This is a proposal oriented on the following assumptions:
- children should receive services in their own home, school and community maintaining at all costs full community membership and maintaining valued social roles.
- children cannot receive effective services through the present system both by reason of technology and by reason of distribution.
- children learn behaviors and find support for them through a variety of systems including family, peer group, schools, etc. and all systems must be coherent in providing support for prosocial outcomes.
- schools are the valued setting for children and provide the first socio-cultural challenge to the child; therefore they become a major setting for social education.
- schools are already the predominant provider of service to children with mental health and delinquency problems although funds are siphoned off to other systems.
Additionally, the proposal assumes that a major transformation can occur which will result in a system of service to children which has a positive impact on the culture which recursively will have a positive impact on children. The change is major – moving as it does from a defect to a competence culture; potentialities instead of limits; and with a dramatic shift in power.
The value of thinking in terms of possibilities rather than of limits is great, whether we are assessing ourselves or others; but it is surely at its greatest when we are assessing children. [Donaldson, 1993]
The Commonwealth of Pennsylvania has 2.8 million young people under the age of eighteen. Many of these children are having problems in living although it is difficult to identify the specifics of either the problem OR the solutions. The Bureau of Special Education1 reports that there are approximately 200,000 children with disabilities and identifies slightly more than 16,000 with emotional disturbance and eligible for specially designed instruction. At the same time the Office of Mental Health Children’s Bureau2 indicates that 192,000 children are likely to have mental health problems. 83,000 of those afflicted with mental disorders are likely to be severe. The mental health system plans to serve only about 51,000 of the total 192,000 and 15,000 of the 83,000 with severe difficulties during the coming year.
Projections of Mental Health Services
The substantial difference between the projections of need and of those who will be provided service suggests that schools or other child serving agencies will be required to fill in the gaps. In fact, if one assumes that schools identify only children with severe mental health problems as serious emotionally disturbed, it would appear that schools provide more serious mental health services than does mental health! Since among child serving agencies, school [with the exception of protective services] is the only mandatory service, it would imply that the largest provider of services to children with mental health problems are public schools [since the 192,000 need to go to school] although they identify only a small percentage for special care. Added to this the fact that many of the 51,000 who do receive mental health services can also be expected to be in public schools and you get a full sense of the schools experiences. This does not include children with severe problems in living that are documented by dependency or delinquency, who also are mandated to go to school.
The Pennsylvania KIDS COUNT4 add that 448,000 children live in poverty, which has a major correlation to metal health problems, dependency and delinquency. The report card for children in Pennsylvania as indicated by these combined reports remains quite vague, although certainly not good. 16% of our children appear to be living in poverty and about 14% have or are projected to have specific disabilities. The relationship between these two cohorts is inferred, but not documented. Regardless of the configuration, the statistics indicate some real areas for concern. The level of poverty and disability is higher than an enlightened society might desire. Somewhere between 16% and 30% of the children in the Commonwealth are potentially not living an appropriate quality life. Of even more concern is the indication that this situation over the last forty years has gotten worse, not better despite some recent improvements. From which one could easily infer that present social technologies are ineffective and that the improved effects occur only when the overall social and economic circumstances occur or the population ages.
We would suggest that the most ineffective of all of the interventions are those that attempt to control the child’s behavior. Not only are such attempts impossible, they have effectively enhanced a society in which responsibility for personal behavior is minimized. The current public debate over the appropriate role of government [the allocation of resources and the implementation of social strategies] in assuring that each of these children achieves and maintains an optimal level of physical and psychological fitness and lives in a safe and secure environment address the core issue of personal responsibility versus public programs. While many people see such debate as a threat to the survival of the Commonwealth’s most vulnerable children; such a debate might properly be also be viewed as an opportunity. The professional literature is unfortunately replete5 with evidence of the failure of present human service efforts to provide adequately for children with emotional and behavioral disabilities and worse yet, failure to be effective with those for whom it does provide. Those who believe that what we are doing is the right thing and that all we need is more money to do the job right seem to miss the point. If we continue to do what we have been doing, we will continue to get what we’ve got, and the record shows that that is not even close to satisfactory.
Whether we spend more or less money on children in the coming years is not the appropriate point of the debate. If we can agree on the goal of adequately providing an appropriate message of personal responsibility for all children; then the truly moot points are the development of effective [quality outcomes] and efficient [prudent expenditures] strategies. Even if such strategies are more expensive in the short term, positive outcome would make them less expensive in the long term since increasing numbers of children with problems in living would become contributing citizens as adults and the numbers of children with such difficulties would diminish over time. An ounce of prevention might well be worth a pound of cure; but the prevention must work effective in order to make this so.
The real fear for many of us is that the desire to cut public budgets will cause both short term and long-term loss, in that we will cut current spending while continuing the current ineffective strategies thus getting the worst of both actions. Unfortunately those who oppose budgetary cuts continue to propagate the faith in present activities, which makes the likely compromise to be the continuation of failed technology, but with reduced resources. This position in light of the continued failure seems to be a survivalist position instead of a strategic position. It indicates a greater desire to maintain the system and its employees than to provide the best technology for children.
An ideal outcome, it would seem, would be to identify very different strategies that are both effective and less costly. It is to this end, that recommendations for dramatic change are made regarding one aspect of the overall strategy to improve the lives of children. This recommendation is in the development technologies that have been proven in research and the market place over the past twenty years, although they have been unable to gain a solid share of the market because of the preeminence of the present advocates. This technology of psychological fitness is based on social learning theory and is built around cognitive change and behavioral skill building. The term “psychological fitness” is, to our way of thinking, more accurately than the metaphor, “mental health ‘ and its companion, “mental illness”.
The continued need to have people ‘feel good’ rather than achieve; the continued view that people ‘cannot help themselves’; the continued need to ‘protect’ clients, the public and the experts themselves from a fear that is self created makes it unlikely that the present system will ever be able to perform using a more positive and enlightened technology. The expert belief that the person with severe and persistent problems in living [the mentally ill] is not in control of their own behavior because of a pathology, would defeat the very fabric of the cognitive technology.
A further concern is that people with problems in living need to be served in valued settings. The arena for cognitive technology should be in settings in which all children participate; home, school and community, not placed in a setting that stigmatizes and reduces social role. Such a change would produce two major difficulties for the traditional system. First, since the person is seen as ‘not in control’ of his/her own behavior, there would be a sense of ‘danger’ and the need for restrictions and protections. Second, such a change which eliminates many of the ‘factories’ of social intervention; the physical locations which are both costly and act as assets for the helping organization.
What is being suggested then is a strategy that would provide to the child, the family and the community the skills, services and supports which are necessary to create an environment for psychological fitness. In addition, it is expected that such involvements would cost less than the present strategies while having more impact through positive outcome and, at the same time, support personal responsibility and rights of the individual. If this seems too good to be true, it should be indicated that the strategy is less well demonstrated in regard to the remedial impact than it is for the developmental and preventative aspect. This is not to indicate that its effect on children who have accumulated severe emotional problems within the present environment and helping system is not effective, only that it has not been demonstrated by many people over time because it has not been tried. If we are to be consistent, we must expect that any new technology must demonstrate quality outcomes across many children and families over time. The present medical model technology with its coercive approaches and restricted locations has had substantial opportunity to demonstrate its effectiveness, and by every indicator, has failed. There is every confidence that the experimental evidence of effectiveness of the cognitive/behavioral technology in remedial situations will be supported in the applied world. And if it does not, we will find something better.
The system of human service delivery management must also be re-tooled in this regard. The implementing organization must be designed as a learning system so that we do not duplicate the continued failures of the last half-century through the establishment of a status group of experts who, although continuing to fail, go unchallenged. The system must be built along continuous quality improvement lines so that the focus on material outcomes, which affect the quality of life is constantly and consistently identified, sought, measured and improved. No longer can our society tolerate a system that defines a limitation of negative outcomes as its goal and then, despite continued failure to achieve even this limited goal, blames it on the lack of funds.
The system must be built on a basic trust in human beings to do the right things, not on the belief that people are defective and deficient. The Theory X of Douglas McGregor suggests that people are naturally lazy, hate work, shirk responsibility, have to be controlled and coerced into exerting effort on behalf of organizational goals, and are concerned primarily with security. In contrast, his Theory Y holds that work is as natural as play or rest, that people can learn to accept responsibility and to be resourceful, creative and imaginative at work, that workers exert great efforts to achieve goals to which they are committed, particularly when attaining those goals leads to a sense of ego fulfillment and self-actualization, and that current organizational arrangements engage only a small part of their members’ productive potential.
History suggests is that human services apply Theory X not only to their own staff, but the people they serve. It is time for Theory Y.
Many offenders are accustomed to feeling unfairly treated and have learned a defiant, hostile attitude as part of their basic orientation toward life and other people. Offenders often think they are entitled to a kind of absolute freedom in the way they conduct their lives. From this point of view, any restriction of their freedom is resented as an unjust intrusion. Relationships with other people are dominated by a struggle for power. Win-lose (us & them) is the dominant form of personal relationship. They picture themselves as the victim and righteous anger displaces the feelings of loss and failure. This logic is a vicious cycle. Whether they win or lose, the underlying cognitive structure is reinforced. John M. Bush & Brian Bilodeau
Aggressive and violent behaviors are increasing among children and youth in America’s schools. Although many children and adolescents occasionally exhibit aggressive and sometimes antisocial behaviors in the course of development, and alarming increase is taking place in the significant number of youth who confront their parents, teachers, and schools with persistent threatening and destructive behaviors. Students who exhibit chronic patterns of hostile, aggressive, and defiant behaviors frequently are characterized as having oppositional disorders or conduct disorders (Kazdin, 1987; Horne & Sayger, 1990), and their behaviors are increasingly identified as antisocial (Wasker, Colvin, & Ramsey, 1995). [Rutherford & Nelson]
There are essentially two broad clusters of childhood disorders:
- Over-controlled or internalizers
This group contains children with social anxieties and withdrawal
- Under-controlled or externalizers
This group contains children who are identified as having a conduct disordered, oppositional defiant disorder or attention-deficit hyperactivity disorder. The under-controlled child lacks or has insufficient control over personal behavior that is expected in a given setting.
While it is the under-controlled child with external antisocial behaviors who draws our attention, schools are equally concerned with children who internalize and withdraw. Teen suicide is an ominous reminder of our failure to pay sufficient attention6.
It is the nature and frequency of behavior patterns that are used to define a person’s level of social competence. Social competence is defined as capacity to expectation. The ability to draw upon a varied repertoire of socially appropriate behaviors pursuant to goal attainment may be considered an important feature of social competence. For purposes of this proposal, our focus is to identify and provide outcome oriented services to children whose externalized behaviors are not socially competent and interfere with the ability of the child to develop mutually satisfactory relationships with adults and peers; and to identify and provide outcome oriented services to children with internalized behaviors. This approach differs dramatically form the ‘one size fits all’ or ‘symptom focused’ interventions presently in use. The central assumption behind our approach is that disorders are acquired and maintained primarily through social learning processes.
The distinction between difficult behaviors and “behavior disorders” lies in the severity and extent of such behavior. It is the degree of the disruption or destruction, the frequency of occurrence of the behaviors in more than one setting, and the persistence of these behaviors over time.
When antisocial behavior endures for at least six months, causes impairment in home, social and school functioning and takes a form deemed more serious and intense than ordinary mischief, a child qualifies for a primary diagnosis of either conduct disorder or severe oppositional defiant disorder [Diagnostic and Statistical Manual].
Thus a social judgement is made which separates normal child behavior from a ‘mental health’ behavior. While a body of knowledge hones such judgement, it has a down side effect of requiring a negative judgement in order to make the child eligible for services. Our belief is that behavior is a continuum and that prevention requires that we serve a child at the earliest point of identification. Because young children who exhibit such behaviors are clearly at risk, there is strong justification for the development of effective early intervention strategies.
A child develops within a complex system of relationships affected by multiple levels of the surrounding environment. Further, it is clear that these various influences have differing levels of influence at different points of development. While the family has the earliest and most profound effect on the emerging person, there are really several interrelated affectional systems that influence [shape] and maintain [reinforce] behavior. These include the mother-infant affectional system that is sustained or terminated in varying degrees and include the onset of father affection and the age group or peer affectional system that concludes with the heterosexual affectional system. Holistic perspectives may be helpful in creative design of corrective interventions.
The seminal work of Patterson and his colleagues that has demonstrated convincingly that families with a conduct-disordered child often have problematic reactions was instrumental in the development of a core model for social learning family intervention.
It should not be presumed that such statements indicate that parents are at fault. There is no blame required to note that parents and other significant adults have a major influence on how their children develop. If that statement is true, it is significant to help parents and others make choices about how they interact with their children in a manner that is most likely to bring about positive results. However, we have few practical approaches offered to families to support them in creating an environment of growth and development, and unfortunately, there are many influences which can diminish family members ability to provide effective for themselves even if they had such knowledge.
We can start with the mother-infant affectional system that prepares the child for the perplexing problems of peer adjustment by providing basic feelings of security and trust. Playmates determine social and sexual destiny, but without the certain knowledge of a safe haven, a potential playmate can at first sight be a frightening thing [Harlow, 1974]. When the mother suffers from her own problems in living or is overwhelmed by stressors, the safe haven may not prevail.
- Parents who are exposed to high levels of insularity and other personal or environmental stressors demonstrate deficient perceptions of their child’s behavior, engage in longer and more inconsistent coercive episodes in the home and have children who display more oppositional behavior.
- Depressed mothers are more punitive in their perspectives on child-rearing practices and less knowledgeable of their children’s developmental milestones.
- Highly distressed families are not likely to use or consistently apply effective child-management skills. Personal and marital problems may interfere with a parent’s ability to accurately focus on their child or to assimilate new child-management patterns.
Each of these examples indicates how family breakdown can contribute to a lack of security and trust. Additionally, the behaviors of such a family are models for the child. In a comprehensive review of treatment research for childhood aggressive and antisocial behavior, Kazdin  identified structured family intervention based on behavioral social learning principles as the most promising treatment tested. For children with externalizing behaviors, intervention with families is mandated if behaviors are to be effectively addressed. It is important also that family services address the individual issues of family member. Maternal depression in particular seems to have a major effect on the development of child behaviors. While schools do not traditionally provide services to families, the failure to have effective services leaves the school without support.
Probably the most pervading and important of all the affectional systems in terms of long-range personal-social adjustment is the age-mate affectional system. One of the primary functions of peer play is the discovery and utilization of social and cultural patterns. [Harlow – 1974]
Peer relations develop through the transient social interactions among babies, crystallize with the formation of social relationships among children, and then progressively expand during childhood, preadolescence, adolescence and adulthood.
We are aware that markedly antisocial children often experience negative repercussions in the form of peer rejection [Berman, 1986; Cantrell & Prinz, 1985; Shantz, 1986]. Since the peer group is predominant in the development of social and sexual destiny, such rejection is substantive.
Traditional interventions also contribute to an interruption of full community membership by placing students with externalizing behaviors in restrictive settings away from normal peer groups and with a peer group more likely to foster and maintain social behaviors that are unacceptable.
Internalizing children are often so fearful or sad, that they withdraw from peer play even when their behavior is not sufficiently different to merit rejection, thus suffering a similar deprivation.
An ecological approach goes beyond intrafamilial or intrainindividual factors and views maladjustment as a problems across entire ecosystems [Haley, 1973]. The aim is to change transactions within and between all pertinent environmental systems that serve to maintain, or to be maintained by, a child’s deviant behaviors. Intervention should be directed across four ecological domains:
- individual adjustment factors,
- interactions in the family [microsystems],
- extrafamilial systems [mesosystem – connections among micro systems, such as home, school and neighborhood, and
- cultural community systems [macrosystem – includes values, laws and customs] [Miller & Prinz, 1990].
Such an approach is not possible when one believes that pathology is the issue and when eligibility thresholds prevail rather than continuum of behavior.
All of the proposed interventions are based on a fundamental assumption that a person is literally what s/he thinks and her character is the complete sum of all thoughts. Acceptance of such an assumption requires that the clinician understand that traditional medical and psychodynamic techniques send messages and cause thoughts or support belief systems that are not particularly helpful to cognitive and behavioral change. Language control is required as well, for language is one of the wonders of the natural world. “… you and I belong to a species with a remarkable ability: we can shape events in each other’s brains with exquisite precision. Simply by making noises with our mouths, we can reliably cause precise new combinations of ideas to arise in each others minds” [Pinker, 1994]. Thus clinicians will need particular training in the use and abuse of language and sensitivity as to what combination of ideas we intend.
Additionally, children with antisocial behaviors and particularly their families are often seen as resistive to help. Researchers have found a correlation between such resistance following specific therapist behaviors. Moreover, certain therapist behaviors have been shown to significantly affect the probability that a parent will respond with resistance [Alexander et al, 1976; Chamberlain & Baldwin, 1987; Chamberlain et al, 1984; Chamberlain & Ray, 1988]. Clinicians need to receive training in supporting and reframing interactional techniques.
Since working with resistant families and children with problem behaviors is rather tedious work, it is also recommended that a weekly staff support group be convened to help maintain the enthusiasm required to interact effectively.
It does no good to preach, to present your ‘expert opinions’ or to tell them what their mistakes are. Our goal is to teach them to see. A condition of seeing is that they use their own eyes.
To predict what form resistance might take, managers need to be aware of the four most common reasons people resist change. These include: a desire not to lose something of value, a misunderstanding of the change and its implications, a belief that the change does not make sense for the organization, and a low tolerance for change.
In making the shift from traditional models of serving people with problems in living to a transitional model dedicated to the use of prosocial education, one is required to look at the full range of organizational elements identified as structure, strategy, systems, style, skills, staff and superordinate goals7 . It is not sufficient to focus on one organizational element as a multiplicity of factors influence an organization’s ability to change.
The diagram intends to convey the notion of the interconnectedness of the variables – the idea is that it is difficult, perhaps impossible, to make significant progress in one area without making progress in the others as well. The shape of the diagram is also significant. It has no starting point or implied hierarchy. A priori, it isn’t obvious which of the seven elements will be the driving force in a particular organization. The following chart compares the transformation model to the traditional model
|Organizational Elements||Traditional Model||Transformational Model|
|Superordinate Goals Fundamental Assumption||Pathology & Cure||Cognition & Learning|
|Strategy Unique Value||Control||Choice & Personal Responsibility|
Basic Values of Management
Attributes or Capabilities
|Capacity or competence
Therapy, biomedical or psychodynamic approaches
social content with cognitive & behavioral techniques
Patterns of action
programs & restrictions
Formal & informal procedures
command & control
continuous quality improvement
Task division & coordination
The chart indicates a clear outline of the changes needed in the Preferred Provider Model. The fundamental assumption of our proposed service has been clearly stated, but we will repeat –
Our strategy is defined by the unique value of personal responsibility, which differs significantly from the strategy of traditional intervention. Each person is responsible for his/her own thoughts and upon learning how these thoughts may contribute to an inability to create mutually satisfying and gratifying relationships, for the decision to change.
Our skills or technology are cognitive and behavioral.
Our systems are outcome oriented and continuous quality improvement focused – which are the systems of a learning organization.
Our style is based on client preference. We are not as interested in client need that is often only a professional articulation of professional expectations. We are interested in the client’s expectations, and the client’s definition of quality. A client who has no desire to change behaviors that are unacceptable must suffer the consequences of that choice.
Such preconceived elements require a staff that is oriented towards productive outcome and personal responsibility, trained in the appropriate technology and holding the values required.
We perceive a temporary service model, with decentralized design and a horizontal hierarchy, with full use of the school districts across the county.
In what may seem to be a paradoxical move given the desire for a decentralized, horizontal administrative model, the organization will place the direction of this endeavor with one project manager. The Project Manager needs particularly to address the constituent issues of early identification and a timely, consistent and appropriate response.
SORE THUMBS– significant adults such as parents and teachers can quickly identify children who stick out like “sore thumbs”. They are annoying, difficult to direct, and fail to do things that adults expect. Across all dimensions [early intervention, head start and all elementary schools, such “sore thumbs are being identified and a range of responses or nonresponses is taking place. The stakeholders need to develop a philosophy of response which is neither labeling nor traumatic, but which specifically addresses the type and frequency of these “sore thumb” behaviors.
PROBLEM KIDS – at some point in time, those kids who stand out like “sore thumbs” or others become ‘problems’. Either they are disrupting classrooms, have committed delinquent acts, are fighting in what seems an excessive manner, or participating in some other activity that no longer feels like a potential for problem, but becomes a problem. Usually this leads to disciplinary action. Such disciplinary action varies across the spectrum of home, school and community involvements. Often the disciplinary action is shown to be ineffective and even detrimental to the goal of social affiliation. The movement of disciplinary actions, as identified in the revised IDEA, is moving towards segregation and punishment and away from prosocial goals.
SELF-FULFILLING PROPHECIES – If adults fear violent children they will often act in a manner that brings such violence about. Just as the artifacts locks, bars and metal detectors send out the message ‘danger’ – so too does a response that is supposed to tell the child “I am in control” send out a similar message. Students therefore deduce that they need to be wary and prepared to defend themselves. The fearful ones become increasingly anxious and the aggressive ones tend to hit first. The thinking of adults becomes counterproductive in the way it shapes the thinking of children.
“The student’s social environment greatly influences the level and intensity of his or her aggressive and violent behaviors in the school and classroom. Social learning may be the most important determinant of both aggressive and prosocial behavior. According to Bandura (1973) aggression is learned through the observation of aggression and its consequences and through experiencing the direct consequences of aggressive and nonaggressive behaviors. Kauffman (1993) made a series of generalizations about the effects of social learning which culminated with a suggestions that “the punishment of children by adults may result in aggression when it causes pain, when there are no positive alternatives to the punished behavior, when punishment is delayed or inconsistent, or when punishment provides a mode of aggressive behavior [Rutherford& Nelson, 1995].
CORRECTIVE ACTIONS – Along with segregation and punishment, the physical culture is increasingly laden with artifacts that send messages of danger and result in fear. These artifacts are quite as powerful as the “stop and think” prosocial icons and have similar impact upon the thinking process and resultant behaviors. Such icons are particularly salient when supported by the underculture of violence that is maintained through the entertainment media.
Disciplinary action must be designed so that it assures that it is timely and consistent, results in no pain, is directed towards the learning of positive alternative behaviors, and provides an adult model of behavior that is appropriate. The consequences of unacceptable behavior therefore must provide the opportunity to learn appropriate ways of behaving. The first order in attaining this goal is to develop a legitimate philosophy of response which can be accepted by the significant adults in the home, school and community environment and to provide to those adults the attitudes and skills necessary for carrying out the model. Since a child moves through locations and levels of school, the consistency of the model needs to be quite broad.
Additionally, a singular approach demands a program for training other child serving agencies and families that requires a basic acceptance of the model.
Once a negotiated response model is accepted, the Project Manager will need to assure that all systems within the metasystem of human services has an opportunity to reshape their own systematic responses. If the philosophic position is that children learn behaviors through the words and actions of significant adults, the metasystem must debate the salient message contained in present words and actions and change the words and actions accordingly. The dimensions of this endeavor can be understood to include:
- County Office of Human Services
- County Department of Children, Youth & Families and all of their contracted providers of service.
- County Department of Drug and Alcohol Services and all of their contracted providers of service.
- County Office of Mental Health/Mental Retardation, the contracted managed care organization and all of the contracted providers of service.
- County Juvenile Probation Department
- County Intermediate Unit and all constituent School Districts.
- The families of all children who are involved with any of the above systems.
- The social institutions that support the moral and character building endeavors of the community such as churches and community recreational programs.
There is no expectation of this proposal that each and every adult in these systems will accept and implement a prosocial response to children who fail to act in a socially acceptable manner. Not only do these systems have a way of thinking that requires substantial renovation, but often the violent behaviors of such children arouse not only fear, but anger and this emotion justifies the need to punish or seek revenge. Thus, the attempt is to change not only culturally acceptable ways of behaving, but the evolutionary nature of human beings. This is not to imply that it cannot be done, only that it is a long process that will be fulfilled, if at all, only incrementally. This does not negate the need for the metasystem to first become aware of its own behavior and to evaluate the message and therefore the response behavior. The essence of the message change appears to be:
You are defective and not in charge of your own behavior [out of control] and therefore need to be controlled.
You are personally responsible for your own behavior and are capable of learning new and more effective ways of behaving if you choose to do so.
The role of the Project Manger is temporary and organismistic. S/he needs the authority to cross unit lines within and without the organization and to tap the resources and skills of a wide variety of people. If authority could be given by the metasystem it would be more productive. For some period of time, the Project Manager needs to be able to convene leadership to discuss, debate, negotiate and accept a mission and strategy for transformation.
Key roles in the development of commitment during the transformation process include:
Change Sponsor – the individual/group with the organizational power to legitimize the change.
At minimum, this requires the organization to take responsibility, at ideal, this would include the leadership of the organizations which make up the metasystem.
Change Agent – the individual/group responsible for implementing the change.
At minimum, the Project Manager carries this role, at ideal, each system offers a change agent to participate in helping the Project Manager implement the process.
Change Target – the individual/group that, as a result of the change, will alter something about their knowledge, skill, attitude and behavior.
The Change Sponsor must be clear as to the identification of the Change Target and understand the potential barriers to transformation. When involved in major change where modifications significantly disrupt the standard operating patters, high levels of commitment are essential. Transformation that results in old patterns of expectation becoming invalid, will cause reactions of uncertainty. Fear, disorientation, and confusion. Crisis is the result of a breakdown in the established relationship between an individual and his/her expectations of the environment. If the Change Sponsor is not clear and consistent on new expectations, such confusion can result in resistance and sabotage.
- Statistical Summary For 1993-94, PennData
- Community MH Service Block Grant Application
- indicates that there has been a 14 year increase in the rate of births to single teens under the age of twenty, the rate of births with late or no prenatal care increased in urban counties by 46.8%, although the rate of infant mortality and child deaths decreased over the same period, including violent deaths despite the continued media message that children are out of control. This implies that the number of children raised by teenage parents most likely in single parent households will increase the potential of mental health and delinquency problems over time.
At the same time the placement rate of Child Welfare and Juvenile Court increased, as did secondary school dropouts. The economic indicators of single parent homes, children receiving AFDC and children in poverty all increased during the period as well. The Pennsylvania Partnership for Children and Philadelphia Citizens for Children and Youth3The Children’s Budget Book – 1995 – 1996 State Budget
- See, for example, All System Failure, published by the National Mental Health Association and the Federation of Families for Children’s Mental Health or Current Issue in Special Education – Integrating Services for Children and Youth with Emotional and Behavioral Disorders published by the Council for Exceptional Children. Both additionally cite such sources as The Joint Commission on Mental Health of Children (1969); the President’s Commission on Mental Health (1978), the Office of Technological Assessment (1986); the Institute of Medicine (1989), the House Select Committee on Children, Youth and Families (1990); the National Governor’s Association of 1989; and the research of Knitzer 91982) along with other citations to indicate the failure. This combined with trends indicate a serious need for change.
- In 1994 comprised 03% of all deaths between birth and age 19 according to the PA Child Death Review Team Analysis Based on PA Depts. of Health and Public Welfare Data.
- Based on the 1980 article, STRUCTURE IS NOT ORGANIZATION, by Robert H. Waterman, Jr., Thomas J. Peters, and Julien R. Phillips.