THE HUMAN SERVICE SYSTEM:
PYRAMID OR CIRCLE?
By: Emma Van der Klift & Norman Kunc
The Oxford Encyclopedic English Dictionary defines "system" as "a complex whole; a set of connected things or parts; an organized body of material or immaterial things".(1991)
Schools and most workplaces in our society operate as systems. When the word "system" is applied to human service organizations, it is generally defined as "a method for managing people to produce specific results". The system provides a way to organize people to provide effective, accountable and quality support. Most, but not all, systems are organized hierarchically, or vertically, with a clearly defined "chain of command". Information flows from the bottom to the top, and back down again.
A system is sometimes represented visually as a pyramid.
It is difficult to provide a concise definition for community. Most definitions are woefully inadequate to describe both the nature of community, and what community means to us in our daily lives. It often comes down to a feeling, or a "sense of something" intangible and a bit elusive. John McKnight defines community as "a social space where citizens turn to solve problems." (Social Policy, summer of 1989) This definition seems to come closest to capturing a sense of what community is. In a practical sense, some examples of community organizations include clubs, churches, associations, housing cooperatives and councils.
Sometimes it is easier to describe certain apects of community than it is to define it. For example, in a community, it is assumed that everyone is equal. People participate voluntarily. Community organizations do not typically rely on rules, regulations or procedures to "manage" or control one another. If expectations for behaviour have been defined, they are usually generated by the group. People take turns leading, or leadership might be a shared role, depending on the task. A community leader is not the "boss".
A visual representation of a community might be best shown as a circle.
A BRIEF HISTORY OF SYSTEMS
It is generally assumed that systems of management came into use during the Industrial Revolution in Great Britain. However, history indicates that systems were developed by the United States military during the early part of the 19th century (Hoskin & Macve, in Postman 1993 pp.139).
In 1817, Sylvanus Thayer, fourth superintendent of the United States Military Academy, developed the first "line and staff" system. This early bureaucracy relied primarily upon written communication systems -- memos, directives, charts and files. The manager, a new class of employee, was created.
Thayer believed that established policies and rules, and a clearly defined chain of command would give managers a means to control workers and ensure consistent production. Workers with well-defined roles would be interchangeable. The system would be more efficient.
Later, Daniel Tyler, one of Thayer's students, went on to develop standards for quality control and productivity. These standards, commonly called "production norms", continue to be used in business and in the military to this day.
The American business community quickly adopted Thayer and Tyler's hierarchical management methods. They continue to be used in industry, business, education, and even human services.
DIFFERENCES BETWEEN SYSTEM AND COMMUNITY
Systems and community exist to accomplish different things. While systems may be the best structures to meet production goals, they were never really intended to meet the needs of individuals. On the other hand, community organizations are expressly designed to meet individual needs. In order to illustrate this point, let us look at some essential differences between a system and community. Here are a few:
1. PAID versus WILLING
Our economic survival is often dependent upon our participation in systems. We are paid to be there. We may have friends within the system that we see during work hours, but our main reason for being there is to earn a living.
In a community group, we participate because we want to. Our needs for connection, friendship and involvement are usually met in our homes with our families and friends, or in community settings, outside working hours.
2. GROUPS OF THINGS versus INDIVIDUAL PEOPLE
The purpose of a system is to produce groups of things that are the same. For example, within an automobile factory, workers will produce hundreds of cars which will be identical in every way.
Within a commmunity, we focus on meeting individual needs and utilizing our complementary skills. For example, in a housing cooperative, one person may be responsible for maintenance while another keeps the books.
3. VERTICAL versus HORIZONTAL
A system monitors itself through rules, policies and procedures. These flow vertically from management to the workers, and are enforced through a clear discipline process. We believe that following rules will ensure quality products and the best service.
In community, monitoring takes place horizontally. The members of a community make decisions collectively, and ensure that solutions satisfy the group's interests. Compliance isn't enforced through discipline, but ensured through democratic process and consensus building.
4. LARGE AND RIGID versus SMALL AND FLEXIBLE
Systems were created to organize large groups of people to perform specific and repetitive tasks. They are deliberately designed to be inflexible and resistant to change. Obviously, this is desirable if the task is auto assembly. Mistakes can be costly and dangerous. Changes that may interfere with the outcome or the quality of the product must be avoided.
Community organizations are usually smaller. As a result, they can be more flexible. Individual preferences and idiosyncratic ways of getting the job done are not only possible, but desirable. Creativity and innovation are valued. Mistakes are seen as opportunities to learn.
SYSTEMS, COMMUNITY AND HUMAN SERVICES
During this century, we did something quite absurd. We developed human service organizations based on a hierarchical model. In other words, we tried to meet the needs of people within a structure that was intended to be used to manufacture goods, not to meet the needs of people!
The consequences of this action have been frustrating human service workers and the people they support ever since. Let's examine a few of the ramifications:
1. People Change to Fit the System's Needs
In a system based on an industrial model, individuals are expected to fit into services. Programs are developed, and people are slotted into them. Those in receipt of services seldom have input into their development. Sometimes the fit is a good one, sometimes not. When it isn't working, the expectation is that the individual will change, not the system.
For example, most hospitals and institutions operate on strict timelines. Residents are assisted to get up at six a.m. Bedtime is nine o'clock. If you happen to be a "night person", it is unlikely that you will be able to change the schedule to suit your needs. The system simply isn't set up to accommodate your individual preferences.
2. A Demand for Compliance
Systems require compliance. Individuals are expected to "fit in" and go along with whatever behaviour is expected of them. Sometimes this means forcing people to do things they do not choose to do. Self-determination and control over one's own life often runs counter to the goals of the system, which are, as we have noted, conformity and uniformity.
3. Clients versus Citizens
Consumers of human services are seen as "clients" rather than citizens. This distancing euphemism reflects a fundamental power imbalance, subtly making peer relationships between someone receiving and someone providing service less likely.
It is inevitable that the needs of a system will collide with the needs of individuals. Unfortunately, because systems are large and generally inflexible, the needs of the individual are often submerged by the needs of the system.
When the needs of people come into conflict with the needs of the system, we typically try to solve the conflict in two ways. Both are based on problematic assumptions.
1. Meeting the System's Needs First
First, we assume that if we can just meet the system's needs, the needs of the individual will automatically be met. Of course, experience tells us that this is often not the case. For example, in our current hospital system, we believe that if we just follow the rules, people will receive the best care. But we know that there are times when delays caused by "following the rules" may result in injury or even death.
2. Applying More Money
The second way we try to resolve the conflict is with money. We believe that if we can just get more staff or more resources, we will be able to make things better. However, the more staff there are, the larger the system/triangle becomes! This, in turn, results in a need for more rules, which results in less flexibility. The problem is, no matter how big you make a triangle, it never becomes a circle!
Of course, this does not imply that underfunded services should simply be "pulled up by their bootstraps" without adequate monetary support. It does, however, imply that we should "be careful what we wish for"!
WHY DON'T WE JUST DISMANTLE SYSTEMS IN FAVOUR OF COMMUNITY?
If systems weren't designed to meet the needs of people, and community organizations can, why don't we simply move to a community model?
Unfortunately, it isn't as simple as that. For one thing, we must be sure that we have not created a romanticized version of community in our minds. No simplistic "shift" from system to community will necessarily result in all of us living happily ever after. Many of our communities have become disempowered and are currently less than functional, optimal places for human beings to be. After all, most of us complain we don't even know our neighbours, much less interact with them in the ways described above. Community, as a rich, equitable and welcoming place for people doesn't exist in many places. Community itself must be re-created.
Let us examine some of the other obstacles that stand in the way of changing structures and creating solid, supportive and interdependent communities.
1. VESTED FINANCIAL INTEREST
A whole sector of our economy is dependent on the maintenance of human service systems. Dismantling or significantly changing human service systems is problematic. This difficulty was illustrated some years ago in northern Ontario when the hazard of asbestos was discovered. The economy was highly dependent upon the industry. Government was caught in a difficult bind. Even though the health risks were obvious, getting rid of the mines posed another problem -- unemployment! In British Columbia, we face a similar issue with the forest industry.
2. VESTED EMOTIONAL INTEREST
As human beings, there are few things that give us more satisfaction than being able to care for another person. It makes us feel worthy and valuable. We like to be needed.
A move towards greater independence on the part of people with disabilities can result in a loss of meaning for caregivers. Sometimes caregivers will resist community involvement because it may make them feel less needed.
Learned helplessness is a term coined by experimental researchers to describe something relevant to this discussion.
In a cruel experiment conducted a number of years ago, scientists kept several dogs in small boxlike cages from early puppyhood until they were adults. If the dogs struggled to get out, they were punished. When the puppies were mature, the researchers opened the boxes and invited them to come out. Strangely, the dogs showed no interest in leaving the boxes! In fact, when they were forced to come out, they were anxious and afraid.
The same dynamics can be applied to any of us, with similar results. People who have been served within a system all their lives come to believe they can't survive outside it. They receive many messages that tell them they will not be able to manage without professional assistance. They learn to be afraid of the world.
In our society, we have come to believe that people need special education and training to do many things that used to be done by ordinary members of the community. For example, communities used to offer support and assistance to each other during times of sickness or death. Now we have hospitals, home support workers and hospices. We used to count on our friends, family and church to help us with our problems. Now we are more likely to rely on psychiatrists, psychologists and therapists.
Learned helplessness doesn't just affect people with disabilities. All of us experience its effects. Because systems develop specialized and professional responses to human issues, ordinary citizens come to believe that they are not capable of the care they have been led to believe is necessary. Where once we might have known what to do to help, now we don't believe we're qualified. Understandably, people sometimes ask, "Aren't there people paid to help?"
Dependence and protection form a vicious circle. People without disabilities worry that people with disabilities will be vulnerable as they enter into community life. A sincere desire to protect the people we care about can become a justification for continued segregation. Ironically, we may come to believe that the purpose of the system is to protect people from community -- the very structure that might meet their needs best!
HOW CAN WE HELP MAKE ORGANIZATIONS MORE RESPONSIVE?
Sometimes people wonder why we should take the time to examine systems and the problems we experience working in them. After all, we have systems, and they're not likely to change into community in the immediate future. Not only that, while we do have communities, many of them seem to be far from the ideal safe and supportive spaces we wish for! Won't we simply become dissatisfied with our lot by talking about all this, and become filled with despair at our powerlessness to change things?
Perhaps this is a risk. However, understanding how the system affects us is important for a number of reasons. Developing a "meta-perspective", or "big picture", helps us to put our perceptions into perspective. Without this larger perspective, individuals working together within human service systems may be inclined to turn inwards and blame each other for the difficulties they encounter.
There are many people currently involved in rethinking how we operate within systems, and working to transform them into places that foster a sense of belonging and community. Can human service systems change and begin to function more like communities? There are some who regard this possibility with skepticism. It is true that systems are probably not the best way to serve people. But for the most part, they are what we have right now.
There are also many people currently looking at the nature of our communities. They are helping to transform individual communities by empowering the citizens who live in them to make constructive changes in how they operate. Community organizing is a valuable effort for any of us to involve ourselves in -- not just for those with disabilities, but for ourselves.
Maybe a better question is, "given that we have systems, how can we participate in changing them? How can we work together to make them better places for all of us; individuals with disabilities and those who support them? How can we begin to look outside the system and facilitate relationships with other members of the community? What is our role in transforming those communities in the process? What have we learned from people with disabilities about interdependence and caring that we can share with others?"
Here are some ideas:
Nothing is more important than listening. Consider your own life. Deborah Tannen (1990), points out that most of us complain that we aren't listened to by others. On the other hand, most of us think we are good listeners. Nobody feels listened to, yet everybody's a good listener? Somehow it just doesn't add up!
Of course, when you listen to people, you will hear things. Sometimes the things you hear will not be what you expected. Sometimes you might even wish you'd never heard them! However, we have an obligation to listen to one another. It is a given that systems will not change until the people in them are heard.
The second part of listening must be responding. Baring your soul into a vaccuum isn't very satisfying or useful. We can and must be advocates for each other. Even if the things we're told are hard to hear (they might even be about us!) we have a responsibility to either change them, or bring them to the people who can.
3. Work "With" People, Not "On" People
Most of the time, we don't know what's best for someone else, even though we sometimes think we do. Spending time in systems can make us feel that we haven't been useful unless we "fix", or in some way remediate the people we support.
Working "on" people with a remedial intent implies that they are somehow deficient. When we work "on" someone, it is assumed that we know what is best for them. When we work "with" someone, we work together as equals. It is then assumed that the individuals we support know what is best for their own lives. Working with people will ensure that our interactions remain sensitive and respectful.
4. Make Connections
Be a bridge builder. Find ways to connect people to other people who aren't in the system. It's nice to be needed, but don't let your pleasure in that role get in the way. It's time to let go of the people we support. Build bridges out of the system and into the community. Start small, but start now. Think of yourself as a "matchmaker". It's the most important work.
5. Be Authentic
It's important to be professional if that means listening to, valuing, respecting and honouring the opinions and choices of the people we support. However, within a bureaucratic structure, professionalism can sometimes mean being distant, making decisions "in the best interests" of others without consulting them, and putting the system's needs ahead of those we serve.
Sometimes experts on professional conduct tell us that self- disclosure, connectedness and caring are "unprofessional". While it is true that unhealthy attachments and self-involved conversations will never be appropriate, it is essential that we present ourselves as real people. We are privy to so many of the most private things about the people we support. If we never share anything of ourselves, we contribute to an increased sense of disconnectedness and perpetuate a power imbalance.
6. Remember the Golden Rule
What's most important in your life? How do you want to be treated by others? Make that your personal mission statement for how you treat the people you support. Do you want to be respected and listened to? Promise yourself you will respect others and listen to them. Does it disturb you when body language and tone of voice don't correspond with what someone is saying? Then make sure that yours remain consistent. Do you want the freedom to do something spontaneous once in awhile? Then honour the choices people make.
7. Respect, Relevance and Relationships
Several years ago, the Canada Employment and Immigration Commission interviewed 5000 high school drop outs and asked them why they left school. The answers they collected fit roughly into three categories, later nicknamed the "three R's". The people interviewed said they left school because they didn't feel respected, what they were learning didn't seem relevant to their lives, and they didn't have meaningful relationships with teachers or peers.
If people had the option, would they drop out of our programs for the same reasons? Do they feel respected? Is the program relevant? Are important relationships developing?
Here are some questions to ask yourself:
Are our interactions respectful? Is our tone of voice supportive, not critical or demanding? Do we ask people's opinions and listen? Do we avoid being directive or parental? Are we always aware of personal boundaries, and take care not to violate personal space or dignity?
Are our activities relevant? Do they make sense to the people we support? Do they help bring people closer to their own vision for themselves?
Are we helping to expand social networks? If we know that someone doesn't have many friends, are we structuring our activities to include others? Are we ourselves building meaningful and equitable relationships with the people we support?
"Person-centered change challenges us to engage with people as friends and allies instead of remaining distant from people in professional roles." Beth Mount from "Imperfect Change -- Embracing the Tensions of Person Centered Work" 1990 (Graphic Futures, Communitas)
When we work within a system, it is sometimes possible to forget that our primary role is to assist the people we support to become connected to the larger community. We can get lost in the day to day logistics of support, and unintentionally continue to isolate and segregate people. Because we are "nice people", and the individuals we support seem happier in their new lives, we can be lulled into thinking we are enough for each other, and that the system can provide everything an individual needs or wants. Deep inside, we know we can't really be all things to all people. There are unavoidable limitations to the roles we play when we work within a system. After all, staff are paid to be with the people they support. Individuals with disabilities usually have little or no choice about who will support them or how that support takes place. People need more than what we can reasonably hope to provide within any system.
David Hingsburger (BCACL newsletter, summer 1993) points out that institutions are "statues to prejudice". It is possible, he contends, to create more "statues to prejudice" -- this time in the name of community living -- if we do not continue vigilantly to examine our attitudes and practices.
Many people in the community living movement now question the validity of continuing to "do what we've always done", and are asking instead, "what can we be? how can we change our organizations? how can we assist people to find the relationships and associations they need that can't be created inside the system?"
Change is rarely easy. As we have noted, systems by their very structure tend to resist change. Anyone who has tried to change a "rule" within a beaurocracy knows the truth of that! However, most agree that change is necessary and will benefit everyone. We are developing a holistic philosophy that values, includes and supports all of us.raining, supervision and evaluation of all