Coaching and the Three Degrees of Organisational Change

First-degree Change: An Illustration from Healthcare

Medical healthcare has traditionally focused largely on providing remedial or “curative” treatments for acute conditions. A patient with bacterial pneumonia is typically diagnosed based on presenting symptoms, and then treated with a course of antibiotics to “fix” or eradicate the health problem. We could call this approach a “first-degree” intervention and it is of course necessary and essential in the management of acute conditions.

But how well does this approach work in the treatment of ‘lifestyle-based’ health problems such as obesity, diabetes, and heart disease?

A first-degree medical intervention can, to some degree, limit the progression of these lifestyle-based diseases, or defend against further complications. But the underlying socialpsychological and environmental systems that perpetuate the development of the disease symptoms are often neglected by a first-degree approach.

For instance, gastric-band surgery is a first-degree medical procedure for the treatment of obesity. Without nutritional education, shifts in the patient’s lifestyle, or addressing the psycho-social and environmental factors that reinforce disordered eating patterns, gastric-band surgery will in itself not lead totruly improved health – even if the patient does initially lose some weight. What’s more, there are accounts of gastric-band patients gradually and painfully “re-stretching” their stomachs to accommodate binge eating episodes.

It is tempting to criticize and blame patients’ inadequacies for not adhering to medical treatments and advice. But interventions that do not address the patient’s bio-psycho-social system of influences are in fact inadequate! Of course we want to invite greater responsibility from people in managing their lives better, but we have to help them identify and transcend the restraints and unconscious patterns that undermine their ability to do so.

First-degree Organisational Change

The same applies to creating lasting change and “health” in organisational functioning.

Traditional first-degree approaches to organisational change have focused on providing “curative solutions” that attempt to fix problems such as poor performance, lack of productivity, lack of engagement etc. In a typical first-degree change approach a poorly functioning team of employees is in a sense “treated” by “administering” leadership skills courses, team-building workshops, communication skills training, and many other well-intentioned programmes that provide a temporary “fix” to the identified problems. Although these first-degree change solutions can to some degree limit the further deterioration of employee relationships and performance, the underlying individual and organisational-systemic patterns that gave rise to breakdowns in communication, leadership, poor team morale etc. are left unchanged.

The problems will re-occur, perhaps in a different form.

First-degree Change – Coaching in an Organisational Context

Phil is a manager in your organisation who is known for the ultra-high standards he places on himself and his department. Under Phil’s leadership his department had initially become more quality-focused and reliable. Phil easily spots how things can be improved and works very hard and long hours to show, by example, how a job can be done well. But a number of employees under Phil’s leadership are complaining about Phil’s recent and more regular critical and angry outbursts. Phil’s exacting standards and “one right way” approach have his team feeling incompetent, under constant stress, and micromanaged. The team has a very ‘negative vibe’ in the office and this is affecting the rest of the organisation’s atmosphere.

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