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The Neuroscience of Leadership in Systems of Care: Transforming the Way We Lead Systems Change With Insights From Brain Science

July 11, 2013

Guest Morning Zen contributor and Network faithful Laurie Ellington of Zero Point Leadership TM offers a unique and forward-thinking look at the relationship between neuroscience and leadership in systems of care. We are sharing her most recent paper on the topic in this Morning Zen post. Enjoy!

Abstract
Effective leadership at all levels is critical to the success of systems of care initiatives.  However, since the system of care concept and philosophy began in the 1980s, the complexities involved in the human resistance to change have created a significant leadership and change management challenge.  This paper provides the most recent neuroscientific findings that underlie effective leadership and change management practices as they relate to the planning, implementation, and evaluation of the system of care approach.  These insights help us to understand why people find change so uncomfortable and how child and family-serving systems can use knowledge from the field of NeuroLeadership to better facilitate positive organizational and systemic change.

Introduction
Leadership in systems of care initiatives is complex and systems change is frequently met with a great deal of unease.  Effective leaders at all levels are needed in order to motivate others to engage children, adolescents, and families in new ways.  However, the field of contemporary neuroscience tells us that human behavior in child and family-serving organizations doesn’t work the way many system of care leaders think that it does (Rock & Schwartz, 2006).  “Getting people on board” during an organizational change initiative is challenging, resulting in most human service system reform efforts historically underperforming.  Changing human behavior requires changing the human brain.  To change the human brain, it must be engaged.  For years, leaders have recognized that engagement, the extent that someone is committed to an organization or relationship (Rutledge, 2005), is the most significant predictor of success in leading positive change.  Engagement is currently viewed as somewhat of an art, with a lack of understanding of what consistently and effectively works to facilitate deeper levels of commitment to a change process.  However, research uncovers that there is science to engagement (Rock & Tang, 2009) that can help us better understand what it takes to inspire others to be actively involved and invested in the personal learning and systems change that leads to improved outcomes for children, adolescents, and families.   

The system of care framework began in the mid-1980s.  As a result of Jane Knitzer’s 1982 report, Unclaimed Children,  and the voices of families who had children separated from their homes and communities, a national social reform movement was launched in an effort to help states create comprehensive community-based mental health systems that would better serve vulnerable and at risk children and their families.  This national movement received its initial financial and organizational support from a small grant funded program called the Child and Adolescent Service System Program (CASSP) directed by Beth Stroul and Robert Friedman (Stroul, 2002).  In 1986 Friedman and Stroul developed a set of guiding principles for the design and planning of the changes needed to address the national failure in serving children with mental health needs.  Although progress has been observed and the system of care concept is nationally accepted and widely used, almost 30 years later struggles continue to exist in the planning, implementation, and evaluation of systems of care across the country.  It is well noted in the literature that barriers involved in engaging families, organizations, and systems in the change process required for system of care initiatives are hindering the pace of progress.  In A View from the Balcony (2005), Gary De Carolis illustrates some of the key barriers to leading system of care reform, highlighting our poor track record of developing public sector leaders.  He further describes how this has contributed to feelings of being powerless while trying to improve mental and behavioral health care for young people and their families- even by communities that are more advanced in their system reform process.   Research highlights that one of the biggest obstacles to furthering the adaptation of the system of care approach and philosophy across the nation is the human resistance to change. 

This discussion presents some recent discoveries in the field of contemporary neuroscience as they relate to effective leadership and change management in systems of care, as well as how this branch of science can assist leaders in better understanding why change is hard for people and how to engage providers, administrators, policy makers, and family members in systemic reform from a systems thinking perspective.   

Applying Neuroscience to Leadership and Change Management
Understanding people means understanding the biology of the human brain.  The field of NeuroLeadership, a term coined by David Rock, leadership consultant and Chief Executive Officer of the NeuroLeadership Group, applies research in contemporary neuroscience to leadership practices and change management so that we may better understand the neural basis of decision making and problem solving, emotion regulation, collaborating with others, and facilitating change (Ringleb & Rock, 2008).   Recent advances in technologies such as functional magnetic resonance imaging (fMRI), positron emission tomography (PET), and electroencephalograph (EEG) are allowing us the opportunity to explore the hard science that underlies the soft skills needed to influence innovation and creative thinking and promote resiliency in the face of change.  New findings are highlighting how the application of brain science to leadership performance challenges many of our traditional and popular approaches to behavior change in human service organizations and public systems of care.  Viewing behavior change through the lens of neuroscience provides system of care leaders a more sophisticated understanding of how to engage people in practice improvement by identifying the biological underpinnings of behavior change in social, interpersonal relationship, and human service workplace settings. 

Why Neuroscience Matters to Leaders in Systems of Care
Change is uncomfortable, evokes physiological pain, and is unsettling.  This presents some unique challenges to building collaborative teamwork between agencies, community stakeholders, and families involved in a system transformation effort.  Systems of care need people who are emotionally invested in positive change, as evidenced by a commitment to develop new solutions to long-standing problems, take risks, and collectively think differently.  There is a growing need to better understand what drives human behavior and motivation in human service workplace settings and to help others gain a clearer awareness of what is involved in complex situations.  Fortunately, recent advances in neuroscience uncover a deeper understanding of why change is so upsetting and difficult.  The neuroscientific findings underscore that most of what is implemented to change behavior in human service organizations is counterproductive, causing the opposite of what is needed to improve outcomes for families.  For example, when a manager of an in-home and community-based mental health program relies on telling a direct support worker what to do as a means to change behavior or uses threats and rewards to develop new skill sets, the worker’s brain becomes less efficient.  When young people and their families find themselves involved in a public-serving system and the primary approach to change is to give advice or use threats and incentives, engagement levels decrease and the family becomes less effective and closed to new ideas.  On the other hand, when providers and family members are communicated with in a way that promotes insight and creativity, given opportunities to make decisions, and treated fairly, their brains are significantly more resourceful.  The field of NeuroLeadership, where science journeys inside the brain to examine what impacts change management and effective leadership, can assist system of care leaders to gain an appreciation of what it takes to deeply engage others in change based on the physiological nature of the organ that controls behavior- the human brain.  Most behavior in the workplace, or any social setting, is based on habitual patterns of behavior that occur automatically below conscious awareness.  These patterns include thoughts, images, and actions and are referred to as habit systems (Dickinson, 1985).  In order to change systems, well-established patterns of habit have to be interrupted and exchanged for new habits that are aligned with best practices.  Leaders that understand how and why the human brain has evolved to resist changing these habit systems are more equipped to lead and manage effective organizational change in systems of care. 

One of the primary hurdles that leaders encounter is the ability to engage others in results-oriented decision making that reflects a well communicated shared vision.   Successfully leading reform initiatives that improve outcomes is contingent upon intentionally utilizing social and emotional intelligence skills and competencies needed to nurture a collaborative and rewarding environment.  Leaders who possess these skill sets have a worldview reflective of a systemic versus mechanistic paradigm.  A systemic perspective values relationships, experience, collaboration, and human potential, whereas a mechanistic view focuses on seeing the whole as a sum total of its parts, reductionistic thinking, and a hierarchically linear approach to organizational change.   System of care leaders with a systemic mindset understand that taking an adversarial stance toward a colleague’s personal values will not propel the system as a whole in uniting around core system of care values. Adding to the body of traditional research on leadership and emotion regulation, neuroscience discoveries are focusing on understanding how a leader’s social and emotional intelligence skills relate to their ability to manage an effective change process (Ringleb & Rock, 2008).  System of care leaders who understand modern neuroscience, one of the most rapidly expanding areas in contemporary science (Ringleb, Rock, & Ancona, 2012), are better prepared to lead change in a thoughtful way that creates an atmosphere of trust, openness, and transparency that are fundamental elements of a ‘learning organization.’ Peter Senge (1990) describes a learning organization as “an organization that is continually expanding its capacity to create its future.” Tackling the challenges that put children at risk and strengthening services and supports for young people and families involved in systems of care will depend on innovative leaders who understand deeply how to influence people and systems. As noted by Gary Blau and Phyllis Magrab (2010), “System of care leaders seeking to improve the lives of children, adolescents, and families must work to develop new skills, new perspectives, and new roles in this ever-changing world.”  The hard science underlying the difficulty systems experience during reform efforts plays a prominent role in helping to identify which forms of leadership are more successful, and which create barriers to progress.  

The Neuroscience of Engagement in System Reform- the Deeply Social Brain
The fields of social, cognitive, and affective neuroscience provide us with some generous insight into the biological underpinnings of social processes, shedding light on some encouraging approaches to getting people more deeply engaged in system reform. Studies show that many of the challenges faced by system of care leaders are connected to our understanding of human cognition and the way it is influenced by how we relate to each other and ourselves.  To begin with, the neuroscience platform that supports deep engagement is based on the organizing principle of the human brain to ‘minimize danger and maximize reward’ (Gordon, 2000), also known as the approach-avoid or threat versus reward response.  At a level outside of conscious awareness, the limbic system, also known as the emotional center of our brain, conducts an assessment five times per second to decide whether or not something in the environment – a sound, person, tone of voice, place, glance, gesture, sensation- is good (rewarding) or bad (threatening) and should be avoided or warrants approach (Gordon, 2008).  The human brain’s default setting is the threat response; also recognized as a state of disengagement.  Being able to rapidly decide what is good and bad in the environment helps people stay alive and mobilize physical resources quickly when needed.  When in a threatened state, the brain’s ability to access cognitive resources is impaired because the brain pulls resources away from the cortical circuitry where higher order thinking takes place, specifically the prefrontal regions where creative insights, complex problem solving and states of functioning that support social collaboration, cooperation,  and teamwork are supported.   In a study by Amy Arnsten (2009) at Yale University’s Department of Neurobiology, stress was demonstrated to impact cognitive abilities by moving resources from the prefrontal cortex to the amygdala, which is helpful in situations that are life threatening, but not useful for effective decision making, the production and recognition of insights, and fresh approaches to unraveling complicated issues.  The ability to have and hear insights, quiet signals in the brain sometimes referred to as “a-ha” moments, is paramount to creative problem solving and for developing novel ways of seeing, thinking, and being that lead to improvements in practice.  To illustrate the implications of this in systems change, a traditional leadership best practice is to “create a burning platform” atmosphere in order to motivate employees to see the need for change.  However, instead of increasing motivation levels this activates the limbic response, recruits the brain’s higher thinking resources, and impairs the processing of new information and ideas.  Neuroscientists at Northwestern University discovered that lower levels of stress and a positive mood lead to an increase in the ability to hear and use new insights (Jung-Beeman, Collier, & Kounios, 2008), providing some evidence to support that happier child welfare administrators, mental health directors, juvenile justice workers, and teachers may be much better positioned to engage in innovative and “out of the box” thinking.  In essence, people need to be in a reward- or toward- state in order to perform at the cognitive level that supports more sophisticated problem solving, effective decision making, and the generation of new beliefs that lead to better policies, programs, and systemic outcomes. 

The human brain is extremely social, with a deep-seated biological need for connectedness.  Eisenberger and Lieberman (2003) conducted a study on the impact of social exclusion, demonstrating that social pain activates the same regions in the brain that physical pain does.  The brain circuitry activated during social rejection or abandonment appears to have piggybacked onto the physical pain circuitry (Lieberman & Eisenberger, 2008).  Translating this into a system of care environment, when a social worker or wraparound care coordinator is told that they are ineffective at their work or expectations are not clearly communicated, it can threaten their perceived sense of status or feelings of certainty for the future.  This quickly sends a message to the brain to disengage.  A feeling of being ostracized or rejected can trigger significant threat states at the biological level, making it difficult to focus and pay attention.  This burdens the productivity level of the worker and the organization, at a time when people need to be able to access their most advanced thinking skills.  When leaders spotlight poor performance, discuss budget cuts, or make decisions in “silos” where people feel left out, social needs are threatened, causing dramatic decreases in higher order thinking and human performance. The significance of this becomes clearer when one realizes that social needs are experienced much the same at the neural level as primary survival needs, like food and water for example.  Being socially accepted is the same as surviving.  David Rock (2008) developed a neuroscience-based framework for engagement called the SCARF Model that describes five domains, or social drivers- status, certainty, autonomy, relatedness, and fairness– as the areas where the human brain can be triggered into either a threat (disengagement) or reward (engagement) state during social interactions.  According to Rock (2009), status is about our relative importance to other people, certainty refers to our ability to predict the future, autonomy relates to a sense of control over situations and events, relatedness concerns feelings of safety with others or deciding whether or not someone is friend or foe, and fairness is about exchanges between people being perceived as fair.  He goes on to state that “…the ability to intentionally address the social brain in the service of optimal performance will be a distinguishing leadership capability in the years ahead” (Rock, 2009).  When people do not feel involved in decisions, important to the change process, or when they are reprimanded for habitual behavior, it can be perceived by the brain to be as painful as smack in the face or a strike to the head, disengaging cognitive resources essential for practice improvement.  In system of care reform, problem solving, creative and innovative thinking, collaboration, and motivation to learn are crucial to improving service delivery and child and family level outcomes.

Modeling the Way
A leader’s mood and behaviors dramatically impact the performance of the entire organization.  Newly discovered brain cells, referred to as mirror neurons, give people the ability to see themselves in other people (Cattaneo & Rizzolatti, 2009; Iacoboni, 2008), underscoring that the mind exists ‘between’ people and that the emotions and behaviors of others are in many ways contagious.  There is a neurochemical link at the interpersonal, organizational, and systemic level that illustrates how learning takes place within the context of relationships, offering a biological explanation for the influence of non-verbal leadership behaviors.   These brain cells allow people to ‘mirror’ what another person is doing and saying, and are only activated when the observed behavior is intentional (Iacoboni, 2008).  For example, a project director of a system of care site can have a biological impact on her staff by actively and intentionally involving families in opportunities to move the system forward.  By enthusiastically recognizing the positive contributions that young people and family members make to transformational change in systems of care, she fosters the same biological process that she experiences in others who observe her behavior.  In this situation, the project director can literally affect her own brain chemistry as well as the people following her lead.  In his groundbreaking book Mindsight (2010), Daniel Siegel explains how this sophisticated neuronal system is a component of our “resonance circuitry”, affording us the capacity to internally map out both the behavioral intentions and emotional states of others.  In their discussion about the neurochemical link between the brain of a leader and that of his or her follower, Daniel Goleman and Richard Boyatsis (2008) state that “mood contagion stems from neurobiology.”   Moreover, Goleman and Boyatsis assert that leaders who understands the biology of leadership, and who work to increase their own social intelligence, can facilitate neuronal changes that create positive emotional and behavioral changes in their employees.  An effective system of care leader-follower dynamic is one that reinforces the brain’s circuitry associated with best practices by leveraging the neural interconnectedness between people.  To demonstrate, the emotional tone and disposition of a child welfare supervisor has a substantial impact on the effectiveness of a feedback session with a social worker who engages in direct practice with families.  If the supervisor’s tone is negative and critical, it will activate the same neural circuits in the supervisee, impairing the mental capacities needed to process the feedback and improve practice.  Telling people what to do, using threats, or providing incentives to get others to change behavior are counterintuitive to relationship-based, socially intelligent leadership, and often create the opposite effect of what leaders want, observes David Rock (2008).

Using Brain-Based Coaching to Create New Habits- the Power of Attention
We know that getting people to change old hardwired behaviors (habits neurobiologically wired in the brain) is not an easy undertaking.  Shifting a culture by changing human thinking and behavior involves changing neural circuitry, which can be biologically distressing.  Child and family-serving agencies invest considerable amounts of funding in training designed to improve the performance of social workers, therapists, probation officers, and other community stakeholders.  However, new behavior results from changes in thinking and viewing challenges from a different perspective.  Transforming culture happens through repetitive practice of new habits supported through, not just training, but ongoing coaching.  New patterns of behavior are reflected first at the biological level in the human brain.  Through the act of continuous observation in the form of intentional focus, new pathways in the brain become stabilized so that it can change (Schwartz, Stapp, and Beauregard, 2005).  Leaders who adopt a coaching approach are shown to be more effective than those following traditional models of supervision or top-down hierarchical methods of changing organizational behavior, where people are told what to do.  Coaching that is based on how the brain functions helps people come to their own insights and make new connections in a safe way that doesn’t evoke a sense of threat to perceived status, certainty, autonomy, relatedness, or fairness. Thus, a brain-based coaching approach aims to offer something that is not currently available to the workforce in systems of care.  Human behavior in the workplace is hardwired, patterned behavior- from how people communicate with each other on a daily basis, to how management and child and family team meetings are facilitated.  Creating new pathways in the brain and making a decision to step away from the well-beaten path requires extensive energy in the form of attention, as described by Jeffrey Schwartz in an interview with David Rock (2006).  Schwartz shares that the human brain is subject to the same laws as quantum mechanics, emphasizing that where attention is placed (the questions we ask) determines both the connections made in the brain, and the outcomes that we see.  There are endless possibilities for the pathways that can be created, depending on where people direct their focus and energy.  Whatever system of care leaders focus on is what they become really good at. By intentionally choosing where to put their focus, system of care leaders can impact the structure and function of their brains and the brains of others, improving the ability to effectively lead and optimizing the performance of their organization.  The literature reflecting findings on the studies of neurogenesis (the creation of new neurons) and neuroplasticity (the brain’s ability to remap and reorganize throughout the lifespan) support this concept of intentionally altering brain circuitry through the act of deciding what is attended to.  To clarify what this looks like in a system of care environment, employees need to own the change that is needed in order for entrenched behaviors to be modified.  If a social worker has a mental map about the wraparound process that is different from that of his supervisor, he won’t shift his perspective until he has a moment of insight, where a set of new connections are made in the brain that help the brain overpower the resistance to change (Jung-Beeman et. al, 2008 ).  Once the insight is heard, it needs to be acted upon and reinforced for a new habit system to develop.  Solution-focused, brain-based coaching, where people are engaged in a self-directed approach to keeping their concentration on the creation of new connections and the change they desire to see, has been found useful in helping people keep their attention on change in light of old hardwired thinking and behavior.

Conclusion
Systems of care transformation efforts require innovation, creative thinking, novelty, and the generation of new insights so that problems can be solved differently than they have been in the past.  The ability to effectively collaborate across multiple service sectors requires leaders to be both systems thinkers and engineers of human relationships.  System of care leaders have to hold a mental model for integration and growth, possess the ability to link, be able to see the intelligence in the whole versus in its parts, and inspire others to do the same.  Self-awareness and powerful engagement at a physiological level within and across service organizations is fundamental.  This article has drawn attention to discoveries about how the human brain works that are yielding new perspectives on effective leadership and change management practices in systems of care, challenging many of our current approaches to engaging the human service workforce in systems change, and underscoring the need for a new leadership paradigm- one that integrates the physiology of the human brain and thinks about people differently.

About Laurie Ellington
laurie
Laurie Ellington, MA, LPC, CPC, RCC is co-founder and Chief Executive Officer of Zero Point Leadership™. She believes that we can change the world by changing our thoughts and beliefs. As a NeuroLeadership Coach, Social Change Facilitator, and Inspirational Speaker, she works with people who want to take an unconventional approach to moving beyond the status quo in order to create remarkable change in their lives and organizations. Laurie combines research from neuroscience, modern physics, positive psychology, and systems thinking to help leaders, teams, and organizations utilize the power of self-awareness, presence, and insight to transform culture and mindfully improve human performance. She co-developed the Zero Point Results Model™, which is a comprehensive organizational and systems improvement framework that rests on a neuroscience and systems thinking platform.

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