The Ladder of Intervention

Changing the world isn’t easy.

Challenges are complex. People are complex.

Finding a point of leverage to start a transformation is non-trivial.

(quick note: this essay was originally published on my personal blog)

One model of systems change is the Ladder of Intervention, which I’ve adapted from the Nuffield Council on Bioethics from 2007. It’s a model that comes up often when I coach leaders on spending less energy leading.

The Nuffield Model was designed to help frame what Government, Industry and individuals could do to enable people to lead a healthy life and address issues like smoking and epidemic obesity but it can be applied to any complex systems change.

For example, as a public safety official, if you decide that obesity is a community challenge you want to address, you have choices: You can ban junk food, provide calorie information, and so on.

The Ladder of Intervention suggests that we can shift a system by forcing a change — eliminating choice and free will (like banning soda) or just by clarifying choices (like putting up signs with calorie counts).

Some options on the ladder are coercive…and this can have negative effects.

I recently got an email from a client who shared some subsequent research (PDF link) (2015) that builds upon the Nuffield Ladder (2007) by framing the steps in terms of the impact on perceived personal freedom and how that might affect engagement and outcomes. He said,

“It essentially reverses the direction of the ladder and adds +/- modifiers to the steps, acknowledging that the more paternalistic / enforced the method to drive change, the greater the negative impact on personal freedom.”

Mic dropped.

The Ladder of Intervention always reminds me of the power of changing the default choice people make (like making participation in a 401K retirement plan opt-out versus opt-in.) Shifting defaults can be helpful without being forceful.

escalating levels of intervention

As Helen Walls wrote in 2015:

“Less intrusive measures on the ladder could include provision of information about healthy and unhealthy foods, and provision of nutritional information on products (which helps knowledge be put into action). More effective than labelling is the signposting of healthier choices.

Taking a few steps up the ladder brings in ‘nudge’, a concept from behavioral economics. A nudge is any aspect of the choice architecture that alters people’s behavior in a predictable way without forbidding options or significantly changing economic incentives. Nudges are not mandates. Putting fruit at eye level counts as a nudge. Banning junk food does not.”

Knowledge, nudge, or nanny are not our only options if we want to lead a change.

THE POWER OF CHANGING THE DEFAULT

Recently, I tried to retweet an article that I hadn’t read. Twitter put some friction into the process and made me think before retweeting. In the language of the Nuffield Ladder, they provided information that clarified the choice. I could still retweet an article I hadn’t read — that choice hadn’t been eliminated. But they were pointing out, subtly, that retweeting without reading wasn’t an awesome choice.

There’s friction created to do something less awesome. The awesome choice (read the tweet and/or save for retirement) is made easy. The non-awesome choice is thus made less easy.

The prompt tells users that retweeting without reading isn’t a great idea.

STICKS OR CARROTS?

In leading teams and transforming culture, I take my inspiration from group dynamics. It’s hard work to make the extroverts talk less and the introverts talk more in a meeting or group working session. And if someone persistently over-talks, or is disruptive, we have to consider escalating our interventions: Are going to try and use a stick or a carrot to get people to behave as we want them to?

For example, if we have a Mr. X who’s being verbose what do we do?

“Guys, we’re running low on time…I need to hear from everyone, or this meeting will run over.”

(That’s just providing information…but in a “stick-ish” sort of way.)

“Excuse me, Mr. X, but you’re taking up a lot of the group’s time …”

(That’s trying to restrict choice after the fact)

ROUNDS, POPCORN, OR QUAKER MEETINGS

It’s much more powerful to shift the default structures…the sweet spot on the ladder of intervention (which I’ve colored green since I love that color and I love changing defaults!).

For example, if we had set up clearer rules for the conversation, we could remind Mr. X that they were violating them.

Simple turn-taking rituals can help balance participation and set up boundaries.

In my men’s group, we use popcorning to balance participation and slow down the cadence of heated conversations. When you pop a pot of popcorn, any kernel can pop whenever it wants, but it must pop and only once. In a popcorn conversation, each person gets to speak once on a key issue, whenever they like, no hand raising required. The whole group takes ownership of balancing the turn-taking.

Round-Robin conversations use seating order to determine speaking order. The conversation flows around a circle of people, and each person takes a turn. This mode can be faster than popcorning, since no one spends time deciding if they want to speak. On the downside, knowing you are going last isn’t always fun. Passing the baton can alleviate this issue. The current speaker chooses the next speaker, keeping everyone focused on distributing turn-taking.

These simple ritual patterns can refresh group conversations and ensure everyone is heard.

Rather than being the enforcer of the rules, we can make the rules clear, simple and egalitarian. Leading the group becomes something everyone is involved in. We’re not babysitting the group or forcing them to
”be good”…we are introducing simple norms (defaults!) that are simple and simply better.

SYSTEMS THINKING: CHANGING OUR MENTAL MODELS

I’ve written about the power of systems thinking and systems change in more depth here.

Round Robin Popcorning and Pass the Mic mechanically shift the rules of turn-taking…and changing the default mode of participation can be profound. But shifting the essential mental model of entire meeting is revolutionary. Take the Quaker meeting:

Quaker meetings ask that we “come with heart and mind prepared” and bring “neither a determination to speak nor a determination to remain silent.”

People only speak when the spirit moves them.

Those are more profound invitations. We might, in the Nuffield language, think about this as changing dynamics through changing incentives. From the Systems thinking approach, we are shifting the entire mental model of a meeting.

In a single meeting, or over time, we can react to a challenge with restricting or incentivizing change…or we can work to shift mental models and transform the default choice. Reacting is draining. Transformation takes time but is ultimately more durable change.

SHIFTING THE DEFAULT OF WHAT (OR: FINDING POINTS OF LEVERAGE)

Looking at your team as a system can allow you to step back and consider: what intervention will create the most durable, lasting change with the least effort? And when you are stepping in to make that change, what are you hoping to shift?

In short, what is your theory of change?

Going back to Nuffield and the perceived challenge of community obesity, it’s most likely that a suite of interventions will provide the shift we want to see.

Professor Susan Jebb from Oxford University was quoted as suggesting “we need a range of policy types, across the range of rungs on the ladder” if we want to transform a complex challenge. Signage, taxes, policies, education, etc. It’s a portfolio approach, based on what points of leverage you feel are most possible, relevant and potent.

Donella Meadows put together this lovely diagram of systemic leverage points, arranged in order of impact. Just like my diagram above, shifting the mental model, overall goals or paradigm of the whole system are most influential…yet, it’s challenging to shift those things directly, in a crisis point. So…

Donella Meadows’ 12 leverage points for a system

WHEN WILL YOUR INTERVENTION BE IMPACTFUL?

Adam Groves, Design Lead at The Children’s Society, suggested a “systems leverage map” to step back and rethink how we transform complex systems from a crisis-based reactivity, to a proactive, portfolio approach.

He integrated Donella Meadows’ 12 leverage points for a system with a chronological perspective — addressing causes before they become problems, as well as dealing with problems and deeper challenges as they arise — since it’s impossible to avoid a crisis.

One version of this Systems Leverage diagram is below. Read his full article here.

What would a systems leverage diagram look like for your team, your department, your culture…or your life!?

The ladder of intervention is a powerful mental model for finding the sweet spot in fostering change, balancing the energy you expend on the change and how much free will you remove from the system. Shifting the default patterns people work with is a great start, since it can stave off the challenge before it comes to a head.

Adam Groves Systems Leverage Map (see/download a larger version here)

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Daniel Stillman

Daniel Stillman

Host of theconversationfactory.com and @gothamsmith co-founder. Often riding bikes to the ocean.