recent research shows that in the forming and storming stages

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Using the Stages of Team Development

By Judith Stein

Team effectiveness is enhanced by a team's commitment to reflection and on-going evaluation. In addition to evaluating accomplishments in terms of meeting specific goals, for teams to be high-performing it is essential for them to understand their development as a team. Most of us are familiar with the concept of "the terrible twos" in early childhood; understanding that developmental stage makes it easier to accept the constant stream of "No No No No No" that we might hear from a two-year old.

Teams go through stages of development. The most commonly used framework for a team's stages of development was developed in the mid-1960s by Bruce W. Tuckman. Although many authors have written variations and enhancements to Tuckman's work, his descriptions of Forming, Storming, Norming and Performing provide a useful framework for looking at your own team.

Each stage of team development has its own recognizable feelings and behaviors; understanding why things are happening in certain ways on your team can be an important part of the self-evaluation process.

The four stages are a helpful framework for recognizing a team's behavioral patterns; they are most useful as a basis for team conversation, rather than boxing the team into a "diagnosis." And just as human development is not always linear (think of the five-year old child who reverts to thumb-sucking when a new sibling is born), team development is not always a linear process. Having a way to identify and understand causes for changes in the team behaviors can help the team maximize its process and its productivity.

Stage 1: Forming

During the Forming stage of team development, team members are usually excited to be part of the team and eager about the work ahead. Members often have high positive expectations for the team experience. At the same time, they may also feel some anxiety, wondering how they will fit in to the team and if their performance will measure up.

Behaviors observed during the Forming stage may include lots of questions from team members, reflecting both their excitement about the new team and the uncertainty or anxiety they might be feeling about their place on the team.

The principal work for the team during the Forming stage is to create a team with clear structure, goals, direction and roles so that members begin to build trust. A good orientation/kick-off process can help to ground the members in terms of the team's mission and goals, and can establish team expectations about both the team's product and, more importantly, the team's process. During the Forming stage, much of the team's energy is focused on defining the team so task accomplishment may be relatively low.

Stage 2: Storming

As the team begins to move towards its goals, members discover that the team can't live up to all of their early excitement and expectations. Their focus may shift from the tasks at hand to feelings of frustration or anger with the team's progress or process. Members may express concerns about being unable to meet the team's goals. During the Storming stage, members are trying to see how the team will respond to differences and how it will handle conflict.

Behaviors during the Storming stage may be less polite than during the Forming stage, with frustration or disagreements about goals, expectations, roles and responsibilities being openly expressed. Members may express frustration about constraints that slow their individual or the team's progress; this frustration might be directed towards other members of the team, the team leadership or the team's sponsor. During the Storming stage, team members may argue or become critical of the team's original mission or goals.

Team Tasks during the Storming stage of development call for the team to refocus on its goals, perhaps breaking larger goals down into smaller, achievable steps. The team may need to develop both task-related skills and group process and conflict management skills. A redefinition of the team's goals, roles and tasks can help team members past the frustration or confusion they experience during the Storming stage.

Stage 3: Norming

During the Norming stage of team development, team members begin to resolve the discrepancy they felt between their individual expectations and the reality of the team's experience. If the team is successful in setting more flexible and inclusive norms and expectations, members should experience an increased sense of comfort in expressing their "real" ideas and feelings. Team members feel an increasing acceptance of others on the team, recognizing that the variety of opinions and experiences makes the team stronger and its product richer. Constructive criticism is both possible and welcomed. Members start to feel part of a team and can take pleasure from the increased group cohesion.

Behaviors during the Norming stage may include members making a conscious effort to resolve problems and achieve group harmony. There might be more frequent and more meaningful communication among team members, and an increased willingness to share ideas or ask teammates for help. Team members refocus on established team groundrules and practices and return their focus to the team's tasks. Teams may begin to develop their own language (nicknames) or inside jokes.

During the Norming stage, members shift their energy to the team's goals and show an increase in productivity, in both individual and collective work. The team may find that this is an appropriate time for an evaluation of team processes and productivity.

Stage 4: Performing

In the Performing stage of team development, members feel satisfaction in the team's progress. They share insights into personal and group process and are aware of their own (and each other's) strengths and weaknesses. Members feel attached to the team as something "greater than the sum of its parts" and feel satisfaction in the team's effectiveness. Members feel confident in their individual abilities and those of their teammates.

Team members are able to prevent or solve problems in the team's process or in the team's progress. A "can do" attitude is visible as are offers to assist one another. Roles on the team may have become more fluid, with members taking on various roles and responsibilities as needed. Differences among members are appreciated and used to enhance the team's performance.

In the Performing stage, the team makes significant progress towards its goals. Commitment to the team's mission is high and the competence of team members is also high. Team members should continue to deepen their knowledge and skills, including working to continuously improving team development. Accomplishments in team process or progress are measured and celebrated.

Is the "Performing" stage the end of the process?

While working on a high-performing team may be a truly pleasurable and growthful experience, it is not the end of team development. There is still a need for the team to focus on both process and product, setting new goals as appropriate. Changes, such as members coming or going or large-scale changes in the external environment, can lead a team to cycle back to an earlier stage. If these changes - and their resulting behaviors - are recognized and addressed directly, teams may successfully remain in the Performing stage indefinitely.

Stage 5: Termination/Ending

Some teams do come to an end, when their work is completed or when the organization’s needs change. While not part of Tuckman’s original model, it is important for any team to pay attention to the end or termination process.

Team members may feel a variety of concerns about the team’s impending dissolution. They may be feeling some anxiety because of uncertainty about their individual role or future responsibilities. They may feel sadness or a sense of loss about the changes coming to their team relationships. And at the same time, team members may feel a sense of deep satisfaction at the accomplishments of the team. Individual members might feel all of these things at the same time, or may cycle through feelings of loss followed by feelings of satisfaction. Given these conflicting feelings, individual and team morale may rise or fall throughout the ending stage. It is highly likely that at any given moment individuals on the team will be experiencing different emotions about the team's ending.

During the Ending Stage, some team members may become less focussed on the team's tasks and their productivity may drop. Alternatively, some team members may find focussing on the task at hand is an effective response to their sadness or sense of loss. Their task productivity may increase.

The team needs to acknowledge the upcoming transition and the variety of ways that individuals and the team may be feeling about the team’s impending dissolution. During this stage, the team should focus on three tasks:

• Completion of any deliverables and closure on any remaining team work
• Evaluation of the team’s process and product, with a particular focus on identifying "lessons learned" and passing these on to the sponsor for future teams to use
• Creating a closing celebration that acknowledges the contributions of individuals and the accomplishments of the team and that formally ends this particular team's existence.

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15.2 Team Development Over Time

• How do teams develop over time?

If you have been a part of a team—as most of us have—then you intuitively have felt that there are different “stages” of team development. Teams and team members often start from a position of friendliness and excitement about a project or endeavor, but the mood can sour and the team dynamics can go south very quickly once the real work begins. In 1965, educational psychologist Bruce Tuckman at Ohio State University developed a four-stage model to explain the complexities that he had witnessed in team development. The original model was called Tuckman’s Stages of Group Development, and he added the fifth stage of “Adjourning” in 1977 to explain the disbanding of a team at the end of a project. The four stages of the Tuckman model are: 3

The Forming stage begins with the introduction of team members. This is known as the “polite stage” in which the team is mainly focused on similarities and the group looks to the leader for structure and direction. The team members at this point are enthusiastic, and issues are still being discussed on a global, ambiguous level. This is when the informal pecking order begins to develop, but the team is still friendly.

The Storming stage begins as team members begin vying for leadership and testing the group processes. This is known as the “win-lose” stage, as members clash for control of the group and people begin to choose sides. The attitude about the team and the project begins to shift to negative, and there is frustration around goals, tasks, and progress.

After what can be a very long and painful Storming process for the team, slowly the Norming stage may start to take root. During Norming, the team is starting to work well together, and buy-in to group goals occurs. The team is establishing and maintaining ground rules and boundaries, and there is willingness to share responsibility and control. At this point in the team formation, members begin to value and respect each other and their contributions.

Finally, as the team builds momentum and starts to get results, it is entering the Performing stage. The team is completely self-directed and requires little management direction. The team has confidence, pride, and enthusiasm, and there is a congruence of vision, team, and self. As the team continues to perform, it may even succeed in becoming a high-performing team. High-performing teams have optimized both task and people relationships—they are maximizing performance and team effectiveness. Katzenberg and Smith, in their study of teams, have created a “team performance curve” that graphs the journey of a team from a working group to a high-performing team. The team performance curve is illustrated in Exhibit 15.5 .

The process of becoming a high-performance team is not a linear process. Similarly, the four stages of team development in the Tuckman model are not linear, and there are also factors that may cause the team to regress to an earlier stage of development. When a team member is added to the group, this may change the dynamic enough and be disruptive enough to cause a backwards slide to an earlier stage. Similarly, if a new project task is introduced that causes confusion or anxiety for the group, then this may also cause a backwards slide to an earlier stage of development. Think of your own experiences with project teams and the backslide that the group may have taken when another team member was introduced. You may have personally found the same to be true when a leader or project sponsor changes the scope or adds a new project task. The team has to re-group and will likely re-Storm and re-Form before getting back to Performing as a team.

Catching the Entrepreneurial Spirit

Starting the startup team.

Nothing is more exciting than a startup business. The enthusiasm is high, and people are excited about the new venture and the prospects that await. Depending on the situation, there may be funding that the startup has received from investors, or the startup could be growing and powering itself organically. Either way, the startup faces many different questions in the beginning, which will have a tremendous impact on its growth potential and performance down the road. One of the most critical questions that faces a startup —or any business for that matter—is the question of who should be on the team. Human capital is the greatest asset that any company can have, and it is an especially critical decision in a startup environment when you have limited resources and those resources will be responsible for building the company from ground up.

In Noam Wasserman’s January 2012 HBSP article “Assembling the Startup Team,” Wasserman asserts:

“ Nothing can bedevil a high-potential startup more than its people problems. In research on startup performance, venture capitalists attributed 65% of portfolio company failures to problems within the startup’s management team. Another study asked investors to identify problems that might occur at their portfolio companies; 61% of the problems involved team issues. These problems typically result from choices that founders make as they add team members…”

These statistics are based on people problems in startups, and it isn’t quite clear what percent of larger company failures could be directly or indirectly attributed to people and team issues. I would imagine that the percentage is also significant. The impact of people problems and team issues in a startup organization that is just getting its footing and trying to make the right connections and decisions can be very significant. If you know anyone who has a company in startup mode, you may have noticed that some of the early team members who are selected to join the team are trusted family members, friends, or former colleagues. Once a startup company grows to a certain level, then it may acquire an experienced CEO to take the helm. In any case, the startup is faced early on with important questions on how to build the team in a way that will maximize the chance of success.

In “Assembling the Startup Team,” the author refers to the three Rs: relationships, roles, and rewards as being key elements that must be managed effectively in order to avoid problems in the long term. Relationships refers to the actual team members that are chosen, and there are several caveats to keep in mind. Hiring relatives or close friends because they are trusted may seem like the right idea in the beginning, but the long-term hazards (per current research) outweigh the benefits. Family and friends may think too similarly, and the team misses the benefit of other perspectives and connections. Roles are important because you have to think about the division of labor and skills, as well as who is in the right roles for decision-making. The startup team needs to think through the implications of assigning people to specific roles, as that may dictate their decision power and status. Finally, defining the rewards can be difficult for the startup team because it essentially means that they are splitting the pie—i.e., both short-term and long-term compensation. For startup founders, this can be a very difficult decision when they have to weigh the balance of giving something away versus gaining human capital that may ultimately help the business to succeed. Thinking through the tradeoffs and keeping alignment between the “three Rs” is important because it challenges the startup team to think of the long-term consequences of some of their early decisions. It is easy to bring family and friends into the startup equation due to trust factors, but a careful analysis of the “three Rs” will help a startup leadership team make decisions that will pay off in the long term.

• Why might it be a bad decision to hire someone for a key startup role based only on the fact that the person is close family or a friend? What are the potential tradeoffs to the business?
• What does it mean for the “three Rs” to be in alignment? What is the potential risk of these not being in alignment? What could go wrong?

Concept Check

• What are the four stages of team development?
• What can cause a team to regress in its development?

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9.2 Group Dynamics

Learning objectives.

• Understand the difference between informal and formal groups.
• Learn the stages of group development.
• Identify examples of the punctuated equilibrium model.
• Learn how group cohesion affects groups.
• Learn how social loafing affects groups.
• Learn how collective efficacy affects groups.

Types of Groups: Formal and Informal

What is a group ? A group is a collection of individuals who interact with each other such that one person’s actions have an impact on the others. In organizations, most work is done within groups. How groups function has important implications for organizational productivity. Groups where people get along, feel the desire to contribute to the team, and are capable of coordinating their efforts may have high performance levels, whereas teams characterized by extreme levels of conflict or hostility may demoralize members of the workforce.

In organizations, you may encounter different types of groups. Informal work groups are made up of two or more individuals who are associated with one another in ways not prescribed by the formal organization. For example, a few people in the company who get together to play tennis on the weekend would be considered an informal group. A formal work group is made up of managers, subordinates, or both with close associations among group members that influence the behavior of individuals in the group. We will discuss many different types of formal work groups later on in this chapter.

Stages of Group Development

Forming, storming, norming, and performing.

American organizational psychologist Bruce Tuckman presented a robust model in 1965 that is still widely used today. Based on his observations of group behavior in a variety of settings, he proposed a four-stage map of group evolution, also known as the forming-storming-norming-performing model (Tuckman, 1965). Later he enhanced the model by adding a fifth and final stage, the adjourning phase . Interestingly enough, just as an individual moves through developmental stages such as childhood, adolescence, and adulthood, so does a group, although in a much shorter period of time. According to this theory, in order to successfully facilitate a group, the leader needs to move through various leadership styles over time. Generally, this is accomplished by first being more directive, eventually serving as a coach, and later, once the group is able to assume more power and responsibility for itself, shifting to a delegator. While research has not confirmed that this is descriptive of how groups progress, knowing and following these steps can help groups be more effective. For example, groups that do not go through the storming phase early on will often return to this stage toward the end of the group process to address unresolved issues. Another example of the validity of the group development model involves groups that take the time to get to know each other socially in the forming stage. When this occurs, groups tend to handle future challenges better because the individuals have an understanding of each other’s needs.

Figure 9.2 Stages of the Group Development Model

In the forming stage, the group comes together for the first time. The members may already know each other or they may be total strangers. In either case, there is a level of formality, some anxiety, and a degree of guardedness as group members are not sure what is going to happen next. “Will I be accepted? What will my role be? Who has the power here?” These are some of the questions participants think about during this stage of group formation. Because of the large amount of uncertainty, members tend to be polite, conflict avoidant, and observant. They are trying to figure out the “rules of the game” without being too vulnerable. At this point, they may also be quite excited and optimistic about the task at hand, perhaps experiencing a level of pride at being chosen to join a particular group. Group members are trying to achieve several goals at this stage, although this may not necessarily be done consciously. First, they are trying to get to know each other. Often this can be accomplished by finding some common ground. Members also begin to explore group boundaries to determine what will be considered acceptable behavior. “Can I interrupt? Can I leave when I feel like it?” This trial phase may also involve testing the appointed leader or seeing if a leader emerges from the group. At this point, group members are also discovering how the group will work in terms of what needs to be done and who will be responsible for each task. This stage is often characterized by abstract discussions about issues to be addressed by the group; those who like to get moving can become impatient with this part of the process. This phase is usually short in duration, perhaps a meeting or two.

Once group members feel sufficiently safe and included, they tend to enter the storming phase. Participants focus less on keeping their guard up as they shed social facades, becoming more authentic and more argumentative. Group members begin to explore their power and influence, and they often stake out their territory by differentiating themselves from the other group members rather than seeking common ground. Discussions can become heated as participants raise contending points of view and values, or argue over how tasks should be done and who is assigned to them. It is not unusual for group members to become defensive, competitive, or jealous. They may even take sides or begin to form cliques within the group. Questioning and resisting direction from the leader is also quite common. “Why should I have to do this? Who designed this project in the first place? Why do I have to listen to you?” Although little seems to get accomplished at this stage, group members are becoming more authentic as they express their deeper thoughts and feelings. What they are really exploring is “Can I truly be me, have power, and be accepted?” During this chaotic stage, a great deal of creative energy that was previously buried is released and available for use, but it takes skill to move the group from storming to norming. In many cases, the group gets stuck in the storming phase.

OB Toolbox: Avoid Getting Stuck in the Storming Phase!

There are several steps you can take to avoid getting stuck in the storming phase of group development. Try the following if you feel the group process you are involved in is not progressing:

• Normalize conflict . Let members know this is a natural phase in the group-formation process.
• Be inclusive . Continue to make all members feel included and invite all views into the room. Mention how diverse ideas and opinions help foster creativity and innovation.
• Make sure everyone is heard . Facilitate heated discussions and help participants understand each other.
• Support all group members . This is especially important for those who feel more insecure.
• Remain positive . This is a key point to remember about the group’s ability to accomplish its goal.
• Don’t rush the group’s development . Remember that working through the storming stage can take several meetings.

Once group members discover that they can be authentic and that the group is capable of handling differences without dissolving, they are ready to enter the next stage, norming.

“We survived!” is the common sentiment at the norming stage. Group members often feel elated at this point, and they are much more committed to each other and the group’s goal. Feeling energized by knowing they can handle the “tough stuff,” group members are now ready to get to work. Finding themselves more cohesive and cooperative, participants find it easy to establish their own ground rules (or norms ) and define their operating procedures and goals. The group tends to make big decisions, while subgroups or individuals handle the smaller decisions. Hopefully, at this point the group is more open and respectful toward each other, and members ask each other for both help and feedback. They may even begin to form friendships and share more personal information with each other. At this point, the leader should become more of a facilitator by stepping back and letting the group assume more responsibility for its goal. Since the group’s energy is running high, this is an ideal time to host a social or team-building event.

Galvanized by a sense of shared vision and a feeling of unity, the group is ready to go into high gear. Members are more interdependent, individuality and differences are respected, and group members feel themselves to be part of a greater entity. At the performing stage, participants are not only getting the work done, but they also pay greater attention to how they are doing it. They ask questions like, “Do our operating procedures best support productivity and quality assurance? Do we have suitable means for addressing differences that arise so we can preempt destructive conflicts? Are we relating to and communicating with each other in ways that enhance group dynamics and help us achieve our goals? How can I further develop as a person to become more effective?” By now, the group has matured, becoming more competent, autonomous, and insightful. Group leaders can finally move into coaching roles and help members grow in skill and leadership.

Just as groups form, so do they end. For example, many groups or teams formed in a business context are project oriented and therefore are temporary in nature. Alternatively, a working group may dissolve due to an organizational restructuring. Just as when we graduate from school or leave home for the first time, these endings can be bittersweet, with group members feeling a combination of victory, grief, and insecurity about what is coming next. For those who like routine and bond closely with fellow group members, this transition can be particularly challenging. Group leaders and members alike should be sensitive to handling these endings respectfully and compassionately. An ideal way to close a group is to set aside time to debrief (“How did it all go? What did we learn?”), acknowledge each other, and celebrate a job well done.

The Punctuated-Equilibrium Model

As you may have noted, the five-stage model we have just reviewed is a linear process. According to the model, a group progresses to the performing stage, at which point it finds itself in an ongoing, smooth-sailing situation until the group dissolves. In reality, subsequent researchers, most notably Joy H. Karriker, have found that the life of a group is much more dynamic and cyclical in nature (Karriker, 2005). For example, a group may operate in the performing stage for several months. Then, because of a disruption, such as a competing emerging technology that changes the rules of the game or the introduction of a new CEO, the group may move back into the storming phase before returning to performing. Ideally, any regression in the linear group progression will ultimately result in a higher level of functioning. Proponents of this cyclical model draw from behavioral scientist Connie Gersick’s study of punctuated equilibrium (Gersick, 1991).

The concept of punctuated equilibrium was first proposed in 1972 by paleontologists Niles Eldredge and Stephen Jay Gould, who both believed that evolution occurred in rapid, radical spurts rather than gradually over time. Identifying numerous examples of this pattern in social behavior, Gersick found that the concept applied to organizational change. She proposed that groups remain fairly static, maintaining a certain equilibrium for long periods of time. Change during these periods is incremental, largely due to the resistance to change that arises when systems take root and processes become institutionalized. In this model, revolutionary change occurs in brief, punctuated bursts, generally catalyzed by a crisis or problem that breaks through the systemic inertia and shakes up the deep organizational structures in place. At this point, the organization or group has the opportunity to learn and create new structures that are better aligned with current realities. Whether the group does this is not guaranteed. In sum, in Gersick’s model, groups can repeatedly cycle through the storming and performing stages, with revolutionary change taking place during short transitional windows. For organizations and groups who understand that disruption, conflict, and chaos are inevitable in the life of a social system, these disruptions represent opportunities for innovation and creativity.

Figure 9.3 The Punctuated Equilibrium Model

Cohesion can be thought of as a kind of social glue. It refers to the degree of camaraderie within the group. Cohesive groups are those in which members are attached to each other and act as one unit. Generally speaking, the more cohesive a group is, the more productive it will be and the more rewarding the experience will be for the group’s members (Beal et al., 2003; Evans & Dion, 1991). Members of cohesive groups tend to have the following characteristics: They have a collective identity; they experience a moral bond and a desire to remain part of the group; they share a sense of purpose, working together on a meaningful task or cause; and they establish a structured pattern of communication.

The fundamental factors affecting group cohesion include the following:

• Similarity . The more similar group members are in terms of age, sex, education, skills, attitudes, values, and beliefs, the more likely the group will bond.
• Stability . The longer a group stays together, the more cohesive it becomes.
• Size . Smaller groups tend to have higher levels of cohesion.
• Support . When group members receive coaching and are encouraged to support their fellow team members, group identity strengthens.
• Satisfaction . Cohesion is correlated with how pleased group members are with each other’s performance, behavior, and conformity to group norms.

As you might imagine, there are many benefits in creating a cohesive group. Members are generally more personally satisfied and feel greater self-confidence and self-esteem when in a group where they feel they belong. For many, membership in such a group can be a buffer against stress, which can improve mental and physical well-being. Because members are invested in the group and its work, they are more likely to regularly attend and actively participate in the group, taking more responsibility for the group’s functioning. In addition, members can draw on the strength of the group to persevere through challenging situations that might otherwise be too hard to tackle alone.

OB Toolbox: Steps to Creating and Maintaining a Cohesive Team

• Align the group with the greater organization . Establish common objectives in which members can get involved.
• Let members have choices in setting their own goals . Include them in decision making at the organizational level.
• Define clear roles . Demonstrate how each person’s contribution furthers the group goal—everyone is responsible for a special piece of the puzzle.
• Situate group members in close proximity to each other . This builds familiarity.
• Give frequent praise . Both individuals and groups benefit from praise. Also encourage them to praise each other. This builds individual self-confidence, reaffirms positive behavior, and creates an overall positive atmosphere.
• Treat all members with dignity and respect . This demonstrates that there are no favorites and everyone is valued.
• Celebrate differences . This highlights each individual’s contribution while also making diversity a norm.
• Establish common rituals . Thursday morning coffee, monthly potlucks—these reaffirm group identity and create shared experiences.

Can a Group Have Too Much Cohesion?

Keep in mind that groups can have too much cohesion. Because members can come to value belonging over all else, an internal pressure to conform may arise, causing some members to modify their behavior to adhere to group norms. Members may become conflict avoidant, focusing more on trying to please each other so as not to be ostracized. In some cases, members might censor themselves to maintain the party line. As such, there is a superficial sense of harmony and less diversity of thought. Having less tolerance for deviants, who threaten the group’s static identity, cohesive groups will often excommunicate members who dare to disagree. Members attempting to make a change may even be criticized or undermined by other members, who perceive this as a threat to the status quo. The painful possibility of being marginalized can keep many members in line with the majority.

The more strongly members identify with the group, the easier it is to see outsiders as inferior, or enemies in extreme cases, which can lead to increased insularity. This form of prejudice can have a downward spiral effect. Not only is the group not getting corrective feedback from within its own confines, it is also closing itself off from input and a cross-fertilization of ideas from the outside. In such an environment, groups can easily adopt extreme ideas that will not be challenged. Denial increases as problems are ignored and failures are blamed on external factors. With limited, often biased, information and no internal or external opposition, groups like these can make disastrous decisions. Groupthink is a group pressure phenomenon that increases the risk of the group making flawed decisions by allowing reductions in mental efficiency, reality testing, and moral judgment. Groupthink is most common in highly cohesive groups (Janis, 1972).

Cohesive groups can go awry in much milder ways. For example, group members can value their social interactions so much that they have fun together but spend little time on accomplishing their assigned task. Or a group’s goal may begin to diverge from the larger organization’s goal and those trying to uphold the organization’s goal may be ostracized (e.g., teasing the class “brain” for doing well in school).

In addition, research shows that cohesion leads to acceptance of group norms (Goodman, Ravlin, & Schminke, 1987). Groups with high task commitment do well, but imagine a group where the norms are to work as little as possible? As you might imagine, these groups get little accomplished and can actually work together against the organization’s goals.

Low task commitmentHigh task commitmentLow group cohesionLow performancePerformance ranges depending on a number of factorsHigh group cohesionLow performanceHigh performance

Groups with high cohesion and high task commitment tend to be the most effective.

Social Loafing

Social loafing refers to the tendency of individuals to put in less effort when working in a group context. This phenomenon, also known as the Ringelmann effect, was first noted by French agricultural engineer Max Ringelmann in 1913. In one study, he had people pull on a rope individually and in groups. He found that as the number of people pulling increased, the group’s total pulling force was less than the individual efforts had been when measured alone (Karau & Williams, 1993).

Why do people work less hard when they are working with other people? Observations show that as the size of the group grows, this effect becomes larger as well (Karau & Williams, 1993). The social loafing tendency is less a matter of being lazy and more a matter of perceiving that one will receive neither one’s fair share of rewards if the group is successful nor blame if the group fails. Rationales for this behavior include, “My own effort will have little effect on the outcome,” “Others aren’t pulling their weight, so why should I?” or “I don’t have much to contribute, but no one will notice anyway.” This is a consistent effect across a great number of group tasks and countries (Gabrenya, Latane, & Wang, 1983; Harkins & Petty, 1982; Taylor & Faust, 1952; Ziller, 1957). Research also shows that perceptions of fairness are related to less social loafing (Price, Harrison, & Gavin, 2006). Therefore, teams that are deemed as more fair should also see less social loafing.

OB Toolbox: Tips for Preventing Social Loafing in Your Group

When designing a group project, here are some considerations to keep in mind:

• Carefully choose the number of individuals you need to get the task done . The likelihood of social loafing increases as group size increases (especially if the group consists of 10 or more people), because it is easier for people to feel unneeded or inadequate, and it is easier for them to “hide” in a larger group.
• Clearly define each member’s tasks in front of the entire group . If you assign a task to the entire group, social loafing is more likely. For example, instead of stating, “By Monday, let’s find several articles on the topic of stress,” you can set the goal of “By Monday, each of us will be responsible for finding five articles on the topic of stress.” When individuals have specific goals, they become more accountable for their performance.
• Design and communicate to the entire group a system for evaluating each person’s contribution . You may have a midterm feedback session in which each member gives feedback to every other member. This would increase the sense of accountability individuals have. You may even want to discuss the principle of social loafing in order to discourage it.
• Build a cohesive group . When group members develop strong relational bonds, they are more committed to each other and the success of the group, and they are therefore more likely to pull their own weight.
• Assign tasks that are highly engaging and inherently rewarding . Design challenging, unique, and varied activities that will have a significant impact on the individuals themselves, the organization, or the external environment. For example, one group member may be responsible for crafting a new incentive-pay system through which employees can direct some of their bonus to their favorite nonprofits.
• Make sure individuals feel that they are needed . If the group ignores a member’s contributions because these contributions do not meet the group’s performance standards, members will feel discouraged and are unlikely to contribute in the future. Make sure that everyone feels included and needed by the group.

Collective Efficacy

Collective efficacy refers to a group’s perception of its ability to successfully perform well (Bandura, 1997). Collective efficacy is influenced by a number of factors, including watching others (“that group did it and we’re better than them”), verbal persuasion (“we can do this”), and how a person feels (“this is a good group”). Research shows that a group’s collective efficacy is related to its performance (Gully et al., 2002; Porter, 2005; Tasa, Taggar, & Seijts, 2007). In addition, this relationship is higher when task interdependence (the degree an individual’s task is linked to someone else’s work) is high rather than low.

Key Takeaway

Groups may be either formal or informal. Groups go through developmental stages much like individuals do. The forming-storming-norming-performing-adjourning model is useful in prescribing stages that groups should pay attention to as they develop. The punctuated-equilibrium model of group development argues that groups often move forward during bursts of change after long periods without change. Groups that are similar, stable, small, supportive, and satisfied tend to be more cohesive than groups that are not. Cohesion can help support group performance if the group values task completion. Too much cohesion can also be a concern for groups. Social loafing increases as groups become larger. When collective efficacy is high, groups tend to perform better.

• If you believe the punctuated-equilibrium model is true about groups, how can you use this knowledge to help your own group?
• Think about the most cohesive group you have ever been in. How did it compare in terms of similarity, stability, size, support, and satisfaction?
• Why do you think social loafing occurs within groups?
• What can be done to combat social loafing?
• Have you seen instances of collective efficacy helping or hurting a team? Please explain your answer.

Bandura, A. (1997). Self-efficacy: The exercise of control . San Francisco: Jossey-Bass.

Beal, D. J., Cohen, R. R., Burke, M. J., & McLendon, C. L. (2003). Cohesion and performance in groups: A meta-analytic clarification of construct relations. Journal of Applied Psychology , 88 , 989–1004.

Evans, C. R., & Dion, K. L. (1991). Group cohesion and performance: A meta-analysis. Small Group Research , 22 , 175–186.

Gabrenya, W. L., Latane, B., & Wang, Y. (1983). Social loafing in cross-cultural perspective. Journal of Cross-Cultural Perspective , 14 , 368–384.

Gersick, C. J. G. (1991). Revolutionary change theories: A multilevel exploration of the punctuated equilibrium paradigm. Academy of Management Review , 16 , 10–36.

Goodman, P. S., Ravlin, E., & Schminke, M. (1987). Understanding groups in organizations. Research in Organizational Behavior , 9 , 121–173.

Gully, S. M., Incalcaterra, K. A., Joshi, A., & Beaubien, J. M. (2002). A meta-analysis of team-efficacy, potency, and performance: Interdependence and level of analysis as moderators of observed relationships. Journal of Applied Psychology , 87 , 819–832.

Harkins, S., & Petty, R. E. (1982). Effects of task difficulty and task uniqueness on social loafing. Journal of Personality and Social Psychology , 43 , 1214–1229.

Janis, I. L. (1972). Victims of Groupthink . New York: Houghton Mifflin.

Karau, S. J., & Williams, K. D. (1993). Social loafing: A meta-analytic review and theoretical integration. Journal of Personality and Social Psychology , 65 , 681–706.

Karriker, J. H. (2005). Cyclical group development and interaction-based leadership emergence in autonomous teams: An integrated model. Journal of Leadership & Organizational Studies , 11 , 54–64.

Porter, C. O. L. H. (2005). Goal orientation: Effects on backing up behavior, performance, efficacy, and commitment in teams. Journal of Applied Psychology , 90 , 811–818.

Price, K. H., Harrison, D. A., & Gavin, J. H. (2006). Withholding inputs in team contexts: Member composition, interaction processes, evaluation structure, and social loafing. Journal of Applied Psychology , 91 , 1375–1384.

Tasa, K., Taggar, S., & Seijts, G. H. (2007). The development of collective efficacy in teams: A multilevel and longitudinal perspective. Journal of Applied Psychology , 92 , 17–27.

Taylor, D. W., & Faust, W. L. (1952). Twenty questions: Efficiency of problem-solving as a function of the size of the group. Journal of Experimental Psychology , 44 , 360–363.

Tuckman, B. (1965). Developmental sequence in small groups. Psychological Bulletin , 63 , 384–399.

Ziller, R. C. (1957). Four techniques of group decision-making under uncertainty. Journal of Applied Psychology , 41 , 384–388.

Organizational Behavior Copyright © 2017 by University of Minnesota is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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Collaborative On-Line Research and Learning

Tuckman's stages of group development, thomas treadwell.

Department of Psychology West Chester University of Pennsylvania [email protected]

Department of Management West Chester University of Pennsylvania [email protected]

Donna Ascraft

Department of Psychology Clarion University Clarion, PA [email protected]

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Stages of Group Development

These stages are commonly known as: Forming, Storming, Norming, Performing, and Adjourning. Tuckman's model explains that as the team develops maturity and ability, relationships establish, and leadership style changes to more collaborative or shared leadership.

Tuckman's original work simply described the way he had observed groups evolve, whether they were conscious of it or not. In CORAL, the real value is in recognizing where a team is in the developmental stage process, and assisting the team to enter a stage consistent with the collaborative work put forth. In the real world, teams are often forming and changing, and each time that happens, they can move to a different Tuckman Stage. A group might be happily Norming or Performing, but a new member might force them back into Storming, or a team member may miss meetings causing the team to fall back into Storming. Project guides will be ready for this, and will help the team get back to Performing as quickly as possible.

The initial forming stage is the process of putting the structure of the team together. Team members feel ambiguous and conflict is avoided at all costs due to the need to be accepted into the group. Team members look to a group leader for direction and guidance, usually CORAL project guides.

Observable Behaviors

• Tentative joining
• Orienting with others personally
• Avoids controversy
• Cliques may form
• Need for safety and approval
• Attempts to define tasks, processes, and how it will be decided here
• Discussion of problems not relevant to the task

Feelings and Thoughts

• Many feel excited, optimistic, and full of anticipation
• Others may feel suspicious, fearful, and anxious working with others
• What is expected of me
• Why are they here
• Uncertainty and Apprehension
• Team mission and vision
• Establish specific objectives and tasks
• Identify roles and responsibilities of team members
• Establish team ground rules
• Team member expectations
• Operational guidelines for team
• Effective in class meetings
• Effective Chat meetings
• 1st set of feedback from project guides

Leadership Required

• Project Guides & Instructors
• provide structure and task direction
• Allow for get-acquainted time
• Create an atmosphere of confidence and optimism
• Active involvement
• Team members believe an appointed leader necessary to make decisions
• One-way communication from leader to team-members

To advance  from this stage to the next stage, each member must relinquish the comfort zone of non-threatening topics and risk the possibility of conflict.

This stage begins to occur as the process of organizing tasks and processes surface interpersonal conflicts. Leadership, power, and structural issues dominate this stage.

• Arguing among members
• Vying for leadership
• Differences in points of view and personal style are evident
• Lack of role clarity
• Team organizing itself
• Power struggles and clashes
• Lack of consensus-seeking behaviors
• Lack of progress
• Establishes unrealistic goals
• Concern over excessive work

Feelings & Thoughts

• Feel Defensive
• Confusion, loss of interest can result
• Resistance to tasks
• Fluctuations in attitude about the team
• Unsure if I agree with teams mission and purpose
• Question the wisdom of team members
• Increase in tension and jealousy
• Unsure about my personal influence and freedom in the team
• We're not getting anywhere
• Inter & intra personal relationships
• Identify stylistic and personal differences
• Effective listening
• Giving and receiving feedback
• Conflict resolution
• Clarify and understand the team’s purpose
• Reestablish roles and ground rules
• How to deal with ‘some’ team members violating team codes of conduct
• Receiving Feedback from project guide
• Project guide & Instructors acknowledge conflict
• Project Guides suggest that consensus among team members
• Get members to assume more task responsibility
• Concept of Shared Leadership emerges
• Teach conflict resolution methods
• Offer support and praise
• Actively involved Team members begin consulting one another – shared leadership emerging but have difficulty with decision making

In order to progress  to the next stage, group members must move from a "testing and proving" mentality to a problem-solving mentality. The most important trait in helping teams move to the next stage is the ability of team members to listen to their team mates - what are they trying to say?

In this stage, team members are creating new ways of doing and being together. As the group develops cohesion, leadership changes from ‘one’ teammate in charge to shared leadership. Team members learn they have to trust one another for shared leadership to be effective.

• Processes and procedures are agreed upon
• Comfortable with relationships
• Focus and energy on tasks
• Effective conflict resolution skills
• Sincere attempt to make consensual decisions
• Balanced influence, shared problem solving
• Develop team routines
• Sets and achieves task milestones
• Sense of belonging to a team
• Confidence is high
• Team members feel a new ability to express criticism constructively
• Acceptance of all members in the team
• General sense of trust
• Assured that everything is going to work out okay
• Freedom to express and contribute
• Develop a decision making process
• Be prepared to offer ideas and suggestions
• Problem solving is shared
• Utilizing all resources to support the team effort
• Team members take responsibility in shared leadership skills
• Receiving Feedback from project guides
• Shared leadership
• Give feedback and support from Project Guides
• Allow for less structure
• Promotes team interaction
• Asks for contributions from all team members
• Collaboration becomes clearer
• Encouraging others in making decisions
• Continues to build strong relationships

The major task function of stage three is the data flow between group members: They share feelings and ideas, solicit and give feedback to one another, and explore actions related to the task. Creativity is high. Collaboration emerges during this stage when team work ethic and shared leadership is understood.

The major drawback of the norming stage is that members may begin to fear the inevitable future breakup of the team; they may resist change of any sort.

True interdependence is the norm of this stage of group development. The team is flexible as individuals adapt to meet the needs of other team members. This is a highly productive stage both personally and professionally.

• Fully functional teams
• Roles are clearer
• Team develops independence
• Team able to organize itself
• Flexible members function well individually, in subgroups or as a team
• Better understand each other’s strengths and weaknesses and insights into group processes
• Empathy for one another
• High commitment
• Begin understanding collaborative work ethic
• Tight bonds emerge
• Fun and excitement
• Lots of personal development and creativity
• General sense of satisfaction
• Continual discovery of how to sustain feelings of momentum and enthusiasm
• Project guides assure team is moving in collaborative direction
• Maintain team flexibility
• Measure knowledge performance – post test
• Provide information
• Giving and Receiving
• Feedback and Dialogue with project guides
• Shared Leadership being practiced
• Observing, Inquiring, Fulfilling, team needs
• Collaborative efforts among team members
• Project guides provides little direction
• Team members offer positive reinforcement and support
• Share new information

The Performing stage is not reached by all groups. If group members are able to evolve to stage four, their capacity, range, and depth of personal relations expand to true interdependence. In this stage, people can work independently, in subgroups, or as a total unit with equal competencies.

In this stage typically team members are ready to leave (course termination) causing significant change to the team structure, membership, or purpose and the team during the last week of class. They experience change and transition. While the group continues to perform productively they also need time to manage their feelings of termination and transition.

• Visible signs of grief
• Momentum slows down
• Restless Behavior
• Bursts of extreme energy usually followed by lack of energy
• Humor (that to outsiders could appear cruel)
• Glad it is over – relief
• Evaluate the efforts of the team
• Tie up loose ends and tasks
• Recognize and reward team efforts
• Project guides help team develop options for termination
• Good listening
• Reflection and carry forth collaborative learning to next opportunity

The final stage, adjourning, involves the termination of task behaviors and disengagement from relationships. A planned conclusion usually includes recognition for participation and achievement and an opportunity for members to say personal goodbyes. Concluding a group can create some apprehension – in effect, a minor crisis. The termination of the group is a regressive movement from giving up control to giving up inclusion in the group.

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Team Development: Stages of Development

• Teamwork and Team Leadership Table of Contents
• Stages of Development
• Teambuilding: Structure
• Teambuilding: Trust
• Jump Starting Teams

1. Overview

• It take time to establish a team
• Forming, storming, norming, performing and adjourning
• Understanding what happens in each stage can help your team become effective 

2. Tuckman's Stages of Team Development

3. Stages of Team Development

4. Additional Reading

Tuckman, B.W. & Jensen, M.C (1977). Stages of small-group development revisited.  Group & Organization Management, 2(4), 419-427.

• << Previous: Teamwork and Team Leadership Table of Contents
• Next: Teambuilding: Structure >>

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StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

StatPearls [Internet].

Group therapy.

Akshay Malhotra ; Jeff Baker .

Affiliations

Last Update: December 13, 2022 .

• Continuing Education Activity

Group therapy is the treatment of multiple patients at once by one or more healthcare providers. It can be used to treat a variety of conditions including but not limited to emotional trauma, anxiety, depression, post-traumatic stress disorder (PTSD), and attention deficit hyperactivity disorder (ADHD). This activity outlines the principles of group therapy and explains the role of the interprofessional team in evaluating, treating, and improving care for patients who undergo group therapy.

• Describe the elements of group therapy that can increase the chance of patients benefiting from the treatment process.
• Review the presence and management of issues of patient confidentiality during group therapy sessions.
• Summarize the management of internal issues that disrupt group therapy sessions.
• Explain the importance of interprofessional collaborative efforts when providing treatment in a group setting.
• Introduction

As the need for behavioral intervention and long-term psychiatric care is steadily rising, alternative methods of treatment must be employed by physicians and healthcare teams to meet this increasing demand. Group therapy provides a solution to this problem by allowing for the treatment of multiple individuals simultaneously. Doing so allows healthcare providers to reduce wait times and increase accessibility. This approach is especially necessary for rural and low-income areas where clinics are often understaffed and have a high volume of patients. Furthermore, group therapy can be used to treat a multitude of conditions including, but not limited to, emotional trauma, anxiety, depression, post-traumatic stress disorder (PTSD), and attention deficit hyperactivity disorder (ADHD). [1] [2] [3] [4]

Yalom Therapeutic Factors

It is vital to patient success that providers understand the mechanisms that exist in group therapy. These factors are:

• Universality: Patients realize that others exist who share similar thoughts, feelings, and issues.
• Altruism: Patients can improve their self-concept by assisting other patients.
• Instillation of hope: Patients benefit from witnessing the success of other group members and can envision themselves following a similar path.
• Imparting information: Patients gain knowledge and information from both the group members and the provider.
• Corrective recapitulation of primary family experience: Patients can benefit from the opportunity to properly recreate family dynamics in a controlled environment.
• Development of socialization techniques: Patients learn effective and proper ways to interact with others.
• Imitate behavior:  Patients gain new insight and understanding through the observation of other group members.
• Cohesiveness: Patients experience feelings of support, trust, and belonging to one another.
• Existential factors: Patients realize that they are responsible for their life decisions.
• Catharsis: Patients share personal experiences from both the past and present.
• Interpersonal learning: Patients gain an understanding of their interpersonal impact via feedback from other members as well as create an environment for one another to learn.
• Self-understanding: Patients understand the covert factors influencing their behavior and emotions.
• The process goals of group therapy are to facilitate patients' growth in comfort and function within the group.
• The outcome goals of group therapy are applied to the patient's life outside of the group and include behavior corrections, development of interpersonal and relationship skills, education, the installation of preventative measures and coping skills, and an eventual return to normal functioning within society. [5]

Selection of Patients

When deciding which patients will benefit the most from group therapy, providers utilize the therapeutic alliance. The more the provider and patient agree on the goals and tasks of therapy as well as the stronger the relationship they share, the more likely the patient will have success in group therapy. [6]

An additional selection method providers can use to gauge group therapy viability is the NEO-Five-Factor Inventory. This measure of personality suggests that those who score high on extraversion (openness) and conscientiousness (hard-working) dimensions are more suited for group therapy, while those who score high levels of neuroticism (emotionally reactive) are less suitable for group therapy. [7]

Group therapy will be useful for the treatment of patients who exhibit interpersonal difficulties and pathology; patients who lack self-awareness; patients who are action-oriented; patients who suffer from isolation and require the stimulation group interaction provides, and those who will benefit from interacting with peers who can both challenge and support them. [8]

Special attention must be paid to ensure patients unfit for group therapy do not get selected as their inclusion can have deleterious effects on both the patient and the group. Specific exclusion criteria are limited to patients who are unable to participate in the major activities of the group due to logistical, cognitive, or interpersonal factors. Additionally, patients in acute distress or actively suicidal should not be considered for group therapy and instead need independent management. Outside of these factors, the exclusion criteria for patients should be more relative than absolute. As a result, a patient unfit for one group due to conflicting personality traits may fit in a group that has similar traits to the patient.

Different Stages of Treatment

It is necessary to include patients at different stages of treatment to help facilitate individual recovery. By comparing themselves to other patients further along in the recovery process, patients can start to imagine themselves in a similar position. Additionally, seeing patients worse off than them but still contributing to the group can provide motivation, keeping patients committed to the treatment process. [9]

Identical or Similar Conditions

Group therapy sessions should include members suffering from similar conditions. Doing so allows patients to realize that their symptoms are not exclusive to them, and others share similar feelings. This feeling of universality can create a sense of community within the group and facilitate the treatment process by fostering feelings of acceptance and belonging. 

Structuring groups with members diagnosed with similar conditions also allow group members to learn from and instruct one another. Interpersonal learning allows members to gain new perspectives on their conditions and learn successful ways to cope. Additionally, members who typically experience social fear as a result of their symptoms become more comfortable with exposure to social situations. [2] [9] [10] [11] [12]

In addition to adhering to the principles of group therapy, providers should use different styles of group therapy based on the diagnosis and needs of the patients.

Psychoeducational Groups

Psychoeducational groups are useful for educating patients about their diagnosis as well as their inclinations and consequences associated with these inclinations. These groups also serve to encourage patients to stay committed to their treatment plans. Additionally, psychoeducational groups teach patients to avoid maladaptive behaviors while also instilling positive behavior change. 

When organizing a psychoeducational group, the provider should follow a highly structured plan and develop a curriculum. Sessions should last anywhere from 15 to 90 minutes, and chairs should be organized in a horseshoe or circle configuration where the provider is the focus.

During psychoeducational group sessions, the provider will act as an educator. Teaching should be performed actively as passive note-taking is inefficient and allows patients to escape the focus of the group. To ensure patient engagement, providers must foster a culture of interaction by creating an environment where patients feel comfortable speaking. Additionally, when leading a session, the provider should incorporate different learning styles, such as visual learning, auditory presentations, and hands-on activities, to accommodate the wide variety of methods in which patients learn. [13]

Skills Development Groups

Skills development groups are useful for patients whose diagnosis has prevented the adequate skill development necessary to function in everyday life. This style of group therapy also focuses on coping methods, emotional control, and socialization techniques. By focusing on specific skills that patients lack, providers can help prepare patients for the treatment process and give them the tools to recover.

Providers running skills development groups should base the content of the group on the needs of that group's patients. As a result, the actual material discussed will vary significantly from group to group. Skills development sessions should range from 45 to 90 minutes in length and be organized in either a horseshoe or circle configuration. These groups should be limited to 8 to 10 patients as it is highly interactive and provides ample time for each patient to practice the skills taught. The provider themselves must have mastery of the skills they plan to teach so they can effectively teach them to the group. [14]

Cognitive-Behavioral Groups

Cognitive-Behavioral groups are useful for changing patients’ learned behaviors by altering their beliefs and perceptions. These groups can also change patients’ perceptions of themselves, turning negative thoughts of being different and unlovable into more positive thoughts. This change in thought process can be extremely freeing to patients as they learn to live with their issues rather than being ruled by them. 

The content discussed in these groups will also vary greatly. The provider should focus on beliefs, coping skills, thought processes, or behavior based on the needs of the patients. The orientation of the room for this particular style of the group should be a circle as the horseshoe orientation can interfere with the cohesiveness of this group. Sessions should last anywhere from 60 to 90 minutes. 

Similar to psychoeducational groups, the provider of cognitive-behavioral groups should take an active role during the session; however, discretion must be used to ensure the provider does not over-participate negating the members' ability to interact. It is vital to the patients’ success that the provider acts as a guide and let the group work through most issues themselves. 

Since the discussions in these sessions are focused on thought and behavior modification, patients may feel uncomfortable and try to resist these changes. Providers must be prepared for this resistance and gently guide the members through their issues with just the right amount of empathy and firmness. [15]

Support Groups

Support groups can be used to help patients who have already begun receiving treatment to maintain their new behaviors and reinforce their new belief systems and thought processes. These groups also focus on the management of symptoms of day-to-day life. During sessions, patients usually discuss recent problems and how they dealt with them. 

Support group sessions should last anywhere from 45 to 90 minutes. Sessions should also be conducted in a circular configuration. 

Unlike psychoeducational and cognitive-behavioral groups, the provider of support groups is less directive and should act only as a facilitator. As such, the provider should assist patients in developing connections with one another and emphasizing similarities between patients. The provider’s main contribution to the group should be limited to positive reinforcement and to bring to attention appropriate interactions patients exhibit. [16]

Group Development

Providers should be aware of the different stages of group development as a transition through each stage indicates group growth and change. Transitioning through all five stages is necessary for patients to benefit from group therapy.

• Forming stage: During the forming stage, patients will exhibit feelings of anxiety, distrust, and uncertainty concerning the group. There will be a high level of dependence on the provider, and actual group interaction will be low during this stage. Providers should use this opportunity to educate the group and establish cohesiveness by discussing goals and expectations. 
• Storming stage: In this stage, patients will now be comfortable sharing intimate details with one another. Additionally, the formation of subgroups may occur as patients establish a hierarchy. Internal conflict will predominantly occur in this stage of group development. The provider should aim to resolve disruptive conflict and encourage patients to develop strong and personal relationships with one another. The reinforcement of goals and the purpose of the group can help bring patients together. 
• Norming stage: After conflict resolution has occurred, the group will enter the norming stage. While in the norming stage, patients' commitment to the group and its goals will strengthen, and group cohesiveness will increase. Patients will take on much of the leadership work initially performed by the provider. As such, the provider should take a less active role in the discussion and instead facilitate discussion and provide insights. The return of conflict is a sign of regression to a previous developmental stage, and the provider should intervene to bring the group back to this stage.
• Performing stage: Upon entering the performing stage, the group has greatly matured relative to the earlier stages. Provider intervention is low, as the group functions almost entirely on its own.  Patients are aware of each other's strengths and weaknesses and can help each other develop and grow. 
• Adjourning stage: The final stage of group development is the adjourning stage, which signifies that group therapy is coming to an end. Patients may experience feelings of sadness and anxiety as they will no longer be attending sessions. During this stage, the provider should assist patients in voicing their feelings and facilitate discussion of closing topics. Additionally, the provider should help patients plan for life outside of group therapy and assist patients in saying goodbye. Improper management of a farewell process can negatively impact patients and hurt the progress they have made. [17]

Length of Treatment

The duration of group therapy treatment is highly individualized and subject to a high degree of variation. Patients should receive therapy until they achieve relief from their symptoms and can begin to develop a normal life with strong relationships and a sense of belonging; this can take anywhere from weeks to months or even years to occur. To facilitate patient improvement, providers should structure the ending of therapy processes. By establishing a set end date during treatment, the provider can prepare the patient for an eventual departure with the patient working towards the achievement of his or her goals until that date.

• Issues of Concern

Patient Confidentiality

Similar to individual treatment, the provider or group leader in group therapy sessions are bound to the laws of confidentiality concerning patients' medical history, diagnoses, and other personal information. The other group members, however, are not bound to these same laws and face no legal consequences for sharing information from sessions. As a result, individual patient confidentiality can be difficult to maintain, especially in larger groups where leaders have less control over what information gets shared within the group.

The ability to share personal information can play a positive role in the treatment process. Some patients may feel uneasy sharing certain details for fear of who may repeat them, which can cause harm to patients' mental wellbeing as they struggle to contribute while maintaining their confidentiality. To reduce this tension, providers should adopt a set of confidentiality/sharing guidelines that the group agrees to and discuss with members the limitations of confidentiality before the first session. [18]

• Clinical Significance

Effectiveness

Research has shown that group therapy is an effective method to treat a myriad of psychiatric and behavioral disorders. Patients often report a reduction in symptoms after receiving group therapy treatment. Additionally, group therapy is found to affect patients positively through Yalom Therapeutic Factors. These factors do reduce symptoms of diagnoses while also providing patients with beneficial skills to learn, develop, and live with their symptoms. As long as patients are subject to proper screening before group therapy sessions, they will receive benefits. [1] [10] [19]

Concurrent Treatment

Although group therapy is an effective method of treatment in itself, providers may also choose to incorporate other treatment methods to treat patients further. 

• Conjoint therapy: When performed conjointly, the provider treating the patient in the group differs from the provider treating the patient individually. Doing so provides patients with different therapeutic settings, allowing them to learn as an individual and apply those teachings in a group setting.
• Combined therapy, on the other hand, occurs when the provider treating in the group setting also treats the patient individually. This method of concurrent treatment allows providers to thoroughly assess patients and provide individual coaching, which is applicable in the group setting. When placing a patient into a group, special care should be used to ensure the patient gets put into a group homogenous for symptoms and diagnosis. [20]

Cost-efficiency  

Group therapy provides a cost-efficient method of treatment, as fewer trained professionals are required to provide treatment to a larger number of patients. A reduction in cost can increase the accessibility of therapy, as costs are often covered by insurance plans. [1]

Flexibility

Treatment in a group setting allows providers to be more flexible with their sessions. Doing so can increase attendance to therapy sessions since providers can schedule sessions during after work and after school hours. Additionally, the inclusion of multiple sessions throughout the day allows providers to treat a larger volume of patients throughout the day, further reducing wait times in high-volume areas. [1]

Training Opportunities

The group format can be used as an avenue to train medical students, residents, and other healthcare professionals by allowing them to serve as co-therapists. The provider can oversee the less experienced professionals as they work with patients, effectively creating on-the-job coaching; this can be especially useful in low resource areas where access to trained professionals is limited. [1]

• Other Issues

Conflict is a natural and expected aspect of group therapy sessions. Many conflicts may not be obvious to the group members, and it is the responsibility of the provider to bring these covert conflicts to the members’ attention. The provider is not required to solve the conflict; however, he or she must make an informed decision on how to deal with the conflict based on the interest of the group. It may be worthwhile to address the conflict, as there is an opportunity for the group to learn. 

Members’ responses to conflict can be complex and unpredictable. When conflict arises, providers should use the last five to ten minutes of the session to speak with patients individually and allow them to voice their concerns.

Patients Who Ramble

Occasionally, a patient may continue to talk for an unnecessary length of time. It is essential to address this patient and see what he or she hopes to gain when doing so. If the patient is unsure as to why they are dominating the conversation, the provider should use this opportunity to teach the patient how to express his or her thoughts and feelings better.

Lack of Engagement

It is the provider’s responsibility to ensure members are alert and attentive during group sessions. When members seem disengaged, the provider should interject and see why members are losing interest. The inclusion of interactive activities can help members to be more engaged in the group discussion. [11]

Patients’ Limits

Providers are encouraged to push their patients to engage with the sessions; however, it is crucial to be aware of a patient’s individual limits. If the provider’s initial request for the patient to continue engaging meets with resistance, then the provider should respect this wish. Providers should remain patient, understanding, and empathetic with their patients and continually encourage without forcing patients to act against their will. [9]

• Enhancing Healthcare Team Outcomes

Pharmacotherapy and Group Therapy

Occasionally, patients receiving group therapy will also benefit from the inclusion of pharmacotherapy. In situations where the provider prescribing the medication differs from the provider providing treatment, proper communication between the two parties is vital to patient success. A thorough report of the patient and his or her reaction and benefits from the medication must be shared with the provider treating with group therapy. Mutual respect for one another and the well-being of the patient are required to prevent adverse reactions and ensure the patient receives the highest quality of medical care. Additionally, putting less of a value on either of the two treatment processes can negatively impact patients, so the therapist should always follow proper inclusion and management of both treatment processes. [21]

When pharmacotherapy is part of the patient's therapy, it is prudent to have a qualified pharmacist examine the patient's medication record, checking for proper dosing, potential drug interactions, and inform the other members of the healthcare team of any red flags.

Social workers can play an important auxiliary role to providers during group therapy sessions. The social worker's presence as a layperson voicing their thoughts and feelings can help facilitate group interaction and reduce members’ resistance to contributing. Also, social workers can assist patients in attempting to reintegrate into their “normal” lives by answering patient’s questions concerning work, relationships, and other lifestyle changes. [22]

An interprofessional team approach can benefit participants in group therapy, where information is shared among various disciplines leading to improved patient outcomes, so long as appropriate privacy considerations are maintained at all times. [Level 5]

• Nursing, Allied Health, and Interprofessional Team Interventions

Nurses trained in psychiatric and behavioral sciences can take on the role of group therapy leader and host group therapy sessions. Their responsibilities reflect those of other healthcare providers, and supervision is not required when a properly trained nurse is leading group therapy. [23]

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Disclosure: Akshay Malhotra declares no relevant financial relationships with ineligible companies.

Disclosure: Jeff Baker declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

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‘Outrageous’ climate activists get in the faces of politicians and oil bosses – will it work?

As the climate crisis has deepened, protesters have become more confrontational – and their ambitions have grown

T he head of ExxonMobil told to “eat shit” as he was about to receive an award. A US senator and coal boss called a “sick fuck”, almost sparking a brawl. Theatre shows interrupted. As the climate crisis has deepened, protests aimed at those deemed responsible are becoming starkly personal, and often confrontational.

At the vanguard of this new style of in-your-face activism is Climate Defiance , a group of just a handful of core staffers now marking its first birthday following a year of disrupting, often crudely, the usually mundane procession of talks, speeches and panels that feature Joe Biden administration officials , oil company bosses and financiers .

“They are seen as the hot climate group right now, which is amazing given how small they are,” said Dana Fisher, a sociologist and author who is an expert in climate activism at American University. “They are obnoxious, but they are having some success in being outrageous enough to get attention, and in an election year that is important. They are certainly pushing the Biden administration.”

Climate Defiance’s tactics are usually clandestine, signing up to or slipping into events before storming the stage and denouncing their targets, who are often referred to as “monsters” or “fiends”, in a sort of public shaming spread via social media.

But as the group’s influence has grown, having been granted a meeting they requested at the White House to share their calls for stronger action on global heating, so has the scale of their ambitions. Climate Defiance is organizing a mass protest involving hundreds of people aimed at shutting down the congressional baseball game , a longstanding bipartisan tradition in Washington, this summer, calling on “every good person to join us” .

“It’s really going to trigger a nerve,” said Michael Greenberg, the 30-year-old founder of Climate Defiance. “People love the tradition of the baseball game, because it’s bipartisan, and we’re going to say, ‘No, we’re shutting it down.’ We really need to shake people awake and make climate a top three issue for this election.”

Greenberg is disparaging of what he sees as the placid, desk-bound conformity of mainstream climate groups, as well as the litany of events that feature those he considers responsible for the climate crisis. “They’re literally risking billions of lives and they’re getting honored at galas,” he said of his targets.

The confrontations themselves are very much fashioned for an era of TikTok and Instagram, where a new visual edge needs to be found each time. “Another soup toss at a painting isn’t going to get attention now, and so cursing is something new they are doing,” said Fisher. “It’s designed to be provocative, but is very performative. It’s designed for younger people who are scrolling through videos.”

Sometimes the swearing is in visual form – Darren Woods, the chief executive of Exxon, stood haplessly alongside a banner reading “eat shit, Darren” as he was denounced as a “climate criminal” by protesters – while sometimes it is uttered by target and activist. “Just close the fucking door,” muttered Jerome Powell, the chair of the Federal Reserve, as his speech in December was interrupted by activists who stormed the stage, causing him to flee.

Occasionally the confrontations can provoke flashes of anger, like recently when a Climate Defiance volunteer accosted Joe Manchin, the conservative Democratic senator and coal baron , and called him a “sick fuck”, causing the incensed West Virginia lawmaker to square up to the protester, who was then pushed away by an aide.

Such interactions will not persuade people such as Manchin to suddenly oppose fossil fuels and may even dismay casual viewers of the video, Greenberg admits, but the founder insists such stunts help push climate up the agenda with an easily distracted public.

“For your average suburban soccer mom, they probably don’t love it, but a lot of our supporters were excited to see it,” Greenberg said of the repeated tangles with Manchin. “I guess there’s a tension in some of these actions. The stuff that gets the most attention is often the stuff that’s a little bit less popular. So yeah, I consider it a trade-off.”

He added: “What we’re aiming to do is much more ambitious than just get some anger off of our chest. We’re really trying to make climate change a top-tier issue in the American political system. Otherwise, it’ll just get ignored.”

For these efforts, Climate Defiance is increasingly feted by political figures and donors. Fundraising parties have been held by the likes of Abigail Disney, the heiress and climate campaigner , and attended by appreciative progressive Democrats. “You have gotten the country’s attention,” Ro Khanna, a Democratic congressman from California, told one of the fundraisers . “People in Congress are talking about you. Senators are talking about you. The president is talking about you. And remember this, the future is with you.”

Even John Podesta, Biden’s top climate envoy, who has had several events interrupted by Climate Defiance, has engaged with the group, agreeing to meet them at the White House for talks last year. Podesta called the group a “pain in the ass” and complained that it did not protest against enough Republicans, Greenberg said. Podesta was contacted about the comments.

But will any of this make a difference? Being hounded by climate activists may have helped nudge the Biden administration to pause new gas exports , but the influence is more opaque when it comes to the broader American public, who are increasingly worried about the ravages of heatwaves, wildfires and flooding but still mostly consider the climate crisis as a background issue when it comes to voting.

“We know historically that radical action can inspire other people to join more moderate components of the movement, but most research on this was done before social media,” said Fisher. “We don’t know how well videos saying ‘eat shit’ will work out yet. It’s frustrating.”

‘Ecocidal pyromaniac’

The protests may even backfire with some voters who consider them to be counter-productive or even violent, as evidenced in some of the negative reactions to a brawl that erupted last week after Climate Defiance activists rushed a stage where Lisa Murkowski, a Republican senator, was speaking. Murkowski is a “murderer” and an “ecocidal pyromaniac”, according to the group, which in its confrontations connects politicians who have supported fossil fuel interests to the harms of the climate crisis.

For now, the currency of success is measured in video views and in how normalized protest interruptions are becoming from a range groups, such as Sunrise or Extinction Rebellion, who have shouted down speeches by Donald Trump or halted performances at the opera or theater to decry the lack of action on the climate crisis.

“Climate Defiance changed the format,” said Nate Smith, a climate activist and theater producer who stood up to interrupt a press preview of An Enemy of the People, the Henrik Ibsen play currently showing on Broadway , in a protest by Extinction Rebellion NY.

“I’ve been in front of unmarked security forces with machine guns and felt way more calm than interrupting my own love, my own business, but there is no Broadway on a dead planet,” said Smith about the action. Smith’s warning about sea-level rise during the show was responded to in character by Jeremy Strong, the Succession actor who plays the protagonist in the production.

Strong, ironically, is on the board of the Climate Emergency Fund, which funds groups such as Climate Defiance. “Listen, I didn’t want it to happen, you know, on my stage but at the same time … I’d feel like a hypocrite if I didn’t, in a way, support what they were saying,” Strong has said .

Acting in an unperturbed way has now become a required skill for politicians and others who risk interruption. At a boosterish breakfast meeting in Manhattan last week, Eric Adams, the mayor of New York, was delivering a self-laudatory speech to several hundred supporters when a group of young people involved in Planet Over Profit, another activist group, clambered on stage to shout “Landlord Adams, burning NYC” and unfurled a banner, before being bundled away. Four arrests were made outside.

Adams plowed on with his speech throughout the intervention, remarking afterwards that the protesters were trying to “hijack the narrative” and that they “mean nothing to me”. If this new era of confrontation becomes commonplace to the point of being ignored, what tactics will climate activists come up with next?

The climate crisis won’t wait to find out. The last 10 months have, globally, smashed all previous temperature records and, just in the past week, new studies have come out showing that the planet’s coral reefs are facing their most serious risk of heat death yet, while the world’s economy is set to lose 19% of its income in the next 26 years , an eye-watering $38tn, because of the impacts of climate change.

“These activists are going to annoy some people, but scientists are screaming at the top of their lungs about the climate crisis, and no one is listening,” said Fisher.

“Not everyone will like it but a range of tactics is necessary right now. The destruction we are seeing is far worse than calling Joe Manchin a nasty name.”

• Climate crisis

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