Changing the Rules: the Key to Expanding What Works

The people who run successful programs for the most disadvantaged Americans will tell anyone who will listen about the constant struggle to swim upstream. They say that every day they have to be willing to break or bend the rules to get the job done, whether it be to educate or protect our children, to feed and clothe the poor, or to strengthen the bonds among citizens.

And they can do that — typically by stealth — while they are running pilot programs that remain small and operate at the margins. But when they attempt to spread what works on a larger scale, they are immediately confronted by rules and regulations and mindsets that end up destroying or diluting the very attributes that made the original approach successful.

Sometimes the limitations are imposed by governments, sometimes by grant makers. Staff members are not allowed to spend the time it takes to create and cultivate personal relationships with the people they serve — relationships that are critical to a program’s effectiveness. Evaluators insist that a standardized procedure be used at all sites, though discretion and flexibility are often essential elements of success. Foundation grants stipulate that a charity cannot pool the funds it receives from different sources, though the charity cannot achieve its objectives without doing so. Is it any wonder, then, that programs get terrific results only while they’re under a protective bubble and led by wizards who are some combination of Mother Teresa, Machiavelli, and a C.P.A.?

After examining programs that work, it’s relatively easy to distill five themes that are crucial to success:

An unrelenting focus on results. Successful programs ask how kids and families are doing and whether the neighborhood feels safer — not whether a detailed maze of rules is being followed. They are flexible and responsive, able to make reassessments, and change what they’re doing when they don’t get results.

The clear focus on results also drives grant makers, along with charity and government workers, to think more realistically about the connections between investments and results. In the non-profit world, there is a constant temptation to fall back on “process measures,” such as numbers of people who participate in a program. In the scramble for evidence, such measures provide comforting evidence of activity — they demonstrate that something is happening, but don’t necessarily lead to results. An unrelenting focus on real results exposes the sham of asking human-service providers, educators, and community organizations to accomplish massive tasks with wholly inadequate resources and tools. It forces the question of whether to expect less from limited investments — or to invest more to operate at the level of intensity that is necessary to achieve promised results.

The creation of new partnerships. Most programs that successfully deal with entrenched social problems create new partnerships between formal and informal organizations and procedures and among a variety of sources of money. In Boston, for example, gun-related homicides among young people have been virtually eliminated because preachers, teachers, police, probation officers, youth workers, and parents worked together to remove weapons, insure the arrest of chronic offenders, tutor the youngsters who are at highest risk, share information, reclaim parks and sidewalks, and strengthen families and neighborhood connections.

Neither government, nor the non-profit world, nor the business world alone can change an entire neighborhood. So those entities must work together. The new partnerships also combine bureaucratic and improvisational mindsets, not only to get specific jobs done but also to build community and social institutions. It is not enough to enlist local organizations and institutions as isolated fragments to serve a practical purpose. Organizations of all sorts must come to trust one another, and identify with each other’s purposes.

Successful programs create another kind of partnership as well — between people at the grassroots who bring the local wisdom, and those who have access to the people who control how money flows to organizations, how programs are held accountable, and what rules they must observe. It is futile for grant makers, both government and private, to keep asking program people to work smarter and more innovatively and more collaboratively — or to come up with the money necessary to sustain a program when the initial funds run out — until they persuade the rule makers to change the rules that govern public and philanthropic funds.

Personal relationships based on trust and respect. Successful programs usually allow staff members to go well beyond the boundaries of their job descriptions, and to find new ways of defining professionalism. At a staff meeting of the Homebuilders program, a clinical psychologist told of appearing at the front door of a family in crisis, to be greeted by a mother’s declaration that the one thing she didn’t need in her life was one more social worker telling her what to do. What she needed, she said, was to get her house cleaned up. The therapist, with her special Homebuilders training and mindset, responded by asking the mother if she wanted to start with the kitchen. After working together for an hour, the two women were able to talk about the out-of-control teen-ager who had set off the family’s difficulty. It was an unorthodox way of forging what the mental-health professionals call a therapeutic alliance, but it worked.

These are obviously tricky waters. The balance between being supportive and being challenging, between building on family strengths without succumbing to family pathology, is hard to achieve and maintain. Today’s charity and government worker, especially those who work with people who lack the support systems traditionally provided by families and neighbors, is constantly striving to instill independence by adopting a new and collaborative approach. Those new professionals operate within the boundaries of well-developed theory about effective practices, while pushing the constraints imposed by job descriptions and bureaucracies.

A strategic approach to spreading their successes. When it comes to expanding a program, the wizards who have developed successful approaches, and those they enlist as partners, know they can’t clone an approach and just parachute it into new settings. But they can distill the essence, the principles that account for their success, and help others to build on those. They realize that effective pilot programs and demonstrations are only the first step of a comprehensive strategy that acknowledges the need to change systems to make them hospitable to the spread of effective programs. The fight to expand without dilution or distortion or cloning is not a fight that every model program should have to wage anew and on its own.

An emphasis on prevention. It takes food to fight hunger, just as it takes water to fight fire. But prevention of both fires and hunger is the ultimate, if less dramatic, remedy. Effective programs recognize that and combine preventive efforts with crisis interventions. And more and more, the people involved in prevention start early and take a long-term view. Few adolescent rotten outcomes — from teen-age pregnancy to alienation to school failure — can be changed at the time of adolescence, because they are a long time in the making. Girls who get pregnant too soon have been in trouble academically for years before they get pregnant. What’s more, we now know the importance of early-childhood development — not only for cognitive learning and school readiness, but also for the ability to feel empathy and a sense of belonging, and of responsibility for oneself and others. Successful programs try to use that understanding to prevent problems from occurring in the first place.

We live in an extraordinary time. We have unprecedented national prosperity to build on. We have a sense of urgency, especially about the fate of our inner cities and the fate of children who are not getting the food or health care they need and who are stuck in failing schools. And we have a rich array of knowledge about what works.

If we are to realize our common purposes, we must find ways to apply more systematically the lessons that are learned in our successful programs. In doing so, we will also be strengthening the values of community, faith, responsibility, civic virtue, neighborliness, stewardship, and mutual concern for each other in which most Americans believe.

Lisbeth B. Schorr is a lecturer in social medicine at Harvard University and director of the Harvard University Project on Effective Interventions. This piece is adapted from a speech she gave last month at a conference sponsored by the Washington charity Share Our Strength.