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Article Excerpt
Hurricane Katrina's impact on the operations of the largest residential, addiction treatment organization in New Orleans is described. Pre- and post-Katrina experiences are discussed and augmented with organizational performance data. Suggestions for future research are provided.
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On August 29, 2005, Hurricane Katrina (Katrina) closed the entire New Orleans addiction treatment system, leaving individuals receiving treatment and those in need of treatment without services. Since then, the New Orleans addiction treatment system has reopened in a state of bricolage, or the practice of creating order out of what resources exist (Mallak, 1998). Serendipitously, the treatment system's recovery and reconstruction from Katrina presents an opportunity to examine how treatment agencies resuscitate themselves in the wake of disasters. Understanding how organizational regression can be minimized in addiction treatment agencies as they reopen in postdisaster environments is of particular interest. Research has suggested that evolving and improving organizations exude the characteristics of so-called resilient organizations (Riolli & Savicki, 2003). This suggests that addiction agencies that are more open to improvement and change may be more resilient in accommodating the changes necessitated by operating in a post-Katrina environment.
Thus, this article describes Katrina's impact on the operations of the largest residential, addiction treatment organization in New Orleans. First, a brief review of literature pertaining to the impact of natural disasters on organizations' operations is provided. This is followed by a description of how this organization operated before Katrina. Next, the major changes implemented by the organization after Katrina are discussed. This discussion is augmented with trend data on the organization's performance on key indicators (i.e., treatment wait time, no-show, admissions, and continuation). Finally, recommendations for future research on organizational resilience in recovering from natural disasters are provided. Occurence of natural disasters is not a question of if but a question of when. Thus, addiction treatment agencies could learn from what happened in New Orleans regarding the barriers to and facilitators of postdisaster organizational resilience.
Natural Disasters and Organizational Resilience Literature
As a result of natural disasters, treatment agencies may have to significantly modify operations to account for changes in resources, staffing, and clientele. For many agencies, such demands would obviously have significant impacts on organizational functioning. For example, research has shown that providing health care in a postdisaster environment may lead to a reduction in staffs' ability to address clients' postdisaster treatment needs, as well as an increase in staffs' own posttraumatic stress symptoms (Benight, Ironson, & Durham, 1999; Benight et al., 1999). Thus, addiction agencies may see an increase in staff taking sick leave (Norris, Friedman, Byrne, Diaz, & Kaniasty, 2002), experiencing physical and/or emotional exhaustion, and battling low morale issues (Clark, n.d.), as well as regressing to less effective intervention techniques (Diamond, 1996). This may translate into a period of postdisaster organizational regression or a return to less desirable performance.
On the other hand, resilient organizations respond productively to significant changes without engaging in an extended period of regressive performance (Riolli & Savicki, 2003). In dealing with change, such as that dictated by natural disasters, resilient organizations emphasize clarity of goals; innovative thinking; open communication between leaders, staff, and clients; empowerment of staff; coordinated change efforts; and consultation with outside experts (Dervitsiotis, 2003; Freeman, Hirshorn, & Triad, 2003; Hamilton, 1999; Kocourek, Burger, & Birchard, 2003). Organizational factors that reduce resilience are authoritativeness; intolerance of failure; being rule oriented; and fostering environments that are fraught with threats, hostility, and miscommunications. In the wake of Katrina, one New Orleans treatment agency certainly realized their level of resiliency.
Bridge House: Before and After the Storm
Bridge House, Incorporated, is Louisiana's largest residential addiction treatment program, treating New Orleans's indigent residents with addiction problems since 1957. Bridge House is a not-for-profit, 501.c.3 organization that, pre-Katrina, employed 80 staff members and had the capacity to treat 130 clients. Approximately 75% of Bridge House funding has been generated through in-house businesses (e.g., used car sales, thrift stores). What follows is an exploration of the transformation process that this organization underwent both before and after Katrina, with a particular emphasis on how the administration and staff used setbacks as opportunities for growth.
Pre-Katrina: On the Road to Transformation
For the past 6 years, Bridge House had been evolving toward a state-of-the-art addiction treatment program. Previously, Bridge House operated from a traditional treatment philosophy that dictated treatment interventions. Counselors would routinely use a confrontational approach in which clients were pressured to (a) accept themselves as an "alcoholic/addict," (b) commit to I year of treatment, and (c) remain abstinent from substance use. This led to ultimatums and a withdrawal of services for client noncompliance. This clinical approach was not idiosyncratic to Bridge House, but it was representative of traditional drug abuse treatment throughout the United States (Hall, 1993, 1994; Miller, Benefield, & Tonigan, 1993; Miller & Rollnick, 2002; Nielsen, Scarpitti, & Inciardi, 1996; Schneider, Casey, & Kohn, 2000).
Bridge House also lacked the infrastructure and characteristics that organizational research has shown to be paramount in effective and sustained organizational change (Addiction Technology Transfer Center, 2000; Gustafson, Cats-Baril, & Alemi, 1992; Lewis, Lewis, Packard, & Souflee, 2001). Common challenges included unstructured and haphazard improvement efforts, a lack of identifiable change teams, poorly piloted (or nonpiloted) implementation plans, inadequately defined performance gains, and a deficit of "troubleshooting" or sustainability mechanisms. Moreover, because counselors were minimally involved in the improvement process, they typically viewed improvement efforts as a separate function within the organization rather...
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