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The study of group dynamics was central to the field of organization development at its inception. More recently, there has been a move away from considering irrational and unconscious dynamics in organizational life and more attention focused on rational and observable behavior that can be measured and quantified. We introduce the tool, Beneath the Surface of the Burke-Litwin Model, that invites consideration of how the overt behavior of individuals, groups, and entire systems is linked to covert dynamics. This more comprehensive view of organizational life provides scholar-practitioners with a systemic perspective, a view of covert dynamics by organizational level, and support for the ongoing development of one’s capacity for using self-as-instrument when engaged in organization development and organization change efforts.

Purpose – This chapter has two central purposes. The first is to suggest that western, as well as non-western, illness categories are culture bound. The second is to elucidate the diagnostic and treatment implications associated with adopting a reductionistic diagnostic approach, including for psychiatric as well as nonpsychiatric illnesses.

Approach – A comparative approach is used to highlight the differences between American psychiatry's diagnostic system (i.e., DSM) and French child psychiatry's diagnostic system (CFTMEA). The analysis begins by identifying the overarching differences between the systems, then analyzes the differences between their respective versions of the Attention Deficit/Hyperactivity Disorder diagnostic category, and ends by tracing the diagnostic and treatment implications of those differences.

Findings – This analysis reveals that the systems differ in three significant ways: (1) theoretical orientation (biological vs. psychodynamic), (2) the view that symptoms should be counted as opposed to understood, and (3) the presence of symptom checklists versus their absence. Additionally, these differences encourage American clinicians to both administer the ADHD diagnosis to a greater number of symptomatic children and to treat these children with psychiatric medications.

Contributions to the field – The analysis makes three contributions to the field: (1) the comparative analysis highlights the limitations of the DSM's ADHD definition; (2) it strengthens the case for seeing western diagnostic categories in general, and the DSM categories in particular, as cultural artifacts; (3) it elucidates the profound relationship between diagnostic systems and both diagnostic rates and treatment practices.

Depressive disorder has been defined by increasingly specific neurophysiological mechanisms and features during the past two decades. At the same time, depression has grown into an epidemic proportion and become a major public health problem. Consequently, the scope of depressive experience and conduct has also widened and the meaning of depression has multiplied and become equivocal. This chapter analyses how this tension is handled in current Western mental health care. The focus of the study is the role of neuroscientific views in mental health reasoning and practice. The empirical case is the mental health discussion in Finland from the late 1980s to the present day. The analysis of the historical change in understandings of depression in Finnish psychiatry and mental health care provides a view of the relevance of neuroscientific models in defining depressive illness and outlining diagnostic and treatment practices. Moreover, the analysis brings forth the relationship of neuroscientific concepts to other ways of defining depression – epidemiology, diagnostic classification, psychodynamic and other psychological theories – within clinical reasoning. A conclusion to be drawn from the analysis of the Finnish case is that neurobiological concepts of depression have only limited influence on the ways in which the disorder is conceived within the practical context of mental health care. It seems that the idea of depression as a multi-factorial disorder remains a good enough conceptual framework for clinical practice. Even the influence of neurosciences on treatment is still somewhat marginal. Within current practices of depression management, it is not the brain that is treated but risks, symptoms, and persons.

The idea that relational processes are central to knowledge creation and knowledge sharing is an idea in good currency (Bouwen & Taillieu, 2004; Brown & Duguid, 1996; Wenger, 1998). Rather than considering knowledge as a commodity that can be transferred from one mind to another, when knowledge is viewed as a relational practice, it resides in social interactions and is actualized in common practices that evolve within a particular community of practice (Sternberg & Horvath, 1999; Van Looy, Debackere, & Bouwen, 2000). Thus, knowledge is both embedded and emergent — subject to change as participants in a community interact with one another. To understand what is known, it becomes necessary to study how members of an organizational community interact and how their knowledge shifts over time.

In the global world we live in, organizations have become progressively complex. “C” organizations have been replaced by “I” organizations, implying that we have moved from organizations permeated by a command, control, and compartmentalization orientation, to organizations distinguished by cultural signifiers such as interaction, information, and innovation. Effective teamwork will be essential to make these complex, highly diverse, increasingly virtual structures work.

Given the complexity of teamwork, this chapter discusses some of its benefits and drawbacks. Particular attention is given to possible team killers. Given the darker side of teams, a group coaching intervention technique is presented to resolve this daunting challenge. Taking this approach will help the members of a team to take control of their key team functions: setting direction, creating alignment throughout the organization, and building the commitment of everyone needed to accomplish organizational objectives.

To explore this intervention technique, the notion of the clinical paradigm is introduced, meaning using a psychodynamic-systemic lens that focuses not only on what is directly observable, but also on out-of-awareness behavior. The five premises that characterize the paradigm are described. It is suggested that applying the clinical paradigm within group coaching setting helps to tease out the central interpersonal role in which executives consciously and unconsciously cast themselves. It also helps explore the complementary roles they take on in an executive role constellation, creating tipping points for change. In addition, a number of other intervention techniques are introduced that help foster change.

Manfred Kets de Vries, one of the pioneers in the field of global leadership, was interviewed on the topic of global leadership development. He described various intervention techniques he utilizes in his Challenge of Leadership program at INSEAD – a year-long seminar aimed at CEOs – that include exercises, life case studies, 720-degree feedback instrumentation, and the use of the group coaching intervention technique to create a “transitional space” or safe environment where senior executives can be both vulnerable and honest; a place where they can experiment with new ways of dealing with their world. Kets De Vries’s reliance on psychodynamic-systemic concepts, given his background as a psychoanalyst and management professor, was also explored. In addition, he discussed the future of global leadership development and the role business schools can play in producing global leaders.

Published studies of the relationships between personality, affect, and organizational change have been overwhelmingly quantitative, while clinical and psychodynamic approaches have seldom dealt with the context of organizational change. We used semistructured interviews to explore the “middle ground”, by researching how participants in change believed aspects of their personalities contributed to their responses, particularly on an affective level. We found that traits such as openness to experience, resilience, pragmatism, change self-efficacy, and locus of control influenced participants' perceptions of how they reacted to organizational change. The findings point to the important role that qualitative research into personality can play in improving understanding of emotional responses to organizational change.

Purpose – There is a paucity of research that examines how diagnostic decisions are made by psychiatrists. Moreover, previous work in the area tends to be grounded in labeling theory, which highlights the conflict-based nature of diagnosis. The goal of this research is to examine the utility and benefits of diagnosis to psychiatrists' everyday work.

Methodology – Using institutional ethnography (IE), I undertook a small-scale interview-based study that documented the diagnostic processes of three psychiatrists in Calgary, Alberta, Canada. The IE-based goals of the study were to: (1) identify what texts were employed during the diagnostic process, (2) map sequences of action and text that coordinated psychiatric decision-making, and (3) theorize the utility of diagnosis for the everyday work of psychiatrists.

Findings – The analysis demonstrates how diagnosis can be understood as a valuable work process that produces a standardized diagnostic story in order to bring an individual's experiences of distress into relation with psychiatrists' daily practices, and institutional discourses more generally.

Limitations – Although IE-based research does not depend on large sample sizes for analytic accuracy, results from the current study need to be replicated because of the limited number of interview participants and to examine whether the diagnostic process is generalizable to other settings.

Social implications – This research challenges the idea that standardization through diagnosis is a negative process and highlights the value of diagnostic decision-making in the daily work of psychiatrists.

Purpose – The DSM-III reflected American psychiatry's shift from a dynamic approach to a descriptive diagnostic approach. This chapter seeks to elucidate the implications of this shift for the diagnosis and treatment of mental illness.

Methodology/approach – To shed light on this issue I analyze the diagnosis and treatment implications of this shift for Attention Deficit Disorder (ADD).

Findings – The transition to the diagnostic approach has had three consequences for the handling of ADD, and later Attention Deficit/Hyperactivity Disorder (ADHD): first, it increased the number of children diagnosed with the disorder; second, it encouraged clinicians to treat the disorder with psychostimulants; and third, it expanded the pool of clinicians who could prescribe stimulants.

Contribution to the field – Beyond illuminating the specific cases of ADD and ADHD, this analysis contributes to the medicalization literature by demonstrating that there is more to be studied than merely the expansion or contraction of diagnostic categories. Researchers also have to analyze the implicit assumptions within the diagnostic definitions, which have implications for the prevalence and treatment of illness.