Case clinic
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This tool is intended for accessing the wisdom and experience of peers and helping a peer respond to an important and immediate leadership challenge in a better and more innovative way.

Description of the tool

Case Clinics guide a team or a group of peers through a process in which a case giver presents a case, and a group of 3-4 peers or team members help as consultants based on the principles of the U-Process and process consultation. Case Clinics take place online or in person (where physical distancing measures can be respected) and allow participants to generate new ways to approach a challenge or question. Principles to be followed: The case should be a leadership challenge that is current and concrete. The case giver needs to be a key player in the case. The participants in the case clinics are peers, so there is no hierarchical relationship among them. Don’t give advice; instead listen deeply.

Steps of application

How to use it? Set Up People & Place: Groups of 4-5 peers This activity can be conducted over videoconference. If social distancing measures allow, groups will benefit from meeting in person, with sufficient space to work without distractions Time: A minimum of 70 minutes is required Roles Case giver: Share your personal aspiration and leadership challenge that is current, concrete, and important, and that you happen to be a key player in. You should be able to present the case in 15 min and the case should stand to benefit from the feedback of your peers. Include your personal learning threshold (what you need to let-go of and learn). Coaches: Listen deeply—do not try to “fix” the problem, but listen deeply to the case giver while also attending to the images, metaphors, feelings and gestures that the story evokes in you. Timekeeper: One of the coaches manages the time. Sequence FIRST (2 min) Select case giver and time keeper SECOND (15 min) Intention statement by case giver Take a moment to reflect on your sense of calling. Then clarify these questions: Current situation: What key challenge or question are you up against? Stakeholders: How might others view this situation? Intention: What future are you trying to create? Threshold: What do you need to let-go of –and what do you need to learn? Help: Where do you need input or help? Coaches listen deeply and may ask clarifying questions (don’t give advice!) THIRD (3 min) Stillness Listen to your heart: Connect with your heart to what you’re hearing. Listen to what resonates: What images, metaphors, feelings and gestures come up for you that capture the essence of what you heard? FORTH (10 min) Mirroring: Images (Open Mind), Feelings (Open Heart), Gestures (Open Will) Each coach shares the images/metaphors, feelings and gestures that came up in the silence or while listening to the case story. Having listened to all coaches, the case giver reflects back on what they heard. FIFTH (20 min) Generative dialogue Reflect together on the remarks of the case giver, and move into a generative dialogue on how these observations can offer new perspectives on the case. Go with the flow of the dialogue. Build on each other’s ideas. Stay in service of the case giver without pressure to fix or resolve their challenge. SIXTH (8 min) Closing remarks By coaches By case giver: How do I now see my situation and way forward? Acknowledgment: An expression of genuine appreciation to each other. SEVENTH (2 min) Individual journaling to capture the learning points


This tool is one of the central practices in the context of the U-process. Building upon two decades of action research at MIT, the process shows how individuals, teams, organizations and large systems can build the essential leadership capacities needed to address the root causes of today’s social, environmental, and spiritual challenges. It contributes to updating the operating code in our societal systems through a shift in consciousness from ego-system to eco-system awareness. U-theory lays on seven leadership capabilities to navigate a transformational journey: Holding the Space of Listening Observing Sensing Presencing Crystallizing Prototyping Co-Evolving This tool is to be used along the whole process presented in the Prefigurating Utopia framework.

Context of origin

Visual representation


Presencing Institute webpage



Otto Scharmer CC BY-SA 3.0 @Presencing Institute