Joining forces,fortunes, and futures: Restructuring and adaptation in nonprofit hospice organizations

Nonprofit organizations operate in tumultuous times characterized by constrained funding, increased competition, and greater demand for social services. Existing bases of intangible and tangible assets often are insufficient to fulfill service missions. These organizations appear to be responding by joining forces and restructuring to better accommodate diminished resources. Relatively little is known about the reorganization strategies being employed. The study described in this chapter examined the phenomenon of organizational restructuring among nonprofit hospice organizations. In particular, it identified the factors that propel nonprofits to pursue restructuring as a strategic solution, the elements that impede such restructuring efforts, and how organizations that pursue and implement restructuring differ from those that do not. The study found that an organization's relative placement along a continuum of political and economic strength is determinative in the outcome of its restructuring efforts. Those that take affirmative steps operate from a position of economic strength and exhibit independence in governance and decision making; those that do not are impeded by internal political factors.     

The development and disturbance of emotions: An application of self psychology to clinical work with children

This article applies self psychology, as developed by Heinz Kohut, to clinical work with children. It begins with a brief summary of self psychology as a theoretical framework, focusing on the role of selfobjects in the development of the self. Then, the role of selfobjects in the development and disturbance of emotions is discussed. The paper concludes by describing the treatment implications of the self psychological perspective for clinical work with children, illustrating them through three case vignettes, and identifying certain questions for further inquiry.     

Explaining support for the Moral Majority

The purpose of this paper is to examine the usefulness of several theoretical perspectives for understanding the popular appeal of the Moral Majority. The perspectives used were cultural fundamentalism, diffusion, resource mobilization, status loss, and alienation. Data came from a series of surveys between 1981 and 1984 carried out in Middletown, Indiana. Overall, diffusion theory was useful in understanding who knew about the Moral Majority, and cultural fundamentalism was most helpful in understanding support for the Moral Majority.     

From the view of a compulsive gambler/recidivist

A compulsive gambler describes his early childhood and his experiences in various county and state penal institutions. He discusses how these influenced his current beliefs about punishment and failure of rehabilitation within the prison system.     

A Person‐Centered Perspective to Welfare‐to‐Work Services: In Pursuit of the Elusive and the Unattainable

Because of changes in legislation regarding the U.S. welfare system, there is an urgency now that has never before existed, except perhaps during the Great Depression, for career counselors to advocate for those of their clients who are on welfare and for their minor dependents. E. B. Lent (2001) has revitalized the debate over the role Rogers's person‐centered perspective should play in career development with welfare‐to‐work (WTW) clients. The usefulness of such an approach with today's clients was explored within the context of inherent limitations of Rogers's person‐centered perspective. Potential ethical conflicts for career counselors working with WTW clients were identified.     

Commissioned analysis of surgical performance using routine data: lessons from the Bristol inquiry

The public inquiry into paediatric cardiac surgery at the Bristol Royal Infirmary commissioned the authors to design and conduct analyses of routine data sources to compare surgical outcomes between centres. Such analyses are necessarily complex in this context but were further hampered by the inherent inconsistencies and mediocre quality of the various sources of data. Three levels of analysis of increasing sophistication were carried out. The reasonable consistency of the results arising from different sources of data, together with a number of sensitivity analyses, led us to conclude that there had been excess mortality in Bristol in open heart operations on children under 1 year of age. We consider criticisms of our analysis and discuss the role of statisticians in this inquiry and their contribution to the final report of the inquiry. The potential statistical role in future programmes for monitoring clinical performance is highlighted.