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How can we better understand Outcome Drift?

On the surface, the Helping Triangle suggests a static model where the elements remain constant over time. Were this the case, containing outcome drift would be a very complex but less daunting process than it actually is. The reality is the elements of the model are not static and the interaction among the elements is also not static. They are, in fact, dynamic and more or less unstable.

If we focus on potential clients, at least two factors change over time. First, the coping difficulties potential clients are experiencing change. Their circumstances and situations change as does their ability to adequately cope. This combined change leads to minor to significant change in the problems needing supports and services. Additionally, the specific people in the potential client group change over time. This adds to the dynamic nature of the issues needing attention. The people being helped today are not the same people who will need help tomorrow. What they need today is not quite the same as what they will need tomorrow. Services appearing to be a good fit today may fit less well tomorrow.

As we move our focus to the Initiators, the dynamics seen for potential clients continue up the left side of the triangle. Membership in the Initiator group changes over time as do members’ understanding of the problem and what they think it will take to help. They develop new and modified proposals and strategies they take to the Authorizers. Although these dynamics are present within all organizational structures, they are particularly pronounced when the authorizing entity is governmental. There more so than in private or religious organizations, there likely is more than one initiator group, e.g., lobbying group. The result is multiple and frequently competing proposals to be considered by the Authorizers.

As focus moves on to the Authorizers, there are several dynamics contributing to further instability within the Helping Triangle. There are competing demands on the resources of the authorizing entity. There are other service areas needing and deserving their support. Additionally, the resources of the authorizing entity are neither unlimited nor constant. Sometimes, the Authorizers have access to more resources and sometimes fewer. They also have varying priorities so the specific project may receive higher and lower priority from time to time. Beyond these issues, the specific members of the Authorizer group periodically change so the level of support for and interest in any specific project or problem area also changes.

Focus next moves to the Implementers. The same types of dynamics operate here. Just as the Authorizers likely have multiple priorities and competing demands, the Implementers are likely working with more than one authorizing entity and more than one Authorizer group. Few human services agencies operate under the auspices of a single entity. Typically, agencies have multiple funders, one or more certification or accreditation entities, governmental regulation in one or more areas, and such. This means they have multiple sets of restrictions and expectations with some degree of inconsistency and incompatibility. Additionally, membership in the Implementer group changes as do the perspectives, strategies, and opinions of the Implementers. These dynamics inevitably lead to instability within the organization and structure of the agency. Both are dynamic and subject to expected and unexpected change.

As the Implementers move to establish the human services agency, they likely use some variation of what are by far the two most common structures for the agency. They hire an Administrator who reports directly to the primary authorizing entity or establish an administrative Board that hires a Chief Executive Officer – CEO – who reports to the Board. The Board is in turn responsible to the authorizing entity. Under either arrangement, the Administrator or CEO manages the agency, using the resources and authority delegated to him (or her) by either the authorizing entity or the Board. – For the present purpose, I use a model including an administrative Board that hires a CEO, although the discussion below applies to both arrangements.

The internal agency structure in turn divides into service providers and support staff. There is normally further subdivision into multiple services and multiple support functions. For all but the smallest agencies, there is also vertical division into line staff, Supervisors, Managers, and so on. The result is a complex structure with multiple components or operating units. This agency structure develops stability over time and takes on a semi-permanent quality. It is also internally dynamic in that the staff members change over time and the priorities of staff within the agency change as well. The result is a semi-stable entity that maintains its structure while dynamic processes are occurring inside. This structure – the human services agency – can easily become a closed universe affected little by outside change forces and pressures. It does what it does and does it how it does it because that is the way it does it. Any internal or external attempts to introduce new or modified strategies, methods, or procedures are typically difficult and often unsuccessful. This is particularly true if the wanted changes also require change or re-negotiation with the Implementers or Authorizers.

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