Julian Randall

Heriot-Watt University, Edinburgh business school, Faculty Member

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Following a successful career in management consultancy I embarked on a part-time PhD at the University of St Andrews. I was invited to lecture on MBA courses and subsequently became Director of Postgraduate Courses at St Andrews and Aberdeen Universities.I have combined teaching with consultancy, working with:The Crown Agents (Senior management development programmes)Ward White (Retail management development programmes)HM Customs and Excise (Management development and change programmes).My work has enabled me to pursue research with my clients in the management of change and internal change agency.My work has been published in Organization Studies

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Papers by Julian Randall

Issues and Challenges of HIV/AIDS Prevention and Treatment Programme in Nepal

Global Journal of Health Science, 2009

This paper explores some of the key issues and challenges of government HIV/AIDS prevention and t... more This paper explores some of the key issues and challenges of government HIV/AIDS prevention and treatment programme in Nepal. Providing HIV/AIDS prevention and treatment services in Nepal is associated with a number of issues and challenges which are shaped mostly on cultural and managerial issues from grass root to policy level. Numerous efforts have been done and going on by Nepal government and non-government organization but still HIV prevention and treatment service is not able to reach all the most at risk populations because cultural issues and managerial issues are obstructing the services. The existing socio-cultural frameworks of Nepal do not provide an environment for any safe disclosure for person who is HIV infected. Thus, there is an urgent need to address those issues and challenges and strengthen the whole spectrums of health systems through collaborative approach to achieve the millennium development goals. It will be the purpose of this paper to contribute to the policy makers by exploring the pertinent issues and challenges in the HIV/AIDS programme.

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Barriers to and Facilitators of Antiretroviral Therapy Adherence in Nepal: A Qualitative Study

Journal of Health, Population and Nutrition, 2013

Patient's adherence is crucial to get the best out of antiretroviral therapy (ART). This study ex... more Patient's adherence is crucial to get the best out of antiretroviral therapy (ART). This study explores in-depth the barriers to and facilitators of ART adherence among Nepalese patients and service providers prescribing ART. Face-to-face semi-structured interviews were conducted with 34 participants. Interviews were audiotaped, transcribed, and translated into English before being analyzed thematically. ART-prescribed patients described a range of barriers for failing to adhere to ART. Financial difficulties, access to healthcare services, frequent transport blockades, religious/ritual obstacles, stigma and discrimination, and sideeffects were the most-frequently discussed barriers whereas trustworthy health workers, perceived health benefits, and family support were the most-reported facilitators. Understanding barriers and facilitators can help in the design of an appropriate and targeted intervention. Healthcare providers should address some of the practical and cultural issues around ART whilst policy-makers should develop appropriate social policy to promote adherence among ART-prescribed patients.

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In what way do Nepalese cultural factors affect adherence to antiretroviral treatment in Nepal?

Health Science …, 2011

Individuals' self administration of medication is an essential component of disease management be... more Individuals' self administration of medication is an essential component of disease management because incorrect and incomplete medication can result in increased morbidity, mortality and healthcare costs and also spreads drug resistance. Its impact is necessarily wider than just medical and includes the cultural and managerial considerations which govern success in medical interventions. This review paper is aimed at how Nepalese cultural factors (beliefs, religious practices, customs and traditions) may affect adherence to antiretroviral (ARV) medication among people living with Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). Results: Cultural factors (individual beliefs and perceptions) are notoriously complex concepts and shape people's identities and influence their attitude and behaviours. The individual behaviours and beliefs about health and seeking treatment can adversely affect health care utilization and adherence to medication. These factors create a complicated and unforgiving environment for patients who are struggling to endure a chronic, life-threatening illness with life-long treatment. We cannot disregard patients' cultural beliefs or practices in order to provide ARV treatment and their adherence because patients and clinicians come from different cultural groups. Conclusion: It is the purpose of this paper to contribute to the policy makers by exploring the pertinent cultural factors relating to the uptake of ARV treatment and its adherence.

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Organizational control & the Catholic Church: a case study

This paper presents an analysis of the problem of child-abusing priests in the Catholic Church us... more This paper presents an analysis of the problem of child-abusing priests in the Catholic Church using data from the USA, UK and Ireland. The apparent scale of this issue raises crucial theoretical as well as policy issues. This paper explores various organizational explanations, linking it to traditional methods of 'confessional control' of organizational members. This is a novel concept which brings the issue into a wider organizational lens. Confessional control creates a series of guilt-laden identities that serve to maintain hierarchical control as well as social inclusion. Thus the process of recycling priests was part of a long-persisting pattern applied to child abuse cases. The theoretical implications of this are explored. The data consists of a series of cases across the three countries, partly drawn from a data-base of 4,000 alleged cases.

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Change in Practice: Surprise and Sense Making

Management Consultancy: The Role of the Change Agent

When Institutional Logics Collide: Reinforcing Dominance in a Merged Government Department

Journal of Change Management, Jun 1, 2013

Institutional logics have been the focus of researchers' interest as a means of comparing and... more Institutional logics have been the focus of researchers' interest as a means of comparing and contrasting groups within organizations and their influence and impact on each other. The findings often suggest that these groups may collaborate, compete, comingle or coexist. The interest for researchers is how such interaction between logics takes place and what the final outcome of their interaction is. But not all logics compete or collaborate in the ways suggested. This article examines how one logic dominates to the detriment of another during a merger between two government departments. Two questions underlie this research into merging institutional logics: how does a logic uphold its dominance when confronted by an alternative or competing logic and what is the wider influential institutional context?

and Singapore) ‘I Don’t Know What I’m Doing, How About You?’: Discourse and Identity in Practitioners Dealing with the Survivors of Childhood Sexual Abuse

Abstract. This research is based on interviews conducted with a voluntary group of health practit... more Abstract. This research is based on interviews conducted with a voluntary group of health practitioners who care for the adult survivors of childhood sexual abuse in one area of Scotland. This project takes a broadly interpretive approach to the interviews, and examines the processes of sense-making apparent in the scripts of the doctors, community nurse and counsellors who comprise this voluntary Forum. Those interviewed were highly sceptical of traditional medical approaches to dealing with survivors of such abuse, and they all questioned the effectiveness of expert professional knowledge. The research highlights the role of patient disclosure as a key mechanism in the process of their treatment, which is akin to the confessional technology discussed in detail in the work of Michel Foucault. Combined with other medical technologies patient disclosure is revealed as a technique of normalization. In this particular case the experts themselves were engaged in unravelling this process...

Management consultancy and change

Institutional Logics and Contradictions: Competing and Collaborating Logics in a Forum of Medical and Voluntary Practitioners

Journal of Change Management, 2010

Institutional logics and professional change has challenged researchers to identify in micro term... more Institutional logics and professional change has challenged researchers to identify in micro terms the empirical evidence for change in day-to-day working practices and professional practices. This lack of evidence is not made any easier by the professional boundaries which can bedevil openness between professionals, even where they may be working in the same teams. Nowhere is this clearer than among medical teams where it is accepted that professional knowledge is to be defended from outsiders and where treatment of patients ...

I Don't Know What I'm Doing, How About You?': Discourse and Identity in Practitioners Dealing with the Survivors of Childhood Sexual Abuse

Organization, 2007

This research is based on interviews conducted with a voluntary group of health practitioners who... more This research is based on interviews conducted with a voluntary group of health practitioners who care for the adult survivors of childhood sexual abuse in one area of Scotland. This project takes a broadly interpretive approach to the interviews, and examines the processes of sense-making apparent in the scripts of the doctors, community nurse and counsellors who comprise this voluntary Forum. Those interviewed were highly sceptical of traditional medical approaches to dealing with survivors of such abuse, and they all questioned the effectiveness of expert professional knowledge. The research highlights the role of patient disclosure as a key mechanism in the process of their treatment, which is akin to the confessional technology discussed in detail in the work of Michel Foucault. Combined with other medical technologies patient disclosure is revealed as a technique of normalization. In this particular case the experts themselves were engaged in unravelling this process in search...

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Foucault’s Care of the Self: A Case from Mental Health Work

Organization Studies, 2010

This research concerns mental health workers who treat the victims of sexual abuse. The health wo... more This research concerns mental health workers who treat the victims of sexual abuse. The health workers were all part of a forum composed of doctors, counsellors and a community psychiatric nurse, who met to discuss issues of best practice in their everyday work. The research examined how these workers make sense of their work, particularly in terms of how they understand the concept of care and the kinds of knowledge that they use in their work, professional and otherwise. A great deal of scepticism was expressed concerning the traditional medical approaches to caring for the victims of abuse, and as a consequence these practitioners developed pragmatic and exploratory approaches to caring in order to help their clients. Many important similarities exist between the accounts given by the medical and voluntary practitioners of this forum and the insights of Michel Foucault’s genealogical studies of medicine, particularly his analysis of processes of normalization and his later work o...

Understanding employee attitudes to change in longitudinal perspective

Qualitative Research in Organizations and Management: An International Journal, 2015

Purpose – The purpose of this paper is twofold: to understand how and why employee attitudes to c... more Purpose – The purpose of this paper is twofold: to understand how and why employee attitudes to change might change over time; and to demonstrate what type of research might best capture this change. Design/methodology/approach – The paper brings together three studies of the same organization, conducted at different times by the same researchers. Findings – Employee attitudes to change in the three episodes are portrayed in terms of the assumptions that seem to underpin them. The first episode is characterized by a challenge to the basic assumptions employees have about their work; the second, by a fragmentation of assumptions according to sub-group; and the third, by the confirmation of a new set of assumptions about what work involves. Research limitations/implications – The paper concludes that fieldwork of a longitudinal nature is something quite rare, and its incorporation into research design needs to move beyond dealing with it through an uneasy combination of retrospection ...

Changing attitudes to employee attitudes to change

The Routledge Companion to Organizational Change, 2011

When Institutional Logics Collide: Reinforcing Dominance in a Merged Government Department

Journal of Change Management, 2013

Ambiguity and ambivalence

Journal of Organizational Change Management, 2008

PurposeImposed change at work can present individuals with ambiguous events about which they expe... more PurposeImposed change at work can present individuals with ambiguous events about which they experience ambivalence in their interpretation of meaning. This paper seeks to examine the dimensions of ambivalence as defined by Piderit among a group of managers in the public sector.Design/methodology/approachThe research is based on a group of 20 Band 11 senior managers responsible for collecting tax and between them covering the UK in a business restructured into a large business group. The authors adopted a qualitative approach involving semi‐structured interviews seeking to uncover individual accounts of imposed change, allowing subjects to reflect on their experience of change and its meaning to them.FindingsThe findings suggested that long‐service civil servants and private sector managers draw on their previous experience to interpret the changes they experience, giving rise to different perceived ambiguity between rhetoric and reality. Each group either comes to terms with ambigu...

Ambiguity and ambivalence: organizational change in government departments

The way in which workers and managers interpret change at work has been an important focus of int... more The way in which workers and managers interpret change at work has been an important focus of interest for researchers. This interpretation may find them assimilating change as they listen to accounts from other workers experienced in the outcomes of such events. On the other hand, there may be a divergence among workers concerning the value and meaning to be ascribed to the change events. If this is the case, a culture of ambiguity may be said to exist, where the nature, degree and value of the cultural change are highly contested and remarkably unclear (McLoughlin et al;., 2005). Following Piderit (2000), this paper suggests this may explain the disparity between an individual's expectancy of change and their response to it, and also that, individuals' ambivalence may influence whether they accept change, adapt to it, or reject it out-of-hand,. We show how different dimensions of ambivalence in different individuals can lead not only to different responses to imposed change at work, but can also account for individuals coming to terms with the demands of change. INTRODUCTION: AMIGUITY AND AMBIVALENCE How individuals respond to change can be complex. Whilst an individual may welcome the imposed changes in theory, in practice they may find its implementation uncongenial. Such variance of response is sometimes referred to as ambivalence. Ambivalence, it is suggested here, involves differences across the cognitive,

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Issues and Challenges of HIV/AIDS Prevention and Treatment Programme in Nepal

Global Journal of Health Science, 2009

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Barriers to and Facilitators of Antiretroviral Therapy Adherence in Nepal: A Qualitative Study

Journal of Health, Population and Nutrition, 2013

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In what way do Nepalese cultural factors affect adherence to antiretroviral treatment in Nepal?

Health Science …, 2011

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Organizational control & the Catholic Church: a case study

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Change in Practice: Surprise and Sense Making

Management Consultancy: The Role of the Change Agent

When Institutional Logics Collide: Reinforcing Dominance in a Merged Government Department

Journal of Change Management, Jun 1, 2013

and Singapore) ‘I Don’t Know What I’m Doing, How About You?’: Discourse and Identity in Practitioners Dealing with the Survivors of Childhood Sexual Abuse