Client-Centric vs Service-Centric

It is a very old paradigmatic struggle for grassroots programs working to transform behavior, which is well addressed in this article from Bridgespan.

From my perspective, the best approach is the mentor model with linkage to needed client services—whether from single-service programs or multi-service ones— determined through the mentoring relationship.

An excerpt from the Bridgespan article.

“Jared is 15 years old. He doesn’t know who his father is; his mother is a heroin addict who bounces in and out of temporary recovery. For four months last year, Jared lived in a dorm for homeless teens.

“Now he is back in an apartment with his mother, three younger brothers and a pregnant older sister, but he is thinking of moving out because there is only one bedroom and his mother has started using again. He doesn’t want to go back to the shelter though, because it’s too restrictive. For the moment, Jared is in summer school, trying to make up classes he failed during the school year. But he’s not sure he is going to go back in the fall; he’s been held back twice, and at 15, he’s embarrassed about starting eighth grade again.

“Jared is on an anti-depressant, and visits a psychiatrist each week, taking a 40-minute bus ride to get there. His social worker’s office is a short walk from his mother’s apartment and he sees her regularly also. Through the social worker, Jared received referrals to see a dentist and a doctor, but their offices are also more than 40 minutes away by public transportation, and since he doesn’t live in the group home anymore, he doesn’t have a ride and keeps cancelling appointments.

“Jared’s teachers and the other professionals he sees try to talk to him about the future, and make it sound as if he can someday go to college and become independent. Jared knows they are all trying to help him, but he doesn’t see how that bright future they all talk about can happen for him.

“Many people, like Jared, face complex and interrelated challenges. To overcome those challenges, they require sustained support over time that addresses both the individual problems with which they struggle and their connection to one another. This type of integrated, extended support is becoming more common in the health care arena. There is also a small, but growing body of literature about its application in human services, and emerging evidence that it is a more effective approach to helping individuals facing multiple challenges achieve significant, long-term outcomes.

“Multi-service organizations (MSOs)—nonprofits that provide services across multiple categories such as substance abuse, housing, and education—are uniquely positioned to provide this kind of holistic help. While nonprofits that provide a single service (from mentoring to job training) often draw more media attention, perhaps because they are easier to profile, MSOs have tremendous potential to help people struggling with complex problems transform their lives. Delivering on this potential should be an MSO’s comparative advantage. Should be, but too seldom is.

“The problem is that many MSOs tend to be organized around the services they deliver, not the needs of the clients they serve. Clients receive the service they were referred to, not the full set that they need in order to improve their lives. Staff are focused on providing a high-quality service and achieving a narrow, short-term outcome, which isn’t a bad thing, but they don’t have authority or accountability for helping the client achieve long-term, life-changing outcomes. We call this “service-centric” strategy.

“To realize their full potential, MSOs have to shift from being service-centric to being “client-centric.” Being client-centric means working with a client to set long-term goals, understanding what services the client will need to reach those outcomes, providing those services in a coordinated way, and following up to make sure the client achieves their goals.”