The Community Approach to the Management of Organizations
It is certain that the functionming and management of an organization has a decisive influence on its human resources and, by extension, on the work it offers. According to Antoniou-Karaolidou (1994), “among the various ways of managing an organization, the most common choice, at least in Greece, is the vertical and hierarchical one, where decisions are made at the highest and higher levels of the organization, and are communicated to the lower levels for implementation. Furthermore, the various departments are independent of each other and each one usually knows only what directly concerns its own work. In other words, it does not have a complete picture of the functioning of the organization, nor of what is happening in other departments, and it has no incentive to cooperate with them. This often results in the various departments to compete with each other and valuable time and effort are lost, which translates into increased operating costs and a low level of employee satisfaction”.
In the case of the O.P.C. the theoretical and methodological innovations, which were implemented from the beginning, do not only concern its therapeutic and educational activity, but also its very structure and organization (administrative and economic). According to Tsegos (1987, Tsegos 1993), “the O.P.V. is a therapeutic unit that belongs to the intermediate institutions and which, in terms of size, administrative organization and economic cost, is classified between a residence and a large hospital. It is the result of the concerns of recent years, mainly for the treatment of pathological phenomena that are more related to the specific psychopathology of the patient’s role and the consequences of institutionalization, and less to the illness or disorder itself. In this way, the intermediate institution, in whatever form or name it is, aims to minimize the mainly social -real or imagined- dimensions that a disruptive event has taken on, either due to the effects of the family institution or due to the effects that came from the therapeutic process that the individual underwent within a large therapeutic institution, such as the hospital, and where he is usually attacked by institutionalism, from which, moreover, the staff is not immune. It is, therefore, the current pathology of the family and large institutions that lead to the choice of treatment by intermediate institutions, such as the Organization under study, which even in this very administrative and economic organization adopts the community approach”. In particular, in a health organization “the community approach certainly does not seek to impose democratic ways of cooperation nor to protect the weak (those being treated, those being educated) from the unquestioning authority figures! The Community – Therapeutic or Training – due to the multiple activities and the continuous alternation of roles both between Therapists-Educators and Treated-Trained as well as between the members of similar groups, implies a continuous Education of the Ego in action with the multiplication of relationships, real and hypothetical, the alternation of roles, and the continuous crossing of innumerable boundaries and the simultaneous reminder of the necessity of their observance by all those concerned whom they concern and exclude” (Tsegos, 2002, pp. 78-79).
When referring to the community approach, as it relates to the operation of an organization, we mean a form of team-centered management and the operation of open systems, where not only the small group is utilized, but also the large one, and where the hierarchical pyramid has an expanded base. According to Tsego (1985, 1987, 2002), the Community Approach aims to facilitate the work of the Organization, utilizing the small and large group for the development of good relations and personal interest, open communication, vertical and horizontal, in the administration, as well as the operation of the Organization, and this in order to carry out in the most effective, most creative and pleasant way the purpose for which it exists.
In the community approach, there are no barriers to communication, there is room to discuss the needs and differences of staff members among themselves, everyone has the opportunity to know and take a personal interest in their colleagues, to have an overall image and personal responsibility for the good functioning of the Organization. This is achieved, according to Antoniou-Karaolidou (1994), in various ways:
“There is a clear therapeutic philosophy, formulated in the founding declaration of the Organization, which is accepted by all employees.
Open communication is encouraged between the staff members of all departments through the Small and Large Meetings in which it participates. The Meetings of each Department (Sensitivity Groups) are exclusively focused on the relationships between the staff members and meet at regular intervals.
The Small Group Meetings bring together the staff members of each department and the Large Group Meeting brings together all staff. The latter is considered the heart of the community approach, because it is there that the inevitable and necessary differences that exist between staff can be expressed and resolved, and on the other hand, everyone can hear and share the joys, successes, difficulties and concerns of colleagues from other departments and sectors (Zerva, 2003).
The involvement of personnel from the bottom up in making decisions concerning the good functioning of the Organization as a whole is encouraged, i.e. the base of the pyramid is widened. This is achieved by mobility at the highest levels of authority and avoiding fixation on roles of those responsible and those not responsible. The coordination of the individual departments changes every 2 years, while the co-coordination every 8 months.
Decentralization in decision-making is strengthened by encouraging the autonomy of each Department regarding the issues that concern it, while at the same time horizontal communication between the various Departments is ensured through regular joint organizational meetings. Thus, the common resources and experience of each Department are better utilized.”
According to Kakouri-Basea (1994), “it has been observed that small groups constitute a model of close interpersonal relationships and bonds, with the aim of cooperation both among their members and with other groups of the Organization. It is no coincidence that the modern trend for the functioning of organizations attributes magical properties to small-sized groups.” It would, therefore, be at least paradoxical not to utilize the potential of the group, on which the Organization bases its therapeutic and educational philosophy, its method of organization and administration. How much more so, especially since this is a mental health service organization, where there is an “accumulation” of pathology (not so much in the clients, but mainly in the therapeutic staff).
As Skynner (1989, p. 158) characteristically states, “the willingness of some to join the so-called humanitarian professions may be based on the benefit they gain from this process psychologically. This is the phenomenon of the goose that lays golden eggs. Many of us “dive” into therapeutic spaces and institutions as potential therapists, in order to receive psychological help without, many times, even recognize that they need it. The possible solutions to this problem are not only found in organizational structures and the improvement of working conditions or wages. For the goose to lay a golden egg, it must first be well fed, and this means understanding the motivations that lead some people to practice the profession of therapist”.
References
Antoniou-Karaolidou M., 1994. “Organizational Dynamics and the Community Approach”. Presentation at the Seminar for Managers of Mental Health Services, EPIPSY, Athens.
Zerva P., 2003. “Burnout of Professionals in Businesses and Health Organizations”. Diploma Thesis, Institute of Psychodrama-Sociotherapy, Open Psychotherapy Center, Athens.
Kakouri-Basea A., 1994. “The Necessity of Conflicts in Organizational Contexts”. Presentation at the Seminar for Managers of Mental Health Services, EPIPSY, Athens.
Skynner R., 1989. Institutes and How to Survive Them. London: Methuen.
Tsegos I.K., 1985. “The Impact of the Institutional Background in the Matrix and the Transference in a Group Analytic Group”. Main Address at the 3rd Group Analytic Symposium of Institute of Group Analysis, Heidelberg.
Tsegos, I.K., 1987. “The Acrophilic Tendencies of Intermediate Institutions”. Paper presented at the 11th Panhellenic Congress of Psychiatry, Athens (Book of Abstracts: 173).
Tsegos, I.K., 1993. ” Strength, Power and Group Analysis”. Group Analysis, 26 (2), pp. 131-37.
Tsegos, I.K., 2002. The Disguises of the Psychotherapist. Athens: STIGMI.
* The above excerpt is a reprint from the book “The Cost of Psychotherapy. “Economic and Operational Evaluation of a Day Psychotherapy Unit”, pp. 53-57.