The tale of an ugly
duckling:
How to overcome barriers to
harnessing the power of the
group
Sabina Nagpal, MD, FRCPC, MPH
Objectives
 Objective 1: Participants will have a working knowledge
of potential overt and covert barriers to harnessing the
power of the group
 Objective 2: Participants will consider strategies to
overcome barriers in their own work and use the group
community to support their initiatives
 Participant objectives
Context
Relationships Group
 Setting
 Service gap
 Innovation
LIterature
Group
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11 weeks, Semi-structured
9 members, 7 completed
2 men, 5 women
3 schizophrenia, 2 bipolar disorder, 1 rx resistant depression (ECT)
 Themes:
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Attachment
Healthy relationships – self psychology
Communication (Scott Stuart)
Emotions vs thoughts  used to focus on emotions in group
Emotional regulation
Anger
Greif and Loss
Termination
Ten common inhibitors to innovation:
1)
Focus on short-term results drives out ideas that take longer to mature
2)
Fear of cannibalizing current business prevents investment in new areas
3)
Resources are devoted to day-to-day business so that few remain for innovative
prospects
4)
Innovation is someone else’s job and not part of everyone’s responsibilities (“I’m
not the manager”)
5)
Our efficiency focus eliminates free time for fresh thinking.
6)
We do not have a standard process to nurture the development of new ideas
7)
Incentives are geared towards maximizing today’s business and reducing risk
8)
Managers are not trained to be innovation leaders
9)
Immediate tendency to look for flaws within new ideas rather than tease out their
potential
10) Look at opportunities using internal lens rather than starting with consumer needs
**Overt are italicized
Ashkenas, R
Organizational Culture
 Culture is about “the story” in which people in the
organization are embedded, and the values and rituals
that reinforce that narrative
 Culture promotes and reinforces “right” vs “wrong”
thinking and behaving
 Cultures are dynamic. They shift, incrementally and
constantly, in response to external and internal
changes.
Change Management –
integrating psychological
approach
 Rider
 rational/cognitive
 Elephant
 Emotional
 Intuitive
 Path
 clear, well prepared/easy more likely
 small environmental changes tweaks
--Direct the rider, motivate the elephant and shape the
path
--Change only works if the Elephant and Rider are
working together.
Heath & Heath. Switch: How To Change Things When Change Is Hard
Inhibitors to innovation
Elephant problems:
1)Focus on short-term results drives out ideas that take longer
to mature (Elephant is impatient)
2)Fear of cannibalizing current business prevents investment
in new areas (Elephant is fearful)
3)Incentives are geared towards maximizing today’s business
and reducing risk (fear)
4)Immediate tendency to look for flaws within new ideas rather
than tease out their potential (the elephant hates to fail)
Heath & Heath. Switch: How To Change Things When Change Is Hard
Wins, Losses and Challenges
Wins:
Recruitment & Retention
Member gains – Insights, Vulnerabilities, Termination
Cultural shift
Losses:
Members need more
Objective measures
Challenges:
Lack of path
Interruption of change  what has stuck?
Accepting small wins
Acknowledgements:
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Brooke Heximar – my co-therapist
Local Vancouver MH team
Jackie Kinley –design of the group
Zenovia Ursuliak – support and guidance
References
Ashkenas, R. Ten Ways to Inhibit Innovation. Harvard Business Review: July 2012
https://hbr.org/2012/07/ten-ways-to-inhibit-innovation.html
Heath, C. & Heath, D. (2010) Switch: How to Change Things when Change is Hard. New York:
Crown Publishing Group
Lakeman, R. Adapting psychotherapy to psychosis. Australian e-Journal for advancement of mental
health, 5 (1) 2006
Watkins,M. What is organizational culture? And why should we care? Harvard Business Review:
May 2013