The LOCI Strategy

A research team at NKVTS conducted the LOCI trainings, leadership coaching, and organizational strategy activities in Norwegian. A train-the-trainer approach was used where the US based LOCI developers worked closely with the team by assisting with translation and adaptation of training materials and measures, meeting remotely to discuss LOCI components and training approaches, and participating in the in-person training held at NKVTS in Norway. The LOCI developers then observed and gave feedback on trainings, leadership coaching, and organization strategy meetings.

The LOCI strategy was structured to be consistent with the original US-based version (Aarons et al., 2017a, 2017b). For first-level leaders, the initial leadership development training included a two-day interactive workshop with theory on the full-range leadership model (Bass & Avolio, 1990), implementation leadership (Aarons et al., 2014a, 2014b), and implementation climate (Ehrhart et al., 2014; Weiner et al., 2011), supplemented with group discussions and interactive activities (e.g., identifying characteristics of effective leaders). The first-level leaders received individual feedback on leadership and implementation climate based on data from a 360-degree assessment completed by therapists, the first-level leader, and the executive leader in the health trust. Continued leadership development training included quarterly one-day follow-up trainings complemented with 360-degree assessments and feedback.

Throughout the duration of LOCI participation, the first-level leaders participated in weekly consultation calls with a LOCI coach to develop individual leadership development plans. Once a month, the coaching calls were replaced with a group collaboration call for all first-level leaders in the same cohort in order to share experiences and develop an informal learning collaborative. In addition, the first-level leaders and executive leaders within the same health trust participated in quarterly organizational strategy meetings where data on implementation climate were presented, and an overall organizational strategy plan for implementation climate development was created. Once a month, executive leaders participated in a consultation call with a LOCI coach to follow up on the organizational strategy plan.

Individual leadership plans and organizational strategy plans were tailored and adapted throughout the one-year program based on the 360-degree assessment feedback reports and individual experiences and needs of each clinic and health trust through a co-creation process approach involving leaders and LOCI coaches. Although participants were free to decide the content of their own plans, they were advised to include targets that are known to be important for EBP implementation (e.g., routines for systematic trauma screening) and goals that addressed specific issues identified in the results of the 360-degree assessment feedback reports. The individual leadership plans differed both in content and scope as a function of each first-level leader’s focus, motivation, and circumstances. Most leaders chose to include both goals for developing their own generic leadership skills and goals more directly and explicitly connected to the EBP implementation. The two often went hand in hand. For example, leaders practiced their individualized consideration and inspirational motivation skills (i.e., transformational leadership) in supporting and motivating the therapists to start using the EBPs (i.e., supportive implementation leadership).