Case Clinic
A Case Clinic is a peer coaching process in which one person presents a current leadership challenge and a small circle of peers acts as coaches. Instead of giving advice, the coaches listen, sit in silence and then mirror back the images, feelings and gestures the case evoked in them before the group moves into open dialogue. It comes from Otto Scharmer's Theory U and is published in the Presencing Institute's toolkit.
Facilitation script
- 1
Settle in, read through the process together, agree confidentiality, and choose the case giver and the timekeeper.
10 min - 2
Intention statement: the case giver presents the situation, their aim, their learning edge and where they need help. Coaches listen and ask clarifying questions only.
15 min - 3
Stillness: everyone is silent and notes which images, feelings and gestures the case has evoked.
3 min - 4
Mirroring: each coach shares what came up, then the case giver reflects on what they heard.
10 min - 5
Generative dialogue: the group explores what the mirroring shows about the case and builds on each other's ideas.
20 min - 6
Closing remarks from the coaches, then from the case giver on how they now see the situation, followed by thanks.
8 min - 7
Individual journaling to capture learning points.
4 min
Tips
The silence and the mirroring are what make this format different, and they are the first things an uneasy group will cut.
Hold the full three minutes and ask coaches to begin with "an image that came to me" or "what I felt was" so they do not slide into analysis.
Choose a case in which the case giver is a key player and can act; a complaint about other people gives the coaches nothing to mirror.
Agree confidentiality before the case starts.
Common pitfalls
Coaches turning the clarifying questions into advice, which puts the case giver on the defensive before the mirroring has started
Shortening or skipping the silence, so the mirroring round produces opinions about the case instead of images and feelings
The case giver using all the time to tell the back story and never naming what they need help with
Treating the generative dialogue as a solutions brainstorm and pressing the case giver to commit to a plan
Mirroring that judges the case giver, for example "I felt you were avoiding the issue", which damages trust in the circle
Variations
The steps add up to 60 minutes and the handout asks for at least 70, which leaves room for settling in and for transitions. In programmes such as u.lab the same small group meets several times so that each member presents a case once; this recurring form is usually called a coaching circle. Online it works well in a breakout room with cameras on and notifications off. If only three people are available, one fewer than the handout asks for, it can still be run with two coaches and a longer dialogue.
Where it fits
When to use it
A participant faces a pressing leadership situation in which they hold a key role and do not yet know what to do
A cohort in a leadership programme should form peer groups that keep meeting after the course
The group already has plenty of advice-giving formats and needs practice in listening and reflecting back
A case is emotionally loaded and the person needs to be heard before they can think about options
You have 70 uninterrupted minutes and a room where a small group can speak confidentially
When not to use it
The person wants concrete suggestions quickly: Troika Consulting or Wise Crowds delivers advice in 15 to 30 minutes
Members of the group are in a hierarchy with each other, since the format assumes peers
The case is hypothetical or the case giver cannot influence it; choose a different case
The group has not met before and is sceptical of silence and of talking about feelings: start with a Peer Coaching Circle and introduce mirroring later
The issue is a personal crisis that calls for professional support; peers mirroring images is not a substitute for that
Related methods
Frequently asked questions
What is a Case Clinic?▾
A Case Clinic is a peer coaching process from Otto Scharmer's Theory U. One person presents a current leadership challenge, and three to five peers act as coaches: they listen, sit in silence and then mirror back the images, feelings and gestures the case evoked, without giving advice. A generative dialogue and closing reflections follow, and the whole process takes about 70 minutes.
How is a Case Clinic different from Troika Consulting?▾
Troika Consulting is short and advice-oriented: two consultants discuss ideas while the client listens. A Case Clinic takes about 70 minutes, rules out advice in the early steps and adds a period of silence and a mirroring round. It suits situations where the person needs a new way of seeing the problem more than a list of suggestions.
What does mirroring mean in a Case Clinic?▾
After the silence, each coach shares what the case evoked in them: an image or metaphor, a feeling, or a gesture. They do not explain, analyse or recommend. The case giver hears how their situation lands with others, which often shows them something they had not put into words.
How many people take part in a Case Clinic?▾
The Presencing Institute handout gives groups of four to six peers: one case giver and three to five coaches, one of whom also keeps time. Larger groups should split so that everyone has room to speak in the mirroring round.
Who should be the case giver?▾
Someone with a challenge that is current, concrete and important to them, and in which they are a key player. The format assumes the others are peers without a reporting relationship to the case giver. In recurring coaching circles the role rotates so that each member presents once.
Plan your next workshop with AI
Workshop Weaver helps you combine methods like Case Clinic into a complete, timed agenda in minutes.
Try it freeMethod descriptions on Workshop Weaver are original content written by our team, based on established facilitation practices. This method was inspired by work from Otto Scharmer / Presencing Institute (Theory U).