August 1, 2016
Organizational cultures often resist change. But that doesn't mean that cultures can't change.
Organizational cultures are a good thing. Commonly held beliefs and values are important because they tend to minimize the likelihood that individual staff members are working at cross purposes. Cultures also help to ensure that staff members consistently apply effective and efficient ways to achieve organizational objectives. Commonly held beliefs comprise the "tried and true" ways staff members achieve mission goals. Each time a practice produces good outcomes, its value as tried-and-true increases, along with the likelihood that it will be used again in a similar situation. As beliefs and values become more widely held, they become reinforced throughout the day by social norms.
Workforce norms ensure quality control. Cultural norms ensure individual staff members apply sanctioned practices in the most effective and efficient manner. Those norms help to ensure adherence to the tried and true ways of doing things by confronting deviations: "We never smoke in front of clients." "You let Bill sit through the entire session without once trying to draw him out." Comments like these from co-workers mold the behavior of staff members far more effectively than management supervision can. Thus, organizational cultures create a self-sustaining system for achieving individual and organizational objectives.
Knowing the way to do something is not the same thing as doing it that way. Culture represents the actual system of therapeutic and business practices used by an organization's staff members--not necessarily what the organization claims or wants them to be. Deviations from management's norms exist in every organization. They develop when prescribed practices prove to be dysfunctional in an ever-changing service context. In most cases, the organizational culture adapts without undermining the actions of colleagues and weakening therapeutic outcomes--and the mission continues to advance. Of course, sometimes these work-arounds have unforeseen consequences for the organization, and discovering better ways to address the issue can improve things.
Culture change doesn't happen overnight. While changing a process or a practice can happen quickly (see an earlier Mythbuster: Change takes time. A lot of time), it's important to keep in mind that organizational cultures do not just pop up. They develop and evolve over many years. Thus, it should not be surprising some organizational cultures may change slowly. There are a few common-sense strategies that help to achieve and accelerate change:
- The organization has to want to change. Building staff consensus that change is necessary is the first step to breaking down resistance to implementing new practices.
The NIATx model recommends having staff members do a walk-through to experience first-hand the system or process that needs improvement. The old adage "If it ain't broke, don't fix it" is a reflection of change conflicting with values and beliefs. When staff personally experience a problem and recognize that "it" (the system) is broke, they are more likely to question current values and beliefs.
- An organizational culture is unlikely to tolerate any attempt at change until staff express interest in experimenting with it. The more strongly staff members adhere to belief in certain practices, the more resistant the organization will be to adopting changes in them. It makes sense to concentrate on challenging those beliefs with evidence that they are no longer serving the interests of the organization and its clients before trying to introduce change. When beliefs are very strong, no amount of training alone will succeed in changing practices.
Counselors with decades of experience using an abstinence-only model might believe that medication-assisted treatment (MAT) is merely substituting one addiction for another. Their values and beliefs may reject MAT as a valid path to recovery. Training and education on the medications, how they work, and their effectiveness compared to abstinence-based treatment can help secure buy-in. Seeing clients begin to succeed at recovery with MAT after repeated failure with other approaches can help reverse strongly-held beliefs.
(See related NIATx story: Vivitrol is for the brain and the 12 Steps are for the Soul.")
- New practices should be selected based on fit with the organization. There are usually a number of options for changing business and therapeutic practices. Selecting ones that are most compatible with existing beliefs and values minimizes cultural resistance.
Training people in new therapeutic approaches won't be enough if there's no effort made to demonstrate how the new practices will integrate with existing ones. Otherwise, cultural values attached to related--often interdependent--practices will hinder implementation. This applies to new treatments, assessment measures, record systems, reimbursement forms, etc.
- Norms are unlikely to support the new practices without rapid-cycle testing. The NIATx change model emphasizes the importance of examining new outcomes against old benchmarks. Rapid-cycle testing and evaluation validates that new practices have been tested and truly are better than the old ones.
Skip rapid-cycle testing, and you run the risk that cultural norms will revert to using old methods “because they work.” Back-sliding is most likely to occur when staff are under pressure and still not fully skilled in applying a new practice. If they lack confidence that the new way of doing things is clearly superior to the old way – research has shown the old way is very likely to re-emerge.
- Start small and gradually build on successes. Momentum is a powerful tool for change. Once staff members start experiencing improvements with small changes, they will be open open to tackling bigger change projects. Strategic planning is one way to minimize culture resistance by building on a succession of successful changes. Each success verified through rapid-cycle testing creates a new tried-and-true practice.
Some organizational cultures will assimilate some changes with scant resistance. This is often the case when introducing new software, forms, or business practices that replace long-standing annoyances. In such instances, the reaction of the staff will usually be; “Finally!” Thus, such changes offer an excellent starting point to build momentum for future change.The NIATx model offers a proven approach to introducing change in a way that minimizes resistance to change. However, it is up to the change leaders to create a strategic approach based on the understanding of their own culture, as well as accepting that all change is culture change.
Read other posts by Tom Hilton:
Mythbusters: True or False? Management should have all the answers
Mythbusters: Change takes time. A lot of time
Mythbusters: Staff don't want to help find solutions
Factors influencing organizations' use of NIATx