NHS EDUCATION FOR SCOTLAND | LEADERSHIP & MANAGEMENT 1

the personal leadership challenge

Making the choice to see things Simply being aware of these factors reduces their
potential to hold us back.
differently
Adopting a “systems” or “lateral” leadership approach is RESISTING THE TEMPTATION TO EXAGGERATE
a personal choice and not something determined by your DEMANDS AND CONSTRAINTS
formal role in the organisation. Typically, we seek to maintain our comfort zone by
exaggerating the demands and constraints ‘imposed’
The choice arises when we see the potential of a ‘bigger on us by the “Authorising Environment” - according to
prize’ to be gained from cross-boundary co-operation. Rosemary Stewart36 as illustrated in Figure 12.

The issue is that there are factors which can limit

our perception about what is possible and limit our
motivation to use our initiative as leaders.

In reality, demands and constraints

are less than we prercieve.
DEMANDS
We act as if we have much less
choice than is available to us.
CHOICE

CONSTRAINTS

CONSTRAINTS

​Figure 12: Constraints vs. Demands (Rosemary Stewart)

We tend to reduce risk-taking, avoid potential conflict “I don’t have time”

and give a low priority to tasks we do not like - by over- “Patients would not like it”
stating demands (“things we must do”) and over-stating
… when, in fact, the potential obstacles are not
constraints (“things we must not do”).
insurmountable.
We say things like:
One way of looking at this is by contrasting “Red Rules”
“That would break policy guidelines” with “Blue Rules” (reference).
“What if the press got a hold of that”
“Red rules” are mandatory and usually involve a
“My boss would never allow that”
requirement codified by law - or a moral/ethical issue.

36. Rosemary Stewart (1982) Choices for the Manager, Prentice-Hall.

NHS EDUCATION FOR SCOTLAND | LEADERSHIP & MANAGEMENT 2
They are best identified by asking what would happen if functions and that these people are expected to attend
they were not followed. For example, if someone will go to all meetings, for the full duration of the meeting. Yet
jail, be injured or suffer financial damage, it is a “red rule”. many of those attending can find that large parts of the
agenda are irrelevant to them.
“Blue rules”, in contrast, involve organisationally
determined policies and procedures, often at the BEING AWARE OF OUR “CONFIRMATION BIAS”
department level. They identify what processes the
We are all pre-disposed to seek to confirm, rather than
department would like to happen. As such, they are open
dis-confirm, what we already believe. For the most
to some degree of interpretation and can be changed.
part, this ‘hard-wired’ behaviour serves us well. We
can be decisive on the basis of past experience - rather
Everything that isn’t a “Red Rule” is a “Blue Rule”.
than faffing around re-analysing every new experience.
An example of a “blue rule” might be the common
We can all think of examples of how what we have
expectations about attending meetings in an
learned has become an “unconscious competence”. A
organisation. Custom and practice might suggest that a
straightforward example is given in Figure 13.
meeting must be attended by representatives of various

Drives without
thinking about it.
Learns to drive.
It needs
Tries driving. It concentration Unconscious
is more difficult incompetence
than they
thought. Unconscious
incompetence
Has never tried
to drive a car Conscious
incompetence

Unconscious
incompetence

​Figure 13: “Four stages of learning”

Daniel Kahneman (in his book Thinking Fast, Thinking granted. We can stand back from the routine of our
Slow)37 refers to this ‘unconscious competence’ as working lives and “get on the balcony” (as Heifetz would
“Thinking Fast” and points out that most of our mental say38) to get a different perspective.
functioning is of this nature. The assumptions we
make - about ourselves, other people, the rules of our NOT SEEING VULNERABILITY AS A WEAKNESS
culture, what leadership means - typically automatically Brené Brown39 makes a compelling argument that
determine our decision-making and behaviour. feeling vulnerable is normal. She says that we hold
back from stating our opinion or from doing something
In contrast, Kahneman describes our ability to “Think
differently because we fear losing face or getting it
Slow” – to use our conscious awareness to reflect and
wrong, when in fact the risk is small. Her key message is
re-consider. We can unlearn what may have become
that we acknowledge the value in being brave.
unhelpful patterns of thinking - about ourselves, other
people, and other things we have come to take for

37. Daniel Kahneman (2011) Thinking Fast, Thinking Slow. Ferrari, Straus and Giroux.
38. Ron Heifetz and Donald Laurie (1997) The Work of Leadership, Harvard Business Review, January-February, pp.124-134.
39. Brene Brown (2012) Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and
Lead. Penguin.
NHS EDUCATION FOR SCOTLAND | LEADERSHIP & MANAGEMENT 3
Peter Block (in his book The Empowered Manager)40
says that each person has a vision of greatness. Every our hearts that visions are not negotiable, and
person wants to make a difference and, in that sense, has therefore we run the risk of conflicting visions
leadership potential. He suggests that how we manage when we put them into words with each other.
our feelings of vulnerability determine our ability to
3. Articulating a vision of greatness also forces us
function as leaders.
to hold ourselves accountable for acting in a way
that is congruent with that vision. The vision
“To take the safe path in an organisation is to states how we want to work with customers and
avoid the frontier and to ask others to chart that users, and the vision states how we want to work
territory for us. In our dependency, we surround with each other. Once we have created a vision
ourselves with corporate insulation. We demand and communicated it to the people around
a lot of data before we make a decision; we act in us, it becomes a benchmark for evaluating all
the short run because it's more predictable and of our actions. This is an uneasy reality to live
under our control. We only do those things that within. The power of the vision is in the way it
have extremely visible results because we can forces internal accountability for our actions. If
measure progress and defend ourselves against we are acting on someone else's vision, we can
accusations that what we're doing is not working. justify actions we don't believe in by claiming
that we had no choice; they were demanded by
When we choose the frontier, we're choosing an the direction that someone else created. You
unmeasurable and unknowable future. This is hear this excuse all the time. If we are driven
a vulnerable choice because if we are forced to by a vision of our own creation, this excuse
explain why we choose that future, how we're disappears and we can no longer make the claim
going to get there, or whether that future is that it's not our fault. We have to listen to the
possible, we have no solid response that we can disquieting words of others about how we are
count on. Moving toward the frontier, creating a not acting in the pursuit of that vision.
vision of greatness, demands an act of faith. Faith,
by its nature, is unmeasurable and indefensible The hardest thing for any of us is to live by the
through the use of data and external evidence. An rules that we create. It's difficult enough to live
act of faith moving toward a preferred future is a by the rules that others create. It is brutal and
leap beyond what is now being experienced. This fierce to live by the rules that we create. When we
act of faith and act of courage are demanded of create the vision for our unit, we create a set of
each of us if we wish to choose autonomy and put requirements and demands on ourselves, simply
our survival into our own hands. because they're our own creation.

Faith in our ability to find meaning and be of To avoid creating a vision for oneself is to protect
service is expressed by our vision. Putting into oneself from disappointment and failure. It is
words our own vision of greatness for the future hard to comprehend how pervasive this wish for
has several effects on us. protection is. When we ask people to change, the
first conversation is about the risks of changing.
1. In an implicit way, it signifies our
When we do training in workshops and try to give
disappointment with what exists now. To
people new skills, their first question is "Does
articulate our vision of the future is to come
top management support these new skills and
out of the closet with our doubts about the
behaviours?" A tremendous amount of literature
organisation and the way it operates, our doubts
and thinking says that every change program has
about the way our unit serves its customers, and
to start at the top and has to be fully supported by
our doubts about the way we deal with each
top management before one can expect people
other inside the organisation.
in the middle and at the bottom to move in any
2. The vision exposes the future that we wish for direction. This belief in "top down" change is a
our unit and opens us up to potential conflict wish to be protected.
with the visions of other people. We know in

40. Peter Block (1992) The Empowered Manager: Positive Political Skills at Work, Jossey-Bass.
NHS EDUCATION FOR SCOTLAND | LEADERSHIP & MANAGEMENT 4
When on the balcony, a good first question to ask
To choose autonomy and create our own vision yourself and others is simply:
is to choose a risky path. It is to act on the belief
that there is no safe path. Any future we move What is going on here?
toward has hazards, and the fact that what we do
Other areas of questioning focus on some of the human
has risks is a sign that we're headed in the right
and relational dimensions of the adaptive challenge.
direction. When we choose protection and opt
Some examples may include:
to maintain what we already have, we believe
that what we have accomplished is enough. It's a • Where are people emotionally? Are people angry,
frustrated, happy?
willingness to stand on our laurels.”
Peter Block (1992) • Who is saying what and to whom? Who is not saying
much?

• What are they actually meaning?

FURTHER RESOURCES ON THE PERSONAL Balcony work is clearly important for adaptive leadership
LEADERSHIP CHALLENGE but if you want to affect what is actually happening
(by taking action in relation to some of the leadership
Marty Linsky, “Adaptive Leadership – Leading Change”
activities detailed below), you will need to get off the
on YouTube (April 2011) http://www.youtube.com/
balcony and return to the ‘dance floor’. Effective adaptive
watch?v=af-cSvnEExM [accessed December 2015]
leadership requires a continual movement between the
Brené Brown, “The Power of Vulnerability” on YouTube balcony (to gain perspective and make observations) and
(June 2010) https://www.ted.com/talks/brene_brown_ the dance floor (to make interventions).
on_vulnerability?language=en [accessed December
2015]
2. IDENTIFY THE ADAPTIVE CHALLENGE
Most complex challenges are likely to have both
Applying the principles of technical and adaptive elements, so it is critical to
identify what requires technical solutions and what
adaptive leadership
requires adaptive work. In addition, distinguishing
Heifetz and Laurie describe a number principles between what is a superficial symptom and what is a
underpinning the practice of adaptive leadership41: root cause is a key consideration. It is perhaps helpful to
1. Get onto the balcony remember that adaptive challenges tend to have one, or
both, of the following characteristics:
2. Identify the adaptive challenge
3. Regulate the distress • A cycle of failure

4. Create a holding environment • A dependence on leaders with authority

5. Pace by maintaining disciplined attention An illustration of these two characteristics might be in

6. Give the work back to the people the common diagnosis and treatment of budget over-
7. Protect the voices of leadership from below spend in the NHS and wider public sector. Treating
budget pressures as a technical problem often means
1. GET ONTO THE BALCONY that budgets for staffing, training, catering, equipment
and supplies, recruitment often get cut first. At the same
The purpose of ‘getting on the balcony’ is to take a step
time, budgetary controls often become tighter, with
back, giving a clearer view of reality and an opportunity
decisions made further up the leadership hierarchy in an
to focus on the bigger picture. Getting onto the ‘balcony’
effort to balance the books within the current financial
requires first getting off the ‘dance floor’ of the adaptive
year. This may result in short-term fixes - but rarely solves
challenge. Although physically changing location (or
the underlying problems. Budgetary pressures tend to
getting onto an actual balcony!) is not essential, creating
recur the following year.
some physical space from where the adaptive work is
happening can help to facilitate a change in mental and
As adaptive challenges tend to be complex, socially
psychological state required for this ‘balcony work’.
constructed, human challenges - adaptive solutions

41. Ron Heifetz and Donald Laurie (1997) The Work of Leadership, Harvard Business Review, January-February, pp.124-134.
NHS EDUCATION FOR SCOTLAND | LEADERSHIP & MANAGEMENT 5
tend to require individuals and groups to change 5. PACE BY MAINTAINING DISCIPLINED ATTENTION
current behaviours. A number of behaviourally focused
Ways of avoiding painful issues have developed over
questions can be posed at this point, including:
• What (hindering) behaviours do we need to discard?
many years. The most obvious examples of work

•
avoidance are:

•
What (helpful or useful) behaviours do we need to keep?
What (innovative) ways of thinking or behaving do we • Denial

need to adopt? • Scape-goating

• Re-organising
3. REGULATE DISTRESS
• Passing the buck
Regulating the distress within the process is necessary • Finding an external enemy
for adaptive work.
• Blaming authority

Like cooking a stew, it requires creating and maintaining • Character assassination

sufficient heat to keep things ‘cooking’, but not so much Although hard to do, holding steady allows you to
heat that everything ‘boils over and spoils’. The job of the accomplish several things at once. By taking the heat,
adaptive leader is, therefore, to control the temperature you can maintain a productive level of disequilibrium
of the conflict in order to make it constructive and or creative tension, as people hear the weight of
creative. The leader can raise the heat by: responsibility for working their conflicts. By holding
• Drawing attention to tough questions steady, you also give yourself time to let issues ripen, or

• Giving people more responsibility than they can cope

with
conversely to construct a strategy to ripen an issue for
which there is not yet any generalized urgency. Moreover,

• Bringing conflict to the surface

you give yourself time to find out where people are at so

•
that you can refocus attention on the key issues.
Protecting and encouraging the dissenters
6. GIVE THE WORK BACK TO THE PEOPLE
Conversely, the leader can reduce the heat by:

• Focusing on the technical aspects for a short time This adaptive leadership activity requires resisting the

• Establishing some structure for problem-solving

temptation to solve people’s problems for them. Instead

•
it is about engaging them in the adaptive work and in
Taking back some responsibility for the tough issues taking responsibility for the change process. People tend
• Employing some work avoidance measures to expect their leaders to get involved and fix things, to
take a stand, make a decision and resolve the problem.
4. CREATE A HOLDING ENVIRONMENT If you fulfil these expectations, they may describe you as
It is important that a ‘holding environment’ is created bold and full of courage and this can be flattering for the
in which the, sometimes, ‘painful’ adaptive work can be leadership ego. However, challenging their expectations
worked on. This can be a physical and/or a psychological of you requires even more courage. It makes sense that
space, providing safety, as well as opportunity to solutions are more sustainable when ‘the people with
challenge and tackle tough questions without flying apart the problem’ go through a process together to become
or descending into unproductive conflict. An effective ‘the people with the solution’.
holding environment may have structural, procedural or
7. PROTECT THE VOICES OF LEADERSHIP FROM
virtual boundaries, but ultimately people feel safe enough
BELOW
to address problems and issues that are difficult.
Ensure that all perspectives and interests are considered,
Some practical suggestions for creating a safe holding that minority viewpoints are taken into account, and
environment include: that dominant views are questioned and challenged.

• Neutral, comfortable, fit-for-purpose venue Adaptive leaders need to learn to think and act

•
politically, placing emphasis on personal relationships.
Collectively establishing and revisiting ‘ground rules’ Some suggestions for thinking and acting politically are
regularly outlined below:
• Time to check-in, check-out and ability to take time-out
• Find allies and partners

• Review of purpose and progress • Listen to opponents giving them more attention

• Protect the contributions of the skeptics and cynics

NHS EDUCATION FOR SCOTLAND | LEADERSHIP & MANAGEMENT 6
The following questions may be useful to consider when • Active Listening
thinking about key stakeholders:
• Questioning skills
• What do they care about?
• Being courageous
• Who has influence?

• What are they potentially losing (role, power, money,

resources, control, identity, security, independence
Being self-aware
etc.)? Fundamentally, adaptive leadership is about people,

• What might different stakeholders have in common

that isn’t readily recognisable.
about dealing with difference, coping with complexity and
managing the loss associated with change. Self-awareness
can be defined as having a clear perception of your
personality, including strengths, weaknesses, thoughts,
Core skills for leading adaptively beliefs, motivation, and emotions. It follows then that
As described above, adaptive leadership has a number being highly self-aware gives leaders the foundations
of specific practices and principles that set it aside from to manage the emotions associated with the process of
traditional leadership approaches. adaptive leadership. One popular leadership concept that
relates to the management of emotion and that is useful
This section describes the foundational skills and to consider for adaptive leadership is that of emotional
behaviours that underpin effective adaptive leadership. intelligence, developed by Daniel Goleman42.
Without being highly competent in these behaviours, it is
likely to be difficult to practice adaptive leadership. Goleman defined the 'domains' of emotional intelligence as:

• Knowing your emotions (self-awareness)

The concepts discussed in this section are not intended
• Managing your own emotions (self-management)
to be difficult to comprehend and you are likely to have
come across some of them before. However simple • Recognising and understanding other people's
emotions (social awareness)
to understand does not necessarily mean easy to
implement, so it is recommended that you take the time • Managing the emotions of others (relationship
management)
to consider the reflective questions within this section.
The core skills, underpinning adaptive leadership that
Goleman suggests that working effectively with others
will be explored in more detail are as follows:

• Being self-aware
or managing relationships starts with self – being
aware of one’s own emotions. He suggests that if we
• Keeping an open mind become more self-aware, we have more capability to

Recognition Regulation
Personal Self-Awareness Self-Management
Competence
Self-confidence Getting along with others
Awareness of your emotional state Handling conflict effectively
Recognizing how your behavior impacts others Clearly expressing ideas and information
Paying attention to how others influence your Using sensitivity to another person's
emotional state feelings (empathy) to manage
interactions successfully

Social Self-Awareness Relationship Management

Competence
Self-confidence Handling conflict effectively
Awareness of your emotional state Clearly expressing ideas / information
Recognizing how your behavior impacts others Using sensitivity to another person's
Paying attention to how others influence your feelings (empathy) to manage
emotional state interactions successfully.

42. See for example Daniel Goleman (1999) Working with Emotional Intelligence. Bloomsbury
NHS EDUCATION FOR SCOTLAND | LEADERSHIP & MANAGEMENT 7
manage our own emotions as well as to understand the themes are suggestions that you may like to experiment
emotions of others. If we can manage our own emotions with to develop your ability to keep an open mind:
effectively and understand the emotions of others, we
are more likely to be able to work effectively with others, 1. Reflect on your own values and beliefs e.g. what is
valuing differences and ultimately generate creative and important to you about working in healthcare/public
sustainable solutions to adaptive challenges. sector, your current role or organisation, how do
your values align with or differ from your colleagues
​ eveloping our core skill of self-awareness is, therefore,
D and friends, can you identify how you come to have
key to developing our ability to be an ‘adaptive leader’. these values? How do you tend to interact and
The following activities are just a couple of suggestions communicate with people with different beliefs and
for enhancing your own self-awareness: values?
1. Notice what you are feeling right now? Can you name 2. Stimulate your senses with new experiences e.g.
the specific emotion? try a new physical activity, buy some different foods
at the supermarket, listen to unusual music, go to an
2. Notice your emotions a few times per day and
art gallery.
observe without judgment or trying to ‘change’
anything. How do these feelings contribute, distract, 3. Learn something new e.g. foreign language, musical
enhance, or challenge you? instrument, strategy game,
3. Be comfortable with and acknowledge your 4. Explore the world around you e.g. explore different
emotions. Can you manage your emotion up or religions or cultures, walk around your local area
down? noticing the people, the buildings and the history,
talk to people you wouldn’t normally speak to.
4. Emotions are not just about feeling something, try
to unpick what the message behind the emotion is.
QUESTIONS FOR ACTION AND REFLECTION
What is the emotion telling you?
5. Recognise your own unique personal strengths and • How important is having an open mind to you?

embrace these strengths more fully. What are your • What are you going to do as a result of some of the
suggestions in this section?
unique strengths? List them.

Keeping an open mind

• Notice some of the excuses or barriers that you have
already mentally put in place to stop you undertaking
some of the above suggestions.
Keeping an open mind or ‘suspending judgement’ is
the next critical skill for adaptive leadership. Heifetz What were they? Are they true? Where do they come
describes a couple of characteristics and behaviours that from? Can you override them?
underpin the ability to ‘keep an open mind’. These are:

• Innocence – the capacity to entertain ‘silly' notions,

think unusually, or be playful.
STAYING OPEN
Being open-minded seems to come naturally for some

• Curiosity – the capacity to listen, ask questions,

challenge assumptions or ’truths' and embrace new
individuals, while others need to work at it. However,
‘staying open’ during an adaptive leadership role is
challenging for many leaders, as the expectation is to
ideas.
fix things quickly, avoid pain and minimize conflict.
QUESTIONS FOR REFLECTION: In addition, individuals with leadership authority are

• How would you rate your current state of innocence

and your current state of curiosity?
expected to have the solution. Staying open requires you
to remember to:

• How have you got to these states? Have they

increased or decreased over time or following a
1. Let go of ‘traditional’ leadership hierarchy and control
2. Challenge your existing values and beliefs
significant event in your life?
3. Accept that you don’t know it all or need to know it all
• What practical things will you do to practice keeping
an open mind?
4. Allow yourself to make mistakes
5. Reflect on your experiences in order to continuously
Like most skills development, keeping an open mind learn and grow
requires practice and mental discipline. The following
NHS EDUCATION FOR SCOTLAND | LEADERSHIP & MANAGEMENT 8

QUESTIONS FOR REFLECTION POSTURE

How will you notice if you are slipping into being less Posture or body language cues can tell a lot about the
open? How will you respond? listener. The active listener tends to lean slightly forward
or sideways whilst sitting, a slight slant of the head so
Active Listening that an ear is closer is to the other or resting the head on
one hand.
Active listening builds on having an open mind and
is another key skill for adaptive leadership. The MIRRORING
rationale for this is that adaptive challenges are socially
Automatic reflection/mirroring of any facial expressions
constructed and complex with multiple perspectives
used by the speaker can be a sign of attentive listening.
and potential solutions. Active listening is about truly
These reflective expressions can help to show sympathy
understanding where other people are coming from, so
and empathy in more emotional situations. Attempting
that the adaptive challenge can be viewed from multiple
to consciously mimic facial expressions (i.e. not
perspectives, thus increasing the chance for a successful
automatic reflection of expressions) can be a sign of
and sustainable solution being discovered.
inattention.
Active listening is as much about a mind-set as it is
VERBAL BEHAVIOURS
about a skill set. In terms of intent, if you have an open
mind and you value the contribution and different People who are actively listening are more likely to
perspectives of others, then you are more likely to want display at least some of the behaviours below, which
to listen. include:

In terms of skillset, there are both non-verbal and • Positive reinforcement

verbal behaviours that support and demonstrate active • Remembering
listening.
• Questioning
NON-VERBAL BEHAVIOURS • Reflection
People who are actively listening are more likely to • Clarification
display at least some of the below behaviours. These
include: • Summarising

• Smiling POSITIVE REINFORCEMENT

• Eye Contact Although a strong signal of attentiveness, caution should

• Posture
be used when using positive verbal reinforcement.
Although some positive words of encouragement may
• Mirroring be beneficial to the speaker the listener should use them

• Distractions sparingly so as not to distract from what is being said or

place unnecessary emphasis on parts of the message.
SMILING
REMEMBERING
Small smiles can be used to show that you are paying
attention to what is being said or as a way of agreeing We are often terrible at remembering details, especially
or being happy about the messages being received. for any length of time. However, remembering a few key
Combined with nods of the head, smiles can be powerful points, can help to reinforce that the messages sent have
in affirming that messages are being listened to and been received and understood – i.e. listening has been
understood. successful. Remembering details, ideas and concepts
from previous conversations proves that attention was
EYE CONTACT kept and is likely to encourage the speaker to continue.
During longer exchanges, it may be appropriate to make
It is normal and usually encouraging for you, as the
very brief notes to act as a memory jog when questioning
listener, to look at the speaker. Eye contact can, however,
or clarifying later.
be intimidating, especially for more shy speakers – gauge
how much eye contact is appropriate for any given
situation. Combine eye contact with smiles and other
non-verbal messages to encourage the speaker.
NHS EDUCATION FOR SCOTLAND | LEADERSHIP & MANAGEMENT 9

QUESTIONING Examples of autobiographical responses:

The listener can demonstrate that they have been paying PROBING
attention by asking relevant questions and/or making
• What happened?
statements that build or help to clarify what the speaker
• What did they say next?
has said. By asking relevant questions, the listener also
helps to reinforce that they have an interest in what the • So where were you when that happened?

speaker has been saying. See also Open Questioning • Who was with you?
Skills.
EVALUATING
REFLECTION
• That was really clever.
Reflecting is closely repeating or paraphrasing what • I totally agree with what you are saying.
the speaker has said in order to show comprehension.
• You are overreacting, I think.
Reflection is a powerful skill that can reinforce the
message of the speaker and demonstrate understanding. • I can’t believe you said that.

ADVISING
CLARIFICATION
• The same thing happened to me.
Clarifying involves asking questions of the speaker to
• If I was in your shoes, this is what I would do…
ensure that the correct message has been received.
Clarification usually involves the use of open questions • Have you thought about…?

which enables the speaker to expand on certain points as • Here’s what I would do…
necessary.
INTERPRETING
SUMMARISING • I’m guessing you regret doing that.

Repeating a summary of what has been said back to • You were probably just trying to hide your
embarrassment.
the speaker is a technique used by the listener to repeat
what has been said in their own words. Summarising • You always seem to do that because…
involves taking the main points of the received message
and reiterating them in a logical and clear way, giving the
• When I was in that same situation, I felt angry.

speaker chance to correct if necessary. It can be difficult to completely remove these filters
as they are extremely useful in other conversational
COMMON BARRIERS TO ACTIVE LISTENING and relational contexts e.g. performance appraisals,
diagnosing medical conditions or building relationships
Stephen Covey in his international best-selling book
and rapport. The real skill in active listening, therefore,
The 7 Habits of Highly Effective People suggests that
is being able to ‘turn down' rather than ‘turn off' these
four ‘autobiographical responses’ are often the reason
inner voices when required. In addition, noticing when
that listening is not effective as it could be. He asks us
you are in autobiographical response mode is helpful
to consider that when we are listening to someone, we
so that you can quickly choose a different response
often struggle to remain open-minded, as we hear what
remaining open-minded and exploratory.
they are saying through our own filters, our own story
(or autobiography) of the world. These filters or ‘inner
QUESTIONS FOR REFLECTION
voices’ can cause us to respond in a number of ways
including: 1. Reflect on the last time you did not effectively listen

•
to someone. Examine your intent, did you genuinely
Probing - asking questions from own frame of
want to listen to them? If not, what do you think was
reference (see section on Questioning)
the reason?
• Evaluating - judging and then either agreeing or
disagreeing 2. Which of the non-verbal and verbal actions could you

•
improve generally? How do others rate your listening?
Interpreting - analysing others’ motives and
behaviours based on own experiences 3. Which of the autobiographical responses do you find

• Advising - giving counsel, advice and solutions to

problems
most difficult to ‘turn down?
NHS EDUCATION FOR SCOTLAND | LEADERSHIP & MANAGEMENT 10

Open Questioning B. OPEN QUESTIONS

In direct contrast to closed questions, open questions
Open questioning skills are critical for the practice of
can often elicit longer, more elaborate or explanatory
adaptive leadership because, by definition, adaptive
answers about knowledge, opinions, thoughts or
problems are ones that we don’t know the answer to.
feelings. They support mutual understanding and can
By asking great open questions, we try to gain multiple
help individuals to reflect and be creative on a particular
perspectives of the adaptive challenge, which can
subject. They often begin with:
support development towards a solution.
• What…?
The practice of adaptive leadership tends to require
• How…?
the asking of more ‘open’ questions than a normal
• Tell me…?
conversation. Some individuals can feel anxious about
asking the right open questions at the appropriate time • Describe…?
and there can be a perception of losing control of the Examples of open questions:
conversation. However, open questions, come from
firstly having an open mind and then from listening with • What happened at the Integration Planning Forum
today?
the intention to understand the other person or groups.
The focus should initially be on these two areas and • What do you think about the organisation’s financial
situation?
open questions will be more likely to flow naturally.
• How did you arrive at this conclusion?
There are many types of question and a number
are described below. This is not supposed to be an
• Can you describe how you felt when the Clinical Lead
said that?
exhaustive list or indeed list of question you should
ask as each adaptive challenge or situation is uniquely • Tell me about a time when the senior team made an
effective decision?
complex. It is intended to raise awareness of the different
types of questions that you can or may ask. With
C. FUNNEL QUESTIONS
enhanced awareness of the different types of questions,
you will be more empowered to ask the right questions This type of question starts with a general question, and
at the right time. The types of questions described below then homes in on a point in each answer, asking for more
are: detail at each level.

A. Closed Questions For example:

B. Open Questions • "Tell me about your most recent Performance
Appraisal."
C. Funnel Questions
• "What were some of the key themes?"
D. Leading Questions
E. Probing Questions
• "Were there any significant development areas
identified?
F. Rhetorical Questions • "Is your leadership development an area for
enrichment?"
A. CLOSED QUESTIONS • "Do you think you need to work on your open
questioning skills?"
Closed questions are useful for testing understanding,
concluding a discussion or making a decision. The The questions in this example become increasingly
answers to a closed question tend to be short ‘one word’ more restrictive. We start with open questions about the
e.g. Yes-No or a short phrase. appraisal, which allow for very broad answers, and at
each step the questions become more focused with the
Some examples of closed questions:
answers become more and more specific.
• Do we agree on this decision?

•
Funnel questions are often used by clinical staff to
Are you happy with how this meeting is being
diagnose a particular illness or condition quickly. It is,
chaired?
therefore, important for clinical leaders to recognise
• Can I help you with that report? when they are slipping into this frame of questioning.

• Who is responsible for developing this service?

NHS EDUCATION FOR SCOTLAND | LEADERSHIP & MANAGEMENT 11

D. LEADING QUESTIONS Being courageous

These questions attempt to lead the respondent towards
There are the times that adaptive leadership requires
your way or a particular way of thinking. They are useful
boldness, confidence and courage. It sounds simple,
for getting the solution or answer YOU want but leaving
but it often isn't easy to be courageous. Demonstrating
the other party feeling that they have had some input
leadership courage - whether it's having an
or choice. They are also useful for closing to a decision
uncomfortable conversation, communicating when you
but can come across as a little manipulative. Leading
don't have all the answers or making a tough decision –
questions often use the following techniques:
can be quite scary.
• Assumption

• Forced choice The following behaviours are examples of courage-

• Easy answer
in-action and help to build personal confidence and

• Personal appeal
courage.

1. Confront reality head-on. Face the facts about the

Examples of leading questions:

• "How over-budget do you think this project will end

up being?” (assumes the project will be overspent).
state of your organisation or service. Only by knowing
the true current state can you hope to lead others to a
better future.
• "Which would you prefer? Option 1 or 2?" (only
Option 1 and 2 are being considered, although
2. Use feedback and listen. We all have blind spots that
impact the way we interact with others. Unfiltered
neither is still an option).

• "Would you like me to go ahead with Option 2?"

(hoping a simple ‘Yes’ or ‘No’ will suffice here).
360-degree feedback is not always easy to hear, but
it can enhance your relationships and improve your
leadership style if you listen and act.
• "Our new Director of Nursing has some really great
ideas, don't you think?". (includes the personal/
3. Say what needs to be said. Real conversations
can be awkward and uncomfortable, especially if
relational aspect)
a conflict is involved. Having crucial conversations
E. PROBING QUESTIONS helps cut through the smoke and move through
issues. This also means having the courage to
Probing questions are used to gather more details
put your opinions on the table, even if they are
and information. They are asked to clarify doubts or
unpopular.
misunderstandings. Some examples are:

• What exactly is the current situation?

4. Encourage dissent. Many leaders feel pressure to

• Who exactly is requiring this information?

have all the answers. By encouraging constructive
dissent and healthy debate, you proactively
• When do you need this Board report by? demonstrate that a better solution can come from
• How do you know that the Medical Director was
involved?
tension of diverse opinions.
5. Communicate openly and frequently. Keep the
• Can you be more specific? lines of communication open, even when you don’t
know all the answers. Courageous leaders refuse
F. RHETORICAL QUESTIONS to hide behind jargon. They use straight-talk and
These are actually statements dressed up as questions, are not afraid to say “I don’t know.” They also share
but can be useful for engaging others, stimulating debate information instead of hoarding it.
and provoking thought around a particular subject. 6. Make decisions and move forward. Especially in
environments of intense change, it can feel unsafe
Some examples of rhetorical questions:
to commit to a decision and move ahead. Forward
• “You don’t really expect that approach will work, do
you?”
movement is always better than being ‘analysis
paralysis’.

• “How awful is this new IT system?”

• “Surely there must be an easier solution to this?”

• “How did that suggestion for service improvement

get put on the table?”