The Importance of Countervailing Role Pressure and Reflective Engagement for Implementing Army Mental Healthcare Reform

• In Event: 213 - Section on Organizations, Occupations and Work Paper Session. Power, Professions, and Movements

Abstract

Institutional theorists find that reform professionals hired from the outside to use their expertise, legitimacy and legal authority to implement reforms in organizations are at risk of cooptation by organizational interests and should be located separately from organizational stakeholders. In a two-year field study of reform implementation in four mental health clinics for active duty soldiers suffering from conditions such as Post-Traumatic Stress Disorder in the US Army, I found that traditional approaches of separating these professionals from organizational stakeholders to avoid cooptation sidelined reform professionals and led reform to fail. Instead, reform professional dual assignment to both organizational and professional hierarchies allowed them to successfully implement reform by creating what I call “countervailing role pressure” from developing strong ties with both organizational stakeholders and a team of fellow reform professionals. This countervailing role pressure to meet incompatible expectations from valued ties led reform professionals to develop the capacity for “reflective engagement” in the form of increased creativity, flexibility and empathy which, in turn, facilitated contextualized reform implementation practices that achieved both reform and organizational objectives. These findings have implications for our understanding of reform implementation and role conflict in organizations.

Author

• Julia DiBenigno, Massachusetts Institute of Technology