Suchergebnisse

This dissertation will examine how street level bureaucrats (in this case, property managers) use their discretion to provide access to housing for permanent supportive housing facilities. Previous research has shown that there is a rate of 15-50% turnover in permanent supportive housing (PSH) facilities. What remains unknown is how decisions about client intake and eviction are made in such facilities. Case Study-qualitative methods such as field observations, unstructured interviews, and focus groups were utilized in order to understand the meaning of property manager discretion. Findings indicate that property managers' discretion is conditioned by policy context, task environment and organizational structure. Specifically, property managers evaluate whether or not to admit or evict residents based on agency expectations of them, which affect their working conditions. Agency expectations are constructed by organizational structures, which depend heavily on task environment and policy context. The social welfare implications to these findings are discussed.

Summary There continues to be a movement to address the gap between empirically supported treatment research and social services practice. While the general social services field values services based in science, many therapists' practices are not grounded in and directed by empirical evidence. This study was a secondary analysis of data collected from 17 (N = 17) social service organizations. The final sample consisted of 440 frontline therapists. Findings We find that about one-third (32.7%) of therapists are reluctant to use a new intervention if required by their state, agency, or supervisor. These reluctant empirically supported treatment users had higher levels of field experience (aOR = 1.02, 95% CI = 1.00, 1.05, p = .002) and more years at their present job (aOR = 1.05, 95% CI = 1.01, 1.09, p = .001). We also find an association between race (white versus nonwhite) and the likelihood of being reluctant to using empirically supported treatments, with nonwhites being more likely to be reluctant to use empirically supported treatments (aOR = 1.72, 95% CI = 1.00, 2.95, p = .001). Applications Outcomes indicate that there is a cohort of frontline clinical therapists who are reluctant to use new, empirically supported interventions even if mandated to do so. Organizational leaders may need to consider barriers such as therapist demographics (e.g. years in the field or at the agency), client demographics (e.g. race/ethnicity concordance), and the perceived level of cultural appropriateness of empirically supported treatments by therapists when determining strategies to achieve increased use of empirically supported treatments.

Abstract Background Substance abuse agencies have been slow to adopt and implement evidence-based practices (EBPs), due in part to poor provider morale and organizational climates that are not conducive to successful learning and integration of these practices. Person-organization fit theory suggests that alignment, or fit, between provider- and agency-level characteristics regarding the implementation of EBPs may influence provider morale and organizational learning climate and, thus, implementation success. The current study hypothesized that discrepancies, or lack of fit, between provider- and agency-level contextual factors would negatively predict provider morale and organizational learning climate, outcomes shown to be associated with successful EBP implementation. Methods Direct service providers (n = 120) from four substance abuse treatment agencies responded to a survey involving provider morale, organizational learning climate, agency expectations for EBP use, agency resources for EBP use, and provider attitudes towards EBP use. Difference scores between combinations of provider- and agency-level factors were computed to model provider-agency fit. Quadratic regression analyses were conducted to more adequately and comprehensively model the level of the dependent variables across the entire "fit continuum". Results Discrepancies, or misfit, between agency expectations and provider attitudes and between agency resources and provider attitudes were associated with poorer provider morale and weaker organizational learning climate. For all hypotheses, the curvilinear model of provider-agency discrepancies significantly predicted provider morale and organizational learning climate, indicating that both directions of misfit (provider factors more favorable than agency factors, and vice-versa) were detrimental to morale and climate. However, outcomes were most negative when providers viewed EBPs favorably, but perceived that agency expectations and resources were less supportive of EBP use. Conclusions The current research benefits from a strong theoretical framework, consistent findings, and significant practical implications for substance abuse treatment agencies. Comprehensive attempts to strengthen outcomes related to EBP implementation must consider both provider- and agency-level characteristics regarding EBP use. Organizational efforts to more closely align provider attitudes and agency priorities will likely constitute a key .