2006 - School of Social Service Administration - University of Chicago

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FACETS OF CARING: AN ORGANIZATIONAL CASE STUDY FOR HOW CLIENT-WORKER RELATIONSHIPS AFFECT SOCIAL SERVICE OUTCOMES AMONG THE MEDICALLY ILL HOMELESS By Lissette M. Piedra Submitted March 2006 to the faculty of The University of Chicago School of Social Service Administration. CHAIR: Jeanne C. Marsh, Ph.D., Dean and George Herbert Jones Professor PPURPOSE The purpose of the study is to understand how service linkage and helping relationships for the medically ill homeless are affected by the organizational context and to extend relationship and organizational theory. This study answers the following questions: (1) How is such care provided? (2) What is the role of the organizational context in shaping relationships between residents and workers? (3) How does the context affect the way workers conceptualize their service provision? METHOD This study was based on data available from Interfaith House (IFH), a 64-bed residential center that provides temporary and transitional housing for medically ill homeless adults. Administrative data was used to examine client factors that predict early discharge from the program. The findings from this part of the study led to in-depth interviews with Interfaith House staff to understand agency influences that facilitate and constrain the client-worker relationship. In addition, a sub-sample of 32 case files were analyzed to discern relational factors that contribute to a client’s ability to acquire housing and other services (outcomes). Although this study is designed in a linear fashion, the analysis is iterative; findings from each phase informed both previous and subsequent stages. The overarching method used to answer these questions is Extended Case Method.
DISSERTATION ABSTRACTS MAJOR FINDINGS What emerged is a portrait of the daily activities that reflects workers’ negotiations and coordination activities. In the midst of these activities, direct practice with clients themselves represents the most profound source of satisfaction as well as the greatest challenges for staff. PRINCIPLE CONCLUSIONS Interfaith House’s holistic interdisciplinary approach emerged as the central organizing principle for service provision. This holistic approach led the agency to expand its on-site services through external linkages, enhancing the way workers are able to respond to client needs. The availability of on-site services was cited as a source of job satisfaction. Staff reported they were able to make a more personalized contribution to client care. Workers attributed the holistic multidisciplinary approach to enhanced job satisfaction for workers and better outcomes for clients at Interfaith House. ABOUT THE AUTHOR LISSETTE M. PIEDRA is an assistant professor at the University of Illinois at Urbana–Champaign School of Social Work. Her research interests center on how race and ethnicity intersect with class to influence the development, delivery, and utilization of health and social services for vulnerable populations. She is the coeditor of the forthcoming book Our Diverse Society (NASW Press). She received her M.S.W. from Loyola University Chicago. 79
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2006 - School of Social Service Administration - University of Chicago

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