Let’s call her Alice. Alice was a poor program director. Her reports were never on time, her billing mistakes were frequent, and her fiscal department constantly corrected her errors. I cringed when they asked me to be a co-therapist with her for a trauma debriefing.
Twenty years later, I still talk about how amazingly Alice managed the group, the surging emotions, the anger, and the confusion. Alice reflected the group's feelings and guided them masterfully, so the group became a truly healing experience. At that moment, I realized that Alice was not a program director. She was a therapist—and a darn good one.
Unfortunately, Alice was the product of a nonprofit human service system that suffered from two misguided ideas. First, we reward excellent therapists by promoting them to positions such as program directors, executive directors, or even vice presidents. Second, we have set up a system that the only way to make a decent salary is to move into a management position.
I consider myself a good family therapist. I was trained by the Child Guidance Clinic in Philadelphia, have several family therapy papers published, and have had speaking engagements across the state. However, when my executive director came to me to promote me to director of the outpatient department, I was honored and did not mind the 30% increase in salary.
I found myself in Trenton, N.J., an hour and a half drive from my office, in a budget meeting, which, at best, I understood about a quarter of what was being said. Suddenly, I now needed to learn about timesheets and approve office supplies. Not to mention clinical supervision, student supervision, and, of course, the dreaded compliance regulations. I was now working extra hours, doing time sheets and budgets on weekends, and checking my email every few minutes. How did I get here?
My examples are not limited to my agency. A few years ago, I met a director of outpatient services at another agency who told me that most of her weekly meetings with the psychiatrists were about utilization reports and compliance. To my horror, she even mentioned that she did not take social work interns because she did not have time to supervise them.
It does not have to be this way. The solution is simple: Hire staff with business degrees to run programs that allow clinical staff to do their jobs. Granted, the solution is simple: the application is not.
It can work. My agency was awarded a significant grant to run a locked ward juvenile detention center with a unique approach that every youth had family therapy sessions at least twice a week. Brilliantly, our agency hired an MBA and a clinical supervisor to run the program. The MBA managed the budgets, program compliance, grant writing, and even transportation for the families to attend therapy sessions. The clinical supervisor ran her sessions and supervised staff and students.
The model can be implemented elsewhere, but the caveats are significant. First is funding. Nonprofit programs have limited budgets, and traditional grants include salaries for program supervisors but not at the level where additional staff can be added to the budget. In addition, most business program graduates, with some exceptions, will not work for the low salaries that social workers tolerate. Here are some suggestions:
Advocate. When writing for grants, setting social policy, and advocating for program development, social workers should consider not only fighting for a decent salary for their staff but also a budget line for hiring administrative positions.
Change the agency culture. Human service agencies are generally run like businesses, which we are not. Rethink how staff are promoted and rewarded. Create positions such as chief clinical supervisor or family therapy expert, rewarding good clinicians with a better salary and a title without removing them from doing the clinical work. Then, hire people for positions such as vice president of budgeting, office management, and administration and regulation compliance.
Finally, administrative services could be contracted out. Big corporations hire outside agencies to run their software and security. An entrepreneur could create a human service program where agencies could contract out the routine work of running an agency and focus on the real work of social work: helping.
As America embarks on a post-pandemic recovery, the role of the traditional work office should be re-evaluated across various sectors. The urgency is amplified in our profession, where the U.S. is grappling with a severe shortage of social workers.
While social workers have managed to maintain a semblance of a working office, it's high time we reconsider the structure of how we conduct the business aspect of our work. With its potential to improve work-life balance and enhance job satisfaction, this restructuring is crucial to recruiting and retaining social workers.
Richard Lange, PhD, MSW, MEd, is a retired social worker with experience in clinical settings, parenting groups, and research. He holds an MSW from the University of Pennsylvania and a PhD from Rutgers University.