A Tale of Two Autonomies

The two autonomies

Among numerous dimensions of autonomy, this article concerns the distinction between personal and work-related autonomy (Engel, 1970). Personal autonomy is the “freedom to conduct tangential work activities in a normative manner in accordance with one’s own discretion” (Engel, 1970, p. 12), while work-related autonomy is “freedom to practice his profession in accordance with his training” (Engel, 1970, p. 12). These dimensions capture two central aspects of autonomy: on the one hand, personal autonomy over tangential work activities such as organizing and scheduling, and on the other, work-related autonomy in applying professional practices and training. Although they are likely to influence each other to some degree, they are understood as inherently different dimensions of autonomy (Engel, 1970).

Research aimed at describing experiences of autonomy tend to lump these two aspects together (Ballou, 1998; Hackman & Oldham, 1975; Mastekaasa, 2011), creating hybrids such as “the degree to which the job provides substantial freedom, independence, and discretion to the employee in scheduling the work and determining the procedures to be used in carrying it out” (Hackman & Oldham, 1975, p. 162: and applied similarly in Mastekaasa, 2011). An understanding that merges Engel’s (1970) dimensions of personal autonomy (controlling tangential aspects of work) and work-related autonomy (the process of determining procedures).

Brante et al. (2015) present multiple dimensions of autonomy, including ones measuring the professional’s control over tangential elements such as when to work, at what tempo and order, and how to act towards clients. This understanding follows the spirit of Engel’s two autonomies in separating between tangential tasks such as when to work, what tempo, and professional autonomy in how to act towards clients. It differs from Engel’s in that they define professional autonomy as the freedom to perform the work and procedures with no explicit connection to training. This understanding is similar to Hackman and Oldham’s (1975). I adopt this understanding because of the close connection between professional training and the decisions professionals make (Bøe, 2013), and that being a “professional” is not necessarily limited to training or education, but can also be considered contingent on the type of work performed (Løwendahl, 2016).

The data in this article comes from a battery of questions measuring “job demands” and “job-decision latitude,” or the “discretion permitted the worker in deciding how to meet these demands” (Karasek Jr, 1979, p. 285). “Job-decision latitude” is similar to Engel’s (1970) work-related autonomy by being concerned with professional decision-making. However, it differs in that it does not include an explicit link between decisions about the professional content of their jobs and their training. Making Karasek (1979) in this regard more similar to Hackman and Oldham (1975), Brante et al. (2015), and Løwendahl (2016) than Engel (1970). In this article, I refer to this kind of professional decision-making as “professional autonomy.”

“Job demands” include both workers’ experiences of having demands on their performance and of being in control over their work situation such as time and workload (Karasek Jr, 1979). The former measuring demands on how hard and fast they work, the latter measuring personal autonomy; being in control of tangential elements of work such as one’s work situation and schedule (Engel, 1970; Hackman & Oldham, 1975; Mastekaasa, 2011). Supported by a principal component analysis, I propose that Karasek’s (1979) category of job demands should be refined into two different concepts: (1) personal autonomy or the degree of control professionals experience over their work situation excluding professional decisions, and (2) performance demands, or the professionals’ experienced demands on their performance.

This refinement allows me to treat autonomy as a concept with multiple dimensions of professional and personal rather than a singularity. Allowing for a better understanding of professional workers’ experiences and how the various dimensions of autonomy may be influenced by performance demands.

Managerialism and autonomy

Welfare professionals’ experiences of autonomy and performance demands are particularly relevant due to the popular notion that new public management (NPM) reforms—part of broader neoliberal governance also in Scandinavia (Peck, 2010)—have weakened professional autonomy through increased control and demands on performance (Brante et al., 2015; Harris, 2002). This “managerialism,” a prevalent aspect of NPM seen in social work in the United Kingdom, represents a trend towards increased managerial control on production (Evans, 2009, p. 146). Research from the Scandinavian welfare context points to similar issues of balancing organizational control and professional autonomy among social workers and nurses (Brænd, 2014; Dalsgaard & Jørgensen, 2016; Hildebrandt, 2016; Shanks, 2016). Such developments have also been found across the spectrum of welfare professions in Denmark (Willig, 2016).

Managerialism is characterized by an increased business orientation among welfare professional organizations, with greater emphasis on finances, budgeting, and control (Harris, 1998). In Scandinavia, this means an increased use of performance control measures, seen in conjunction with a loss of trust in professionals and an organizational need for control to compensate for this (Øverbye, 2013). Some research has pointed out that a skewing of the balance between management and professional practices could lead to restrictions on professional autonomy and the prioritizing of managerial control (Harris, 2002; Lawler & Bilson, 2009). For example, Danish and Norwegian nurses have experienced a disconnect between performing tasks they are trained to do as caregivers and meeting specific production measures such as turnover rates in hospitals (Brænd, 2014; Thomassen & Larsen, 2016). Managerialism and NPM are broad, general descriptions of trends not easily measurable; however, both theoretical and empirical contributions suggest that an emphasis on performance and ensuring production are central elements. Therefore, I treat welfare professionals’ experiences of performance demands as an indicator of managerialism.

As for the consequences of managerialism on the professional role, Evans (2009) argue that increased managerialism can complement rather than limit it. This because social work managers in the United Kingdom report adhering to professional values despite being tasked increasingly with production and performance goals. This then becomes an additional part of the manager role, working alongside and not against professional autonomy. Added responsibilities, such as budgeting, allows local human service managers to operate flexibly within the system and providing maneuverability in gray areas (Evans, 2009, p. 153–156). With the result that professionals report that their managers give them the discretion to make sound professional decisions despite increased managerialism (p. 157).

These complementary functions are possible because managers see themselves as performing independent professional and managerial roles (Lawler & Hearn, 1997). Derber’s (1983) literature review found that professionals are controlled differently in how they work and what they produce, suggesting that professional and personal autonomy are two separate dimensions which may co-exist (p. 335). A literature review by Kirkpatrick (2006) shows that increased control over social work practices in the United Kingdom manifests itself as an increase of rules, procedures, and standardization, without these changes influencing professional values and practice to the degree one might suspect.

This is also found in the Scandinavian welfare system as Shanks (2016) suggests that Swedish welfare service managers keep a strong professional identity regardless of increased focus on cost effectiveness. The ability to maintain their professional identities in the midst of neoliberal reforms suggests that increasing demands may not necessarily limit the “controller’s” professional role, nor the professional autonomy among the “controlled.” As professionalism and control coexist in “professional bureaucracies,” professionals may lose some control over the means of their work (personal autonomy) but retain power over the ends (professional autonomy) (Engel, 1970; Harris, 1998). These theories explain how professional and personal autonomy can coexist and support each other as separate dimensions of autonomy; individuals need not possess one or the other exclusively but can possess both to different degrees.

Variables

I combined eight self-reported statements concerning work characteristics into three merged variables measuring welfare professionals’ self-reported experiences of performance demands and personal and professional autonomy. I devised the variables from Karasek’s (1979) model for measuring job demands and job-decision latitude, which asks, “To what degree would you agree with these statements about your current job?”

Karasek’s merged variable “job demands” consists of five statements. This variable is refined to measure two merged variables for this study. Two statements concerning how professionals experience demands on how quickly and hard they work are used to measure the variable “performance demands,” while the three statements concerning professionals’ experience of being able to control their own work situations are used to measure the variable “personal autonomy.” The principal component analysis, shown in Table 1, collaborates this separation, providing empirical evidence that Karasek’s variable “job demands” actually contains two different variables. Three statements measuring “job-decision latitude” are then used to measure the variable “professional autonomy.”

“Performance demands” measures how professionals experience demands on how hard fast and hard they work, is the mean of the following two questions: 1) “My work demands that I work very fast” and 2) “My work demands that I work very hard.” A high score indicates a high level of experience of performance demands, and relates closely to demands on performance and production, central features of managerialism.

“Personal autonomy” measures how professionals experience their ability to control their own work situations, is the mean of the following questions: 3) “I am not asked to do disproportionate amounts of work”; 4) “I have enough time to get the work done”; and 5) “I am not exposed to conflicting demands from others.” A high score indicates a high level of experience of personal autonomy.

“Professional autonomy” measures the freedom professionals experience in making decisions about the content of their work and their discretion to determine procedures (Brante et al., 2015; Hackman & Oldham, 1975; Løwendahl, 2016). As a measure of experienced autonomy in decision-making, this variable does not differentiate between decisions made based on individual preference and those based on professional knowledge. Nevertheless, it is considered professional autonomy because it concerns the say that professionals have in determining the measures to use in their work. Professional training is thus treated as an implicit element in the decisions professionals make. Professional autonomy is measured as the mean of the following questions: 6) “My job makes it possible to make a lot of decisions on my own;” 7) “In my job, I have very little freedom to decide how I do my work;” and 8) “I have a lot of say about what happens in my job.” (The answers to question 7 were reversed to create a unified scale.) A high score indicates a high degree of experienced professional autonomy.

I utilized the educational code registered to each participant to determine their professional backgrounds. Previous studies have used different praxes when grouping professionals. For instance, Mastekaasa (2011) included physicians, nurses, teachers, and social workers. Inspired by Brante et al. (2015), and the availability of professional groups in the dataset, I included the following welfare professions in my analysis: nurses, teachers, preschool teachers, social workers, and child-welfare workers. Multiple regression analysis with ordinary least squares (OLS) to control for the effects of professional group, age, and gender showed a non-substantial effect on the relationship between performance demands and the two autonomies. This does not mean that every profession experienced the three variables similarly, but that the relative relationship between the variables is not substantially different between the included professions. Based on this I treated all included professions as one cohort of welfare professions. Subsequently, I present the findings as correlation coefficients for easier interpretation.

Analytical approach and methods

The internal consistency of each merged variable was measured by their Cronbach’s Alpha score. The principal component analysis shows that each scale was unidimensional (Table 1). A high Cronbach’s Alpha score (zero to one) indicates that the merged variables measure the same underlying concept. The values for “personal autonomy” for each of the three years (2004, 2006, and 2010) are 0.65, 0.64, and 0.69 respectively. Values for “professional autonomy” are 0.62, 0.64, and 0.63, and for “performance demands,” 0.71, 0.77, and 0.74. One potential weakness of Cronbach’s Alpha is that few items, as in this study, tend to score lower than many (Tavakol & Dennick, 2011). As there is no absolute threshold for internal consistency (Cortina, 1993), care must be taken not to use Cronbach’s Alpha as the only proof of a merged variable being internally consistent. Although the scores in this study are not very high, the combination of unidimensional variables demonstrated by principal component analysis (Table 1) and the Cronbach’s Alpha scores, give me confidence that the three merged variables measured different, unidimensional concepts to a satisfying degree.

I confirmed the refinement of Karasek’s “job demands” into “personal autonomy” and “performance demands” with a principal component analysis and a rotated components matrix using Varimax rotation with Kaiser Normalization. Principal components analysis indicates how statements load into different variables, signifying which statements measured the same underlying concept. Statements loading in the same variable are understood to measure the same underlying concept. I performed a preliminary analysis with Direct Oblimin, a rotation-assuming correlation, to confirm the different variables before presenting with Varimax rotation to present the variables clearly. Rotation with Varimax illustrates the differences between variables more clearly by assuming that they are independent of one another.

I used Spearman’s rank order to determine the correlation between performance demands and professional and personal autonomy. Results that point to statistical significance are indicated with no stars (p>0.05), two stars ** (p<0.05), and three stars *** (p=0.00). All statistical analyses were performed using IBM SPSS Statistics v.23 for Windows.

Experiences of autonomy and performance demands

The average scores of welfare professionals’ reported experiences in years 2004, 2006, and 2010 show a slight increase for performance demands, and that personal and professional autonomy are experienced as different dimensions in all three samples (Table 2).

Note: Responses on a scale from low (1) to high (5) experiences of each concept with N and standard deviation.

Concerning hypothesis 1 the results indicates that “personal autonomy” and “professional autonomy” are experienced as different dimensions of autonomy. Comparing the experiences of personal and professional autonomy with paired samples T-test show that these differences are statistically significant (p=0.00) in all three samples. The recurring nature of these differences suggests that this is a stable relationship. The results also support hypothesis 2 in that experiences of performance demands increased somewhat in the period, specifically:

Relationship between autonomies and performance demands

While the means indicate the stability and development of how these concepts are experienced, correlation analysis is necessary to test hypotheses 3 and 4 regarding how the experiences of one concept influence the experience of the others. Correlation analysis indicates that welfare professionals who experienced increasing performance demands experienced less personal autonomy (Table 3). Experiences of increasing performance demands were not related to experiences of professional autonomy. Results show a moderate negative correlation between experiencing performance demands and experiencing personal autonomy in the study years (-0.341***, -0.414***, and -0.444*** respectively). The correlation analysis indicated no statistically significant relationship between experiences of increasing performance demands and professional autonomy (p>0.05).

Note: Correlation Coefficients for all three years with N. No stars (p>0.05), ** (p<0.05), and *** (p=0.00).

The results demonstrate that increasing performance demands influence these dimensions of autonomy differently. While correlation is not causality, the data indicates that experiences of personal autonomy are moderately related to experiences of performance demands, while experiences of professional autonomy are unrelated to experiences of performance demands.

My interpretation of this is that the professional actors experience that they are able to keep their professional decision-making ability despite being of increasing performance demands. This does not reject that increasing performance demands may limit experiences of autonomy as a whole, but it suggests there are substantial differences in the influence of increasing performance demands on the distinct dimensions of autonomy. The difference shown here indicates that the relationship is stronger between performance demands and personal autonomy than performance demands and professional autonomy. These results reject hypothesis 3, and support hypothesis 4, specifically:

Personal autonomy and professional autonomy appear as weak dependent concepts with a statistically significant correlation in all three years (0.137***, 0.112**, and 0.103**), supporting hypothesis 1 suggesting that they are experienced as distinct dimensions.

Managerialism and autonomy

The multidimensional aspects of autonomy can explain why there are two schools of thought regarding the effects of managerialism and performance demands and how both can be right in their own way. Managerialism may limit autonomy as a whole, and yet affect the dimensions of personal and professional autonomy differently.

Although these results support the notion that experiences of performance demands tended to increase among welfare professionals in the 2000s, the correlation coefficients indicate that increasing managerialism is not necessarily an obstacle to experiencing professional autonomy. Supplementing previous research, my findings suggest that managerialism may not be as limiting to professional autonomy as has been suggested, but that it may limit welfare professionals’ experience of personal autonomy. The takeaway being that professional autonomy—and through it, the professional role—may not be under the same stress as professionals’ ability to organize their own work situation.

As welfare professionals experienced having to perform better, their experience of personal autonomy decreased, while professional autonomy remained unchanged. This duality may be explained by theories on the separation between control and professionalism in professional bureaucracies (Engel, 1970; Harris, 1998); that is, professionals may treat freedom to plan and freedom to perform as independent dimensions (Lawler & Hearn, 1997), or that they may be governed differently in the means and ends of their work (Derber, 1983).

An alternative explanation is that limitations on professional autonomy may be experienced as indirect or entangled restrictions. For example, too little time and too many tasks could indirectly hamper professionals’ ability to perform their jobs with the desired professional autonomy. However, the weak correlation between professional and personal autonomy suggests that they are largely independent dimensions and that indirect restrictions cannot explain the results alone. Nevertheless, the direct and indirect effects of managerialism on professional autonomy through personal autonomy warrants further research considerations.

Some of this effect could potentially be explained by differing expectations coming into their professional career. Professional workers who enter initial job positions may be conscious of the tension between professional autonomy and managerial control, but have fewer or no expectations of limitations on how to control their workday. Coming recently from an educational situation with a high level of personal autonomy, new professionals may experience a “shock” of having less control over their own workday as employees. The effect of this should be limited by the study measuring experiences three years after graduation.

The professional contract

The “professional contract” regulating the relationship between control and freedom for professionals is one in which a governing body provides education and protection of professional status and in exchange professionals’ use their abilities for the betterment of society (Brante et al., 2015). This study’s findings suggest that any limitations from this contract are more poignant for professionals’ ability to organize their workday, than for their application of professional expertise. Which indicates that the professional contract work as intended: Welfare professionals experience an ability to perform their job as trained professionals, even with increased demands on performance. Rather than losing professional influence over their work, professionals lose control over the organizing of their work. This is compatible with the intention of the professional contract, which describes a trade-off in which professional workers exchange something for their status (Brante et al., 2015; Derber, 1983; Engel, 1970). The professional contract may still be viable under increasing managerialism as welfare professionals experience continued control over their decision-making, even as they lose control over the tangible aspects of their workday. A possible explanation for this is that personal autonomy may lack the explicit and historical protection of professional autonomy in the professional contract, making it a more likely casualty of increasing demands for control and production.

Consequences for managers

According to Noordegraaf (2011), conflicts between professional and managerial logics are not solvable by adding more professionalism to “rescue” professional work from control, nor by “moving beyond” professionalism through more restrictions on the work. Rather, Noordegraaf (2011, p. 1362) argues that professionals must realize that they need to be managed and thus adapt to changing contexts. My findings suggest that practitioners and managers in welfare professions are adapting to these changes by compartmentalizing personal autonomy and professional autonomy; treating them as two separate dimensions rather than one, allowing for increased performance demands without it limiting professional autonomy.

The mechanism behind this has been previously described among nurses who take individual responsibility for providing the care they deem necessary, independent from organizational goals focusing on performance demands (Thomassen & Larsen, 2016). Serving as an example of how professionals are able to compartmentalize the decisions about what is professionally necessary, and what is organizational preferable. This poses a potential challenge for managers as professionals appear to favor their professional training over managers’ instructions. Creating a chasm between organizational needs, defined in their routines and enforced by control, and what the professionals prioritize. When creating measures and instructions concerned with ensuring performance, managers should be aware of how these measures might be individually adapted by the professional to fit their professional understanding, rather than being uniformly applied. This is important in order to avoid goal displacement which risks that the provision of care becomes an individualized effort rather than an organizational goal (Brænd, 2014; Thomassen & Larsen, 2016). One way of avoiding this is to involve the professionals in creating performance measures aligning professional considerations with organizational goals and need for control.

Managers should be aware that efforts to increase performance influences experiences of professional and personal autonomy differently, the non-relationship between performance demands and professional autonomy is no argument for managers to demand performance under the veil that professional autonomy appears to be unaffected. Managers must consider that a decrease in experiences of personal autonomy may have negative impact on organizational and personal performance by limiting the sense of empowerment and trust necessary for work performance (Dirks & Ferrin, 2002; Harter, Schmidt, & Hayes, 2002) and for work satisfaction (Barak, Travis, Pyun, & Xie, 2009), both of which are important elements in job retention (Barak, Nissly, & Levin, 2001). Although autonomy is neither good, bad, nor absolute (Evans & Harris, 2004), managers and professionals must work together to ensure that their blend of demands and autonomy suit their work situation. It should also be considered that limits on personal autonomy are not necessarily negative, a straightjacket for the professional, in some instances it may benefit professionals who are freed to spend time on professional decisions rather than administrative ones.