Transformational and Transactional Leadership: Association With Attitudes Toward Evidence-Based Practice

Abstract

Objective-Leadership in organizations is important in shaping workers' perceptions, responses to organizational change, and acceptance of innovations, such as evidence-based practices. Transformational leadership inspires and motivates followers, whereas transactional leadership is based more on reinforcement and exchanges. Studies have shown that in youth and family service organizations, mental health providers' attitudes toward adopting an evidence-based practice are associated with organizational context and individual provider differences. The purpose of this study was to expand these findings by examining the association between leadership and mental health providers' attitudes toward adopting evidence-based practice.Methods-Participants were 303 public-sector mental health service clinicians and case managers from 49 programs who were providing mental health services to children, adolescents, and their families. Data were gathered on providers' characteristics, attitudes toward evidence-based practices, and perceptions of their supervisors' leadership behaviors. Zero-order correlations and multilevel regression analyses were conducted that controlled for effects of service providers' characteristics.Results-Both transformational and transactional leadership were positively associated with providers' having more positive attitudes toward adoption of evidence-based practice, and transformational leadership was negatively associated with providers' perception of difference between the providers' current practice and evidence-based practice.Conclusions-Mental health service organizations may benefit from improving transformational and transactional supervisory leadership skills in preparation for implementing evidence-based practices.There is growing momentum and pressure to move evidence-based mental health interventions into real-world practice settings (1-5). Most of these practice settings involve a relationship between a clinical or case management supervisor and practitioners who provide services. Often in community settings the clinical supervisor also supervises work activities, including conducting performance appraisals and other human resource functions. Leadership is important in these activities. Recent work has also demonstrated that mental health service providers' attitudes toward adopting evidence-based practice are associated with organizational context (for example, structure and policies) and individual provider differences (for example, education and experience) (6,7). Yet, although leadership is held to influence the adoption of innovations, such as evidence-based practices (8), there has been little research on the association between leadership of the mental health supervisor and staff attitudes toward adopting evidence-based practice. However, some more general leadership studies have been conducted.Leadership research is pervasive in the organizational literature, and studies in mental health services suggest that leadership is important for both for the organizational proces...

A utilização de instrumentos para avaliação da liderança nos serviços de saúde e enfermagem

“…Hence, instruments or tools, whose development is based on different leadership theories/models/styles, can be applied to evaluate leadership. The most abundant theoretical framework in the investigated manuscripts was transformational leadership: more than half the papers addressed this model (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(56)(57)(58) , which corroborates other studies (59)(60)(61)(62) . Transformational leadership is wide, visionary and charismatic, characteristics that made it one of the most popular in the present days.…”

“…in general, four with nurses and nursing technicians and a few described investigations with a mix of nurses and other professionals. Nineteen instruments were identified to evaluate leadership: Authentic Leadership Questionnaire (ALQ) (five papers) (51)(52)(53)(54)(55) ; Charismatic Leadership Socialized Scale (one paper) (39) ; Clinical Leadership Survey (CLS) (one paper) (25) ; the Coaching tool (two papers) (41)(42) ; Scale of attitudes toward leadership styles (one paper) (33) ; the 360º tool (one paper) (40) ; Global Transformational Leadership Scale (three papers) (56)(57)(58) ; Grid Gerencial (one paper) (43) ; Leadership Effectiveness and Adaptability Description (LEAD) (two papers) (49)(50) ; LMX-Leader-member Exchange (two papers) (46)(47) ; Leadership Practices Inventory (LPI) (six papers) (21)(22)(23)(24)(25)(26) ; Leadership Reward and Punishment Behavior Questionnaire (LRPQ) (one paper) (33) ; Multifactor Leadership Questionnaire (MLQ) (eleven papers) (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37) ; Multisource Feedback Tool (MSF) (one paper) (44) ; the Quantum tool (one paper) (38) ; Servant Leadership Questionnaire (SLQ) (one paper) (48) ; Servant Leadership Survey (SLS) (two papers) …”

“…The styles/models/theories of leadership found in the selected materials were: transformational leadership (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(56)(57)(58) , cited in 20 papers; transactional leadership (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37) , in 11 papers; situational leadership (41)(42)(49)(50) , in four papers; servant leadership (45)(46)48) , in three papers; authentic leadership (51)(52)(53)(54)(55) , in five papers; quantum leadership (38) , in one paper; charismatic leadership (39) , in one paper; and clinical leadership (25,44) , in two papers. Three studies did not mention a specific style/model/theory …”

“…This model was important in the instruments that evaluate leadership in health professionals; MLQ (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37) , which assesses transformational and transactional leadership, stood out as one of the most cited. Transactional leadership is characterized by exchange between leader and subordinate, who is rewarded for obeying (63) .…”

Who will guard the guards? Medical leadership and conflict of interest in South African healthcare

“…[1] There is a need for transformational medical leadership [2] that unifies followers, restores professionalism and takes back control of the direction and purpose of medical care.…”