Bureaucratic Causes of Client Problems

in Human Service Organizations

by

Henry C. Finney 

Published in:

Management Perspectives

Vol. 2, No. 1, Spring 1983

University of Vermont

One of modern society's most basic features is its unrelenting bureaucratiza­tion. The process has brought problems to all walks of life, including such human service organizations as schools, hospitals, prisons and welfare agencies, which are the focus of this article. Specifically, the bureaucratization of society is responsible for some — although certainly not all — of the problems suffered by clients and in­mates in service agencies. The irony here is that normally one thinks of service agencies as organized programs to benefit, change or control clients whose problems originated elsewhere and earlier. Instead of seeing the agency as a cause of the client's problem, one normally thinks of it as a source of help.

Unfortunately, the bureaucratization of human service creates unanticipated problems for clients and inmates. Prisons often socialize rather than rehabilitate criminals; urban schools subvert the aspirations of some disadvantaged students and blunt the talents of others; mental hospitals and prisons sometimes brutalize and stigmatize their inmates; and general hospitals may overcharge, provide un­needed service, or induce illness. Probably the majority of service agencies perform reasonably well. But all suffer some of the problems I will describe; and some, like prisons, have dismal records.

It is important to emphasize the bureaucratic origins of these problems. Many of the failings of human service organizations cannot be understood simply as moral, human or professional lapses by individual case workers or service ad­ministrators, or in terms of the perversity or bad luck of clients. Instead, the problems stem from the bureaucratization of human service. Most agencies share common organizational features, face similar administrative difficulties, and, as a result, develop similar, quite normal, managerial practices. It is these managerial practices that generate the problems to which I refer.

If this is true, then solutions must be sought in the organization and its adminis­tration, through change in management policy and organizational design, not merely through change in the individual client, inmate, or service practitioner, nor through changes in program content. These individualistic and programmatic approaches are very popular, while the organizational approach developed here is still relatively unfamiliar.

Common Features of Human Service Agencies

Service agencies share distinctive traits that help explain their bureaucratic prob­lems. A key feature is that the raw material they process is human: they are "people processing" organizations. The methods they use involve various human relations technologies. Thus, programs of in­struction, and methods of testing and pupil management are used to "teach" students. Prisoners are controlled and rehabilitated by various custodial and training programs. Patients in asylums participate in various forms of therapy. Most human service technologies involve programmed interaction between client and service worker to effect change in the client or in his circumstances.

It is in this interaction that problems emerge. First, the interaction is often coerced, and therefore generates alienation. This is especially true of prisoners and, also, of many students. Second, the interaction produces con­siderable dependency and passivity - demanded by the roles of "patient," "student" and "prisoner." Third, clients often make heavy demands on service personnel, as illustrated by overburdened case workers, school teachers, nurses or prison guards. As a result, service per­sonnel adopt numerous defensive strategies that undercut service quality (Lipsky, 1980). Finally, some human service technologies are highly "indeterminate" in that they do not work well. Considerable research has shown that psychotherapy, behavior modification, and many teaching methods are relatively (although not totally) ineffective compared to no treatment, to competing techniques, or to more advanced technologies, like medicine. These problems — alienation, dependency, overload, and technological indeterminacy — all lead to difficulties for clients and inmates.

The Organizational Problems of Clients and Inmates

The bureaucratically induced problems of clients include program ineffectiveness, depersonalization and outright abuse. Organizational ineffectiveness is, simply put, failure to attain desired or mandated objectives. Even in the absence of a profit criterion, available evidence clearly shows that human service agencies suffer per­vasive problems of ineffectiveness. For example, sociological case studies have revealed repeated instances of "goal displacement," in which emphasis on agency maintenance replaces original service goals. Goal displacement at the expense of clients has been found in workshops for the blind, public employ­ment agencies, community development organizations, industrial safety en­forcement offices, police departments, schools, and welfare agencies, to name a few.

Also, systematic surveys of available evaluation studies have concluded that ineffectiveness was the rule, not the ex­ception, in welfare agencies and prison rehabilitation programs during the 1970s. Regarding prisons, specifically, one Federal judge concluded that, instead of rehabilitating inmates, "... most of our penal institutions (have) prove(d) to be schools of crime" (Tittle 1974:385). As for public schools, evidence of limited ef­fectiveness includes the prolonged decline in national student test scores, skyrocketing rates of teacher turnover, and growing quantitative evidence that school tracking reduces chances of upward mobility for low-tracked students. A 1979 study by the Carnegie Council went so far as to conclude that "one in every three youths is ill-educated, ill-employed and ill-equipped to succeed in American society because of a public education system in need of an overhaul." Vermont schools have shared in the national problem, as reflected in the findings of one survey showing that 60 percent of the State's teachers wanted to change jobs in 1981 (BFP).*  Vermont Education Commissioner Lloyd Kelley undoubtedly explained part of the survey results when he argued that the median starting teacher's salary of only $8,882 in 1981 was contributing to a shortage of teachers and eroding the quality of education in Vermont (BFP).

*Information pertaining to Vermont is taken generally from issues of The Burlington Free Press listed at the end. Except for quotations, such information is identified in the text by the notation “(BFP).”

Even general hospitals suffer inef­fectiveness, especially regarding provision of health services for a given population, unnecessary or erroneous surgery, and hospital induced illness, such as the epidemic of Legionnaire's Disease in Ver­mont hospitals. Effectiveness has suffered also from the wave of nurses' strikes that swept the country — including Brattleboro, Vermont — in 1980 and 1981 (BFP).

Depersonalization is also a common complaint. To a point, some impersonal treatment is unavoidable and is a reasonable trade-off for fair and businesslike service. Sometimes, however, it undermines the service itself. Deper­sonalization is worst in prisons and state asylums. There, treatment of clients is frequently authoritarian and extremely regimented. To a lesser degree, students, general hospital patients and welfare recipients are also subjected to routinized, impersonal treatment — waiting in lines, absence of personal encounters with staff, and so on.

The result is passivity, boredom and hostility that can inhibit active and constructive participation in the healing, learning or service process.

Finally, outright abuse is surprisingly common. In general hospitals and middle-class public schools it is rare. In maximum security prisons, ghetto public schools, and state asylums, it is more common. It may involve harassment, assault, homosexual rape (in prisons), or even murder by other clients or inmates. Staff also commit abuses. In the 1950s and early 1960s, typical abuses included forced labor among prisoners and mental patients, beatings, involuntary psycho-surgery, and punitive electro-shock therapy. Today, such violence has declined markedly. But use of tranquilizing drugs, coercive behavior modification techniques, solitary con­finement, and corporal punishment are still widespread. As one inmate reported of her experiences in that Vermont State Hospital, "They either drug you to the point you don't know what you're doing or ignore you completely." (BFP, April 7, 1981:9B).

Of all service organizations, prisons commonly have the most abuse. Again, Vermont has not been entirely free of these difficulties. While far less serious than the lethal Santa Fe prison riot in 1980 that left 33 inmates dead, prison problems in Vermont — outbursts at the Woodstock and St. Albans Correctional Centers in 1980 and 1981, respectively (BFP) — were part of the national wave of inmate disturbances. The extremely common problem of homosexual rape even touched the State in 1981 when a local convict was gang-raped in a New York prison after transfer there from Vermont — over the protests of a citizen's group who feared precisely that outcome.

Bureaucratic Causes of Client and Inmate Problems

It is tempting to blame "human error" for such problems but they are much too widespread for that. Instead, a number of common bureaucratic problems and processes account for at least some of the client difficulties. The following organiza­tional causes are especially noteworthy.

1.) Channeling: All organizations must route or channel raw materials to the correct programs for processing. In service agencies this involves assignment to ap­propriate wards, grades, programs, or security levels. However, this assignment is often problematic because of the indeter­minacy of human relations technology. The problem is minimal in general hospitals, where procedures for diagnosing and treating pneumonia or bone fractures, for example, are well understood. But honest determination of welfare needs, diagnostic tests for assessing IQ, or the psychotherapeutic or instructional tech­niques for effecting change are much less reliable. An immediate result is faulty diagnosis, incorrect assignment to service programs, unsuccessful treatment or in­struction, and inappropriate admission or discharge of inmates.

An example of clinically inappropriate "channeling" of a mental patient occurred in March 1981 when the Vermont State Hospital at Waterbury moved insane murderer Louis Hines out of its maximum security ward — leading to a great public outcry, which forced the hospital to rescind its decision (BFP). One reason given for the faulty move was "shortage of beds in the maximum security ward" (BFP, March 6, 1981:1 B). As often happens in overcrowded institutions using unreliable diagnostic and treatment techniques, a clinically irrelevant con­sideration guided the channeling decision. Although Hines evidently did not suffer discrimination, more generally the com­bination of indeterminate human relations technology and overburdened facilities often invites prejudicial influence of social-class position, race, or interpersonal demeanor in making channeling decisions. Extensive research on school tracking, for example, has repeatedly shown students' class origins have an impact on track placement quite apart from their measured ability or personal track preferences.

2.) Professionalism: Normally, one assumes that high professional training of personnel is an unqualified blessing, and in many ways it is. But professionalism is a mixed blessing for two reasons. First, professionals are relatively autonomous. Their loyalty is to their professions as much as to their employing agencies, with resulting low institutional commitment, especially when working conditions are bad.

Even when institutional loyalty is strong, as among many faculty at the University of Vermont (UVM), their professional commitments may result in work patterns that are unappreciated by citizens using the institution's services. Thus, many UVM faculty spend considerable time during the year, and full-time during the summer, conducting research and writing profes­sional books and articles. Professionals also move when better job opportunities arise, creating problems of chronic tur­nover in some agencies, as among psychiatrists in state asylums, or doctors at city hospitals. Also, the expertise of professionals conveys power to practice autonomously according to professional standards. The hospital administrator or college dean cannot tell the physician or professor how to practice or teach. Consequently, the accountability of such professionals to their agencies is low. Fortunately, high ethical standards forestall many dif­ficulties; but unethical or unscrupulous practices by some are difficult to control.

Professionalism also accentuates the agency's hierarchy or stratification system. Professionals are normally on top, with semi-professionals and other staff below them; clients and inmates are on the bottom. The combination of expertise, autonomy and high bureaucratic rank gives service professionals great power over subordinates. While interactions among fellow professionals tend to be collegial, relations with subordinates are often truncated and authoritarian. This is a common complaint by nurses regarding physicians and by students and secretaries regarding professors. The extreme stratification of hospitals, with the resulting low status and poor pay of nurses, is a major cause of the nation's current nurse shortage. Professional domination also encourages client passivity and dependence — characteristics that inhibit the initiative required for successful learning, therapy or rehabilitation.

3.) Bureaucratic Complexity: Large size and reliance on advanced technology lead to extreme agency complexity, as illustrated by the large modern hospital or university. Each physician or professor knows only his own specialty. But somehow the pieces of Humpty Dumpty must be reassembled, for patients, students and welfare clients usually need a variety of different treatments, courses, or services. Unfortunately, these problems of rein­tegration are often poorly solved. In hospitals, medical files for a single patient are often located in many different offices, and patients all too often get the wrong medicine or surgery because of mixed-up records. One report by researchers at the Medical Center Hospital of Vermont (MCHV) describes the general problem well:

...(T)he formidable paperwork leads to chaos: consultation letters, lab results, and radiology reports are lost; hand­writing is indecipherable; records be­come too thick to refer to; one patient may have ten records at ten sites, each with important and unique information. Th(is)... problem of coordination could be solved by using a single record for each patient, accessible only to those in­volved in his care, structured to allow many types of questions to be answered from it in seconds (PROMIS, 1980:3).

In response to the general national problem, MCHV sponsored a program to integrate patient records in the manner suggested.  Unfortunately, this attempt to develop a "Problem Oriented Medical Information System" failed because of lack of support from the many specialized hospital departments involved. In a sense, the project was a victim of the very problem it set about to solve — extreme specialization and complexity.

Problems of integrating complex, specialized programs plague other service agencies too. As illustrated by many University of Vermont students struggling with the challenges of an "independent major," students have difficulty devising a coherent personal plan of study. The problems of welfare service coordination are legendary.

4.) Conflicting Organizational Goals: Most organizations pursue multiple goals; but, because all cannot be maximized, some are sacrificed for the sake of others. Thus, rehabilitation in prisons and asylums suffers as com­munities place greater emphasis on custody. Students see less of their professors as institutions place greater emphasis on research. Hospitals may curtail community services due to staff teaching or private practice.

Concerns with agency survival and order also displace other goals. Welfare and community service agencies are frequently torn between delivery of non-self­-supporting services and the need to attain economic self-sufficiency. A poor people's cooperative studied by the author had to curtail numerous member benefits when Federal funding ceased, forcing it to struggle for business survival. Prisons and mental hospitals sometimes undermine their clinical integrity because of pressure to maintain internal order. Because of the uncertainty of rehabilitation, and because of a resurgence of custodial goals, ostensibly clinical or rehabilitative regimens in reality may amount to little more than maintenance of bureaucratic order. Inmates usually sense the discrepancy, with bad effects for rehabilitation efforts. ("I'll go to therapy if necessary to get out, but don't expect me to take it seriously!") The conflict usually is not fully resolved, leading to the irony that.. .

many (prisons and asylums) ... seem to function merely as storage dumps for in­mates, but nevertheless . . . present themselves to the public as rational orga­nizations designed consciously ... as ef­fective machines for producing (change). . ." (Goffman 1961:74).

5.) Inmate Sub-cultures: In agencies where clients spend prolonged periods of time — universities, asylums or prisons - inmate "sub-cultures" flourish. These consist of distinctive patterns of norms, values, and roles. Common examples are gangs in prisons and student groups stressing academic, vocational or leisure values in high school or college. Sub-cultures defend inmates against institutional power, help preserve member values, and facilitate adaptation to the strains of institutional life. However, they also neutralize the benefits of in­stitutional programs.

Counter-values are one of the reasons some students won't learn and why prison rehabilitation programs so often don't work. College student sub-cultures, for instance, usually take collegiate, vocational, non-conformist or academic form. As recent headlines regarding widespread fraternity drinking in Burlington illustrate, the collegiate sub­culture, which emphasizes fun and social life, is strong among many students at the UVM. By contrast, the vocational and academic orientations seem to be relatively stronger at Champlain College and Middlebury College (respectively). Such differences are significant because extensive research shows that the collegiate orientation tends to reduce academic performance and the development of intellectually liberal at­titudes.

A more dangerous consequence of subcultures in prisons is that inmate trespasses against the inmate code may provoke violence. In 1981 the life of an inmate in the St. Albans Correctional Center was allegedly threatened for in­forming on other prisoners (BFP). The seriousness of this violation of inmate norms is shown by the word "RAT" that was carved across the chest of one inmate murder victim during the 1980 Santa Fe prison riot.

6.) Problems of Control: Human service agencies have difficulty controlling both clients and "front line personnel" - teachers, case workers, guards and at­tendants. Clients are difficult to control in part because of their involuntary, needy or dependent status and the frequently intense alienation that results. The more alienated the client, the more coercive is the means necessary for control, and this in turn magnifies the alienation. But there are legal and moral limits to coercion, so the vicious cycle often results in chronically in­sufficient control. Unruly students and prisoners are typical examples.

Front line staff are hard to control due to their professional autonomy, their low visibility due to continuous shifts and unit decen­tralization, and their much greater familiarity with immediate working conditions. These circumstances convey more de facto power than their rank suggests. The result is frequently documented physical abuse of clients and inmates.

Prisons provide an extreme illustration of problematic control, for as guards struggle against frightening odds to maintain order, they often make deals to enlist inmate help. Such "corruption of authority" does lead to a semblance of order, but at the cost of illegal activity and abuse against other inmates. The problem is compounded by extremely widespread understaffing, poor training, and low pay of prison guards. All of these difficulties have beset the Vermont correctional system, as reflected in its 55 percent tur­nover of guards in 1979 alone, and the 100 percent turnover that year at one particular facility (BFP).

7.) Problems of Agency Innovation and Responsiveness: A frequent criticism of human service agencies is that, instead of responding creatively, flexibly and sym­pathetically to client or inmate needs, they are rigid and unimaginative. Interestingly, studies have found that innovative and responsive service agencies have distinctive characteristics. They tend to be less authoritarian, more loosely structured, more decentralized, more informal, more professionalized, and more complex. In a word, they tend to be more "dynamic" or "organic" in nature. Development of an innovative and locally responsive structure, however, involves some basic dilemmas. Such agencies may be so vulnerable as to be captured by some special interest groups at the expense of others. Furthermore, less innovative and responsive agencies have the advantage of tending to provide more standardized, more reliable, and more technically specialized services, and of being more accountable to central headquarters. Which form is best ob­viously depends on one's objectives. Either way, service agencies must strike a careful balance between responsiveness and fair, reliable procedure according to rules:

Service organization(s) must steer be­tween two dangers. On the one hand, they must not lose sight of the welfare of . . . clients . . . through preoccupation with ... rigid adherence to ... proce­dures ... On the other hand, the(y) ..  must not become `captives' of their clientele and surrender to them the power to determine the nature of service ... (Blau and Scott 1962:52).

Before its dismantlement under the Nixon Administration, the Office of Economic Opportunity was criticized for having become too much the "captive" of the clients it served. In Vermont, the same argument by the Governor's Office led to the reorganization several years ago of the Community Action Agency of Orleans County.

8.) Chronic Environmental Uncer­tainty: Human service organizations are more vulnerable to uncertainties in their environments than generally realized. True, they do not have to compete in the marketplace. Nevertheless, they must coordinate with other agencies, adapt to dependency on governmental decisions, and cope with various pressures from the local community.

A fateful government decision is the budget. It determines what programs can be added or must be cut and how un­derstaffed the agency will be. Under-staffing is a chronic problem, with predictable results of overcrowding, in­sufficient service, inter-inmate abuse and staff alienation. In prisons, overcrowding has been aggravated by the passage of mandatory sentencing laws in many states, or by generally tougher sentencing, as in Vermont (BFP). The resulting over­crowding, in turn, has led to high guard turnover and recurring violence. In mental hospitals, budget cuts have been so severe that even the steady trend toward "deinsti­tutionalization" has been unable to prevent overcrowding and understaffing in state asylums, including Vermont's hospital in Waterbury (BFP). (The problem of un­der-funding has blunted the success of dein­stitutionalization as well.)

Broader societal changes, including various social movements, demographic trends, economic cycles, or periods of national emergency also profoundly affect operations. The upshot is that service agencies tend to be very defensive. Prisons, school, hospitals and welfare agencies often resist direct citizen inquiries and pressures to improve service. Just as often, however, the local community resists plans for agency development, as illustrated by the vehement recent opposition of Essex Junction, Vermont, to proposals for a new juvenile correctional facility there.

Uncertainty in the environment of most agencies also is aggravated by competition among them, competition generated by dependency on a common, limited budget. Laws of confidentiality may also discourage cooperation, as in the case of Louis Hines (mentioned earlier), who bludgeoned a woman to death not long ago on a church lawn during lunch hour in Burlington, Vermont. Lack of cooperation between agencies dealing with the case precluded preventive action. As the psychotic's parole officer noted,

. . . the various units within the State Agency of Human Services are `scared silly about confidentiality' — so worried ... they did not share information that would have helped put together an accur­ate picture of a man who represented a genuine threat ... 'All this information was available ... and no one bothered to use it ... Everyone guards his own little dynasty.' (BFP, July 28, 1980:1A,5A.)

Instead of cooperating, complained the head of the Vermont Office on Aging in 1978 (BFP), state agencies are more often concerned with "empire building and turf fighting." The difficulty of the problem is suggested by the failure of at least two efforts in Chittenden County in recent years to develop a system of inter-agency referral and cooperation for clients in need.

Conclusion

Client and inmate problems can originate in the normal workings of the very agencies designed to deal with them. Certainly, the agencies cannot be blamed for the poverty, ill health, ignorance or criminality that clients bring to them. But problems develop subsequent to agency contact that may reinforce the earlier problems. Because these subsequent difficulties are partly organizational, their solution must be too. Remedies call for changes in management policy and organizational design.

Unfortunately, space permits only the briefest mention of potential remedies. Tracking errors may be reduced by use of more rigorous testing and diagnostic procedures, along with introduction of independent quality controls, such as an internal ombudsman or appeals agent. The autonomy of professionals could sometimes be counterbalanced through more meaningful client participation in agency affairs, and through independent organizational committees of review.

Problems of complexity might be reduced if top management committed its authority to active support of such efforts as PROMIS, or by experimenting with new forms of more decentralized organizations from the business world. The influence of inmate (e.g. student) sub-cultures can be affected by providing resources for desired activities (e.g. "academic" student clubs, internships, research centers, etc.), and by discouragement of others (e.g. fun-and­ drinking oriented living arrangements). Controls over clients or inmates may be enhanced by application of more "par­ticipatory" styles of supervision - although these cannot compensate for insufficiently or poorly trained and poorly paid staff. The responsiveness of agencies to clients can probably be enhanced by increasing formal interdependencies with other agencies, and by encouraging staff professionalism. Competition or poor coordination between agencies may be reduced by empowering permanent, funded community offices for referral and program coordination.

Could some of the problems of human service agencies be solved by adopting methods employed by businesses to im­prove "bottom line" performance? The answer probably is "only somewhat." In fact, greater stress on economic self-sufficiency can actually magnify problems. The reason for such pessimism is that service agencies differ fundamentally from businesses in certain ways. They rely more on autonomous professionals who are difficult to control. Also, "effectiveness" in public agencies refers to qualitative changes in people, not to economic out­comes. Thus, not only are the criteria of effectiveness different, but they are ex­traordinarily hard to measure. How do you measure "good education," "superior law enforcement," or "rehabilitation?" Finally, service agencies are more infused with public mission and responsibility. This is reflected in their dependency on public budgets, which leads to a fourth difference of chronic under-funding.

More economical service could be achieved, and agencies could move closer to "paying their own way"; but past a certain point, such improvements displace basic service goals. Private, profit-oriented hospitals illustrate the problem. Their service is good, but limited to a very af­fluent clientele. Public hospitals, in contrast, cannot be run to make a profit because doing so would undercut their obligation to serve all income levels. A more promising approach is to continually evaluate service programs to determine their relative cost effectiveness. But this approach is limited by the difficulty of measuring agency effectiveness. Reliance on quantitative, economic yardsticks tends to reduce commitment to quality and to unquantifiable goals that are also part of most agency missions.

In day-to-day administration, service agencies can probably learn much from private business, especially in the areas of personnel evaluation, organizational and job design, and administrative cost-effectiveness. Nevertheless, fundamental differences remain. The problem can be summed up this way: whereas the primary immediate beneficiaries in business are management and investors, the prime beneficiaries of human service agencies are clients and the broader public. The criteria for evaluating the effectiveness of each type of enterprise differ accordingly.

Selected Bibliography and Suggested Readings

Alexander, K.L., M. Cook & E.L. McDill, "Curriculum Tracking and Educational Stratification: Some Further Evidence," American Sociological Review, Feb. 1978, Vol. 43 :47-66.

Blau, P.M., & W.R. Scott, Formal Organizations, Chandler, S.F., 1962.

The Burlington Free Press, Burlington, Vermont:

Nov. 27, 1978:3B May 31, 1979.

Oct. 28, 1980:8A.

Oct.31, 1980:1B.

Nov. 13, 1980:1B.

Dec. 27, 1980:IA,4A.

Dec. 30, 1980:1A,12A.

Feb. 12,1981:1B.

Feb. 27, 1981:3B.

March 6, 1981:1B.

March 7, 1981:1 B.

April 5, 1981:1A,14A.

April 6, 1981:1A,IIA.

April 7, 1981:1A,8A

August 30, 1981:7B

Sept. 2, 1981:1A, 10A.

Sept. 9, 1981:1B.

Sept. 13, 1981:4B.

Sept. 15, 1981:1B.

Sept. 18, 1981:1B,28.

Oct. 5, 1982

Oct. 6, 1981:2B.

Oct. 9, 1982:1 B.

Burns, Tom, and G.M. Stalker, The Management of Innovation, Tavistock, London, 1961.

Clark, Burton R., and Martin Trow, "The Organizational Context: Deter­minants of the Sub-Cultures of College Students," pp. 17-70 in T.M. Newcomb & E.K. Wilson (Eds.), College Peer Groups, Aldine, Chicago, 1966.

Feldman, K.A., & T.M. Newcomb, The Impact of College on Students, Jossey­ Bass, S.F., 1970.

Georgopoulos, B.S. (Ed.), Organization Research on Health Institutions, Institute for Social Research, Univ. of Michigan, Ann Arbor, 1972.

Goffman, Erving, Asylums, Anchor Books, Doubleday, N.Y., 1961.

Hage, J. & M. Aiken, Social Change in Complex Organizations, Random House, N.Y., 1970.

Hasenfeld, Y. & R.A. English (Eds.), Human Service Organizations, University of Michigan Press, Ann Arbor, 1974.

Johnston, N., & L.D. Savitz (Eds.), Justice and Corrections, Wiley, N.Y., 1978.

Katz, E., & B. Danet (Eds.), Bureaucracy and the Public: A Reader in Official-Client Relations, Basic Books, N.Y., 1973.

Katz, D. & R.L. Kahn, The Social Psy­chology of Organizations, Wiley, 1978.

Lipsky, M., Street-Level Bureaucracy, Russell Sage Foundation, N.Y., 1980.

March, J.G. (Ed.), Handbook of Organizations, Rand McNally, Chicago, 1965.

Martinson, Robert, "What Works? Questions and Answers about Prison Reform," The Public Interest, 1972, Vol. 35:22-54.

Meyer, M.W. & Associates (Eds.), Environments and Organizations, Jossey ­Bass, S.F., 1978.

Perrow, C., Complex Organizations: A Critical Essay, Scott, Foresman, Glenview, Ill., 1979.

PROMIS, "The Problem-Oriented Medical Information System," Medical Center Hospital of Vermont, mimeograph, March 3, 1980.

Rosenhan, D.L., "On Being Sane in Insane Places," Science, Jan. 1973, Vol. 179:250-258.

Sarri, R.C., & Y. Hasenfeld (Eds.), The Management of Human Services, Columbia University Press, N.Y., 1978.

Tittle, Charles, "Prison and Rehabilitation: The Inevitability of Disfavor," Social Problems, Vol. 21, 1974:385-394.