Change Theories:  from 5 People:  copied from the book

Change Theories:  from 5 People:  copied from the book

Because change occurs within the context of human behavior, understanding how change does (or doesn’t) occur is helpful in learning how to initiate or manage change. Five theories explain the change process from a social–psychological viewpoint. See Table 5-1 for a comparison.


Lewin (1951) proposes a force-field model, shown in Figure 5-1. He sees behavior as a dynamic balance of forces working in opposing directions within a field (such as an organization). Driving forces facilitate change because they push participants in the desired direction. Restraining forces impede change because they push participants in the opposite direction. To plan change, one must analyze these forces and shift the balance in the direction of change through a three-step process: unfreezing, moving, and refreezing. Change occurs by adding a new force, changing the direction of a force, or changing the magnitude of any one force. Basically, strategies for change are aimed at increasing driving forces, decreasing restraining forces, or both. The image of people’s attitudes thawing and then refreezing is conceptually useful. This symbolism helps to keep theory and reality in mind simultaneously. Lippitt and colleagues (1958) extended Lewin’s theory to a seven-step process and focused

Lippitt and colleagues (1958) extended Lewin’s theory to a seven-step process and focused more on what the change agent must do than on the evolution of change itself. (See Table 5-1.) They emphasized participation of key members of the target system throughout the change process, particularly during planning. Communication skills, rapport building, and problem-solving strategies underlie their phases.

Havelock (1973) described a six-step process, also a modification of Lewin’s model. Havelock describes an active change agent as one who uses a participative approach.

Rogers (2003) takes a broader approach than Lewin, Lippitt, or Havelock (see Table 5-1). His five-step innovation–decision process details how an individual or decision-making unit passes from first knowledge of an innovation to confirmation of the decision to adopt or reject a new idea. His framework emphasizes the reversible nature of change: participants may initially adopt a proposal but later discontinue it, or the reverse—they may initially reject it but adopt it at a later time. This is a useful distinction. If the change agent is unsuccessful in achieving full implementation of a proposal, it should not be assumed the issue is dead. It can be resurrected, perhaps in an altered form or at a more opportune time. Rogers stresses two important aspects of successful planned change: key people and policy makers must be interested in the innovation and committed to making it happen. Erwin (2009) found that organizational change in hospitals could only be successful and sustained if senior administrators were fully committed to the change. Used primarily as a tool for patient teaching, Prochaska and DiClemente (2005) proposed a transtheoretical model of behavior change. Five stages characterize their model. The stages occur in sequence, and the person must be ready for change to occur, according to this model.

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