Reflections of client satisfaction: reframing family perceptions of mandatory alternative school assignment.
Key Words: chronically disruptive students, client satisfaction, mandatory alternative schools
Client satisfaction is an emerging topic of interest in social work practice. The application of client satisfaction surveys in social work is rooted in the marketing industry as a measure of a business's worth to its clients. With increasing choice in providers, agencies and organizations may feel positive client satisfaction increases their competitive potential. Although client satisfaction studies cannot prove a program's effectiveness there is at least a suggestion that positive client satisfaction increases their competitive potential, as the information derived from such surveys is better than no information. Additionally, the perceived usefulness of a program may influence continued support and funding. Rose, Wykes, Doran, Sporle, and Bogner (2008) provided three compelling reasons to conduct satisfaction studies: First, if satisfaction studies are not conducted, then there is no organized or systematic means for learning about clients' perceptions. Second, if the ratings tend to come back relatively high it is reassuring that there are no hidden or obscure problems. Third, if ratings come back with clients reporting below 75 percent satisfaction, then that further investigation is required to determine the source of dissatisfaction. Despite the inability of client satisfaction surveys to prove program's effectiveness, many people have begun to emphasize the importance of measuring client satisfaction.
In the current climate of evidence-based practice, client satisfaction assessment is an appealing, although somewhat subjective method of monitoring programs and practice. Client satisfaction surveys are easy to administer, inexpensive, and efficient. Although client satisfaction surveys are routinely used as the first line of evaluation, they may have certain biases. For example, a number of studies indicate that levels of high client satisfaction may support the premise that only the higher functioning and more satisfied client will report in these surveys (McMurtry & Hudson, 2000; Ribner & Knei-Paz, 2002; Trotter, 2008). Other studies suggest that the client is influenced by the social desirability of the instrument and that such a measurement tool may produce biased or unusually high levels of client satisfaction (Fischer & Valley, 2000; Harris, Poertner, & Joe, 2000; Turner, 1996; Carr, Copeland, Koeske, & Greeno, 2004; Walsh & Lord, 2004). Clients could also be pleased to be terminating or completing the program thereby creating a euphoric effect, often referred to as a halo effect, thereby creating a greater report of satisfaction (Barker, 2003). Furthermore, staff, environment or program curriculum can influence client comments (Peak & Sinclair, 2002). Dropouts or early termination of a program can also affect client satisfaction reports (Tanner, 2002). Most client satisfaction measures are related to program completion. Clients who were unhappy with the program or did not find it helpful would drop out prematurely and would not have the ability to give their feedback. Investment of time, energy and work has also been shown to play a factor in client satisfaction (Barton, Folaron, Busch, & Hostetter, 2006; Clair-Bolich, 2005; Roe, Dekel, Harel,Fennig, & Fennig, 2006; Strug, et al. 2003; Tilbury, Osmond, & Crawford, 2010; Turner, 1996). Clients involved in the program that had spent a considerable amount of time completing their assignments and made an effort in fully participating in the program may find it unfulfilling to, at the end of their placement, give a negative feedback on their experiences (Roe et al., 2006). By giving a high report of client satisfaction, clients can legitimize their time and energy and validate the entire experience, proving the placement worthwhile. In sum, issues of pre-treatment expectations, social desirability of the survey instrument, education levels of participants, faculty and environment have all been shown to affect satisfaction following participation in a program. The client satisfaction survey has been identified as a relatively inexpensive and fruitful assessment of satisfaction. The survey can identify which components of the program are not being successful. The reason for this lack of success would still need to be identified through other evaluation procedures, but a narrowing process has occurred.
Although the literature supports the theory that most client satisfaction surveys tend to report positive, high rating (Boulton, Markella, Mossman, Moynihan, Laydon, & Ramirez, 2001; Chang-ming, 2006, 2009; Chapman, Gibbons, Barth, & McCrae, 2003; Harris et al., 2000; Martin, Petr, & Kanpp, 2003; McMurtry & Hudson, 2000; Peak & Sinclair, 2002; Roe et al., 2006; Wong, 1999), there are a limited number that report negative outcomes (Barton et al., 2006; Carr et al., 2004; Walsh & Lord, 2004). Satisfaction is reported in the literature as either extremely high or low satisfaction (Roe et al., 2006; Dekel, Harel, Fennig & Fennig, 2006; Barton et al., 2006; Kanpp & Propp, 2002; Tilbury et al., 2010; Walsh & Lord, 2004). Influences can include environment, program curriculum and personal opinions of staff members (Royse et al., 1998; Strug et al., 2003; Ribner & Knei-Paz, 2002). Quantitative reports (Fisher & Valley, 2000; Martin et al., 2003; Roe, et al., 2006; Tilbury et al., 2010); routinely show high rates of client satisfaction, while open-ended qualitative reports (Barton et al., 2006; Knapp & Propp, 2002; Walsh & Lord, 2004) typically give low levels of client satisfaction (Chang-ming, 2009; Fisher & Valley, 2000; Harris et al., 2000; Trotter, 2008; Turner, 1996). Importantly, surveys of a quantitative nature tend to rate high client satisfaction, while surveys containing qualitative questions typically find low client satisfaction. It is evident that satisfaction is not a simple concept. There are a number of power relationships that have to be distinguished, acknowledged, and solved.
Terminology is often an issue in the client satisfaction literature, therefore, for the purposes of this study clients will be defined as the student and family because the family was actively involved in the program. Likewise, client satisfaction survey is defined as an appraisal of services where there was no measure of pretreatment functioning. This is the simplest of pre-experimental designs and often used for client satisfaction studies (Thyer & Myers, 2007). The mandatory alternative school in this study is best described as an often-used intervention for students found in violation of the student code of conduct as a result of a due process hearing. Rather than facing long-term suspension, alternative school assignment removes these disruptive, violent students from the traditional school setting and provides them with intensive social services to prevent them from dropping out of school later on. In regard to alternative school literature, specifically mandatory alternative schools, client satisfaction could be expected to be low due to the mandatory nature of the assignment. In a review of the literature reports of satisfaction following participation in mandatory alternative school settings are sparse. Therefore the intrinsic value of client satisfaction surveys may be suspect; however, the information derived from such surveys is better than no information, especially if the evaluation results are used for program improvement.
One theory that was used to guide the application of a client satisfaction survey in a mandatory alternative school setting was the problem-solving theory, which focused on cognitive activity aimed at changing a problem from the given to the goal statement. This theory holds a belief that chronically disruptive students and their family (clients) come for help only when they realize that a crisis exists and when they are motivated to seek help (Turner, 1996). While the mandatory assignment to the alternative school alone may not always evoke this type of recognition for change, often clients are very motivated to complete the assignment and exit. Moreover, problem-solving theory's emphasis importance of the "here and now," time and place all influence the client's desire to change and to move into partialization, or taking a set of problems and breaking them into smaller, more manageable parts to focus on within a therapeutic environment, accentuated at this alternative school. Notably, the hallmark of this particular mandatory alternative school, the subject of this study, was family involvement in which the family was involved in problem-solving, discipline, and progress through the program (Aeby, Manning, Thyer, & Carpenter-Aeby, 1999; Carpenter-Aeby & Aeby, 2005). The social worker engaged the family to work as a compatible, consistent unit to support the student to be successful. Through this relationship and by becoming comfortable with the idea of change, the social worker and client are able to begin processing the new ideas and evaluating the available resources that will be helpful in approaching the identified problem.
A second consideration in the application of the problem solving theory emerging in the literature is the potential of contributing to a halo effect experienced by the client completing the mandatory alternative school assignment. The halo effect refers to a cognitive bias in which perception of one characteristic influences another (Betts, 2006). In social work practice, the halo effect is defined as "The tendency to evaluate individuals either too favorably or too negatively on the basis of one or a few notable traits" (Barker, 2003, p.190). When applied to client satisfaction, "the measurement of consumer opinion is fraught with difficulties because of the halo effect produced when there is a lack of perceived independence of satisfaction assessment and treatment support" (Royse et al., 2001). In this study, students and families may have been so excited, happy, or relieved to exit the alternative school that they may have been overly positive about their experiences.
Additionally, the assignment to a mandatory alternative school, with a few notable exceptions, is frequently used to address the needs of students who are perceived to be at-risk. The term at risk has been used to refer to everything from the developmental prognoses of a given set of infants to various forms of social disruptions. Specifically, a student can be thought of as at-risk if he/ she is subject to inadequate parenting, illiterate, comes from low-income homes, suffers from a cultural mismatch between home and school, or lacks the necessary life experiences to participate successfully in school (Rayle, 1998). Therefore it becomes essential for these at-risk clients to legitimize their assignment to the alternative school and proving the placement worthwhile.
Despite high potential for skewed result, incongruent outcomes and related design issues there is sufficient evidence to support client satisfaction survey as one way to assess programs. With the growth of "zero tolerance" policies in public schools and a continued emphasis on removing behaviorally disruptive students, alternative schools are seeing a constant influx of students with few opportunities for client feedback to be given on their programs. There is a need for examining client satisfaction in the mandatory alternative school and with other types of mandatory disciplinary programs as participants often have limited choice or forced participation in order to continue their education.
In this study a single group posttest only evaluation (X-O) was deemed the appropriate research design. The single group posttest only evaluation makes it possible to evaluate a clients perception of assignment to a mandatory alternative school program when there is no available comparison group and no pretest data. Furthermore, the design can assess for the usefulness of a more rigorous evaluation and search for promising variables or perceived improvements that need explaining. Described as the simplest of pre-experimental designs in the literature and is often used for client satisfaction studies.
The survey instrument was provided by the granting agency, Community and Schools, for use in a mandatory alternative school at the concluding stages of the program, Spring 2000. The client satisfaction survey gave participants the opportunity to evaluate the client's perception of the mandatory assignment as a rountine part of the exit interview. It is anticipated that the independent variable, assignment to the alternative school may bring about changes in the client satisfaction, or dependent variable. The administration involved employed the client satisfaction surveys as a method to research students' and families' perceptions of the program. At the end of the academic year (1999-2000) the surveys were analyzed by a social work intern and utilized as part of a program evaluation. In sum, the purpose of the study was to examine client satisfaction of a mandatory alternative school placement. It was believed that client satisfaction for students and families (clients) at the alternative school would be high due to the quantitative nature of the exit surveys and the previous literature despite the mandatory nature of the assignment. Furthermore, it is believed that the results from this study will be used to inform the next program evaluation.
The participants in this study were involuntary students and their families (clients) who were mandated to a disciplinary alternative program during 1999-2000. Together, they completed three client satisfaction surveys at their exit interview. These surveys were the social artifacts under examination in this study (N=189). Of those completing the surveys, approximately 79% were boys and 21% were girls. The majority of students were African-Americans (81%) while Euro-Americans represented another 18%. Almost 86% of the students received free lunch. Students ranged in age from 11 to 18 (m= 14.85). Thirty-five percent of the students were in the ninth grade. Another 19% were in the 10th grade and 18% in the seventh grade. Almost 62% did not meet the qualifications to receive special education services. Of the remainder, 15.9% of the students met the requirements to receive services in the Emotionally Behavior Disabled classes (EBD). Based on the quantitative nature of the surveys (with only two open-ended questions) and increased level of family engagement, it is believed that client satisfaction will be high.
Students were assigned to the alternative school following a due process hearing for serious violations of the code of conduct. A referral letter indicated the code of conduct violation and term. Assignments were time limited at less than 45, 45, 90, or 180 days. Over 84% of the students were assigned for 45 days. As shown in the literature, about 62% of the students assigned to the alternative school had probation officers. However, another 32 % had no agency involvement. For the purposes of this study, all clients were considered at-risk.
Students and their families received informed consent. The University Institutional Review Board (IRB) reviewed this study and found little or no client risk and discomfort. Therefore, IRB support was granted. Data were gathered from existing student files using student identification numbers that could not be connected to their names. Data were stored in locked file cabinets accessible only to the social worker. Thus, anonymity was preserved and confidentiality maintained.
Research Design. This study implemented a secondary data analysis of information collected at the exit interview by the school social worker as part of the assignment to the alternative school. Data were analyzed independently at the end of the grant by an MSW intern. As with other client satisfaction surveys, the design reflected an intervention-posttest only (X-O) also known as a one group post-test only design (X-O). The design was selected to measure client satisfaction following completion of the alternative school program. Results were inspected from three client satisfaction surveys administered during exit interviews to students and their families assigned to a mandatory alternative school. These social artifacts contain information addressing reasons for referral, program helpfulness, staff helpfulness and likes and dislikes in the program. Family surveys provided opinions on aspects of good alternative schools, staff helpfulness and student behavior changes. This was a pre-experimental study. Descriptive statistics were applied to examine frequencies and percentages among the responses.
Client Satisfaction Surveys (Outcome Measurements). This was a purposive sample of 189 clients who completed the client satisfaction forms at the exit interview from the mandatory alternative school. Of the 209 clients assigned to the mandatory alternative school for 1999-2000 school year only 20 clients dropped out or transitioned to other facilities such as "Youth Detention Center", hospitals or similar school districts. The client satisfaction forms were developed by Communities in Schools to be used as a form of program evaluation similar to those of other social service agencies and private contractors (Harris et al., 2000; McMurtry & Hudson, 2000). Three instruments were used in this study to assess client satisfaction in the alternative school program. Students completed the Student Exit Survey, which consisted of 15 questions. It used a Likert scale to examine questions regarding the reason for referral, program helpfulness, staff helpfulness and two qualitative questions regarding what students like best and least about the program. This instrument was not valid or reliable but it appeared to have face validity and was used routinely by other alternative schools and that received Community and School funding.
The families completed two surveys: the Family Exit Interview-Client Satisfaction Survey, which was a 20-item inventory focusing on staff helpfulness and student behavior changes and the Family Exit Interview-Characteristics of an Effective Alternative School, which was a nine-item inventory that rated the aspects of a good alternative school. Similar to the student's survey, the instruments were not valid or reliable but appeared to have face validity and were used routinely by other programs.
Assignment to the Alternative School (Intervention). The alternative school in this study is a public, mandatory, off-campus program for "chronically disruptive" students found in violation of the student code of conduct as a result of a due process hearing. The mission of the program is two-fold: to make schools safer by removing disruptive, violent students from traditional school and to provide intensive social services to those students to prevent them from dropping out of school. Students were assigned to the alternative school as a result of serious violations in the student code of conduct. The length of assignment (less than 45,45,90, or 180 days) was determined by the disciplinary hearings officer and based on severity of the offense. Students were assigned to the alternative school in lieu of long-term suspension or expulsion. Of the thirteen categories of referral, the three most common were fighting, possession of weapons, and possession of drugs and alcohol. The driving force of this program was family involvement. Conspicuously, 8 of 15 interventions were family related.
Three client satisfaction instruments were used to evaluate the level of satisfaction with the alternative school program for students and families. For the purpose of analysis, data from each instrument were inspected separately. The data were reported using descriptive statistics with particular attention to frequencies and percentages.
Student Exit Survey
Reason for Referral. Almost 25% of the students who completed the survey were referred to the program for fighting. Another 14.3% were referred for the use of alcohol or drugs. Other notable reasons for referral were for violent offenses such as weapons, insubordination, disruptive conduct, and sexual harassment. Importantly, the information above is from the prospective of the client and may be different from the letter.
Program Helpfulness. The majority of the responses were positive. In 10 out of 14 questions, between 54 and 98% answered positively in their responses relating to their satisfaction with the alternative school program. After completing the program, 98.4% of the students expected to graduate from high school. Approximately 94% felt the program helped them do better work. An equal number of students (85.7%) felt the program helped keep them out of trouble at school, tutoring helped them do better work, and the staff helped them get services needed to stay in school. Despite these facts, only 33.3% of the students felt this program was good for them.
Qualitative Questions--Best and Least. Two of the 15 questions were qualitative, asking the students what they liked best and least about the program. For 25.4% of the students, getting out early was what they liked best and 20.6% liked the staff best. Of particular note, students considered the social worker as a teacher and included her in the client satisfaction surveys in that category. Almost 35% of the students liked other aspects of the program, such as food, extra curricular activities, academics, and structure. Although an equal percentage of the students (15.9%) chose the food and the dress code as their least favorite aspects of the program, the majority (52.4%) chose other aspects of the program. Some examples were other students, the strictness of the program, and the work requirements.
Family Exit Interview-Client Satisfaction Survey
The majority of the questions received a positive response regarding the family's satisfaction with the alternative school program. Note that staff included the school social worker. The student's families answered positively (50.8 % or more) in 19 of 20 questions. The lowest positive response (47.6%). was related to the student and family getting needed services. Surprisingly, in the same category, 39.7% of the families responded they either had no personal experience with receiving social services or did not know. The highest levels of satisfaction were in the areas of assisting students to transition (85.7%), staff's encouragement for students to take responsibility and feeling free to ask staff about student's work, both 84.2%. Also notable, 77.8% of the families felt staff listened to their opinions. In this survey, the majority of the families either responded positively to improvements made by their child or felt their child did not need to improve and was doing well.
Family Exit Interview-Characteristics of an Effective Alternative School
Family response's indicated that the characteristics of the alternative school program contributed significantly to the success of their child. Seventy-three percent or more of the families responded positively to questions regarding the characteristics of the program. Eighty-four percent of the families felt the program's supportive environment was a contributing factor to their child's success. Another 82.5% of the families felt the individual attention and well-defined standards and rules equally contributed to the success of their child.
In conclusion, three client satisfaction instruments were examined, one for students and two for families. Even though this was a mandatory alternative school program, the levels of client satisfaction for students and families were shown to be high in accordance with the previous literature. Notably, although students recognized the benefits of attending the program, they also were cognizant of the fact that they should not want to be there due to its disciplinary nature.
There is clear support for the hypothesis that client satisfaction will be high even though it is a mandatory assignment for involuntary clients. This study is similar to other studies regarding client satisfaction. For these surveys, provisions were made for lower functioning clients, thereby differing from previous findings that indicated bias due to higher functioning clients. In fact many families requested that their students return to the mandatory alternative school the next year. Schools of choice appear to have greater satisfaction and autonomy than mandatory second chance alternative schools. According to Lange (1998) "Some states have implemented school choice options that address the needs of these students giving them a choice of an alternative high school setting" (p. 196). However, it appears that the students and families at the mandatory alternative school in this study felt enough of the benefits of the small class sizes, lower teacher-student ratio, and the family engagement aspect of the program that they wanted to return. The findings of this study confirm the conclusion that there is a high level of client satisfaction with the services provided at the mandatory alternative school, whether the perceptions reflected the school size, climate, autonomy or emphasis on the family.
The findings were evaluated using percentages of the responses from the client satisfaction surveys. They were completed during the exit interview of successful students completing the alternative school program. The findings may be interpreted based on the context of the involuntary assignment to the program for both the student and the family and with the existing literature. Important to note, would be the gains the students and family members made in life and social skills and development of social support in the hope of enabling students to become productive citizens.
The scope of this study involves only the students and families participating in the mandatory alternative school program. Therefore, the findings are limited to this group and setting which would indicate that further research of mandatory alternative schools is necessary to determine if these programs are effective in improving students' self-concept, academic achievement, and chances of graduating from high school (Clair-Bolich, 2005). Further, the instruments used in this study were not valid or reliable and as such may not have yielded accurate information outside the scope of this study. Although the instruments were developed by the granting agency, routinely used in similar programs to measure client perceptions, and required by the conditions of the grant, the outcomes appear to be congruent within the context of the existing literature. Despite the common usage of client satisfaction surveys, they may imply or presume that clients are actually satisfied. Further, these findings may not be generalized due to the lack of a comparison group or replication. However, given the strong emphasis on family involvement interventions, client satisfaction surveys from the families' perspectives were vital elements for program evaluation.
All this considered, the use of client satisfaction surveys can provide benefits for program and practice accountability. Because of the presumption of client satisfaction, one would expect the responses on the survey to be high, however, not necessarily with an involuntary population. Therefore, the high level of client satisfaction in this case may indicate the recognition of positive change and may contribute to the effectiveness of program evaluation. In many cases and perhaps for the first time the family felt they obtained needed assistance with their child and engaged working together rather than in isolation. According to the students and families, the program was particularly helpful in transitioning students back to public school, one of the missions of the program. This study provides support for the belief that the level of client satisfaction will be high for students and families assigned to a mandatory alternative school. Regardless of the high levels of client satisfaction with this program, students recognized it was a disciplinary program and they should not want to be there. The findings may contribute to modifying and improving social work intervention at this program and may encourage the use of client satisfaction surveys in other settings. School social workers will be able to use this information to modify their practice, develop new interventions, and incorporate client satisfaction surveys into the evaluation of new programs.
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Tracy Carpenter-Aeby, MSW, PhD, LCSW, Associate Professor, School of Social Work. Victor G. Aeby, MA, EdD, Associate Professor, Department of Health Education, East Carolina University.
Correspondence concerning this article should be addressed to Dr. Tracy Carpenter-Aeby at firstname.lastname@example.org.
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|Author:||Carpenter-Aeby, Tracy; Aeby, Victor G.|
|Publication:||Journal of Instructional Psychology|
|Date:||Mar 1, 2012|
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