Understanding Conflict in Multisite Nonprofit Organizations

Due to distance, Multisite Nonprofit Organizations (MNOs) experience conflicts that differentiate them from organizations with only a single site. Through a qualitative analysis of interviews with 25 professionals and volunteers in a national diseasespecific nonprofit, in this study I explore the conflicts that arise between headquarters and affiliate offices in MNOs. The findings reveal that some conflicts are likely unique to this particular type of nonprofit. However, other conflicts are likely representative of those experienced in MNOs more broadly. I, therefore, propose strategies for managing these conflicts.

When compared to an organization with only a single site, there are internal tensions associated with an MNO. These tensions arise due to the distance between the central office and the affiliates. Though this is not the only factor that impacts tension, distance is a unique variable for MNOs. These tensions can be at the individual or the organizational level. Conflicts that occur between the central office and affiliates because of these tensions, such as localization or how to deliver programs, have been explored by Grossman and Rangan (2001). They found that conflicts arise due to allocation of resources from the central office, the payment of fees from the affiliates to the central office, and how services are delivered. They also explored factors that led to autonomy for these affiliate organizations, which was a major source of tension. Table 1 provides an overview of MNO conflicts that have been explored in the literature. With the exception of work by Grossman and Rangan (2001), most studies have focused on one or two conflicts (Balser & Carmin, 2009;Gibbons & Hazy, 2017;Paarlberg & Meinhold, 2012;Smith, 2003). These conflicts arise partly because affiliates of MNOs "…must satisfy local constituencies while aligning individual missions, structures, governance practices, and programs with parent organizations" (Siddiki & Lupton, 2016, 157S). This leads to conflict when what is perceived as best for the local affiliate is not the same as what is perceived as best for the central office (Harris, 2011).
Many of these existing studies have a) primarily focused on larger organizations (e.g., United Way (Paarlberg & Meinhold, 2012), Goodwill (Gibbons & Hazy, 2017), Planned Parenthood (Grossman & Rangan, 2001;Oster, 1996)), or b) have focused on international organizations (Harris, 2011;Siddik & Lupton, 2016;Smith, 2003). MNOs, however, are diverse with varied  Balser & Carmine, 2009;Grossman & Rangan, 2001 structures (Brown et al., 2012), sizes, and sectors represented. Therefore, in this study I focus specifically on smaller organizations with diverse structures, including networks, centralized, and mixed structures. Based on interviews with individuals associated with, both, the central office and affiliates of MNOs, this study builds on the work of Grossman and Rangan (2001) by identifying conflicts in MNOs and their impacts on the organization. Specifically, the research questions are: What conflicts, if any, exist between the central and affiliate offices of MNOs? What outcomes, if any, do these conflicts have on the organization?

Understanding Conflict
Conflict is "…perceptions by the parties involved that they hold discrepant views or have interpersonal incompatibilities" (Jehn, 1995, p. 257). It happens within all organizations, whether they are nonprofit, for-profit, or government. The way professionals respond to conflicts are situational. In other words, there is no one way to respond to a specific organizational conflict but, instead, diverse ways based on the specific issue (Temkin & Cummings, 1986). For example, when managing conflicts between stakeholders, organizations tend to try to find compromise and balance among these difficult needs (Provan et al., 2004). Some conflicts within nonprofits can originate around the conflicts they were trying to deal with externally, known as mission mirroring. This can happen, for example, when the staff of a conflict resolution organization do not get along (Allyn, 2011). How these conflicts translate to organizations with multiple sites, though, and their strategies for managing conflicts is not fully understood.
Social categorization theory (SCT) is a way to understand conflict by exploring in-group and out-group relationships. Specifically, SCT places oneself and others into in-groups and outgroups, which focus on group prototypes, language, and interactions (Hogg & Terry, 2000).
In an organizational setting, the question is who is part of the ingroup and who is part of an outgroup. It also explores how these group memberships influence behavior. For example, being part of the same group can encourage cooperation (Turner, 1985). Within organizations, in-groups and out-groups are naturally created. In an MNO, distance adds an extra layer to this relationship. Specifically, affiliates tend to be their own in-group, and view the central office as an out-group. The distance aspect may encourage an in-group/out-group relationship due to the isolation of affiliates. One strength of using SCT in understanding conflict, especially between affiliates and central organizations, is that it allows for the exploration of different roles, perceptions, identities, and expectations between two groups of people (Blazejewski & Becker-Ritterspach, 2011).
This study takes a holistic approach to conflict. In other words, it is not just about the conflicts that the organization faces, but also how those conflicts impact the organization as a whole as well as the strategies used to overcome such conflicts. Though much of the research has explored types of conflicts and management of conflicts independently, there has been some literature on conflict resolution, which has been merging these two areas to better understand conflict from beginning to end (Blazejewsik & Becker-Ritterspach, 2011;Mikkelsen & Clegg, 2019). Studies have explored how conflicts may end up with various outcomes for the organization. For example, an ever-growing body of research suggests that there are positive outcomes to conflict (Tjosvold, 2008).

Research Setting: Disease-Specific Nonprofit Organizations
This research was conducted by exploring disease-specific nonprofit organizations with affiliate offices across the United States. Disease-specific organizations are defined in this article as nonprofit organizations which focus on providing support and services around one specific disease. These organizations are also known as Patient Advocacy Organizations, but this title limits the work being done by these nonprofits on advocacy and research. Other titles have included Voluntary Health Associations and Self-Help/Mutual Aid Organizations. Many of these organizations also provide support and services to people affected by the disease or disorder, including patients, family members, and professionals. These services can include, but are not limited to, support groups, social workers, and patient education.
The number of disease-specific organizations in the United States expanded greatly between 1990 and 2003, from 400 to over 1,000, due to the influence of the internet (Best, 2012). These organizations provide many services including research, education, advocacy, and social service support (Beard, 2004;Moreira et al., 2014) at both the macro level (e.g., advocacy) and the micro level (e.g., support groups) (Greenspan & Handy, 2008). Many of these organizations are also considered self-help groups, which are grassroot (or start as grassroot) organizations established by and for people who focus on a specific issue (Borkman, 1999;Wood, 2000), such as breast cancer (Borkman, 1999) or HIV/AIDS (Chambré, 2006).

Methods
This qualitative study is based on interviews with 25 professionals and volunteers from 9 disease-specific national nonprofit organizations in the United States. This was a purposive sampling strategy to get a better understanding of how conflicts impact MNOs. Specifically, I used a stratified sampling to look at organizations which were, based on affiliate size, both small (e.g., 7 affiliates) and large (e.g., over 150 affiliates). This provided variation on MNO size (Robinson, 2014). Also known as voluntary health organizations, these nonprofits provide support and education for those affected by specific diseases, such as breast cancer or Fragile X syndrome. Disease-specific MNOs were used in this exploratory study due to their diversity in size and structure. The organizations in this study were diverse in their structure, including franchise organizations, bureaucracies, and networks (Brown et al., 2012). Though there is no right number of organizations to study, these nine organizations provided rich information on how conflicts played out in MNOs along with a way to compare conflicts within similar organizations. For example, Mason (2016) also used nine organizations for her comparative case study. Balser and McClusky (2005) were able to gain rich information on organizational effectiveness by looking at 14 nonprofit executives in three organizations. Saturation was identified when the last three interviews provided no additional information on the conflicts that were identified. Table 2 provides information on the organizations that participated in this study. Names in this study have been changed.
This study was part of a larger mixed-method study. My interest in this topic is rooted in my past experience working in the central office of an MNO. During this time, I experienced conflicts between the affiliate and central offices that were different than my work at organizations with a single site. Outreach was initiated through both a snowball sampling procedure as well as through direct contact with specific nonprofit organizations (Berg & Lune, 2012). To start, I reached out to agencies with whom I have a personal relationship. Along with having them participate in the study, I asked for their help in connecting me to other diseasespecific organizations that may be willing to take part in my study. Furthermore, using the National Taxonomy of Exempt Entities (NTEE) code of G (Disease, Disorders, and Medical Disciplines), I searched Guidestar's website for relevant organizations which fit my sample criteria, yielding 300 disease-specific organizations with a national focus. I looked at the website of the agencies to find out if I could find information on either the CEO or the person who worked with affiliates or outreach. I sent two e-mails to the appropriate person along with a follow up call.
When a representative of an organization agreed to take part in my study, I interviewed professionals in the central office who worked with those in the affiliate offices. The central office then reached out to the affiliate offices via e-mail and Facebook for participants. When a respondent expressed interest in being interviewed, I e-mailed the respondent and interviewed him/her via phone or Skype. Interviews were continued until a point of saturation (Berg & Lune, 2012). Saturation was identified when, during the last three interviews, no new information was obtained regarding the conflicts that they experienced.
I conducted 11 interviews of 13 professionals in the central office, along with 12 interviews of 12 professionals and volunteers in the affiliate offices. The interviews took place between April 2017 and September 2017. These interviews were focused on various aspects of MNO structure and behavior. I included questions exploring the history of the affiliate and the organization, the interactions that the affiliate and the central office have had, the current service and fundraising plans of the affiliate and the central office, and how those interviewed felt these relationships could be improved.
Specifically, I asked about conflicts that respondents have experienced in their MNO and how such conflicts were dealt with. Though this question led to the majority of the discussion on conflicts, my general questions about the relationship between the central and affiliate offices also led to some interesting data. Many of the participants were eager to discuss their experiences. These questions included: • Do you feel that you have a friendly relationship with those in the central office?
• Are there any challenges you face due to your size and distance from the main organization? • Have you experienced any conflicts within your organization?
• What was the outcome of said conflict?
There were 227 pages of single-spaced transcriptions, totaling 988 minutes. Apart from two organizations, the interviews included at least one conversation with a member of the central office and one conversation with a member of the affiliate office. More information regarding the respondents can be found in Table 3. Three people interviewed did not identify any particular conflicts within their organization.
I performed pre-coding by taking notes during the transcriptions of interviews (Saldaña, 2016). These notes focused on the main themes of conflict I noticed while transcribing. As the interviews looked at a variety of issues, the first level of coding was data reduction so that I could focus on the specific issues of conflicts within the interviews (Namey et al., 2008). Utilizing NVivo 11, I went through the interviews and identified specific questions and answer sections that focused on any type of conflict.
I performed the second round of coding by hand using an in vivo coding technique of pattern coding. I printed out the snippets that were identified as conflicts and put notes next to each one which encapsulated the main issue of the conflict in one or two words. I compared these words with the codes I originally identified when transcribing the interviews. This type of coding focused on taking data from the first cycle of coding and parsing it out into meaningful units of analysis (Saldaña, 2016). In this case, the units of analysis were created based on the specific conflicts that were identified. Codes included "Trust and Sharing," "Perceptions of National," "Fees," and "Personality/Individual Issues." During this time, I also started to code the ways in which the conflicts impacted the organization. Once all of the conflicts were identified, similar conflicts were merged together. Through this process, the list of conflicts were created, which mimic the conflicts identified here. I then went through all of the conflicts one last time and put them into the codes that were identified.

Conflicts in Multisite Nonprofit Organizations
During the interviews, many respondents were excited to discuss the various conflicts they experienced. This section specifically looks at the various conflicts that were individually identified. Some of these conflicts are unique to MNOs, while others can be found in most nonprofit organizations. The conflicts and definitions can be found in Table 4.

Centralization and Decision Making
Centralization is focused on top-down approaches of nonprofit management (Albareda, 2018) and autonomy of decision making (Schmidt, 2019;Young & Faulk, 2010). Within MNOs, centralization puts into question the locus of decision-making within the organizational structure. Specifically, centralization reveals how much power a local affiliate has to make decisions, compared with the central office (Wong, 2012). Tran (2019) found that although many leaders of MNOs praised the idea of decentralization, they found it hard to implement within their own organizations. This conflict focuses on the push for more autonomy and the ability of affiliates to make their own decisions (Rost & Graetzer, 2014). Whether or not a more centralized or decentralized structure is best for an MNO depends on many different variables, such as resource density, age of the organization, and the type of work the organization does Trust An "us" versus "them" mentality leading to limited trust between the affiliate and central office.

Fees
The amount the affiliate office pays to the central office to maintain its affiliated status 2, 9 Reporting Requirements The paperwork and other information needed by the central office from the affiliate office.
1, 6 (Hudson & Bielefield, 1997;Taylor & Lansley, 2000). Both centralization and decentralization have their pros and cons. While centralizing can make an organization more efficient with a central form of power, it may also limit creativity within the organization (Wong, 2012).Organization 4 dealt with issues around centralization, specifically around branding. When Jenny, the CEO, wanted to have all of the affiliates use the same logo, the argument from the affiliates was that they already had a logo that they liked and that others within the community already identified with them. For Jenny and those in the central office, branding was important because they wanted to make the organization recognizable across the country. Similar to other organizations, Jenny felt that having all of the affiliates with the same logo represented a singular brand that could be identified no matter where in the United States a person is located. According to her, as the affiliates "…create websites and create publications and things of their own, we want them to be using the logo that we provide and essentially using the language that we recommend." Furthermore, a singular brand represented a unified identity for the organization. Eventually, the affiliates agreed to the singular logo, but not without putting up a fight. For the central office, centralization meant coming together under a singular identification (a common logo); however, for the affiliates, it meant a loss of local identification and control.
The conflict around centralization is not unique to MNOs. The amount of power and decision making opportunities of each unit within an organization (or even each person) is an important part of nonprofit organizations. The most efficient centralization structure differs for each organization (Schmid, 2002;Tran, 2019). Changes in centralization of the organizational structure can even be seen as a threat to the identity of an organization on the whole (Balser & Carmin, 2009). What may make centralization unique in MNOs is that the affiliate may feel isolated from the central office and the decision making process due to the distance between them. It can be perceived as someone from an out-group making decisions for an in-group, instead of being seen as an organization making internal decisions.
Maria, also from Organization 4, reported that some of the conflicts surrounding the direction of the organization were influenced by how much power the affiliate had in the national decision-making process, which may have caused some of the conflict regarding branding and logo. Several years earlier, the organization's direction was influenced by a board of affiliate representatives, not by the national board. During a reorganization, the organization decisionmaking powers were transferred from a group of affiliate representatives to the national board. This led to complaints from those associated with the affiliates, as well as to soul searching within the organization regarding who was responsible for influencing the organization and its direction, specifically, where the power and decision-making should be located. This is one of the reasons why several affiliates left the organization to start their own competing nonprofit. From Maria's standpoint, this conflict was initiated because the affiliate felt as though some of their power regarding the organizational direction and governance was taken away. By having the central office as the other who is 'imposing' decisions onto the affiliate, the affiliate may feel separated from the central office's decision making. This builds on the perception of the central office being some form of "other" entity imposing decisions, as opposed to different parts of one organization working together to move forward.
Part of centralization conflicts may also focus on the age of the chapter. Bobby from Organization 7 talked about how templates or formulas for programming and communication would be great for new affiliates, but affiliates which have been around awhile would find this as a type of intrusion on their autonomy. While newer affiliates may welcome a more centralized structure and perceive it as helpful, older affiliates may see centralization as an imposition. Sarah, from Organization 9, reported that she was working slowly to get centralized branding and templates together for more senior affiliates. By using a slow process, she was hoping to minimize the conflict by getting the volunteers involved. Instead of creating an us versus them situation, Sarah tried to create the larger organization as one social category by bringing the volunteers into the conversation early on.

Interpersonal Conflicts
Interpersonal conflicts are not unique to MNOs. The difference, though, is that interpersonal issues in MNOs are exacerbated by distance. It is not that being in separate offices make relationship conflicts easier or harder to manage. Instead, the distance means that an extra effort needs to be made by the offices to create and maintain these relationships. For example, Sarah, from Organization 9, discussed how …it has become more of my role and part of that was because there were some challenges with chapter relations when I came on board...And I don't know how much our board...the national board knew about it, but it became very quickly apparent that I had to repair some of those relationships with the national office.
As CEO of the organization, Sarah had to spend a large portion of her time mending and sustaining relationships that were strained by her predecessor. This was made more difficult by the distance between the central and affiliate offices. Relying on e-mails and other forms of communication, instead of face-to-face interactions, leads to a different type of conflict (Byron, 2008;Cheshin et al., 2011).

Misperceptions of the Organization
Another issue Sarah discovered when she became CEO is that part of this animosity was connect to the perceptions and misperceptions of the central office by those in the affiliate office. Sarah noted, To manage these relationships, Sarah did a webinar to introduce those in the affiliate office to her office and the people who work there with her. She also encouraged board members and staff visiting the area to see the office. This helped to start smoothing things over with the affiliates, as they were able to identify those in the central office and create stronger identifications of those who used to be "faceless central office staff." Furthermore, by showing that the office was not as lavish as most people thought, Sarah was able to show that the central office was not spending a large amount of money on the office in New York. Instead, Sarah started talking honestly about the fees that the affiliates paid and where those fees went, including for support services for the local nonprofit, such as auditing and accounting. This honest and open conversation helped the local affiliates to feel supported and change the perceptions of the central office.
Part of the issue with this conflict is distance. Being separated from the central office, those in the affiliates would not be able to visit and see the resources available to the central office. By having a separate office, those in the affiliate are left wondering what is happening in the central office. From a SCT perspective, this idea that the central office has resources that it is not sharing would help solidify the in-group/out-group perspective held by the affiliates and solidify an identity of the central office as an out-group. In general, perception gaps have been found to be a conflict in MNEs, and lead to dysfunction and coordination between the affiliates and central office (Schotter & Beamish, 2011).
Amy from Organization 6 complained that there is a disconnect between the resources the central office has available and the resources and staff that the affiliates think the central office has available to them. When discussing her interactions, she found I think that our chapters sometimes see us as a different organization just because we know that we're small and we don't have a lot of staff here but they might not necessarily know that. They might see us as a big organization with a bunch of employees and a bunch of volunteers and really when people see national…they mean me because I'm national to them whereas they might consider national as...as more people than me and not as willing to help them…it's difficult because there's only one of me and so many of them.
There is sometimes a perception by affiliates that the central office has more staff and resources available than it actually does. This can lead, as discussed in the interviews, to affiliates complaining about the amount of work being done by the central office to support affiliates. Because affiliates believe the central office has more capacity than it really does, affiliates are unhappy about the resources and support they receive and their relationship with the central office.

Trust
For Organization 1, the issue of lack of trust is a source of conflict. Mary, who worked in the affiliate for four months, but had worked at another MNO before, discussed how this attitude stems from regional differences in culture. Mary, thinking back to a previous job working with an organization based in Minnesota and North Dakota, found that even within a small geographic region, this us versus them mentality existed, creating conflict between the affiliate and the central office. Mike, the CEO of Organization 1, hypothesized that "[t]he us/them mentality is when… when folks don't have confidence in what the other part is doing." Indeed, affiliates find it harder to trust the central office when it is seen as an out-group member.
This lack of trust impacts the organization in various ways, such as leading to a lack of sharing between the affiliate and the central office. One respondent expressed that affiliate offices "…are afraid that if they give that membership list to national or to state associations, their members are going to get…flooded with e-mails for donation requests." The affiliate was concerned that sharing donor information with the central office would be detrimental to the affiliate's relationship with the donor. Those in the affiliates did not trust the central office to handle these relationships respectfully and, therefore, refused to share information.
Lack of sharing can have a negative effect on fundraising. Without information sharing, both the central and the affiliate offices may go after the same donors. This may confuse donors as they are not always aware of the difference between donating towards the affiliate and the central office. Trust helps build up group relationships. Without trust, the central office will be seen as an out-group by the affiliate. Creating trust beyond the affiliate office to include the whole organization would help alleviate conflict.

Fees
One conflict around financial issues, specifically fees, was a focus for those in Organization 4. Fees can vary by organization, with some affiliates paying 2% of their donations, and others paying up to 30% of their revenue (Oster, 1996). Recently, Jenny decided to allow one of her affiliates to forgo the fee until they were able to get back on their feet. Once they were on better footing and, therefore, expected to pay the fee again, the affiliate balked and started to discuss leaving the organization because of the fee payments. Jenny reported that "…they want a meeting…a special meeting because they don't think there's value in the affiliation fee." Though the affiliates want the support from the central office, whether there should be a cost for this support was a cause of intraorganizational conflict. One of the reasons affiliates left Organization 4 was due to difficulties paying the affiliation fee.
Another concern around fees is what the affiliates receive for the payment. Without communication, the affiliates have the perception that they are paying money to the central office without getting anything in return. Distance adds to that conflict because the affiliate is not in the office to see how fees are utilized. The affiliates may not feel that they are getting enough attention for the amount of funds they are spending, feel as though the funds are supporting out-groups instead of their affiliate, or feel they are not getting enough of a say in the way funds are dispersed.
In some cases, respondents reported conflicts existed not because of the fee, per se, but because the affiliates felt that the support received from the central office was insufficient for the amount paid. For example, when Josh from Organization 2 was discussing his affiliate's stagnation, he wished there would be more support from the central office concerning growth. He would have liked the central office to invest more in his affiliate so that they could expand.
One of his issues with growth was that, as the affiliate grew …we end up giving more to the national organization, which takes it out of our coffers, puts it into theirs…I think there needs to be more support from the national office for the organic growth of an organization that there currently isn't.
Josh felt that although greater growth would lead to more money for the central office, the central office was not doing enough to support his affiliate in growing and gaining new funders. Another issue around fees is that the affiliates were unaware of how the fees were used. This lack of communication and trust exacerbated this conflict.

Reporting Requirements
Maria, who worked at one of the affiliates in Organization 4, found that overly complicated reporting requirements were a strain on affiliate offices, further straining the relationships with the central office. She noted, We were to report numbers to them. We were to provide, you know, finances... money to them. We were to provide a number of other things. During this time, there were a lot of reporting requirements that were difficult for the affiliate offices to meet, especially the smaller ones. This led to being overwhelmed by the requirements. Furthermore, affiliates were unclear about the use of paperwork they had completed. Maria reported that it was not just that it was a lot of paperwork, but without any feedback on how the paperwork was used, it felt like busy work. As with other conflicts, the affiliates would not be able to see how the central office used this paperwork due to being located far away. Furthermore, by not being in the same office, the central office may not have always thought to explain how the paperwork was being utilized. There was, instead, the perception that the affiliate was doing this work, but it was going into a void, while the central office felt that this information was vital to understanding local initiatives.

Outcomes of Conflicts
During these interviews, four basic outcomes were identified. First, sometimes the affiliates left the organization. Maria, from Organization 4, reported, Other reasons reported for affiliates leaving the organization included being unhappy with the direction of the organization. Jenny, from Organization 4, discussed how multiple affiliates left to start a competing nonprofit when they were unhappy about governance decisions, specifically the loss of influence on the organization by the affiliates. Altogether, Organization 4 lost almost 20 affiliates. After leaving Organization 4, these affiliates started a rival nonprofit. Though each person from Organization 4 identified one thing that led to this exodus, it seems as though the combination of conflicts, all at the same time, created a situation where the affiliates were unhappy with the central organization as a whole. It is not always one conflict or a direct line from conflict to impact that leads to affiliates leaving. Instead, it is a combination of situations that may lead to this impact.
Second, individuals who held leadership positions sometimes left the organization due to conflicts. This was particularly prevalent in discussions regarding interpersonal conflicts. Josh from Organization 2 came into his position as an executive director of an affiliate when the previous executive director left the organization due to conflicts between herself and those in the central office. Ariel from Organization 5 spent time managing these interpersonal relationships with affiliate leadership because, before she became CEO, affiliate leaders left due to these interpersonal conflicts.
Sometimes, the conflicts led to changes in the organizational processes and behaviors. For example, Ariel from Organization 5 discussed changing the way that fees are presented to the affiliates so people could gain a better understanding of how their money is used. Due to conflicts regarding requirements, Maria reported that her organization changed what they ask the affiliates to report and discussed with the affiliates how the paperwork is used. Instead of being a hinderance to the relationship between the central and affiliate offices, the conflict can provide a way for the organization to engage in positive change.
The most common impact due to conflicts was no change. The conflicts usually either persisted or tapered off, leading to no particular impacts. It is possible that the conflicts did not have an impact during the time of the study. But these conflicts also existed as a normal part of the organizational relationship, with no expectations of resolution or change. For example, Monique from Organization 4 reported that part of the reason behind the conflict between her affiliate and the central organization is due to the difference in scale (local versus national). This conflict leads to different priorities. It is possible that the conflicts will lead to organizational change in the future, but was not recorded in the time frame of this study. But, as conflict is a normal part of the organization, it would not be surprising to find that those in the affiliate or the central offices just let it be. Though some conflicts did lead to impacts, it seems to take multiple conflicts over a long period of time to create these kinds of positive or negative changes.
To better understand the relationship between conflicts and impacts, Table 5 provides examples of specific conflicts and their impacts. As can be seen, similar conflicts can lead to different impacts in an organization. For example, interpersonal conflicts in Organization 2 led to an individual leaving, while in Organization 9, it led to positive changes. In Organization 5, interpersonal conflicts sometimes led to no changes, while other times led to volunteers leaving the organization. It does not seem as though there is a one-to-one relationship between conflicts and impacts. Instead, conflicts may have various impacts, depending on the situation, the person, and the organization. Furthermore, an impact may be linked to multiple conflicts (de Wit et al., 2012).
Based on these impacts, the conflicts can be distilled into two themes. First, there are conflicts that lead to no outcomes. These are the conflicts which are perceived as minor, or remain because those involved may not want to exacerbate the issue. Second, there are conflicts with an outcome that impacts the organization. These impacts can be detrimental for the organization (e.g. Balser & Carmin, 2009;de Dreu, 2008), such as an affiliate leaving, or they can lead to positive impacts (de Wit et al., 2012;O'Neill et al., 2013;Tjosvold, 2008). In this study, some of the positive impacts of conflict included a change in programming or how to change the organizational structure. It is unclear, in this study, what might lead a conflict to go from no impact to major changes within the organization. It is possible that seeing the central office as a member of an in-group as opposed to an out-group may limit a conflict's negative impact. This can be done by working with the affiliates, communicating the purpose and progress of the changes (even if there is no progress), and inviting affiliate representatives to help build up organizational decision making so that they feel a part of the process. This means exploring novel ways to build communication so that the organization feels like one group. This communication can also help dispel misperceptions which an affiliate may have of the central office.

Strategies
Several strategies were discussed during the interviews around how to manage these issues. These include increased communication and support, both face-to-face as well as via e-mail, webinar, and phone. These meetings can include information about the staff in the central office so that the affiliates feel more of a connection, learn who is there to support them and how, and help the local affiliates feel as though they are not alone in providing services. Communication, especially when the organization is dispersed, is key. Small workgroups can provide the affiliates with more alone time with the central office, as well as help the affiliates feel as though they are part of the decision-making process. Providing insight and input from local affiliates in both the decision-making process and implementation provides affiliates with agency within the agency. Though face-to-face meetings would be preferred, these can be difficult due to cost and timing. These strategies can help those in the affiliate feel as though they are part of the same in-group as the central office, minimizing the us versus them mentality. Strategies identified in this study can be found in Table 6.
A lack of trust can especially create a situation where communication becomes limited between the central and affiliate offices. Building up the trust between the central and affiliate offices can help create stronger relationships and a freer exchange of information. Conflict does not have to be a source of tension, it can be an opportunity to create positive change within the organization, including a change in the requirements, and honest conversations about the resources available to the central office. The variable of distance adds issues to MNOs. By not being in the same office, managers in the central office reported having to spend additional time building and maintaining relationships with the affiliate offices. Requirements Have discussions about what the purpose of the requirements are, and work together to limit the paperwork. 2 Interpersonal Increase e-mails and phone calls to create stronger bond.

A Holistic View of Conflict
Understanding conflicts within MNOs is important because managing conflicts is a large part of managing MNOs. Multiple staff members at both the CEO and middle manager level, throughout this study, talked about conflict management as part of their job. It may be surprising to those who start working in central offices the amount of time they spend managing these conflicts. To provide guidance for those employees, this exploratory study builds on previous work examining conflicts within MNOs (Grossman & Rangan, 2001). Though there are no exact numbers on how many organizations have affiliates, these are an important aspect to the nonprofit landscape. Understanding the differences that these organizations face and how these differences impact their organizational behavior can help support managers within these organizations.
A holistic view of conflict builds on previous research that identifies specific conflicts as well as the ways such conflicts impact an organization (Tjosvold, 2008). It looks at conflicts which lead to different outcomes, as well as the strategies involved. This builds on the conflict management literature, which is concerned not only with conflict, but also with strategies and outcomes. Importantly, conflict is not a one-to-one system, where one conflict leads to one strategy and one outcome (as seen in Figure 1, A). Instead, multiple conflicts are dealt with by multiple strategies, leading to an outcome that may include the conflict dying out (Figure 1, B). With an MNO, distance acts as a moderating variable, adding complexity to the conflict (Figure 1, C). In the end, the purpose of this exercise is to show the complexities of conflict and conflict resolution. Multiple conflicts may interact with each other and lead to specific outcomes. Multiple strategies may be attempted. These conflicts are complicated parts of the organizational behavior. By looking at conflict from this perspective, managers can see how outcomes and responses are based not just on one conflict, but multiple conflicts that interact with each other. Furthermore, multiple strategies may be attempted before an outcome is reached.

Limitations and Future Research
This study builds on the current literature on MNOs and conflict, but there are limitations. Future research can be used to create a better understanding of how these types of conflicts play out in nonprofit organizations. As this is a qualitative study, I only looked at a small group of people in a specific type of nonprofit. Further quantitative research can provide interesting exploration into the experiences of MNOs. These studies can look at different types of nonprofit organizations, produce a larger N, and help to explore the prevalence of different types of conflicts. Furthermore, these studies can explore how size and affiliate type may affect different types of conflict. A study like this may also be able to compare MNOs to organizations with single sites to gain deeper understanding of how conflicts differ between these types of Even looking solely at MNOs, a study comparing conflict between different MNO structure can provide insight into how MNOs function. Lastly, a larger study can explore how different personal and professional traits may lead to conflicts and various impacts. For example, a future study can explore how variables such as tenure with the organization or distance may lead to whether or not a conflict may have an impact. Another limitation is that, due to my outreach approach, there is potential bias in who might have agreed to be interviewed. This response bias may lead to a limited perspective of the conflicts reported.
A longitudinal study of how a nonprofit organization deals with conflict, or perhaps avoids dealing with conflicts, can provide insight into the way conflict plays out in nonprofit organizations and its effects on the organization in general. From this study, one can see that conflicts can lead to volunteers or even whole affiliate offices leaving the nonprofit organization. Why some of these conflicts lead to the affiliate leaving the organization, while others do not, is something I was unable to ascertain in this study. Longitudinal and case studies can provide a better examination of how these types of conflicts affect intraorganizational relationships in the long term.

Conclusion
Conflicts are a common occurrence in any organization. Though conflicts within organizations have been the topic of research in the management literature (De Dreu & Weingart, 2003;Greer et al., 2008;Kerwin et al., 2011;Schaeffner et al., 2015) and the human resource management literature (Jackson et al., 2014;Stevens & Campion, 1994), there has been limited work in understanding conflicts within nonprofit organizations, specifically MNOs. These conflicts may look different from conflicts in an organization with a single site due to the impact of distance. This leads to conflicts such as competition for resources, perceptions of the central office, and fees, which may not be seen in an organization with one office. Though this exploratory study looks at one type of organization (disease-specific organizations), it shows not only the conflicts that are experienced in MNOs, but also the impact of these conflicts on the organization. By understanding and identifying these conflicts, nonprofit organizations can make sure they are able to continue to provide services across various offices. This study contributes to the nonprofit literature by building an understanding of how various conflicts impact MNOs, how SCT can help better frame conflicts as an issue of in-group/out-group relationships, and by exploring conflicts with a holistic approach. This study provides support for professionals by normalizing the conflicts which they face, exploring strategies used, and identifying the outcomes of conflicts.
To better understand conflicts, this study uses SCT to examine how in-group/out-group relationships may impact conflicts. Specifically, due to the distance between the affiliate and central office, the affiliate may see the central office as a member of an out-group. These ingroup/out-group relationships may exacerbate conflicts, especially those around trust, misperceptions of the central organization, and centralization/decision-making. This study explores how in-group/out-group relationships, within SCT, create and support conflicts within an organization.
For practitioners, this study explores strategies used to ameliorate conflicts within organizations which have multiple sites (see Table 6). Specifically, organizations which manage conflict over distance can better understand that not only are their conflicts normal, but they will not necessarily have a negative impact on the organization. Instead, conflicts may dissipate or can be used to create positive change within the organization. It is imperative to work with the local affiliate in conflict to better understand the roots of the conflict and ways that the organization can mitigate future conflicts. Furthermore, this study provides guidance to organizations that are thinking of expanding to multiple sites. As nonprofits move from a single-site model to a multisite model, they should be aware of the unique conflicts that exist within this model and prepare strategies.
Instead of viewing all conflicts as equal, different types of conflicts will affect organizations and individuals in unique ways, including having no impact or leading to positive change within the organization. Looking at a conflict holistically, including how multiple conflicts lead to specific outcomes, helps build on the research exploring the complex nature of conflicts (de Wit et al., 2012). Conflict in MNOs, specifically, may be affected by distance, both physical and cultural, which may lead to conflicts that are different from organizations with only one site (Smith, 2003). Understanding not only the conflicts, but their impacts as well, can provide insight into the long-term impacts of conflicts on the organization. Grossman and Rangan (2001) suggested that, " [t]he key for management is to develop a governance system that accommodates this tension in a constructive rather than destructive fashion" (p. 335). By identifying conflicts and their impacts, this study builds on the ways researchers and managers can better understand the impact of conflict within an organization.

Disclosure Statement
The author declares that there are no conflicts of interest that relate to the research, authorship, or publication of this article.