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MODULE 3 STUDY GUIDE
Rolling with resistance
‘Every creative person, and I think probably every other person, faces
resistance when they are trying to create something good...The harder
the resistance, the more important the task must be.’
Donald Miller
http://www.theedge.nhsiq.nhs.uk/school/
@Sch4change #S4CA
www.facebook.com/sch4change/
Module 3 Study Guide
www.theedge.nhsiq.nhs.uk/school/ 2 SCA 2017
Contents
Introduction ..................................................................................................................................................3
This study guide ........................................................................................................................................3
The overall goals [learning outcomes] for this module............................................................................4
What are YOUR goals for this module? ....................................................................................................4
What do we mean by resistance to change?................................................................................................5
What is our mindset about resistance?....................................................................................................5
An old power versus new power view of change and resistance.............................................................6
The power of resistance................................................................................................................................8
Diversity ....................................................................................................................................................8
Intent and impact..........................................................................................................................................9
Go for no!............................................................................................................................................... 10
Embracing resistance and surviving....................................................................................................... 10
Resistance and cream paint or shades of grey ..........................................Error! Bookmark not defined.
Understanding why people resist and what to do about it....................................................................... 11
Where am I in the change cycle and what will help me to progress to the next stage?....................... 11
The Stages of Change (or Transtheoretical Change) model .................................................................. 11
Building resilience...................................................................................................................................... 15
What is resilience?................................................................................................................................. 16
Get your five a day................................................................................................................................. 17
Call to action .............................................................................................................................................. 17
Questions for reflection............................................................................................................................. 18
Bringing it all together ........................................................................................................................... 18
Reference list for Module 3 ....................................................................................................................... 19
Additional resources.............................................................................................................................. 20
If you have ten minutes… ...................................................................................................................... 20
If you have more than ten minutes…..................................................................................................... 20
This Study Guide was prepared for the School for Change Agents by Pip Hardy, Pilgrim Projects Limited and updated by Helen
Bevan.
School for Change Agents
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Module 3
Rolling with resistance
Introduction
‘Learning is in the relationships between people.’ McDermott 1999
Welcome to Module 3 from the School for Change Agents.
In Module 1, we considered what it means to be a health and care change agent; we looked at the
differences between rebels and troublemakers, and thought about some of the risks inherent in being a
change agent. We talked about the importance of living and being the change you want to see in the
world and identified some useful ways of building self-efficacy in order to help you be an effective
change agent. We hope that you have continued to reflect on the content of Module 1 and on the
various conversations that have continued via Twitter @Sch4change and #S4CA and the School for
Change Agents Facebook group.
In Module 2, we shifted the focus from ourselves as individual agents of change to the importance of
community, networks and the power of working together. We looked at lessons from great social
movement leaders and community organisers and discussed techniques for connecting with our own
and others’ values and emotions to create a call for action through the practice of effective framing and
storytelling.
In Module 3 we will turn to a phenomenon that will be familiar to everyone who has tried to make
changes: resistance. It is common to perceive resistance as a negative force, something to be battled
with in order to win ground. Here we will explore different ways of approaching resistance and offer
some tools that will help you to harness the energy of resistance.
This study guide
This study guide is intended to enhance and complement the webinar and help deepen your thinking
and reflection. It is not compulsory, but it may give you some ideas of things to think about and
questions to ask and you may take some inspiration from some of the examples and quotations. If you
would find it helpful, please feel free to use this guide as a place to keep track of your own thoughts and
ideas so you will have a record of your work on the module and the overall programme.
Every week, we will make a study guide available one week before the next live webinar. You can
download the study guide from the website and use it to record your reflections during and after the
seminar. You can also use the study guide in the discussions you have with your coach, mentor or
learning group after the webinar.
Throughout this study guide there are shaded sections for you to reflect on your own experiences or
respond to key questions related to the content of the module. We hope that you will feel free to use
these questions as prompts to your own thinking, and the space provided to record your ideas.
The schedule for the release of the study guides is as follows:
Module 3 Study Guide
www.theedge.nhsiq.nhs.uk/school/ 4 SCA 2017
Module Date of study guide release Date of webinar
4 Making change happen 3rd
March 2017 9th
March 2017
5 Moving beyond the edge 10th
March 2017 16th
March 2017
The overall goals [learning outcomes] for this module
By the time you have worked through this module, we hope that you will be able to:
• understand what is meant by resistance to change and why people resist
• explore different approaches to resistance
• discover the difference between impact and intent, and learn how to utilise both
• explore different ways of meeting the challenge of resistance
• harness the power of resistance
• use the Stages of Change model to help you identify where people are at on the cycle of change
and what to do about it
• build resilience to help you deal with resistance.
What are YOUR goals for this module?
In order to make the most of this module and of the
overall programme, you may find it helpful to give some
thought to your own personal goals – what do you hope
to achieve by engaging with The School for Change
Agents? What do you hope to take away from this
module?
If you have engaged with Modules 1 and 2, please
reflect briefly on what you have learned so far, and
begin to connect where you are now in your thinking
with your goals for this module, carrying forward what
you have already learned to inform your future
intentions.
In Module 1, you were encouraged to think about being the change you want to see and you will have
begun to realise that you are unlikely to accomplish your goal single-handedly. In Module 2, our focus
was on the importance of sharing both power and responsibility and of working with others to
accomplish your goals. We hope you have thought about your own networks and communities. In
Module 3, we will turn to the challenge that all change agents will meet: that is, the challenge of
resistance. We will be looking at some of the reasons why people – including you – resist change.
ACTIVITY: THE STORY CONTINUES
1 What do you hope to achieve from this module?
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2 Have you ever given any thought to how you deal with resistance?
3 Have you considered the ways in which you may able to use resistance to help you achieve your
goals?
4 What would you like to change as a result of engaging with this module?
Perhaps one of the best outcomes from studying this module is the recognition of your patterns of - and
responses to - resistance!
What do we mean by resistance to change?
Resistance means any force that stops or slows movement.
Resistance is inevitable… learn to expect it, welcome it.
What is our mindset about resistance?
How we deal with ‘resistance to change’ depends on how we perceive the resistance. Is resistance
something negative that will get in the way of the changes that we are seeking to implement, something
that we need to overcome if we are to deliver the change? Or is it something to welcome that ensures a
diversity of perspective and builds better change?
REFLECTION: YOUR APPROACH TO RESISTANCE
Think of a time when you were seeking to lead or make a change and other people were resistant.
1 What was the situation?
2 What was your response to the resistance?
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3 How did your feelings manifest themselves?
4 Why did you react this way?
5 What was the outcome?
6. What might you do differently if faced with the same situation now?
It’s clear that we need to be thinking differently about change and resistance if we are going to be
successful in our change efforts. Some of our work in Module 1 can help us here.
An old power versus new power view of change and resistance
You may remember this diagram from
Module 1, helping us to recognise changes
in power structures, guiding us from the
traditional, dominant approach to change
to the emerging direction for change, from
‘old power’ to ‘new power’. Old power
approaches tended to be hierarchical,
diagnostic and transactional. Problems
were identified by a few people, solutions
sought by other people and then imposed
by those in power, while all actions and
behaviours were viewed as transactions.
As new power replaces old power, the
future will be characterised more by solutions that arise from improved and open communication, more
creative dialogue, stronger connections and better relationships.
We can also contrast these two ways of thinking about change when it comes to how we think about
resistance. The change we want isn’t going to happen all at once, and it can’t always be easily managed.
Acknowledging that change is often emergent and hard to predict; sharing power, valuing diversity and
nurturing relationships all make- it more likely that we will succeed in creating capability in establishing
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and maintaining connections, stimulating different perspectives and shaping how people think about
things.
Adopting these different approaches that rely more on connection, communication and dialogue than
on diagnosis, equips us to create better conditions for positive outcomes from our change efforts; part
of that is the realisation that resistance is natural but that it can lend strength and power to our change
efforts.
ACTIVITY: OLD POWER / NEW POWER APPROACHES TO CHANGE
Reflecting on my current activities in leading change:
1 Who are the ‘resisters’ and how would I manage them from an ‘old power’ perspective?
2 How might I work with a ‘new power’ approach in my own setting?
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You have already begun to make connections and strengthen your weak and strong ties – we have seen
this via the Twitter and Facebook groups, as well as the learning groups that have been established.
We’ll go on now to look at some of the different approaches to resistance and ways of harnessing its
power.
The power of resistance
Resistance is powerful. If unharnessed, it can be harmful,
much like lightning. But, when the power of electricity is
harnessed, it is immensely useful.
Find ways of harnessing the power of resistance to help
you achieve your goals. Go with the energy rather than
against it.
Diversity
Research studies show that teams of people with diverse backgrounds, experiences and views of the
world will consistently outperform groups of more talented but homogenous individuals.
Diverse teams have better insights, they are more effective as problem solvers and they make fewer
mistakes.
The ‘best people’ for our change projects are not necessarily the people who are most like us. As health
and care change agents, we want to embrace diversity and bring people into our change teams who
think differently to us or who have had different experiences of life. This may include patients and
families, community leaders, people from other industries and organisations. By deliberately seeking
diversity we create the risk of greater resistance, challenge and disagreement within the group, even
though the outcome is likely to be better.
As change agents, we need to embrace and value the differences.
ACTIVITY: DIVERSITY - VALUING THE DIFFERENCE
1 In the context of ‘rolling with resistance’, what are the implications of embracing diversity of
thought, experience and background in my change initiative?
2 What skills and perspectives do I need to develop to work effectively with diverse groups of people
for change?
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Intent and impact
‘The road to hell is paved with good intentions.’ Proverb
What do we mean by intent and impact? If we assume that
everyone starts from a position of good intent then we
need to reflect on why we sometimes react to others in the
way that we do. A good intention can nevertheless have a
negative impact upon us; by the same token, our good
intentions may not always have the impact we hope for.
Why is this?
The deeper our knowledge of self, the more able we are to
understand WHY someone's well-intended actions cause us
anger, frustration, pain or leave us feeling disempowered.
Remember the model in Module 2 of how we overcome
negative feelings, how hope overcomes fear, how rage and
outrage can overcome apathy? When we find ourselves
reacting to the words or actions of another person, we can
step back and think about what emotion is being stirred
within us and how then to overcome it. This is not an easy
thing to do! It requires considerable self-awareness, including the awareness that we are reacting,
rather than responding appropriately to a given situation. It takes considerable strength and a degree of
mindful awareness to be aware of these reactions so that we can examine them and, hopefully, learn
from them.
REFLECTION: NEGATIVE REACTIONS
1 Think of a time when you reacted negatively to someone else's actions. What happened?
2 What do you believe their intention was?
3 Was it to cause a negative reaction in you?
4 What frame did you use to interpret their intention?
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5 If you were advising your change agent self today, how would you (re)frame the same story?
Go for no!
In the Module 3 webinar, we will look at
one very practical but not entirely
intuitive way of rolling with resistance:
Going for No!
It is only natural to seek out those who
are in sympathy with and who will
support our cause and our desire for
change. However, one of the most
effective ways of working with diversity
is to embrace other viewpoints, listen
carefully to objections and then figure out how to turn a ‘no’ into a ‘yes’. Going through this process will
often result in a better ultimate outcome while at the same time enabling you to realise your own
strength and become more resilient.
Source:www.goforno.com/think-of-rejection-differently/
Embracing resistance and surviving
Maxine Craig, an organisational development professional and graduate of the 2014 School, shared an
important story about resistance with the first School cohort. She begins by talking about ‘us’ and
‘them’ – the ‘good guys’ (us) and the ‘bad guys’ (them).
Then she relates the story of her grandfather who was taken prisoner by the Japanese in World War 2
and interned in a POW camp. Conditions, as you may imagine, were terrible and men were starving.
Some guards took pity on her father and some
of the other men and gave them extra food.
Clearly this was a risky action for those guards
to take: they were breaking the rules and
would undoubtedly have been severely
punished had they been found out.
So who was resisting and what were they
resisting? The guards were showing
compassion and humanity to their prisoners.
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And yet, they were breaking the rules: they were rebels, agents of change.
The realisation for Maxine was that resistance is all about perspective, a matter of where you stand.
She describes her growing awareness that the world isn’t always black and white and there are many
ways to accomplish the same goals. Often, those who appear to be resistors are simply seeing things
differently and doing things differently. Resistance can be more about where you stand than an inbuilt
desire to maintain the status quo. Maxine also talks about her work with a team in difficulties,
describing the anguish and frustration she and others felt when things weren’t changing and the power
of the team’s resistance to change, even when they knew, in some way, that change was necessary for
them and for their patients.
Eventually, a listening and storytelling approach was adopted and, from the pain and truths revealed in
the stories that were told, an intervention was agreed which resulted in the desired change.
If you are interested in watching some of the stories that eventually emerged from Ward 14, they can
be seen at www.patientvoices.org.uk/ht.htm
Understanding why people resist and what to do about it
There are a number of models and frameworks that can give us insight into why people are resisting
change and suggest actions to take as a change agent to roll with resistance. Many health and care
change agents use the ‘Stages of Change’ or ‘Transtheoretical Model of Behaviour Change’ from
Prochaska, DiClemente and Norcross to support their change effort. It is a model of health-related
behaviour change that many clinicians are already familiar with through their clinical practice; it can also
be used for improving service quality and patient safety.
Where am I in the change cycle and what will help me to progress to the next
stage?
The basic model consists of five stages of change that individuals go through in changing their
behaviours. By working out where on the cycle an individual is, we can plan some appropriate actions to
help that person embrace and contribute to the change. In health and care, when people ‘resist’
change, it is much more likely to be a result of their interpersonal interaction with the change process
than their innate character traits. This means that people are more likely to be resisting because of a
bad change process rather than because they are difficult people. The Stages of Change model helps us
to understand this and work out where the person is at.
The Stages of Change (or Transtheoretical Change) model
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Prochaska, DiClemente and Norcross offer us a framework that we can use to work out which stage of
change a particular individual is at and plan actions to help the person get to the next stage. We unpack
the model on the next couple of pages.
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Stage Where am I in the change cycle? What will help me move to the next stage of
change?
What’s a good
outcome from
efforts at this
stage?
PRECONTEMPLATION
I am not thinking about changing my
behaviours, actions or work processes. The
problem or issue is outside my frame of
awareness or my perceived need.
Therefore, there is no problem because I am
not aware of the situation as it might affect
me. Obviously, I have no intention to change
at this stage and my defences may be raised
if you push me to change. I often get
labelled as ‘resistant’, ‘blocker’ or ‘in denial.’
The focus should be on creating awareness for
me of the need to change.
 Use strategies to raise my awareness and
lower my doubt.
 Increase my perception of risks and
problems with current ways of working
 Emphasise the consequences and costs
associated with maintaining the existing
system.
 Emphasise the benefits that I and others
will get from the change.
 Use basic communication skills such as
reflective listening and open-ended
questions.
 Function as my collaborator not my
educator.
Remember, the goal is not to make me (as a
pre-contemplator) change immediately, but to
help me move to contemplation.
I begin to recognise
that there might be
a problem that I
need to do
something about.
CONTEMPLATION
I am aware a problem exists and I am
seriously considering action, but I have not
yet made a commitment to an action. I have
some level of awareness of the problem. I
might not want to admit it but I also have a
large degree of fear of the unknown and of
the amount of effort I may need to make for
the change. If you force me to change at this
stage, there is a risk that my defences will
remain in place. This means that I might be
compliant with the change but not
committed to it. As a result, the change may
not be sustained.
The focus should shift to increasing the
perceived benefits of the change and reducing
the expected or perceived negative
consequences of changing for me. You will
want to create a ‘tipping point’ where the
expected benefits outweigh the expected costs
of the change. To get me to this point it may be
necessary for you to help further clarify both
the benefits (which may be unknown) and
costs (which may be unrecognised). You need
to try to step into my shoes, considering the
pros and cons of change from my perspective.
I have made a
tentative
commitment to
changing the way I
currently do things
but it is fragile.
PREPARATION
I have made a decision to take future action,
but I am not yet actually prepared to take
the action now. I need to do some more
thinking about the individual steps that I
need to take prior to attempting the new
behaviour or new way of working. There is a
strong likelihood that my peers will still be
at the precontemplation and contemplation
stages (80% of others in many research
samples). As a result, I may be discouraged
or question my decision to take action.
Help me to build my skills, knowledge and
confidence in the new way of working:
• Build an action plan for change.
• Include others in the plan.
• Examine barriers to change and help me
work through potential solutions (what will
the first week be like?).
• Encourage me to take part in formal
training sessions and workshops.
• Give me interesting articles to read that
include robust evidence.
• Agree how the change will be evaluated.
I’m making clear
statements about
the change and I
have an action plan
in place.
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ACTION
I am aware a problem exists and have
actively modified my behaviour, work
process and/or environment in order to
overcome the problem. I’ve actually made
the changes and I’m working in a new way.
However, some of my old habits and
tendencies toward the old behaviour are
still in place and it is quite likely that I will
revert to the old way of working. The good
news is that my commitment is clear and I
am making a big effort to change.
Reinforce the changes I have made by coaching
and mentoring me:
 Recognise and acknowledge the success of
the change even if the success is only the
attempt with results not yet evident.
 Reaffirm your own commitment to the
change and engage in active problem
solving with me and my colleagues.
I’m working in the
new way. The risk
of relapse is
diminishing as my
new
behaviours/ways of
operating replace
the old ones.
MAINTENANCE
I have made a sustained change. My new
ways of working have become firmly
established and the threat of relapse is
becoming less intense. It’s no longer
necessary for me to think consciously about
and plan the new way of working as it has
become more automatic. I (and my patients
and colleagues) are realising the benefits of
the change and my confidence that it was
the right thing to do is growing. However, in
times of stress there is still a risk that I might
revert to the old ways of doing things.
Understand that even though I am well
established in the ‘maintenance’ phase, I still
need ongoing support and encouragement. Be
there for me if I relapse. If this happens, help
me to:
• Reaffirm the original reasons for the
change.
• Explore the factors that precipitated the
crisis.
• Get back on track.
Hopefully, I
successfully exit the
final stage of
change cycle and
move into a new
cycle for a new
change. If I relapse,
I will re-enter the
contemplation or
preparation stage.
Adapted from DiClemente, 1991; Prochaska and Norcross, 1994 and Wirth 2004 by Robert Ferris-Rogers and Helen Bevan
REFLECTION: STAGES OF CHANGE
1 At what stage of change are some of the key people that you need to influence for your change
initiative?
2 What actions can you take to help them move to the next stage?
When you are trying to help people through change, you might find it useful to look at the Bridges
Transition model. William Bridges realised that people need time to make the transition from one state
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to another, to adjust to the loss of something known, to acknowledge and possibly even mourn the end
of one state before accepting and becoming comfortable with a new state.
Giving yourself time and allowing time for others to adjust to change will make your change efforts
more likely to succeed and will also go a long way towards building the capacity for resilience in yourself
and those with whom you are working.
Building resilience
‘Every great personal story you have to tell involves overcoming adversity.
If you shy away from adversity, you take away your ability to tell new stories.’
Farrell Drake
In Module 2 we explored the importance of building communities and forming alliances. We gain our
strength from these alliances and this is a way in which we can overcome feelings of isolation. Within
these alliances and communities there are always critical friends: people who can connect with us at an
individual level and whom we trust. In Module 1 we looked at self-efficacy. Teachings on emotional
intelligence show us how to develop our own support mechanisms from within. We can do this through
building our self-efficacy and taking time to be kind to ourselves. Sometimes this is simply in sitting
quietly and breathing, in practising some mindfulness techniques, in sitting still to eat our lunch, in
going for a walk. By taking time simply to be, we are building our reservoirs of self-support.
REFLECTION: TAKING CARE
1 How do you take time to take care of your own physical and emotional well-being?
2 Please note down three things/activities that help to build your emotional reserves rather than
deplete your energy.
William Bridges Transition model
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3 What do you do for fun and/or to relax?
4 How can you build activities like this into your daily routine?
One change agent of our acquaintance has adopted a pragmatic approach to looking after herself. She
says:
‘I only ever have three things on my “To do” list each day. And one of them is always
“eat lunch”.’
Another, slightly more dramatic response was:
‘The decision to leave my job was the biggest act of self-care in the whole of my 34-year
career – I needed to make sure that I thrived, rather than the job.’
And still another:
‘It’s the hardest thing! I’ve been trying to do that for 26 years! Reading, family history,
painting…. I have to schedule fun and ease into my life. It’s usually alone time –
I go for a walk.’
Caring for ourselves is particularly important if we want to care for others. In Module 5, we will look
more deeply at the importance of being compassionate to yourself. But, if we are to ‘be the change we
want to see’ and remain committed to being an agent of change, we may have to become even more
resilient in order to roll with resistance.
What is resilience?
Resilience can be defined as ‘the ability of an individual to adjust to adversity, maintain equilibrium,
retain some sense of control over their environment and continue to move on in a positive manner’
(Jackson et al 2007). Resilient individuals tend to:
• have an optimistic style
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• operate in their circle of influence
• be aware of and use their strengths
• set goals
• stay connected to others
• have a ‘can do’ mindset
• exercise self-care.
Get your five a day
If you find that you are not bouncing back from
adversity quite as quickly as you would like, here are
five things you can do in order to improve your mental
health and well-being, which will, in turn, make you more resilient: www.happiness-wellbeing.org
Connect … with friends, family and colleagues, building connections and investing time to maintain
them. It’s also useful to think about connecting – or reconnecting – with purpose and your passion for
change.
Be active… Walk, run, cycle, dance, swim, workout in the gym, or whatever other physical activity
makes you feel good.
Take notice… find time to be curious, notice beautiful sights, comment on unusual ones, appreciate
your surroundings and the people you are with.
Keep learning … Try something new or rediscover an old interest, learn to knit or play a musical
instrument or change a tyre, challenge yourself to something new.
Give … do something nice for someone: say thank you, help an elderly person with their shopping, pick
up a child’s toy. You might try volunteering or joining a community group, but find ways to connect with
others in your community.
Call to action
Try to keep the momentum and enthusiasm going by taking some concrete actions. Here are our
suggestions:
 Look after myself: commit to doing one thing every day that gives me joy/makes me feel good.
 Identify three things I can do to support colleagues through the ‘Stages of Change’.
Make time to watch The Edge talk on resilience here:
http://theedge.nhsiq.nhs.uk/edge-talk-practical-skills-resilience/
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Questions for reflection
Each webinar ends with some questions for you to reflect on during the week. Here are the questions
for this week.
REFLECTION: WHAT DOES RESISTANCE MEAN TO YOU?
1 How do I experience resistance?
2 How can I make sure that the changes I make achieve the impact I desire and…
- are sustainable?
- do not create dependency?
- generate self-efficacy in others?
3 How can I make sure that my intentions actually result in the impact I want?
4 What do I need to do to develop resilience so that I can roll with resistance?
Bringing it all together
Make a note of the things that stand out for you from this module and then give some thought to how
you will use your new learning to make a difference.
REFLECTION: MAKING IT REAL
1 What have you learned?
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2 How do you know you’ve learned it?
3 How will you take your learning forward? What will you do differently?
Reference list for Module 3
These are the references that we have referred to in the webinar and/or that we have used to help
shape the content. Click on the reference to get the link.
Anderson L (2014) ‘Collective wisdom: are we making the most of interprofessional education?’ Lecture
presented at University of Leicester, 6th
February 2014
Boyd S (2014) Is cultural fit a cop-out?
Bushe G (2009) Dialogic OD Turning Away from Diagnosis
Bushe G, Marshak R (2010) Revisioning Organization Development: Diagnostic and Dialogic Premises
and Patterns of Practice
Bridges W (2009) Managing transitions: Making the most of change (3rd
edition)
Cancer Prevention Research Centre Detailed Overview of the Transtheoretical Model
Diaz-Uda A, Medina C and Schill E (2013) Diversity’s new frontier
Farquhar K (2013) NTL’s ‘Conference on the New OD’: Turning Thought into Action
Holman P (2013) A Call to Engage: Realizing the Potential of Dialogic Organization Development
Jaben M (2016a) The science behind resistance: Slide deck from British Columbia Patient Safety and
Quality Council
Jaben M (2016b) The science behind resistance II: now what? Slide deck from British Columbia Patient
Safety and Quality Council
Johnson S (2010) Where good ideas come from A four-minute video that explains how a truly innovative
environment encourages diversity of thought and experience.
Kegan R and Lahey L (2009) Immunity to change. Boston, Mass: Harvard Business School Press
Kotter J and Cohen D (2011) The heart of change: real-life stories of how people change their
organisations. Boston, Mass: Harvard Business Review Press
Module 3 Study Guide
www.theedge.nhsiq.nhs.uk/school/ 20 SCA 2017
Miller D (2011) A million miles in a thousand years
Mootee I (2013) Diversity is the short cut to building an innovation culture
NHS Institute for Innovation and Improvement (2010) Resistance – working with it
Page S (2007) Making the difference: applying a logic of diversity Academy of Management Perspectives
Prochaska J, DiClemente C, Norcross JC (1992). In search of how people change. Applications to
addictive behaviours Am Psychol 47:1102
Waltz A (2014) Handle rejection positively to succeed SlideShare
Additional resources
Here are some additional resources that you might find helpful if you would like to learn more about
resistance and how it can be harnessed to bring about constructive change.
If you have ten minutes…
The power of two: how listening shapes storytelling TED talk by Paul Browde & Murray Nossel
Three myths of behaviour change – what you think you know that you don’t TED talk by Jeni Cross
If you have more than ten minutes…
The science behind resistance by Mark Jaben
A webinar presented to the British Columbia Patient Safety and Quality Council
The science behind resistance II: by Mark Jaben
Practical example and strategies on recognising resistance; a further webinar presented to the British
Columbia Patient Safety and Quality Council
rEvolution How to Thrive in Crazy Times by Bill Lucas
Look especially at Rule 3: Slow down and Rule 7: Sometimes it’s smart to resist.
The New Leaders by Daniel Goleman
The author of many books on emotional intelligence and personality; this book reviews the emotional
component of leadership, and discusses its role in modern leadership.
Switch: how to change things when change is hard by Chip and Dan Heath
Well-written, engaging and insightful book about why we insist on seeing the obstacles rather than the
goal and explaining how we can unlock shortcuts to switches in behaviour
Hesperian Health Guides
Resources on health and community empowerment
Useful websites for resilience, health and happiness
www.wellbeinginfo.org
www.mindapples.org
School for Change Agents
www.theedge.nhsiq.nhs.uk/school/ 21 SCA 2017
www.mind.org.uk
www.mentalhealth.org.uk
www.moodgym.anu.edu.au
Please do contact us with your ideas and contribute to the growing collection. We look forward to
seeing you in School – and please keep in touch!
Email: england.si-horizons@nhs.net Telephone: +44 2476 627543
Facebook: www.facebook.com/sch4change/ Twitter: @Sch4change #S4CA

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Module 3 study guide - School for Change Agents

  • 1. MODULE 3 STUDY GUIDE Rolling with resistance ‘Every creative person, and I think probably every other person, faces resistance when they are trying to create something good...The harder the resistance, the more important the task must be.’ Donald Miller http://www.theedge.nhsiq.nhs.uk/school/ @Sch4change #S4CA www.facebook.com/sch4change/
  • 2. Module 3 Study Guide www.theedge.nhsiq.nhs.uk/school/ 2 SCA 2017 Contents Introduction ..................................................................................................................................................3 This study guide ........................................................................................................................................3 The overall goals [learning outcomes] for this module............................................................................4 What are YOUR goals for this module? ....................................................................................................4 What do we mean by resistance to change?................................................................................................5 What is our mindset about resistance?....................................................................................................5 An old power versus new power view of change and resistance.............................................................6 The power of resistance................................................................................................................................8 Diversity ....................................................................................................................................................8 Intent and impact..........................................................................................................................................9 Go for no!............................................................................................................................................... 10 Embracing resistance and surviving....................................................................................................... 10 Resistance and cream paint or shades of grey ..........................................Error! Bookmark not defined. Understanding why people resist and what to do about it....................................................................... 11 Where am I in the change cycle and what will help me to progress to the next stage?....................... 11 The Stages of Change (or Transtheoretical Change) model .................................................................. 11 Building resilience...................................................................................................................................... 15 What is resilience?................................................................................................................................. 16 Get your five a day................................................................................................................................. 17 Call to action .............................................................................................................................................. 17 Questions for reflection............................................................................................................................. 18 Bringing it all together ........................................................................................................................... 18 Reference list for Module 3 ....................................................................................................................... 19 Additional resources.............................................................................................................................. 20 If you have ten minutes… ...................................................................................................................... 20 If you have more than ten minutes…..................................................................................................... 20 This Study Guide was prepared for the School for Change Agents by Pip Hardy, Pilgrim Projects Limited and updated by Helen Bevan.
  • 3. School for Change Agents www.theedge.nhsiq.nhs.uk/school/ 3 SCA 2017 Module 3 Rolling with resistance Introduction ‘Learning is in the relationships between people.’ McDermott 1999 Welcome to Module 3 from the School for Change Agents. In Module 1, we considered what it means to be a health and care change agent; we looked at the differences between rebels and troublemakers, and thought about some of the risks inherent in being a change agent. We talked about the importance of living and being the change you want to see in the world and identified some useful ways of building self-efficacy in order to help you be an effective change agent. We hope that you have continued to reflect on the content of Module 1 and on the various conversations that have continued via Twitter @Sch4change and #S4CA and the School for Change Agents Facebook group. In Module 2, we shifted the focus from ourselves as individual agents of change to the importance of community, networks and the power of working together. We looked at lessons from great social movement leaders and community organisers and discussed techniques for connecting with our own and others’ values and emotions to create a call for action through the practice of effective framing and storytelling. In Module 3 we will turn to a phenomenon that will be familiar to everyone who has tried to make changes: resistance. It is common to perceive resistance as a negative force, something to be battled with in order to win ground. Here we will explore different ways of approaching resistance and offer some tools that will help you to harness the energy of resistance. This study guide This study guide is intended to enhance and complement the webinar and help deepen your thinking and reflection. It is not compulsory, but it may give you some ideas of things to think about and questions to ask and you may take some inspiration from some of the examples and quotations. If you would find it helpful, please feel free to use this guide as a place to keep track of your own thoughts and ideas so you will have a record of your work on the module and the overall programme. Every week, we will make a study guide available one week before the next live webinar. You can download the study guide from the website and use it to record your reflections during and after the seminar. You can also use the study guide in the discussions you have with your coach, mentor or learning group after the webinar. Throughout this study guide there are shaded sections for you to reflect on your own experiences or respond to key questions related to the content of the module. We hope that you will feel free to use these questions as prompts to your own thinking, and the space provided to record your ideas. The schedule for the release of the study guides is as follows:
  • 4. Module 3 Study Guide www.theedge.nhsiq.nhs.uk/school/ 4 SCA 2017 Module Date of study guide release Date of webinar 4 Making change happen 3rd March 2017 9th March 2017 5 Moving beyond the edge 10th March 2017 16th March 2017 The overall goals [learning outcomes] for this module By the time you have worked through this module, we hope that you will be able to: • understand what is meant by resistance to change and why people resist • explore different approaches to resistance • discover the difference between impact and intent, and learn how to utilise both • explore different ways of meeting the challenge of resistance • harness the power of resistance • use the Stages of Change model to help you identify where people are at on the cycle of change and what to do about it • build resilience to help you deal with resistance. What are YOUR goals for this module? In order to make the most of this module and of the overall programme, you may find it helpful to give some thought to your own personal goals – what do you hope to achieve by engaging with The School for Change Agents? What do you hope to take away from this module? If you have engaged with Modules 1 and 2, please reflect briefly on what you have learned so far, and begin to connect where you are now in your thinking with your goals for this module, carrying forward what you have already learned to inform your future intentions. In Module 1, you were encouraged to think about being the change you want to see and you will have begun to realise that you are unlikely to accomplish your goal single-handedly. In Module 2, our focus was on the importance of sharing both power and responsibility and of working with others to accomplish your goals. We hope you have thought about your own networks and communities. In Module 3, we will turn to the challenge that all change agents will meet: that is, the challenge of resistance. We will be looking at some of the reasons why people – including you – resist change. ACTIVITY: THE STORY CONTINUES 1 What do you hope to achieve from this module?
  • 5. School for Change Agents www.theedge.nhsiq.nhs.uk/school/ 5 SCA 2017 2 Have you ever given any thought to how you deal with resistance? 3 Have you considered the ways in which you may able to use resistance to help you achieve your goals? 4 What would you like to change as a result of engaging with this module? Perhaps one of the best outcomes from studying this module is the recognition of your patterns of - and responses to - resistance! What do we mean by resistance to change? Resistance means any force that stops or slows movement. Resistance is inevitable… learn to expect it, welcome it. What is our mindset about resistance? How we deal with ‘resistance to change’ depends on how we perceive the resistance. Is resistance something negative that will get in the way of the changes that we are seeking to implement, something that we need to overcome if we are to deliver the change? Or is it something to welcome that ensures a diversity of perspective and builds better change? REFLECTION: YOUR APPROACH TO RESISTANCE Think of a time when you were seeking to lead or make a change and other people were resistant. 1 What was the situation? 2 What was your response to the resistance?
  • 6. Module 3 Study Guide www.theedge.nhsiq.nhs.uk/school/ 6 SCA 2017 3 How did your feelings manifest themselves? 4 Why did you react this way? 5 What was the outcome? 6. What might you do differently if faced with the same situation now? It’s clear that we need to be thinking differently about change and resistance if we are going to be successful in our change efforts. Some of our work in Module 1 can help us here. An old power versus new power view of change and resistance You may remember this diagram from Module 1, helping us to recognise changes in power structures, guiding us from the traditional, dominant approach to change to the emerging direction for change, from ‘old power’ to ‘new power’. Old power approaches tended to be hierarchical, diagnostic and transactional. Problems were identified by a few people, solutions sought by other people and then imposed by those in power, while all actions and behaviours were viewed as transactions. As new power replaces old power, the future will be characterised more by solutions that arise from improved and open communication, more creative dialogue, stronger connections and better relationships. We can also contrast these two ways of thinking about change when it comes to how we think about resistance. The change we want isn’t going to happen all at once, and it can’t always be easily managed. Acknowledging that change is often emergent and hard to predict; sharing power, valuing diversity and nurturing relationships all make- it more likely that we will succeed in creating capability in establishing
  • 7. School for Change Agents www.theedge.nhsiq.nhs.uk/school/ 7 SCA 2017 and maintaining connections, stimulating different perspectives and shaping how people think about things. Adopting these different approaches that rely more on connection, communication and dialogue than on diagnosis, equips us to create better conditions for positive outcomes from our change efforts; part of that is the realisation that resistance is natural but that it can lend strength and power to our change efforts. ACTIVITY: OLD POWER / NEW POWER APPROACHES TO CHANGE Reflecting on my current activities in leading change: 1 Who are the ‘resisters’ and how would I manage them from an ‘old power’ perspective? 2 How might I work with a ‘new power’ approach in my own setting?
  • 8. Module 3 Study Guide www.theedge.nhsiq.nhs.uk/school/ 8 SCA 2017 You have already begun to make connections and strengthen your weak and strong ties – we have seen this via the Twitter and Facebook groups, as well as the learning groups that have been established. We’ll go on now to look at some of the different approaches to resistance and ways of harnessing its power. The power of resistance Resistance is powerful. If unharnessed, it can be harmful, much like lightning. But, when the power of electricity is harnessed, it is immensely useful. Find ways of harnessing the power of resistance to help you achieve your goals. Go with the energy rather than against it. Diversity Research studies show that teams of people with diverse backgrounds, experiences and views of the world will consistently outperform groups of more talented but homogenous individuals. Diverse teams have better insights, they are more effective as problem solvers and they make fewer mistakes. The ‘best people’ for our change projects are not necessarily the people who are most like us. As health and care change agents, we want to embrace diversity and bring people into our change teams who think differently to us or who have had different experiences of life. This may include patients and families, community leaders, people from other industries and organisations. By deliberately seeking diversity we create the risk of greater resistance, challenge and disagreement within the group, even though the outcome is likely to be better. As change agents, we need to embrace and value the differences. ACTIVITY: DIVERSITY - VALUING THE DIFFERENCE 1 In the context of ‘rolling with resistance’, what are the implications of embracing diversity of thought, experience and background in my change initiative? 2 What skills and perspectives do I need to develop to work effectively with diverse groups of people for change?
  • 9. School for Change Agents www.theedge.nhsiq.nhs.uk/school/ 9 SCA 2017 Intent and impact ‘The road to hell is paved with good intentions.’ Proverb What do we mean by intent and impact? If we assume that everyone starts from a position of good intent then we need to reflect on why we sometimes react to others in the way that we do. A good intention can nevertheless have a negative impact upon us; by the same token, our good intentions may not always have the impact we hope for. Why is this? The deeper our knowledge of self, the more able we are to understand WHY someone's well-intended actions cause us anger, frustration, pain or leave us feeling disempowered. Remember the model in Module 2 of how we overcome negative feelings, how hope overcomes fear, how rage and outrage can overcome apathy? When we find ourselves reacting to the words or actions of another person, we can step back and think about what emotion is being stirred within us and how then to overcome it. This is not an easy thing to do! It requires considerable self-awareness, including the awareness that we are reacting, rather than responding appropriately to a given situation. It takes considerable strength and a degree of mindful awareness to be aware of these reactions so that we can examine them and, hopefully, learn from them. REFLECTION: NEGATIVE REACTIONS 1 Think of a time when you reacted negatively to someone else's actions. What happened? 2 What do you believe their intention was? 3 Was it to cause a negative reaction in you? 4 What frame did you use to interpret their intention?
  • 10. Module 3 Study Guide www.theedge.nhsiq.nhs.uk/school/ 10 SCA 2017 5 If you were advising your change agent self today, how would you (re)frame the same story? Go for no! In the Module 3 webinar, we will look at one very practical but not entirely intuitive way of rolling with resistance: Going for No! It is only natural to seek out those who are in sympathy with and who will support our cause and our desire for change. However, one of the most effective ways of working with diversity is to embrace other viewpoints, listen carefully to objections and then figure out how to turn a ‘no’ into a ‘yes’. Going through this process will often result in a better ultimate outcome while at the same time enabling you to realise your own strength and become more resilient. Source:www.goforno.com/think-of-rejection-differently/ Embracing resistance and surviving Maxine Craig, an organisational development professional and graduate of the 2014 School, shared an important story about resistance with the first School cohort. She begins by talking about ‘us’ and ‘them’ – the ‘good guys’ (us) and the ‘bad guys’ (them). Then she relates the story of her grandfather who was taken prisoner by the Japanese in World War 2 and interned in a POW camp. Conditions, as you may imagine, were terrible and men were starving. Some guards took pity on her father and some of the other men and gave them extra food. Clearly this was a risky action for those guards to take: they were breaking the rules and would undoubtedly have been severely punished had they been found out. So who was resisting and what were they resisting? The guards were showing compassion and humanity to their prisoners.
  • 11. School for Change Agents www.theedge.nhsiq.nhs.uk/school/ 11 SCA 2017 And yet, they were breaking the rules: they were rebels, agents of change. The realisation for Maxine was that resistance is all about perspective, a matter of where you stand. She describes her growing awareness that the world isn’t always black and white and there are many ways to accomplish the same goals. Often, those who appear to be resistors are simply seeing things differently and doing things differently. Resistance can be more about where you stand than an inbuilt desire to maintain the status quo. Maxine also talks about her work with a team in difficulties, describing the anguish and frustration she and others felt when things weren’t changing and the power of the team’s resistance to change, even when they knew, in some way, that change was necessary for them and for their patients. Eventually, a listening and storytelling approach was adopted and, from the pain and truths revealed in the stories that were told, an intervention was agreed which resulted in the desired change. If you are interested in watching some of the stories that eventually emerged from Ward 14, they can be seen at www.patientvoices.org.uk/ht.htm Understanding why people resist and what to do about it There are a number of models and frameworks that can give us insight into why people are resisting change and suggest actions to take as a change agent to roll with resistance. Many health and care change agents use the ‘Stages of Change’ or ‘Transtheoretical Model of Behaviour Change’ from Prochaska, DiClemente and Norcross to support their change effort. It is a model of health-related behaviour change that many clinicians are already familiar with through their clinical practice; it can also be used for improving service quality and patient safety. Where am I in the change cycle and what will help me to progress to the next stage? The basic model consists of five stages of change that individuals go through in changing their behaviours. By working out where on the cycle an individual is, we can plan some appropriate actions to help that person embrace and contribute to the change. In health and care, when people ‘resist’ change, it is much more likely to be a result of their interpersonal interaction with the change process than their innate character traits. This means that people are more likely to be resisting because of a bad change process rather than because they are difficult people. The Stages of Change model helps us to understand this and work out where the person is at. The Stages of Change (or Transtheoretical Change) model
  • 12. Module 3 Study Guide www.theedge.nhsiq.nhs.uk/school/ 12 SCA 2017 Prochaska, DiClemente and Norcross offer us a framework that we can use to work out which stage of change a particular individual is at and plan actions to help the person get to the next stage. We unpack the model on the next couple of pages.
  • 13. School for Change Agents www.theedge.nhsiq.nhs.uk/school/ 13 SCA 2017 Stage Where am I in the change cycle? What will help me move to the next stage of change? What’s a good outcome from efforts at this stage? PRECONTEMPLATION I am not thinking about changing my behaviours, actions or work processes. The problem or issue is outside my frame of awareness or my perceived need. Therefore, there is no problem because I am not aware of the situation as it might affect me. Obviously, I have no intention to change at this stage and my defences may be raised if you push me to change. I often get labelled as ‘resistant’, ‘blocker’ or ‘in denial.’ The focus should be on creating awareness for me of the need to change.  Use strategies to raise my awareness and lower my doubt.  Increase my perception of risks and problems with current ways of working  Emphasise the consequences and costs associated with maintaining the existing system.  Emphasise the benefits that I and others will get from the change.  Use basic communication skills such as reflective listening and open-ended questions.  Function as my collaborator not my educator. Remember, the goal is not to make me (as a pre-contemplator) change immediately, but to help me move to contemplation. I begin to recognise that there might be a problem that I need to do something about. CONTEMPLATION I am aware a problem exists and I am seriously considering action, but I have not yet made a commitment to an action. I have some level of awareness of the problem. I might not want to admit it but I also have a large degree of fear of the unknown and of the amount of effort I may need to make for the change. If you force me to change at this stage, there is a risk that my defences will remain in place. This means that I might be compliant with the change but not committed to it. As a result, the change may not be sustained. The focus should shift to increasing the perceived benefits of the change and reducing the expected or perceived negative consequences of changing for me. You will want to create a ‘tipping point’ where the expected benefits outweigh the expected costs of the change. To get me to this point it may be necessary for you to help further clarify both the benefits (which may be unknown) and costs (which may be unrecognised). You need to try to step into my shoes, considering the pros and cons of change from my perspective. I have made a tentative commitment to changing the way I currently do things but it is fragile. PREPARATION I have made a decision to take future action, but I am not yet actually prepared to take the action now. I need to do some more thinking about the individual steps that I need to take prior to attempting the new behaviour or new way of working. There is a strong likelihood that my peers will still be at the precontemplation and contemplation stages (80% of others in many research samples). As a result, I may be discouraged or question my decision to take action. Help me to build my skills, knowledge and confidence in the new way of working: • Build an action plan for change. • Include others in the plan. • Examine barriers to change and help me work through potential solutions (what will the first week be like?). • Encourage me to take part in formal training sessions and workshops. • Give me interesting articles to read that include robust evidence. • Agree how the change will be evaluated. I’m making clear statements about the change and I have an action plan in place.
  • 14. Module 3 Study Guide www.theedge.nhsiq.nhs.uk/school/ 14 SCA 2017 ACTION I am aware a problem exists and have actively modified my behaviour, work process and/or environment in order to overcome the problem. I’ve actually made the changes and I’m working in a new way. However, some of my old habits and tendencies toward the old behaviour are still in place and it is quite likely that I will revert to the old way of working. The good news is that my commitment is clear and I am making a big effort to change. Reinforce the changes I have made by coaching and mentoring me:  Recognise and acknowledge the success of the change even if the success is only the attempt with results not yet evident.  Reaffirm your own commitment to the change and engage in active problem solving with me and my colleagues. I’m working in the new way. The risk of relapse is diminishing as my new behaviours/ways of operating replace the old ones. MAINTENANCE I have made a sustained change. My new ways of working have become firmly established and the threat of relapse is becoming less intense. It’s no longer necessary for me to think consciously about and plan the new way of working as it has become more automatic. I (and my patients and colleagues) are realising the benefits of the change and my confidence that it was the right thing to do is growing. However, in times of stress there is still a risk that I might revert to the old ways of doing things. Understand that even though I am well established in the ‘maintenance’ phase, I still need ongoing support and encouragement. Be there for me if I relapse. If this happens, help me to: • Reaffirm the original reasons for the change. • Explore the factors that precipitated the crisis. • Get back on track. Hopefully, I successfully exit the final stage of change cycle and move into a new cycle for a new change. If I relapse, I will re-enter the contemplation or preparation stage. Adapted from DiClemente, 1991; Prochaska and Norcross, 1994 and Wirth 2004 by Robert Ferris-Rogers and Helen Bevan REFLECTION: STAGES OF CHANGE 1 At what stage of change are some of the key people that you need to influence for your change initiative? 2 What actions can you take to help them move to the next stage? When you are trying to help people through change, you might find it useful to look at the Bridges Transition model. William Bridges realised that people need time to make the transition from one state
  • 15. School for Change Agents www.theedge.nhsiq.nhs.uk/school/ 15 SCA 2017 to another, to adjust to the loss of something known, to acknowledge and possibly even mourn the end of one state before accepting and becoming comfortable with a new state. Giving yourself time and allowing time for others to adjust to change will make your change efforts more likely to succeed and will also go a long way towards building the capacity for resilience in yourself and those with whom you are working. Building resilience ‘Every great personal story you have to tell involves overcoming adversity. If you shy away from adversity, you take away your ability to tell new stories.’ Farrell Drake In Module 2 we explored the importance of building communities and forming alliances. We gain our strength from these alliances and this is a way in which we can overcome feelings of isolation. Within these alliances and communities there are always critical friends: people who can connect with us at an individual level and whom we trust. In Module 1 we looked at self-efficacy. Teachings on emotional intelligence show us how to develop our own support mechanisms from within. We can do this through building our self-efficacy and taking time to be kind to ourselves. Sometimes this is simply in sitting quietly and breathing, in practising some mindfulness techniques, in sitting still to eat our lunch, in going for a walk. By taking time simply to be, we are building our reservoirs of self-support. REFLECTION: TAKING CARE 1 How do you take time to take care of your own physical and emotional well-being? 2 Please note down three things/activities that help to build your emotional reserves rather than deplete your energy. William Bridges Transition model
  • 16. Module 3 Study Guide www.theedge.nhsiq.nhs.uk/school/ 16 SCA 2017 3 What do you do for fun and/or to relax? 4 How can you build activities like this into your daily routine? One change agent of our acquaintance has adopted a pragmatic approach to looking after herself. She says: ‘I only ever have three things on my “To do” list each day. And one of them is always “eat lunch”.’ Another, slightly more dramatic response was: ‘The decision to leave my job was the biggest act of self-care in the whole of my 34-year career – I needed to make sure that I thrived, rather than the job.’ And still another: ‘It’s the hardest thing! I’ve been trying to do that for 26 years! Reading, family history, painting…. I have to schedule fun and ease into my life. It’s usually alone time – I go for a walk.’ Caring for ourselves is particularly important if we want to care for others. In Module 5, we will look more deeply at the importance of being compassionate to yourself. But, if we are to ‘be the change we want to see’ and remain committed to being an agent of change, we may have to become even more resilient in order to roll with resistance. What is resilience? Resilience can be defined as ‘the ability of an individual to adjust to adversity, maintain equilibrium, retain some sense of control over their environment and continue to move on in a positive manner’ (Jackson et al 2007). Resilient individuals tend to: • have an optimistic style
  • 17. School for Change Agents www.theedge.nhsiq.nhs.uk/school/ 17 SCA 2017 • operate in their circle of influence • be aware of and use their strengths • set goals • stay connected to others • have a ‘can do’ mindset • exercise self-care. Get your five a day If you find that you are not bouncing back from adversity quite as quickly as you would like, here are five things you can do in order to improve your mental health and well-being, which will, in turn, make you more resilient: www.happiness-wellbeing.org Connect … with friends, family and colleagues, building connections and investing time to maintain them. It’s also useful to think about connecting – or reconnecting – with purpose and your passion for change. Be active… Walk, run, cycle, dance, swim, workout in the gym, or whatever other physical activity makes you feel good. Take notice… find time to be curious, notice beautiful sights, comment on unusual ones, appreciate your surroundings and the people you are with. Keep learning … Try something new or rediscover an old interest, learn to knit or play a musical instrument or change a tyre, challenge yourself to something new. Give … do something nice for someone: say thank you, help an elderly person with their shopping, pick up a child’s toy. You might try volunteering or joining a community group, but find ways to connect with others in your community. Call to action Try to keep the momentum and enthusiasm going by taking some concrete actions. Here are our suggestions:  Look after myself: commit to doing one thing every day that gives me joy/makes me feel good.  Identify three things I can do to support colleagues through the ‘Stages of Change’. Make time to watch The Edge talk on resilience here: http://theedge.nhsiq.nhs.uk/edge-talk-practical-skills-resilience/
  • 18. Module 3 Study Guide www.theedge.nhsiq.nhs.uk/school/ 18 SCA 2017 Questions for reflection Each webinar ends with some questions for you to reflect on during the week. Here are the questions for this week. REFLECTION: WHAT DOES RESISTANCE MEAN TO YOU? 1 How do I experience resistance? 2 How can I make sure that the changes I make achieve the impact I desire and… - are sustainable? - do not create dependency? - generate self-efficacy in others? 3 How can I make sure that my intentions actually result in the impact I want? 4 What do I need to do to develop resilience so that I can roll with resistance? Bringing it all together Make a note of the things that stand out for you from this module and then give some thought to how you will use your new learning to make a difference. REFLECTION: MAKING IT REAL 1 What have you learned?
  • 19. School for Change Agents www.theedge.nhsiq.nhs.uk/school/ 19 SCA 2017 2 How do you know you’ve learned it? 3 How will you take your learning forward? What will you do differently? Reference list for Module 3 These are the references that we have referred to in the webinar and/or that we have used to help shape the content. Click on the reference to get the link. Anderson L (2014) ‘Collective wisdom: are we making the most of interprofessional education?’ Lecture presented at University of Leicester, 6th February 2014 Boyd S (2014) Is cultural fit a cop-out? Bushe G (2009) Dialogic OD Turning Away from Diagnosis Bushe G, Marshak R (2010) Revisioning Organization Development: Diagnostic and Dialogic Premises and Patterns of Practice Bridges W (2009) Managing transitions: Making the most of change (3rd edition) Cancer Prevention Research Centre Detailed Overview of the Transtheoretical Model Diaz-Uda A, Medina C and Schill E (2013) Diversity’s new frontier Farquhar K (2013) NTL’s ‘Conference on the New OD’: Turning Thought into Action Holman P (2013) A Call to Engage: Realizing the Potential of Dialogic Organization Development Jaben M (2016a) The science behind resistance: Slide deck from British Columbia Patient Safety and Quality Council Jaben M (2016b) The science behind resistance II: now what? Slide deck from British Columbia Patient Safety and Quality Council Johnson S (2010) Where good ideas come from A four-minute video that explains how a truly innovative environment encourages diversity of thought and experience. Kegan R and Lahey L (2009) Immunity to change. Boston, Mass: Harvard Business School Press Kotter J and Cohen D (2011) The heart of change: real-life stories of how people change their organisations. Boston, Mass: Harvard Business Review Press
  • 20. Module 3 Study Guide www.theedge.nhsiq.nhs.uk/school/ 20 SCA 2017 Miller D (2011) A million miles in a thousand years Mootee I (2013) Diversity is the short cut to building an innovation culture NHS Institute for Innovation and Improvement (2010) Resistance – working with it Page S (2007) Making the difference: applying a logic of diversity Academy of Management Perspectives Prochaska J, DiClemente C, Norcross JC (1992). In search of how people change. Applications to addictive behaviours Am Psychol 47:1102 Waltz A (2014) Handle rejection positively to succeed SlideShare Additional resources Here are some additional resources that you might find helpful if you would like to learn more about resistance and how it can be harnessed to bring about constructive change. If you have ten minutes… The power of two: how listening shapes storytelling TED talk by Paul Browde & Murray Nossel Three myths of behaviour change – what you think you know that you don’t TED talk by Jeni Cross If you have more than ten minutes… The science behind resistance by Mark Jaben A webinar presented to the British Columbia Patient Safety and Quality Council The science behind resistance II: by Mark Jaben Practical example and strategies on recognising resistance; a further webinar presented to the British Columbia Patient Safety and Quality Council rEvolution How to Thrive in Crazy Times by Bill Lucas Look especially at Rule 3: Slow down and Rule 7: Sometimes it’s smart to resist. The New Leaders by Daniel Goleman The author of many books on emotional intelligence and personality; this book reviews the emotional component of leadership, and discusses its role in modern leadership. Switch: how to change things when change is hard by Chip and Dan Heath Well-written, engaging and insightful book about why we insist on seeing the obstacles rather than the goal and explaining how we can unlock shortcuts to switches in behaviour Hesperian Health Guides Resources on health and community empowerment Useful websites for resilience, health and happiness www.wellbeinginfo.org www.mindapples.org
  • 21. School for Change Agents www.theedge.nhsiq.nhs.uk/school/ 21 SCA 2017 www.mind.org.uk www.mentalhealth.org.uk www.moodgym.anu.edu.au Please do contact us with your ideas and contribute to the growing collection. We look forward to seeing you in School – and please keep in touch! Email: england.si-horizons@nhs.net Telephone: +44 2476 627543 Facebook: www.facebook.com/sch4change/ Twitter: @Sch4change #S4CA