found between the COPES Form 1 profiles. Hypothesis 83 results are shown in Table 23 and Figure 7. The WES Form R profiles are not significantly different on the multivariate test. The univariate tests shows that the work pressure subscales are significantly different, with the low hierarchial level seeing more work pressure in their jobs than does the high level. Hypothesis 84 results are displayed in Table 24 and Figure 8. The Idea Work Environment profiles are not significantly different between the hierarchial levels. Hypothesis B5 results are shown in Tables 25 and 26. Ineffectiveness criteria are significantly different in the structural area cited and the nature of the response. Hypothesis C: Line vs. Organization Staff Results for Hypothesis C1 are shown in Table 27 and Figure 9. No significant differences are found in the COPES Form R profiles. Hypothesis C2 results are shown in Table 28 and Figure 10. No significant differences are found between the COPES ideal profiles. Hypothesis C3 results are shown in Table 29. No signifi- cant differences are found in the Critical Incident results. 81 .PN mpnmh .n mpoz mmmn somw>swazm mmuapuxmm .m.z 3.. u h. 2.2 ... ....o ”emoh-c memese>eepsz mucmume_cmwm N. m.p N.N o.~ m._ N. ¢.N o._ e. N. u mp.P u .m.o ”mummhuu mummcm>_ca N.m N.m F.N ¢.m m.N m.m m.m m.~ m.m v.m op emcee v.o m.m m.m m.N w.m m.m m.m ¢.N m.m m.m _~ mmmmum Emcmoca ”mmcoum 3mm as 3.0 00 Vuv 0.0.0 0.0 NV 5 S I 01. [J JJ 5U JJa JJ n .0 n U Up. 90 DD. 55 L.OJ 1:? 1. 0 .0 A 11... JD 28 J8 90.5 33 O U .0 0 J1: L.J UJ BJ UlO 01. U .4 O I. O 1.9 L. S 1.3U 1L. 0 P J A I. Am 20. So. Emu. 93 m U 1. a EU l.U 1.. 1. 1+0. .A a w 170: CD- I... I..ll L. a W U U .A 1. .Apmmuuv H Eco; ”mpmom acmEcocw>zm msmcmosa umpcmwco ape::EEou .mucmwcm> 4o mwmxpmc< new mppammm "m mwmmcuoqszI.NN u4mFo>:H Form I (Ideal). COPES: Profiles. Figure 6.--Hypothesis B: 83 .moo. w.a .1 «a .umwcpmwcuxmm mcwapzmcoo .ANV chcomcmm .couumcwo Emcmoca .com_>cma=m mmuapocHn mucmmpu use cemw>cmazm mmuzpuxmm .m.z N.F u u m.op u .u.o "poop J opaLLescepsz ... ooeeoee_emcm m.N o.F m. m. o.m_ N. m. o.F o. m. u SP.F u .J.o upmmh m mumwgm>wza 0.0 ¢.N o.m N.o N.¢ N.o m.m m.n N.m o.N m gaze; o.m e.m N.¢ m.m N.N F.m F.N N.o m.m F.N FF mmmmpm Emcmoca "mmcoum 3mm op m m N o m e m N _ 2 3d I. AJ 3 I0” 01.. V SS 3d .1. DUI U 0 1. J0 JD. 0 01. OS U wA U U 9 SJ [.5 1. .09 US A I35 0 1. J Sud Sun. 0 01. SJ 0 O... A J L. S U U OI: S I. JD D. 0 1. n 1. O J L. A 1.9 1. I. ..A J D. w .4 O S 0 I. S U 0 U U 1. m Egon ”mpmom newscocw>cu xcoz .AFaomv .mucmwcm> mo mmmzpa=< Sam mppammm ”m mwmmcuoaxzuu.mN ubm—__—(> Program Staff 1*....¢y Line 100 90 70 o_ x mucoum 3mm ucoweou pwowmzza cowum>occfi Pocucou xuwcmpu mesmmmca xcoz :owumu:m_co xmmp xsocouz< eeoaasm cceem :o_mm;ou coma ucmEm>Po>cH Work Environment Scale: Profiles. Form R (Real). Figure 7.--Hypothesis B: 85 .Sseom gopeox Peace: Neweseeoo o2» co coweweee any guNz mN open» cw epmccmpxms mm msmmn .mucmNNo ucm comw>cmasm mmcapuxmm .m.z N mN.oN u .u.a "emoN a oeawseswepsz mocmoNchmwm m.m N. S. N. m. S.S o.N S. S. w.— J NN.N u .J.o ”mumthm mummgm>wcz N.N o.m N.m m.N N.m m.N N.w o.m m.m m.m m_ none; m.m m.N m.S m.N m.N m.m m.w m.w S.w o.m NF meNmum segues; ”mmgoum 3mm op m m N o m S m N N z AJ.d I. dd “J ASMH nuII H. (Sc. nJ.d .1 0 u. U 0 I. J O J P n n 1. O S U w.A U U P S J 1.5 1. .0 P U.S A 1.5 O 1. J S W. S M. O .0 I. S J O O I. A J I. S u U 0 I. S .l J 3 P 0 1. n 1. O J L. A 1.8 1. I. ,A J 9 w 1. O S l. I... a 1... K U w 0 I. S U 0 U U 4+ H Exam umpmom acmEcocN>cm xcoz .mocm_cm> we mmepmc< new mupammm .Npmwqu um mwmmnuoazzII.SN m4moccm Pogacou xuwgmpo mgsmmmga xgo: copumucmwgo xmmh xaocouz< ugoaaam Sumpm cowmmcou mem acmsm>Fo>2H work Environment Scale: ProfiIes. Form I (Ideal). Figure 8.--Hypothesis B 87 TABLE 25.--Hypothesis B: Critical Incident Results. Chiz Tests on Group Differences. c1112 D.F. Functional Area Cited: Effectiveness 13.6 8 Ineffectiveness 10.6 6 Structural Area Cited: Effectiveness 3.2 3 Ineffectiveness 12.4 5* Nature of Response: Effectiveness 10.1 5 Ineffectiveness 15.8 7* p 5 .05 88 TABLE 26.-~Summary of Critical Incident Responses. Hypothesis B: Program Staff vs Line (percent of group responses by category). Effectiveness Ineffectiveness Program Program Staff Line Staff Line Structural Area Cited: Client 36.4 10.0 9.1 10.0 Staff and Supervisor 36.4 30.0 81.8 10.0 Supervisor Alone 18.2 50.0 0 0 Administration and 0 0 9.1 30.0 Organization Staff Outside Agencies 0 0 0 20.0 General Program, Other 0 0 0 20.0 Couldn't Think of an 9.1 10.0 0 10.0 Incident Nature of Response: Client Behavior, Functioning 36.4 10.0 .1 10.0 Staff Competence, Skill 18.2 50.0 9.1 40.0 Staff Attitude 0 10.0 9.1 0 Resource Availability 0 0 18.2 0 Cooperation, Communication 36.4 0 54.5 within the Program Cooperation, Communication 0 0 0 20.0 with Outside Agencies Efficiency, Effectiveness 0 0 0 20.0 of Organization and Procedures Couldn't Think of an 9.1 10.0 0 10.0 Incident 89 .ANV cowpm=_m>u Emcmoca .mcwccmpa Emcmoca .ANV Pmecomcma .umwcumm;o>ma mcwupsmcoun .ucmom cupmm: .mpcmz zuwczssou .LopumLPo m>wuzuwxm .Louumgwo smcmoga .comw>cwa=mm 8.. u h. 3: u .2 “Swah-a mpmwcm>wp_=z mucmow»_:mwm o.~ F.F m.S N. S. m. o. —. o.m m. a mp.p u .m.o ”mumwpuu mumwcm>wca m.o m.m m.m n.m m.m m.o w.m N.o o.m N.m m a$wmum cowpm~mcmmgo N.m m.m N.m m.n o.m ~.m m.m m.m m.m N.“ p— mm:_4 ”mmgoum 3mm o— m m m m m S m N p 2 as 3d 00 VV Odd 0d V S S I 01.. [In lulu 6U Juana land n d n u up. 90 SD- 66 ......OJ It? 1 0 d A ll... J6 93 J3 aqs 33 o u d O Iul... I..lu UJ Bin ”[0 uni... u 1... O .I. O 10.. I... S .173” 11].. 0 D. la A l [N 29 SD. Dump- 93 w u 1.. a PU l.U 1.. ..L 1.9 A 3 w 1p on. I... l.l IL. W 0 u u K 1.. u .Apmmmv m Eco; ”upmom pcmscogw>cm mamcmocm umpcmwco xpwcassou .mocmwcm> mo m_mzpmc< new mupzmmm no mwmmzuoaaznu.- m4m

occm Focucou xu_cm_u mczmmwca xcoz cowumucmwgo xmwp xsocoaaq uconazm Semum =o_mmgou cum; acmem>—o>:H Form R (Real). COPES: Profiles. Figure 9.--Hypothesis C: 91 .N mpnmh cw omega mm msmm asp my masocm span mo cowuwmoquu make .m.z m; u h. 3: u .2 "....-. a...2.>.p_=z mocmquwcmwm F. S. S.N o. P. o. S.— F. N._ o. u m_.p u .m.o "mummhum mpmwgm>wca N.m m.m m.w o.o m.~ o.m 5.0 w.n o.op m.m o mwmum cowamecmmco m.m m.m S.m m.o F.m m.m n.m o.m m.m m.m FF mwcwg ”mmcoom 3mm 35 3d 00 VV Odd 0d V S S I 01 I.J JJ 5U JJS JJ n d n U Up. 90 BP 55 L.0J 1.9 .4 0 d A 1.1: J5 PS JS 30.5 SD 0 U .0 0 J1: L.J UJ SJ UlO U1. U 1. O I. 0 1b.. l. S 173" 11L. 0 P J A .L Am 29 SD. Pwn. 93 m U 1. S 9U L.U 1. .L .49 .A S w 1p on. I... Irl ..L. a L. U 0 0 1. U W U U ..A 1. .ApmmSHV H Egom ”mpmum acmEcocw>cm mamsmoga umucmwco zuw:=EEou .mocmwcm> So mwmxpmc< Sam mgpzmmm no mwmmsuoazxuu.mm m4mPo>:H Form I (Real). COPES: Profiles. Figure 10.--Hypothesis C: 93 TABLE 29.--Hypothesis c: Critical Incident Results. Chiz Tests on Group Differences. Chi2 D.F. Functional Area Cited: Effectiveness 5.5 6 N. . Ineffectiveness 6.2 7 N. . Structural Area Cited: Effectiveness 3.0 4 N. . Ineffectiveness 6.8 5 N. . Nature of Response Effectiveness 4.4 5 N. . Ineffectiveness 2.9 5 N. . N.S.: Not Significant 94 Hypothesis 0: Program Staff vs. Referral Agencies Hypothesis 01 results are shown in Table 30 and Figure 11. No significant differences are found in the COPES Form R results. Results for Hypothesis 02 (COPES) ideal profiles are shown in Table 31 and Figure 12. No significant differences are found. Results for Hypothesis D3 are shown in Tables 32 and 33. There are significant differences in effectiveness criteria in both the functional area cited and the nature of the response (Table 32). Detailed results for these two categories are presented in Table 33. Hypothesis E: Program Staff vs. Clients Results for Hypothesis El (COPES Form R) are given in Table 34 and Figure 13. The multivariate analysis shows no significant differences between profiles. The univariate analysis shows significant differences in the Involvement and Personal Problem Orientation subscale, with Staff being higher in both cases. In nine of the ten subscales, Staff scores are higher, which indicates that the profiles may actually be different. The multivariate test may not reflect this due to a relatively high variance in client scores. Hypothesis E2 results (COPES Form 1) are presented in Table 35 and Figure 14. Multivariate analysis shows a significant difference between profiles. Univariate analysis shows significant differences in the Involvement, Support, Spontaneity, Autonomy, 95 .m.z _ mm. H e P~.op u ...a a.m..-. memweeswepaz mucmupmwcmwm m.F F. _. N. S. o. N. o. 0.. o. m om.p u .m.a "mummhum muowgm>wcn S.m w.m m.m m.w m.m N.m S.S m.o S.w 0.x ON wwwucmm< nggmmmm m.m m.n m.m m.w m.m N.o m.¢ m.m m.n N.n NF Swmum Emguoga ”mmsoum 3mm op m m N o m S m N P z 35 3d 00 VV Odd 0d V S S I 01. [J JJ 5U JJS JJ 0 d n U UP 90 50. 55 I.OJ I.p. 1. 0 d A .41.. J5 9S JS qu SD 0 U .0 0 J1... I.J UJ SJ UlO U1. U 1. O I. 0 1.9 I. S 1mu 1.I. O P J A I. Am Zn. Sp. 9 P 93 m U 1 S 1.0. OD. I. I.|. I. S I. U 0 O 1. U W U U ..A 1. .prmmv m Ego; "mpmum newscocw>cm mamcmoca nmpcmwco zuwczeeoo .mucmwcm> mo mwmapmc< use mapsmmm no mwmmsuoaazun.om m4mFo>:H Form R (Real). COPES: Profiles. Figure ll.--Hypothesis D: 97 .m.z cm. H e FN.o_ . .e.o Hume.-. meeweeswepaz mo=m8wmm=mwm m.N N. —.N w. m. o. m.N _. o. S.N u om.P u .m.a "mummh-m mamwgm>wca m.m m.m m.m o.m S.w o.m w.m m.w o.m N.m 0N mmwucmm< Fmggmwmm S.o m.m S.m N.m m.m m.w m.o S.m o.m m.m Np memum Eggnog; "museum 3mm OS Dd 00 VV Odd 0d V S S I 0.4 [J JJ 5U JJS JJ 0. d n U ”D. ”.0 5p 55 1.01“ [.9 a]? 0 d A 1.]: J5 93 J3 30.5 33 O U .0 0 JI: IL.J u...“ a!“ ”[0 U1? u 1.7 0 ul- 0 1.9 I. S «emu 1L. 0 o. J A IL Am 29 Sn. 9 D. 93 m U 1. S PU I.U 1. I. 1.9 A S m 1p op lo [0" Ilb. a l. U 0 O 1. U nUU u u ..A 1.. .Apmmqu H Eco; ”mpmum “coacocw>cm mamcmoea umucwwco auw::EEoo .mocmmcm> we mwmapmc< new mupzmmx no mwmmguogxrlu.Pm m4mpo>:H Form I COPES Profiles. Figure 12.--Hypothesis D: 99 TABLE 32.--Hypothesis 0: Critical Incident Results. cni2 Tests on Group Differences. Chi D.F. Functional Area Cited: Effectiveness 16.9 7* Ineffectiveness 11.1 6 Structural Area Cited: Effectiveness 2.9 4 Ineffectiveness 4.3 5 Nature of Response: Effectiveness 12.6 6* Ineffectiveness 6.1 7 100 TABLE 33.--Summary of Critical Incident Responses. Hypothesis 0: Program Staff vs Referral Agencies (percent of group response by category). Effectiveness Ineffectiveness Program Referral Program Referral Staff Agencies Staff Agencies Functional Area Cited: Testing, Intake 0 47.4 8.3 26.3 Therapy 33.3 36.8 41.7 47.4 Case Review, Planning 33.3 5.3 16.7 5.3 Termination, Aftercare 16.7 0 O 10.5 Administration 0 5.3 8.3 O (as function) Clinical Supervision 8.3 O O 0 General Program, Other 0 5.3 25.0 0 Could Not Think of 8.3 O O 10.5 an Incident Nature of Response: Client Behavior 33.3 26.3 8.3 5.3 Functioning Staff Competence, Skill 16.7 21.1 8.3 15.8 Staff Attitude 8.3 21.1 8.3 10.5 Resource Availability 0 O 16.7 15.8 Cooperation, Communication 33.3 0 50.0 15.8 within the Program Cooperation, Communication 0 10.5 8.3 21.1 with Outside Agencies Efficiency, Effectiveness O 21.1 0 5.3 of Organization and Procedures Could Not Think of an 8.3 O O 10.5 Incident 101 a Poo. trek 8o. w e ere VI .m.z N.F u m m.o~ u .m.o ”ummkim mwmwgm>mupaz err **** mucmuwmmcmwm m.F w.m o. S.N m.SF F.N F. _.S m.m a.mp m m~.~ u .m.n ”mummkid mumwgm>_:: S.@ «.0 ¢.m S.N o.m o.m S.S S.S m.S m.S m mucmwpo N.“ m.N N.m m.w m.m N.o o.S m.o S.N 0.“ NF Swmum Emsmoga ”mmcoum 3mm 38 3d 00 VUV Odd 0.0 V S S I 01.. ILJ JJ 5U JJB Jud n d nu U Up. 90 5p 55 I..0.J 1:9. 1.. 0 d A .41: J5 93 J3 90.5 33 0 U .0 0 JI... It.“ UJ and Ulo U1? U 1. 0 .I. O 1.9 I: S 1+3U 1.I.. 0 P J A I Am 29 SD. 9w? 0.3 m U 1. S EU I...“ 1.. II. 110.. K a w 1p on: .L. I..l l. a W U U ..A 1. .Apmmmv m Econ "upmom ucmscocw>cm mamcmoca Smacmwco auwcaseoo .mucmwcm> mo mwmapmc< use mapsmmm ”m mwmmcuoazrii.Sm m4m_o>:H Form R (Real). COPES: Profiles. Figure l3.--Hypothesis E: 103 a «*kk VI :5. 8. w e «* kkm.0 u m w.op u .u.o "ummhim mpwwgm>wppzz *err ¥¥** «*kr «err kkkr «««¥ «k¥r mocwuw$wcmwm m.N a.mm m.m 0.0 0.0m S.NN m.0p o.mm 0.0m n.00 u NF.F u .m.o ”mummhid machc>Hcs 0.0 0.0 0.0 m.m 0.0 0.S m.v m.m m.m m.0 n mucwwpo v.0 m.m 0.0 m.n m.m 0.0 0.0 «.0 0.m 0.0 NP w$mum Emgmogm "mmcoum 3mm op m w m 0 m S m N P 2 not. quad nunu Hvuv nu.a.d AU.d ”V ,5 .5 .1 o 1. I.J J J .D U J J S J J n .0 n U U P P O .b D. .D.D I.0 J I.B 1. 0 .0 A 1} J5 ES JS SQS as no U 0 o J 1. I.J u J S J U 1.0 u 1. U .4 0 .I O 1.9 I. S .+.Snu «+1: 0 9 J A I. Km 29 SP em? 93 m U 1. S PU l.U 1. I. 1.9 A 9 w 110. CD. 1.. l.l.. 1.. 3 n... u 0 o 1.. u W U U ..A 1. .AHmmvHv H Econ umHmum ucmEcocH>cm Emcmoce umaccho an::EEoo .mucchm> Ho mmeHmc< new mpHamwm ”m mHmmgaoaxzii.mm ugmHo>=H Form I (Ideal). COPES: Profiles. Figure 14.--Hypothesis E: 105 Practical Orientation, Personal Problem Orientation, and Program Clarity subscales. In every case, the Staff score is higher than the Clients'. Hypothesis F: Program Staff vs. Parents of Clients Hypothesis F1 results (COPES Form R) are shown in Table 36 and Figure 15. The multivariate test shows a significant difference between profiles. The univariate test shows no significant differ- ences between individual subscales. The largest absolute difference that appears between subscales is in Order and Organization, with Staff seeing the program as more highly organized than do Parents. Hypothesis F2 results are presented in Table 37 and Figure 16 for COPES Form 1. The Multivariate test shows significant differences between the two profiles, but show no significant differences in the univariate tests. The greatest absolute difference is in the Spontaneity subscale, with Staff seeing more spontaneity than do Parents in their ideal programs. Results for Hypothesis F3--the Critical Incident responses-- are presented in Tables 38 and 39. There is a significant differ- ence in ineffectiveness criteria for nature of response. The ineffectiveness classifications for the Nature of Response category are shown in Table 39. mo. v a k. *mm.m u u oH.oH u .u.o 106 "emeh-e ...HcmsHeHaz mucmuHmmcmHm m mH.H u .m.o "mpmmhim mumHgm>ch mpcmHHu we managed meum segues; ”mucoum zem F m N LO [OJ1U03 JJPIS 4114913 weJBOJd uotqeztuefiuo pue JSpJO uoIssaJ66V pue JS5UV uotnenuaIJo malqoud 0 [EUOSJSd uotuenuaIJo [eogqoeud Kwouoanv S Anatuequods as 1Joddn5 a. zuawanlonul .— "mHmum ucmscocH>cm "m mwmmcuonzzii.0m NAm mo mHmszc< Sew mqumwm 107 o-——OProgram Staff .A._ A Parents of Clients H: x mmcoum 3mm Hoceeeu H...m xchmHu Emcmocm :oHHSNHcmmco a emcee :onmmgmm< a cmmc< :oHamuccho emHaoce Hmcomcmm :oHuouccho HmuHaumca Neocoua< qumcmpcoqm aconaam acmEm>Ho>cH Form R (Real). COPES: Profiles. Figure lS.--Hypothesis F: mo.vQ k. «NN.m n m op.op u .m.o 108 "emeH-d eHSHc.>HHH=z mucmuHHHcmHm d mH.H u .u.o ”mummhiu mumHLm>ch mucmHHu Ho mucmcwa wwmum Emgmogm ”mmgoom 3mm P w [x LO [OJ1U03 JJ91$ AiIJPIO weJBOJd uotqeztuefiuo pue JapJo uotssaJfifiv pue JS5UV UOI1P1USIJO IIISlQOJd 0 leuosuad uotzenuaIJo [PDI1DPJd Kmouonnv S Antauezuods en 1Joddns N nuawanlonul .— "mHmum acmscogw>cm "m mHmmcpoaxzii.Nm mgm<~ .HHeeSHV H Eco. mangoes; Smuccho AHH::EEou .mucmHgm> Ho mHmaHm=< use muHsmom 109 o——-o Program Staff b—--fl Parents of Clients 100' H H H d H H H u H I. 4 . \t K. I n" s a .ho H W n I I I I I. \ \\ \ .5 ‘ l ‘ . H .. H H p H p F 0 0 0 .U 0 0 0 0 0 9 8 7 .b 5 4 3 2 1 oH x mucoum 3mm Hoceeeu Heepm HuHcmHo Emcmoce :oHpmNHcmmco a cmuco :onmmcmm< a cmmc< :oHumuccho EmHnoce Hmcomcme coHumuccho HmuHuumcm Neocouz< quwcmucoam acoaazm acmEm>Ho>cH Form I (Ideal). COPES Profiles. Figure 16.-~Hypothesis F 110 TABLE 38.--Hypothesis F: Critical Incident Results. Chi2 Tests on Group Differences. Chi2 D.F. Functional Area Cited: Effectiveness 8.5 5 Ineffectiveness 11.1 6 Structural Area Cited: Effectiveness 2.5 3 Ineffectiveness 7.4 4 Nature of Response: Effectiveness 5.8 4 Ineffectiveness 17.9 7* 111 TABLE 39.--Summary of Critical Incident Responses. Hypothesis F: Program Staff vs Parents (percent of group response by category). Effectiveness Ineffectiveness Program Program Staff Parents Staff Parents Nature of Responses: Client Behavior, 33.3 66.7 8.3 9 Functioning Staff Competence, Skill 16.7 11.1 8.3 33.3 Staff Attitude 8.3 O 8.3 0 Resource Availability 0 O 16.7 0 Cooperation, Communication 33.3 0 50.0 0 within the Program Cooperation, Communication 0 O 8.3 O with Outside Agencies Efficiency, Effectiveness O O O 33.3 of Organization and Procedures Couldn't Think of an 8.3 22.2 0 33.3 Incident CHAPTER IV DISCUSSION General The thesis of this dissertation is that the effectiveness of an organization can be studied and broad conclusions drawn about its state of effectiveness by examining the organization's climate and process using an open systems approach. In addition, with a public social service organization such as the one under study, effectiveness criteria must be developed. Study of the different groups involved leads to hypothesizing certain inter-group differences which can be tested statistically. The nature of the study is such, however, that descriptive data ranks equally in weight with statistical tests. The question is not only "Is there a significant difference between groups?" but also "What are the perceptions and values of the groups involved?" Effectiveness Criteria An atheoretical approach to effectiveness may be desirable in order to avoid forcing responses into a preconceived theoretical mold, or forcing choices that fit only one or two theories of organization when factors involved in one or more other theories may, in fact, be operating. Difficulties are, of course, encountered in keeping data gathering entirely theory-free and this study is no 112 113 exception. Open-ended responses were obtained to the question "Can you think of something that has happened which has led you to believe that the program is operating effectively (ineffectively)?" were obtained from each respondent. Then each response was classi- fied into three categories, all of which have some theoretical roots. The first category is that of functional area of the program and the second is the structural area of the organization which was referred to by the respondent. These concepts of function and structure are well used and accepted in the field. The third category used is the nature of the response, i.e., what did the respondent say about the functional and structural areas referenced? The categorization here is drawn from both a Classical and a Human Relations approach. The results for the three categories will be discussed in order, beginning with the functional program area classifications shown in Table 14. The principal finding is that all respondents mentioned the program's therapeutic function most frequently, followed by the admission procedure (testing, intake, and referrals in), followed by administration as a function. Case reviews, plan- ning, and consulting follow in frequency. In interpreting this, it should be noted that this function is almost completely internal to the program and its existence or significance may not be known to many of the respondents who are outside of the program. It is here that detailed reports of progress are discussed amongst the program staff, individual treatment plans and goals are fomulated, and an updated prognosis set forth for the client. It would appear 114 that if this function were not effectively performed, that effective therapy would be far less likely. Clinical supervision was mentioned by only one staff member, yet it may be another key determinant of the effectiveness of the therapeutic effort. Hhile case reviews are public and focus on the client, clinical supervision is private and focuses on the individual therapist. Staff members, teachers excepted, are strongly encouraged to seek regular, formal sessions of supervision. This process involves discussion and resolution of problems the therapist perceives in the actual performance of therapy with clients. Content may range from coaching about appropriate techniques and procedures, exploration of the dynamic interaction between therapist and client, and dealing with the therapist's frustrations aroused through the therapeutic process. This function may range from technical discussions to some therapeutic content for the therapist. It may be viewed as a key both to professional growth and development for the therapist and an essential training component for the organization. The fact that it is not mentioned frequently by the individuals concerned (7 people) can be interpreted as meaning that they consider other things more important, or they do not think that the procedure has value for them at their current stage of development. The modal occurrence of the therapeutic function is not surprising because the principal service the program provides is 115 therapy for disturbed children. In view of this, this response might be expected more frequently than one-third of the time. Nevertheless, it remains the function which was most often involved in effectiveness criteria. Critical incident data classified by reference to organiza- tional structure is given in Table 15. The data from references to organizational structure in the critical incident responses shows the program staff, including the supervisor, referenced more than half the time, with clients and supervisor alOne following in frequency. This may reflect the high visibility of the supervisor's position with respect to everyone external to the program. Since therapy for disturbed children is the program's major function, some reference to the children themselves is not unexpected. Evaluation of therapeutic procedures almost always focuses on changes in attitude or behavior on the part of the client. It's apparent that this emphasis is not shared in effective- ness criteria for this particular therapeutic program, with thera- pists being cited with three times the frequency of clients. Considering Administration and Outside Agencies as a group, it should be noted that these parts of the organizational structure were cited almost completely (with only one exception) by external groups as sources of ineffectiveness, rather than by the program staff. Cognitive dissonance theory would lead to a hypothesis that people within the program would tend to see sources of effectiveness within the program and sources of ineffectiveness outside the program. This is not confirmed by the data in Table 15. 116 Critical incident data was also classified by the nature of the responses. These data are given in Table 16. In interpreting these response frequencies, one must recognize that they are not independent of the organization structure or function. For example, if therapy and program staff were referenced in a particular response, then there would be a high probability that staff competence or attitude or cooperation within the program would appear as the nature of the response. . This helps to explain the modal occurrence of Staff Competence in the response, since Program Staff and Supervisor were named 51% of the time in the structural criteria. Staff Competence, Client Behavior, and Cooperation with Outside Agencies were the classifications most frequently cited as effectiveness criteria. The Cooperation classification encompasses cooperation, conflict, communication, and non-communication. Generally, in response to the ineffectiveness critical incident classification a response in this classification indicated the dysfunctional area; for example the existence of dysfunctional conflict or non-communica- tion, when the respondent felt that communication should have occurred. Considering the cooperation classification inside and out- side the program, it occurs in 23% of the responses, or with nearly the same frequency as the modal response of 25% for Staff Competence. It appears, then, that staff and supervisor actions are named more than half the time in the nature of the response, about half of these responses are concerned with professional 117 competence as therapists and the other half of the responses are concerned with intra- and inter-program relationships. The purpose of the Critical Incident question was not to determine respondent's opinions of the state of effectiveness of the program. Some of the data may, however be viewed as an indica- tion that further exploration of a particular question may prove fruitful as a starting point in organizational change efforts. Compare the frequences between the effectiveness and ineffective- ness columns in Table 16. Client Behavior is cited in the effective- ness column approximately four times as often as it is in the ineffectiveness column. This could be construed as an indication that respondents consider that the program's effect on children is positive. This can only be a highly tentative conclusion, since only 16% of the respondents chose to address the question of client behavior at all. It does say, however, that of those who considered client behavior as an effectiveness criterion, a favorable response was obtained four times as often as an unfavor- able one. Staff Attitude and Motivation is mentioned with twice the frequency as an effectiveness criterion than as one for ineffectiveness. This could be construed to mean that staff morale is satisfactory. Conflict within the program is mentioned with about twice the frequency than is cooperation. This could indicate that there are unresolved conflicts remaining amongst the staff. In the same vein, cooperation and communication with 118 outside agencies may be another area where effectiveness could be increased. Social Climate Instruments Overall Results Figure l is a standard score plot of results of the Community Oriented Program Environment Scale, both Real and Ideal forms. Real responses all fall within two standard deviations of the norm group's mean, as do the Ideal responses. Overall, the respondents would like to see increased emphasis on the relationship dimensions of Involvement, Support and Spontaneity. The Autonomy scale is below the norm group, nearly significantly so, with the ideal very little higher. This may be explained by the norm group's composition having few children's programs included. It is probable that respondents would see less autonomy being appropriate for children than for adults. The Practical Orientation scale shows a large difference between Real and Ideal, with the latter being higher. The items in this scale are concerned with planning for the future, job orienta- tion, and client participation in planning for discharge. The entire group of respondents felt that these items should receive more emphasis. Again, norm group selection may have an effect. The items comprising this scale are more appropriate for adolescents than for younger children; in other words, the older the child, the more closely is the norm group's composition approached. If 119 respondents thought of older children in responding to these items, the Real-Ideal discrepancy becomes more understandable. Overall results for the Work Environment Scale are given in Figure 2, both Real and Ideal. These results are presented as Standard Scores, and it should be noted that the norm group results for Form I are not published. Both forms, then, are plotted against the norms for Form R. Sample sizes and composition are quite different from that obtained for COPES, as were the instructions given to respondents completing Form I (ideal). The Real form was administered to the program staff and line, as well as that portion of the organization staff who were familiar enough with the work environment of the program staff to complete it. As distance from the program increased, more and more resistance was encountered to completion of the Real form. Because of this, the sample actually obtained for the Real form consisted of the program staff and supervisor, the program director, the personnel director, his assistant, and the consulting psychiatrist; giving 16 respondents to Form R of the Work Environment Scale. The organizational composition of respondents to Form I is the same as Form R, with the addition of the Executive Director and the Community Mental Health Board. In other words, the entire organizational line was obtained for Form 1, but not for Form R. There were 24 responses to Form 1. All respondents had just com- pleted the Community Oriented Program Environment Scale, where 120 they were asked to "Think of an Ideal program, and tell whether the question would be true or false in your ideal program." For the Work Environment Scale Form I, respondents were instructed "You have an Ideal Program in mind. Now please think of an ideal work environment which would tend to encourage staff members to carry on this ideal program. Answer 'true' if you think the statement would be true of the ideal work environment, answer 'false' if you think the statement would not be true in the ideal work environment." The Ideal work environment, then, should encourage those staff behaviors that would lead to an ideal program environment. Respondents felt that Job Involvement, Peer Cohesion, and Staff Support (support of the program staff from management) would ideally be higher than it is now. The largest discrepancy (and a significant one) is in the Peer Cohesion subscale. This subscale is slightly below the norm, and respondents put the ideal about 2% standard deviations above the norm. To confirm the existence of a problem in peer cohesion, the nature of the response for Critical Incident from the staff themselves (Table 33) gives con- flict and lack of communication as the modal response for ineffec- tiveness (a frequency of 50%). This tends to confirm Peer Cohesion as one area in which program effectiveness can be improved. Task Orientation and Clarity of rules and procedures are slightly below the norm, with the ideal higher. Nork pressure is seen as being above the norm, with the ideal lower. It makes sense that low Task Orientation (the extent to which the climate 121 emphasizes good planning and efficiency, and encourages the staff to get the job done) and low Clarity would go hand in hand with high perceived Work Pressure. The remainder of the Work Environment results are not remarkable. The high discrepancy in Physical Comfort appears to be the result of a rather poorly designed hot air heating system, which leads to drafts, and temperature differentials between different parts of the building. This completes the discussion of overall results for the Critical Incident method, the Community Oriented Programs Environment Scale, and the Work Environment Scale. Effect of Organizational Stucture vs. Trainipg Data were grouped so as to examine the question of whether role in the organization (position in the organization structure) or the professional field in which training was taken had a signifi- cant effect on the respondent's perception of the program environ- ment, or on the choice of effectiveness criteria. The results of COPES Real and Ideal forms are given in Table 40 and for the Critical Incident responses are given in Table 41. Table 40 shows quite plainly that a respondent's position in the organization is associated with significant differences in both current perceptions of the program environment and his concept of an ideal program. The results summarized in Table 41 shows a definite tendency for the same independent variable to be associated with differences in choice of effectiveness criteria, as far as 122 TABLE 40.--Effect of Organization Structure vs Professional Training. Multivariate F-Test Independent Variable D.F. F Organizational Structure COPES Real 60,298 l.9**** COPES Ideal 60,298 2.8**** Professional Training COPES Real 90,363 1.10 COPES Ideal 90,363 1.19 **** p < .001 123 TABLE 41.--Effect of Organization Structure vs Professional Training on Critical Incident Results. 2 Independent Variable Chi D.F. Organizational Structure Function Cited: Effectiveness 86.1 45**** Ineffectiveness 86.9 40**** Structure Cited: Effectiveness 28.3 20 Ineffectiveness 40.7 30 Nature of Response: Effectiveness 58.9 30*** Ineffectiveness 45.8 35 Professional Training Function Cited: Effectiveness 64.6 54 Ineffectiveness 60.1 48 Structure Cited: Effectiveness 19.8 24 Ineffectiveness 37.9 36 Nature of Response: Effectiveness 46.2 36 Ineffectiveness 58.8 42* 'k p 5_.05 *** p §_.005 * t'k'k .001 124 function cited and the nature of the response to the critical incident question are concerned. In contrast, no significant differences in response are noted in the COPES criteria, and only one response classification barely reaches significance in the critical incident results when professional training is the independent variable. One question that arises is why the part of the organization cited in the Critical Incident response shows no difference. The answer most probably is that the preponderance of responses in this category refer to the program staff and supervisor--this appears to be one part of the effectiveness criteria on which respondents agree--hence no difference in this category is evident here. These results also bear on the possible effects of profes- sional training on the organization's ability to influence an employee. These results indicate that, in this organization at least, organizational influence (and more specifically, organiza- tional role) is the greater influence by far. Groups for each hypothesis coincide closely with those in the organizational structure classification, but it should be noted that not every possible pair of groups is examined. This means that all the inter-group differences which resulted in the data noted in Tables 40 and 41 will not necessarily be explained by the results and discussion of the various hypotheses made. 125 Hypothesis A: Internal vs. External This hypothesis is concerned with the differences between the program staff and supervisor, and all other respondents. Please recall that two statistical tests are run on each profile pair studied; ten univariate F-tests (one for each subscale) with a threshold of significance of .005 (.05 divided by ten tests), and a multivariate F-Test which tests for a difference in the overall profile with a threshold level of significance of .05. All tests for differences between profiles are run on raw scores, all profile plots depicted in the various figures are raw scores, unless other- wise noted. Perceptions of the program between these two groups show a significant difference in the Multivariate F-Test at a level of p = .008, as shown in Table 17. The Support subscale shows a significant difference (p = .0004) in the Univariate tests. Figure 3 shows the raw score plots, with the relationship subscales of Involvement, Support, and Spontaneity showing the largest absolute differences. In each case, the external group is higher. The Ideal results, presented in Table 18 and Figure 4 help to explain the group differences. The Ideal program for both groups is higher than the real on the relationship dimension and a possible explanation for the external group being higher on their perceptions of the program is that, the more the distance from the program increases (and hence, the less familiarity with it), the more a respondent's perception shifts towards their ideal program. 126 In comparing the Real and Ideal profiles, each group is seen to have a generally elevated Ideal profile over their Real profile. Absolute Real-Ideal differences were also calculated and tested for each group, and no statistical differences (multivariate or univariate) were found. The Ideal profiles are significantly different between the internal and external groups. Univariate analysis shows significant differences in the Involvement, Support, Practical Orientation, and Program Clarity subscales, with the external group being higher in each instance. If the clients are excluded entirely from these respondents, then no significant differences between these groups are found on either real or ideal scales. Interpretation of these results lead to some favorable and unfavorable explanations with respect to organizational effective- ness. These differences (between clients and the rest of the group) could arise because the staff is not clearly communicating their routine expectations and long-term goals to the clients. These differences could also arise because of characteristics of the clients themselves, specifically, that the differences arise because the clients are disturbed (first) and that they are adolescents (second). A psychologist's common assumption is that test results reflect a client's problem in some way, and that tentative hypotheses concerning diagnosis can be made from such results. In other words, test results are, at least in part, a reflection 127 of disturbance. If clients are disturbed, then (so the reasoning goes) their perceptions of their environment would be somewhat distorted. The degree and direction of such distortion would be a function of the degree and direction of the client's problem. The second point is that all of the client respondents were children, and specifically adolescents. Further, they were those adolescents whose attention span and state of mind were such that they could complete the instrument. Children generally are less patient than adults in awaiting gratification of their needs, and may also be more likely to disregard practical limitations surrounding their felt needs of the moment. In other words, if asked what they would like to have (or what they would like their program to be) they may respond quite freely, without regard to their own reality-based needs or the resource limitations of the program. The author's opinion (staff vs. clients will be reviewed in a later hypothesis) is that the perceived Support subscale deserves attention on the part of the staff. It seems likely that the children do not perceive the support from the staff or from each other that the staff perceives. It also seems likely that the significant differences in the Ideal form of the instrument may be attributed to confusion regarding their own goals, i.e., it is not considered a reflection on the effectiveness of the program, or of a serious conflict in the goals and values of those associated with the program. 128 The Critical Incident responses for individual hypotheses will be presented in two tables. The first will give the results of all Chi2 tests run on the appropriate groups, with responses categorized by functional and structural areas cited and by the nature of the response. Effectiveness and ineffectiveness responses are considered separately under each category. Table 19 is an example. Should the differences in either the Effectiveness or Ineffectiveness responses under any category reach a significance level of at least .05, then the detailed results will be reported for each significant category in the following table. Table 20 is an example. Should there be no differences, then refer to the overall Critical Incident results presented in Tables 14 through 16 in order to get a general idea of these responses. Turning to the results for Hypothesis A, Table 19 shows that there are differences in the Functional Area cited and in the Nature of the Response, but not in the Structural Area cited. Table 20 then gives detailed results for these two categories. The first significant finding is that there are differences in effectiveness criteria between these two groups, keeping in mind that clients did not participate in the critical incident procedure. Recall that, with clients excluded, there were no significant differences between the program perceptions or the goals and values of these two groups with respect to the program. Thus, it is possible for there to be no difference in COPES results, and still have differences in effectiveness criteria. 129 In the functional area, the largest difference in percent- ages is in case reviews and planning, with the internal group 25 percentage points higher than the external. Next is testing, intake, and referrals into the program with a 19 percentage point difference and the external group being higher. These differences are explain- able in terms of the functional relationship between these groups. The importance of the case review and planning function has already been explained, as well as the fact that those outside the program may not even be aware that it exists. A prime reason for contact between the program and out- siders is to select and admit clients. In view of this it is not surprising that some proportion of the external group (19%) considers this process as an effectiveness criteria. When they contact the program, they have a need which they are trying to satisfy, i.e., to discover whether a particular child can be helped by the program and to arrange for evaluation and admission if possible. If the program satisfies their needs (accepts the clients or arranges for an alternative placement) the external group member will be satis- fied. Similarly, if the procedure is not well handled, either technically (proper tests and observations not made, reports inadequate) or administratively (e.g., appointments not kept, delay in report preparation) the external group member will not be satisfied. Therapy is considered the most important function by both groups. Staff and supervisor repeatedly expressed concern about 130 the program's reputation with outsiders. The results show that the major determinants of the reputation are outsider's perceptions of the therapeutic process, and the testing and intake function. Staff competence, client behavior, and cooperation and communication were the responses cited most frequently. Continuing with the nature of the responses made, the staff consider that client behavior and functioning, and communication and cooperation within the program are important criteria. The external group agrees as far as client behavior is concerned, but does not consider internal communication issues to be an important effectiveness criteria, possibly because they are not aware that a problem exists. Hypothesis B: Low vs. High Levels in the Hierarchy In order to provide a sharper difference between the groups, the program supervisor was excluded from the data entirely. The program staff represents the lower end of the organizational line. The higher end of the line organization is represented by a group consisting of the Program Director, the Executive Director, and the Community Mental Health Board. There are no significant differences in the COPES results, either Real or Ideal, as shown in Tables 21 and 22, and Figures 5 and 6. Testing each group separately for Real-Ideal differences, no significant differences are found. Real results for the Work Environment Scale are shown in Table 23 and Figure 7. The Ideal form is summarized in Table 24 131 and Figure 8. No significant differences between profiles are found in the multivariate tests. The only univariate difference is in perceived Work Pressure with the program staff higher than the line. This difference could be due to distance from the program, and to the pressures arising from working in a program where Order and Organization and Program Clarity are relatively low and yet Autonomy (referring to clients) is also relatively low. This would mean that staff sees a program that is not particularly high in structure, yet they feel they cannot give clients a great deal of autonomy,aistate which would require structure. A conflict such as this could lead to high perceived work pressure. Generally, these results show that communication within the organizational hierarchy is satisfactory, and that goals and values both for the program and work environments are similar between the two groups. Referring to the overall results for the Work Environment Scale (Figure 2 is a standard score plot of these results) the largest Real-Ideal differences occur in the Peer Cohesion and Task Orientation subscales. This could lead to hypothesizing the existence of internal conflict and a certain amount of perceived general lack of goals that are clear and practically attainable. On the other hand, these results may simply be confirming that the therapeutic process is not structured, direct, and clear. This latter explanation becomes more probable if one considers that the group responses are not significantly different from the norm group, although both Peer cohesion and Task Orientation results are somewhat below the norm. 132 Another possible explanation is that client contact produces more stress than is appreciated by non-therapists. None of the line respondents are currently practicing therapists and some have not been trained as such. As far as the author can determine, the correlation of therapist effectiveness with weekly client contact hours is a research question that has not been studied. The Critical Incident results between these two groups show some barely significant differences in the structural areas cited and in the nature of the response. The significance tests are given in Table 25 and a summary for those categories which were significantly different are shown in Table 26. The structural category data shows the largest inter-group differences in the Supervisor Alone classification, with the line being higher than the program staff. The line tends to focus less on the clients and more on the staff, as shown in both the area cited and the nature of the responses. Ineffectiveness critical incidents show a tendency for line managers to consider staff competence, while staff considers internal conflict to be criteria for ineffectiveness. To an extent, these Critical Incidents reflect what the respondents consider the source of effectiveness or ineffectiveness to be, as well as an example of effectiveness criteria. It would seem logical that line might consider staff incompetence as a source of program ineffectiveness, while staff would see internal conflict as the source of ineffectiveness. 133 Hypothesis C: Line vs. Organizational Staff The line group for this hypothesis consists of the program supervisor, the program director, the executive director, and the Community Mental Health Board. The organizational staff consists of the Consulting Psychiatrist, the Personnel Director and his assistant, Program Planning, and Program Evaluation. There are no significant differences between these groups in the perceived or the ideal program environment, or in the Critical Incident results. Organizationally, this can be inter- preted as showing effective communication between staff and line in areas of shared goals and values for the program, and a similar- ity of effectiveness criteria. The results are summarized in Tables 27, 28, and 29. COPES profiles are shown in Figures 9 and 10. Hypothesis 0: Progpam Staff vs. Referral Agencies Results for COPES real profiles are shown in Table 30 and Figure 11. Ideal profiles are shown in Table 31 and Figure 12. No significant differences are found. 2 tests on the Critical Incident responses A summary of Chi are shown in Table 32. There are significant differences in the functional area referred to by the two groups, as well as the nature of their responses. The responses for these categories are summarized in Table 33. The most frequent staff responses in a functional area were to Therapy. Case Review and Planning, and Termination and 134 Aftercare, in that order. Referral agencies differed in that they referred to Intake Procedures more frequently. This is understand- able since these respondents have the most contact with the program through the intake procedures. The major difference in the nature of the responses is in the Efficiency and Effectiveness of Organization and Procedures, which is also reference to the Intake Procedures. In summary, the organizational position of the referral agencies seems to strongly effect their choice of effectiveness criteria for the program, with those areas bearing most heavily on dealings with outside agencies receiving emphasis. Hypothesis E: Program Staff vs. Clients Current perceptions of the program are given in Table 34 and Figure 13. Although the profiles appear quite divergent, the multivariate analysis shows no significant difference between profiles. Univariate analysis shows significant differences in the Involvement and Personal Problem Orientation subscales, with staff seeing these environmental components higher on these subscales than do the clients. In 9 of the 10 subscales, staff scores are higher. This indicates that the profiles may, in fact, be different and that the multivariate test does not reflect this due to the high variance in client scores. The possibility that client scores may differ from the rest of the group due to the fact that clients are considered disturbed has already been discussed. The differences in the Involvement and 135 Personal Problem Orientation subscales could be quite easily explained on this basis. It is also true, however, that staff consider both of these environmental components as important to therapy. This is reflected in their Ideal program responses. Thus an alternative explanation for the discrepancy is that seeing large amounts of these environmental components reduces dissonance for them (i.e., for the staff). This latter factor is somewhat confirmed by the fact that the Autonomy and Order and Organization Subscales have nearly identical scores between the two groups. These sub- scales are relatively concrete and carry little, if any, emotional content. Thus, defenses on the part of clients and cognitive dissonance reduction on the part of staff may not come into play very strongly. The Staff Real-Ideal difference is quite low on both of these subscales. The Ideal profiles are shown in Table 35 and Figure 14. Multivariate analysis shows a significant difference between the profiles. Univariate analysis shows highly significant differences in the Involvement, Support, Spontaneity, Autonomy, Practical Orientation, Personal Problem Orientation, and Program Clarity subscales. As previously discussed, most of these sharp differences are probably explainable by the fact clients do not have a clear idea of what they want from the program. This tends to be confirmed by the way their Ideal responses cluster around the 50 point on the scale. Random responses would tend to do this. 136 Hypothesis F: Pppgram Staff vs. Parents Profiles for staff and parents are shown in Table 36 and Figure 15, reflecting current perceptions of the program. The multivariate test shows that the differences between profiles are barely significant, but the univariate tests show no significant differences in individual subscales. Inspection of the profiles shows one or two subscale differences that appear larger than the others. These results may simply be the result of choosing the univariate level of signifi- cance at .005, which was done in the interests of conservation since 10 tests are run on the same data. Where the .05 significance level used for the univariate as well as the multivariate tests, then both the Autonomy and Order and Organization subscales would have shown significant differences. The author's inclination is to consider these results as showing no significant differences. The magnitude of p is borderline for the multivariate test (p = .02), the univariate tests and inspection of the profiles do not support the finding of a real inter-profile difference, and an assumption of no difference is the more conservative. The Ideal profiles and results are shown in Figure 16 and Table 37. Again, the univariate tests show no differences and the multivariate test shows that p is barely significant (p = .039). The same arguments hold as for the Real profiles, and these results will be treated as not being significantly different. 137 Chi2 test results for the critical incident responses are shown in Table 38. The nature of response category shows a signi- ficant difference for ineffectiveness. Table 39 summarizes the responses in this category. More than any other group, the parents focus on Client Behavior as a criterion of effectiveness, which is not surprising in view of the fact that they live with the clients, and have had them admitted to the program in hopes of seeing behavior and attitude changes. The author's impression from the Critical Incident interviews is that some parents are truly at their wit's end concerning their children's behavior, and are very anxious that the program prove to be effective in solving their child's problem. In evaluating this impression, one must bear in mind that if the program prove to be effective in solving the few choices left for the parents is total institutionalization of their child--a situation that is perhaps more frightening in prospect than it would be in fact. This helps explain why parents see their child's behavior as an effectiveness criterion, but never as an ineffectiveness criterion. The percentage difference between effectiveness and ineffectiveness for this response is the highest in the entire study (66.7% to 0%). The rest of the staff-parent criteria differ- ences are probably due to the facts that parents are external to the program, and as a group, have no professional training. These facts could help explain the discrepancies in Internal Cooperation 138 responses, and the high incidence of the rather general response classification of Efficiency of the Organization and Procedures. Viewing the program environment results together with the critical incident results, it speaks well for staff-parent communi- cation that parents view the program and its goals in nearly the same way as do staff. CHAPTER V SUMMARY AND CONCLUSIONS Summary Organizational effectiveness is not a clear and unified concept and the process of its determination is much less clear. This statement has even more force when public sector social service organizations are concerned, where there are fewer generally accepted standards of effectiveness. The purpose of this study is to supplement the rather sparse literature on the evaluation of the effectiveness of children's partial hospitalization programs. This is accomplished by establishing baseline levels of environmental and therapeutic perceptions of a program, by studying individual's differential perceptions of their work milieu as professionals and as employees, and by studying differential perceptions of effectiveness criteria as seen by various groups associated with the program. An open systems approach is used. The program studied is a children's partial hospitalization program in the Lansing, Michigan area. It is one of the programs administered by the Tri-County Community Mental Health Board. The program employs a multi-disciplinary staff of twelve persons, and serves 30 children ranging in age from 5 to 17. 139 140 There were 12 respondents from the program staff, 10 from the organization line, 6 from the organization staff, 7 clients, 9 parents of clients, 20 from agencies who refer clients to the program, and 8 from formal consumer advisory committees attached to the Community Mental Health Board. The total number of respondents is 72. Three instruments were used. The Community Oriented Program Environment Scale (COPES) was used to measure respondents' perceptions of the therapeutic environment; the Work Environment Scale (WES) to measure perceptions of the program staff's work environment; and two Critical Incident questions to develop effec- tiveness and ineffectiveness criteria. COPES and WES were used in two forms, Form R (real) to measure current perceptions of the therapeutic and work environments, and Form I (ideal) to define some characteristics of what respondents consider to be ideal environments; thus giving an indirect measure of their goals and values with respect to the program. Data were analyzed descriptively and statistically, using univariate and multivariate analysis of variance for COPES and wes, and the Chi2 statistic for the Critical Incident results. Overall results were analyzed as well as groupings by organizational position, and professional training. Independent variables were as follows: Internal (the the program) vs. external, program staff vs. line, line vs. organizational staff, program staff vs. referral agencies, program staff vs. clients, and program staff vs. parents of clients. 141 Overall results are within the norm groups on which the COPES and WES instruments were standardized. Organizational position overshadows professional training in all three instruments. Internal vs. external groups show differences in COPES Real results, and in effectiveness and ineffectiveness criteria. Different hierarchial levels show no significant differences in the thera- peutic or work environment instruments, but do show differences in ineffectiveness criteria. The line and organizational staff groups show no differences in either form of COPES, nor in effectiveness criteria. The program staff and referral agencies show no differences in COPES responses, and some barely significant differences in effectiveness criteria. Program staff and clients show significantly different responses to COPES, both real and ideal forms. Clients did not complete the critical incident questions. Program staff and parents of clients show barely significant differences in COPES responses and in ineffectiveness criteria. Conclusions Generally, an approach to organizational effectiveness through measurement of the work environment, the process employed in the work of the organization, and the development of effective- ness criteria using an open systems approach, appears to be viable. This conclusion is drawn from the reactions of participants as well as from the analysis of the data. Respondent's interest was aroused enough so that there were multiple requests for presentation 142 of the results following the conclusion of the study from groups ranging from the Program Staff to the Community Mental Health Board. This tends to support the further conclusion that the particular methodology employed was considered appropriate, and the results understandable and usable by those who are ultimately responsible for evaluation and change in the organization. The results of the pilot administration were used as survey-feedback data by the program staff at the beginning of their annual joint planning session, and appeared to be reasonably well accepted. The overall results for the COPES and WES show that the sample involved is not atypical of the sample on which the instru- ments were standardized. Some differences between the norm group and the study sample are expected because the norm group was composed of adults, and the study sample is about 10% children. An overall view of all hypotheses shows that significant differences seem to appear in the Critical Incident responses, even when there are few, if any, significant differences in either the COPES and WES results. Respondent's perceptions and goals of and for the program might be similar, and yet their choice of effectiveness criteria might be different. This is a significant reflection on a goal-oriented approach to developing effectiveness criteria. If organization member's goals and values concerning a program can be similar, and yet their effectiveness criteria be 143 different, then the development of effectiveness criteria from either formal or operative goals will not be valid. Similarly for criteria that are based on efficient use of resources. Use of resources was seldom mentioned by the respondents. and only mentioned when resource availability was seen as restrict- ing the program, i.e., it was mentioned as a criteria for ineffec- tiveness, but not as a criteria for effectiveness. This conclusion must be generalized with great caution, since it may not apply to those organizations whose existence may be threatened by inefficient resource use, e.g., transportation and manufacturing organizations. Possibly the most significant finding is that organizational role overshadows professional training in influencing respondent's perceptions of the existing program, goals and values associated with the program, and their choice of effectiveness criteria. This finding has more force in this particular organization since most respondents have less than five years experience in their fields and have had 6 or more years of training (nearly all hold master's degrees in their field, the supervisor holds a Doctorate). It would appear reasonable to expect professional considerations to be strongest during the first few years out of school, but in this organization these considerations are a weaker influence than organizational role- A consistently mentioned problem in this work group is internal conflict and lack of cohesiveness. The people in this group are trained to be aware of interpersonal dynamics and to 144 help others to modify their dysfunctional ways of interacting. One must conclude that such training will not necessarily result in cohesiveness or harmony within the work group. This has implica- tions for the usefulness of certain kinds of human relations train- ing that may be employed in any work group. Plainly, the acquisi- tion of quite a high level of knowledge and skill in human relations will not, by itself, produce harmony or cohesiveness in a work group. Apparently, such traditional considerations as organizational structure and leadership can have such antagonistic effects to this training, that the training does not predominate. The most common approach to the evaluation of treatment techniques found in the literature of mental health fields is the definition of some change in clients after the application of whatever treatment technique is being studied. One could reasonably expect this approach to be carried over to program evaluation. Yet, it does not. Overall, staff behavior or attitudes is the subject of effectiveness criteria more than half the time, clients about one-third of the time. One can only speculate about the reasons for this. For those not familiar with the program or clients, or for those who are not mental health professionals, it's much easier to evaluate staff behavior than client behavior. As an example, it's easy to judge that it's undesirable when a report is late; it's difficult to judge when a client runs shouting through the building whether he's getting better or worse. This tends to be confirmed 145 by the fact that when staff are mentioned in effectiveness criteria, only half of these references are to professional competence, the other half are to organizational relations. The Critical Incident method as used here is apparently more sensitive to inter-group differences than is COPES and WES. 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