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When theory meets practice
(2017)
Although more than seven decades have passed since Lewin laid the foundation for how employees’ behaviour could be changed within organizations, his ideas are far from being obsolescent. Accordingly, this article demonstrates how Lewin’s concepts can still be of use in tackling current issues (i.e. the need to raise energy-saving behaviours within organizations). In order to revive Lewin’s concepts, we combine his approaches on organization change with Motivational Interviewing (MI), a facilitation approach that fits well with his democratic and participatory mind-set. After a theoretical consideration of how Lewin’s ideas could be accompanied by MI principles, we outline a practical concept for raising the level of employees’ energy-saving behaviours to a higher standard. The usefulness of our concept is highlighted on the basis of qualitative (a force field analysis) and quantitative (an increase of energy-saving norms and – behaviours) data. Lewin’s legacy for current organization development, and the theoretical as well as practical implications for how his ideas could be applied through a combination with MI practices, are discussed.
Background
This cluster-randomised monocentric controlled trial focuses on improving the uptake symptoms of mental health care in adolescents with chronic medical conditions who have been identified by screening to have depression or anxiety. The study aims to determine the efficacy of motivational interviewing (MI) delivered by trained physicians to increase 12- to 20-year-old adolescents’ utilisation of psychological health care for symptoms of anxiety or depression.
Methods/design
In this single-centre approach, n = 1,000 adolescents will be screened (using PHQ-9 and GAD-7), and adolescents with results indicative of anxiety or depressive symptoms (n = 162) will be advised to seek psychological health care in clusters from treating physicians in specialised outpatient departments. Participants who screen positive will receive either two sessions of MI or treatment as usual (TAU; regarded as the typical daily clinical practice), which is focused on recommending them to seek psychological health care for further evaluation. MI efficacy will be compared to the current TAU as the control condition. The primary outcome is the utilisation rate of psychological health care after counselling by an MI-trained physician vs. an untrained physician. Additionally, reasons for not claiming psychological support and changes in disease-related parameters will be evaluated in a 6-month follow-up session.
Discussion
This trial will evaluate the feasibility of MI as a way to improve the utilisation of mental health-care services by adolescents who need further support other than that provided by standard care for chronic diseases. Physicians offering MI to adolescents may serve as a model for optimising health-care management in daily clinical practice, which may improve adolescents’ long-term well-being by improving adherence to medical treatment and preventing negative lifelong consequences into adulthood.