Having Difficult Conversations and Managing Conflict within a Multidisciplinary Team

Communication and Team Dynamics[1]

While there are considerable demonstrated benefits to forming a multidisciplinary team (MDT), the process of sorting out the underlying framework requires patience. Working across disciplines towards a common goal can be rewarding, but transparency and trust are vital in maintaining a smooth, successful process. Along the way, it is probable that conflicts and tension will manifest; this is likely to be unavoidable, as each member/agency will bring their own personal and organizational governing values and principles to the table. Whether tensions are the result of individual conflicts or system-wide pressures, these challenges must be confronted directly and addressed as soon as they become apparent.

Without confronting these tension points head-on, an MDT runs the possibility of reaching troubling impasses which may arise at inopportune times. These difficult conversations are not indicative of failure on the part of a team or any member.

It’s not the absence of conflict, but rather how conflict is navigated that supports the conditions for a healthy team. In fact, working across differences is necessary to create a response that is truly in the best interest of children, youth and families as well as each MDT member agency. This guide provides an overview of the Crucial Conversations model as a method for addressing team dynamics.

Crucial Conversations

Fortunately, there is a considerable amount of research which can help MDTs to manage Crucial Conversations surrounding conflict and tension within the team. This is essential, as “developing a communication climate where information is proactively shared, and the needs of other agencies are understood”[2] is a staple of high-functioning MDTs. Similarly, trust is the foundation of authentic teamwork, and “for a successful MDT, members must trust and respect each other and be committed to the team.”[3]

A Crucial Conversation is a discussion between two or more people where (1) stakes are high, (2) opinions vary, and (3) emotions run strong.[4]

These “crucial” conversations, though important, do not always go smoothly. They are distinguished from “typical” conversations in three distinct ways:

• First, opinions vary.
• Second, the stakes are high.
• Third, emotions run strong.

In the case of an MDT, this is particularly relevant, as members are highly trained and experienced professionals making substantial decisions affecting the lives of abused children, youth and their families. There are several reasons these conversations tend not to go well:

• Emotions tend to rule.
• The body physically reacts.
• Members are under pressure.
• Members are stumped.
• Members act in self-defeating ways.

For conflicts to become productive instead of damaging, an MDT should seek to appreciate the value of these tension points and develop skills to manage them constructively. Look out for when conversations become “crucial” – pay attention to heightened emotions, silence, and spitefulness as conversations move into this territory.

How to Prepare for Crucial Conversations

Start with yourself! Focus on what you really want, avoiding your default choice, and asking yourself if you are behaving in ways that move you towards your true goals. Look inward, and ask yourself the following:

• Am I noticing/reflecting on my role in the problem?
• What can I do right now to move forward?
• Am I really open to others’ views, opinions, and ideas?
• Am I confidently expressing my own views?
• Am I actively exploring others’ views or just pacifying?

Make it a safe environment for all members to have these conversations without the threat of things becoming disrespectful. Apologize when it is appropriate, create mutual purpose, and be intentional in ensuring that you are maintaining your respect and integrity.

Many crucial conversations arise over simple misunderstandings, but even minor squabbles can fester and significantly impact communication over time. Regardless of what stage of the MDT development/operation process a team is in, periodically ask: what conversations are we not having that are keeping us stuck?

The Process of Confronting and Negotiating

As teams begin the process of resolving their tension points, there are a number of issues to tackle and address before diving in. When necessary, refer back to the team’s mission statement (or similar governing philosophy) that has been collectively identified, and facilitate a straightforward and respectful conversation bridging this with the concerns of the team members. Common tension points within teams include:

• Conflicting/competing interests.
• Critiquing a team member’s work.
• Longstanding interpersonal/interagency disputes.
• Giving a team member feedback about their conduct.
• Approaching a team member who isn’t keeping commitments.
• Talking to a team member hoarding information or other resources.
• Cases with circumstances related to difficult issues.

After taking the necessary time to reflect and do the self-work these situations require, a process of confrontation and negotiation is likely to result in the most favorable outcomes. Here, confrontation is defined as, “the direct expression of one’s view of the conflict and one’s feelings about it while inviting the opposition to do the same.”[5] To initiate crucial conversations from a neutral standpoint, team members should abide by the following:

• Confront only with ample time to cooperatively articulate the issue.
• Schedule a mutually agreeable negotiating session.
• Communicate feelings and perceptions of the issue directly and non-hostilely.
• Ensure all sides fully understand each other’s viewpoints.

When managed successfully, this confrontation style will set up a negotiation opportunity. Here, negotiation is defined as, “a conflict resolution process by which people who want to come to an agreement, but disagree about the way to resolve, try to work out a settlement.”[6] Upon commencing a mutually agreed upon negotiation session, the following steps are recommended of all parties in the course of negotiating a conflict:[7]

• Mutually define the current tension points.
• Communicate feelings, standpoints, and the intention to cooperate.
• Verbalize the conflicting perspectives.
• Coordinate the motivation to negotiate.
• Reach agreements which satisfy all parties.
• Ensure agreements remain true to the MDT’s written overarching ideals.

Resolving tensions via this process of confronting and negotiating requires time and energy, but the results are worth the effort. As a team gains more experience working through this process, it will become increasingly incorporated into team practice over time. Similarly, as a team progresses and its interpersonal relationships develop, members will come to better understand each other’s unique personalities, idiosyncrasies, and communication styles. In the meantime, here are several additional useful tips for managing these crucial conversations:

• Refrain from disengaging and/or ignoring tensions.
• Avoid engaging in “win-lose” negotiations.
• Compromise in the interest of youth/families when time is short.
• Confront to begin problem-solving negotiations.
• Dialogue, not monologue.
• Use a sense of humor.

Sustainable Communications

To be successful, these conversations must occur within a structure where members are neither blamed nor ostracized for divergent views or lapses in performance but are truly esteemed and encouraged to learn. This model allows for true growth and development of team members. More importantly, when necessary, ensure solutions focus on broader system change rather than unsustainable/momentary interventions at the level of the individual worker. Promoting a safe, open, and honest climate can help team members raise controversial issues and have crucial conversations constructively.

There are many complicating factors in the MDT development process – politics and interpersonal dynamics; competing interests, ideologies, and philosophies; staff turnover; and many others.  Certain partners (either individual stakeholders or entire agencies/systems) working together may prove challenging. Having diverse membership is an essential component of teams which can effectively handle the complex issues associated with child abuse cases.

Regardless of the difficulties associated with having these conversations, for your team to be as successful as possible, it’s important to master this process of confronting and successfully negotiating conflict. This not only helps improve the relationships and overall functioning of teams but move them towards better outcomes and realities in the lives of the youth and families they serve.

Endnotes

[1] Much of this article draws upon the following two works: Crucial Conversations, by Kerry Patterson, Joseph Grenny, Ron McMillan, & Al Switzler (2002), Managing Conflict in Multidisciplinary Teams, by Karl Smith (1999)

[2] Ballard et al., 2017

[3] Lashley, 2005

[4] Vital Smarts. “Glossary.” Accessed online: https://www.vitalsmarts.com/crucialskills/glossary/#q7.

[5] Smith, 1999

[6] ibid

[7] Johnson & Johnson, 1995