Overview:  The CARF standard that requires a “person-centered” philosophy be demonstrated by leadership and personnel, that the philosophy guide service delivery, and the philosophy is communicated to stakeholders in an understandable manner,” was first published in the ASPIRE 1.A. Leadership subsection in all 2010-2011 CARF standard manuals.

Although the majority of the CARF standards of accreditation are focused on a person-centered philosophy, many organizations struggle with fully integrating this approach within their operations. For example, an organization’s policies and procedures may indicate that the “assessment and individual planning process is person-centered and focused on the individual needs and preferences of the person served” (and the assessment and individual planning forms may embed these aspects in their formats), yet when the assessments and individual plans are complete, person-centered planning and treatment is lacking.

It is common for the leadership of an organization to focus their efforts on the content of policies, procedures, program materials, and other documents when seeking to address the “organizational person-centered philosophy” standard. Using the previous example, a typical content-focused approach might be “So what we need to do is change that form, and get our counselors some training in that area and we should be fine. Right?” I very carefully respond to this common approach by organizational leaders with a statement such as: “Well, it’s not really so much about the form you are using or a lack of training of the counselors, although such approaches are always helpful in improving practices. It’s really more about establishing and maintaining an organizational culture in which a person-centered philosophy and approach is consistently reinforced through the values, beliefs, and resulting management style of the leadership.”

Person-Centered Organizational Culture

The following are some management styles that, when valued by leadership and embedded in day-to-day operations, support establishing and maintaining a person-centered organizational culture.

The organization’s leadership values and supports the accreditation process. In other words, it is not handed off to someone as “another regulatory hurdle we have to jump through.” Leadership has a working knowledge of the standards of accreditation and is ultimately responsible for accreditation outcomes.

There is a clearly defined and communicated organizational structure. Everyone in the organization knows the “chain of command” and the responsibilities of those making the decisions. “I really don’t understand what so and so does” is rarely, if ever, spoken by personnel with regard to the leaders/managers of the organization.

There are access points that provide all employees with the ability to shape and influence the operations of the organization. Providing personnel with an explicit organizational structure that consistently creates opportunities to contribute to the growth and improvement of the organization embodies the true concept of “human resources.”

All sections, parts, and/or departments within the organization are equally valued and represented within the leadership’s management of the organization. An organization’s quality and success is determined by the total sum of its parts. Organizations who have personnel, or work groups, that operate “on the fringe” of the organization, or are “out-of-the-loop” with regards to leadership communication, are exhibiting symptoms of an impersonal and off-centered culture.

Open, honest, and constructive communication is modeled and encouraged by leadership throughout the organization. The old saying “what you don’t know won’t hurt you” has no value in supporting a person-centered organizational culture. Person-centered cultures treat adults like adults. Information flows freely. Withholding of information, by leadership, is never used as a primary personnel management strategy.

Input from the organizations’ stakeholders (personnel, persons served, referral sources, and family of persons served) is valued by leadership and influences strategic and related planning processes. One of the most common reasons given for business failure, by leaders of formerly successful businesses, is “We quit listening to our customers, shareholders, and stakeholders.”

For additional resources supportive of a leadership and management structure consistent with a person-centered organizational culture, see our Information Management resources.