Missed connections: Individual and organization-level responses to managing conflicting expectations in human service organizations

Literature has documented that direct care providers in human service organizations commonly experience feelings of being caught in double-bind situations. While the focus of previous research has been on the separation created between providers and those around them as a defensive response, little has been known about how direct care providers in these situations manage the interface between themselves and their environment when they need an adequate level of connection to fulfill organizational goals.;This research was undertaken to come to a fuller understanding of how direct care providers, under conditions of multiple and conflicting demands, experience and respond to these dynamics, what strategies they employ for managing their work, what strategies are employed by others for facilitating that work, and what constitutes an effective relationship between direct care providers and others such that they can obtain resources and support to fulfill their task and provide effective care. A qualitative, multi-method theory-generating study was undertaken to compare two work teams in a community mental health agency, combining participant observation, semi-structured interviews, and document analysis. A particular focus was placed on identifying how factors from multiple levels of analysis influence these dynamics.;Results suggest that although goal conflict was prevalent in the daily lives of providers, they did not identify a systemic aspect to these conflicts and minimized its effect on their work. There were both individual and group level variables that affected provider experiences and responses to goal conflict and mixed messages, with leadership style appearing to have the strongest organizational impact. The nature of much of the goal conflict that the teams experienced was either privately inadmissible or publicly undiscussible.;A number of strategies have been identified that were utilized by providers when faced with conflicting expectations, as well as a number of key dimensions of an effective relationship, that heighten the likelihood that providers will be able to provide effective care. A set of propositions summarizes key findings and suggests certain consequences for communication, problem solving, and the management of ambiguous situations at multiple agency levels.;Contributions to theory development and implications for practice are discussed.