Transformational Leadership and the Mental Health Team

Administration and Policy in Mental Health, Vol. 30, No. 2, November 2002 ( 2003)

TRANSFORMATIONAL LEADERSHIPAND THE MENTAL HEALTH TEAM

Patrick W. Corrigan, Sarah Diwan, John Campion,and Fadwa Rashid

ABSTRACT: Bass’s (1990) multifactor model contrasts transformational and transactionalstyles of leadership with an essentially ineffective style: laissez-faire leadership. This studyexamines the relationship between these leadership styles and measures of organizationalculture and staff burnout in mental health services teams. There were 236 leaders and 620subordinates from 54 mental health teams who provided their perceptions of leadershipstyle, organizational culture, and burnout in their program. Results show transformationalleadership to be positively associated with a cohesive organizational culture and negativelyassociated with burnout. Moreover, leaders and subordinates differ in their ratings of trans-formational leadership—leaders viewed themselves more positively. These findings arehelpful for understanding the central role of leaders in the organizational structure ofteams.

KEY WORDS: leadership; program development; teamwork.

Mental health and psychiatric rehabilitation programs have a significantimpact on the lives of persons with severe and persistent mental illness(Bachrach, 1992; International Association of Psychosocial RehabilitationServices, 1994; Liberman, 1992). These programs typically rely on interdis-ciplinary teams to provide services. Teams that work well together providebetter quality services to their clientele (Corrigan & McCracken, 1995;

Patrick W. Corrigan, Psy.D., is a Professor of Psychiatry and the Executive Director of the Universityof Chicago Center for Psychiatric Rehabilitation. Sarah Diwan, Ph.D., is the Director of Research; JohnCampion, B.A., is a Research Assistant; and Fadwa Rashid, B.A., is a Research Assistant; all at theUniversity of Chicago Center for Psychiatric Rehabilitation.This project was made possible, in part, by a grant from the U.S. Department of Education

(H263A50006).Address for correspondence: Patrick Corrigan; University of Chicago Center for Psychiatric Rehabil-

itation; 7230 Arbor Drive; Tinley Park, IL 60477. E-mail: [email protected].

2003 Human Sciences Press, Inc.97

98 Administration and Policy in Mental Health

Yank, Barber, Hargrove, & Whitt, 1992). Effective leaders are essential forteam members to function well (Sluyter, 1995).Organizational psychologists have researched a variety of models for un-

derstanding leadership. A particularly useful theory to arise out of thiswork is the multifactor model of leadership (Bass, 1985, 1990; Bass & Yam-marino, 1991; Hater & Bass, 1988; Yammarino & Bass, 1990). This modeldistinguishes two factors relevant to the effective leader: (1) transforma-tional leadership: effective leaders help team members who are subordi-nates to transform programs to meet the ever-evolving needs of theirclientele, and (2) transactional leadership: effective leaders attend to theday-to-day tasks, which subordinates need to complete so the program canoperate effectively. Transformational goals are achieved through charisma,inspiration, intellectual stimulation, and individual consideration of staffinterests. Transactional goals are achieved through contingent reward andmanagement-by-exception (responding to organizational issues only whenthey arise as a problem, or an “exception” to standard practices). Manage-ment-by-exception may be active (where the leader seeks out exceptionsand responds appropriately) or passive (where leaders respond only whenexceptions are obvious). These effective styles are contrasted to what hasbeen a fundamentally ineffective approach: laissez-faire leadership. The lais-sez-faire leader remains aloof, uninvolved, and disinterested in the day-to-day activities of the treatment team. (For the remainder of this article, wedistinguish team members who are leaders [i.e., have supervisory responsi-bility] from team members who are subordinates.)

The ineffective laissez-faire leadership style is characterized by a leaderwho remains aloof, uninvolved, and disinterested in the day-to-day ac-tivities of the treatment team.

The multifactor model was originally developed in business and militarysettings. Two subsequent studies, involving more than 1,000 staff membersworking in mental health settings, showed that independent groups ofmental health (Corrigan, Garman, Lam, & Leary, in press) and rehabilita-tion staff (Corrigan, Garman, Canar, & Lam, in press) identified leader-ship factors that paralleled the transformational and transactional distinc-tion. The purpose of the study reported in this article is to determine therelationship between transformational/transactional styles of leadershipand mental health team functioning. We expect to show that teams withleaders using transformational and transactional styles will show betterfunctioning.Team functioning was evaluated in this study by examining staff percep-

99Patrick W. Corrigan, Sarah Diwan, John Campion, and Fadwa Rashid

tions about organizational culture and individual burnout. Organizationalculture reflects a set of mutually acceptable and important beliefs held bya cohesive program staff. Like the multifactor model of leadership, thesebeliefs may be transformational (reflecting a perceived sense of purposeand a feeling of family) and/or transactional (reflecting explicit and im-plied contractual relationships among staff) (Bass & Avolio, 1993a). Thisdichotomous model of organizational culture would seem to neatly corre-spond with the transformational/transactional leadership styles; hence,significant correlations should be found between transformational leader-ship and transformational culture as well as transactional leadership andtransactional culture. However, research suggests transformational leader-ship augments transactional leadership; namely, transactional leadershipoccurs effectively only when a transformational style is in place first(Bass & Avolio, 1993a; Bass & Yammarino, 1991). Given its augmentingeffect, transformational leadership is expected to yield greater correlationswith organizational culture than transactional leadership.The second way that team functioning was assessed in this study was

through staff burnout. Earlier research suggests that burnout is signifi-cantly lower when teams have effective leaders (Wilcoxon, 1989; Seltzer &Numerof, 1988). Hence, we expect to find that transformational leader-ship leads to a greater sense of personal accomplishment and diminishedburnout.A leader’s style depends on the eye of the beholder; a leader’s own per-

ceptions of his or her style may vary from perceptions of the subordinates.Hence, in this study, we contrast leader and subordinate perceptions ofleadership style. In particular, we will examine the correlations of leader-ship and team functioning within leader and subordinate groups as well asbetween groups.

METHOD

As part of a large, multi-year investigation of factors that enhance leader-ship, 54 teams providing services to persons with severe and persistentmental illness participated in the Midwest Mental Health Team LeadershipStudy. These teams worked in state hospitals and community mentalhealth programs and ranged in numbers of staff members from 9 to 41.Data were collected from two levels of participants as part of this study:team leaders, providing perceptions of the organization and their leader-ship style; and subordinates, rating the leader and organizational culture.Team leaders in this study were defined as individuals who have directresponsibility for supervising a group of staff members who provide clini-


cal or rehabilitation services to persons with severe mental illness. Thisexcludes administrators and persons who lead ancillary services. Subordi-nates were limited to the group of staff members who provide direct clini-cal or rehabilitation services.

Data Provided by Leaders

Data were provided by 236 leaders from these 54 teams; this representsa response rate of 70.0%. Most teams had more than one leader; theseleaders commonly included a lead psychiatrist, charge nurse, and clinicalmanager. The leader sample was, on average, 46.2 years old (SD=9.3) and69.8% female. In terms of ethnic background, the sample was 82.2% Euro-pean American; 7.0% African American; 0.5% Latino; and 10.3% other,which included Asian American and Native American. They had diverseeducational backgrounds: high school, 6.4%; some college, 15.4%; associ-ate’s degree, 21.8%; bachelor’s degree, 21.8%; master’s degree, 21.3%; anddoctoral degree, 13.3%. On average, leaders worked 12.5 years in the field(SD=9.5). Each leader completed three measures that assessed perceptionsof their leadership style, organizational culture, and level of burnout.

The Multifactor Leadership Questionnaire. Leaders were instructed to rate 44items representing leadership skills according to “how you think your sub-ordinates view you” (Bass & Avolio, 1993a). Items were rated on a 5-pointfrequency scale (1=frequently if not always, 5=not at all); lower scores rep-resent greater endorsement of the scale’s construct. The Multifactor Lead-ership Questionnaire (MLQ) has been widely investigated and shown tohave excellent internal consistency, test-retest reliability, and construct va-lidity (Bass & Avolio, 1993a). Results of factor analyses have shown thatthe test yields eight reliable factors. Four factor scales represent transfor-mational leadership: charisma, inspiration, intellectual stimulation, and in-dividualized consideration. Three scales comprise transactional leadership:contingent reward, active management-by-exception, and passive manage-ment-by-exception. The final factor represents laissez-faire leadership.

Organizational Description Questionnaire. Leaders completed the Organiza-tional Description Questionnaire (ODQ) to describe their program’s cul-ture. The ODQ comprised 28 items (e.g., “People are hesitant to say whatthey really think.”) that were to be answered as “true,” “false,” or “can’tsay” (Bass & Avolio, 1993b). Leaders were supposed to answer these itemsin relation to “the team you are leading.” These items are summed togenerate two reliable and valid scores: the Transformational Culture Scoreand the Transactional Culture Score. Higher scores represent greater en-dorsement of a cohesive and positive culture.

Maslach Burnout Inventory. Leaders reported their level of burnout usingthe Maslach Burnout Inventory (MBI), a 22-item self-report measure that


assesses burnout in human service professions (Maslach & Jackson, 1986).Research participants rated the frequency with which they experiencedjob-related stressors on a 7-point Likert Scale (7=highly agree). Prior analy-sis of the MBI has uncovered three reliable and valid factors, which areincluded in this study: emotional exhaustion (e.g., “I feel emotionallydrained from work.”), depersonalization (e.g., “I feel I treat some of theconsumers as if they were impersonal objects.”), and personal accomplish-ment (e.g., “I feel exhilarated after working closely with my consumers.”).

Data Provided by Subordinates

In this study, 620 subordinates from the 54 teams participated. Teamswere included in the study if at least five subordinates from the team pro-vided useable responses. All subordinates had to provide useable re-sponses if the team comprised less than five members; 85.2% of teams metthis criterion. Their age (M=41.6 years, SD=11.4) and gender (71.3% fe-male) were not significantly different from the group of leaders (p>.10)nor did they differ significantly in ethnic backgrounds from leaders: thesubordinate sample was 80.6% European American, 13.2% African Ameri-can, 1.6% Latino, and 4.6% other. Overall educational levels were signifi-cantly lower in subordinates compared with leaders (p<.001): high school,24.3%; some college, 30.6%; associate’s degree, 16.0%; bachelor’s degree,15.0%; master’s degree, 0.8%; and doctoral degree, 0.2%. Subordinatesalso worked in the field for a significantly shorter time (p<.05) than leaders(M=8.1 years, SD=7.3). In terms of specific positions, subordinates were66.5% nurses/technicians/aides, 31.2% psychologists/social workers, or2.3% other.Subordinates provided their perceptions about the quality of their lead-

ers, organizational culture, and level of burnout. They were given the fol-lowing questionnaires: the MLQ, and they were instructed to rate individ-ual items in terms of “how frequently it fits your supervisor”; the ODQ,and they were instructed to complete it about the “program you work in”;and the MBI, and they were told to complete it about themselves.

Data Analysis

Two sets of analyses, using different units of analysis, were completedto examine the hypotheses of this study. In the first analyses, correlationsamong leadership, organizational culture, and staff burnout measureswere separately examined within team leader groups and subordinategroups. Analyses represented the relationship between leader MLQ self-ratings and their ratings of organizational culture and self-burnout. Analy-ses also summarized subordinate ratings of their leaders’ MLQ scores, or-ganizational culture, and self-burnout. Hence, the individual team leader


or subordinate was the unit of analysis; statistical tests had good power(N=236 and 620 for leader and subordinate groups, respectively).In the second analyses, correlations among leadership, organizational

culture, and staff burnout measures were examined between groups of teamleaders and groups of the corresponding subordinates. The unit of analy-sis for these tests was the average leader or average subordinate score foreach team (N=54). This process makes conceptual sense because mosttreatment teams are run by a group of leaders whose decisions are experi-enced jointly by staff (Avolio & Bass, 1995; Yammarino & Bass, 1991).These analyses assume that group mean values of leader and subordinatescores parallel the distribution of individual leader and subordinate scores.This assumption is supported because the matrix of within-group correla-tions based on individual scores was similar to that of the aggregatedgroup means.

RESULTS

Within-Group Correlations Among Leadership, Organizational Culture, and Burnout

Table 1 lists the correlation coefficients between MLQ scores and scoresfrom the ODQ and MBI. These coefficients are listed separately for lead-ers and subordinates. A more conservative alpha (p<.01) was used to inter-pret these coefficients to avoid a Type I error.Interesting correlations were found between MLQ and ODQ scores. For

leaders, the transformation score from the ODQ was found to be signifi-cantly associated with three scores representing transformational leader-ship on the MLQ: Inspiration (r=−.35), Individualized Consideration(r=−.24), and Charisma (r=−.22). Hence, leaders who viewed themselvespositively in transformational leadership also saw their organizational cul-ture as cohesive and transformational. Moreover, leaders who rated them-selves as laissez-faire leaders did not view their organizational culture astransformational (r=.23). Interestingly, only one significant association wasfound between the ODQ transaction score and the MLQ factors: Inspira-tion (r=.23).A similar pattern was found for subordinates. Subordinates who pro-

duced high ODQ transformation scores viewed their leaders as charis-matic (r=−.50), inspiring (r=−.52), intellectually stimulating (r=−.47), andindividually considerate (r=−.51). Those subordinates with high ODQtransformation scores also viewed their leaders as unlikely to be laissez-faire (r=.22) and unlikely to use passive management-by-exception (r=.25).Subordinate data also yielded surprising findings between the ODQ

transaction score and MLQ factors. Subordinates who viewed their cultureas highly transactional were less likely to rate their leaders as charismatic


TABLE1

Within-GroupCorrelationsforScoresProvidedbyLeadersandbySubordinates

MultifactorLeadershipQuestionnaireRatingsProvidedbyLeaders

Intel

Indiv

Con

Act

Pass

Laissez-

CharismaInspire

Stim

Con

Rew

MBE

MBE

Faire

OrganizationalDescriptionQuestionnaire—

Leaders

Transformation

−.22*

−.35***

−.17

−.24*

−.12

−.11

.13

.23**

Transaction

.12

.23*

.06

.03

.15

−.01

−.09

−.09

MaslachBurnoutInventory—Leaders

EmotionalExhaustion

.23*

.19

.16

.13

.02

−.01

−.15

.01

Depersonalization

.24**

.24**

.15

.22*

−.05

−.01

−.33***

−.19

PersonalAccomplishment

−.22*

−.37***

−.26***

−.24**

.04

.01

.20

.17

MultifactorLeadershipQuestionnaireRatingsProvidedbySubordinates

Intel

Indiv

Con

Act

Pass

Laissez-

Charisma

Inspire

Stim

Con

Rew

MBE

MBE

Faire

OrganizationalDescriptionQuestionnaire—

Subordinates

Transformation

−.50***

−.52***

−.47***

−.51***

−.36***

−.14

.25***

.22***

Transaction

.23***

.22**

.20**

.24***

.14

−.06

−.29***

−.15

MaslachBurnoutInventory—Subordinates

EmotionalExhaustion

.24***

.23***

.15

.23***

.12

.03

−.09

−.08

Depersonalization

.15

.13

.07

.11

.08

.08

−.06

−.03

PersonalAccomplishment

−.14

−.21**

−.20**

−.17*

−.17*

−.05

.17*

.09

Note.LowMLQscoresrepresentendorsementofthecorrespondingconstruct.Inspire:Inspiration;IntelStim:Intellectualstimulation;IndivCon:Individual-

izedconsideration;ConRew:Contingentreward;ActMBE:Activemanagement-by-exception;PassMBE:Passivemanagement-by-exception;Laissez-Faire:

Laissez-faireleadership.

*p

<.01.**p

<.001.***p

<.0001.


(r=.23), inspiring (r=.22), intellectually stimulating (r=.20), and individuallyconsiderate (r=.24). Viewing leaders as passive management-by-exceptionwas associated with higher ratings of transactional culture. This trend sug-gests an inverse relationship between transformational and transactionalcultures.The group of leaders showed a clear pattern of correlations between

leadership and burnout. Each of the four transformational leadershipscales was positively associated with personal accomplishment assessed onthe burnout scale. Moreover, Depersonalization on the MBI was inverselyassociated with Charisma, Inspiration, and Individualized Consideration.Subordinates showed somewhat similar results: Emotional Exhaustion wasinversely related to viewing the leader as charismatic, inspiring, and indi-vidually considerate.

Differences in Leader and Subordinate Ratings of MLQ

Table 2 summarizes the means and standard deviations of MLQ ratingsfor the leader and subordinate groups. The leader statistics represent self-ratings. Subordinate scores represent perceptions of their leader. These

TABLE 2Differences in Multifactor Leadership Questionnaire Ratings

Across Groups

Leaders Subordinates

Factor M SD M SD F Tests

Charisma 26.0 7.2 26.1 6.7 F(1, 53)=0.00, n.s.Inspiration 8.8 2.2 8.9 1.8 F(1, 53)=0.08, n.s.Intellectual stimulation 8.5 1.5 9.2 2.0 F(1, 53)=4.83, p<.05Individualizedconsideration 6.2 1.4 7.3 2.0 F(1, 53)=11.5, p<.01

Contingent reward 13.2 3.6 13.5 2.5 F(1, 53)=0.37, n.s.Active management-by-exception 9.9 2.3 9.1 1.5 F(1, 53)=5.14, p<.05

Passive management-by-exception 15.5 2.2 14.2 1.7 F(1, 53)=9.17, p<.01

Laissez-faire 15.5 1.8 13.6 1.9 F(1, 53)=29.8, p<.001

Note. Low Multifactor Leadership Questionnaire scores represent endorsement of the correspondingconstruct.


data have the team as the unit of analysis; they represent aggregated scoresof all leaders and all subordinates on a team.One-way ANOVAs showed that leaders tended to rate themselves more

positively than their subordinates. They viewed themselves as more intel-lectually stimulating and individually considerate. Leaders also viewedthemselves as less likely to use management-by-exception, both the activeand passive forms. Finally, leaders viewed themselves as less likely to belaissez-faire.

Correlations Between Leader Ratings of Their Leadership and Subordinate Ratings

Correlations between leader self-ratings and subordinate perceptionsare listed in Table 3. The diagonal list of correlation coefficients in boldrepresent the association between leader and subordinate on each MLQscale. Note that only two of the eight associations were significant. Subor-dinates tended to parallel leader ratings of intellectual stimulation andcontingent reward (p<.01). Contingent reward was also found to be in-versely related to three of the four transformational leadership scales; lead-ers who rated themselves high on contingent reward were likely to havesubordinates who viewed the leaders’ transformational scores as low.In support of the findings in Table 1 (the within-group associations), the

Transformational Score on the ODQ was correlated with two MLQ scores.Leaders who viewed their charisma and propensity for intellectual stimula-tion as high were likely to have subordinates who viewed their organiza-tional culture as transformational. No clear pattern of relationships wasfound between leader MLQ ratings and subordinate burnout.

DISCUSSION

The purpose of this study was to determine the relationship among mea-sures of transformational, transactional, and laissez-faire leadership andmeasures of organizational culture and burnout. Overall, results suggestclear correlates with transformational leadership for both leader and sub-ordinate samples, but not so with transactional or laissez-faire leadership.Moreover, leader and subordinate samples seemed to view leadershipqualities differently. These findings are more apparent when consideringspecific results.Leaders who viewed themselves as high in transformational leadership

also viewed their organizational culture as transformational and reporteda sense of personal accomplishment from work. Moreover, subordinateswho viewed their leaders as high in transformational qualities also re-ported diminished burnout and a more positive organizational culture.Transformational leadership seems to have an overall positive effect on


TABLE3

CorrelationsBetweenLeadershipVariablesandSubordinateVariables

MultifactorLeadershipQuestionnaireRatingsProvidedbyLeaders

Intel

Indiv

Con

Act

Pass

Laissez-

SubordinateVariables

Charisma

Inspire

Stim

Con

Rew

MBE

MBE

Faire

MultifactorLeadershipQuestionnaire

Charisma

.20

.40**

.09

−.32**

.18

.07

.16

Inspiration

.08

.07

.25*

.07

−.17

.20

.06

.10

Intellectualstimulation

.15

.00

.34**

.20

−.32**

.12

.10

.15

Individualizedconsideration

−.01

−.05

.15

.06

−.29*

.06

.09

.13

Contingentreward

.12

.04

.09

.16*

.40**

.00

−.13

.09

Activemanagement-by-exception

.22

−.19

.04

−.01

−.09

.07

.04

.17

Passivemanagement-by-exception

.01

−.03

−.01

.08

−.01

−.07

−.18

−.06

Laissez-faire

−.10

−.15

−.03

.12

−.12

−.23*

−.13

.01

OrganizationalDescriptionQuestionnaire

Transformation

−.27*

−.18

−.40*

−.21

.19

−.13

−.16

−.11

Transaction

.07

.11

.04

.02

−.10

.10

−.16

−.11

MaslachBurnoutInventory—Leaders

Emotionalexhaustion

−.03

−.05

.08

−.01

−.17

−.12

.02

.11

Depersonalization

.05

−.02

−.08

.03

−.26*

−.15

−.02

−.04

Personalaccomplishment

.11

−.01

.23*

.12

.04

−.16

−.24*

.11

Note.LowMultifactorLeadershipQuestionnairescoresrepresentendorsementofthecorrespondingconstruct.Inspire:Inspiration;IntelStim:Intellectual

stimulation;IndivCon:Individualizedconsideration;ConRew:Contingentreward;ActMBE:Activemanagement-by-exception;PassMBE:Passivemanage-

ment-by-exception;Laissez-Faire:Laissez-faireleadership.Thediagonallistofcorrelationcoefficientsinboldrepresenttheassociationbetweenleaderand

subordinateoneachMultifactorLeadershipQuestionnairescale.

*p

<.05.**p

<.01.


team functioning. Viewing oneself or one’s leader as charismatic, inspir-ing, intellectually stimulating, and individually considerate seemed to beassociated with positive views of the organization’s culture and lowburnout.

Transformational leadership seems to have an overall positive effect onteam functioning.

This kind of effect seems to be specific to transformational leadership.Laissez-faire leadership was found to be associated with low transforma-tional culture. Transactional leadership failed to show any clear associa-tions with organizational culture and burnout as reported by leaders orsubordinates.Despite similar within-group associations between transformational lead-

ership and team functioning variables, leaders and subordinates failed toview the quality of leadership on their teams similarly. Leaders tended torate themselves as more intellectually stimulating and individually consid-erate; they rated themselves as less likely to use management-by-exceptionand laissez-faire leadership. These results make sense; they support thenotion that people rate themselves in a more positive light than others.What is more disconcerting was the relative absence of significant correla-tion between leaders’ and subordinates’ ratings of the MLQ. Only two ofeight correlation coefficients representing leader and subordinate agree-ment on MLQ subscales were significant. These findings suggest that lead-ers and subordinates are viewing team leadership differently—leaders viewthemselves more positively.Future research is necessary to further examine the significant associa-

tion between leadership styles and measures of organizational culturefound in samples of leaders and subordinates participating in this study.These results do not suggest the direction of association. It is unclear fromthese results whether transformational leadership leads to positive cultureand diminished burnout or whether staff who are not burned out andwork in a positive culture are more likely to view themselves positively.Future research is needed to tease out these differences. Moreover, re-search should determine how these attitudinal measures relate to actualbehaviors. For example, does transformational leadership and positive cul-ture lead to better treatment practices by the team? Nevertheless, resultsfrom this study, if supported, have implications for training leaders. Trans-formational skills that seek to inspire and intellectually stimulate staffmembers seem to be more important for affecting the team than transac-tional skills.


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Transformational Leadership and the Mental Health Team