RICORP Article Culture and Leadership in Residential Treatment

by Ernest Campagnone, Ed.D.

Many new mangers assume their positions in residential treatment and begin a journey into understanding, self-awareness and growth unprepared for the challenges of a new and diverse world. The challenge of “leadership” can create a crisis of identity and performance for these new managers; for the “the thoughts, beliefs and knowledge that had been acquired over those years enter a shambled construct of confusion and fear. At the same time, strong beliefs that had become characteristic of a leadership style had already become crystallized into a set of values and beliefs that have grown over the years for these individuals.

Today, numerous nation-wide programs are designed to teach managers how to manage, coach, direct, or otherwise interact with their staff in new and different ways. The older, top-down management style has given way to a new work environment where employees are required to perform higher-level tasks in an ever-changing environment. As the structure of organization changes, so do the roles and tasks of and within the organization. The importance of management and leadership become critical components of an organizations success.

As individuals, each member of the organization brings unique and diverse skills and limitations into the group. The interplay of individuals toward achievement of specific goals and objectives remain critical to the success of the organization. Staff members are required to work in challenging, emotionally painful situations with suicidal and abused children and adolescents daily. The skill and interpersonal relationships the staff must bring to these environments every day places tremendous pressure on the internal support systems of the program. Each member of the organization must have “task roles and personal roles” (Bolman & Deal, 1997, p.152-153) to ensure the successful functioning of the unit for the ultimate consumer, the client and their families. Managers in these organizations must master both the interpersonal skills and the group dynamic skills to be effective. Belman and Deal refer to this as “interpersonal competence… which is seen as a basic managerial skill requirement” (p.145).

The difference between leadership and management has been a most striking revelation. John Kotter provides the following definitions of management and Leadership in his book, Leading Change (1996): Management is a set of processes that can keep a complicated system of people and technology running smoothly. The most important aspects of management include planning, budgeting, organizing, staffing, controlling, and problem solving. Leadership is a set of processes that creates organizations in the first place or adapts them to significantly changing circumstances. Leadership defines what the future should look like, aligns people with that vision, and inspires them to make it happen despite obstacles” (p.25). It is easy to confuse the two when you are blindly going about your work and duties and no training or leadership is provided in executing the necessary programmatic groundwork to create an environment where leadership skills can flourish. It is another issue when one stops and reflects on the events of the past and the realities of today. Several years ago, being a good manager seemed to be critical in managing the residential programs. “Task orientation is so important to getting things done” (E. Campagnone, personal communications, September, 2000) seemed to make a great deal of sense. Today, in some ways it still does, but for different reasons and different situations. The difference between a leadership theory and a management approach is a bright notion that has changed the landscape of residential work throughout the United States.

In our current environment, values, motivation, focus, goals, culture and imagination have become critical factors in a management approach. Terms such as mission, vision, mental models, and leadership play an important role in the structure of a strong functional program. It is clear that not only is there a struggle for leadership at the unit level, but “the truest test of leadership is in the ability to incorporate the styles and beliefs of those around you into a system of growth and development, in spite of the forces working against this growth, both internally and externally” (E. Campagnone, personal communication, March, 2000).

Since leadership is more than just affecting the course of events, goals are critical to the functioning of an organization. These goals must be obtainable and correct. James MacGregor Burns has stated “ That socially useful goals not only have to meet the needs of followers, they also should elevate followers to a higher moral level. Calling this transformational leadership, he posits that people begin with the need for survival and security, and once those needs are meet, concern themselves with ‘higher needs like affection, belonging, the common good or serving others’. This approach has the benefit of provoking discussion about how to construct a hierarchy of orienting values”. Heifetz, 1999, p. 21.)

Three years ago, a friend stated “ It is hard to identify the goals of my profession in light of the things I am thinking about today. I know where I want to go, but do I do a good job at getting others there with me”. This salient point has been a focal point of understanding of highly successful programs and ones that fails to provide leadership under the guise of intended success. It requires a hard assessment of program goals and achievements at a foundational level to grasp the cultural implication of treatment over growth. as defined in program goals and objectives. As the goals of the program became clearer and more defined, the reality that the environment or milieu of the program can often be counter to actualization. There often is no effort at understanding the culture of the program, the impact of the staff or the reality of the children and their families in the programs. The expectations of successful treatment were that upon completion of the program, you were better. However, the question now became “What the hell is better and how do we get them there” (E. Campagnone, personal communication, July, 2000).

This led to finding a definition of culture as: “a pattern of shared basic assumptions that the group learned as it solved its problems of external adaptation and internal integration, that has worked well enough to be considered valid and, therefore, to be taught to new members as the correct way to perceive, think, and feel in relation to those problems” (Schein, 1992, p.12).

Sounds intriguing and intellectual, but it presents an interesting complex problem. The culture of programs intreaditional development, was not ours, it was someone else’s idea that had to be translated at all levels by everyone into one culture or understanding. Often, the communication and interpersonal relationships of the management, leadership and milieu staff was too fragmented to be successful. Thus, what was on paper and what occurred in the units were strikingly different. It is not uncommon, upon close examination to find vastly different perception of treatment by management and milieu staff and clients in the same unit. The concepts of culture and leadership has not been addressed. In Organizational Culture and Leadership , Schein (1997) states that “the product of our human need for stability, consistency and meaning” (p.11) is manifested in our culture.

The process of learning must ultimately be made part of the culture, not any given solution to any given problem” (p. 366). Again, the concept is intriguing but here was the first great revelation of the translation of business concepts into residential treatment. The therapeutic milieu is often defined as a learning environment, based on values and standards and expectations. How close were the values and standards lived by the staff and the children; by the management or by the leadership in the professed values of the milieu? Who were the leaders that were establishing our milieu and maintaining it?

In the book The Fifth Discipline Fieldbook, Peter Senge, (1994) discusses the concept of learning. In the chapter on “Co-creating”(p. 323), the author presented excellent examples in the development of a learning environment, team building and program development. The role of the leader in this environment, beginning with a “shared vision” (p.323-326) reinforced several essential ideas that should be pondered during the construction of a work environment based on the materials presented. Senge’s guidelines established in this chapter are excellent and certainly applicable across industry, human service, and educational settings.

A deeper understanding of cultural issues in groups and organizations is necessary to decipher what goes on in them but even more important, to identify what may be the priority issues for leaders and leadership. Organizational cultures are created by leaders, and “one of the most decisive functions of leadership is the creation, the management, and sometimes even the destruction of culture” (Schein, p. 5).

As the concept of culture grew, the issue became one of focus. “A major challenge of leadership therefore is to draw attention and then deflect it to the question and issues that need to be faced. “To do so, one has to provide a context for action…needs to readily comprehend the purpose of unusual behavior or deviant behavior so that it focuses less on the behavior itself, or the person, and more on its meaning” (Heifetz, p.225).

While management can give definition to a system and maintain it, leadership gives the milieu its life, its energy, its thirst to take risks, and challenges others to maintain a growth pattern over one of acceptance and compliance. This seemed to be as important for the staff as it is for the children and their families.

This leads to the more provocative issue of motivations. Surrounded by the pathologies of depressed adolescents and children, dealing with thoughts of them wanting to hurt or kill themselves made the issue of motivation difficult to grasp and understand in its complexities. Is the role of the leader to energize the system, the role of management to maintain a safe structure and how does one meld these two needs. In such an individualized work environment, each staff member has to be able to feel the freedom of autonomy in action and decision making with these clients. “I ask each staff every day to risk making decisions that can result in the injury of a child or themselves and what do I give back, a pat on the shoulder, or is that enough, them knowing that I see, understand, help and do not criticize them” (Campagnone, personal communication, January 22, 2001).

At some point, the staff must understand that they are alone with these choices and in many ways, they are the leaders of the moment in that child’s life, this alone should provide a level of energy for staff members to be motivated on a personal level. “Motivation is a power that arises within an individual to satisfy a need” (Bittel and Newstrom, 1990, p. 269). The desire to complete and process is time consuming and arduous, it has to come from inside. It is fair to say that one can manage easier than lead and motivate because of this internal drive of the individual. “A person can have motivation without another person’s leadership. Leadership cannot succeed without the motivation on the follower’s part” (p. 269). In “Flight of the Buffalo” (1993), Belasco and Stayer identify four leadership principles in their leadership paradigm: Leaders transfer ownership for work to those who execute the work. Leaders create an environment for ownership where each person wants to be responsible. Leaders coach the development of personal capabilities. Leaders learn fast themselves and encourage others to learn quickly (p. 19).

The hardest challenge of new networks and systems in today’s corporate culture is that the upper level management and leadership reflect an authoritative leadership style (p.16). The problem is that the newness of the network has not allowed anyone to learn how to reach below themselves and trust. Mangers assume that if we follow their mandates, things will be fine; except that there are a multitude of sites and managers who must try to understand what is going on and it does not work.

Strong leadership is justifiably considered an essential ingredient of successful companies, but when leadership is invested in only one person or a select few it is only natural that the vast majority of employees feel less than personally responsible for producing high-quality products and services (Seifter and Economy, 2001, p.41).

This decision-making process and micro-management can have noticeable effect on the staff. Belman and Deal discuss Douglas McGregor’s Theory X and Theory Y ideas of the manager’s assumptions of people. Theory X is a “set of beliefs advocating that subordinates are passive and lazy, have little ambition; prefer to be led, and resist change (Bolman and Deal, p.105)”. Theory Y postulates, “the essential task of management is to arrange organizational conditions so that people can achieve their own goals best by directing their efforts toward organizational rewards” (p. 106). As can be seen, the extremes of reality and theory exist at times together.

For residential treatment programs, the challenge is to understand the X’s and Y’s of their management beliefs and leadership styles.

Theory X, Theory Y

Theory X is a traditional model for management thinking based on the following assumptions:

Average human being has an inherent dislike of work and will avoid it if possible;

Because of this human characteristic of dislike of work, most people must be coerced, controlled, directed or threatened with punishment to get them to put forth adequate effort toward the achievement of organizational objectives;

The average human being prefers to be directed, wishes to avoid responsibility, has relatively little ambition, and wants security above all achievement (Bittel and Newstrom, 1990, p. 270).

In his book, Leadership Ensemble, Harvey Seifter and Peter Economy (2001) comments “ Apparently, there are two principal downsides to the traditional model of fixed organizational leadership. Not only does the failure to take full advantage of the skills and talents of every worker represent a high opportunity cost borne by the entire company, but disenfranchised employees also tend to grow cynical about the elite few who comprise a leadership nucleus. As a result, organizations that restrict leadership to a small number of people, tend to suffer poor moral, high turnover and the loss of competitive advantage (p. 89).

Theory Y finds it roots in recently accumulated knowledge about human behavior:

The expenditure of physical and mental effort in work is as natural as play or rest;

External control and the threat of punishment are not the only means for bringing about effort toward organizational objectives; Individuals will exercise self-control in the service of objectives to which they are committed;

Commitment to objectives depends on the rewards associated with their achievement. The most important rewards are those that satisfy needs for self-respect and personal;

The average human being learns, under proper conditions, not only to accept but also to seek responsibility;

The capacity to exercise a relatively high degree of imagination, ingenuity, and creativity in the solution of organizational problems is widely, not narrowly, distributed in the population among both men and woman;

Under the conditions of modern industrial life, the intellectual potentialities of the average human beings are only partially realized (Bittel and Newstrom, 1990, p. 271).

Fostering horizontal teamwork means encouraging employees to work together to solve problems and ensuring that teams have the authority to put their solutions into action (Seifter and Economy 2001, p. 109).

The question becomes how to choice and implement this theory. In residential treatment, task management is critical to a safe milieu. Here the concept of Situational leadership has great merit as well. As Hersey and Blanchard (1976) define Situational Leadership, it is “based on the amount of direction (task behavior) and the amount of socio-emotional support (relationship behavior) a leader must provide given the situation and the ‘the level of maturity of the follower or group”.

It is evident in this setting that due to the high level of personal involvement in the daily pathological issues of the client, direction and support are critical factors.

This has led to another important concept in the development of a leadership style where no one style/theory need apply. There are times for strong, authoritative leadership where the vision of the program represents the context of the work being accomplished. This is due to the conflicting pressures the clients and the administration present in caring for children. In Leadership That Gets Results, Daniel Goldman (2000) states “the authoritative leader is a visionary; he motivates people by making clear to them how their work fits into a larger vision of the organization”(p.83).

At the same time, the concept of democracy in our setting is important. The therapeutic community model involves the inclusion of all participants in the development of the program milieu (Maxwell Jones, Therapeutic Community, 1954, p 4). Goldman states, “By spending time getting people’s ideas and buy-in, a leader builds trust, respect, and commitment” (p.85).

In bring in these concepts, it is also important to create an atmosphere where leadership is open to positive challenges and review. In human service, this is the one clear obstacle to the creation of therapeutic milieus. In a profession that verbalizes the concepts of personal growth and development, client autonomy and problem solving, there is constant struggles with the inherit battle of egos and ideological superiority of one belief system over another. Often, our leaders exist on a different set of standards and norms than what is expected of others. It seems contradictory to encourage staff to participate and then stop the process by dictates. In “Why Should Anyone Be Led By You”, Goeffe and Jones (2000) make the point that self-disclosure is an important characteristic of leadership. “Such admissions work because people need to see leaders own up to some flaw before they participate willingly in an endeavor” (p. 65). For many, the issue of congruency in belief and reality is key to positive program development. A strong therapeutic community model encourages people to dare to be different. Goeffe and Jones (2000) comment that “ Often, a leader will show his differences by having a distinctly different dress style or physical appearance, but typically, he will move on to distinguish himself through qualities like imagination, loyalty, expertise, or even a handshake” (p. 69).

Bolman and Deal discuss Argysis’s work. They present Argysis six points of staff response to frustration “They withdraw or quit, they stay but psychologically withdraw, resist by restricting output, deception or sabotage, they try to climb the hierarchy to better jobs, they form groups to redress power, or they socialize their children to believe that work is unrewarding and hopes for advancement are slim” (p.109).

Clearly, most of these situations have become present over the past years in residential treatment work. Those that remain have low investment, not completing the little extra tasks necessary for a residential program to function properly. They have, to some degree, done only what is expected of them and then only under tight supervision and oversight. Many have opted out for other positions in the organization or outside of the organization or the profession itself.

In all, the most amazing factor of this journey of leadership discovery can be the eclectical dynamics of the work environment and the many ways individuals can affect upon it. In developing an understanding of the theory, methods, and roles of a small system, the function of a sound mission and vision, role clarification, personal growth and development, inclusion, and partnership emerges.

Meg Greenfield, (as cited in Hesselbein, F., Goldsmith, M, and Beckard, R., 1996) stated, “We expect a human being who, to be successful, must combine in the right way many seemingly contradictory qualities: worldliness and idealism, toughness and charity, skepticism and belief, humility and self-confidence, enthusiasm and restraint” (p. 280). For some of us, the view that “True leadership must lead to changes that translate into social betterment” (p.75) is a benchmark concept that should be a basic component of all treatment environments.

References

Belasco, J., and Stayer, R., (1993). Flight of the buffalo: Soaring to Excellence learning to let employees lead. New York, New York: Warner Books.

Bittle, L.,and Newstromn, J. (1990) What every supervisor should know. New York, NY: McGraw-Hill Publishing Company.

Bolman, L. & Deal, T. (1997) Reframing organizations: artistry, choice, and leadership. San Francisco, CA: Jossey-Bass Publishers.

Breiberg, K & Freiberg, J (1996) Nuts! Southwest Airlines ‘crazy recipe for business and personal success. San Francisco, CA: Jossey-Bass Publishers.

Goeffe, R. and Jones, G. (2000). Why should anyone be led by you?. Harvard Business Review, September-October 2000, 63-70.

Goldman, D. (2000). Leadership that gets results. Harvard Business Review, March April, 2000, p. 78-90.

Hesselbein, F., Goldsmith, M, and Beckard, R. (1996). The leaders of the future. San Francisco, CA: Jossey-Bass Publishers

Hersey, P and Blanchard, K. (1976). Situational leadership. Center for Leadership Studies.

Kotter, J. (1996). Leading change. Boston, MA: Harvard Business School Press.

Schein, E. (1997). Organizational culture and leadership (2nd ed.). San Francisco, CA: Jossey-Bass Publishing.

Seifter, H. and Economy, P. (2001). Leadership ensemble. New York, NY: Henry Holt and Company.

Senge, P. (1990). The fifth discipline. New York, NY. Currency, Doubleday Books.

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