Appreciative Practice:An Overview
Rebecca Bouterie Harmon, PhD, RN, PMHCNS, BC
University of Virginia School of Nursing
What is Practicing “Appreciatively”
…in a nutshell…
Finding what is best in your organization (& you)
Figuring out how to get more of it
Focus on good and good appreciates
Foundational Theorists
Maslow, Hierarchy of Needs, 1943
Rogers, Client Centered Therapy, 1951 (unconditional acceptance)
Peplau, Interpersonal Relations in Nursing, 1952 (communication)
Bandura, Social Learning Theory, 1977 (self-efficacy)
Antonovsky, Health, Stress, & Coping, 1979 (salutogenesis & sense of coherence)
Appreciative Practice combines Self-help Movement
Dale Carnegie, Dr. Joyce Brothers & others
Positive Psychology Research Diener, Subjective Well Being, 1984 Csikszentmihalya, Flow, 1990 Seligman, Learned Optimism, 1991 Fredrickson, Broaden and Build, 2000 Julienne Bower, benefit finder, 2007
Organizational Development Cooperrider & Srivastva, Appreciative Inquiry
in Organizational Life, 1987 Whitney & Trosten-Bloom, The Power of
Appreciative Inquiry: A Practical Guide to Positive Change, 2003
Applies the Appreciative Eye to business models
A Generative or “Anticipatory Theory that has the capacity… to challenge guiding assumptions of culture, to raise fundamental questions regarding
everyday life, to foster reconsideration of that which is
taken for granted, and thereby furnish new alternatives...”
(Influenced by Ken Gergen’s 1982 book,Toward Transformation of Social Knowledge)
Appreciative Inquiry
Cooperrider, D.L., and Whitney D. (2005). Appreciative Inquiry: A Positive Revolution in Change.
Traditional Problem Solving
Focuses on a problem Identifies solutions, action
plans, interventions Break down the problem Fragmented response Slow resolution Change is mandated
The Medical Model
Chief Complaint:Problem focused
Differential Diagnosis:What is the worst thing that could happen?
Interventions:How do I prevent / fix it?
Break it down:Labs, x-rays, procedures
Diagnosis:The Problem
Action Plan:Often includes behavior modification
The Nursing Process
Assess Diagnose Identify outcomes
Plan Implement Evaluate
Cooperrider, D.L., and Whitney D. (2005). Appreciative Inquiry: A Positive Revolution in Change.
The Appreciative Approach
Focus is on the positive Asks, “What is working?”
“What is going well?” Identifies positive core values Builds on creativity &
imagination to co create Expands the vision of a
preferred future
10
The AI Process
Decide what to learn about
DISCOVERY:Find &
Appreciate the Positive Core
DREAM:Imagine what
might be
DESIGN:Determine what
should be
DELIVERY:Create what
will be
Positive Core:(What you
want more of)
Adapted from Whitney, D., and Trosten-Bloom, A. (2003). The Power of Appreciative Inquiry: APractical Guide to Positive Change.
DiscoveryAsking the Question… Unconditional, positive question Asking the question influences the
answer & sets the tone Not: “Who/what is the problem?”
Not: “How do we fix the problem?”
The Appreciative Practitioner asks: “What is working?” “Where is it working?” “How are they doing it?”
identify positive deviance encourage staff to find out provide psychological safety
(Amy Edmondson, 1999)
Example: Appreciative Check-in
“What went well today?” A great presentation on rounds. My patient got all the diagnostic tests
she needed. A patient said “thank you.” A coworker said “thank you.” My son hit a home run
(and I was there to see it !)
Guiding Principles of AI/AP
Constructionist Principle We create our reality Our interactions with others
determine who we areKenneth Gergen, 1994, 1999
Poetic Principle Everything is open to
interpretation We choose what we see
Rollo May, 1994
More Guiding Principles
Simultaneity Principle Change begins with the
question (Frankel, 1998; Goldberg, 1998)
Positive PrincipleWe’re more creative & able
to solve problems when we’re happy (Fredrickson, 2000)
Even More Guiding Principles
Wholeness Principle Everyone involved and focused on
higher ground Anticipatory Principle Our image of the future guides
our present actions Pictures &
images are more powerful than words
Anticipatory Principle Quote
“If you want to build a ship, don’t drum up the people to gather the wood, divide the work, and give orders. Instead, teach them to yearn for the vast and endless sea.”
-- Antoine de Saint Exupery
Cooperrider, D. & Whitney, D. (2005). Appreciative Inquiry:
A positive revolution in change.”
Why the positive approach works
Positive, energizing focus Builds the organization you
want to be a part of “Be the change you want to be.”
Builds a future with roots in the present (Doesn’t focus on
changing people)
Hammond, S.A. (1996). The Thin Book of Appreciative Inquiry
Why it works
Creates a shared vision
Statements are grounded in real experience
People know how (& want to) repeat their success
Why it works
Doesn’t ignore problems Uses collective wisdom of
group to move forward Identifies core values and
strengths as a basis for growth
UVA Projects in Process
PICU - Environment of Care Family Medicine - Magic of
Teaching Students SNMA - Success of Minority
Faculty Students Interventional Radiology School of Nursing Inpatient Psychiatric Unit TCV And more
UVA Appreciative Practice Executive Team“Moving as one into the future.”
Dorrie FontaineDean,UVA School of Nursing
Steven DeKosky Vice President and Dean,UVA School of Medicine
Ed HowellVice President and CEO,UVA Medical Center
UVA Appreciative Staff
Julie Haizlip, MDPICU and Pediatric Sedation Services
Peggy Plews-Ogan, MDGeneral Medicine, Geriatric, & Palliative Care
John Schorling, MDGeneral Medicine,Healer’s Art, Mindfulness Center
Anne Williams, MA Natalie May, PhD
Not pictured: Cathy Keefe-Jankowski, MTS
Selected References Cooperrider, D.L., & Whitney, D. (2005). Appreciative Inquiry: A Positive
Revolution in Change. San Francisco: Berrett-Koehler Publishers. Fredrickson, B.L. (2009). Positivity. New York: Crown Publishers. Hammond, S.A. (1996). The Thin Book of Appreciative Inquiry. Bend, Oregon:
Thin Book Publishing Company. Haizlip, J.A., & Plews-Ogan, M.L. (2010). Successful adaptation of
appreciative inquiry for academic medicine. AI Practitioner, 8, 3, 44-49. Kelm, J.B. (2005). Appreciative Living: The Principles of Appreciative Inquiry
in Personal Life. Wake Forest, N.C.: Vener Publishers. Ludema, J.D., Whitney, D., Mohr, B.J., & Griffin, T.J. (2003). The Appreciative
Inquiry Summit. Berrett-Koehler Publishers, Inc. San Francisco. Plews-Ogan, M.L., May, N.B., Schorling, J.B., Becker, D.M., Frankel, R.,
Graham, E., Haizlip, J.A., Hostler, S., Pollart, S., & Howell, R.E. (2007). Feeding the good wolf: Appreciative inquiry and graduate medical education. ACGME Bulletin, 11: 5-8.
Whitney, D., & Trosten-Bloom, A. (2003). The Power of Appreciative Inquiry:A Practical Guide to Positive Change. San Francisco: Berrett-Koehler.
Whitney, D., Trosten-Bloom, A., Cherney, J., & Fry, R. (2004).Appreciative Team Building. New York: iUniverse, Inc.
http://appreciativeinquiry.case.edu http://appreciativepractice.virginia.edu
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