Pennsylvania has been structured for integration since 1984
• CASSP
• SAP
all the way up to
• Single System of Care
The question arises – why does this system and other attempts across the country continue to fail?
Premise: Because Structure is not organization.
• Superordinate goal
• Strategy
• Staff
• Skills
• Style
• Systems
• Structure
Unless Pennsylvania changes the other six elements, its integration will not work.
• Superordinate goal is based upon the fundamental assumption as to why people behave atypically.
• Strategy relates to the theory of change – how does the change process relate the fundamental assumption to the expected outcomes?
• Staff relates to the values of management
• Skills are the manifested characteristics [attributes, capabilities, capacity and competence] of staff, which must be related to the theory of change.
• Style relates to the patterns of action and symbolic behavior of staff. What does lateness for meetings with a client symbolize?
• Systems relates to the formal and informal procedures that are carried out in the organizational unit.
• Structure relates to how we divide and coordinate tasks
Premise: The failure is primarily connected to the fundamental assumption
All of these elements are, or must be, interrelated. Presently we have a belief that atypical behavior is caused by deficit or pathology. Although systems may be integrated structurally, they have no related context – what is the educational, protective or corrections role with atypical clients in this context? They are required to separate clients between the pathological and the otherwise if they are to function.
If, on the other hand, the fundamental assumption is that clients behave atypically because of the way they think – every person who comes into contact with the client has a role.
We can identify six [06] functions of the transformational system:
Universal prevention – the sending of balanced and rational messages
Selected prevention – the intervention with at-risk students
Indicated prevention – the intervention with students manifesting atypical behaviors
Remedial Interventions- the intervention with students/families who are manifesting severe and persistent problems in living
Referral – the transfer of a child to a higher level of care
Assessment – An ongoing evaluation of the child/child management system for identification of messages and interpretations – this is not an event – it is a process
Premise: The first four create a functional matrix that can help define roles
The role of education is to
a) send balanced and rational messages [universal prevention]
b) listen for distorted ‘inner logic’ [early identification]
c) correct cognitive errors [selected prevention]
d) assessment
e) referral
f) provide academic instruction
The role of the protective agency is to
a) send balanced and rational messages [selected prevention]
b) listen for distorted ‘inner logic’ [early identification]
c) correct cognitive errors [indicated prevention]
d) assessment
e) referral
f) enforce protective rules
The role of the corrective agency is to
a) send balanced and rational messages [selected prevention]
b) listen for distorted ‘inner logic’ [identification]
c) correct cognitive errors [indicated prevention]
d) reconstruct ‘inner logic’ [remedial intervention]
e) assessment
f) referral
g) enforce corrective rules
The role of the clinician is to
a) send balanced and rational messages [selected intervention]
b) correct cognitive errors [indicated intervention]
c) reconstruct the ‘inner logic’ [remedial intervention]
d) assessment
The role of the family is to
a) send balanced and rational messages [universal prevention]
b) listen for distorted ‘inner logic’ [early identification]
c) referral
The role of the community is to
a) send balanced and rational messages [universal prevention]
b) listen for distorted ‘inner logic’ [early identification]
c) referral
While the language may be somewhat ambiguous and have slightly different meanings for different functions, each of these entities has a clear role in the transformational process. Ambiguity occurs when the primary function is intense – such as crisis intervention, but a universal intervention – balanced and rational messages – is a criterion of the function. Because the individual has already been selected or indicated – the universal application appears to be paradoxical language. However, everyone in the system is expected to provide balanced and rational messages at all times, regardless of the functional level on which they are performing. Ergo, a guard in a high security detention center has an absolute responsibility to enforce the rules of the center while continuing to send balanced and rational messages. this may require the invention of new language and vocabulary to accomplish this is a manner that satisfies both responsibilities.
Premise: the transformational system will need to create a new language and vocabulary that is balanced and rational and can be used across all aspects of the system
In addition, the change in fundamental assumption should cause cross training to become substantially easier. A cross system case manager, for example, would need to learn about each of the functions of universal, selected, indicated prevention and remedial interventions, understand referral, and something about the rules of protection and correction.
Premise: any system must have the ability to ‘learn’ from feedback regarding is impact on reaching the initial outcome expectations
This will require clarity on what outcomes are expected and the measures to be used to determine how close we are to reaching such expectations. Are we to measure the degree of ‘integration’ of the system, or the expected outcome of such integration, or both?
1. Superordinate Goals: The mission statement must include:
• the fundamental assumption
• the expected outcome
• the means to measure that outcome
• the means to use and respond to the variance between the expectations and the results.
2. Strategy: The strategy defines the unique value of this system as compared to all other systems. This is normally developed through a consensus. The collective discovery of the summum bonum, (life’s greatest good) cannot be determined without a discussion of philosophy. “The right act can readily be known once the greatest good has been determined, for it becomes simply that act which enhances the realization of the greatest good, and the immoral act is that mode of behavior which is a deterrent to its realization” [Sahakian & Sahakian, 1993]. The strategy defines the greatest good.
3: Systems: The systems are the formal and informal procedures of the organization. All systems [formal & informal] must be coherent with the superordinate goals and strategy. Therefore the development of such procedures is vital, but the content cannot be achieved without the superordinate goals and strategy being complete.
The tactical plans of each department [operations, finance, human resources, etc. Must define “right actions” which enhance the “greatest good” as defined by the system leadership.
4. Staff: The employment and deployment of staff are indicative of the basic values of management. These basic values must be made coherent with the Superordinate Goals. If natural supports are a vital part of the intention; then management must find and use professional staff who are capable of motivating, training and supporting the most resistive families in the process of providing prescribed services to their children through child management practices.
5. Skills: The attributes, capabilities, capacity or competence of the staff are their skills. If teaching is not one of these, the parents are unlikely to every be able to carry out their 24/7 interventions. A determination of skills that are coherent with the Superordinate Goals and Strategy is the first step; followed by training and keen observation and discussion to determine whether the personal goals of staff match up with the organizational goals.
6. Style: Every organization has its own personality. It is formal or informal; pleasant or unpleasant; bureaucratic or flexible in whatever combination or degree. The style of an organization is determined by its patterns of action or symbolic behavior. Whether the Superordinate Goals are ever attainable is highly contingent upon the prospective target group being able to feel that the style reflects the Goals. Parents become oppositional when they feel they are being shut out.
7. Structure: defines the task division and coordination. One of the historic difficulties of structure has been the inability to take people off the “factory” floor to provide ‘temporary” services. Another structure issue has to do with heterogeneous/homogeneous groups. With the former, a decentralized structure is possible, while the latter tends towards centralization. The educational system has a broad distribution pattern that covers the County, while the mental health and mental retardation systems are less well distributed. The combination of systems for better distribution needs consideration.