Frontiers Friday #137. Creating a Culture of Learning in an Organisation ⭕️
Our first contribution from Finnish social psychologist, Heidi Nygård-Michelsson on creating a deep learning organisation.
“We have a strategic plan. It’s called doing things.”
~ Southwest Airlines co-founder, Herb Kelleher (1931-2019)
I have deep respects for people who are at the frontline giving everything they’ve got to support the growth of each person in a team.
They are not focused on themselves. Borrowing Adam Grant’s terminology, this people are Givers.
Finnish social psychologist, Heidi Nygård-Michelsson is not only a Giver, but one who thinks deeply before saying anything and, when ready, will execute and guide the collective to action and learning.
Even though I’ve mostly collaborated with others in book writing and research projects, in the last 9 years of writing in Frontiers for Psychotherapist Development (FPD), I’ve been the sole writer for the website.
How foolish.
I’ve asked others on their own frontier to help break this spell of mine.
And I’m thrilled that Heidi is our first.
She’s been at the forefront of helping her organisation and others implement a feedback informed culture from the ground up, and she’d be addressing the process and challenges of implementing good ideas in today’s Frontiers Friday.
After you’ve read her essay, please leave a comment below for Heidi.
And if this email is truncated due to the length, click on "View entire message" below.
Creating an Organization-Wide Growth Path Through a Feedback-Informed Culture
When Daryl asked me if I could write a guest post about developing an agency-wide feedback culture, I was baffled. I felt truly honored, yet surprised and scared. I’m a huge fan of Daryl’s work and this blog site. My immediate reaction was self-doubt: how could I possibly be able to contribute with anything newsworthy or beneficial to readers of Frontiers of Psychotherapist Development!?
But then I realized, this is not about performing. It’s about stepping out of the performing zone into the learning zone and see what’s there and share with you some of my learnings.
As an International Center for Clinical Excellence (ICCE) certified FIT trainer I have worked with helping different agencies (including the organisation I work in Finland) implement feedback-informed treatment into their work during the past six years. Looking back at this period is fascinating – it really has been a learning journey.
In this blogpost I will summarize some of my key learnings, what to look out for and look after when developing an agency-wide feedback culture.
What is FIT Implementation in an agency?
FIT implementation refers to the process of incorporating Feedback-Informed Treatment (FIT) into clinical practice. This process typically involves several steps, including:
Training: Therapists need to be trained in the use of standardized assessment tools and the principles of FIT.
Assessment: Clients need to be assessed using standardized measures at regular intervals throughout treatment. These measures may include rating scales, questionnaires, or interviews designed to assess clients' symptoms, functioning, and progress in therapy.
Feedback: Once assessment data is collected, it needs to be provided to therapists in a timely and meaningful way. This may involve providing therapists with summary reports, graphs, or other visual aids to help them interpret and use the data.
Modification: Therapists need to be able to use the feedback to modify their treatment approach as needed. This may involve making adjustments to the treatment plan, trying different interventions, or providing more support to clients who are struggling.
Evaluation: Finally, the effectiveness of FIT implementation needs to be evaluated regularly to ensure that it is producing the desired outcomes. This may involve monitoring client outcomes, tracking therapist adherence to FIT principles, and making adjustments as needed.
Overall, FIT implementation is a process that requires ongoing training, assessment, feedback, and evaluation to ensure that it is being used effectively and appropriately. When implemented properly, as the body of evidence suggests, FIT can help improve client outcomes, reduce drop-out rates, and increase therapist effectiveness.
The Messy Road
Implementing a new idea or way of working is seldom straight forward and tend to be quite messy, at least in the beginning. It’s hard to know where to start, what to consider, and how to make room for change.
It’s so easy to think that you can skip some of the crucial steps involved in the implementation process or combine your implementation efforts with other organizational changes to be more efficient. You want to believe that you can be that one agency that is able to speed things up and does this in a much faster way than others. This is understandable, since you usually want to be able to see the results of your efforts pay off sooner than later. The problem though with doing so, is that you develop shallow solutions that are missing depth. And with that you lose the most important thing, which is the people involved in the process.
Developing an agency-wide feedback culture requires an organizational change, that both affects and needs everyone involved. I’m a big fan of the work of Sheila Heen and Douglas Stone and their brilliantly titled book Thanks for the Feedback: The Science and Art of Receiving Feedback Well. I think the title speaks for itself: we are so used to learn how to become better at giving feedback that we easily forget about the even more important part of feedback conversations—asking for, receiving feedback and becoming better at that. And becoming better at actively seek out the kind of feedback you are looking for, feedback that will “feed forward” and help you grow. As the authors put it, it is all about creating “pull.”
Internalizing feedback-informed treatment into the way we work will lead to questions about our performance: “What can we do differently to better fit the needs of the client?” This will cumulatively change the service delivery one practitioner, team and organization at a time.
In my attempts to describe how I see the process of developing a successful agency-wide feedback-informed culture, I’ve drawn up the following visualization.
The arrow in the middle represents the force you need to set these processes in motion. And that force shouldn’t be “pushing”, it should be “pulling” towards the people we are serving, informed by their goals, needs and preferences. At all levels of the service delivery we need to also be “pulling” for learning and growth. This “pulling” motion set the processes in place, making sure the feedback moves through all the different levels and help us get a clearer vision of where we need to go to grow. Consequently, an improvement of performance will follow. For this to happen you need to have “binocular vision,” i.e., keeping one eye on performance and the other on learning.1
Once you begin routinely measuring your outcomes it is easy to get lost in the data and not knowing what to look for and where to go next. Putting on those glasses, using that binocular vision, helps you stay focused on the right path. This seemingly small, yet significant principle has prevented me from getting lost in the data countless times.
By Design
Creating an agency-wide feedback-informed culture doesn't happen by default, but by design. A feedback-informed culture requires courage and daring to move from the comfort zone to the learning zone and give room for the possibility of growth. This also requires time and space. It's hard to develop and find space for learning new things under pressure, let alone develop as a giver and receiver of feedback. Being aware and informed by feedback is something that is easily left at the wayside for more “urgent” matters. But if we want to succeed in developing a feedback culture, it is something that needs to be prioritized, and time allocated to it.
In working with clients, we must also accept and consider that it requires time and reflection between meetings, if we really want to act and develop our services based on feedback. After all, as Daniel Coyle says in his introduction chapter to his inspiring book The Culture Code: ”Culture is a set of living relationships working toward a shared goal. It’s not something you are. It’s something you do.” (p.xx). In order to succeed, you have to act and purposefully design a culture that allows the action needed. I highly recommend reading this book if you want to broaden your understanding about the culture in highly successful groups and how to become better at the three key skills that Coyle identifies: build safety, share vulnerability and establish purpose.
From Scoreboard to Spotlight
However, in the visualization above lies an huge obstacle hidden in plain sight. Whenever we talk about measuring and using feedback to monitor our outcomes, a lot of different reactions and emotions arise. Everyone has some kind of experience with feedback, and not all the associations with that are positive. Also, using numbers tend to automatically push people into a space of performance anxiety. Which is totally understandable – we are indoctrinated to using numbers in an evaluative manner since our early education. Therefore, it’s important to highlight a small, but yet important distinction in regards to numbers – we don’t need numbers as an scoreboard, but rather as a spotlight. We need to see beyond the numbers and understand what’s behind them. What’s really the point otherwise?
As I see it, in any organization’s scoreboard, next to “our results” section, we should also have an “our learnings” section, involving our key learnings from our outcomes. This could be about creating a report that includes not only our key performance indicators related to our goals but also our key learnings derived from the data. Analyzing the data to understand why we succeeded with some of our goals but perhaps not with all of them and what we have learned from that. If I were a funder of your service I would be impressed by this and see it as a sign that you as an agency relate seriously and responsibly to the data you collect. This would also have a positive effect on motivation at an individual level, as this highlights that your agency is not only interested in performance, but equally in learning.
Making Room for Change
But getting to this point of implementation takes time, since it often involves changing how we think about things. It also takes time to create a common understanding about why we are developing this culture and how we plan to use the information we get.
When we get to this point, new benefits start to emerge. I’ve learned, seen and experienced that feedback is contagious. Once you get over that threshold of routinely and actively soliciting feedback, and start seeing the value with that, you become hungry for more. You will become genuinely interested in knowing what you could improve, and start asking for that not only from your clients but also from your coworkers, team members, supervisor, manager. If you are a manager in this situation, this is gold! Being able to act as a role model for this feedback-seeking behavior is extremely valuable.
Asking for and receiving feedback is not easy. As human beings we want to be accepted, seen and heard alongside with our hunger to grow. It takes courage, curiosity, and compassion for us to see beyond the obvious and seek out our possibilities to grow and develop.
Without a doubt, psychological safety is foundational for this to work. The more we enable time and space for learning, value shared expertise where we can learn from each other, allow humbleness and the possibility of being wrong, the more psychological safety also increases.
Brené Brown speaks to this in her work on daring leadership. If we throughly want to become better at what we do, we need brave leaders that lean in to vulnerability, ask the right questions and stay curious.2 Her work resonates with the feedback loop you see in the diagram above. These loops won’t work correctly without vulnerability. You have to be able to acknowledge your own growth area and being open for making changes on all the different levels in order for this to work.
This virtuous cycle of giving and receiving feedback as part of everyday work also functions as a very good lever for increasing psychological safety. All of this will take us to a place of a more open atmosphere, an increased work-motivation and engagement as well as a curious and open mind for lifelong, continuous learning.
So…easy and straight forward, right?
About Heidi Nygård-Michelsson
I’m a development-oriented social psychologist that loves to seek out new opportunities for both professional and personal growth. I live and work in the Helsinki area of Finland together with my husband, our two daughters and our dog.
I work as the head of development at HelsinkiMissio, which is an NGO striving to reduce the unfortunate global expanding phenomenon of loneliness, increase wellbeing and strengthen social inclusion. Our psychosocial work constitutes of services formed by a tight collaboration between professionals and volunteers and expands all over the country, reaching out to all the different age groups ranging from families with children to senior citizens.
Heidi’s Professional Path
Even though several things have affected my professional path, a couple of the bigger ones stand out for me. The first one is coming across Feedback-Informed Treatment (FIT). In 2015 I had the opportunity to participate in Scott Miller’s very engaging and inspiring introduction to FIT, which led me to further FIT trainings by the ICCE (International Center for Clinical Excellence) and a new drive in my growth orientation. FIT gave me that much needed compass and tools for mapping out a highly relevant and timely path forward.
In 2017 I became the first ICCE certified FIT trainer in Finland, and started implementing FIT into our organization as well as provide training to other agencies together with my amazing fellow FIT trainers.
The second big milestone that has had a huge impact on my professional development has been participating in the online course Reigniting Clinical Supervision by Daryl Chow. That was such an excellent course that really helped me both see the bigger picture and at the same time become aware of the small parts of the process that leads to the big picture. On top of that I had the opportunity to get coaching and mentoring from Daryl for a couple years, which has further expanded my understanding and learning laterally and deeply—just when I thought I couldn't stretch any further.
It’s actually a relieve to realize that you never stop learning.
For more on Caring for an Organisation, see
p/s: If you like to contribute to Frontiers of Psychotherapist Development (FPD), please drop me an email (admin@darylchow.com). True gifts goes in a circle, and not a straight line. Others might benefit from your gifts. Or if you decide to start your own Substack, let me know. I’d love to support your efforts.
Warm Welcome to New Folks on Frontiers of Psychotherapist Development (FPD)
I’m not sure what’s the explanation for the recent upsurge in subscribers to FPD, but if you have recently joined us, I want to make a quick warm greetings to you.
I'm glad you can join us at the "bleeding edge" of your own frontier.
In the coming weeks, I will be laying out the roadmap for FPD and our weekly Frontiers Fridays (FF) newsletter. Meanwhile, feel free to check out the back catalogue of Frontiers of Psychotherapists Development (FPD). You might also want to go into specific topics in the FPD Archives like
And if you want to see past newsletters, the entire archive of more than 130 series are now made available in Substack.
In case you missed it, see the most recent missives
Devotion to the Craft (6 Parts)
Caring for People in Organisations (3 Parts)
Clinical Supervision (3 Parts)
Feedback Informed Treatment (4 Parts)
Unintended Consequences (2 Parts)
Deep Learner (4 Parts)
Going Further with Deep Learner and The Use of Obsidian (6 Parts)
See What You Hear, Hear What You See (4 Parts)
Trauma (3 Parts)
Deliberate Practice (5 Parts)
Empathy (6 Parts)
Therapist Effects (2 Parts)
Client Point of View (4 Parts)
Tech Tools for Therapists (4 Parts)
Emotions (6 Parts)
Sensitivity (3 Parts)
Alliance (6 Parts)
Existence (6 Parts)
Play (4 Parts)
Humour (4 Parts)
Dropouts (4 Parts)
Structuring Sessions (4 Parts)
Common Therapeutic Factors (4 Parts)
Daryl Chow Ph.D. is the author of The First Kiss, co-author of Better Results, and The Write to Recovery, Creating Impact, and the new book The Field Guide to Better Results .
This is elaborated in the Reigniting Clinical Supervision (RCS) course.
Check out her book Dare to Lead or her podcast with the same title.
Hi Heidi!
It was inspiring to read your post.
I think you highlight the importance of seeing feedback-informed culture as a relational project.
And from an organization's perspective, you need to see all levels and different functions as important players in order to create a learning culture. Everyone in the organization has things to learn! And that it requires that everyone can show themselves vulnerable and see the point of rethinking certain things.
In Sweden, where I live and work, I think we have missed the important issues surrounding the implementation of FIT. I can't say that I have complete insight into how to implement FIT in our country, but what I've seen so far leaves a lot of the implementation process up to the individual clinician. At best, to the group of colleagues. There are of course exceptions to this.
My impression is that you, Heidi, have thought about and experienced a lot about these issues and I would be happy to talk more with you. Is it possible to get in touch with you? Do you have a website or email address where you can be reached?
Greetings
Bengt Lindberg
Stockholm, Sweden
Congratulations Heidi in sharing your exciting learning journey in such a clear, appealing and humble way. It sounds like you've had much success in your organisational implementation of FIT. Daryl, what a generous idea to open up your fabulous blog to others' contribution.