The Brazilian health sector has undergone a severe crisis, affecting the case-resolving capacity, efficiency and governability of the health system as a whole and health organizations in particular. Although innovative management systems and tools have been encouraged, such innovations are limited in their ability to spawn organizational change, especially with regard to the challenge of enabling individual adherence to institutional projects and relations involving individuals and organizations. This paper focuses on the French psychosociological approach for analyzing and intervening in organizations, one of whose main thinkers is Eugène Enriquez. In its view of contemporary organizations, this approach focuses on the conflict between reproduction and creation as the main problem to be solved by management processes. While an organization is essentially seen as a place of order and repetition, organizational change implies the challenge of bringing creative individuals into the organization's project, avoiding the trap of controlling their minds and behavior.