Case Study Adaptive Leadership

Case-in-Point is a method of experiential learning used to teach leadership. An integral part of the theory of Adaptive Leadership™  it was developed over the past 15 years by Ronald Heifetz, Marty Linsky, and their colleagues at the Harvard Kennedy School of Government. The method involves using the actions and behaviors of individual participants as well as focusing on the group of which they are members.

Case-in-Point is an immersive, reflective, and ideally a reflexive exercise facilitated by an instructor but in best practice, shaped by group/class participants. Case-in-Point help leadership practitioners with two key components of leadership development:
• It is teaching method that more realistically prepares people to have stamina, resilience and a willingness to work with others in the heat of change in order to adapt, because “to lead is to live dangerously.
• It helps practitioners generate a heightened awareness of themselves, their impact and the systems they are a part of.

Two Critical Distinctions
According to Heifetz, the Adaptive Leadership framework includes two critical distinctions that are central for understanding case-in-point:
• Authority/Leadership
• Technical Problems/Adaptive Challenges

Authority/Leadership. The first distinction clarifies that having a position of authority does not mean that we exercise leadership. Heifetz reminds us that an expert is not necessarily a leader:

For many challenges in our lives, experts or authorities can solve our problems. . . . We look to doctors to make us healthy, mechanics to fix our cars. . . .We give these people power, authorizing them to find solutions. . . . The problems may be complex, such as a broken arm or a broken carburetor, but experts know exactly how to fix them.

To determine whether we need to exercise authority or leadership, we need to analyze the nature of the problem we face. That brings us to the second distinction:

Technical Problems/Adaptive Challenges. Rather than being technical problems, many of the challenges we face today are adaptive. Heifetz and Linsky maintain:

The problems that require leadership are those that the experts cannot solve. We call these adaptive challenges. The solutions lie not in technical answers, but rather in people themselves. . . . The surgeon can fix your son’s broken arm, but she cannot prevent your son from rollerblading without elbow pads. The dietitian can recommend a weight-loss program, but she cannot curb your love for chocolate chip cookies. . . . Most people would rather have the person in authority take the work off their shoulders, protect them from disorienting change, and meet challenges on their behalf. But the real work of leadership usually involves giving the work back to the people who must adapt, and mobilizing them to do so.

The practice of leadership takes place in an authority structure. In an adaptive challenge, the authority structure—the people in charge—can contribute, but others must participate as well. All people involved are part of the problem, and their shared ownership of that problem becomes part of the solution itself.

Reflecting on these two distinctions, it is easy to see how professors, trainers, and consultants often end up treating the adaptive challenge of teaching as a technical problem, and applying the power of expertise by telling people what to do.

Professors, trainers, and consultants are paid for teaching, not for facilitating learning in others. “You are the expert: teach us” seems to be the implicit contract that students expect instructors to uphold. Many educators consider teaching a technical problem, exercise authority rather than leadership, and deploy their power or personality to influence student learning. In the process, they avoid conflict, demonstrate resolve and focus in their use of time, and provide decisive and assertive answers to problems through authoritative knowledge built over many years. Learners in the class find comfort in the predictability of the endeavor and by its inevitable output delivered according to the plan.

The cost of this collusion is the energy, engagement, effectiveness, and ultimately meaning of the learning enterprise itself. The result is that people lose their ability to grow through experience, tolerate ambiguity, and use sense-making skills.

Case-in-point supports learning over teaching, struggle over prescription, questions over answers, tension over comfort, and capacities and needs over deficiencies. It is about embracing the willingness to be exposed and vulnerable, cultivating persistence in the face of inertial pushbacks, and self-regulating in the face of challenge or open hostility. Why? Because this is what leadership work looks like in the real world. In the process, students and the facilitator learn to recognize their default responses, identify productive and unproductive patterns of behavior, and test their stamina, resilience, and readiness to change the system with others.

Planning and Facilitating with Case-in-Point
In case-in-point, a facilitator must not take reactions toward him personally and must encourage the same in participants. This may mean not taking offense for disrespectful behavior and later asking the person to reflect on how productive his statements were.

Ultimately, the role of the facilitator in case-in-point is to demonstrate the theory in practice, by acting on the system in the class. Case-in-point uses the authority structure and the roles in a class (instructor, participants, stakeholders) and the social expectations and norms of the system (in this case, the class) to practice in real time the meaning of the key concepts of authority, leadership, adaptive challenge, technical problems, factions, and so on.

Planning. How does a facilitator plan a session where she uses case-in-point? As in Jorge Luis Borges’ novel The Garden of the Forking Paths, the text—in this case, the lesson plan—is the point of departure for many possible learning events. The facilitator follows the emergence of interesting themes amid interpersonal dynamics and investigates those dynamics, in response to the guiding question, “What does this moment illustrate that is relevant both to the learning and to the practice of leadership in participants’ lives?” What emerges in the action pushes the class down one path of many possible junctures. For the facilitator, the implicit lesson plan turns into a labyrinth of many exciting—albeit sometimes overwhelming— possibilities.

Facilitating.A case-in-point facilitator’s main tool is the question. Questions are the currency of inquiry, and ultimately case-in-point involves ongoing research into the art of leadership that benefits as more people join the conversation. Here a few questions that I have used successfully:
“What’s your intention right now?”
“What did you notice as you were speaking?”
“In this moment, what do you need from the group to proceed?”
“What happened as soon as you asked everyone to open their books to page 5?”
“What have you noticed happens in the group when I sit down?”
“Am I exercising leadership or authority right now?”

Michael Johnstone and Maxime Fern have expanded on four different levels of intervention for a case-in-point facilitator.

At the individual level: The facilitator may comment on someone’s contribution or action for the sake of reflection, trying to uncover assumptions or beliefs. For example, “Mark, could I ask you to assess the impact on the group of the statement you just made?” “What should I do at this point and why should I do it?” “Are you receiving enough support from others to continue with your point?”

At the relationship level: The facilitator might intervene to name or observe patterns that develop between two or more participants. For example, she may say something like, “I noticed that when Beth speaks, some of you seem not to pay attention.” Or “What does this disagreement tell us about the different values that are present in the room?”

At the group level: The facilitator might confront a faction or a group with a theme emerging from the conversation, maybe after participants agree with or disagree on a controversial statement. For example, “What does the group propose now? Can you articulate the purpose that you are pursuing?” “I noticed many of you are eager to do something, as long as we stop this process of reflection. Why is that?”

At the larger level: The facilitator might comment on participants’ organizations, communities, nationalities, or ethnicities, saying for example, “In light of the large number of foreign nationals in the room, what are the implications of the insistence in the literature that Jack Welch of GE is a model for global leadership?”

 A Way of Being, Not a Way of Teaching
For me, case-in-point is rooted in the distinction between an ontological (science of being) versus an epistemological (science of knowing) view of leadership. When we teach using the case-in-point approach, we’re helping our students learn how to act their way into knowing what is right for their specific organization rather than bestowing our knowledge for them to apply, whether it fits their circumstances or not. Likewise, case-in-point is a statement of congruity, of “practicing what we preach” and, in the process, learning to be better instructors. At the same time, we introduce our students to an exciting realm of possibility, aspiration, and innovation beyond technique or theoretical knowledge.

Rules of Engagement
Johnstone and Fern provide the following rules of engagement for case-in-point facilitators:
• Prepare participants by warning them that learning will be experiential and may get heated. For example, create a one-page overview to leave on each table that clarifies all the concepts of the class and includes bibliographical information.
• Encourage listening and respect (though not too much politeness). For example, establish a clear rule that participants need to listen to each other and state their opinions as such rather than as facts.
• Distinguish between case-in-point and debriefing events. For example, set up two different places in the room—one for case-in-point sessions and one for debriefs—or announce ahead of time which kind of event will follow.
• Facilitators must not take reactions toward them personally and must encourage the same in participants.
• Recognize that no one, including the facilitator, is flawless. Acknowledge and use your own shortcomings by recognizing mistakes and openly apologizing for errors.
• Treat all interpretations as hypotheses. Ask people to consider their own reactions and thoughts as data that clarifies what is going on in the room.
• Respect confidentiality.
• Take responsibility for your own actions. Invite people to own their piece of the “mess” by asking how they have colluded in the problem they are trying to deal with.

For Further Reading
Brown, J., and Isaacs, D., The World Café: Shaping Our Futures Through Conversations That Matter (Berrett-Koehler, 2005)
Daloz Parks, S., Leadership Can Be Taught (Harvard Business School Press, 2005)
Johnstone, M., and Fern, M., Case-in-Point: An Experiential Methodology for Leadership Education and Practice (The Journal, Kansas Leadership Center, Fall 2010)
Heifetz, R., Grashow, A., and Linsky, M., The Practice of Adaptive Leadership (Harvard Business Press, 2009)

The text for this post originally appeared as a longer article by Adriano Pianesi: “The Class of the Forking Paths”: Leadership and “Case-In-Point.” The Systems Thinker, Vol. 24. No. 1. Feb. 2013.

*****************************************************************************************************

Adriano Pianesi teaches leadership at the Johns Hopkins University Carey Business School and is the principal of ParticipAction Consulting, Inc.  He holds a Master’s degree in Corporate Communication from the University of Milan. Pianesi is a member of the Society for Organizational Learning and the World Cafe’ community of practice, as well as a certified Action Learning coach and a passionate experiential learner/teacher.


Image Source: Microsoft Clip Art

Posted inActive Learning, Best Practices, Classroom Management, Engaging Students, Pedagogy, Teaching Methods | Taggedadaptive leadership framework, Adriano Pianesi, case-in-point, experiential learning, leadership training |

1. Wilbur K. Nonviral hepatitis. J Pharm Pract. 2009;22(4):388–404.

2. Haeusler JMC. Medicine needs adaptive leadership. Physician Exec. 2010;36(2):12–15.[PubMed]

3. Williams D. Real Leadership: Helping People and Organizations Face Their Toughest Challenges. Berrett-Koehler; San Francisco, CA: 2005.

4. McCrimmon M. Thought Leadership [homepage on the Internet] Leadersdirect; Ontario: [Accessed April 1, 2012]. [updated 2011; cited April 1, 2012.]. Available from: http://www.leadersdirect.com/thought-leadership.

5. Steers RM, Porter LW, Bigley GA. Motivation and Leadership at Work. 6th ed McGraw-Hill; New York: 1996.

6. Cummings GG, MacGregor T, Davey M, et al. Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. Int J Nurs Stud. 2010;47(3):363–385.[PubMed]

7. Plowman DA, Solansky S, Beck TE, Baker L, Kulkarni M, Travis DV. The role of leadership in emergent, self-organization. The Leadership Quarterly. 2007;18(4):341–356.

8. Uhl-Bien M. Relational leadership theory: exploring the social processes of leadership and organizing. The Leadership Quarterly. 2006;17(6):654–676.

9. Thygeson M, Morrissey L, Ulstad V. Adaptive leadership and the practice of medicine: a complexity-based approach to reframing the doctor-patient relationship. J Eval Clin Pract. 2010;16(5):1009–1015.[PubMed]

10. Anderson RA, Issel LM, McDaniel RR., Jr Nursing homes as complex adaptive systems: relationship between management practice and resident outcomes. Nurs Res. 2003 Jan-Feb;52(1):12–21.[PMC free article][PubMed]

11. McDaniel RR, Driebe DJ. Complexity science and health care management. In: Blair JD, Fottler MD, Savage GT, editors. Advances in Health Care Management. Vol 2. JAI Press; Stamford, CT: 2001. pp. 11–36.

12. Begun J, White KR. The profession of nursing as a complex adaptive system: strategies for change. Research in the Sociology of Health Care. 1999;16:189–203.

13. Cilliers P. Complexity and Postmodernism: Understanding Complex Systems. Routledge; London; New York: 1998.

14. Lichtenstein BB, Uhl Bien M, Marion R, Seers A, Orton DJ, Schreiber C. Complexity leadership theory: an interactive perspective on leading in complex adaptive systems. Emergence: Complexity and Organization. 2006;8(4):2–12.

15. Uhl-Bien M, Marion R, McKelvey B. Complexity leadership theory: Shifting leadership from the industrial age to the knowledge era. The Leadership Quarterly. 2007;18(4):298–318.

16. Heifetz R, Grashow A, Linsky M. The Practice of Adaptive Leadership: Tools and Tactics for Changing Your Organization and the World. Harvard Business Review Press; Boston, MA: 2009.

17. Rise MB, Solbjør M, Lara MC, Westerlund H, Grimstad H, Steinsbekk A. Same description, different values. How service users and providers define patient and public involvement in health care. Health Expect. 2011 Epub ahead of print. [PMC free article][PubMed]

18. Ledema R, Sorenson R, Jorm C, Piper D. Co-producing care. In: Sorenson R, Ledema R, editors. Managing Clinical Processes in Health Services. Elsevier Australia; Chatswood, NSW Australia: 2008. pp. 105–120.

19. Heifetz RA, Linsky M. When leadership spells danger. Educational Leadership. 2004;61(7):33–37.

20. Leventhal H, Leventhal EA, Breland JY. Cognitive science speaks to the “common-sense” of chronic illness management. Ann Behav Med. 2011 Apr;41(2):152–163.[PubMed]

21. Barclay-Goddard R, King J, Dubouloz CJ, Schwartz CE, Response Shift Think Tank Working Group Building on transformative learning and response shift theory to investigate health-related quality of life changes over time in individuals with chronic health conditions and disability. Arch Phys Med Rehabil. 2012 Feb;93(2):214–220.[PubMed]

22. Pierobon A, Giardini A, Callegari S, Majani G. Psychological adjustment to a chronic illness: the contribution from cognitive behavioural treatment in a rehabilitation setting. G Ital Med Lav Ergon. 2011 Jan-Mar;33(1 Suppl A):A11–A18.[PubMed]

23. Charles C, Gafni A, Whelan T. Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model. Soc Sci Med. 1999 Sep;49(5):651–661.[PubMed]

24. Deber RB. Physicians in health care management: 8. The patient-physician partnership: decision making, problem solving and the desire to participate. CMAJ. 1994 Aug 15;151(4):423–427.[PMC free article][PubMed]

25. Miller BF, Kessler R, Peek CJ, Kallenberg GA. Establishing the Research Agenda for Collaborative Care. Agency for Healthcare Research and Quality; Rockville, MD: 2011.

26. Peek CJ. A Collaborative Care Lexicon for Asking Practice and Research Development Questions. Agency for Health-care Research and Quality; Rockville, MD: 2011.

27. Peek CJ, Oftedahl G. A Consensus Operational Definition of Patient-Centered Medical Home (PCMH) Also Known as Health Care Home. University of Minnesota and Institute for Clinical Systems Improvement (ICSI); Bloomington, MN: 2010.

28. Day J. Compassion fatigue in informal caregivers. The Gerontologist. 2010;50(Suppl 1):106.

29. Frosch DL, Kaplan RM. Shared decision making in clinical medicine: past research and future directions. Am J Prev Med. 1999 Nov;17(4):285–294.[PubMed]

30. Adams JA, Bailey DE, Jr, Anderson RA, Galanos AN. Adaptive leadership: a novel approach for family decision-making. J Palliat Med. 2012 In press. [PMC free article][PubMed]

31. Carthron D, Anderson R, Bailey D. The trajectory of self-management activities among diabetic African-American caregiving grandmothers. Paper presented at the 26th Annual Meeting of the Southern Nurse Research Society; New Orleans, LA. Feb 22nd–25th, 2012.

32. Livingood W, Allegrante J, Airhihenbuwa O, et al. Applied social and behavioral science to address complex health problems. Am J Prev Med. 2011;41(5):525–553.[PubMed]

33. Moser A, van der Bruggen H, Widdershoven G, Spreeuwenburg C. Self-management of type 2 diabetes mellitus: a qualitative investigation from the perspective of participants in a nurse-led, shared-care programme in the Netherlands. BMC Public Health. 2008;8(91):1–9.[PMC free article][PubMed]

34. Siminerio LM, Piatt GA, Emerson S, et al. Deploying the chronic care model to implement and sustain diabetes self-management training programs. Diabetes Educ. 2006 Mar-Apr;32(2):253–260.[PubMed]

35. Wilson T, Holt T, Greenhalgh T. Complexity science: complexity and clinical care. BMJ. 2001;323(7314):685–688.[PMC free article][PubMed]

36. Bailey DE. Patient self-management and gene guided therapy for CHC. The National Institutes of Health/National Institute of Nursing Research; 2012. Funded grant 1R21NR013461. Available at http://projectreporter.nih.gov/project_info_description.cfm?aid=8265041&icde=13345746&ddparam=&ddvalue=&ddsub=&cr=1&csb=default&cs=ASC.

37. Kwo PY, Lawitz EJ, McCone J, et al. SPRINT-1 investigators Efficacy of boceprevir, an NS3 protease inhibitor, in combination with peginterferon alfa-2b and ribavirin in treatment-naive patients with genotype 1 hepatitis C infection (SPRINT-1): an open-label, randomised, multi-centre phase 2 trial. Lancet. 2010 Aug 28;376(9742):705–716.[PubMed]

38. Afdhal NH, McHutchison JG, Zeuzem S, et al. Pharmacogenetics and Hepatitis C Meeting Participants. Hepatitis C pharmacogenetics: state of the art in 2010. Hepatology. 2011 Jan;53(1):336–345.[PubMed]

39. Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness: the chronic care model, part 2. JAMA. 2002;288(15):1909–1914.[PubMed]

40. Stoller EP, Webster NJ, Blixen CE, et al. Lay management of chronic disease: a qualitative study of living with hepatitis C infection. Am J Health Behav. 2009 Jul-Aug;33(4):376–390.[PMC free article][PubMed]

41. Audulv A, Asplund K, Norbergh KG. Who's in charge? The role of responsibility attribution in self-management among people with chronic illness. Patient Educ Couns. 2010 Oct;81(1):94–100.[PubMed]

42. Bacon BR, Gordon SC, Lawitz E, et al. HCV RESPOND-2 Investigators Boceprevir for previously treated chronic HCV genotype 1 infection. N Engl J Med. 2011 Mar 31;364(13):1207–1217.[PMC free article][PubMed]

43. Corazzini K, Twersky J, White HK, et al. Implementing Culture Change in Nursing Homes: An Adaptive Leadership Framework. Duke University; Durham, NC: 2012. Unpublished manuscript. [PMC free article][PubMed]

44. White HK, Corazzini K, Twersky J, et al. Prioritizing culture change in nursing homes: perspectives of residents, staff, and family members. J Am Geriatr Soc. 2012 Mar;60(3):525–531.[PubMed]

45. What is culture change? [homepage on the Internet] Pioneer Network; Chicago: [Accessed December 7, 2011]. [cited December 7, 2011]. Availble from: http://www.pioneernetwork.org/CultureChange/Whatis/.

46. Doty MME, Koren MJ, Sturla EL. Culture Change in Nursing Homes: How Far Have We Come? Findings from the Commonwealth Fund 2007 National Survey of Nursing Homes. Commonwealth Fund; New York: 2008.

47. Koren MJ. Person-centered care for nursing home residents: the culture-change movement. Health Aff (Millwood) 2010 Feb;29(2):312–317.[PubMed]

0 thoughts on “Case Study Adaptive Leadership

Leave a Reply

Your email address will not be published. Required fields are marked *