Is there such a thing as ‘Resistance to Change’ and should implementers care about it? Deborah Ghate reflects on an ‘essentially contested concept’ and concludes yes and yes, but not, perhaps, in quite the ways we first imagine…..
As Heraclitus famously observed, the only constant is change. Yet, whether through ignorance, fear of the unknown, inertia, or for well-founded reasons, ‘resistance’ to change is a feature of the change process much-bemoaned by would-be policy and practice innovators. Yet although adoption of innovation is a fundamental pre-occupation for implementation scientists, we tend to talk more in terms of ‘readiness’ to innovate (e.g Weiner, 2009) and less in terms of ‘resistance’ to innovation.
So it was with considerable interest that I agreed to take part in an inter-disciplinary workshop in London in October 2017, organised and chaired by Quassim Cassam, professor of philosophy at Warwick University, alongside an intimidatingly distinguished panel of health, complexity, social and management scientists and practitioners.
Perhaps the first surprise was that across our many disciplines, across the panel and the audience, there was a remarkable amount of consensus: although as Quassim told us ‘resistance to change’ is what philosophers would call an ‘essentially contested concept’ (defined as a concept that gives rise to endless disputes about its proper use), most of us agreed (a) there is a phenomenon whereby some people, organisations and indeed systems ‘resist’ change when it is pressed upon them, but (b) such resistance is often entirely understandable and not always a bad thing. Noting that some psychologists claim there are certain types of people that by disposition resist change (ie, there’s a measurable trait for what we might call a ‘resistive personality’ – see for example Oreg, 2003, 2006), the panel were as one in proffering examples of why (c) the automatic assumption of all would-be innovators that change is good is basically flawed. Change (it turns out) isn’t always good: a lot of it is misconceived and half-baked, and very little attention has been paid to checking not just that new innovations are ‘evidence-based’ within the terms of research, but also that they align with what folk on the ground practically can accommodate, given all the other conflicts arising in complex adaptive systems and complex, stressful and conflict-producing professional environments.
So, Trish Greenhalgh (University of Oxford) gave an example of an IT project introduced into the NHS for onward referral to specialists (‘Choose and Book’), resisted by GPs on the entirely reasonable grounds that it was more ‘book’ than ‘choose’ and did not leave space for them to use their own judgement. Geraldine MacDonald (University of Bristol) wondered if the way we select, train and prepare practitioners (her example was social workers) was optimal for developing staff with the confidence – and especially the intellectual confidence - to embrace change and its concomitant risks; and Chris Mowles (University of Hertfordshire) reflected on the tendency of change initiatives to underestimate the unpredictable, emergent qualities of real-world human systems (and noted our penchant for using animal and natural world examples that aren’t, in fact, quite as analogous to human-systems complexity as we like to think). Daniel Thornton (Institute for Government) explained how in Whitehall, the often highly divergent professional backgrounds and experience of elected politicians and permanent government policy-makers creates all kinds of tensions as both try to work towards policy change inside a complex bureaucracy; and Neal Pearse, change strategy consultant from Aberkyn (part of Mackinsey) reflected on the current enthusiasm in cutting-edge businesses for Agile methodologies (self-managing teams as an alternative to traditional command and control leadership - an idea borrowed from software development processes) and what the possibilities here might be for other fields. As part of my own presentation, on an implementation lens on resistance to change, I reflected on what is known about innovations most likely to be resisted (not a great deal, in fact, though see Fleur Jongepier’s tweet https://twitter.com/fleurjongepier/status/923855300989521921 for my list). But I also found myself thinking about the key principles of systems leadership that came up in some work I was recently involved with (e.g the necessity to have humility, and to share and cede power in order to get things done), and suspecting that in implementation and improvement science, we could benefit from doing a lot more thinking about what lies below the surface of our assumptions about readiness for change, whether at the individual or organisation and system level. Quassim Cassam’s summing up points, which amongst other things urged us to think most carefully about the distinction between ‘warranted’ and ‘unwarranted’ resistance and reminded us that ‘unlearning’ is difficult and even emotional work, seemed to lead us in the direction of being much more sensitive to what change-makers can learn from listening carefully to ‘resistors’, and not just strategising to neutralise and divert dissent as fast as possible, when we come across it.
Deborah Ghate was a panellist at Exploring Resistance to Change: individuals, organisations and systems organised by Warwick University Department of Philosophy and funded by the Academic and Humanities Research Council, October 27th 2017, held at the Institute for Government, London SW1. She is Chair of the UK Implementation Society and is based at the Colebrooke Centre for Evidence and Implementation (www.cevi.org.uk).
The UK Implementation Society wishes to thank the organisers for making available at this workshop a number of free places for UK-IS members.
For details of the workshop, abstracts and speaker biographies, see: https://exploringresistancetochange.wordpress.com/
References and related reading
Aarons G.A (2005) Measuring provider attitudes towards evidence-based practice: consideration of organizational context and individual differences Child Adolesc Psychiatric Clinics of N America 14(2) 255-271 DOI: http://dx.doi.org/10.1016/j.chc.2004.04.008
Cassam Q (2017) Change can disturb our peaceful existence: are we right to resist it? Podcast for Philosophy 24/7 : http://www.philosophy247.org/podcasts/no-change/
Ghate D., Lewis J. and Welbourn D. (2013) Systems Leadership: exceptional leadership for exceptional times [on line] Nottingham: the [Virtual] Staff College http://thestaffcollege.uk/wp-content/uploads/VSC_Synthesis_complete.pdf
Greenhalgh T. et al ( 2014) Choose and Book: a sociological analysis of ‘resistance’ to an expert system Social Science and Medicine Vol 104 210-214 http://www.sciencedirect.com/science/article/pii/S0277953613006904
Mowles C (2014) Complex, but not quite complex enough: the turn to complexity sciences in evaluation scholarship Evaluation 20 (2) 160-175
Macdonald G (2002) Transformative unlearning: safety, discernment and communities of learning Nursing Enquiry 9(3) 170-178
Oreg S. (2003) Resistance to Change: developing and individual differences measure J. Applied Psychol 88 (4) 680-693 http://pluto.huji.ac.il/~oreg/files/jap_2003.pdf
Oreg S.(2006) Personality, context and resistance to change European Journal of Social Work and Organisational Psychology 15:1 73-101
Rigby et al (2016) Embracing Agile: Harvard Business Review May 2016 https://hbr.org/2016/05/embracing-agile
Rushmer R and Davies H (2004) Unlearning in Health Care Quality and Safety in Health Care 2004 13 (Suppl II) :ii10–ii15. doi: 10.1136/qshc.2003.009506
Weiner B.J. (2009) A theory of organizational readiness for change Implementation Science 4:67 doi:10.1186/1748-5908-4-67
© The UK Implementation Society, 2017
All views expressed are the author's own and not those of the UK Implementation Society.