Posted: February 26th, 2023

Case Study

Students will provide a one page summary of each case activity within the assigned chapter for the week’s readings in the Lewis, Packard, and Lewis (2012) text. The students will include a summary of the challenges faced by the individuals in each particular case as well as an analysis of the strengths and limitations of the approach and state whether they believe the situation was resolved effectively. In addition, students will discuss if they would have proceeded differently. Each case summary is worth 5 points. Be sure to follow APA Publication Manual (7th edition) guidelines when writing your case summary. You will need a title page and references page. 

(Case Activity 5.1 on pages 114-115, Case Activity 6.1 on pages 137-138, and Case Activity 7.1 on pages 160-161.)

Students will provide a one page summary of each case activity within the assigned chapter for the week’s readings in the Lewis, Packard, and Lewis (2012) text. The students will include a summary of the challenges faced by the individuals in each particular case as well as an analysis of the strengths and limitations of the approach and state whether they believe the situation was resolved effectively. In addition, students will discuss if they would have proceeded differently. Each case summary is worth 5 points. Be sure to follow APA Publication Manual (7th edition) guidelines when writing your case summary. You will need a title page and references page. 

(Case Activity 5.1 on pages 114-115, Case Activity 6.1 on pages 137-138, and Case Activity 7.1 on pages 160-16

CASE ACTIVITY 5.1

THE UMBRELLA ORGANIZATION

The roots of the Atlantis Community Mental Health Center (ACMHC) were in its inpatient, outpatient, and emergency services. Although, in keeping with the federal mandate, consultation and education services had always been included, emphasis had never been placed on preventive, community-based interventions until a recent major upheaval.
In response to an evaluation report showing that many groups within its highly diverse geographic area were not being reached through traditional services, the board and administrative staff of the ACMHC decided to add several new service components. The new programs were to include an outreach program for families, a drug and alcoholism program, a crisis intervention team, and several storefront outposts that would encourage using the service by members of the minority community.
The ACMHC’s funding sources were uniformly in favor of this approach but would provide funding only if a major organizational change were made. The funding sources recognized that many of the proposed services were already being offered on a smaller scale by tiny, community-based agencies scattered throughout the area. Each of these small agencies had worked independently for years, often with unknowing duplication of the services of other organizations. This new thrust of the ACMHC was recognized as a possible vehicle for a more efficient approach to human services than had been possible before. It was suggested that the human service net- work of Atlantis develop more effective linkages, with each agency maintaining a degree of autonomy but with the organizations joining for the sharing of resources. The mental health center would act as the umbrella organization, offering community outreach services through existing local agencies rather than duplicating these services with the development of new programs.
Because of the obvious financial benefits to be gained through this cooperative endeavor, the mental health center and a number of community agencies made the commitment to developing a new organi- zational structure. A subcommittee, including a number of agency and center service deliverers, as well as funders and community members, was charged with the responsibility of drafting a suggested
structure, to which the various member agencies could respond. Of course, representatives of differing organizations brought divergent viewpoints to the meeting.
Hilary Johnson, the ACMHC’s program officer, represented a major source of funding for the orga- nization. Her primary concern was that services be effectively delivered at Atlantis without needless duplication of effort and without the usual endless competition among agencies for limited funds. She knew that all of the agencies involved provided greatly needed services, but she also knew that these services could be provided more efficiently through greater coordination. She thought it would be possi- ble to centralize the work of these agencies to accomplish common goals and to divide resources equitably among programs.
Caroline Brown, Juan Casel, and Evelyn Mays were all staff members of small, community-based agencies. Each of them brought to the meeting a high degree of concern for maintaining the nature of his or her own agency. They knew that their agencies’ strengths lay in their responsiveness to local needs and in the fact that their programs had been developed by community members. They had always resisted pressures to expand, recognizing that the smaller agency can sometimes maintain a degree of responsiveness and flexibility that a large organization cannot duplicate. They knew that fiscal realities meant they had to become part of a larger entity, but they also realized that there would be dangers involved in losing their own identities. They could not duplicate the center’s lack of accessibility; they understood that if that happened, they would go under.
Similarly, Nick Chan and Sally Allen, representing local citizens’ groups, recognized that maintaining accessibility would be important. They knew that many of their neighbors resisted using the services of the center but felt more comfortable in their dealings with the smaller agencies in their immediate neighbor hoods. They knew that the creative and open atmosphere of the small agencies needed to be maintained. Chan and Allen also realized, however, that the service consumers would be the losers if more efficient use of funds did not begin to take place.
Nelson Richards, director of the ACMHC, was most interested in the degree of centralization that could be accomplished. Although he would have preferred unilateral expansion of services on the part of the center, he recognized that some major benefits could be gained from using the center as an umbrella organization. He could see great possibilities for the sharing of resources. For instance, each agency could become part of the management information system so that the flow of clients from agency to agency would be enhanced. Common budgeting could mean a significant increase in the funding available for the center as a whole. Such activities as staff training, personnel, and purchasing could be centralized, so each agency would gain greatly in efficiency. Planning could be broadly based, and purchases could be made in money-saving quantities. Looking at it from a more humanistic standpoint, services to consumers would be improved, and no client would ever again be able to “fall between the cracks” because of lack of information or lack of comprehensiveness.
Melvin Hammond was also in favor of a high degree of centralization but for a different reason. As a human service consultant called in by the state funding agency, he knew that the best resource utili- zation would involve having one central agency to act as fiscal agent for funds. He recognized, however, that the direction this agency would take would depend to a great extent on the kind of organizational structure they developed. One possibility would be to departmentalize the new, enlarged organization by type of service, with all direct service providers in one department, all outreach specialists in another, and all community organizers in still another. A different alternative would be to divide the organization according to population served, with all drug abuse program personnel working in one department, all family service professionals in another, and so on. To Hammond, the important aspect of the organization was that workers should identify themselves with Atlantis rather than with their former agencies.
Each of these individuals had organizational priorities that differed. Yet the committee would need to decide on an organizational structure that would please everyone, at least to a degree, and that would work.
1.What are the major organizational issues involved here?

2.What do you see as the primary alternatives for the organizational structure?

3.What would be the implications of varying approaches to departmentalization?
If you were asked to give input to the committee, what organizational structure would you suggest? Why?

4.What processes would you suggest to ensure effective coordination, decision making, and communication among the various programs?

CASE ACTIVITY 6.1
DIRECTOR OF TRAINING
When the Atlantis Community Mental Health Center became an umbrella organization, the traditional services normally offered by the center were combined, for the first time, with the more nontraditional approaches favored by the small grassroots agencies in the community. ACMHC now included both “the center” and the “neighborhood outposts” that had formerly been independent agencies.
This drastic change in the organization brought with it the need for new approaches to training. now working under the Atlantis name, so they would have to provide professional-level services. He would leave the methods up to Shore, but the mental health skills of the community agency workers would need to be enhanced.
Shore began this work with great enthusiasm. He created, almost single-handedly, a series of work- shops designed to develop trainee competencies in individual, family, and group therapy. He also developed a complex schedule that would allow the workshops to be provided on-site at each of the neighborhood centers. She would know how to get these service providers more actively involved.
“Isabel, I’ve been given the authority to make these workshops compulsory,” Shore pointed out, “but I really don’t want to do that if I can avoid it. How can I light a fire under these people? You know them. Why aren’t they motivated?”
“As a matter of fact, you’re right,” Phillips responded. “I do know these people, and what I know about them is that they’re the most motivated people you’re ever going to see in your life. Every one of them has put in more hours in a week than you can imagine for pay that hardly puts them over the poverty level. They do it because they believe in what they’re doing and because they know how much they’re needed. When you say they’re not ‘motivated,’ I have a hard time picturing what you’re talking about.”
“Well, what I’m talking about is the fact that they’re not showing up for these workshops, which they know are encouraged by the director, which they know they have released time for, and which they don’t even have to step outside doors of their agencies to get to. Now, if these folks are so concerned about their work, something just doesn’t fit.”
“You’re right, Ellis. Something doesn’t fit, but the thing that doesn’t fit is your training program. What makes you think they need upgrading in their thera- peutic skills?”
“Isabel, are you kidding? That’s what I was hired to do. When Richards gave me the job, he told me that he didn’t care what methods I used, but that the skills of the paraprofessionals in the outreach programs had to be upgraded. That was the word he used: upgraded.”
“Well, let me tell you something about Richards. He’s completely out of touch with the community. He’s always been out of touch. He doesn’t know what the people need from the agencies, and he doesn’t know what kind of training the workers need. They don’t do therapy in those agencies. They don’t have the luxury of sitting in their offices dealing with one person at a time for months on end. They’re out there in the streets, getting people organized and helping them deal with real, concrete problems. In fact, has it ever occurred to you that you just might be designing all these beautiful training interventions for the wrong people? The folks in my agencies know what they’re doing. It’s the people in the center who need training. They don’t know how to do anything but therapy, and the community isn’t buying it. If you want to make a training contribution, why don’t you hire yourself some paraprofessionals as co trainers, go up to the center, and provide some on-site training on how to close the gap between the center and it so- called consumers? From what I hear, business isn’t exactly booming in that big granite building uptown.

1.If you were Ellis Shore, what steps might you take to develop a more comprehensive and appropriate training program?

2. What special leadership issues might be involved in a decentralized agency such as the ACMHC?

CASE ACTIVITY 7.1
THE TOKEN ECONOMY
Having worked as a therapist for a number of years, Jim Forrest had developed a high level of expertise in dealing with problems related to substance abuse. His work had included jobs in several settings, including a short-term detoxification program in a hospital, a community-based methadone treatment center, and
a community mental health outpatient program. Although his work with clients had always been
satisfying, two things continued to trouble him. One major issue for Forrest was that his experience had convinced him that his clients’ milieu was more important than any other aspect of treatment. Although one-to-one counseling could be helpful, it was always less important than the reinforcement clients got for various behaviors in their immediate social environments.
The other aspect of his work that tended to trou- ble him was the question of management. As a pro- fessional therapist, he had grown impatient with the pressure on him to stick to specific time lines and methods regardless of his clients’ needs. In each agency, managers tended to create methods of oper- ation based more on business principles and treat- ment costs than on the effects of various treatmentmodalities. Forrest felt that given the chance to do what he felt was best for his clients, he could work both effectively and efficiently.
Forrest finally had the chance to try out his ideas when he was invited by a former colleague to take on a job as head of a newly funded detoxification pro- gram being set up in one wing of the local community mental health center. The program had been funded to provide short-term services, and two of the thera- pists from the previous, smaller program were to remain on staff. With this exception, Jim would be free to develop the program in whatever way he saw fit. Funding was sufficient to provide for the hiring of a staff of four more professional therapists and eight paraprofessionals.
Forrest began interviewing potential employees, telling each of them the same thing. The program would be based on use of a token economy, meaning that clients would receive concrete and specific rein- forcements for behaviors that were consistent with responsible, adult conduct. Every staff member would need to be involved in recording and reinforcing appropriate client behaviors, for only then would the clients begin to learn new ways of dealing with their environment. Beyond this “bottom line” of commitment to the token economy as a treatment modality, professionals would be free to set their own hours and work with clients according to their best interests. Newcomers would be more closely supervised at first. Later they, too, might have the kind of freedom already granted to the experienced professionals.
Most of the new workers started in at their tasks with a high degree of enthusiasm. It was like a dream come true, and after a few weeks, Forrest began to think that he was already seeing results in terms of client change. A few problems, however, were begin- ning to surface.
First, Hugh Schmidt, one of the two therapists who had already been employed at the center, began to complain to anyone who would listen about the idea of the token economy. Schmidt believed that long-term therapy, insight, and intrapsychic change were the only ways to deal with substance abusers. Changes in behavior could not get at the root cause of the problem, and the token economy could change only concrete behavior, not attitudes. He continued to work with clients in the same way he always had, but the token economy was constantly being sabotaged.
Another member of the professional staff was troubled not by the token economy but by the free- dom Forrest allowed the employees. Carol Cooke pointed out that although the staff members had been enthusiastic at first, they would not maintain a high level of commitment unless they were aware of the rules and regulations governing their own behaviors. Forrest scoffed at these concerns until one Friday afternoon when he had to make a presentation at an out-of-town conference. When he realized he had forgotten something, he called the office. Not one of the professional staff members was there.
The problems Forrest had begun to face were minor, but they started to make him think. Could he maintain a central focus in the program if every member of the professional staff were not necessarily committed to it? Could he trust the professional staff in the way he had always wished to be trusted? The challenges began to seem a little more difficult than he had expected.

1. What do you think of Jim Forrest’s approach to the position of program administration? What are his strengths and weaknesses in dealing with his new leadership position?
2. If you were Forrest, what would you do about the problem Hugh Schmidt’s attitude poses? Is it necessary for the staff to work as a closely knit
team, or is there room for a great deal of variation?

3. What would you do about the problem Carol Cooke poses? Do employees—even trained professionals—need clearer behavioral guidelines than Forrest provided?
4.Do you think Forrest has the potential to be more effective than the business-oriented profes- sional managers he had encountered before?

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Case Study Summary 1

Jane Smith

Nova Southeastern University

HSDD 5500: Disability Services Administration

Dr. Alina Gonzalez

May 23, 2021

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Case Activity 1.1

There are two main challenges that Lillian Sanchez will face in her particular situation.

Firstly, she will be transitioning from a high school counselor to an elementary school counselor,

and therefore will be serving a new population of children with a unique set of personal and

educational problems (Lewis et al., 2012). Next, she will be tasked with the responsibility of

developing, implementing, and hopefully marketing and expanding, an entirely new program,

which can have its own distinct challenges and difficulties (Lewis et al., 2012). Additionally,

Lillian’s case presents with specific strengths and limitations. Her biggest strength in her

approach to this new career path is that she has past experience working both with elementary

aged children and as a school counselor (Lewis et al., 2012). Considering that this is a

completely new program being created, she is particularly well-equipped to be taking on this

position and to help the district expand this program into other schools. While Lillian is

confident in her abilities to effectively counsel these children and provide them with all the

necessary help and support, her biggest weakness and limitation in taking on this position and

this new project is her administrative and leadership skills and her ability to develop these skills

while simultaneously fulfilling her role as school counselor (Lewis et al., 2012).

I believe that in this situation, Lillian’s past experiences as both an elementary school

teacher and a high school counselor has provided her with enough background knowledge and

practical experience in both careers and with both age groups to succeed in this new career. In

addition, I feel that being given the chance to create a program where none existed before in a

field that she is extremely passionate about is an extremely unique opportunity. I personally

would have opted to take on this knew role and work with the school to develop this new

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elementary school counselor program. I think an important piece to consider in this decision is

the district’s expectations and proposed timeline. If I were in Lillian’s position, it would be

important for me to establish boundaries in what I would be able to accomplish with regards to

expanding the counselor program and consulting with new schools and within new districts. This

project is a big undertaking and I think it would be important to set clear expectations before

accepting the job. For example, the first year would be dedicated to planning and implementing

the program within my own school, the second year would be dedicated to modifying and

refining the program based on feedback from the past year, and the third year would be dedicated

to expanding the program and consulting with other schools in the development of additional

programs. I believe that this type of structure would set me up for a much less stressful and more

successful transition to my new position as elementary school counselor.

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Case Activity 2.1

In this case, Marcia Butler, Angela Ortiz, and Pam Collins recognized a need for a more

comprehensive program to better support the needs of women who are battered in their locality

(Lewis et al., 2012). This program would need to combine a variety of different supports and

services, such as physical refuge, medical services, personal and family therapy, and vocational

counseling (Lewis et al., 2012). The two major challenges that these individuals faced in the

development of this program is that they lacked the funds necessary to invest in creating and

growing this program, and that it would require a much more significant level of involvement

than they first anticipated. A notable strength to this program is that they already garnered a

significant amount of support in their effort to develop this program, not only from the general

manager of the Department of Human Services, but similarly from community agencies, such as

women’s shelters (Lewis et al., 2012). Conversely, the biggest limitation in the development of

this program is the commitment, initiative, and level of responsibility required of each individual

in order to succeed.

The fact that Marcia, Angela and Pam were able to recognize the above mentioned

limitation and still remained invested in and passionate about the development of this program

leads me to believe that they will be successful in their efforts. I believe that I would have

proceeded similarly if I was in the same situation as these individuals. They first brought the idea

to people in more senior leadership roles who they thought would be able to help, which would

be my first instinct as well. Subsequently, after recognizing that they would need to develop this

program themselves, they began to brainstorm and problem-solve ways to fund and further

advance this concept into reality. I believe that Marcia, Angela and Pam have the drive,

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resources, and support necessary to successful develop, implement, and grow this program into

something that could help a significant number of women and families. 


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Reference

Lewis, J. A., Packard, T. R., & Lewis, M. D. (2012). Management of human service programs

(5th ed.). Brooks/Cole.