Using Psychiatric Rehabilitation Tools to Assess Readiness for Change: A Case Study

Based on the assumption that organizations are living organisms and techniques and interventions applied to help people change can be used to lead organizations through growth and change, I created an organizational readiness determination tool that I adapted from practitioner training manuals prepared by the Center for Psychiatric Rehabilitation. 4 These manuals describe the Psychiatric Rehabilitation Readiness Determination (PRRD) process involved in assessing an individual’s readiness to engage in change. I began to apply this readiness assessment to my agency on my first day as executive director, assessing the organization’s readiness to change on five dimensions:

  • Dissatisfaction/Need for change: Organizational readiness determination begins with the assessment of an agency’s felt need to change and the level of dissatisfaction with its existing situation. As discussed earlier, this need or dissatisfaction can be internally or externally motivated. For my new agency, the degree of dissatisfaction/need for change was high both before and during the process. Everyone involved knew that, to thrive, the agency had to change. In planning for change, privatization was the vehicle implemented to operationalize that change.
  • Commitment to change: This second dimension of the readiness assessment is based on the belief that the change will be possible, positive, and supported. On this dimension, my agency was rated somewhat lower. Staff and service recipients worried that, once privatized, the agency would be forced to treat only those who could pay for services, and people who could not afford to pay for behavioral health treatment would not receive it. On the other hand, staff had been a part of many of the pre-privatization discussions. They knew that the county was serious about changing the auspices of the agency, and they were highly motivated to show that they could make an independent agency run better than past management had.
  • Environmental awareness: On the third dimension of environmental awareness, or understanding the array of options that change would afford our organization, my agency was rated fairly highly. Staff and government officials worked side by side to investigate all possibilities for change in the community. Those possibilities included merging the existing services with the local community hospital, merging the services with another not-for-profit, developing a public benefit corporation, or creating an independent organization.
  • Self-awareness: On this dimension, the agency’s staff, service recipients, board members, and government officials also had a high degree of knowledge about their preferences and goals. The staff and the board had worked in committees to develop a strong mission statement and a listing of goals and objectives for the new agency. They were clear about their needs and the direction in which they wanted the agency to go.
  • Personal closeness: A high rating on the dimension of personal closeness results from an agency’s desire and ability to trust someone enough to lead them successfully through the change process. On this dimension, my agency also rated highly. They were invested in finding someone with the organizational skill set to lead them in accomplishing the goals they had articulated. Thus, when I became executive director, knowing that the agency needed and wanted a strong leader, I made it clear that if we were to survive, we would have to work as a unified team to achieve our goals.
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