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When you participate in a program evaluation, you may examine any aspect of the service system. The service system will show all the parts of a program that contribute to success in one way or another. We can view some of the aspects of the system as follows:

1 A depressed woman asks your agency for therapy.

2 This woman is eligible for your service because she is a resident of your county and this is the only eligibility criterion that is employed for this service.

3 The client receives cognitive–behavioral therapy.

4 The therapist is a licensed clinical social worker, so she is qualified to offer the service.

5 The therapy is in the form of eight 1-hour treatment sessions.

6 The client’s level of depression is reduced by 35%.

7 The estimated cost of this therapy is $800 ($100 per hour of therapy).

In a later chapter, you will see the above in the systems terminology of input, process, output, and outcome. You will also see that efficiency is determined by the cost per output (e.g., an hour of therapy). For now, you will review the complexity of the aspects of service that could be the subject of a program evaluation.

Let’s suppose you are evaluating the system for the Hampton Behavioral Health Practice. Each of the clients treated for depression by this agency is given a pretest for depression using a given depression scale where higher scores represent higher depression. This scale has the score of 20 as the cut point for a level of depression that indicates that treatment is needed. Let’s suppose that you examined the mean pretest depression score for the clients of this agency and found that it was below 20. This suggests that the typical depressed client did not have a level of depression that suggested a need for therapy. These data are contrary to the major goal of the agency, which focuses on the rehabilitation of persons who are severely depressed. You have evaluated one aspect of the service system for this agency and learned that it is not doing a good job of reaching the intended target population.

You may learn from a program evaluation that a given agency is not adhering to the standards of good service with regard to things such as the credentials of the staff or the size of caseloads. Adherence to established protocols for the delivery of service is another possible theme for a part of a program evaluation. For example, the Rape Crisis Program of your hospital may have a list of seven things that must be done for each victim of rape who is served. You might examine the cases for this service to see if all these elements of service were offered. What percentage of clients had all the elements provided?

The most critical aspect of an evaluation of a service system is the measurement of client outcome. Did the clients get better? Is the level of depression lower? Are the school grades higher? Is the recidivism rate for delinquency lower? Here you can see some conceptual overlap between the program evaluation and the evaluation of an intervention. You might want to characterize a program evaluation as having, among its many components, data on various interventions.