The most important single thing I learned in business school is a strategic process for managing change. It works for creating change at the highest level executive functions within a business. It works for the most basic projects.

It also works in therapy.

Why does this transformation process work at all levels of business and even at the level of individual people?

Because organizations function in a manner that reflects how individuals function.

Strategic planning and management is a best-practices process for how to create and manage change. It’s a process for transforming an organization and it can also be a process for transforming an individual.

In this article, I’m going to present the basic strategic planning and management model, illustrating how it applies to therapy. However, if you’re involved at any level in leadership, management, or project and program development then this is a process you should know.

What people have discovered in studying business is that there is a basic strategy to creating transformational change. There’s a basic process to unifying people to all work together with the same purpose. While there are different models to strategic planning and management, the following diagram presents the basic approach that has proven itself to be effective over and over again:

Again, it doesn’t matter whether you’re at the highest level in a complex organization, or a therapist working with a single particular client. This model suggests certain steps and actions if you want to maximize your chances of being a successful change-agent.

Step 1: Principles

Establish and communicate the mission, values, and vision that are intended to drive and guide the change process. For a therapist,
that translates into early work that you do with a client to create a shared understanding of:

• the purpose of your therapy sessions,
• your values as a therapist, and
• a general vision for how therapy will likely progress.

Step 2: Shared Vision

Develop a therapeutic alliance based on an idealized shared vision for how life will be better for your client after therapy. This is important for creating a sense of hope and inspiring your client to do the work involved.

This isn’t a one-time discussion, but rather is developed over the first, relationship-building, stage of a new course of therapy.

Step 3: Analysis

Analyze the issues and problems that are preventing your client from having an awesome life. There’s two tracks to this analysis, external and internal.

The external analysis involves comparing your client’s experience to other’s. This corresponds with psychoeducation about the issues impacting your client. Typically, that would be things like trauma, abuse, domestic violence, problems in school, or whatever issues and presenting problems your client brings to your sessions.

Your goals in this stage, as a therapist, include empowering your client through education and also normalizing for your client that their struggles are understandable, they are a normal human being, and their problems can be overcome.

In the business world, the internal analysis frequently takes the form of a SWOT analysis – strengths, weaknesses, opportunities, and threats. For a therapist, the same process (although typically with different labels) can be very helpful. The degree to which this analysis can be done with the client, or solely by the therapist, really depends on the client’s cognitive abilities.

In either case, it is highly advantageous for the therapist to have a strong understanding of a client’s strengths and weaknesses. Their strengths will determine a lot of how you approach your transformational efforts. Their weaknesses will also inform your approach and may need to be specifically addressed. Likewise, a strategically sophisticated therapist will want to take advantage of any opportunities that arise for your client to demonstrate their growth, and will want to help clients anticipate any threats to their success.

Some version of a SWOT analysis can be applied to many different aspects of your client’s functioning. Consider coping skills. Transformation is inherently stressful. Your client will need sufficient coping skills so that your work doesn’t trigger too many unwanted behaviors. Obviously, the concept of weaknesses can also be applied to an analysis of your client’s coping skills. In working with kids, addressing coping skills issues is almost always going to be part of your work together.

Outside of your sessions there will certainly be opportunities for your client to put their improved coping skills into practice. Likewise, you’re always doing your client a service when you foster improvements in anticipating situations that threaten to be overwhelming and can either be avoided, managed, or treated as an opportunity to put new skills into practice.

Regardless of example, this stage of therapy involves an analysis of your client and your client’s situation. This in turn leads to the next step of developing a strategic plan.

Step 4: The Plan

Guided by your principles, inspired by your vision, informed by your analysis, it is now time to develop a plan of action. Most therapists are familiar with various models of treatment planning. Unfortunately, treatment plans can be more reflective of bureaucratic regulations than reflecting a strategic approach. Since the structure of the treatment plan needs to fit into a highly prescribed structure and time-table, these documents are frequently not truly a driver of treatment.

So, while you may never formally write it down, you should, through the process of creating a therapeutic alliance with your client, establish a mutually agreed upon strategic plan for addressing the issues and problems that are hurting your client. For very small children, this might look very similar to an understanding of how sessions are going to be structured. For more cognitively capable children, this should include the client taking responsibility for the issues that therapy is going to address.

Step 5: Implementation

Implementation of a strategic plan, or a strategic management process, is going to look completely different depending on the situation. However, as an example, for a traumatized client this might include psychoeducation about trauma, training in relaxation, and the development of a trauma-narrative. Sessions might typically begin with a check-in. There might, most of the time, be some time saved at the end for “fun” unwinding activities.

Regardless of the details, the key to creating a transformational process is that session time is used strategically. Activities are based on a combination of values, a shared vision and an analysis.

Step 6: Reality Testing

Reality testing should involve looking at how your client is doing outside of sessions. It can also include looking at various benchmarks that occur in sessions. These might be specific behavioral goals, spending a certain amount of time of a specific task, or any other relatively objective and observable milestones.

Are techniques introduced in therapy being used successfully? Are presenting problems disappearing? Are other problems emerging?

Step 7: Feedback

Looking at the reality of how your client’s doing outside of therapy should be combined with feedback from your client and potentially others.

What in the therapy experience, in the strategic plan, worked, what didn’t work, and what could work if tweaked? It’s now time to modify the plan and run through the subsequent steps again.

Step 8: Modification of The Plan

Strategic planning and management is incredibly powerful. A core principle within strategic management is that planning, implementation, and transformation are iterative processes.

Perfect planning requires more time and resources than it is worth. Perfect planning also requires more wisdom than most human beings can be expected to possess.

Instead, the better way to manage change is to devote serious time to being clear about your mission and values. Then devote your energy to creating a shared vision. The key word there is “shared.”

These early steps in the strategic change process are what seem to get rushed. Instead, we throw ourselves into analysis and trying to come up with the perfect plan. There appears to be a belief that if we could only write the perfect goals we would certainly achieve our desired outcomes!

Instead, spend only a wise amount of effort on analysis and planning. Respect that achieving therapeutic outcomes rarely follows a direct path. Rather, it’s more like sailing. You try to head in the generally correct direction, knowing that you’re going to have to repeatedly make course corrections to reach your destination.

Therefore, once you’ve implemented your imperfect plan, based on your imperfect analysis, it’s time to do some reality testing and get feedback. Now go back and modify your analysis, modify your plan, and implement a better plan.

If necessary, go back and re-envision the entire process. The point is that your efforts will need to be iterative, because that’s how we imperfect human beings work!

Is This Just Academia Or Does It Really Work?

After graduating from business school I had the opportunity to use this change model. I was in a position to develop four different human services programs: a youth-mentoring program, a foster grandparent program, an interfaith caregivers program, and a family homeless shelter.

This model works. My team was able to expand each of these programs in size, sophistication, and effectiveness. So I’ve seen it work and I’ve read numerous case studies illustrating how strategically managed businesses are successful.

In the next phase of my career I was able to use this same change model as an individual, group, and family therapist. The result was that my cases tended to have clear direction. My clients demonstrated improved functioning. In treatment team meetings I was able to talk about the course of treatment in a fashion that made more sense to others than simply checking off goals and objectives on a treatment plan.

Why Don’t I See This Being Used?

Unfortunately, in my experience the above model of strategic planning and management is all too rarely followed. Principles are taken for granted and are not effectively communicated. Shared vision is assumed and the energy of initial enthusiasm soon dissipates. Analysis is done informally, with minimal time and resources devoted to truly understanding what, other than surface behaviors, actually need to be changed. Planning is driven by bureaucratic concerns. Therapists are pressured to produce behavioral change rather than transformation.

Implementation, without a strategic basis, becomes dependent on extreme individual effort, and becomes reactionary rather than proactive. In the context of therapy, success becomes overly dependent on the “fit” between the therapist and the client.

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Questions for the readers:

Can you see how this process can relate to managing the course of a therapeutic experience?

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For a Bear Clan story about strategic planning see When Deer Had Rabbit Clear the Brambles: The Strategic Change Compass – Part 1 of 3.

An integrated approach to helping people achieve balance and transformation is what Bear Clan is all about. To read about how the strategic planning and management model becomes blended into the Bear Clan Meta-Compass read The Strategic Change Compass Part 3 of 3.