This paper presents the current Dutch sociotechnical design approach to integral organizational renewal in a contextual way. Both its design theory and intervention processes are reviewed and some aggregated empirical evidence is presented. Next, the paper compares the ideas developed in the Dutch approach to those presented in its American, Scandinavian, and Australian counterparts. It is concluded that, at a meta-level, they all share the ideal of participative democracy, while at the conceptual level, these distinctive approaches appear quite incompatible. Notwithstanding substantial diversity, it is presumed these approaches can be seen as local manifestations of a single sociotechnical paradigm.