Destroying Sanctuary: The Crisis in Human Service Delivery Systems

Paperback | January 16, 2013

bySandra L. Bloom, Brian Farragher

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For the last thirty years, the nation's mental health and social service systems have been under relentless assault, with dramatically rising costs and the fragmentation of service delivery rendering them incapable of ensuring the safety, security, and recovery of their clients. The resultingorganizational trauma both mirrors and magnifies the trauma-related problems their clients seek relief from. Just as the lives of people exposed to chronic trauma and abuse become organized around the traumatic experience, so too have our social service systems become organized around the recurrentstress of trying to do more under greater pressure: they become crisis-oriented, authoritarian, disempowered, and demoralized, often living in the present moment, haunted by the past, and unable to plan for the future.Complex interactions among traumatized clients, stressed staff, pressured organizations, and a social and economic climate that is often hostile to recovery efforts recreate the very experiences that have proven so toxic to clients in the first place. Healing is possible for these clients if theyenter helping, protective environments, yet toxic stress has destroyed the sanctuary that our systems are designed to provide.This thoughtful, impassioned critique of business as usual begins to outline a vision for transforming our mental health and social service systems. Linking trauma theory to organizational function, Destroying Sanctuary provides a framework for creating truly trauma-informed services. Theorganizational change method that has become known as the Sanctuary Model lays the groundwork for establishing safe havens for individual and organizational recovery. The goals are practical: improve clinical outcomes, increase staff satisfaction and health, increase leadership competence, anddevelop a technology for creating and sustaining healthier systems. Only in this way can our mental health and social service systems become empowered to make a more effective contribution to the overall health of the nation.Destroying Sanctuary is a stirring call for reform and recovery, required reading for anyone concerned with removing the formidable barriers to mental health and social services, from clinicians and administrators to consumer advocates.

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For the last thirty years, the nation's mental health and social service systems have been under relentless assault, with dramatically rising costs and the fragmentation of service delivery rendering them incapable of ensuring the safety, security, and recovery of their clients. The resultingorganizational trauma both mirrors and magni...

Sandra L. Bloom, MD, is Associate Professor of Health Management and Policy in the School of Public Health at Drexel University. Brian Farragher, MBA, is Executive Vice President and Chief Operating Officer of The Andrus Children's Center.

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Format:PaperbackDimensions:442 pages, 9.21 × 6.14 × 0.68 inPublished:January 16, 2013Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0199977917

ISBN - 13:9780199977918

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Table of Contents

PrologueIntroduction1. Human Service Delivery Organizations: Dead or Alive?2. "I Gotta Get out of This Place": Workplace Stress as a Threat to Public Health3. When Terror Becomes a Way of Life4. Parallel Processes and Trauma-Organized Systems5. Lack of Basic Safety6. Loss of Emotional Management7. Organizational Learning Disabilities, Organizational Amnesia, and Decision-Making Under Stress8. Miscommunication, Conflict, and Organizational Alexithymia9. Authoritarianism, Disempowerment, and Learned Helplessness10. Punishment, Revenge, and Organizational Injustice11. Unresolved Grief, Reenactment, and Decline12. Restoring Sanctuary: Organizations as Living, Complex Adaptive Social SystemsReferencesIndex