Leadership Toward Organizational Change

A Core Strategy ©

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The New York State Office of Mental Healthwishes to acknowledge the contributions of the National Association of State Mental Health Program Directors (NASMHPD) and its Office of Technical Assistance (formerly NTAC) for many of the following slides.

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The Role of Leadership

Leadership can be considered the most important and fundamental resource in any project seeking culture change

Leadership is the most important component in successful reduction projects.

(Anthony, 2004)

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The Power of Leadership

Think of a king in the Middle Ages telling his court jester to go down in the middle of a mob of angry peasants and telling them: “Make them laugh!”

Used ineffectively, or not at all, leadership becomes the major barrier in any effective organizational change…

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Five Practices of Exemplary Leadership

Model the way Inspire a shared vision Challenge the process Enable others to act Encourage the heart

Kouzes, J & Posner B. 2002

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Model the way

• Leaders must model the behavior expected of staff

• People follow the person first, then the plan

• Leaders need to not only have strong beliefs/values; they must also openly share those values with staff

• Words and deeds must be consistent

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Inspire a shared vision

• Leaders cannot command commitment, only inspire it• People will follow when they accept the vision as their own• Leaders forge a purpose of unity by showing how the dream

is for the common good

“If you want to build a ship, don’t drum up the men to gather up the wood, divide the work and give orders. Instead, teach them to yearn for the vast and endless sea.” Antoine de Saint-Exupéry

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Inspire a shared vision

Three essentials: • Listen deeply to others• Discover and appeal to a common purpose• Give life to a vision by communicating expressively,

so that people can see themselves in it

Kouzes, J. & Posner, B. 2002

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Challenge the process

Leaders must get clarity and consensus on the values that underlie a different culture of care…

From one that is rule-based, institutional, impersonal, and at times coercive, to one that is based on person-centered care, that is respectful, never shame-based, and that strives to avoid homogenous approaches and generalities

Anthony, 2004; Huckshorn, 2004

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Challenge the process

• Processes are designed to keep the status quo• Search for opportunities to change and improve• Generate small wins• Learn from mistakes• Policy, procedures, treatment activities, language, and rules

need to be held up to this “values threshold” and measured against it.

• Review your treatment values and objectively critique whether current practices are working

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Crosswalk values with practices

Value: Person-Centered Care

Practice: “Everyone goes to bed at 10:30pm and lights out”

Change:A range of bedtimes that identifies and adapts to individual’s difficulty with nighttime, bedrooms, and different bio-rhythms

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When this happens, practices change…

Agencies become “informed” about becoming congruent (what we say is what we do)

Anthony, 2004; Huckshorn, 2004

Challenge the process

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We are prisoners of our organizational vocabulary

Shoshana Zuboff, 1988

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The routine, consistent use of “one word” to describe groups of diverse individuals is dehumanizing, demeaning, ignores individuality, encourages a herd mentality, and institutionalizes

The Importance of Language

“Needy”……………..... Has unmet needs

“Attention-seeking”….. Needs attention

“Manipulative”……….. Resourceful

“Patient”…………….... Person

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• Chosen language to use for recovery-oriented systems of care

• A major change/shift from usual language• Is culturally competent, respectful, and person-centered• Based on linguistic philosophy: “How we speak about

something is indicative of how we value and treat it”

IAPSRS, 2003

Person-First Language

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Using terms such as “persons with a mental illness” describes what a person has…not what a person is!It reminds us those we serve are:

– Mothers and Fathers– Sisters and Brothers– Sons and Daughters– Employees and Employers– Friends and Neighbors– Students and Teachers

Person-First Language

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Enable others to act

Empower staff to negotiate and empower customers; provide choices that are win-win

Anthony, 2004; Huckshorn, 2004

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– Foster collaboration and trust…– Empower staff to break rules…– Provide staff with tools/training…– Help staff to exceed their own expectations…

Enable others to act

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Avoidance of trauma and re-traumatization becomes valued over rules, property damage, and negotiation time

Staff become change agents, without fear of repercussions

A culture of CQI is embedded: one that understands that mistakes will be made but learning will occur

Anthony, 2004; Huckshorn, 2004

Enable others to act

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Leaders build their organization around exemplary performers

…Best practices are recognized and rewarded

…Efforts are made to encourage reports of

near-misses, and what worked

…Knowledge is transferred and sustained

Anthony, 2004; Huckshorn, 2004

Encourage the heart

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Create a culture of celebration!

It carries staff through rough times.

Value exemplary performance by individuals or groups which are aligned with values.

Thank you!

Encourage the heart