The leadership role can be demanding and depleting. Using self-regulation and social exchange theory as a framework, we developed a three-step sequential mediation model that explains how feelings of depletion can degrade leaders’ own performance level, via the reciprocating behavior of their employees. Specifically, we hypothesized that leader depletion is negatively related to their trust beliefs. This lack of trust is expected to be reciprocated by employees in such a way that they display less citizenship behaviors towards their leader. These lowered citizenship behaviors are, in turn, predicted to negatively impact leader performance. Additionally, we hypothesized that these negative effects of feeling depleted are more pronounced for leaders who believe that their willpower is limited. Studies 1 and 2 illustrated that leader depletion indirectly influences their own performance level through leaders’ trust beliefs and employees’ leader-directed citizenship behaviors. Study 3 extended these findings from the inter-individual to the intra-individual level, and demonstrated the predicted moderating role of belief in limited willpower. Together, our studies provide new and useful insights in the broader, more distal implications of leader depletion, which have not yet been considered in existing self-regulation models. When individuals feel depleted, they find it harder to plan and achieve their goals and, as a result, they may perform less well3. Within the literature, these types of depletion effects are commonly referred to as self-regulation failures5. One type of organization member who is particularly confronted with a demanding workload are organizational leaders. Indeed, those in leadership positions are frequently confronted with challenging and complex problems that put constraints on their finite pool of self-regulatory resources8, which makes them especially prone to self-regulation failures.Contemporary organizations are characterized by highly demanding environments. In such environments, members at all levels of the organization may feel that their resources are getting depleted10. Despite these insights, we argue that leader depletion can nonetheless harm leader performance, especially so as leaders’ role in their organization is socially embedded and many of their tasks are interdependent in nature and therefore require a certain level of cooperation with others (see13). Because of this embeddedness, we expect that leader depletion can indirectly harm leaders’ own performance level, and that this will happen through their interactions with their employees. Specifically, we develop the argument that leaders’ attitudes towards their employees as a result of feeling depleted shape a negative exchange relationship in which employees’ reciprocating behaviors will be detrimental to the performance of their leader.Although being a leader can be a demanding and depleting job, some prior research suggests that those in a leadership position are not always influenced by their decreased mental resources and that their performance level can remain unchangedIn explaining how leader performance can be negatively influenced by leaders’ own depletion level, via the reciprocating behavior of their employees, our model adopts a three-stage process. The first step of our model assumes that feelings of depletion will make leaders less willing to trust others. In a second step of our model, these negative trust beliefs are expected to be reciprocated by employees in such a way that they show decreased organizational citizenship behaviors towards their leader. The third step of our model assumes that, as an important downstream consequence, these lowered citizenship behaviors will undermine the leader’s own work progress. In addition, we also test a potential boundary condition of this model, as not all leaders are expected to be equally affected by a depleted state of mind. In this vein, we envision the predicted negative impact of leader depletion to be more pronounced for leaders who hold the belief that their willpower to exert self-control is a limited resource. Figure 14. As soon as an individual sets his or her goals, this internal management process is activated and continued throughout the goal pursuit process15. In order for this continuous internal management process to succeed, the individual needs to be able to exercise self-control and withstand distracting urges and temptations that could undermine the goal pursuit process. Of course, for an individual to effectively regulate this goal-pursuit process, he or she needs to have sufficient resources available to draw the necessary energy from. Specifically, if there is a discrepancy between one’s current performance level and one’s desired goals, then more energy needs to be devoted for improving the pursuit of one’s goals. An important assumption of self-regulation models, however, is that individuals can only draw mental energy from a limited and finite pool of resources5. These models assume that people’s energy levels are limited and, once those resources are depleted, people will feel mentally exhausted, which makes it harder to exert self-control and foster the internal management of one’s goal pursuit. In line with this assumption, a recent study reported that when leaders feel that their resources get depleted their capacity to engage in work is diminished6. Besides, it has been found that resource depletion at work also leads to higher levels of conflict at home16.Leaders face continuous pressure to uphold their own performance level. In doing so, leaders need to regularly assess whether discrepancies exist between their current level of performance and their expected goals. Self-regulation theories adopt a specific focus on how people can internally manage such a process at work18, Lanaj et al.19 aptly noted that prior research has “largely overlooked the fact that leaders have limited energy reserves” (p. 1). This lack of attention can at least in part be ascribed to the belief that leaders are simply more efficient in self-regulation and are effective in pursuing the tasks they want to achieve9. Moreover, prior research suggests that, because those in leadership positions are more powerful, their power base itself may buffer against the negative influence of feeling depleted, which enables them to still execute tasks and act under pressure10. Because of these two reasons, an understanding has grown in the literature that—while leaders can indeed feel depleted—this does not necessarily translate into lower levels of performance.Although organizational leaders are confronted daily with responsibilities which may pose a significant burden on their energy level20, p. 218). This means that leaders’ performance level not only depends on their own solitary actions, but primarily so on the help and support that they receive from their employees. This insight therefore implies that to examine whether and how depletion affects leader’s performance, we also need to examine how employees respond to the beliefs and behaviors of leaders—something that prior leadership depletion studies did not do. Indeed, although a substantive number of studies has examined how feelings of depletion may impact leaders’ behavior towards their employees ; these studies did not investigate how these employees subsequently react towards their depleted leader, and how those reciprocal actions of employees, in turn, may affect leader performance. To provide deeper insights in those broader, more distal effects of self-regulation failures, the present paper aims to investigate exactly that question. In examining this question, we rely on insights from social exchange theory and its application to self-regulation theory.Importantly, however, is that these prior studies did not consider fact that “leadership is an interpersonal process … in which each subordinate and leader exert mutual control and influence over one another and are mutually dependent”  and more likely to fail in resisting the temptation to engage in negative interpersonal behaviors . Finally, a recent study showed that leader depletion not only made leaders act in unethical ways, but also made their subordinates act in similar negative ways30.Earlier work into self-regulation has showed that, when people feel depleted they suffer from regulatory failures, which negatively affects their performance on a variety of cognitive, attention, intellectual, and physical performance tasks31, pp. 253–254), “leadership does not occur in a vacuum devoid of followers; rather, it is very much a group phenomenon where leader–follower dyads are often interdependent with each other.” This quote illustrates that leaders do not have absolute control over how well they perform; instead, they are also dependent on the contributions and the help others (such as their employees) provide them. For this reason, to provide a more complete picture of how leader depletion influences leaders’ own performance level, it is necessary to also examine how leaders’ depleted state of mind affects their interactions with their employees, and how those employees’ reciprocating reactions subsequently affect the depleted leader.From the above, it can thus be concluded that most prior depletion research either focused on what happens within the depleted individual him or herself  or how depletion affects the depleted individual’s reactions towards others . We argue that to fully understand the impact that a depleted state has on leader performance, we need to go one step further. Specifically, we argue that we need to examine more precisely how the intra-individual effects of depletion on a leader’s beliefs and attitudes influence how the interaction partners of the leader will respond, and how their interpersonal responses, in turn, affect leader performance. We make this argument because leadership is essentially a socially embedded construct. Or, to put it in the words of Day and Schyns  mediation model that articulates in detail through which pathway leader depletion can degrade their own performance level . Ample prior studies have found that the presence of trust is linked to a variety of positive outcomes, while its absence is associated with negative outcomes . To date, however, the existing literature has hardly investigated how trust-related beliefs are linked with depletion. One of the few studies that has been conducted so far concerns the experimental research of Righetti and Finkenauer38, who demonstrated that people are more willing to trust someone with good rather than poor self-control. The presumed reason is that trustors anticipate that trustees with good self-control will be able to resist the temptation to exploit them for short-term advantages. Ainsworth et al.39 further extended this analysis by arguing that just as (and because) trustees may be tempted to exploit, trustors may be tempted to distrust them. In other words, when the chances of being exploited loom, people may be inclined to withhold their trust. In that case, self-control can override the skepticism and enable a person to take the risky step of making oneself vulnerable to others39. But when people are depleted, they lack the self-control that is needed to deal with possible negative outcomes and are, as a result of this, more prone to avoid risky alternatives40. Or, to put it in the Unger and Stahlberg’s40 own words, depleted individuals are simply “too exhausted to take a risk” (p. 28), and are therefore expected to also be less willing to be vulnerable towards others. Thus, insofar as trust depends on self-control, it can reasonably be assumed that people will become less trusting of others when being in a state of depletion. In line with this reasoning, Ainsworth et al.39 found that depleted individuals offered their counterpart less money in the context of a trust game compared to those that were not depleted. As such, this study provides a first indication that feelings of depletion may not only negatively impact other people’s trust in the depleted individual, but also the depleted individual’s trust in other people. In the present paper, we put these experimental findings in an organizational context, and argue that feeling depleted will make leaders display negative trust expectations in their relationships with employees:Trust can be defined as “the willingness of a party to be vulnerable to the actions of another party based on the expectation that the other will perform a particular action important to the trustor, irrespective of the ability to monitor or control that other party”  and that contributes in supportive and positive ways to the “environment in which task performance takes place” . Several prior studies have investigated the role that trust plays in the exhibition of such citizenship behaviors . Particularly interesting in light of our research question is the study of Brower et al.46. These authors reported that leaders’ trust in their employees had a strong effect on employees’ display of citizenship behaviors, even beyond the effects of employees’ trust in their leader. Based on this finding, which suggest that the trust leaders display towards their employees is a critical determinant of whether these employees engage in citizenship behaviors, we predict the following:An important assumption of social exchange theory is that the process of trust guides reactions to subsequent exchangesH2: Leaders’ trust beliefs are positively related to employees’ display of leader-directed citizenship behaviors.47, p. 264), for instance, noted that “the more employees help each other with work-related problems, the less time a manager needs to devote to these activities; thus, freeing up the manager for more productive activities.” In a similar vein, MacKenzie et al.  noted that “employees who exhibit ‘sportsmanship’, by not complaining to their manager about every little aspect of the job they dislike, permit the manager to ‘conserve energy’ and direct his or her attention to those aspects of the job which are important to the success of the manager’s unit.” These observations all seem to suggest that employees’ display of citizenship behaviors can indeed ease their leader’s job, and thus help him or her perform better. Conversely, when employees do not feel motivated to display citizenship behaviors, this may undermine their leader’s work progress. Based on this reasoning, we formulate the following hypothesis:So far, our model assumes that leader depletion installs negative trust beliefs, which are reciprocated by employees in such a way that they display less leader-directed citizenship behaviors. We now argue that this process will further lead to a situation where employees’ decision to show more versus less citizenship behaviors is, in turn, decisive for their leader’s performance level. That is, we expect that when employees engage in discretionary behaviors, this may benefit the performance of their leader. In line with this strain of thought, several scholars have argued that employees’ citizenship behaviors reduce the amount of time leaders have to spend on certain activities, thereby increasing the time that they can spend on other, more important tasks. Podsakoff et al.  mediation model in which leaders’ trust in their employees and employees’ display of leader-directed citizenship behaviors act as two key mediating mechanisms. That is, we expect that being depleted makes leaders display negative trust expectations in their relationships with employees, who may subsequently ‘pay back’ their leader by engaging in less discretionary behaviors, thereby undermining the performance of their leader. In other words, leaders’ trust beliefs and employees’ leader-directed citizenship behaviors are expected to serially mediate the impact of leader depletion on leader performance. This reasoning leads to the following serial mediation hypothesis:H4: Leaders’ feelings of depletion are negatively related to their own performance via the mediating mechanisms of leaders’ trust beliefs and employees’ display of leader-directed citizenship behaviors.50. These insights suggest that there might be certain personality traits that can buffer the negative consequences of depletion. One personality trait that might be particularly relevant in the context of our research question concerns willpower beliefs. More specifically, we propose that whether the predicted detrimental effects of leader depletion take place (or not) might be contingent on the extent to which those in leadership positions believe that their willpower to exert self-control is a limited resource. Due to the reduced amount of cognitive resources, depleted individuals find it harder to exert self-control. We therefore expect that leaders’ implicit beliefs regarding their self-control as a limited resource will also impact the relationship between leader depletion and leaders’ trust in their employees. Job et al.50 demonstrated that individuals vary in the degree in which willpower is believed to be a limited resource. When individuals have a strong belief that their willpower is a finite resource, the negative effects of depletion are expected to be more pronounced. Stated otherwise, we expect that the negative relationship between leader depletion and leaders’ trust in their employees will be especially strong for those leaders who hold the belief that their willpower to exert self-control is limited. This reasoning results in the following moderation hypothesis:An important question to add to our research, however, is if all leaders are equally prone to display low performance levels when feeling depleted, or whether some leaders are more negatively affected by a depleted state of mind than others. Some prior studies have shown that the negative consequences of feeling depleted are constrained by people’s motivations and beliefs about self-controlH5: Belief in limited willpower moderates the relationship between leaders’ feelings of depletion and leaders’ trust beliefs in such a way that this relationship is stronger for leaders who are characterized by a high (vs. low) belief that their willpower is limited.H1-H4). Study 3 aimed to replicate the findings of Studies 1 and 2 by employing an experience sampling method research design. Study 3 additionally also investigated belief in limited willpower as a potential boundary condition of our proposed model (test of H5). Studies 1 and 2 were both part of a larger data collection, whereas Study 3 was conducted solely for the purpose of the present research. The data of Study 1 were analyzes using SPSS (version 27), the data of Study 2 were analyzed using Stata (release 17), and the data of Study 3 were analyzed using Mplus (version 8). The datasets of all three studies are publicly available at: https://osf.io/djnvq/.Our hypotheses were tested in a series of three studies. We started our research endeavor with two multi-source field studies (Studies 1 and 2), in which we investigated if leader depletion negatively influences leaders’ trust beliefs, if this decrease in trust subsequently negatively affects employees’ display of citizenship behaviors towards their leader, and if these lowered citizenship behaviors in turn undermine the leader’s performance level (test of N = 104 leader-subordinate dyads working in various Dutch organizations) was a cross-sectional multi-source field study. In this study, leaders provided ratings on their own depletion level and their focal subordinate’s citizenship behaviors, whereas subordinates rated their leader’s trust beliefs as well as their leader’s performance level . Table Study 1 .To test our hypotheses, we first conducted a series of linear regression analyses, of which the results are summarized in Table N = 247 leader-subordinate dyads from 25 different Taiwanese firms), we employed a longitudinal research design that consisted of three measurement moments, with a three-week interval between each moment. During the first moment, leaders rated their own level of depletion and the extent in which they trust their subordinates, whereas subordinates rated the quality of the relationship with their leader. During the second moment, leaders rated their focal subordinate’s citizenship behaviors. During the third and final moment, subordinates assessed the performance level of their leader. Table In Study 2 .A series of multilevel regression analyses were conducted to test our hypotheses. Each dyad is nested within a firm, and by varying intercepts across firms, we take the non-independence of our observations into account. The results, which are summarized in Table indirect effect = − 0.01, CI95% = ).As an additional robustness test, we reran all our analyses while controlling for the quality of the leader-member exchange relationship. As shown in Table 54). In order to capture daily variations in the constructs of our model, in the present study we employed an experience sampling method research design . Note that by employing this particular design type, we were able to test if the between-person effects that we reported in Studies 1 and 2 also hold when examining within-person effects. This is particularly important given that prior research has shown that the association among variables sometimes differ depending on whether they are measured on the intra-individual or the inter-individual level .A limitation of Studies 1 and 2 is that these studies did not test our full conceptual model, which aims to also identify a potential boundary condition of our proposed serial mediation chain. Moreover, the between-person approach that we employed in our prior studies may not accurately capture the ebbs and flows of psychological states such as depletion and trust. Yet, several recent studies have shown that these variables exhibit substantial within-person variations  were asked to complete three surveys per day for ten consecutive work days: The morning survey measured the extent in which they felt depleted, the midday survey probed the extent in which they trusted their subordinates, and the evening survey measured the extent in which they received help from their subordinates as well as their perceived work goal progress. Additionally, we also included a trait measure of belief in limited willpower, which was administered one week before the start of the daily surveys. Table Participants in the present study , we controlled for all endogenous variables from the prior day to account for temporal changes in these variables. We further controlled for daily hours spent at work. Before testing our hypotheses, we first checked for the proportion of within-person variance in the Level-1 variables. We found substantial within-person variance in leader depletion (28.0%), leaders’ trust in their employees (66.4%), leaders’ experienced citizenship behaviors from employees (66.8%), and leader performance (40.3%), supporting the suitability of our within-person approach.We used multilevel modeling to account for the nested structure of our data. Specifically, the Level-1 variables were leader depletion, leaders’ trust in their employees, leaders’ experienced citizenship behaviors from employees, and leader performance, all of which could vary within individuals. The Level-2 variable was belief in limited willpower, which was specified to vary between individuals. Prior to running our analyses, we grand-mean centered this between-person variable to improve interpretability of the regression coefficientsH1 predicted that leaders’ feelings of depletion are negatively associated with leaders’ perceptions of trust in their employees. This relationship, however, did not emerge as significant, γ = − .05, SE = .04, p = .16. H2 predicted leaders’ trust in their employees to be positively associated with their experienced citizenship behaviors from employees. In support of this hypothesis, we found this relationship to be positive and significant, γ = .36, SE = .15, p = .012. H3, which predicted that leaders’ experienced citizenship behaviors from employees is positively associated with leader performance, also received support, γ = .19, SE = .07, p = .003. Finally, in line with the predictions made in H4, the indirect effect of leader depletion on leader performance through leaders’ trust beliefs and employees’ citizenship behaviors also turned out to be significant .We subsequently conducted a multilevel path analysis. The results of this analysis are summarized in Fig. γ = − .12, SE = .05, p = .009. To further investigate the nature of this interaction, in Fig. H5, we found that when belief in limited willpower was high, the relationship between leader depletion and leaders’ trust in their employees was strong and negative . This relationship, however, was not significant when belief in limited willpower was low .To test our moderation hypothesis, we subsequently examined if and how the relationship between leader depletion and leaders’ trust in their employees is influenced by leaders’ belief that their willpower is a limited resource. This cross-level interaction was tested by having belief in limited willpower as a Level-2 predictor of the intercept and slope for the Level-1 relationship between leaders’ feelings of depletion and leaders’ trust in their employees. This analysis revealed that the cross-level interaction of leader belief in limited willpower and leader depletion predicting leaders’ trust beliefs was significant, 59. These conditional indirect effects of our full model indicate that the indirect effect of leader depletion on leader performance via leaders’ trust in their employees and leaders’ experience of citizenship behaviors from employees was significant and negative when belief in limited willpower was high , whereas it was non-significant when belief in limited willpower was low . Note that these latter findings are in line with the simple slopes results (see above), as well as with our full conceptual model.To assess the conditional indirect effects where the proposed indirect effect is moderated by belief in limited willpower, we additionally also conducted a Monte Carlo simulation with 20,000 replications to obtain bias-corrected confidence intervals around the estimatesPrior depletion research has mainly looked at how the state of depletion influences leaders’ performances on tasks that are segregated from the inherent social role that they occupy within their organization. As such, these studies have neglected the fact that many leadership tasks are interdependent in nature and thus require cooperation with others, most notably their employees. In line with this strain of thought, we proposed that leader depletion indirectly impact leaders’ own performance level via the mediating mechanisms of leaders’ trust beliefs and employees’ display of leader-directed citizenship behaviors. The results of two multi-source field studies (Studies 1 and 2) provided robust evidence for our predicted serial mediation chain. Using an experience sampling methodology, Study 3 extended these findings by showing that leaders who have a strong (vs. a weak) belief that their willpower is limited were more strongly affected by the negative effects of feeling depleted. Yet, unlike in Studies 1 and 2, in Study 3 we did not observe a significant main effect of leader depletion on leaders’ trust beliefs. A possible explanation for this discrepancy may be that effects might be smaller on the daily level, as opposed to the cumulative effects in Studies 1 and 2.4. This idea seems to be especially at place for those in positions where they face high workloads, have many responsibilities, and steer collaborative challenges, which usually are leadership positions19. In fact, examining the role that depletion plays especially among leaders is an interesting and important task given the fact that leadership within organizations is an interdependent activity which makes that multiple parties are affected.A number of studies has revealed that the general idea behind ego depletion theory is that the capacity to exert self-control is a limited resource that is depleted after exertion24) or how depleted individuals behave towards others , but has not extended these perspectives. An important theoretical contribution of our work is that our studies go beyond this approach by also testing the broader, more distal implications of this negative leader state. Specifically, in our studies we do zoom in on the outcomes and beliefs of the depleted individual , but add the perspective where we examine how those beliefs affect others that have an interdependent relationship with the leader (in our case their employees) and how the reciprocal behaviors of those others affect the performance level of the leader in return.Yet, as we mentioned earlier, prior depletion research has focused almost exclusively on how depletion influences outcomes of the depleted individual . Yet, an important implicit assumption of self-regulation theory is that the effects of depletion on performance are fleeting, meaning that once depleted resources are replenished performance should almost immediately be restored. This assumption makes most sense when investigating depletion effects in the context of socially isolated tasks, but in real-life settings, where social dynamics are at play, the consequences of leader depletion are likely to be more insidious. It is, in other words, possible that in the workplace leader depletion also has more lingering negative effects, which would imply that its negative impact may persist even when the source of depleting is being removed.In light of this perspective, it must be noted that several prior studies on the consequences of self-regulation failures have found that feelings of depletion can indeed hinder performance (see62), it is possible that the leader’s performance level remains low—even when he or she no longer feels depleted. We therefore strongly encourage future research in this domain to further unravel the potential long-term negative consequences that leader depletion might have for organizational functioning.Our findings provide some indication that leader depletion may indeed have such persisting negative effects. The results of our second study, for instance, showed that leader depletion was negatively linked with leader performance via the mediating mechanisms of leaders’ trust beliefs and employees’ leader-directed citizenship behaviors, and this even though leader performance was measured several weeks after the measurement of leader depletion. Because low trust as a result of earlier depleted states of the leader cannot easily be restored . Organizations who aim to counteract the detrimental effects of leader depletion are therefore advised to make such interventions available to their leaders.Besides several theoretical contributions, the present research also offers some important practical insights for organizations and its members. Being in a leadership position comes with heavy workloads and with numerous choices and decisions that need to be made each day. From a managerial perspective, we believe that it is crucial for organizations to be aware that overloading their leaders in this respect may bring unwanted costs. Of course, creating awareness itself is not enough. Organizations should also try to actively prevent their leaders from becoming depleted. In this light, several studies, for example, have reported that brief mindfulness interventions can decrease feelings of exhaustion .Moreover, leaders themselves should also understand that, whenever they face important tasks, their cognitive state can affect their performance level; thus, it is necessary to schedule such tasks carefully. Because of this, tasks that have important implications and/or that might significantly affect others—like strategic actions and ethical decisions—should preferably be executed by leaders when they are well rested  rather than when they are tired and fatigued , because rest  can replenish their cognitive resources  there was no indirect negative effect of leader depletion on leader performance via leaders’ trust in employees and employees’ leader-directed citizenship behaviors, indicating that these particular leaders may actually be immune to the negative effects of feeling depleted.67, p. 263). Prior willpower training interventions have indeed revealed that—similar to a muscle—willpower can be strengthened with practice68. Interestingly, however, is that several studies have even shown that training individual acts of self-control in any domain (from improving your posture to watching your finances) can increase ‘overall’ willpower70. Organizations are therefore encouraged to also provide systematic training programs that can help leaders to enhance their willpower, as such training programs might be helpful to mitigate the potential negative effects of leader depletion.We believe that this latter finding is particularly important given that “willpower is not exclusively determined by ‘nature’, but it is also something that can be trained” (A strength of this work lies in the fact that our studies consisted of both between-person (Studies 1 and 2) and within-person assessments (Study 3) of our core concepts. With respect to our measure of leader performance , subordinates’ peer-ratings (Studies 1 and 2) ware complemented with leaders’ self-ratings (Study 3). Moreover, to increase the cross-cultural generalizability of the reported findings, our studies were conducted among participants from three different continents, those being: Europe (Study 1), Asia (Study 2), and North-America (Study 3). Despite these differences, our studies revealed very similar results, as such promoting our confidence in the robustness of the reported findings.71 and Bullock, Green, and Ha72 have argued that only so-called “experimental-causal-chain” designs, in which both mediators are sequentially manipulated in separate experiments, can resolve issues related to inferring causality from statistical analysis. Hence, we strongly encourage future researchers to implement such designs, in order to further disentangle the causal roles that leaders’ trust beliefs and employees’ citizenship behaviors play in the relation between leader depletion and leader performance.Yet, no research is without its limitations, and our paper is no exception. A first and foremost limitation of our work is that, although we employed a longitudinal approach in our second study, we cannot infer causality from any of our studies, as we did not manipulate variables or use random assignment techniques. Instead, in each of our studies we tested our predictions in existing leader-subordinate relationships using survey data. In this regard, both Spencer, Zanna, and Fong73 illustrated that depletion can either be internally or externally imposed. Internally imposed depletion is depletion due to personal factors, whereas externally imposed depletion is depletion due to situational factors. In the context of our work, we expect that the source of depletion may influence whether an increase in depletion translates into a decrease in trust or not. It is, for instance, possible that depleted leaders only trust their employees less when they see these employees as the cause of their depletion , but not when they see themselves as being responsible . This assumption, which can possibly also help to explain why we did not find a significant main effect of leader depletion on leaders’ trust beliefs in our third study, needs to be further examined in future research.Another issue that must be mentioned here is that, due to the nature of our data collection, we do not know what caused leaders to feel depleted in our studies. A recent study by Zhang et al.Our research is a first step in mapping out through which pathway leader depletion may negatively influence leader’s own performance. However, to get a more complete picture of the link between depletion and performance, future research might also want to investigate how depletion spreads and fluctuates within teams. Finally, our research illustrates that whether leader depletion negatively impacts leader performance depends on the extent to which those in leadership positions believe that their willpower to exert self-control is a limited resource. It is, however, important to note that, besides willpower beliefs, other individual difference variables might exist that also moderate the impact that leader depletion has on leaders’ trust beliefs. Future research in this domain is therefore encouraged to further investigate which other leader traits can buffer the negative effects of feeling depleted.https://www.ugent.be/pp/en/research/ec/general_ethical_protocol_fppw.pdf), where the first author is affiliated, no formal ethical approval was required. Informed consent was obtained from every participants.Given that our studies were conducted according to the ethical rules presented in the General Ethical Protocol for Scientific Research of the Faculty of Psychology and Educational Sciences of Ghent University . In return for their voluntary involvement in completing questionnaires, panel members receive a small reward in the form of points, which they can collect and eventually convert into a voucher of their choice.-subordinate dyads. The mean age of the leaders was 42.64 years (SD = 9.59), 62.5% of which were male. The mean age of the matched group of subordinates was 36.68 years (SD = 10.42), 56.7% of which were male.We only invited participants who have a leadership position at work. Leaders were asked to identify one of their subordinates to answer a brief survey. By entering their subordinate’s email address, a message was automatically generated that asked this person to participate in the study. Each participant received a unique identification number to ensure anonymity and to allow the proper matching of focal subordinate and leader data. This procedure generated a final sample of 104 unique leaderSeveral steps were taken to optimize data validity and to ensure that survey responses corresponded to the correct organizational role . First of all, when introducing the study, we noted to all participants that integrity is crucial in the scientific process and, therefore, compliance with the instructions is necessary. Moreover, it was also clarified that it was necessary and important that the leader and the corresponding subordinate filled in the correct survey. When participants submitted their online survey, time stamps and IP addresses were recorded to ensure that the surveys were submitted at different times and with different IP addresses. No irregularities in the responses were found.. The full item lists are included in the During the study, leaders provided ratings on their own depletion level and their subordinates’ citizenship behaviors, whereas subordinates rated their leader’s trust beliefs as well as their leader’s performance level. All items were answered on seven-point Likert scales74; see also 18) probed the extent in which leaders feel depleted. A sample item is: “I feel mentally exhausted” . This scale was answered by the leader him or herself .Five items adapted from Ciarocco et al. . This scale was answered by the subordinate .Leaders’ trust beliefs were measured using an eight-item scale, of which the items are based on the NEO-PI-R76. A sample item is: “My subordinates defend me when other employees criticize me” . The leader answered this scale .To measure the extent in which employees engage in leader-directed citizenships behaviors, we used an eight-item scale of which the items are based on the scale of Lee and Allen77; also see 78). A sample item is: “To what extent do you expect that your supervisor is able to achieve his or her objectives” . The second scale is a ten-item scale of which the items are adapted from the performance scale of Wright et al.79. A sample item is: “I would never be disappointed in the quality of the performance that my supervisor delivers” . Both these performance scales were answered by the subordinate .Finally, we employed two different performance scales to measure subordinates’ perceptions of their leader’s performance. The first scale is a six-item scale of which the items are based on the six in-role performance criteria of De Cuyper et al. , we sent a survey containing measures of demographics to all participants. At this time point, leaders were also asked to rate their own level of depletion as well as the extent in which they trust their subordinates. We received responses from 279 matched leader-subordinate dyads. During the second data collection phase (Time 2), leaders were asked to rate their focal subordinate’s citizenship behaviors. In total, 253 leaders of the matched leader-subordinate dyads successfully completed the survey during the second data collection phase. During the third and final data collection phase (Time 3), we asked each subordinate from the 253 matched leader-subordinate dyads to assess the performance level of their leader and received responses from all of the subordinates. Note that this temporal separation of our study variables is consistent with the causal order of our proposed sequential mediation model.SD = 9.27), 38.5% of which were male. The mean age of the matched group of subordinates was 33.33 years (SD = 7.86), 32.8% of which were male.A total of six participants did not fully respond to all the items from our study variables. Because of this, our final sample consisted of 247 unique leader-subordinate dyads from 25 different firms ; with the average number of leader-subordinate dyads from each firm being 9.88 (range = 3–35) and with each leader-subordinate dyad coming from of a different team. The mean age of the leaders was 42.77 years (strongly disagree to (7) strongly agree. The full item lists are included in the With exception of the leader-member exchange items, all items were answered on seven-point Likert scales ranging from (1) 74 scale. A sample item is: “I have felt drained.” The leader answered this scale during the first data collection phase .To measure the extent in which leaders feel depleted, we again used five-items which are adapted from Ciarocco et al.’s80. A sample item is: “I trust my team members.” So, contrary to Study 1, in the present study these trust belief items specifically referred to the leader’s trust in his or her subordinates. Moreover, in the present study the leader (instead of the subordinate) answered this measure .During the first data collection phase, leaders’ trust in their employees was also measured using a five-item scale developed by De Jong and Elfring76. A sample item is: “My subordinate willingly gives his or her time to help me when I have work-related problems.” This scale was administered during the second data collection phase .Leaders were also asked to rate the extent in which their focal employee engages in leader-directed citizenships behaviors. Towards this end, we again administered an eight-item scale of which the items are based on the scale of Lee and Allen81; cited and used by 82). This scale was adapted so that it measures the extent to which subordinates agree with five statements about the quality and the quantity of their leader’s performance. A sample item of this scale is: “My supervisor fulfils all responsibilities required by his or her job” .During the third and final data collection phase, subordinates assessed their leader’s performance with the job performance scale developed by Podsakoff and McKenzie (85), we measured the quality of the leader-member exchange relationship as a control variable. To this end, subordinates were asked to complete a seven-item scale of which the items are based on the leader-member exchange (LMX) scale of Graen and Uhl-Bien . They answered this scale during the first data collection phase.Given that prior research has shown strong relationships between leader-member exchange and many of the variables that are included in our model , we chose a two-week period. During the two weeks of the study (including only workdays), participants were asked to complete three surveys per day. In line with the causal order of our hypothesized mediation model, the morning survey (sent at the start of the workday) measured leaders’ feelings of depletion. The midday survey (sent in the middle of the workday) assessed leaders’ trust in their employees. Finally, the evening survey (sent at the end of the workday) captured leaders’ experienced citizenship behaviors from employees as well as leaders’ perceived work goal progress.The sample for our experience sampling study consisted of 52 leaders enrolled in a part-time executive MBA class at a large midwestern university in the United States. They worked in a large variety of industries, including manufacturing, information technology, healthcare, accounting, banking or finance, engineering, and transport or logistics. We collected data over a two-week period using a series of daily surveys that were delivered online via email. One week before we began administering the daily surveys, leaders completed a one-time survey that assessed individual differences in belief in limited willpower as well as demographic information. Afterwards, we administered daily assessments for ten consecutive workdays. Similar to prior experience sampling research in the management literature  and managed an average of 4.92 employees (SD = 7.62).After screening out missing responses and accounting for days where leaders did not report interacting with any employee, our final dataset was composed of 365 daily matched observations from 50 leaders . This sample was 67.7% male and the majority (77.0%) of the leaders were between 31 and 60 years of age. They reported a mean organizational tenure of 6.26 years ” .One week before we started the daily surveys, belief in limited willpower was measured using a scale developed by Job et al.88. A sample items is: “Right now, I feel mentally drained”. For two consecutive weeks, leaders answered this scale daily during the morning survey. Leaders were asked to report the extent in which they felt these states at that specific moment .To assess daily fluctuations in leader depletion, we adapted three items from scales representing the content domain of depletion80, which was also used in Study 2. A sample item of this scale is: “Right now, I am confident that my subordinates will keep me informed about issues that concern my work.” Leaders answered this scale daily during the midday survey, and they were asked to report the extent to which they trusted their subordinates at that particular moment .Daily fluctuations in leaders’ trust in their employees were measured using the five-item scale by De Jong and Elfring89 to capture daily fluctuations in the extent in which leaders received helping behavior from their employees. Leaders answered this scale each day during the evening survey. An example item is: “So far today, my subordinates have gone out of their way to be nice to me” .We used the six-item scale by Dalal et al.90. These items, which were also administered daily during the evening survey, captured the leader’s perceived goal progress so far during that day. An example item is: “Today, I have moved forward with my work progress” .Finally, daily fluctuations in leaders’ perceptions of their own work goal progress were assessed using three items developed by Koopman et al.https://www.ugent.be/pp/en/research/ec/general_ethical_protocol_fppw.pdf). Informed consent was obtained from all participants.The research was conducted according to the ethical rules presented in the General Ethical Protocol of the Faculty of Psychology and Educational Sciences of Ghent University (Supplementary Information.


The need to transform mental health care toward person-centered, recovery-based, and network-oriented care is recognized worldwide. Open Dialogue (OD) is seen as a hopeful approach in the context of this transformation and is introduced in countries around the globe. Five Dutch mental health care organizations spread over the Netherlands introduced the Peer-supported Open Dialogue (POD) approach, which adds an explicit role of peer-support workers to the OD approach. It appeared that (P)OD-trained professionals face issues in introducing the (P)OD approach in existing MHC settings. One of the reasons, which is the focus of this study, may be that they encounter difficulties in explaining to non-(P)OD-trained professionals what (P)OD entails. The main objective of this study is to provide guidance to and contribute to making (P)OD better understandable for non-(P)OD-trained professionals. In this study, we used a qualitative design and conducted 23 semi-structured interviews with POD-trained professionals with various backgrounds, to cultivate a rich understanding of which aspects could contribute to a better understanding of POD for non-POD-trained professionals. We used a hybrid approach to analyze the data, meaning that the technique of both inductive and deductive thematic analyses has been applied. From these analyses, six aspects emerged that could give guidance to and contribute to making (P)OD more understandable for non-(P)OD-trained professionals: (1) Experiencing (P)OD by attending treatment network sessions, (2) a coherent and profound narrative about (P)OD, (3) adjusting terminology to better fit the context, such as the two terms “principles” and “responsibility” in this study, (4) the order in which (P)OD elements are introduced in the narrative, (5) bringing the elements “presence,” “reflecting,” and “expertise by experience” more to the foreground, and (6) conceptualizing the main elements in a “talking paper.” A better understanding of (P)OD might be one of the building blocks for improving (P)OD adoption in existing MHC practices, which are on their way toward person-centered, recovery-based, and network-oriented care. This trOpen Dialogue (OD) is seen as a hopeful approach to this necessary transformation . The OD In this study, we focus on the introduction of the OD approach in a context of changing mental health care toward person-centered, recovery-based, and network-oriented care. In the search for better recovery-oriented care, five Dutch MHC organizations spread throughout the Netherlands introduced the Peer-supported Open Dialogue (POD) approach into daily ambulatory care for people diagnosed with severe mental illness. POD adds an explicit role of peer-support workers to the OD approach , referriOrganizations may encounter difficulties in translating a broad vision of a needed change into practice as The main objective of this study is to provide guidance to and contribute to making (P)OD better understandable for non-(P)OD-trained professionals. A better understanding of (P)OD might be one of the building blocks for improving (P)OD adoption in existing MHC practices, which are on its way toward person-centered, recovery-based, and network-oriented care.2.This study was part of a broader study that aims to gain a better understanding of the introduction of POD in the Dutch (MHC) context. In this study, we used a qualitative design and conducted semi-structured in-depth interviews, to cultivate a rich understanding  of which2.1.via WhatsApp, in which they organize couples for POD network treatment sessions. These POD sessions were organized on request of and in addition to regular care. The POD professionals delivered care to clients suffering from severe mental illness, who differed with respect to the living situation  and registered diagnoses . At the point of data collection, over 90 POD-trained professionals have been striving to provide care within the Dutch MHC context based on the POD approach.In 2017 and 2018, POD-trained professionals formed six POD networks spread over the Netherlands and introduced the Peer-supported Open Dialogue (POD) approach in five (MHC) organizations . One of 2.2.2.2.1.The first author asked the board of the national Dutch POD foundation, represented by the five organizations, to provide a POD-trained contact person for each POD network . These contact persons had coordinating roles in the implementation of POD and had a representative overview of the specific organization. They introduced the study and researcher to the POD professionals. With the intention to incorporate different perspectives, the researcher asked each contact person to list the names of POD-trained professionals working in their network, who had different professional backgrounds and preferably differed in the extent to which they support the POD approach. The researcher approached four POD-trained professionals per POD network.Sampling was based on purposive  and convenience approaches . The 24 All POD-trained participants attended the 1-year postgraduate training entitled “Peer-supported Open Dialogue, Social Network and Relationship Skills” at the Academy of Peer-supported Open Dialogue (APOD) in the United Kingdom, which is a course accredited at an English-speaking University at Post-Graduate Certificate level. The course consisted of four 5-day residential modules. Furthermore, the first author of this paper attended this one-year postgraduate training prior to this study.2.2.2.a priori for the interviews as an aid memoir for the interviewer, which included questions related to participants’ vision of the POD approach, e.g., the appropriateness and innovativeness of the OD principles, the adage “Nothing about me without me,” and the role of peer-support workers. For example, related to the first principle, the interviewer asked participants “Could you say something about what you think of the first principle?,” “How should the principle be applied according to you?,” “Why do you think that this principle is important?,” and “How does it match with client’s needs?” The participants were encouraged to share their views, regardless of whether they managed to apply them in practice at that time and to speak freely on aspects they considered relevant for the introduction of POD in practice.The first author conducted 23 semi-structured interviews for 60–90 min using zoom video conferencing during September and October of 2020. The interviewer showed the seven OD principles  and 12 k2.3.All interviews were audio-recorded with permission of the interviewees, transcribed verbatim, and analyzed with the program Atlas.ti. These interviews were analyzed through Braun and Clarke’s six phases of thematic analysis, respectively: familiarizing with the data, coding, generating themes, reviewing themes, defining and naming themes, and producing the report . Prior k3.In this section, we outline the aspects, which emerged from the analysis process, which could contribute to making POD better understandable for non-POD-trained professionals.3.1.Participants reported that both experiencing POD by attending POD network sessions and a narrative about POD as a handhold to explain POD could contribute to a better understanding of POD among non-POD-trained professionals. Interestingly, by reading the transcripts, we found a clear common ground in the individual meaning of (why important) and vision (what is “good care”) on the POD approach and what participants considered important ingredients to include in such a narrative for the Dutch context.One thing that would help enormously is if at some point POD could be properly explained to people who are not POD-trained, so that there is more support, and more understanding of POD. And I think one way to make POD more understanding is if someone just joins a POD network session once. As network. Because I have noticed, for example, that because a colleague had once experienced such a POD session, she was better able to judge later whether a POD session could be useful” (POD-trained peer-support worker).“In such a narrative, participants would consider the following as the main ingredients of POD: the dialogical process , including the involvement of the network with its multiplicity of perspectives , and the adage “Nothing about me without me.” Furthermore, they would describe the other organizational elements as valuable elements to improve the quality of treatment and to effect change. Moreover, participants would add that the principles of “flexibility and mobility,” “responsibility,” and “psychological continuity” should not be drawn into the absolute or regarded as limitless.It’s not limitless…And here too, it plays a role again. You can also draw that into absolute, making it impossible to do anything with it” (POD-trained manager)“In addition, participants mentioned that they would adjust the two commonly used terms within the (P)OD approach “responsibility” and “principle” for terms that better fit the Dutch context. First, they explained that the term “responsibility” can be confused with the commonly used term “principal responsibility” within Dutch mental health care, referring to a practitioner who is formally responsible for the treatment. Therefore, participants proposed using the term “involvement” instead. Second, they proposed to use the term “elements” as a more neutral term in Dutch instead of the word “principles,” as is the case in the “original” approach. They said that the word “principle” in Dutch can give the impression that it is a matter of principle with an obligatory character, and therefore, the risk of dogma is lurking.3.2.Participants expressed that they experience difficulties in explaining the POD approach in a coherent manner and bringing to light the profoundness of the POD approach. By coherence, they meant the interrelatedness of the elements and layering of the approach itself. By profoundness, they meant the underlying theories and history of the approach and the notion that POD goes beyond learning new skills  and also involves a personal change in the vision, values, and attitude of the professionals .They said that when telling non-POD professionals about POD, they often use the seven (P)OD principles to explain what one is doing in POD because it provides a practical framework. However, they notice that it is not immediately obvious that (P)OD is based on certain values and entails a certain culture. They also explained that if you do not manage, in such a narrative, to convey this complexity to non-POD-trained professionals, misconceptions quickly arise. Their suggestion for a narrative would, therefore, be to also explain why something is done in a certain way.There is such a deep great history, and there are actually all kinds of deliberate forms of therapies underlying it, but you do not see it directly in the principles. I also find that difficult when you explain what Open Dialogue is and you use the seven principles to make it clear that it is not just a conversational technique that you also learn in a course…Maybe that is what I miss in the POD principles, that POD requires another culture” .““POD is of course a way of working, but it is not just a technique. It is a complete change of your whole being. As a human. So it has not only changed me in my work, but also in my general balance, being and contact and in terms of resilience…it really changed and helped me very positively, and I had not thought of that beforehand and did not expect it” (POD-trained case manager).These findings brought to light that the introduction of (P)OD to non-(P)OD-trained professionals summing up the seven (P)OD principles may not be enough to show the coherence within and profoundness of the (P)OD approach. In addition, three meta-communicative aspects emerged from the data analyses that might help to emphasize in such a narrative the coherence and profoundness of the (P)OD approach, to make it better understandable for non-(P)OD-trained professionals: (1) the order in which (P)OD elements are introduced in the narrative, (2) putting the elements “presence,” “reflecting,” and “expertise by experience” more to the foreground, and (3) conceptualizing the main elements in a “talking paper.”3.2.1.In telling non-POD professionals about POD, participants tended to start by explaining the organizational elements, with the result that non-POD-trained professionals often stated that they already work that way. Therefore, participants considered it helpful to start a narrative by explaining the innovative core aspects of (P)OD followed by organizational elements.Because when people talk about POD, the 7 principles are often used, but there is still a whole layer underneath. And if you only name those seven principles, you may interpret them completely differently because you interpret from a different starting point. That is of course what often happens now, when we talk about POD somewhere. That people often say that they already do that. And sometimes I can imagine that people say that, but then I still think, no! Your starting point is different” (POD-trained manager).“Therefore, participants suggested that in such a narrative it matters in which order (P)OD elements are introduced and they proposed to: (1) start with the underlying theories and paradigm shift (the “why”), (2) continue with the adage “Nothing about me without me” (the “doing”), (3) explain the required attitude (the “being”), (4) elaborate on the required skills (the “being” and “the doing”), and finally (5) describe how to involve the network in combination with the other organizational principles (the “doing”). For each of these four parts, we elaborate on what participants considered important ingredients to explain in the Dutch context:3.2.1.1.The participants suggested that it is important to explicitly explain the underlying theories and paradigm shift (the “why”) that are new for non-(P)OD-trained professionals. Therefore, they suggested for the Dutch context to describe in such a narrative the underlying view of the (P)OD approach on mental problems, namely as a resonance in the interpersonal. They would describe in such a narrative that the problem underneath the request for help should be seen as a shared interactional problem instead of an individual problem. Additionally, they would explain that these problems are often related to a lack of connectedness and language, as a result of things that are difficult to say aloud.Psychiatric…or problems are never problems of one individual. It is always a resonance in the interpersonal. There is always a network involved” .“because you are never alone in a crisis. It is always an interaction with your environment. With involving the network you already take so much burden away from the person who can no longer bear it” (POD-trained peer-support worker).“Another foundation they considered relevant to mention is that no one has a monopoly on the truth and to explain that truth is based on a shared meaning where everyone’s voice is equally important. By this, they would refer to the theory of social constructionism and the importance of polyphony. They would add that the source of both the underlying problem and the power to recover lies within the client and their network. They considered this foundation helpful to explain why they find it fundamental to collaborate with the client and their network, to (re)connect with and between the network members and to find shared meaning, instead of involving the network as a resource group to “solve problems.”And which is really different. Very often in the past you have been approached as a network to solve other people’s problems. And POD is not about helping the other, it’s about everyone sitting there” (POD-trained manager).“Participants conceived starting such a narrative with these foundations as important to clarify the rationale behind the proposition that connection and insights rather than consensus and solutions are considered the driving force behind change. Participants foresaw that this proposition entails a fundamental shift in Dutch mental health care since society expects mental health care to solve problems and current Dutch mental health care is also set up this way at the moment.There are expectations from the mental health care that problems will be solved so that you no longer suffer from those problems, and that is not how POD is set up” .“3.2.1.2.The participants expressed that these underlying foundations and fundamental changes are embodied by and become tangible through the adage ‘Nothing about me without me’. Moreover, they said that this adage adds shared sense-making to the already familiar concept of shared decision-making, which ensures that the narrative would fit in with a concept that is already known. Therefore, they suggested continuing such a narrative with this adage because it could help to understand the implication (‘the doing’) of these fundamentals, e.g., abolition of multidisciplinary consultations.If you would apply the adage for 100%, I have often said, you radically change mental health care. The ‘Nothing about me without me’ adage helps enormously to continuously involve people because you need them” (POD-trained manager).“3.2.1.3.According to POD professionals, such a narrative should then go into the basic attitude of (P)OD (the “being”) because it says something about what the foundations and adage imply for the professional himself and the way they connect and interact with the other. They used words such as “humble attitude,” “dropping the professional mask,” the importance of “unlearning,” and “the courage to be vulnerable in your profession.”It’s not about them, it’s about us. If you want to change mental health care, you should not change the clients, but you will have to change the way you approach them. And that change is up to us. And the POD training provided for that” (POD-trained manager).“In describing this basic attitude, participants would explain what is meant with and emphasize the importance of being authentic, present, and open in contact (“being with” instead of “doing to” people in distress). According to participants, this could help to explain to non-(P)OD-trained professionals how to shift from intervening expert to participating human being with experience and expertise. Participants would also describe the notion of unconditional warmth, referring to compassion and a full unconditional appreciation of the other because it differs from the common notion of distance and proximity.There are many implicit assumptions about how to do POD right. ‘Sitting with the family’ is a baseline for whether you have worked the POD way: have I really been there, have I really sat down next to people. Presence is the essence” .“3.2.1.4.As a next theme, participants would elaborate on the required skills. They expected that these skills give an answer to the ‘doing’ of (P)OD and could show non-(P)OD professionals how to enhance connectedness between the client and their network and to create space in which hidden insights are given room to be unraveled . Participants found that the (P)OD elements dialogism and tolerating uncertainty best describe the needed core skills of professionals and that these skills belong together as reciprocal conditions.With regard to dialogism, participants said this element could help to explain why and how to shift from a solution-oriented perspective to a relation-oriented perspective with polyphony as a core concept. They would explain that professionals’ prior focus should be on establishing connectedness and creating a safe culture of sharing. Additionally, they would explain that in order to do this, professionals need to be fully present and responsive to what is happening at the time, rather than having their own or preset agenda and taking the lead.…because that’s where we catch ourselves time and again: we are or remain a kind of detective in the mystery of that misery that is presented. You want to know things as care professionals: how did it come about. You may be curious about what is happening and certainly you may ask to say a little more about what someone is saying, but you are responding to what is being said, and you are not looking for new information. You leave that detective role and step into the in-depth role” .“In addition, participants would emphasize in a narrative that dialogism is also an end to foster dialogue between people, empower people, and effect change. So that it becomes clear that the shift from “doing” to “being” is not the same as doing nothing, which participants said was sometimes the concern of non-POD-trained professionals. Therefore, in a narrative, they would underline the importance of not taking too little responsibility in contributing to change under the guise of following the pace of the process, tolerance of uncertainty, and the not knowing. That is, professionals should take responsibility to assume their role in the dialogical process: listening to each other and mutual sharing during reflecting moments. They would add that the extent of sharing and the boundary of tolerating uncertainty are personally and contextually determined, that this is a timing matter and that finding this balance is a personal process.For example, I admire Seikkula, who sits on the edge of his seat leaning forward toward people. I think that’s wonderful and I can sit like this, but I cannot react like him. When Kurti talks, I think ‘wow’, that is a lot of energy and she also shares personal things. Whereas, Jaakko never speaks about himself. And so we all have something good. And we should use that for God’s sake. You have to. So it has to be internalized and not become a trick .”“Moreover, participants found it important that in such a narrative tolerating uncertainty is properly explained because this element shows the paradoxical approach of POD, and it gives guidance to non-POD-trained professionals on how to provide recovery-oriented care. They found that this element helps to explain how professionals, instead of trying to solve the problem, can better align to the clients’ and networks’ pace in the process, respond to and reflect on utterances of each person and create space so that client and network can take responsibility in their own recovery process. In doing so, often the solutions in the form of insights come naturally from the client and her/his network.In addition, participants would highlight in a narrative the skill reflecting to explain dialogism and tolerating uncertainty to non-trained-POD professionals because this skill is more tangible and already common. They would then elaborate on the so-called reflection moment (referring to sharing reflections with a colleague in the presence of the client and network during a network session), which they considered innovative for the Dutch context. They found it important that the narrative includes an explanation of how to disclose appropriately (from the POD perspective). They would add that, with unconditional appreciation as a basic attitude, this would imply that professionals reflect on what resonates and emerges in them, allowing themselves to be affected more and share more personal experiences from an authentic vulnerability than professionals educated with distance and proximity might be used to.Sharing  things requires a certain authenticity, a certain modesty, a certain vulnerability, which is not easy for everyone. So even if people want to share that, do you dare to say that? Do you dare to be vulnerable, in your profession? And I mean really genuinely vulnerable” (POD-trained peer-support worker).“There was a discussion about professional contact and POD contact. But I am a very professional POD’er, also just a person with experiences in life, which can be both part of the dialogue if they are at the service of the dialogue. Then I find that very professional” (POD-trained casemanager).“3.2.1.5.Participants would end such a narrative with a description of the organizational (P)OD elements in which they would view the facilitation of the network sessions with (at least) two POD-trained professionals as the backbone of the treatment process, in which all necessary therapies can be integrated. In this part, they would describe the reasoning behind the notion to involve the client’s closest network from the beginning on. They would refer to, e.g., developing a well-established therapeutic relationship, broadening everyone’s perspective on the situation, supporting and engaging the network, and smoothing the process of getting back to life without getting bogged down in old patterns again. In this context of creating a safe collaborative culture, participants would explicitly mention the value of peer-support workers. They found that peer-support workers are often very sensitive and adept at bringing out the unspoken, putting it in words, and making people feel heard and seen.“The peer-support worker, I work with… I find that every time a gift to facilitate network sessions with her. She always knows how to press the right buttons, where I theoretically feel there is something there, but she does that so beautifully because she can also place her own emotional experience in it. They naturally get the role of a ‘confidant’ pretty quickly and that’s very nice” .Finally, to explicitly show (P)OD’s need-adapted philosophy, participants would explain the elements “flexibility and mobility,” “responsibility/involvement,” and “psychological continuity” similar to the original OD approach. With regard to flexibility, participants would explicitly stress the importance of being flexible related to time (duration and frequency) and content of the session, without being limitless (90 min on average). They would explain when the time for a session is too limited as they were used to, it is challenging to get out of the “chak-chak-chak-mode,” and professionals will tend to reach for solutions, may be more formal, more directing, and monological in contact. In terms of frequency, they would explain in such a narrative that at the end of a treatment session, it is determined through shared decision-making if and when the next meeting will take place instead of automatically scheduling sessions.3.2.2.So, in addition to introducing the (P)OD elements in a certain order in a narrative, participants would also bring three elements more to the foreground in their communication about (P)OD: “presence,” “reflecting,” and “expertise by experience.” They suggested that the elements “presence” and “reflecting” should be brought to the foreground to give more meaning to the term dialogism. Moreover, participants said that these terms are familiar to non-(P)OD-trained professionals and may, therefore, help them to gain a better picture of what is meant and needed to be dialogical. They expected that this could help non-(P)OD-trained professionals to differentiate between dialogism and having a dialogue with someone, as we all engage in conversation with one another.So dialogue as a word, as an element, has little appeal to the imagination. We all do, don’t we? And that’s right. Only within the Open Dialogue does it have its own meaning. Can’t we grasp that in that principle? The answer is probably no. And then ‘reflection’ is also an important word. To make the attitude explicit.” .“Furthermore, they would propose to use the term “expertise by experience” in a narrative to express the role of peer-supported workers and the importance of the professional skill to share experiences in a proper way as peer humans, which applies to all professionals. The latter is the reason that participants would propose the term “expertise by experience” instead of “peer-support workers” in a narrative about POD because they suggested focusing on the expertise and not the expert role. However, they would position the element “expertise by experience” as an organizational element in this stage of development because they believed that in the current context the desired position of “peer-support workers” within treatment teams is not yet self-evident and needs to be organized.3.2.3.Finally, to show the coherence and profoundness of such a narrative, participants considered a visual “talking paper” helpful to make (P)OD better understandable for non-(P)OD-trained professionals. They would use such a “talking paper” as a communication aid to untangle, illuminate, and delve into the key elements of the POD approach, without losing sight of the coherence and profoundness of POD (the “being” and the “doing”). They suggest not only listing the elements but also visualizing the elements in an interrelated (coherence) layered (profoundness) constellation. (P)OD professionals could then talk through layer by layer in the order that they suggested for a narrative. In practice, participants emphasized that the appearance of and relationships between the (P)OD elements are not linear or disentangleable and that such a “talking paper” similar to a narrative could change over time.“I think then, assemble the big picture” .“I think those seven principles are preconditions, while those three core elements about attitude, that’s actually how you should be as a human being. That goes deeper. But I do not know why it’s been pulled apart like that” (POD-trained manager).4.The main objective of this study is to provide guidance to and contribute to making (P)OD better understandable for non-(P)OD-trained professionals. There is rich literature about the OD approach and its underlying foundations e.g., . In addiWe found six aspects that could provide guidance to and contribute to making (P)OD more understandable for non-(P)OD-trained professionals: (1) Experiencing (P)OD by attending treatment network sessions, (2) a coherent and profound narrative about (P)OD, (3) adjusting terminology to better fit the context, such as the two terms “principles” and “responsibility” in this study, (4) the order in which (P)OD elements are introduced in the narrative, (5) bringing the elements “presence,” “reflecting,” and “expertise by experience” more to the foreground, and (6) conceptualizing the main elements in a “talking paper.”One of the main suggestions in this study is that it can be helpful to consciously introduce the (P)OD elements in a certain sequence, in order to make (P)OD more understandable: starting with the underlying theories and fundamental view on mental health problems, continuing with the adage “Nothing about me without me,” followed by the required attitudes and skills, and finally the involvement of the network in combination with the other organizational elements. The POD professionals in this study indicated that it is tempting to use the seven OD principles as a quick start guide to introduce the POD approach to non-POD-trained professionals since it makes the profound multilayered approach more tangible and demarcated. Literature shows that these principles have been used to evaluate OD practices as well . HoweverThis study proposes to start such a (P)OD narrative by explaining its underlying theories and fundamental different view on mental health problems. (P)OD addresses the question of the etiology of mental disorders. As non-(P)OD-trained professionals look through these new lenses, it may be clearer that the collaborative nature of (P)OD sheds new light on network-oriented care. This study proposes to continue such a narrative with the adage “Nothing about me without me” as a tangible statement, which could be seen—from a POD perspective—as an embodiment of the “earth-is-round” fundamental for the current MHC context. For example, this adage takes shared decision-making, which is being pursued in current practice, to a higher level by extending it to shared meaning-making and shared decision-making . This adThis study suggests continuing, after this adage, with the required values, attitude, and skills because the associated elements relate to the dialogical mindset . SubsequHowever, leaving the organizational elements until the last part of such a (P)OD narrative may also involve a risk of misconceptions. As In line with the literature, the results of this study suggest that explaining the (P)OD approach only partly or fragmented in separate elements may result in a lack of genuine understanding of the (P)OD approach and dilute the uniqueness and innovativeness of the (P)OD approach . For exaWe hope that these six aspects give guidance to and contribute to making (P)OD more understandable for non-(P)OD-trained professionals. In doing so, we hope that this better understanding might be one of the building blocks for improving (P)OD adoption in existing MHC practices, which are on their way toward person-centered, recovery-based, and network-oriented care.4.1.We acknowledge that the study also has a number of caveats. One relates to the sampling, in which care was taken to include multiple perspectives of the POD-trained professionals to gain a rich view. However, we only took into account different professional backgrounds and their attitude on (P)OD. Other possible influencing factors were not taken into account, e.g., level of communication skills, degree of experience with applying (P)OD, or communicating about (P)OD. In addition, none of the participants was decidedly negative in their vision of POD. This may have skewed our participants’ view on what is needed to make (P)OD better understandable. Furthermore, the consequences of the COVID-19 pandemic may have influenced the choice of eligible POD professionals to participate in this study.Moreover, these six aspects to provide guidance to and contribute to making (P)OD better understandable may be context-dependent. For example, the order in which the elements can best be introduced in the narrative can differ per context. If, for example, in a context the notions of involving the network, visiting clients in the home situation, or staying involved are new, it might be needed to introduce these elements earlier in the narrative than portrayed in this study, which took place in the Dutch context.Furthermore, the aim of this study was to provide guidance to and contribute to making (P)OD better understandable for non-POD-trained professionals. However, the saying ‘it takes two to tango’ applies also to making (P)OD better understandable. In this study, we have only included the perspective of POD professionals. Whether the found aspects can truly contribute to making (P)OD better understandable should also be viewed from the perspective of non-POD-trained professionals. An example of an aspect that might be difficult for (P)OD professionals to judge is whether the language they use is attuned to the context. Moreover, the way it will be perceived may also be influenced by the tone of voice and the manner in which the message is conveyed by the (P)OD-trained professional. Introducing such a transformative philosophy requires an understanding, attentive, and careful approach. The (P)OD approach may provide guidance on how to convey the POD approach to non-POD-trained professionals. Analogous to the transformative dialogue with clients and the network during treatment sessions, POD professionals could entice non-POD-trained professionals to join in a creative collaborative reciprocal act of finding new meanings. First, the POD professional would then aim to connect with colleagues by being responsive to the utterances of the non-POD professional, and second, to gradually introduce the POD philosophy in an active participatory manner. Being dialogical could help to carefully consider the socio-cultural fit to local conditions  by beingThe next valuable step after this study may be to evaluate with non-(P)OD-trained professionals whether and how the six aspects improve the understanding of (P)OD among non-(P)OD-trained professionals. The moment that (P)OD is better understood, the question will rise whether this better understanding indeed leads to greater support for (P)OD and to better adoption. Because even when (P)OD is fully understood and embraced, applying it in practice is another matter and requires nuance, timing, and balancing. For example, professionals should not draw the elements of the (P)OD narrative in absolute, which may be the risk of trying to capture (P)OD in a compact, comprehensive, and demarcated (P)OD narrative, just as Even though there are still questions to be tackled on the road to broader adoption of (P)OD, starting with making the POD approach better understandable for non-(P)OD-trained professionals, could be the first step to facilitating an open dialogue about the potentials of this approach within a changing mental health system on its way to (inter)person-centered, recovery-based, and network-oriented care.c.a.g.lorenz@tilburguniversity.edu.The datasets presented in this article are not readily available because the raw data supporting the conclusions of this article cannot be made completely anonymous. Requests to access the datasets should be directed to KL-A, The studies involving human participants were reviewed and approved by Ethical Review Board of Tilburg School of Social and Behavioral Sciences, Tilburg University (REF RP195). The patients/participants provided their written informed consent to participate in this study.KL-A, JB, and IB: conceptualization and methodology, and writing, reviewing, and editing. KL-A: thematic analysis and writing the original draft preparation. KL-A and JB: analysis and interpretation of results and project administration. JB and IB: supervision. All authors contributed to the article and approved the submitted version.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.