The influence of the organization on clinical practice

Professional Norms Versus Managerialism in Campus Mental Health Centers: The Experiences of Eight Clinicians

“…Research suggests managerial concerns tend to focus on efficiency, cost reduction, unhindered communication, and accountability, both in clinical practice and academic settings (Anderson, 2008;Ayers, 2009;Giroux, 2002;Herlihy & Dufrene, 2011;Much, Wagener, & Hellenbrand, 2010;Smeenk, Teelken, Eisinga, & Doorewaard, 2009). In contrast, healthcare clinicians tend to emphasize client needs and the availability of services (Chaharbaghi, 2007;Gitterman & Miller, 1989). Given these differences, clinicians may perceive increased managerial scrutiny as incompatible with professional norms such as autonomy, confidentiality, and care (Ayers, 2009;Hall, 1968;Waring & Currie, 2009).…”

Ethical Conflicts Over Access to Services

“…However, the social workers' in the sample reported that their influence was enhanced by recognition of their professional competence or expertise (Joseph & Conrad, 1989) and through networking with informal allies within the organization and "working the system." Thus, these findings suggest that informal influence (i.e., influence emerging from individual status rather than official position) can be developed through recognition of professional expertise and competence and/or through informal networking within the agency (Gitterman & Miller, 1989;Joseph & Conrad, 1989;Mechanic, 1962;Wax, 1971).…”

“…Social workers may be unlikely to have formal authority in their agencies (i.e., the power to make decisions derived from occupying a formal position in the organization) (Gitterman & Miller, 1989). However, the social workers' in the sample reported that their influence was enhanced by recognition of their professional competence or expertise (Joseph & Conrad, 1989) and through networking with informal allies within the organization and "working the system."…”

The Social Work Supervisor as Teacher of Educational Methods and Skills

“…Please take a few minutes to sit down and to talk to me (identify the requested behavioral change). I will be less upset and become a more cooperative patient'' (describe the positive consequence of the behavioral change (Bower & Bower, 1979;Germain & Gitterman, 1996;Gitterman & Miller, 1989;Hepworth, Rooney, & Larsen, 1997).…”