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Agility in Adversity: Integrating Mindfulness and Principles of Adaptive Leadership in the Administration of a Community Mental Health Center
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- 자료유형학술지논문
- 저자명Raney, A. F.
- 학회/출판사/기관명Springer Science + Business Media
- 출판년도2014
- 언어영어
- 학술지명/학위논문주기Clinical social work journal
- 발행사항Vol.42No.3[2014]_x000D_
- ISBN/ISSN0091-1674
- 소개/요약The combination of mindfulness and adaptive leadership principles is a means by which a community mental health center has achieved program innovation and financial stability in an environment of decreased public funding. Mindfulness is present-oriented and reflective, is willing to cultivate uncertainty, and approaches operational and client care practices from a non-judgmental frame of mind. In addition, adaptive leadership, an approach developed by Ronald Heifetz and associates, considers crises to be opportunities and offers a set of guiding principles that help to direct the organization’s resilience while building mutual trust and creativity among administration, staff, and community. The case study focuses on how one community mental health center cultivates organizational agility in adversity, using mindfulness and adaptive leadership to guide the provision of resources for all stakeholders. As a result, staff members practice self-care at work, feel included in all administrative decisions, and participate in developing new and cost effective ways to serve the increasing needs of low-income clients in the midst of decreased funding. The relationship between administrators and clinicians is critical in creating a successful environment for serving clients. Why should clinicians care about administrative practice? In a national survey published in National Association of Social Workers &Center for Health Workforce Studies (2006), licensed social workers reported spending 72 % of their time engaged in administrative and management work. In the same survey, 73 % of the workers reported an increase in paperwork, 65 % noted an increase in caseload, and 68 % reported an increase in severity of client problems. It is understandable, then, that a frequent lament of clinicians is that increasing expectations of administrative work draw them away from their practice. Indeed, administrators who are charged with enforcing these rules are too often viewed as the “other” that must be rallied against. Social service agencies are particularly affected by these requirements, and many clinicians feel understandably frustrated in their efforts to provide excellent treatment while managing these responsibilities. Some become so discouraged that they leave agency jobs to seek other environments, such as private practice or other work altogether. It is imperative, however, that agency clinicians join with administrative leaders to take ownership of the therapeutic organizational system that demonstrates best therapeutic practices to clients and community. As we move to focus more holistically on treatment that combines the mind/body/spirit in practice, we must remember that these same concepts can establish the facilitating environment in which compassionate and healing practice occurs. Effective and efficient clinical programs are essential to successful community mental health organizations. This is a crucial combination in a managed care environment where best practices must be accompanied by very careful decision-making to ensure the best use of resources. Just as important, administrative efforts must be founded on principles and shared commitments that focus on staff support and a shared sense of mission and purpose. Organizational health depends upon a clinical staff team that is mission-focused, is engaged with clients and community, and is in open communication with administrators. This paper considers the nexus of administrative direction and clinical practice in an urban community mental health center where the principles of mindfulness and constructs of adaptive leadership provide the foundation for continuous organizational monitoring and improvement of service delivery. Socioeconomic conditions and historic circumstances establish the conditions for any social service organization. Currently, significant fiscal stressors at local, state, and federal funding levels intersect with an increasing severity of mental illness and social anxiety, resulting in a confluence of pressure upon community mental health centers to provide critical care in a very distressed environment (Goodman et al. 2013). Client needs often require expert, lifesaving responses while staff are stretched to provide best clinical practices and to meet ever-changing and extensive requirements for documentation. This situation is a challenge for everyone involved, from clients who deserve ready access to care and best treatment practices yet have difficulty finding adequate services (Santiago et al. 2013), to clinical staff who strive to provide client-centered interventions, to administrators who advocate for additional services with insurance providers as well as with local, state, and federal agencies. The implementation of the Affordable Care Act, although providing increased and well-deserved access to care, presents its own problems as providers scramble to understand requirements and provisions of these new measures. At the same time, providers are faced with the important responsibility of helping to support current clients who are making important decisions regarding their health care plans. No one solution exists to address the challenges facing nonprofit organizations in a managed health care environment, but teams of administrators and clinicians of mental health institutions and other social service agencies, can develop an atmosphere of resiliency and organizational agility in spite of such adversity by incorporating mindfulness practices and principles of adaptive leadership. Agency clinicians can no more remove themselves from participating and intervening in the environment in which they work than social workers can view clients from only one therapeutic perspective and ignore the context in which their clients live and work. Finally, it is important to note that these practices are derived from clinical work; they follow important clinical social work principles that honor clients and their preferences and prioritize a mission-focused perspective that considers mental health to be a right, not a privilege. In the following case study, examples come from one organization’s efforts to unite administration with clinical work, a stance that is very different from the common path of administering on the basis of constraints and limited resources.
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