David Godot, Psy.D.

Transformational Leadership In Mental Health Administration

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The transformational model of leadership has gained considerable traction among leadership theorists and researchers over the past few decades. It appears to be a fairly reliable and unitary construct referring to a set of leadership behaviors which are associated with a variety of positive organizational outcomes. In this paper we will briefly detail the behaviors included within the transformational leadership model. We will review some of their benefits for organizations in general and health care organizations in specific. Finally, we will argue that a transformational leadership model offers unique benefits in the field of mental health, and should therefore be considered best practices for mental health service administrators. Throughout our discussion, we will attempt to make the subject matter directly applicable to mental health administrators by suggesting similarities to existing psychological concepts and opportunities for implementation in a mental health setting.

Overview of Transformational Leadership

Under a transformational leadership model, the leader focuses on creating positive change in followers through behaviors which help them to “transform” into more motivated, satisfied, and harmonious members of the organization. Transformational leadership is generally characterized by four types of leadership behaviors, often referred to as the four ‘I’s: idealized influence, intellectual stimulation, individual consideration, and inspirational motivation (Fisher, 2009).

Idealized Influence

 

The concept of idealized influence is similar to what might generally be thought of as charisma. Although the vast majority of literature on charismatic leadership focuses on the potential for negative social consequences, there is also an argument to be made that charisma is a component of highly effective transformational leadership (Aaltio-Marjosola & Takala, 2000). In this sense, the exertion of idealized influence refers to a “leader’s ability to generate enthusiasm and draw people together around a vision through self-confidence and emotional appeal” (Fisher, 2009, p.362).

At a more tangible level, a leader can become a more idealized influence by modeling desirable role behaviors within the organization and culture. By positioning him or herself as a positive role model, a leader can thereby engender the trust, respect, and even admiration of subordinates. In mental health terms, this has similarity to what clinicians refer to as ‘fostering transference’ with their clients. By exhibiting the types of behaviors that one would expect from a leader in a given situation, one can generally assume that they will be automatically afforded greater deference within that situation.

Intellectual Stimulation

Transformational leaders help to provide intellectual stimulation for their subordinates. In practice this means that transformational leaders foster more democratic working environments than other types of leaders, because they are frequently engaging their team members in creative and innovative problem solving (Fisher, 2009). This may be a key reason for the significant association between transformational leadership and feelings of psychological empowerment among subordinates (Fuller, Morrison, Jones, Bridger, & Brown, 1999).

Psychological empowerment is a state of increased intrinsic motivation. Empowered individuals have a sense of agency in their work roles; they feel as though they are doing their jobs in ways that they choose and for reasons that they choose (Fuller et al, 1999). It is easy to see how engagement in problem-solving tasks related to the work situation itself would help to instill this sense of agency and improve personal investment in the workplace, because individuals are being actively recruited as collaborators in shaping their own organizational culture.

Individual Consideration

This leads naturally into the next aspect of transformational leadership, which is individual consideration. This refers to the ability of the leader to ‘get to know’ team members and show them individual respect and concern. If team members are being recruited as intellectual collaborators in organizational problem solving, their personal needs and preferences will naturally emerge.

Leaders can further the sense that individual consideration is being by regularly assessing their followers’ personal goals and working to create new opportunities which match those goals (Fisher, 2009). Monitoring followers’ progress and providing mentoring along the way will help to enhance this effect while also bolstering the leader’s position as an idealized influence. The leader’s requests will be more likely to be perceived as in the followers’ best interests, and so should be more likely to be fulfilled with enthusiasm.

Inspirational Motivation

Finally, a transformational leader “moves team members toward action by building their confidence levels and generating belief in a cause” (Fisher, 2009, p.362). This is highly compatible with the previously discussed aspects of transformational leadership. Through individualized consideration and mentoring, individuals are led to work toward improving themselves and their status within the organization. By providing a positive role model, individuals are given direction and momentum for guiding their own role behaviors. And by providing intellectual stimulation and making individuals active participants in their workplace, they are led to see how their own growth and development corresponds to the growth and development of the organization as a whole.

This latter effect is the key ingredient in inspirational motivation. Transformational leaders put this into practice by drawing team members around a vision of what the organization can be in the future. By setting high expectations for the organization as a whole and behaving in ways that are congruent with those expectations, transformational leaders are able to inspire their subordinates to hold similar expectations and to work toward realizing those expectations.

Benefits of Transformational Leadership

Transformational leadership behaviors have been associated with a variety of positive organizational outcomes across industries and across cultures. They are positively associated with overall leader effectiveness (Jung, Yammarino, & Lee, 2009). Employee effectiveness is also positively affected, with extra perceived effort, organizational citizenship behaviors, and job satisfaction all being associated with transformational leadership (Fuller et al, 1999). In this section we will discuss three effects of transformational leadership that may be particularly important for mental health care administrators: group cohesiveness, psychological well-being, and creativity.

Group Cohesiveness

Group cohesiveness is a concept that is well-known to mental health workers providing group therapy services. When there is cohesiveness among group members, each individual member is propelled by the group to accomplish more than could be done alone. The same is true of work teams.

According to Wang & Huang (2009), group cohesiveness among work teams results in more and better group interaction, stronger group influence, and greater individual involvement in the group. Studies have shown that group cohesiveness is associated with emotional intelligence, and this is a quality that mental health workers should exhibit relatively high levels of due to the demands of their profession. However, the primary mediating factor between emotional intelligence and work team group cohesiveness is transformational leadership (Wang & Huang, 2009).

Particularly in service agencies where turnover rates are high because of provider burnout, higher levels of group cohesiveness may serve as a protective factor by increasing the level of support that workers receive from one another. The higher levels of group interaction that cohesiveness brings about should also increase consultation between colleagues, resulting in a higher quality of services.

It is also pertinent that group cohesiveness induces higher levels of personal involvement with the group. A study of health care organizations found that employees’ personal involvement in their organizations was negatively correlated with their stress levels (Skela Savic & Pagon, 2008). In that study, the single greatest predictor of successful individual involvement was transformational leadership.

Psychological Well-being

Psychological well-being is the subjective experience of being in a positive state of mental health. Several studies have found that a leader’s behavior can affect the mental health of his followers, but there has been little research examining the possible mechanisms for this interaction. Arnold, Turner, Barling, Kelloway, & McKee (2007) noted that there is an established connection between transformational leadership and the sense that one’s work is meaningful. Since deriving meaning from events has been called a “fundamental human motive,” they hypothesized that the positive effects of transformational leadership on psychological well-being could be accounted for by this enhancement of meaningfulness. In their two studies of Canadian health care workers, they found that after controlling for humanistic beliefs about their work, the relationship between transformational leadership and psychological well-being was fully mediated by workers’ perceptions that their work was meaningful.

It is notable that these studies were carried out among health care workers, as most people would agree that this work—like mental health—is intrinsically meaningful. Yet it is not uncommon to hear workers in mental health service organizations describe their work experience in terms of a progressive loss of meaning. High case loads, inadequate funding, and arduous paperwork all contribute to the type of personal crisis that leads to burnout. It is the sense that one is simply making no difference in the world by continuing on with his or her work.

By directly enhancing the sense that there is meaning in the work that mental health care providers are doing, transformational leadership has a potential to strongly affect worker satisfaction and reduce burnout. And because this effect improves psychological well-being, it may also help clinicians to exercise a higher level of clinical judgment than they would otherwise be capable of. This improves the quality of services that are provided and so circularly enhances the sense that meaningful work is being done.

Creativity

We have discussed the possibility that transformational leadership could improve clinical judgment, but most mental health workers would agree that a high degree of creativity is also required for their clinical work. Interventions must frequently be designed on-the-fly, and should ideally be tailored for each individual on the basis of their present behavior considered alongside their full history. There is some evidence to suggest that transformational leadership may increase creativity at both the individual and organizational levels.

Gumusluoglu & Arzu (2009) performed a study on transformational leadership in another field requiring a high degree of creativity: software research and development. They studied Turkish personnel and managers from organizations of various sizes in order to determine whether transformational leadership had an effect on creative output. They found that the most creative workers were those whose managers exhibited the most transformational leadership behavior. In examining possible mechanisms for this association, they found that psychological empowerment was the strongest mediating factor.

Whether by creating a culture of psychological empowerment within the organization or through some other mechanism, this effect seems to also be true at the organizational level. In a study of 50 Taiwanese electronics and telecommunications companies, a positive relationship was found between overall organizational innovation and transformational leadership behaviors from the CEO (Jung, Wu, & Chow, 2008).

Although neither of these studies were performed within the mental health industry, it seems likely that similar effects could be found among mental health care providers and administrators. Higher levels of personal investment, psychological well-being, and support from other employees should reasonably be expected to enhance the individual creativity of clinicians and to foster a culture of creative clinical intervention.

Transformational Leadership is a Natural Fit for Mental Health Administrators

Fisher (2009) has pointed out that adherence to any leadership model tends to produce better results than leadership which is not guided by any model at all. Therapists have long held a similar view of theoretical orientation as it applies to the psychotherapy situation. When a therapist or leader operates in accord with a coherent theoretical model, it provides a consistency and predictability. This helps people to feel safe and affords them an understanding of their situation which they could not otherwise have. This may be why both transformational and transactional leadership styles are associated with providers having positive attitudes toward adopting evidence-based practices (Aarons, 2006).

Regardless, there is some reason to believe that the transformational leadership model may be a natural fit for the social service fields, including mental health. For example, a study of social service supervisors found that they generally tended to use transformational leadership techniques spontaneously, whether or not they consciously identified themselves as doing so (Arches, 1997).

Mary (2005) found similar results in a survey of members of the National Network for Social Work Managers and the Association of Community Organization and Social Administration. When asked to think of a leader they had worked with and to rate them on the Multifactor Leadership Questionnaire, she found that the leaders discussed generally operated in a manner consistent with the transformational leadership model. In addition, transformational leadership qualities were positively correlated with leader effectiveness, satisfaction with the leader, and extra effort on the part of workers. These results match those of Gellis (2001), who found that transformational leadership factors in social service administrators were positively correlated with similar positive organizational outcomes. Social workers were more likely to engage in requested activities and reported feeling more satisfied with their leader when more transformational leadership qualities were present.

Conclusion

There is substantial evidence that the transformational leadership model produces organizational outcomes which mental health administrators would generally find desirable. By providing a practical means for generating positive role identification, intrinsic motivation, personal investment in the workplace, motivation and resiliency, transformational leadership promises to enhance the quality of services provided while reducing negative effects on workers. Because provider burnout is such a widespread and troublesome phenomenon in social service agencies, the benefits of transformational leadership may prove particularly compelling in this industry.

As we have seen, transformational leadership is already prevalent among social service organizations. Furthermore, the degree to which it is practiced corresponds to leader effectiveness, among other positive organizational outcome variables within these types of agencies. It results in better group cohesiveness, which will help workers to feel better supported and to feel more personally involved in their agencies. It also results in lower stress and greater psychological well-being for health care workers.

Transformational leadership also increases individual creativity and organizational innovation among workers in some creative fields, and this benefit may also apply to mental health workers. More creative workers will be more capable of adapting their skills and techniques to the needs of individual patients, thereby resulting in a higher quality of services and better clinical outcomes. For all of these reasons, the transformational leadership model is a natural fit for the mental health field, and its implementation should be considered an integral part of best practices for mental health administrators.

References

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