Institutional members access full text with Ovid®

Share this article on:

Coordinating nonprofit children’s behavioral health services: Clique composition and relationships

Bunger, Alicia C.; Gillespie, David F.

doi: 10.1097/HMR.0b013e31828c8b76

Background: Why organizational cliques are associated with better performance in service delivery networks has yet to be explained. Certain properties of cliques may account for improved performance including the composition of clique members and the quality of their relationships.

Purpose: The aim of this study is to offer insight into how organizations working through cliques improve network performance by exploring the complementarity of services provided by clique members and testing two hypotheses about trust and perceived benefits among clique members.

Methodology: Survey and archival data were collected from a regional network of 36 nonprofit children’s mental health agencies that belong to a coalition. First, clique analyses and network visualization were used to identify cohesive subgroups. Second, the complementarity of services provided by the groups was explored by calculating scores for each group to reflect the level of differentiation in services and client population as reported in archival data. Third, ANOVA density models were used to test whether clique relationships are characterized by higher perceived trust and benefits compared with nonclique member relationships.

Findings: Three groups were identified. These groups provide complementary services to similar client populations. Trust within all three cliques was higher than nonclique member relationships. Members of all three cliques perceived greater efficiency, and two of the three cliques also perceived greater access to care and service quality.

Practice Implications: Results support selecting clique partners based on service mix. To gain organizational benefits and improve network performance, partners should offer distinct services relative to one another but to similar clients.

Alicia C. Bunger, PhD, MSW, is Assistant Professor, College of Social Work, The Ohio State University, Columbus. E-mail:

David F. Gillespie, PhD, is Professor, The Brown School of Social Work, Washington University in St. Louis, Missouri. E-mail:

This research was supported by a National Research Service Award Predoctoral Fellowship for Dissertation Research (F31 MH088037) and Postdoctoral Traineeship (T32 MH019117) from the National Institute of Mental Health, jointly sponsored by Cecil G. Sheps, Center for Health Services Research, University of North Carolina at Chapel Hill, and the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center. This work was approved by the institutional review boards at the Washington University in St. Louis and University of North Carolina at Chapel Hill.

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins