© Riemer &Bickman, 2003 General Introduction Improving organizational improvements.

© Riemer &Bickman, 2003

General IntroductionGeneral Introduction

Improving organizational improvements

In this presentation you will learn …

…about the basic idea and the logical structure of the Contextualized Feedback Intervention Theory


Improving organizational improvements

I. IdeaWhen do individuals change? When they have an important goal they want to

accomplish & They notice a significant discrepancy between the

goal and their current status regarding the goal &

They believe they can reduce the discrepancy

GOAL

Significant discrepancy

CurrentStatus


When Do Individuals not Change?

A) When the goal is not important enough

GOAL


CurrentStatus



B) When the perceived discrepancy between the current status and the goal is smaller than a significant discrepancy

GOAL


CurrentStatus

PerceivedCurrentStatus



C) When they believe they have no control over changing the current status

GOAL


CurrentStatus


Example: Changing Practice Behavior

• Your goal is to help your patients• You are unlikely to change your practice if you

think you are already doing your best to help• However, if you find that you are not helping them

as much as you thought and you think you could potentially change

• Then it is more likely that you will change your practice

Question

• How can you influence each of these factors?

You need a theory that explains processes and important factors of behavior change

=> CFIT


II. Description

Actual status -desired goal status

discrepancy

Perceived status -desired goal status

discrepancyDissonance Action plan Action

Feedbackabout actual

status

Attention Acceptance

Goalcommitment

Causalattribution


Cognitive Dissonance

• Two cognitive elements that are dissonant cause psychologically uncomfortable feeling

• Significant discrepancy between desired goal status and perceived goal status constitute dissonant cognitions

• Uncomfortable feeling creates motivation to reduce dissonance

• This motivation can be channeled into motivation to change

• => self-persuasion more effective and persistent than coercive approaches to change


Feedback


discrepancy




status


Goalcommitment

Causalattribution


Feedback

• Function: Close gap between perceived status and actual current status to create significant discrepancy

GOAL


CurrentStatus



Feedback

• Function: Close gap between perceived status and actual current status to create significant discrepancy

GOAL


CurrentStatus




• You do not notice any significant discrepancy when there is no external feedback. “My patients are doing fine”

• You receive feedback that your patients are not doing as well as you thought

• These two thoughts are dissonant with each other.

Factors That Affect Feedback• Attention

– Competing feedback sources– Perceived feedback validity & utility– General feedback propensity– Goal commitment– External pressure to attend to feedback (conditional)

• Acceptance– Relative importance of feedback– Current perception of reality & self-evaluation skills


Goal Commitment


discrepancy




status


Goalcommitment

Causalattribution


Goal Commitment (GC)• GC is "the determination to try for a goal and the persistence

in pursuing it over time” (Hollenbeck, Williams, & Klein, 1989, p.18 ) • Goals are hierarchically structured• Assumption of CFIT: There is a higher level goal that all

members of the target group share (e.g. improving the health status of clients)

• The target goal should be instrumental for accomplishing the higher level goal (e.g. improving therapeutic relationship)

• GC should be high to increase the chance of experiencing significant dissonance


Factors That Affect Goal Commitment

• Goal attractiveness– Perceived instrumentality

• Goal expectancy– Self-efficacy– Competing goals and activities– Supporting factors


• In order for the feedback about your patients to cause a change in your practice you need to– Notice the feedback about your patients– Believe that the feedback is valid– Be committed to the goal of helping your patients– Believe that changing your practice will result in better

outcomes for your patients. – Believe that you are capable of changing your practice

based on your own sense of efficacy, the feeling of sufficient support and few competing goals

Causal Attribution


discrepancy




status


Goalcommitment

Causalattribution


Causal Attribution

• Action plans are based on the perception of the cause for the current status

• 3 Dimensions of Attributions– Locus of causality: internal vs. external– Stability: stable vs. variable– Controllability: controllable vs. uncontrollable

• If minor changes are needed (e.g. effort, attention):– Internal, controllable, and variable

• If major changes are needed (e.g. learning new skills):– Internal, controllable, and stable



• Your specific plans to change will depend on whether you see your practice behavior determined by– Stable factors -- your skill level

– Variable factors – your effort or attention

– Internal factors -- your intelligence

– External factors --- insufficient time

– Controllable – you can make time

– Uncontrollable -- you don’t control your time

Our Web Page Provides More Information On the Theory and How It Is Applied To Both Changes Based On Outcomes Feedback and The Introduction of New Procedures

http://www.cfit-solutions.org/


http://www.cfit-solutions.org/

© Riemer &Bickman, 2003 General Introduction Improving organizational improvements.

Documents

perceived status

perceived goal status

feedback riemer bickman

actual current status

perceived discrepancy

desired goal status

practice slide

cfit riemer bickman