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Title: Exploring the contribution of safe uncertainty in facilitating change
Author: Evans, Nicola
ISNI:       0000 0004 5365 4075
Awarding Body: Cardiff University
Current Institution: Cardiff University
Date of Award: 2014
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Background This PhD study was an examination of the mechanism adopted by a change agent during an organisational change in healthcare. The context for the study was the secondary analysis of action research in a Child and Adolescent Mental Health Service (CAMHS) that had developed practice at an organisational level to address the excessive waiting list impacting upon that service. Aims and Objectives The research question addressed in the thesis was How does a change agent facilitate organisational change in a health setting? The objectives of this study were to i. explore the current literature available discussing the role of the change agent, thus identifying what is already known about this mechanism ii. through a secondary analysis of the data generated through the aforementioned action research in CAMHS examine the relationship between the change agent and the change participants iii. formulate an understanding of the mechanism of the change agent during organisational change. iv. use these findings to make recommendations for practice and further research. Methods The impact of the change agent during this organisational change was investigated using a triangulation of three methods: interviews with change participants, observations in the field and a reflexive diary. Findings The data were thematically analysed looking at the interaction between the change agent and participants. The way that the change agent used anxiety through the change process was presented in three themes: introducing anxiety into the system to initiate change; tolerating anxiety through the change process; sustaining the change. Analysis if the data generated through this study illustrated the change agent acknowledged the anxiety expressed by change participants and used this in a functional way to lever, maintain momentum and sustain the change process in the field. Conclusion This builds on the available literature that discusses how change agents might hold or contain anxiety during change processes. This thesis presents evidence that the change agent introduces and then uses anxiety functionally to initiate organisational change in a way similar to that described by Mason (1993) in his safe uncertainty theory. Mason had developed that theory to explain the work a family therapist does with families. Mason suggested that a family therapist invites a family into a position of ‘safe uncertainty’ in order to facilitate behavioural change within that family. From this study, there is evidence to suggest that a change agent working with health organisations works in a similar way, by inviting participants in an organisation to move into a position of safe uncertainty in order for change to be effected.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: H Social Sciences (General) ; R Medicine (General)