Conducting A Diagnostic Interview With A Mental Status Exam

Before moving through diagnostic decision making, a social worker needs to conduct an interview that builds on a biopsychosocial assessment. New parts are added that clarify the timing, nature, and sequence of symptoms in the diagnostic interview. The Mental Status Exam (MSE) is a part of that process.

The MSE is designed to systematically help diagnosticians recognize patterns or syndromes of a person’s cognitive functioning. It includes very particular, direct observations about affect and other signs of which the client might not be directly aware.

When the diagnostic interview is complete, the diagnostician has far more detail about the fluctuations and history of symptoms the patient self-reports, along with the direct observations of the MSE. This combination greatly improves the chances of accurate diagnosis. Conducting the MSE and other special diagnostic elements in a structured but client-sensitive manner supports that goal. In this Assignment, you take on the role of a social worker conducting an MSE.

 

To prepare:

  1. Watch the video describing an MSE. Then watch the Sommers-Flanagan (2014) “Mental Status Exam” video clip. Make sure to take notes on the nine domains of the interview.
  2. Review the Morrison (2014) reading on the elements of a diagnostic interview.
  3. Review the 9 Areas to evaluate for a Mental Status Exam and example diagnostic summary write-up provided in this Week’s resources.
  4. Review the case example of a diagnostic summary write-up provided in this Week’s resources.
  5. Write up a Diagnostic Summary including the Mental Status Exam for Carl based upon his interview with Dr. Sommers-Flanagan.

Submit a 2- to 3-page case presentation paper in which you complete both parts outlined below:

 

Part I: Diagnostic Summary and MSE

Provide a diagnostic summary of the client, Carl. Within this summary include:

  • Identifying Data/Client demographics
  • Chief complaint/Presenting Problem
  • Present illness
  • Past psychiatric illness
  • Substance use history
  • Past medical history
  • Family history
  • Mental Status Exam (Be professional and concise for all nine areas)
    • Appearance
    • Behavior or psychomotor activity
    • Attitudes toward the interviewer or examiner
    • Affect and mood
    • Speech and thought
    • Perceptual disturbances
    • Orientation and consciousness
    • Memory and intelligence
    • Reliability, judgment, and insight

 

Part II: Analysis of MSE

After completing Part I of the Assignment, provide an analysis and demonstrate critical thought (supported by references) in your response to the following:

  1. Identify any areas in your MSE that require follow-up data collection.
  2. Explain how using the cross-cutting measure would add to the information gathered.
  3. Do Carl’s answers add to your ability to diagnose him in any specific way? Why or why not?
  4. Would you discuss a possible diagnosis with Carl at time point in time? Why?

 

the Diagnostic Interview: The Mental Status Exam and Risk and Safety Assessments  Resources  Readings 

  • Morrison, J. (2014). Diagnosis made easier: Principles and techniques for mental health clinicians (2nd ed.). New York, NY: Guilford Press.   o Chapter 10, “Diagnosis and the Mental Status Exam” (pp. 119–126)   o Chapter 17, “Beyond Diagnosis: Compliance, Suicide, Violence” (pp. 271–280)
  • American Psychiatric Association. (2013s). Use of the manual. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.UseofDSM5
  • American Psychiatric Association. (2013b). Assessment measures. In Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.AssessmentMeasure s   o Focus on the “Cross-Cutting Symptom Measures” section.
  • Chu, J., Floyd, R., Diep, H., Pardo, S., Goldblum, P., & Bongar, B. (2013). A tool for the culturally competent assessment of suicide: The Cultural Assessment of Risk for Suicide (CARS) measure. Psychological Assessment, 25(2), 424–434. doi:10.1037/a0031264

The Diagnostic Interview: The Mental Status Exam and Risk and Safety Assessments

  • Blackboard. (2018). Collaborate Ultra help for moderators. Retrieved from https://help.blackboard.com/Collaborate/Ultra/Moderator
  • Document: Case Collaboration Meeting Guidelines (Word document)
  • Document: Collaborating With Your Partner (PDF)
  • Document: Diagnostic Summary Example (Word document) Media
  • Laureate Education (Producer). (2018b). Psychopathology and diagnosis for social work practice podcast: The diagnostic interview, the mental status exam, risk and safety assessments [Audio podcast]. Baltimore, MD: Author.
  • MedLecturesMadeEasy. (2017, May 29). Mental status exam [Video file]. Retrieved from https://youtu.be/RdmG739KFF8
  • Sommers-Flanagan, J., & Sommers-Flanagan, R. (Producers). (2014). Clinical interviewing: Intake, assessment and therapeutic alliance [Video file]. Retrieved from http://www.psychotherapy.net.ezp.waldenulibrary.org/stream/w aldenu/video?vid=276

o Watch the “Suicide Assessment Interview” segment by clicking the applicable link under the chapters tab. This is the interview with Tommi, which will be used for the Discussion. o Watch the “Mental Status Examination” segment by clicking the applicable link under the chapters tab. This is the case of Carl, which will be used for the Application.

Journal Reflection: Reciprocal Determinism

Assignment Instructions

The Learning Reflection Journal is a compilation of weekly learning reflections you’ll independently write about across Weeks 2, 3, 5, 6 and 7. During each of the assigned weeks, you will write two paragraphs, each 300 words in length (i.e., 600 words total). The first paragraph will describe a topic that you found particularly interesting during that week and what made it interesting, and the second paragraph will describe something that you have observed occurring in the real world that exemplified that topic. Only one topic may be recorded in the journal for each assigned week and your observed real word occurrence must be clearly related to it.

In week 7, these five journal entries will be submitted together, merging these weekly experiences into a single document. The summary document should conclude with an additional two summary paragraphs (500 hundred words in length), integrating your thoughts and insights about the experience.

This is WEEK 2,3,5,6,7 WHICH IS ALREADY DONE. I ONLY NEED TWO SUMMARY PARAGRAPHS (500) WORDS

Week 2 Learning Reflection Journal

During my reading for week 2, Erik Erikson eight stages of development seemed to have caught most of my attention. Erikson did not theorize these stages, and he drew upon Sigmund Freud basic theories. There were very few theorists who addressed personality changes in old age. Erik Erikson was one of the few personality theorists who addressed the entire lifespan. Life expectancy continues to grow in our country, there are so many more older people than ever before. Sigmund Freud indicated that there were five distinct stages of Psychosexual development, and that children experienced psychological development within the framework of a series of set stages. What made this very interesting to me is that Erik Eriksons knew Sigmund Freud personally and was trained in psychoanalysis by Anna Freud. Anna did not believe he was true to Freud’s theories and rejected his work, because he shifted from psychosexual stages to psychosocial crises and because of his extension of them throughout the lifespan. This part was very interesting to me, because it got me to thinking more about personality on this part. I felt you really had to have a very strong personality to be rejected by someone who you trusted and believed in who trained you on a subject you dedicated your life to.

Many of us are familiar with Erikson’s eight staged of life, but what is not so known is each stage is tied to specific, basic social institutions and a particular strength, which Erikson believed gave the individual a “semblance of Instinctive certainty in his social ecology” (Erikson, 1968a). The first stage, Infancy-Basic Trust vs. Basic Mistrust-Hope. Second stage Early Childhood – Autonomy vs. Shame, Doubt – Will. Stage three Play Age – Initiative vs. Guilt – Purpose. Stage four School Age-Industry vs. Inferiority – Competence. Stage five Adolescence-Identity vs. Role Diffusion, Confusion-Fidelity: Stage six, Young Adulthood- Itimacy vs. Isolation – Love: Stage seven, Adulthood – Generativity vs. Stagnation, Self-Absorption – Care: Stage eight, Old Age – Integrity vs. Despair – Wisdom:

Erik Erikson’s theory of how people think and treat each other development is very important, highly looked on and a relevant concept. Life is full of constant lessons and challenges which all helps us to grow. Erikson’s great theory helps to tell us all why. In today’s society, I truly know and believe that his theory is very helpful for child development, and adults too. I truly agree with Erik Erikson’s  theory that an individual’s personality is developed over the entire course of one’s life span, from birth to death. I have a friend who use to be an introvert, really laid back and to himself which actually worked perfectly for the career he was in.  He was a truck driver for Miller Genuine Draft which was minimum interaction with people. He would actually go into stores and setup beer stands and have minimum interaction with anyone, other than the dropping off of merchandise to the customer. He was a very hard worker and always had really great rapport with the customer. Then he changed careers and became a salesman for Miller Genuine Draft, which forced him to become an extrovert. He stated being a salesman forced him to come out of his introvert ways, because he had to be more social and interactive to gain the customer trust. He also still had to be an introvert because he really had to have the skills to be able to listen to what the customer was actually saying. Personality is often shown through your behavior as an adult or a child.  I know we all are shaped into our personality at a young age, however; as we age we experience lots of different things learning new things and experiencing life lessons, hurt and losses which ultimately sometimes alters our personality. I know some people who have the same personality they had when they were kids, which I consider being stuck. I can speak for myself when it comes to your personality changing over a life span. I can say I have always had a very strong personality even when I was in my early 20’s. The difference between my early 20’s and now me being 50, my personality is still very strong, however; it is a strong but very calming personality. I believe for some of us as we age we do mature and think differently and reflect on the things and actions when we were younger, which ultimately makes us wiser and much better. I am almost sure my personality will continue to change throughout the rest of my life journey.

references:

Kelland, M. (2017, July 07). Personality Theory. OER Commons. Retrieved May 20, 2020, from https://www.oercommons.org/authoring/22859-personality-theory.

Week Three Journal Reflection: Reciprocal Determinism

Topic Description

The concept of human behavior requires an integrated approach to explaining human beings’ actions. Therefore the author (Kelland, 2017) acknowledges Bandura’s effort in that individual learning response from observing other people and accepting rewards and punishment that people receive. The concept leads to a modem perspective of social learning. Therefore in the topic reading, I acknowledge the topic of Reciprocal Determinism in appreciating psychological concerns in the knowledge of behavior. The subject provides fundamental views of Bandura on learning of the practice where each individual is an agent of personality leading to behavior and action. According to the author, specific conditions and environments interact to influence behavior in personalized learning. The topic offers three leading associations in resulting response due to interlocking interceptions. The reading establishes the concept in behavior components, individual components, and the environmental aspect, which shapes behavior and influences personal traits explanations. The behavior components in the topic provide the control of expression through the cognitive process, environmental, and external social stimuli. The author expounds on the idea to provide personal disposition, and results such as punishment and reward cause a behavior (Kelland, 2017. The environmental components consist of physical surroundings of individuals encompassing reinforcing stimuli such as people present or absent thus, influencing action just like behavior components. According to the topic reading, individual components include the characteristics of the past reward. In the sector, personality, cognitive process, and personal expectations and beliefs affect resulting action. Therefore, the topic provides a detailed evaluation of reciprocal determinism in personality doctrine explanations. However, according to Bandura, the concern of behavior, individual and environment works interactively and determinant in personality explanation domains (Geukes, Zalk & Back, 2019). Thus, the topic is interesting since it establishes functional interaction between environment, individual and behavior, and central domains of personality to explain behavior learning.

Real-World Simulation 

A parent who does not like the relationship may act out in the connection causing a negative influence on the other partner and related friends. The partners and friends may resort to altering the relationship goals to accommodate the acting out partners. The aspects of behavioral elements resulting from cognitive process and external social interactions influence the partner’s relationship, goals, and achievements. Therefore the acting out partners suggest behavioral components manipulating the environment forcing adjustments for accommodations. Consequently, if the other friend and partners decided to become physically aggressive on the misbehaving partners, the effect does not only present an adverse behavior on the acting out partners but also environmental and physical components. For instance, arising arguments may result in chaos, and noise influences the ecological elements. Therefore the case the stage nest explains the environment components in the reciprocal determine. The aspects of reciprocal establishing include individual, behavior, and environmental perspective on the disturbed partners in a relationship that results in an interactive influence in action. In the first place, the individual does not like the link and acts out in response to the behavioral aspects. The partners and friend act are creating reinforcement and a hostile environment for the misbehaving partner and the defending friends.  The real-world example provides a practical evaluation of the topic relating to the elements of individual behavior and the context in controlling behavior. Therefore, dislike of the relationship, acting out partners, the other partners and friends ‘action lading to interlocking of behavior, individual and environmental aspects.

References

Geukes, G., Zalk, M., and   Back, M. (2018). Understanding personality development: An integrative state process model. International Journal of Behavioral Development. DOI: 10.1177/0165025416677847

Kelland, M. (2017). Personality Theory. Common Open Education Resources. Retrieved on May 21, 2020, from https://www.oercommons.org/authoring/22859-personality-theory/13/view

WEEK 5 JOURNAL  REFLECTION: PERSONALITY THEORY

Personality is the way human beings are characterized by their behaviors. Individuals are described by their characters, for example, on how one reacts to a situation (Guntrip, 2018). The reaction is, therefore, determined by their personalities. An individual’s behavior is inclined to what they believe in. Personality theories help us in understanding, explaining, and predicting the behavior of an individual in case of an event that requires one to react. People have different personalities, and the theories guide us to know the real behavior of someone. Therefore, the argument is a guide to action. For example, we end up figuring out that specific patterns of events that have occurred before are likely to occur after. Personality theory is the most interesting because it is one crucial topic of interest in psychology. Professionals try to identify the behavior of someone with their personalities by analyzing the sequences and patterns of their daily life occurrences.

Major personalities are categorized into four significant perspectives, and each of them will try to describe the different patterns in character. The psychoanalytic perspective emphasizes experiences in early childhood and the unconsciousness of the mind. Personality is influenced by the unconscious mind, and it can be through dreams and a slip of the tongue. The humanistic perspective focuses on personal awareness and psychological growth. People are motivated by their human needs based on the more important ones (Bland, & DeRobertis, 2020). The trait perspective centers on identifying the traits that define an individual’s personality. The specific characteristics of an individual’s help us to comprehend the difference among individuals. This sums up to show that individuals are not the same and are guided by their traits. Lastly, the perspective of social-cognitive emphasizes on the importance of learning by observation and situational influences.

As a person grows from childhood to adulthood, they are faced with different conflicts of biological drives and moral conscience (Ammaniti, 2016). The child’s ability to solve such internal issues reflects on their destiny. For example, a child should learn and understand ways to control sexual urges and needs. Failure to do so will need to stagnation in that stage, leading to an unhealthy personality. In the current society, a lot of adults have been charged with rape accusations. Such behaviors can be based on the inability of an adult not going through stages of growth. These personalities are a result of the unconscious mind. The hierarchy of needs determines the humanistic perspective personality of an individual. The basic needs of an individual revolve around food, clothing, and housing, however, as people move up the hierarchy, interests, and needs change. For example, in society, people are after their selfish gains.  Most politicians are involved in corrupt activities because of their unlimited wants. Therefore, their personalities are reflected by selfish interests.

Individuals have different personality traits; some can be talkative and energetic, while others can be sympathetic (Diener, & Lucas, 2018). Sympathy is a good trait because an individual can decide to help the needy. Most of the children’s homes in society are funded by sympathizers who give out donations as a form of funding. Also, some, through their traits, offer to adopt street children and treat them as their own, for example, by providing a roof and schooling them. Individual’s personalities differ based on their observational learning. Some individuals prefer to learn through observations and make their conclusions. There has been a lot of cases of police brutality. Most of the police have been judged by the murdering of citizens in society. This has led to protests and demonstrations. The observation shows that society cannot tolerate the killings of good citizens. An individual can, therefore, learn and make conclusions through such views. This kind of personality is vital as it enables one to avoid crossing paths with the police in danger zones.

Reference

Ammaniti, M. (2016). Psychodynamic and Neurobiological Perspectives on Personality Disorders during Adolescence. Adolescent Psychiatry6(1), 5.

Bland, A. M., & DeRobertis, E. M. (2020). Humanistic perspective. Encyclopedia of personality and individual differences, 2061-2079.

Diener, E., & Lucas, R. E. (2018). Personality traits.

Guntrip, H. Y. (2018). Personality structure and human interaction: The developing synthesis of psychodynamic theory. Routledge.

WEEK 6 JOURNAL REFLECTION

Experiences’ Power to Influence Personality

Personality development is greatly influenced by a person’s early experiences in life as well as adulthood experiences. Because, the way a person thinks, feels, and behaves is determined by how he/she related to others in life early as well as how others think and what they say about the person. For example, the way Horney’s father used to take his family out sailing as a successful sailor it had a significant impact on Horney’s personality as she ended up loving to travel as well as developing an interest in foreign customs. Also, Horney’s personality for fighting for women’s rights came about because of her early experiences regarding how society throught her father did not value women’s education (Kelland, 2017). She sees that a woman’s development is greatly influenced by social customs surrounding her. What makes this topic interesting is the way minor childhood experiences that people put less emphasis on have a great chance of determining who a person will be in the future. Therefore, people should direct more energy in developing desirable personality in children from their younger ages.

It is indisputable that there are some personal experiences that one goes through in the real world and end up shaping the person’s personality forever. It is also important to note that as humans, people keep altering their personalities as they meet other people. This is because they will be listening to what other people say about them hence giving them a chance to change their personality. This means that one’s personality is greatly influenced by both childhood experiences as well as adulthood experiences. For example, in the real world, a person who is constantly loved by his/her parents will grow up being a loving person simply because his/her personality will have been shaped by the parents. Also, an adult who receives negative comments about his/her behavior will eventually change hence changing his/her personality for a greater good. Therefore, the issue of that personality is influenced by experiences is not only found in books but also in real life.

Reference

Kelland, M. (2017). Personality Theory.

Week 7 Journal Reflection

Cultural Influence on Personality

Personality is the way a person is defined through a combination of aspects such as behavior, feelings, motivation, and personal thinking patterns. It is important to note that a person’s culture has a greater chance of influencing his/her personality from birth to death. Culture is seen as features and knowledge of a specific group of people and usually encompasses aspects including but not limited to social habits, language, music, religion, and cuisine. It is essential to identify that in Africa, hospitality is something that should be shown to everyone, even if the person is a stranger (Kelland, 2017). This is because African culture demand that to be done; by far, this will impact profoundly on someone’s personality as the society will have taught the person to be hospitable to other people. Also, as a family is a miniature society, it represents the society in the development of personality in people. This topic is impressive, mainly because it provides a close connection between society and an individual’s personality.

As society has enough power to determine someone’s personality, it is essential to note that where there is a rebellious person, then it means his/her society brought him/her that way hence deducing that the society is rebellious will is valid. This is not a thing that is only found in books, but it is with the people in the society. In Africa, some communities have continuously been involved in cattle raiding for decades now (King, 2017). It is crucial to identify that these communities value cattle a great deal. It is the society that tells its people that for them to survive and show that they are the best, they will have to steal cattle from neighboring communities. This, by far, shows how there is a perfect connection between how personality is greatly influenced by culture and society. The society dictates to its people, the way to behave in the social context to survive.

Reference

Kelland, M. (2017), The Role of Culture in Personality Theory.

King, R. (2017). Cattle, raiding and disorder in Southern African history. Africa87(3), 607-630.

The grading rubric below details specific grading criteria.

 

Learning   Reflection Journal
100 %

 

Introduction
15 %

Exemplary

Introduction which very clearly summarizes the major points to be covered in   the paper. Topic sentence is well developed.

 

5 Weeks of Weekly Journal Entries
  50 %

Exemplary

Five distinct weeks of journal entries (minimum 600 words in length for   each), well written, including a paragraph completely describing what weekly   content you found interesting (and why) and one paragraph linking that   content to a real-world experience of your own.

 

Summarizing Paragraphs
  25 %

Exemplary

Two summary paragraphs (minimum 500 words) which very clearly and   thoughtfully synthesize the weekly reflections, distilling themes and   summative observations from the experience. Sources are credited and cited   appropriately.

 

Format/Writing
  10 %

Exemplary

Work is presented in a logical and coherent way. Writing is clear,   articulate, and error free. Citations are composed in proper format with few   or no errors. The student uses a preponderance of original writing (i.e., use   of own words and proper paraphrasing) and uses direct quotations minimally   and only when necessary/or appropriate.

Discussion Board – Spiritual Formation

Discussion Board 3

Spiritual Formation and Your Call to Ministry

 

Topic: Pettit, chs. 8-9 Thread Prompt: How would you connect leadership and calling to spiritual formation?

 

450 WORDS

 

 

Chapter 8.

Leadership and Spiritual Formation

 

Andrew Seidel

 

Leadership is one of the most observed and least understood phenomena on earth.

 

—-James MacGregor Burns, Leadership, 158

 

Now that I, your Lord and Teacher, have washed your feet, you also should wash one another’s feet. I have set you an example that you should do as I have done for you.

 

—John 13:14-15

 

Leadership and spiritual formation have a symbiotic relationship. Both, by their very nature, require the production and experience of continuous change. From one perspective, spiritual formation involves individual change while leadership involves group or organizational change, which also requires individual change. Certainly spiritual transformation in a group or ministry setting requires effective spiritual leadership. But the most critical element of the symbiotic relationship is that effective transformational leadership1 in any environment, religious or secular, requires the spiritual transformation of the leader. As leadership studies have progressed over the last few years, the role of the inner life of the leader is becoming more commonly recognized.

Even with the avalanche of new books on leadership, there is still no common agreement on the meaning of leadership. A surprising number of these new books claim to provide the “secret” to effective leadership, as though there is some previously undiscovered simple key to leadership success. Definitions of leadership seem to multiply at an alarming rate, with each mutation focusing on the particular writer’s own perspective or reflecting the values of the current culture. The frustration with so much detail but so little definition is expressed by one of the leading researchers in the area of leadership: “Four decades of research on leadership have produced a bewildering mass of findings. … It is difficult to know what, if anything, has been convincingly demonstrated by replicated research. The endless accumulation of empirical data has not produced an integrated understanding of leadership.”2

While the lack of resolution is frustrating, what is encouraging is the fact that more and more writers in the area of leadership are recognizing the importance of the inner life of the leader. Leading “from the inside out” has become a recurring theme, even in the secular arena. The inner motivations of the leader are not hermetically sealed in a secure place within the leader. Rather, they stretch far beyond the leader and have a powerful impact on the followers as well as on the organization as a whole.

Jim Collins, in his excellent book, Good to Great, notes that one of the key factors that enable good companies to make the transition to become great companies is the presence of what he calls “Level 5 Leadership.” His researchers noted a striking similarity in the great companies studied: all the CEOs of these companies possessed two traits in common. They were not charismatic personalities; none were favorites of the media, and their names were not commonly recognized. But they were characterized by the two qualities of “extreme personal humility and intense professional will.”3 Together, these qualities describe the inner motivation of a leader who focuses his strong passion on the good of the company he leads, not on his own personal ego needs. In contrast, for self-centered leaders “work will always be first and foremost about what they get—fame, fortune, adulation, power, whatever—not about what they build, create, and contribute.”4

Collins might have called this type of leadership “servant leadership”; in fact, some of his researchers suggested that he do so. But the title was rejected because of the current common use of the term. In fact, “servant leadership” has enjoyed a resurgence in the secular leadership literature. Robert Greenleaf’s Servant Leadership, published in 1977, began the current interest in the connection between leadership and servanthood. Writers, both secular and Christian, now focus on servant leadership. The connection between leadership and servanthood moves the leadership discussion into the inner life of the leader. No longer can the leader’s inner life be crowded out by the pragmatic emphasis on the skills of leadership.

The Meaning of Servant Leadership

Servant leadership is a biblical concept that Jesus worked diligently to impress on his disciples. They, like us, had a difficult time with it. Jesus’ last and clearest statement of servant leadership occurred on the way to the garden of Gethsemane shortly after the Last Supper. By this time the disciples had been with him almost three years. They had seen him heal the sick, raise the dead, and cast out demons from afflicted people. They had heard his teaching, experienced close community with him, and, only a few moments before, reluctantly allowed him to wash their feet.

But as they walked toward the garden that night, they went back to a common issue among them: they got into a heated argument about which one of them was regarded to be the greatest! If it were not also so true of us, we might chide them, wondering how they could possibly be so blind and self-centered.

And there arose also a dispute among them as to which one of them was regarded to be greatest. And He said to them, “The kings of the Gentiles lord it over them; and those who have authority over them are called ‘Benefactors.’ But it is not this way with you, but the one who is the greatest among you must become like the youngest, and the leader like the servant. For who is greater, the one who reclines at the table or the one who serves? Is it not the one who reclines at the table? But I am among you as the one who serves.” (Luke 22:24-27 NASB)

With great patience Jesus draws their attention to the self-centered leadership of the Gentile political leaders of their day, leaders who had the audacity to require their subjects to call them “benefactors,” while these same leaders selfishly used their subjects and lorded it over them. This kind of leadership is better described as self-serving leadership. Jesus challenged his disciples to be different; in his view the leader is to be like a servant. While there is much talk about servant leadership today, there is also much confusion. Some suggest that servant leadership is simply a passive style of leadership in which the leader has no agenda. But Jesus himself was anything but passive, and he certainly had an agenda.

Servant leadership is not a style of leadership at all; it is much more foundational. Servant leadership is primarily expressed in the inner motivation of the leader. Stated simply, a servant leader is not motivated by personalized power or benefit. A servant leader is primarily motivated by two things: (1) the fulfillment of God’s mission for his or her ministry or organization and (2) the fulfillment of God’s purpose in the lives of the people who are part of the ministry or organization. This means that the passion of this leader is not focused on his or her power, benefits, reputation, perks, or privileges; it is on the fulfillment of a godly purpose and on the good of the people being led. This is a high and unselfish focus. No wonder we, like the disciples, have such difficulty living it.

How God Develops His Servant Leaders

 

Servant leadership is so critical to God’s purpose in the world that God will go to great lengths to develop it in his followers. The missionary statesman J. Oswald Sanders comments, “It has been said that in achieving His world-purpose, God’s method has always been a man. Not necessarily a noble man, or a brilliant man, but always a man with capacity for a growing faith. Granted this, there appears to be no limit to the pains God is willing to take in his training. He is limited by neither heredity nor environment.”5

In the past several years, leadership training has concentrated on knowledge and skills. But from a Christian perspective, there is more to leadership development than knowledge and skills, as important as both are. God is more concerned with the development of the person of the leader. Through the course of life, God works in our lives to mold and strengthen us, to prepare us to be his leaders. God either brings or allows experiences into our lives; some are pleasant and enjoyable, and others are excruciatingly painful and anything but enjoyable. Either way, God uses our experiences to work on our heart. He orchestrates our experiences as challenges to mold our heart, to jar us out of our comfort zones, to shake up our complacency, to make us look inward, deep into our heart, until some crisis shows who we have become. God focuses his effort on our heart, because, at its core, leadership is more a matter of heart than it is of knowledge or skills.

God will involve each of us in something that is more of a pilgrimage than a process. “Process” is much too mechanical; “pilgrimage” is much more personal. Pilgrimages are powerful experiences. A pilgrimage is “a transformative journey to a sacred center full of hardships, darkness, and peril.”6 People make pilgrimages in order to be transformed by the experience. Sometimes they are religious pilgrimages; most of the time they are personal pilgrimages. Either way, there must be an element of difficulty and hardship, even danger, something that challenges us to the depths of our souls. Without the hardship there would be no extending of ourselves past the boundaries of our comfort zone, no true transformation.

God will see to it that you are stretched far enough that the effect of your pilgrimage will be to get you to examine your heart, your inner life.

This is why your willingness to enter deeply into your own “life story” is so critical (see chapter 10 for a discussion of life story). We are so immersed in the pressured flow of life that we move from one crisis to the next activity to the following event, seldom if ever pausing to reflect on what those experiences are teaching us. Unless we stop and reflect on the formative experiences and relationships of our life, we will miss the transformative purpose that God intended. But there is indeed “no limit to the pains God is willing to take in our training.”7 In all our experiences, his goal will be to teach us to depend upon Christ … for everything, including a secure sense of personal identity.

Personal Identity: The Enabling Element in Servant Leadership

 

Through our pilgrimage, one of the primary elements God wants to deal with is our sense of personal identity. He has good reason for doing this. Leadership is primarily an expression of who we are. No matter what leadership style we use, or what leadership skills we employ, our actions as leaders always come through the grid of who we are. One might expect Christian writers to focus on the inner life of the leader, but even secular writers are recognizing that, first and foremost, leaders lead out of who they are. Bennis observes that “no leader sets out to be a leader per se, but rather to express himself freely and frilly. That is, leaders have no interest in proving themselves, but an abiding interest in expressing themselves. The difference is crucial, for it’s the difference between being driven, as too many people are today, and leading, as too few people do.”8

Leadership is about self-expression. In its best form, leadership is about the outward expression of the reality that is within the heart of the leader. The reality in the heart of the leader is related to the leader’s sense of personal identity. The importance of this for leadership is that we will either lead out of our sense of personal identity, or we will lead in order to establish our sense of personal identity. The difference is critical, for those who lead in order to build an identity for themselves will end up selfishly using those they lead to gain from their followers what they themselves desperately desire. At this point, servant leadership crosses that dim line in the sand into self-serving leadership.

On that same night in which the disciples got into the argument about which one of them was regarded to be the greatest, Jesus had given them an experience that was a visible model of servant leadership. As the disciples entered the borrowed room that had been arranged for the supper, most of them seemed primarily concerned about getting the prime positions at the table. One of them was preoccupied with the betrayal he had already committed himself to accomplish. All of them passed by the basin and the towel set near the door to enable them to wash the dust of the road off their feet. Because it was a rented room, there was no servant at the door to wash their feet; and none of the disciples was willing to take on the role of a servant, not even temporarily.

The gospel of John describes in vivid terms what happened during the supper. Jesus got up from supper, took the basin and towel, and performed the role of a servant by washing the disciples’ feet, one at a time. Some were embarrassed, Peter so much so that he resisted. It was inconceivable to Peter that one in Jesus’ position, “the Christ, the Son of the living God” (Matt. 16:16), would be willing to act as a servant. Even today, two thousand years later, it is still astounding. But John gives us insight into Jesus’ thinking, which gives perspective on what enables the greatest leader to act as the humblest servant. If we diagram John 13:1-5, the insight becomes evident:

John 13:1-5

1 Now before the Feast of the Passover,

Jesus

knowing that his hour had come

that He would depart out this world to the Father,

having loved His own who were in the world,

He loved them to the end.

2

3   knowing that the Father had given all things into His hands,

and

that He had come forth from God

and

was going back to God,

4   got up from supper, and

laid asided His garments; and taking a towel, He

girded Himself.

5   poured water into the basin, and

began to wash the disciples’ feet. (NASB)

John indicates that it was what Jesus knew about himself that was a precursor to his washing the disciples’ feet. Jesus had a secure sense of his personal identity. He had a thorough understanding of his divine origin, his eternal purpose, his authority as the Son of God, and his destiny to be seated again at the right hand of the Father. With this secure sense of his own personal identity, taking the role of a servant was not the threat to him that it was to the disciples. For any of us, the ability to be a leader who acts as a servant will depend on the presence of a personal identity that is secure enough that we do not need to focus our attention on protecting an insecure identity that is threatened by unselfishly focusing our attention and efforts on the good of others. A secure sense of personal identity is what sets us free to focus on the good of others.

The Meaning of Identity

A sense of personal identity is a complicated concept to describe. It has many elements, some visible, some invisible. Parker Palmer describes the complexity this way: “By identity I mean an evolving nexus where all the forces that constitute my life converge in the mystery of self. … identity is a moving intersection of the inner and outer forces that make me who I am, converging in the irreducible mystery of being human.”9

Starting with the most concrete and visible elements, personal identity includes a person’s gender and ethnicity. These are outward marks of who we are. Identity also includes our temperament and our gifts, our strengths, weaknesses, and character flaws. Identity includes who we have become as a result of the life experiences God has taken us through. These experiences, and especially our responses to them, have shaped and molded us.

But identity is still more than that. Residing deep within us is a powerful need to feel secure and significant.10 Each of us desperately longs to feel warmly and securely loved and accepted and to sense that we are persons of substance, that our life makes a meaningful difference. Thus our sense of identity at a deeper level includes feelings of competence and a sense of significance, that our life has value and worth. Because of the strength of these normal human longings, our early experiences play a dominant role in the formation of our sense of identity. Our experience of relationship with our parents, siblings, and other family members leave a powerful imprint on our sense of identity, an imprint that we carry into later life. Feelings of rejection, criticism, shame, or abuse make us feel deeply devalued and expendable. Because our very survival seems to be at stake, and we do not have the maturity to know how to get the help we so desperately need, we develop coping strategies to dull the pain and create the illusion of being loved and valued. These strategies become such a part of us that we no longer recognize them, even while they control our search for identity.

All of these elements, both positive and negative, are blended together in a powerful mix that strongly impacts the way each of us lives our life. One way of picturing our personal identity is to view it as a personal inner map, a map that is part of a larger map. In this view, our identity becomes a boundary that marks us off as different from others. The borders on our part of the larger map distinguish us from the rest of the map and show us how and where we fit into the larger scheme of things. Our identity, filled out by our gifts and abilities, indicates what we uniquely contribute. In this sense the boundary is one that frees us to focus on doing well those things that are unique to us. We can concentrate on the things God has gifted and developed us to do. We do not have to spend energy trying to focus on other parts of the larger map. This kind of boundary is an expanding boundary. The more we work and lead from the center of our giftedness, the greater our fulfillment.

However, if we do not have a positive and secure sense of our personal identity, the boundary can be one that limits us to self-centered attempts to fill up that painful sense of emptiness we feel because we are insecure about who we are and what significance and value we have. In this case we begin to feel a sense of compulsion and drivenness to demonstrate to the world that we are persons of value and substance, worthy to be loved and respected.

It is from within this boundary of identity that we exercise leadership. As Warren Bennis suggested, there is a difference between being driven and leading. A driven person feels a powerful sense of being compelled to gain a desired response from others in order to fill up an empty pit of internal need. He needs their approval, or applause, or acquiescence, or adoration. So he will relate to them in whatever ways he feels will get them to give the desired response. This is not real leadership; it is actually manipulation of others so that the person in a leadership position can gain whatever he thinks will meet his identity needs. His concern is for himself, not for the good of those he is responsible to lead.

In contrast, true leading is enabled by the internal security that gives a joyous sense of freedom to use one’s gifts and developed skills to express oneself for a godly purpose and for the good of those led. This secure personal identity allows a leader to turn his or her attention away from personal needs to focus on the needs of the ministry or organization and the people in it. There is no servant leadership without it.

How Identity Impacts Our Leadership

Our sense of personal identity becomes a boundary that determines how we see reality. This is one primary reason why people see things differently. For example, a church was split into two opposing sides in a controversy over the form the church would take in the future. Would it become more contemporary and “seeker” focused, or would it continue in its more traditional and “blended” form? As the argument gained power, the opposing camps became more antagonistic toward each other. After an especially heated congregational meeting, a church member who had been out of town and missed the meeting asked friends from both sides of the conflict about what happened at the meeting. The two descriptions he heard were so different that he wondered whether they had been at the same meeting! The different accounts were the result of selective perception. People tend to see what they expect to see. Even more, we tend to see what we need to see. If our sense of identity is connected to a need to be right or to be on the winning side, we tend to see things in harmony with that, and other information is screened out. And, of course, people on the other side do the same thing. Our ability to lead well is in this way severely restricted.

Second, our identity tends to strongly impact what we do. If we are attempting to construct our identity from our work or ministry, we will feel a strong compulsion to be successful, or to be needed, or to be in control of things, or to be in a position of recognized power. Or we will feel an inner need to always be “right,” or always have the last word, or to be recognized and applauded. A leader in this situation will be strongly self-focused as he tries to make sure that he gets what he feels he cannot do without.

Third, it follows that our sense of personal identity will strongly influence how we relate to others. If our sense of identity is not satisfying and secure, we will sense a painful inner deficit. That personal deficit will become a powerful motivator to fill up our sense of emptiness, and we will begin to manipulate others to get from them that which we think will give us a satisfying sense of personal identity. In this way, an inadequate sense of personal identity leads directly to self-serving leadership.

Saul, the Example of a Driven Leader

Saul of Tarsus was clearly a driven man. He was driven to extremes of cruelty and oppression that would certainly qualify him as a terrorist in today’s terminology. The first time we encounter him in Scripture is in Acts 7:58, where he is cheering on the angry crowd in its stoning of Stephen. Putting several descriptions of Saul together, we get this picture of him.

• He was in hearty agreement with stoning Stephen to death (Acts 8:1).

• He was ravaging the church, entering house after house, and dragging off men and women, and putting them in prison (Acts 8:3).

• He was breathing threats and murder against the followers of Christ (Acts 9:1).

• He asked for and received letters from the high priest authorizing him to search the synagogues in Damascus for followers of Jesus so that he might bring them bound to Jerusalem (Acts 9:2).

• He persecuted the church beyond measure and tried to destroy it (Gal. 1:13).

• He was a blasphemer (1 Tim. 1:13).

• He was a persecutor (1 Tim. 1:13).

• He was a violent aggressor (1 Tim. 1:13).

The natural question is, “Why was he so extreme; why did he lead such intense and brutal opposition to the followers of Christ?” Surely he thought that his own religion was threatened by the growth of the followers of Jesus. But there was more to his violent opposition. Paul, in his own words, indicates that there was a deeper, more personal motivation in his heart. The first indication of this comes in Galatians 1:10, where Paul hints that earlier in his life he was “seeking the favor of men” and “striving to please men” (NASB). But, now, having become a bond servant of God, he would do no such thing, especially regarding the truth of the gospel. Three verses later (Gal. 1:13), he specifically states that in his former life in Judaism he went to extremes in persecuting the church. It was through his extreme zealousness that the Pharisees over him recognized him as a young man of promise. As Paul describes it, “I was advancing in Judaism beyond many of my contemporaries among my countrymen, being more extremely zealous for my ancestral traditions” (Gal. 1:14 NASB). He is here pulling back the cover over his heart to expose the fact that the motivations for his extreme zealousness in persecuting Christians included competition with his contemporaries and a desire for personal recognition and advancement. His identity needs drove him to extremes in his search for significance and value through his persecution of Christians.

Paul is a good example of the power of identity needs because they drove him to such extremes in an attempt to fill the gaping hole within his heart. Most of the time in our lives the extremes will not be so clearly visible. Nevertheless, the identity needs show up in the pastor who is all about numbers, who is only too happy to announce to anyone who will listen that his church has passed the three-thousand mark. They show up in the elder who always has to have the last word, no matter what the discussion is, or in the leader who must always be in control of everything and is not willing to truly delegate responsibilities to others. What Paul did, and what each of these contemporary examples do, is allow their own identity needs to impact their leadership in such a way that they do not lead others; rather they manipulate others and use them for the leader’s own benefit. For such leaders, identity is a zero sum game: If I let you do things that strengthen your sense of identity, that takes away from my sense of identity. So in order to protect my identity, I take away yours. Parker Palmer put it this way: “When leaders operate with a deep, unexamined insecurity about their own identity, they create institutional settings that deprive other people of their identity as a way of dealing with the unexamined fears in the leaders themselves.”11

Palmer’s description is seen very clearly in Saul, whose bondage to his own identity needs drove him to extremes in denying other people their identity. It may be difficult to admit, but the same is true in varying degrees of all of us. In contrast, a leader with a secure sense of personal identity is free to create organizational culture that allows everyone to express their giftedness, take responsibility, and enjoy the blessing that comes from making a significant contribution. Such a leader can take pleasure in the success of others and has no hesitancy in celebrating that success for them.

Identity or Image?

Each of us must deal with two competing characteristics in our own life, and the competition between them spills over into every area of our life. Each of us has some sense of personal identity. It may be healthy and satisfying, or it may be deficient and demanding, clamoring for us to do something to sustain it and increase it. We also have an outward image that we project to others in our interactions with them. We inflate an image of ourselves much like the huge, inflatable gorillas car dealers put on the top of their buildings to attract the attention of drivers on the freeway as they speed by the dealership.

When our sense of identity is strong and satisfying, our need to project an image to others tends to decrease. This situation could be pictured like this:

 

However, if our identity is weak and unsatisfying, we will feel the need to project an image to others. We develop an image of what we want others to think about us, an image that seems to satisfy the emptiness within our own hearts. Then we relate to others through the medium of this image, which now looks like the one at the top of the next page.

We project an image in our interactions with others because we feel we must. We long for others to view us in the way the image suggests. We project images of competence, importance, superiority, knowledge, or value, hoping that people will think of us in these ways. The problem, however, is that others are not really relating to us, only to the image of ourselves that we are setting up and pointing in their direction. In normal relationships, this is empty and unsatisfying. In leadership situations, it is not only empty and unsatisfying; it is also painfully destructive.

The difference between leading out of a secure identity and leading from image, or insecure identity, is the difference between light and darkness. If I lead from a secure identity, I can be who I am. I can use my gifts

 

and abilities to the maximum. I do not have to hide my weaknesses; I can allow others, whose gifts and abilities are different from mine, to use them fully. There is a high level of authenticity in this. On the other hand, if I lead out of an image that I have constructed, I relate to those I lead out of who I think I have to be. In other words, I have to act a part, play a role. Of course, I have chosen the role myself; I have designed the part I play because I think that by playing that part people will think of me and relate to me in ways that I think will provide the sense of identity I am desperately seeking. The trap is that I have to continually play the part, because if they really knew me, they would not think of me in the way I desperately need.

LEADING FROM IDENTITY and LEADING FROM IMAGE

IDENTITY IMAGE

Who I am Who I think I have to be

Authenticity Acting

Freedom that enables me to:

• Be concerned for others

• Serve others

• Trust others

Bondage that requires me to:

• Be concerned for myself

• Use others

• Fear others

Openness Control

Courage Avoidance

Relaxed Uptight

The difference between these two ways of leading is the difference between freedom and bondage. When I lead out of a secure sense of identity, I am free to be concerned about others. I can serve them by giving their needs priority over my own. Because they know I am concerned for them, they do not have to be in competition with me, so I can also trust them. But if I am leading out of image, I am in bondage, because I have to constantly make sure that the image I have blown up is not leaking. In fact, I have to use others to get what I think I need to fill up the emptiness within me. And, simultaneously, I have to fear them, because if I am not careful, they might withhold from me the very thing I desperately need from them. So, I have to always be in control and very careful to avoid anything that might expose the emptiness of the image or cause others to act in ways that are contrary to what I want.

If I am leading out of a secure identity, I am much more free to lead with openness and to invite the real participation of others in the process. I can also lead with greater courage, because if someone does not like one of my decisions and pulls back from agreeing with my position or even from following me, it is not a threat to my survival.

We might be tempted to think that we can control the expression of these identity issues so that they will not impact our leadership relationships. As appealing as this may sound, it is not true. The leader’s inner struggles always work their way into his or her leadership relationships. No matter how hard we try to hide them or cover them up, they come out in unexpected ways. “Leaders not only embed in their organizations what they intend consciously to get across, but they also convey their own inner conflicts and the inconsistencies in their own personal makeup.”12

This was the problem with the disciples; they continually argued about which one of them was the greatest. Their inadequate identities required it. The problem with the Gentile leaders was not only self-serving leadership, but also self-deceived, self-serving leadership. Rather than deal with their own hearts as leaders, they projected blame on others and elevated themselves by glorifying their own motives, congratulating themselves for being “benefactors” of the people (Luke 22:24-27)! Leaders struggling with their own identity rob those they lead of theirs! A modern-day version of this might look like the following examples.

Identity Issues: The Pastor Who Always Has to Be the Authority

Discussion: Case Study: Organizational Analysis And Assessment

Organizational culture is so ubiquitous that it affects all areas of group life. Though organizational culture is not always immediately obvious in organizations, its outcomes (e.g., turnover, morale, productivity) can be. Some workplaces require employees to wear business attire whereas others allow employees to dress casually. In some workplaces, formal address is used and in others, people use first names regardless of position. Both examples reflect organizational norms, or “the way we do things around here,” otherwise known as organizational culture. Organizational culture may be subtle yet pervasive and may have a profound effect on employee attitudes and behavior.

Organizational culture affects each of the levels of organizational assessment: individual, small group, large group, intergroup, and organization. As an organizational consultant or practitioner, it is beneficial to have a toolbox of assessments for organizational evaluation for each of these levels. By assessing organizational culture, practitioners and consultants can then develop evidence-based interventions to address the issues identified by the assessment and evaluation processes.

Consider how the information above may be applied to the Greenvale Correctional Facility case study that follows.

Greenvale Correctional Facility is a large, privately-owned, medium-security prison in the southeastern United States. The prison opened in 1988, and, until recently, it employed 300 security, operational, facilities, maintenance, healthcare, and administrative employees.

The prison’s salary and benefit structure are comparable to other prison systems around the country. However, Greenvale is currently experiencing significant attrition, creating an unsafe and unstable environment, both for the inmates and remaining employees. Staff has reduced from 300 to 210 employees during the last 6 months, and attempts to recruit and hire new staff have been challenging. Online recruitment, employee sourcing, and participation in various job fairs have not created a plentiful base of trained, experienced employment candidates, and efforts to retain existing personnel have been unsuccessful. Exit interview data point to leadership issues, and poor working conditions.

Prison leadership is comprised of Warden Bob Jones, who started at Greenvale when it first opened; Sergeant Dave Lee, the senior-level correctional leader with over 15 years of experience; and Officer Stan Phillips, a correctional manager who joined the leadership team in 2015. All three leaders work collaboratively, but they tend to remain siloed away from the other employees. All of the prison’s communications are top-down and authoritative; the leadership team believes this style is necessary given the work environment and inherent risks involved. While the team believes they are fostering a management-by-objectives culture, many employees feel excluded from the process and perceive more of an in-group/out-group mindset. Consequently, several recent attempts to implement new policies and procedures have met with resistance from the current employees.

To prepare:

  • Review this week’s Learning Resources. Reflect on how organizational culture can be used to help assess and evaluate organizational needs, develop interventions for different levels, and implement change.
  • Read and analyze the Greenvale Correctional Facility case. Greenvale is a large, privately-owned correctional facility facing staff-retention issues.

By Day 3

Post a response to the following:

Identify what you believe are Greenvale Correctional Facility’s key issues. Explain your assessment process and the factors you considered during your analysis. Be sure to include how organizational culture affects assessment in organizations.