Turn the CARES of Stage 0 into problems that can be solved

The relationship between you and your client is based on an assumption of need (Stage 0). You both believe that something is wrong with the status quo and you both are ready to work for something better. All too often, however, we accept this assumption of need without much further thought because we are eager to move on to "solutions." If you do not take the time to study and understand the current state of the system, your change efforts are likely to be misdirected-and disappointing in the long run. For this reason you and your client should pause, at the beginning of your relationship, and take a careful look at the system around you. This is what we mean by "examine." There needs to be a systematic attempt to understand the present situation. In medicine it is called "diagnosis," and we shall use that word here also.

 A good diagnosis is a description of the patient's problem, which includes the essential details of symptoms, history, and possible causes. Your client is the patient. You will probably begin this diagnostic stage with the client's "pain"-the system's feeling of need-as the most obvious fact. As you begin to work on diagnosis, however, you help the client to articulate that need: to describe the type of pain, to pinpoint its location, and to recall its origin. When diagnosis is com­plete, the original concern of Stage 0 should have been transformed into a defined problem stated in such a way that both you and your client can work rationally on its solution.

Stage 2: EXAMINE


With at least rudimentary relationships in place the change agent and his/her clients will be able to consider in more detail what the nature of the problem is, defining its elements and dimensions, considering what elements are most urgently crying out for change, and what elements are most likely to yield to a change effort. All these defining tasks can be grouped together under the term "diagnosis," following the medical analogy of a doctor's first approach to an ailing patient.