This volume offers empirically based insights and findings on the question of how human service organizations are reacting to the increasing need for greater impact, effectiveness, and performance.As demand for increased impact outstrips our knowledge of how best to achieve these goals, the book’s contributors discuss the innovative strategies being used to ensure that multiplex goals are being met and the degree to which client and staff concerns are being sacrificed for the organizational bottom line. Taken together, these discussions demonstrate that specific management strategies and collaboration based on trust and consideration of mission may help improve the quality of some services; however, many of the pressures which organizations and managers experience are resulting in lower staff morale, compromised missions, and inefficiencies.This book will be of interest to those researching human service agencies, as well as those with a broader concern for how organizations react to doing more with less. This book was originally published as a special issue of the Human Service Organizations journal.