Scenario-big river community health care center


Scenario:

Big River Community Health Care Center has consulted with you because it is facing a funding crisis due to an increasing loss of clients. The funding for the center is proportionate to the number of clients served. Clients must appear for at least three consecutive sessions to be counted on the center list. A funding loss will inevitably result in the dismissal of a number of the counselors and staff.

Clients do not remain in care long enough after the initial intake interview to qualify for inclusion on the center's list of clients. Clients come often for services, such as birth control planning, family counseling, and prenatal classes but they often don't follow through.

Dressing in formal clothes, you meet with the administrator, and then lead an early morning meeting with the staff and counselors. The workers in the center are mostly dressed in casual clothes; you notice that they are talking among themselves and looking at you somewhat skeptically. You explain why you have been retained as a consultant-to increase client engagement in the center programs-mention some plans you have in mind, and ask for feedback and questions.

Some of the questions are personal-have you ever worked in a public health center, do you understand Spanish or Chinese, what is your degree in? And, there are also questions about the program, such as how much time will it take to learn the new programs, and what type of incentives are offered. In general, there is little eye contact during the meaning and the staff seems wary.

After the meeting, the staff breaks for coffee before seeing their clients. You enter the coffee shop and one of the counselors comes over to sit with you. She says, "You know, I don't want to be a wet blanket, but you gotta know this--we are all overloaded with work. Maybe our clients don't stay in treatment, but that doesn't mean we don't work hard. We see client after client, day after day. Lots of them live in sad situations and it's so frustrating to us because we really can't do anything to change those situations. Many are referred from the courts or welfare system; the solutions we offer them don't seem to have relevance for them in their neighborhood. The same girl who comes in for counseling services after being battered at home, comes in three months later seeking birth control after running away, and three months after that for at least one prenatal care session so she can get free food coupons. Now, after all the stress and sadness we go through here, our jobs are being threatened. I'm sure you mean well, but, I just don't see how you can possibly help."

Create a paper analyzing this scenario. Name and describe what you see as possible sources of resistance, and how you would plan to deal with them.

Support your analysis with at least five outside sources-three of which should be research articles published in peer reviewed journals in the past five years.

Response should be 5 to 7 pages.

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