American Association for Physician Leadership

Team Building and Teamwork

Addressing Uninformed Resistance to Change

Robert Hicks, PhD

September 8, 2019


Abstract:

People initially resist change when they are in the precontemplation stage — they don’t see a need for it. How can you coach people who need to make changes for their personal or professional benefit, but clearly are in the precontemplation stage, unaware or under-aware of the negative aspects of their current behavior? First, you must know what kind of resistance you are facing. There are two kinds of resistance: uninformed resistance and rebellious resistance. Each requires a different approach. This article focuses on uninformed resistance and the first steps in addressing it.




People initially resist change when they are in the precontemplation stage — they don’t see a need for it. As discussed in previous articles, only when they come to the self-realization that it is in their best interest will they be open to change.

According to Prochaska’s Transtheoretical Model of Change,(1) this realization represents movement from the precontemplation stage to the contemplation stage of behavioral change — a prerequisite for any action toward change. A person who has reached the contemplation stage can be coached; until then, however, they may resist coaching.

How can you coach people who need to make changes for their personal or professional benefit, but clearly are in the precontemplation stage, unaware or under-aware of the negative aspects of their current behavior? First, you must know what kind of resistance you are facing.

There are two kinds of resistance: uninformed resistance and rebellious resistance. Each requires a different approach. This article focuses on uninformed resistance and the first steps in addressing it.

Education As a Tool

People who engage in uninformed resistance lack knowledge about why the change is needed. It’s analogous to driving toward a cliff without being aware of the drop-off ahead or underestimating the length of the drop. In either case, the driver does not recognize the need to change direction.

The first strategy for dealing with uninformed resistance is to start from their level of awareness, not from yours. Do not assume that what is obvious to you is enough to convince others to change. People must come to their own realization of the need to change by experiencing an “aha” moment — a moment that illuminates the personal benefits of change or the potential negative consequences of not changing. Education is one means of combating uninformed resistance.

An adage in sales training asserts “you never sell, you only educate.” Attempting to sell people on something they need to do is often met with resistance. Conversely, educating people so that they come to their own conclusions about its importance gains buy-in. Providing information from a source the person respects — and that may not be you — gives the person a new perspective from which to reevaluate the need for change. For example, finding educational programs that give the person new insights is often successful.

Consider this scenario:

Dr. Wells is the technical director of radiology for a large community hospital system. Her command-and-control style is being rejected by those under her direction and Dr. Sato, her director, is concerned that her inability to build relationships and influence through persuasion is undermining her capacity as a leader.

Dr. Sato suggested to Dr. Wells that a more collegial managerial style might work better than the directive style but was met with a blank stare. It was obvious to Dr. Sato that Dr. Wells was in the precontemplation stage with regard to changing her leadership style.

Dr. Sato considers Dr. Wells an “up and comer” and passed off her style as a function of her relative inexperience in a leadership role and her desire to avoid failure; however, Dr. Sato does acknowledge that Dr. Wells needs to modify her style if she is going to be successful long-term. Perhaps an educational approach to raising awareness is required.

Dr. Wells was provided the opportunity to attend an executive level leadership development program for high potential healthcare leaders at a local university. She was honored to be selected for the program and eagerly participated in the first class: Motivational Leadership.

At first, like many elite professionals, she was convinced that her strong suit as a leader was her personal drive and a strong need for achievement; after all, it had gotten her to this point in her career. As the class progressed, however, she began to view the role of the leader differently. She began to understand that her ultimate success depended on her ability to influence others and not on her own individual achievements.

After reflecting on her current leadership style and its negative impact on the motivation of those upon whom she depends for the department’s success, she realized that she had work to do; a change was needed.

It is not uncommon in healthcare to use education as a means to induce change. In fact, an important part of the role of a healthcare professional is to educate patients about the effects of lifestyle choices harmful to their health, moving them from the precontemplation to the contemplation stage of making healthful changes.

Education is a useful tool in overcoming uninformed resistance so long as the information is directly relevant to the person’s situation and delivered by a respected source. Books written by experts in their field and seminars or classes taught by highly regarded professionals meet these requirements.

Reducing Resistance Through Mentoring

Another and perhaps a more reliable educational tool for reducing uninformed resistance is mentoring. Mentoring is like teaching, but with one crucial difference: Mentors provide information gleaned from their personal or professional experience — information that can’t be learned in a classroom. It is more personal than an educational program because the mentors share a part of themselves as they impart “higher” learning or wisdom.

An effective mentor–mentee relationship is defined by trust and respect. When those elements are combined with the interchange of ideas and questions that typify the mentoring process, mentoring may very well create an “aha” moment that moves the mentee from precontemplation to contemplation. When the mentor suggests that the mentee makes some changes and educates the person as to why, based their own personal or professional experience, it often causes the mentee to pause and consider what the mentor is saying. If the advice is perceived as genuine, with no agenda on the mentor’s part except for concern about the person’s well-being, the advice may motivate them to contemplate making the changes.

Looking Ahead

Whether education (information unknown to the person that generates insights leading to change) is provided in a formal setting or as part of a trusted professional relationship, it may help overcome uninformed resistance.

Giving feedback is another educational process that can move people from precontemplation to contemplation; however, giving feedback can be tricky. Fortunately, a long history of research specifies the guidelines for giving feedback in such a way that the person receiving it is more likely to accept it. That will be the next topic in this series.

References

  1. Prochaska JO, Norcross JC, DiClemente CC. Stages of Change: Prescriptive Guidelines. In G. P. Koocher GP, Norcross, JC and Hill III SS (eds), PsychologistsDesk Reference, 2nd ed. New York, NY: Oxford University Press, 2005, pp. 226–31.

  2. Hicks RF. Coaching as a Leadership Style: The Art and Science of Coaching Conversations for Healthcare Professionals. New York, NY: Routledge, 2014.

Robert Hicks, PhD

Robert Hicks is a licensed psychologist, a clinical professor of organizational behavior, and founding director of the Executive Coaching Program at the University of Texas at Dallas. He also is a faculty associate at UT Southwestern Medical Center and the author of Coaching as a Leadership Style: The Art and Science of Coaching Conversations for Healthcare Professionals (2014) and The Process of Highly Effective Coaching: An Evidence-based Framework (2017). robert.hicks@utdallas.edu

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