1

The development of self-managing teams

in mental healthcare

An integration of theory and practice

By

I.A.G.M. Geerts

Master Thesis Organization Studies

Tilburg University

June 2017

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The development of self-managing teams in mental healthcare

An integration of theory and practice

Master Thesis Organization Studies

Tilburg University

I.A.G.M (Iris) Geerts BSc

Details of the student

Name:

ANR: 671618

Details of the supervisors

Supervisor 1: Dr. S.W.M.G. Cloudt

Supervisor 2: R.S. Mannak MA MSc

MTO supervisor: L.J.A.M. van Baest

Professional supervisor: Dr. J.J.P.A Bierbooms

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“Nothing ever goes as planned.”

- Anonymous

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Preface

Here I am, one stage left from getting my Extended Master’s degree in Organization Studies. When I

started the Extended Master track, I knew a difficult time had begun. The exploration of finding the

right research question, with an interesting topic for all parties, including myself, was one of the first

challenges I faced. This, however, turned out to be nothing when I started the actual writing process of

my thesis. It took more time than I expected, which asked extremely much of my determination and

perseverance. Overall, it was a learning process that, I believe, was very meaningful for me. The result

of all the hard work lies before you, and I am happy to finally present my master thesis ‘The

development of self-managing teams in mental healthcare: An integration of theory and practice’.

It must be said that I never would have reached the point of finishing my master thesis without

the help and support of others. First of all, I want to thank my academic supervisor, Stefan Cloudt, for

all his extensive feedback throughout the last year. I highly appreciated his time and effort. I would

like to thank Remco Mannak, my second academic supervisor, for all his refreshing ideas during the

defense sessions. Next is Joyce Bierbooms, my professional supervisor at GGzE. Thank you for

finding the time to answer questions and your wonderful ideas that helped me out when I got stuck. I

also want to thank Alice Stokkink for helping me to better understand the mental healthcare context.

The many hours I spend with her lie at the basis of this thesis. Of course, I also want to thank the team

advisors for their openness during the retrospective interviews as well as the SMTs for allowing me to

observe them. I want to thank my co-trainee, Daphne Berbers, for understanding me, always being

ready me and helping me out when I was highly stressed. Last but not least, I want to thank my family

and friends for believing in me and dealing with my daily stress.

Iris Geerts

Vessem, June 2017

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Abstract

Whereas an increasing number of healthcare organizations implements self-managing teams (SMTs)

as an answer to the increasing demands faced by them, research on how SMTs develop towards

effective functioning is lacking. This study fills this gap by investigating the development pattern of

SMTs in mental healthcare as well as the factors that influence these patterns. Based on an extensive

review of team development literature, a tentative model of SMT development was constructed. This

model proposed that SMTs develop along a non-sequential pattern of three processes - (1) task

management, (2) team management, (3) and boundary management and improvement - that is largely

the result of eight internal and external factors at four different levels: individual, team, organization

and environment. Following this, the tentative model was empirically assessed in a Dutch mental

healthcare organization by retrospective interviews with the self-management process facilitator and

13 team advisors that provided support to 100 primary mental healthcare SMTs. Next to this,

observations of 13 primary mental healthcare SMTs were performed. Empirical results supported the

tentative non-sequential model of SMT development. SMTs were found to develop backwards and/or

forwards along each of the three processes in a variety or possible patterns or simultaneously over

time, depending on many factors of the tentative model and four others. Overall, the following factors

were found to influence SMTs’ development pattern: individual human capital, team member attitudes

and perceived workload on the level of the individual, psychological safety, team turnover, team size,

nature of the task, and bureaucratic history at the level of the team, management style, material

support and social support at the organizational level, and requisite for self-management on the level

of the environment. Based on these findings, a final non-sequential model is presented in which SMT

development is depicted as an integrative I-P-O approach towards factors, development processes, and

SMT effectiveness. Managers, advisors and policy makers are encouraged to continuously monitor the

development of SMTs through the lens of the non-sequential model, and in that way uncover

important factors that are open for improvement.

Key words: self-managing teams; team development; non-sequential SMT development model; mental

healthcare

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Table of contents

1. Introduction ..................................................................................................................................... 10

1.1. Research problem ....................................................................................................................... 10

1.2. Research goal and question ........................................................................................................ 11

1.3. Relevance of the research ........................................................................................................... 12

1.4. Research design .......................................................................................................................... 12

1.5. Outline of this thesis ................................................................................................................... 13

2. Theoretical background and tentative model ............................................................................... 14

2.1. Introduction to the literature ....................................................................................................... 14

2.2. Methods of the literature review................................................................................................. 16

2.3. Overview of team development models ..................................................................................... 17

2.4. Analysis of team development models ....................................................................................... 28

2.5. Factors ........................................................................................................................................ 33

2.6. SMT development: a tentative model ......................................................................................... 37

3. Methodological framework ............................................................................................................ 39

3.1. Research context ......................................................................................................................... 39

3.2. Sample strategy .......................................................................................................................... 39

3.3. Data collection ............................................................................................................................ 40

3.4. Data analysis............................................................................................................................... 41

4. Results .............................................................................................................................................. 42

4.1. SMTs’ development pattern ....................................................................................................... 42

4.2. Factors ........................................................................................................................................ 43

4.3. Summary of the results ............................................................................................................... 50

5. Conclusion ........................................................................................................................................ 52

6. Discussion ......................................................................................................................................... 54

6.1. Theoretical implications ............................................................................................................. 54

6.2. Practical implications ................................................................................................................. 57

6.3. Limitations and future research .................................................................................................. 59

References ............................................................................................................................................ 61

Appendices ........................................................................................................................................... 68

Appendix I: Search table ................................................................................................................... 69

Appendix II: Author matrix ............................................................................................................... 72

Appendix III: Topic list ..................................................................................................................... 92

Appendix IV: Hierarchical coding scheme retrospective interviews ................................................ 96

Appendix V: SMT development pattern retrospective interviews .................................................. 100

Appendix VI: Questionnaire of Kommers & Dresen (2010) .......................................................... 101

Appendix VII: Example visualization Kommers & Dresen (2010) ................................................ 105

Appendix VIII: Example SMT observation .................................................................................... 106

Appendix IX: Hierarchical coding scheme SMT observations ....................................................... 108

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Appendix X: SMT development pattern SMT observations ........................................................... 110

Appendix XI: Translated quotes ...................................................................................................... 111

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1. Introduction

1.1. Research problem

Nowadays, healthcare organizations are searching for more cost-efficient ways of delivering care as

the current economy asks for reduction of costs, while patients demand a higher quality, shorter

waiting time, and more diverse and flexible care (Aronsson, Abrahamsson, & Spens, 2011; Joosten,

Bongers & Janssen, 2009). In order to adequately deal with these changing market demands, new

approaches are required (Manz & Sims, 1987). Healthcare organizations place more reliance on

organizational flexibility and respond by decentralization, attributing responsibility and autonomy to

the workforce. This has led many healthcare executives to reorganize their organizations’ structures by

organizing employees into self-managing teams (SMTs) (Yeatts, Cready, Ray, DeWitt, & Queen,

2004). The rationale for adopting SMTs, in this study defined as permanent “groups of interdependent

individuals that can self-regulate their behavior on relatively whole tasks.”(Cohen, Ledford &

Spreitzer, 1996, p. 644), derives from the proposition that empowered teams are more effective at

allocating their resources (Neck & Manz, 1994). Hence, SMTs are more flexible in adapting structures

to a variety of tasks, situations and conditions in comparison with traditional, hierarchical teams

(Langfred, 2007).

The assumption that SMTs have increased flexibility often holds true, yet there are instances

when this is not the case. It is found that SMTs can be particularly susceptible to the detrimental

effects of conflict (Langfred, 2007; De Dreu & Vianen, 2001), high or low levels of trust (Langfred,

2004; Kirkman & Rosen, 1997, 1999), and high turnover (Van der Vegt, Bunderson, & Kuipers,

2010). One reason for these detrimental effects may lie in the development of team members into an

effective functioning team (Miller, 2003). Many theorists have argued that teams, in the early stages of

development, are confronted with interpersonal conflicts, communication blocks, and poor tasks and

process skills. Only after some time, if team members continue to meet each other, do teams reach the

point of effective functioning (e.g. Tuckman, 1965; Wheelan, 2005). It is for this reason that more

developmentally advanced SMTs may be better able to exploit their flexibility benefits.

The development of team members into an effective functioning team is a central theme of

most team development literature. Although authors agree that teams somehow develop towards

greater levels of self-management, there seems to be little consensus on the overall development

pattern (Kuipers & Stoker, 2009). One main line of thinking in several publications is that the

development pattern of (self-managing) teams can be described in distinct linear phases. The socio-

technical phase model for the development of SMTs (Van Amelsvoort & Benders, 1996) has explicitly

dealt with this. In each phase of this model, the individual involvement in the team’s effort grows

stronger and the team’s coherence more tight.

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Even though research has vigorously focused on such theoretical descriptive models (Marks,

Mathieu, & Zaccaro, 2001), empirical evidence is limited and failed to find prescriptive linear phases

of SMT development. Instead, SMTs did not show any particular pattern in their development (De

Leede & Stoker, 1996; Kuipers & De Witte, 2005; Kuipers & Stoker, 2009). Moreover, the limited

amount of research only investigated SMTs in production organisations. Despite the commonalities

between teams in production and healthcare organizations (i.e. both are intensive teams because they

involve a high degree of interdependence and coordination among members) (Tesluk, Mathieu,

Zaccaro, & Marks, 1997), it is difficult to make generalizations. This is because teams in healthcare

organizations work in a complex environment and with a high degree of accountability (Baker, Day &

Salas 2006), while teams in production organizations are more focused on improving processes and

maintaining standards (Bhuiyan, Baghel, & Wilson, 2006). Moreover, healthcare is characterized by

the clear definition of roles, which is advantageous for decision making and conflict management

(Jaca et el., 2013). As a result, the development pattern of SMTs may be different in healthcare and

production organizations.

Other factors may cause changes in SMTs’ development pattern as well. Wheelan (2005), for

example, considered team behavior to be a function of the team and its psychological environment,

indicating that team development might not only be affected by environmental and production factors,

but also by intragroup factors such as team turnover and team size. Yet, there is limited empirical

evidence to drawn on support those implications, because most existing development models were

based on teams with constant membership, tasks, and operating conditions (i.e. self-analytic groups)

(McGrath, 1991). In doing so, teams have been modelled as closed systems, which might limit their

utility for SMTs in organizations (Gersick, 1988).

1.2. Research goal and question

Given the preceding paragraphs, it is clear that a theoretical and empirical understanding of SMTs’

development pattern and its influencing factors is important. The primary goal of this study is

therefore to contribute to the team development knowledge and, more specifically, to extend it by

empirically examining SMT development in mental healthcare: is this a unitary development pattern

or rather a non-sequential process in which SMTs follow different development patterns, and which

factors impact on SMTs’ development pattern? To this end, this study has been written with two sub-

goals in mind. The first sub-goal is to provide a review of the team development literature by

examining several phase models as well as other approaches to team development and proposing a

perspective on SMT development in the form of a tentative model. The second sub-goal is to assess

and, if necessary, modify and/or expand this tentative model by empirically examining the

development pattern of SMTs in mental healthcare. Collectively, these goals lead to the following

research question:

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What is the development pattern of SMTs in mental healthcare and which factors influence these

patterns?

1.3. Relevance of the research

1.3.1. Theoretical relevance

There are several theoretical contributions of this study. First of all, this study contributes to the

already existing team development literature because empirical research focusing on SMT

development is limited. This holds both for quantitative as well as qualitative research (Curseu & Van

Hootegem, 2014; Kuipers & Stoker, 2009) since most research tends to be focused on theoretical

descriptive models rather than real, in-context empirical data (O’Connel, Doverspike, & Cober, 2002;

Kuipers & Stoker, 2009). On top of that, team development research that is based on empirical data

tends to be focused on self-analytic groups, student project teams, or common hierarchical teams

rather than on SMTs. These type of teams are difficult to compare, which necessitate a more precise

examination of the development pattern of SMTs. Additionally, this study contributes to Kuipers and

Stokers’ (2009) call for future research. They recommend to investigate SMT development in settings

such as healthcare and commercial service industries, because the limited amount of research only

includes SMTs in production organizations. Finally, this study adopts an open system perspective by

identifying factors that affect SMTs’ development pattern. In doing so, a contribution is made to the

need to address the issue of why teams develop differently (Arrow, Poole, Henry, Wheelan, &

Moreland, 2004).

1.3.2. Practical relevance

Currently, the increasing complexity of patients’ need necessitates multiple health care professionals

(e.g. psychologist, physiotherapist, nurse, social worker), who build an effective team to ensure high-

quality, safe patient care (Körner, 2010). For this reason, knowing how SMTs do develop towards a

state of effective functioning, and which factors affect this development pattern is of paramount

importance for providers of mental healthcare. Especially for advisors, managers and policy makers as

this knowledge enables them to facilitate SMTs, and guide interventions that improve SMT

effectiveness and move SMTs further along its developmental progression.

1.4. Research design

Because relatively little knowledge is available on the development of SMTs in (mental) healthcare, an

exploratory design was chosen. More specifically, this study can be characterized as a mixed methods

comparative case study design using qualitative research methods. The research design consists of two

phases. The first phase was performed to gain insight into the available knowledge on (self-managing)

team development. By integrating this knowledge, which was realized by performing a literature

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review, a tentative model of SMT development was designed that constituted the foundation for the

data gathering in the empirical follow-up phase. In this follow-up phase, the tentative model of SMT

development was assessed and expanded in order to answer the research question. To do this,

retrospective interviews and SMT observations were performed at GGzE, a provider of mental

healthcare. Throughout these phases the unit of observation involved SMTs or individuals, while the

unit of analysis relied at SMTs.

1.5. Outline of this thesis

This thesis does not follow the more traditional outline. Instead, the different parts are built around the

research design of this study. Chapter 2 introduces first some general theory about SMTs and team

development, followed by the method of the literature review. Then, several team development models

have been explored and analyzed, which eventually led to a first tentative model of SMT development.

Chapter 3, subsequently, outlines the empirical analyses that were used to assess and expand the

tentative model, after which the results of these analyses are presented (chapter 4). Finally,

conclusions are drawn with regard to the research question (chapter 5), and the results of the study are

discussed (chapter 6).

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2. Theoretical background and tentative model

This chapter is built around the first research activity: constructing a tentative model of SMT

development based on literature. Section 2.1. provides a brief introduction of the concepts central to

this study, followed by the methods of the literature review. Subsequently, various team development

models that were found in the literature are presented and classified in section 2.3. Section 2.4. further

analyzes the presented models and works towards a perspective on SMT development, which forms

the heart of this chapter. Based on this, factors that influence SMTs’ development pattern were

identified in section 2.5. Section 2.6. ends this chapter by proposing a synthesized tentative model of

SMT development.

2.1. Introduction to the literature

In order do ‘set the stage’ for the literature review, this section provides an exploration of the concepts

central to this study. To this end, definitions of the concepts ‘SMTs’ and ‘team development’ are

provided, and theory underlying SMTs is described.

2.1.1 SMTs

A number of labels exist to refer to the concept of SMTs, namely (semi) autonomous (e.g. Kuipers, &

De Witte, 2005), empowered (e.g. Wellins, Byham, & Wilson, 1991), self-leading (e.g. Manz &

Sims, 1993) self-directed (e.g. Van Amelsvoort & Benders, 1996), self-regulated (e.g. Cummings,

1978) or self-organizing teams (e.g. Balkema & Molleman, 1999). In this study, it was decided to use

the term SMTs because this seems to be most appropriate. Terms such as (semi) autonomous appear to

imply more freedom than the team actually has, and might give the impression that management has

no control over the team at all (Tjepkema, 2003).

SMTs can be described as “groups of interdependent employees that have the collective

authority and responsibility to manage and perform relatively whole tasks.” (Jong, De Ruyter, &

Lemmink, 2004). When considering this definition in more detail, it is clear that responsibility for

whole tasks and authority are common attributes of SMTs. Responsibility for whole tasks means that

the team is responsible for a complete set of interdependent tasks: not only tasks related directly to the

primary process (i.e. operational tasks), but also those that are necessary to support the primary

process (i.e. regulatory tasks (Goodman et al., 1990; Van Amelsvoort & Scholtes, 1994). The second

common attribute, authority, is necessary to implement team decisions with regard to the work

process. Authority can be described along several dimensions, like (1) the freedom of workers to

choose their own working method, (2) the planning and distribution of tasks, and (3) the freedom of

workers to formulate the objectives of their work (Breaugh, 1985). Freedom along these dimensions

can be provided by ‘minimal critical specification’ (see section 2.1.2). Another defining characteristic

of SMTs is the providence of products or services to internal or external customers. This characteristic

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is mentioned by Wellins et al. (1991) and Van Amelsvoort and Scholtes (1993), who defined SMTs as

groups of employees who share the responsibility for a whole task aimed at producing a product or

service, supplied to either an internal or external customer. In addition, Wellins et al. (1991) and Van

Amelsvoort and Scholtes (1993) specified SMTs as permanent groups of employees. Considering

SMTs as permanent groups is also deemed important in order to distinguish SMTs from teams with a

temporary character (e.g. project teams) (Tjepkema, 2003).

All in all, taking into account the above mentioned characteristics, this study considers SMTs

as permanent “groups of interdependent individuals that can self-regulate their behaviour on relatively

whole tasks” (Cohen et al., 1996, p. 644). Key characteristics include: (1) employees with

interdependent tasks who share the responsibility for making a product or providing a service; and (2)

employee authority over decisions such as work assignments, work methods and scheduling of

activities.

2.1.2. Socio-Technical Systems Design theory

The concept of SMTs was originally developed as a key element within the Socio-Technical Systems

Design Theory (STSD). This theory is aimed at designing a work structure that integrates and

optimizes social and technical subsystems into one sociotechnical entity (Emery, 1959). The first

system refers to the people who work in the organization and the relationships among them, while the

second system consist of the tool, techniques, procedures, strategies, skills, knowledge and devices

used by people of to social system (Emery, 1959). Advocates of the STSD propose a radical break

with the basic bureaucratic principles that originally stem from Taylor’s (1922) theory of Scientific

Management. Taylor (1922) developed this theory out of the belief that productivity and profitability

could be enhanced by specializing, standardizing and simplifying tasks. In order to achieve this, tasks

had to be maximum segmented into small parts and mental and physical work had to be separated (i.e.

management should focus on developing, designing and supervising improved systems, whereas

workers should concentrate on performing their manual duties). STSD, however, abandoned these

bureaucratic principles by arguing that responsibility for the whole task need to be handed to the team

(Tjepkema 2003; De Sitter, Den Hertog, & Dankbaar, 1997).

To support these general ideas, STSD has developed an extensive set of design principles that

made major contributions to the implementation of SMTs. Some of these principles are elaborated in

Morgan’s (1998) holographic image of organizational systems. In this work, Morgan (1998) presents

four interrelated principles that provide a means of self-management, namely: (1) ‘requisite variety’,

(2) ‘redundancy of functions’, (3) ‘minimum critical specification’, and (4) ‘learning to learn’. The

first principle, ‘requisite variety’, prescribes that the amount of local-decision making must be

contingent on the level of environmental variety with the organization has to deal. The second

principle, ‘redundancy of functions’, states that there should be “a kind of excess capacity that can

create room for innovation and development” (Morgan, 1998, p. 101). This principle refers to a certain

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degree to multiskilling and job enlargement because “members acquire multiple skills so that they are

able to perform each other’s jobs” (Morgan, 1998, p. 102). The principle of ‘minimal critical

specification’ pertains the rule that managers should define as few restrictions as possible to ensure

that a task is performed properly. This suggests that managers should create ‘enabling conditions’ that

give employees as much autonomy as possible to perform management activities (i.e. job enrichment)

(Hut & Molleman, 1998). The final principle, ‘learning to learn’, concerns a system's ability to engage

in processes of single- and double-loop learning. This type of learning implies the reconsidering of

ineffective single loops and is most relevant when the variety in transaction and transformation

process generates a lot of unique problems (Hut & Molleman, 1998).

2.1.2. Team development

First, it is importantly to note that most research on group development seems the focus on a smaller

niche of groups, namely groups that have a common goal (i.e. teams) (Raes, Kyndt, Decuyper, Van

den Bossche, & Dochy, 2015). That is why this study generalizes the theory of group development to

teams. In this study, the focus is on SMTs, as defined above.

Throughout the literature, there seems to be a shared understanding of what the term team

development means, namely the systematically change of a team over time (Arrow et al., 2004).

However, finding an acceptable phrase of team development is difficult because change has been

defined in many ways, like changes in the relationship among team members, changes in the primary

concerns of team members or changes in task orientation and output. The change of a team over time

can therefore be best defined as changes through time in the internal structures, processes, and culture

of the team (Sarri & Galinsky, 1974). Another explanation for the problem of finding an acceptable

phrase of team development is that some theorists do not claim that development leads to optimal

functioning; rather, they describe what happens to teams over time (e.g. cyclical processes) (in Bushe

& Coetzer, 2007). In this study, the focus is on how SMTs develop towards effective functioning.

Therefore, team development is defined as the maturation of a collection of individuals into an

effective functioning team (Wheelan, 2005).

2.2. Methods of the literature review

After introducing the most important concepts of this study, literature on (self-managing) team

development needs to be collected, analyzed, and eventually be synthesized into a tentative model.

To this end, a literature review dating back to 1965 was undertaken. The search of articles was

conducted via the ISI/Web of Science and Google Scholar databases, using different combinations of

the following search terms: (1) commonly used concepts of SMTs, (2) team development, and (3)

group development (see Appendix I). Publications were included in the data sample if they were

published by 1990 or later (an exception was made for certain ‘classic works’), fitted in the

management, business and social science studies, and when they identified at least two dimensions of

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change to ensure that articles limited to only one dimension were ruled out (e.g. longitudinal study on

conflict). Based on these criteria, 19 articles were selected as representing the current state of the

(self-managing) team development literature. However, it was possible that, due to some biases,

highly relevant articles were excluded from the data sample. Therefore, the data sample was further

expanded through backward and forward snowball sampling, which resulted in 5 additional articles.

The next steps entailed the analysis and synthesis of the data. Initially, this process involved

reading all articles from beginning to the end. To create a clear and structured overview, important

building blocks and findings were recorded in an author matrix (see Appendix II). The final step

involved further analyzing the articles by means of a concept matrix, as recommend by Webster and

Watson (2002). To this end, the main concepts and their underlying sub concepts were mapped against

the 24 reviewed articles, followed by an identification of the most important concepts, and logical

ways to group and present them. This resulted in two concept matrices that were used to construct a

first tentative model of SMT development. The concept matrices, as well as the tentative model of

SMT development are presented in the next sections of this chapter.

2.3. Overview of team development models

The literature search resulted in an extensive data sample of 25 articles. In organizing these articles,

Mennecke, Hoffer and Wynne’s (1992) framework was used to classify and discuss the team

development models. The framework of Mennecke et al. (1992) divides team development models

into three categories: (1) linear progressive models, (2) cyclical models, and (3) non-sequential

models. Each of these categories can be further subdivided into more specific subcategories. In the

following sub-sections, the (sub)categories and the specific models that are classified into each

category will be briefly discussed, including the critics that are levelled at them.

2.3.1. Linear-progressive models

The linear-progressive models operate under the assumption that team development is based on the

completion of a definite and ordered set of stages, phases or periods (Smith, 2001). Overall, three

types of linear-progressive models can be distinguished: (1) group dynamic models, (2) socio-

technical phase models and (3) consultancy models. An overview of these models is given in Table 1.

The most commonly used and cited group dynamic approach (Miller, 2003) is Tuckman’s

stage model (1965). After reviewing 50 therapy-group, T-group, and natural and laboratory

group studies, Tuckman (1965) proposed a model of four sequential stages, labelled as: (1) ‘forming’,

(2) ‘storming’, (3) ‘norming’, and (4) ‘performing’. A fifth stage, ‘adjourning’, was added in 1977

when a new set of studies were reviewed (Tuckman & Jensen, 1977). Tuckman (1965) suggested that

when moving through these stages, team members are concerned with resolving both interpersonal

relationships and task activities. In the ‘forming stage’, members try to determine their positions in the

team and the procedures to follow. The second stage, ‘storming’, starts when intra-group conflict

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arises as team members resist the influence of the team and rebel against accomplishment of the task.

Teams then move onto a norming stage, where in-group feeling and cohesiveness develop, new

standards evolve and new roles are adopted. Finally, the team attains the fourth stage, ‘performing’, in

which the teams shows proficiency in working together to achieve its goals and becomes more flexible

in following their procedures for working together The adjourning stage occurs as teams disband upon

the completion of a project. Another, more integrated, group dynamic model is provided by Wheelan

(2005). The content of the stages of her model are very similar to Tuckman (1965).

Based on STSD principles (as described in section 2.1.2), both Van Amelsvoort and Benders

(1996) and Hut and Molleman (1998) developed a socio-technical phase model for SMTs. The model

of Van Amelsvoort and Benders (1996) distinguishes four partly overlapping phases in which

attention shifts from the individual to the team level, from simple to more complex tasks, and from

inwards orientated to outwards directed. In the first phase, ‘bundling of individuals’, the emphasis is

on technical proficiency, which implies the broadening of the types of task performed. In the second

phase, ‘group’, the focus is on increasing the organizational autonomy and responsibility of the team.

In the third phase, labelled as ‘team’, the team becomes socially mature. This encompasses

teambuilding, working on communication, and joint decision-making. In the fourth and final phase,

‘open team’, the team is engaged improving one’s own initiative, and ‘management of team

boundaries’. Hut and Molleman (1998) further developed Van Amelsvoort and Benders’ (1996)

approach by integrating it with the holistic principles of Morgan (1998). The first stage was linked to

the principle ‘redundancy of functions’, the second and third stage to the principle ‘minimal critical

specification’, and the fourth stage to the principle of ‘double-loop learning’.

A more applied consultancy model has been developed by Wellins et al. (1991). Their

approach describes SMT development as increases in the levels of job responsibility and authority.

They refer to this as the team empowerment continuum, and explain how a SMT in the final level

takes care of about 80 percent of the total possible job responsibilities. In order to reach this final

level, SMTs have to pass four stages. Important aspects of these stages are: team commitment, team

goals, the broadening of responsibilities and continuous improvement.

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Table 1. Overview of linear-progressive models

Group dynamics models

Consultancy models

Socio-technical phase models

Phase

Tuckman (1965, Tuckman

& Jensen, 1977)

Wheelan (2005)

Wellins et al. (1991)

Van Amelsvoort and

Benders (1996)

Hut and

Molleman (1998)

Phase 1 Forming: testing,

dependency, orientation to

the task

Inclusion and dependency:

significant member

dependency on the

designated leader, concerns

about safety, inclusion

issues

Getting started: diverse

collection of individuals,

arranging simple tasks

Bundling of individuals:

multi-skilling, team

meetings, performance

management

Job enlargement:

multi-functionality

Phase 2

Storming: intragroup

conflict, emotional

response to task demands

Fight and

counterdependency:

members disagree about

group goals and procedures

Going in circles: focus on

tasks and roles, greater sense

of purpose, increasing

responsibilities

Group: managerial tasks,

analysis of performance

Job enrichment:

delegation of control

tasks

Phase 3

Norming: group cohesion,

open exchange of relevant

interpretations

Trust and structure:

positive working

relationships, mature

negotiations about roles,

organization, and

procedures

Getting on course: focus on

goals, cross-training,

development of routines for

handling crises, new

situations, and problems.

Team: decision-making,

solving conflicts, team-

building activity,

productivity and individual

appraisal

Teamwork:

autonomy, team-

building,

communication,

decision-making

Phase 4

Performing: functional

role-relatedness,

emergence of solutions

Work and termination:

goal achievement, task

accomplishment.

Full speed ahead:

proactiveness, arranging

complex tasks and higher

order responsibilities

Open team: external

relations, appraisal of

team-leader and support

staff

Developmental

learning and boundary

management

Phase 5

Adjourning: termination

20

Critics to linear-progressive models

Since several fundamental criticisms have been levelled at the linear-progressive models. The first

criticism is that Tuckman (1965) based his theory on observations of time-limited self-analytic groups

(e.g. therapy and laboratory groups), which due to expert facilitation and the nature of their task are

more likely to become highly developed (Bushe & Coetzer, 2007). Because several linear-progressive

models are based on Tuckman’s (1965) findings, it has been questioned whether these models can

adequately describe team processes in an organizational setting. Second, Tuckman’s (1965) stage

model only claims that more well developed teams will be able to function more effectively across

tasks and environmental context. By doing this, Tuckman (1965) has treated teams as closed systems,

which limits the applicability of his model to teams in organizations (Gersick, 1988). The more recent

models of Wheelan (2005), Wellins et al. (1991), Van Amelsvoort and Benders (1996), and Hut and

Molleman (1998), however, have updated Tuckman’s (1965) model by specifying teams as open

systems that are influenced by internal and/or external factors. Another critical remark concerns the

fact that the development of teams often deviates from the linear sequential steps. Teams that omit

certain of the stages defined by Tuckman (1965), move through the phases in a different order or

develop in ways that cannot be described by these stages (Kuipers & Stoker, 2009). Moreover,

although the findings of Wheelan, Davdson and Tilin’s (2003) study are consistent with linear-

progressive models, there is no empirical evidence that supports the socio-technical phases. Kuipers

and De Witte (2005) conducted a longitudinal study and could not even detect the overlapping pattern

suggested by Hut and Molleman (1988). Also De Leede and Stoker (1996) could not find any linear-

progressive pattern and concluded that the normative character of phase models might partly explain

this.

2.3.2. Cyclical models

The models outlined in this category were developed based on the notion that teams revisit different

stages or phases, depending on the issues that surface a given time. Each cycle serves to strengthen the

team’s understanding of its present situation and modifies the team’s approach to dealing with those

issues. One cyclical approach is offered by Bushe and Coetzer (2007), who described two

developmental phases that work and management teams face in becoming high performing: (1)

‘membership’ and (2) ‘competence’. The ‘membership’ phase is important for individuals to

psychologically join the team. Then, the ‘competence’ phase becomes salient for them in which

individuals turn to the tasks, clarify external expectations, manage boundaries, conform to team goals,

and established norms of decision-making and processes for allocation of tasks and responsibilities.

When membership, context, tasks or constraints a team faces change, issues of membership or

competence must be revisited. Another complementary perspective is offered by Marks et al. (2001).

Although they do not take a developmental view of how teams develop towards optimal functioning,

their theory can be labelled as cyclical model. This is because Marks et al. (2001) focus on team

21

performance as a recurring set of temporal cycles, called I-P-O episodes. Outcomes from initial

episodes serve as input for the next cycle and teams are actively engaged in different performance

episodes at different phases of task accomplishment, referred to as action phases and transition phases.

Moreover, Marks et al. (2001) present a taxonomy that indicates that various team processes are

critical at different phases of task accomplishment and that interpersonal processes occur throughout

both transition and action phases (see Table 2 for an overview).

22

Table 2. Overview of cyclical model

Author(s) Main components Description

Bushe and Coetzer (2007) Two phases: membership, competence Task groups shift from being a collection of individuals to a team that can work

successfully together via two sequential phases. When membership, context, tasks or

constraints a team faces change, phases must be revisited.

Marks et al. (2001) 10 processes that can be allocated to:

(1) Action phase: monitoring progress

toward goals, systems monitoring,

team monitoring and backup,

coordination.

(1) Transition phase: mission analysis,

goal specification, and strategy

formulation, planning

(2) Interpersonal processes: conflict

management, motivation and

confidence building, affect

management.

Teams perform in temporal cycles of goal-directed activity, called I-P-O episodes.

These episodes constitute the rhythms of task performance for teams, and are marked

by identifiable action and transition phases. Teams use different processes over

episodes. Some processes transpire more frequently in action phases and others in

transition phases. Interpersonal processes are expected to occur throughout transition

and action phases.

23

Critics to cyclical models

The primary criticism levelled against the models of Marks et al. (2001) and Bushe and Coetzer

(2007) is their limited applicability. Kuipers (2005) noted that Marks’ et al. (2001) taxonomy seems to

have a limited utility for teams because it is complicated to measure every episode for every (sub-)

task, especially when these episode can be broken down into ten process. The critical remark that

applies to the model of Bushe and Coetzer (2007) is that their model aims at exploring the

development of work and management teams, while empirical evidence from self-regulating student

project teams “are much less likely to apply to practicing managers, employees or executives” (Cohen

& Baily, 1997, p. 240).

2.3.3. Non-sequential models

The models described in this section do not have a predetermined sequence of events. Most of models

can be viewed as ‘contingency models’ because the observed team development patterns are largely

the result of internal and external factors. Hence, these types of models recognize teams as open

systems, which makes them more capable for explaining and predicting team development in

organizational settings (Smith, 2001). Three primary non-sequential models are described in the

literature: (1) time-based models, (2) hybrid models and (3) process models. An overview of these

models is provided by Table 3.

Time-based models focus on the role of time and highlight the importance of temporal issues

in the development of teams (Chadambaram & Bostrom, 1997). The first model included in this sub-

category, Gersick’s (1988) punctuated equilibrium model, is one of the first models that examined

what factors caused teams to develop by focusing on time and its awareness. In this model, a teams’

evolution is marked by two periods of stability, punctuated by abrupt changes at the project midpoint

that occurs halfway to the deadline. The specific issues and identical activities across teams are left

unspecified, since teams’ historical paths are expected to vary. Another time-based model is provided

by McGrath (1991). McGrath (1991) argues that research into team behavior often has neglected the

context in which most teams operate. As an alternative to such research of team behavior, McGrath

(1991) offers the time-interaction-performance (TIP) theory. This theory posits that all organizational

teams must participate in Modes I (inception) and IV (execution). These modes are the beginning and

end stages of team development. Modes II (problem solving) and III (conflict resolution) may or may

not be needed depending on factors such as the characteristics of team members, the nature of their

tasks, and the environmental demands. Another basic premise in explaining team development is

social entrainment, which refers to the coordination of various processes over time among team

members. The patterns of entrainment can vary for different teams, based on the internal and external

pressures they face.

Hybrid models tend to be models that combine several different models to form a new model.

They are grouped within the non-sequential models because they also do not propose a specific pattern

24

of team development (Smith, 2001). Kozlowski, Gully, Nason and Smith’s model of team compilation

(1999) can be seen as a conceptual integration as it explicitly addresses linear-progressive

development and cyclical variation. In this model, the overall process of team development is

conceptualized as an emergent multilevel phenomenon in which newly formed teams shift from an

individual self-focus to a self-managing entities via a compilation process. This compilation process is

a continuous set of four phases, with important aspects like goal orientation, performance monitoring,

establishment of coordination patterns, and continuous improvement. Within these phases, multiple

iterations of task cycles provide opportunities for learning and skill acquisition. As team members

have acquired the targeted skills, they are prepared to shift attention to the development of more

complex skills in the next phase. The ‘Big Five’ model of Salas, Sims and Burke (2005) also draws on

linear-progressive and cyclical models of team development. Their model distills the large number of

team processes in the literature down into five core components: (1) ‘team leadership’, (2) ‘mutual

performance monitoring’, (3) ‘backup behavior’, (4) ‘adaptability’ and (5) ‘team orientation’. In

addition to these five core components, three coordinating mechanisms are identified that facilitate the

enactment of the five core components. The importance of each component and its coordinating

mechanisms is proposed to vary in prominence during development stages and the team task cycle.

The final model included in this sub-category is Team Evolution And Maturation (TEAM) model of

Morgan, Salas and Glickman (1993). The TEAM model combines the constructs developed by

Tuckman (1965) and the findings of Gersick (1988) to form a model of team performance that predicts

the stages that teams go through before, during, and after performance of a task. A team’s beginning

point and pattern of progression trough the stages is suggested to depend on the demands, constraints,

and operational imperatives of the social and organizational context. Another interesting idea proposed

by this model is that teams develop along two separate activity tracks throughout all stages. One track,

labeled ‘taskwork skills’, includes the specific behavior required by the individual to perform his or

her specific individual duties. The other track, ‘teamwork skills’, includes those activities that are

devoted to enhancing the quality of interactions, relationships, cooperation, communication, and

coordination of team members.

Kuipers (2005) identified another developmental approach that is distinctly different from the

linear-progressive and cyclical models, namely process models. “Process models claim that the

different processes they present are not specifically ordered in phases. Instead, these are merely

simultaneous processes that occur during the existence of a team” (Kuipers, 2005, p. 24-25). Two

process models were found that are specifically aimed at the development of SMTs. The first model is

provided by Dunphy and Bryant (1996), who define three team attributes that can be easily considered

as processes. These attributes are: (1) ‘breadth of technical expertise’, (2) ‘degree of self-management’

and (3)‘degree of self-leadership’. The content of the first two attributes is highly similar to the first

two phases of the sociotechnical models (job enlargement and job enrichment). The third attribute, on

the other hand, involves high order middle management function of implementing strategy and

25

corresponds therefore to aspects of cooperation and continuous improvement (phase three and four of

the sociotechnical models). Dunphy and Bryant (1996), however, do not consider them to be linear-

progressive. Instead, they introduce the idea that teams can develop each of the attributes

simultaneously. Based on this, Kuipers and Stoker (2009) incorporated the idea that SMT

development can be conceptualized as three simultaneous processes – (1) ‘internal relations’, (2) ‘task

management’, and (3) ‘external relations and improvement’ - which are described in and linked to

several team development models. The process of ‘internal relations’ concerns the “internal

cooperation and common accountability of the team” (Kuipers & Stoker, 2009, p. 408), while ‘task

management’ includes aspects of both job enlargement and job enrichment. The third process,

‘external relations and improvement’, reflects “the extent to which the team explores and develops its

boundaries” (Kuipers & Stoker, 2009, p. 408). The existence of these three processes is empirically

supported by data from SMTs in the production industry (Kuipers & Stoker, 2009).

26

Table 3. Overview of the non-sequential models

Author(s) Main components Description

Time-based models

Gersick (1988) Two phases: period of inertial movement,

and period of revolutionary quantum

change

Teams alternate between periods of revolution and inertia: relatively stable periods of

activity are punctuated by intense and sudden changes in the behavior of the team.

Toward the middle of team’s life, its equilibrium is shattered and new behaviors are

established.

McGrath (1991) Four modes: inception, problem solving,

conflict resolution and execution

All teams must are involved in Modes I (inception) and IV (execution), while Modes II

(problem solving) and III (conflict resolution) may or may not be needed in any given

team activity depending on the task and the history of the group’s activities. Social

entrainment is a primary mechanisms underlying team development.

Hybrid models

Kozlowski et al. (1999)

Salas et al. (2005)

Four phases: team formation, task

compilation, role compilation, and team

compilation

Five core components: team leadership,

mutual performance monitoring, backup

behavior, adaptability, and team

orientation; Three coordinating

mechanisms: shared mental models,

closed-loop communication an, mutual

trust.

Newly formed teams shift from being a collection of individuals to a fully functioning

interdependent team via four linear-progressive phases. Within these phases, multiple

iterations of task episodes or cycles provide opportunities for learning and skill

acquisition.

The core components and its coordinating mechanisms vary in prominence in the early

development stages of the team (e.g. team leadership and communication), whereas

other core components gain prominence in later team development stages (e.g.,

performance monitoring and backup behavior). The team task cycle also affects the

prominence of each component and its coordinating mechanism.

27

Table 3. (continued)

Author(s) Main components Description

Morgan et al. (1993) Nine stages: pre-forming, forming,

storming, norming, performing-I,

reforming, performing-II, confirming, and

de-forming

Teams might follow different paths to maturity depending on internal and external

factors: different teams might begin a given period of development at different stages

and spend different amounts of time in the various stages. Throughout these stages,

teams develop along two separate activity tracks: taskwork skills and teamwork skills.

Process models

Dynphy and Bryant (1996) Three team attributes: breadth of technical

expertise, degree of self-management, and

degree of self-leadership

Teams can develop each of the three attributes simultaneously.

Kuipers and Stoker (2009)

12 key aspects that can be divided in three

team processes:

(1) Internal relations: goal orientation,

planning activities, feedback,

conflict management.

(2) Task management: multi-

functionality, delegated

management and support tasks,

work communication, decision

making and control, performance

management.

(3) External relations and

improvement: improvement

activities, customer and supplier

relations, advanced management

and support activities.

Teams can develop each of the three processes simultaneously.

28

Critics to non-sequential models

A relatively small amount of criticisms have been levelled at the non-sequential models because most

of them are considered as advancements over the linear-progressive and cyclical models of team

development (Smith, 2001). However, Kuipers (2005) emphasized that the models of Gersick (1988),

McGrath (1991), and Morgan et al. (1993) have limited applicability to work teams as they have a

clear beginning and end. These models were therefore indicated be only relevant for teams that carry

out specified projects and must orient themselves to a time limit (Gersick, 1988).

2.4. Analysis of team development models

One of the primary goals of this study is to clarify SMTs’ development pattern by designing a

tentative model based on literature. In this section, the above presented models are analyzed in order to

arrive at some building blocks for the tentative model (see section 2.6). To this end, the

appropriateness of the various development models is reviewed, followed by a comparison and

integration of the non-sequential models. Then, based on this, further input for the tentative model is

obtained by synthesizing the most important key aspects from the overall team development literature.

After presenting the various development models, it became apparent that there is little

consensus on the overall development pattern of (self-managing) teams. However, when regarding the

critics that are levelled at several models, it can be suggested that the literature cannot be considered

truly representative of permanent naturally occurring (self-managing) teams. This is because certain

settings (i.e. self-analytic groups, student teams, teams with a fixed time-line) were indicated to less

likely apply to these type of teams. In contrast, the non-sequential models were pointed to be more

appropriate for permanent naturally occurring teams since they (1) represent teams as open rather than

closed systems and/or (2) do not have a specific ordered pattern of team development. Taking the

analysis on the non-sequential models a step further, it seems that that the process models of Dunphy

and Bryant (1996) and Kuipers and Stoker (2009) are most suitable for describing SMTs’ development

pattern Process models allow for the consideration of various development processes as simultaneous,

which makes this perspective more dynamic than the clearly demarcated phases of the time-based and

hybrid non-sequential models. Nevertheless, the tentative model will not rely solely on the process’

model ‘thinking’ as it can be argued that different types of non-sequential models can be viewed as

being complementary. The models of Kuipers and Stoker (2009), Kozlowski et al. (1991) and Salas et

al. (2005) merely attempted to describe the patterns of (self-managing) team development. By doing

this, as was discussed in regard to the linear-progressive models, these models have neglected the

internal and external factors that affect the development pattern of (self-managing) teams. In contrast,

the contingency models of Dunphy and Bryant (1996), Gersick (1988), McGrath (1991), and Morgan

et al. (1993) highlight the importance of such factors. Hence, different types of non-sequential models

contribute to our understanding of team development: Kuipers and Stoker (2009), Kozlowski et al.

29

(1991) and Salas et al. (2005) are preoccupied with describing in what way (self-managing) teams do

develop, while Dunphy and Bryant (1996), Gersick (1988), McGrath (1991), and Morgan et al. (1993)

also focuses on factors that cause changes in the way teams do develop. Based on this, the various

non-sequential models are integrated by arguing that SMTs develop towards effective functioning

along a series of non-sequential processes. These processes may follow one another in a variety of

possible patterns or may take place simultaneously over time, either up or down. Importantly, each of

these processes is influenced by internal and external factors, which are identified in the next section.

Furthermore, the literature review provides insights in the defining aspects of each of these

various SMT development processes. These insights are obtained by comparing not only the non-

sequential models, but also the linear-progressive and cyclical models because they exhibit, despite

their fundamental differences, strong similarities on a number of key aspects. It seems that these

models are able to deliver input for 13 key aspects, which can be grouped into three processes: (1)

team management, (2) task management, and (3) boundary management and improvement. In Table 4,

these processes are described and linked to those authors who explicitly referred to it. The table is

almost similar to the SMT development processes of Kuipers and Stoker (2009) (i.e. internal relations,

task management and external relations and improvement). The only difference can be addressed by

the process of ‘team management’. This process was expanded by two additional key aspects that were

identified in the literature: ‘backup behavior’ and ‘motivating and confidence building’. In addition,

this study has attempted to create a more general overview since Kuipers and Stokers’ (2009)

processes are characterized by context-specific terms (e.g. production support activities).

A detailed examination of the fundamental processes demonstrates that the ‘team

management’ aspects refer to the interpersonal feelings and behaviors among team member. Most key

aspects are covered in the third phase of the socio-technical phase models and the second and third

phase of the models of Tuckman (1965) and Wheelan (2005), in which team members resolve

differences and develop a set of unified goals. Furthermore, team management aspects also relate to

the cyclical and non-sequential models. Marks et al. (2001), for example, referred to it as interpersonal

processes and Morgen et al. (1993) distinguished a separate track that encompasses teamwork skills.

Planning and coordination activities were explicitly mentioned by McGrath (1991), who pointed out

that teams over time synchronize variety of team processes (i.e. social entrainment). Next, the process

of ‘task management’ involves “the extent to which the team manage its primary process” (Kuipers &

Stoker, 2009, p. 408). The key aspects ‘multi-functionality’, ‘decision-making and control’, and

‘delegated management and support tasks’ represent the principles of Socio-Technical System Design

(Morgan, 1998) and can be found in the first two phases of the socio-technical phase models and in the

second and third phase of Wellins et al.’s (1991) model. In addition, Dunphy and Bryant (1996)

referred to these aspects in their technical expertise and self-management attributes. The other more

general key aspects, ‘work communication’ and ‘performance management’, can be found in all SMT

development models, Marks et al.’s (2001) action phase, Morgan et al.’s (1993) taskwork skills track

30

and Wheelan’s (2005) integrated model. Finally, the process of ‘boundary management and

improvement’ represents the extent to which the team handles external relations and engages in

activities of continuous improvement, and advanced management and support. The aspects of this

process are mainly covered by the development models specifically aimed at SMTs: in the fourth

phase of both the socio-technical phase models and the model of Wellins et al. (1991), and as part of

Dunphy and Bryant’s (1996) self-leadership attribute. Moreover, Bushe and Coetzer (2007) identified

‘external relations’ as part of the phase of ‘competence’, while the models of Kozlowski et al. (1999),

Marks et al. (2001) and Salas et al. (2005) examined ‘continuous improvement activities’.

31

Table 4. Key aspects of team development models (based on Kuipers & Stoker, 2009)

Key aspect Description Authors

Team management

Goal orientation Identification and prioritization of goals and

subgoals (Marks et al., 2001)

Tuckman (1965), Wellins et al. (1991), McGrath

(1991)Kozlowski et al. (1999), Marks et al. (2001), Wheelan

(2005), Bushe and Coetzer (2007), Kuipers and Stoker (2009)

Planning and coordinating activities

Planning of work and support activities and

orchestrating the sequence and timing of these

activities.This includes identifying team members

capabilities and specifying team members roles

(Kuipers & Stoker, 2009; Marks et al., 2001)

Tuckman (1965), Wellins et al. (1991), McGrath (1991), Morgan

et al. (1993), Dunphy and Bryant (1996), Van Amelsvoort and

Benders (1996), Hut and Molleman (1998), Kozlowski et al.

(1999), Marks et al. (2001), Wheelan (2005), Bushe and Coetzer

(2007), Kuipers and Stoker (2009)

Conflict management

Preemptive conflict management involves

establishing conditions to prevent, control, or guide

team conflict before it occurs. Reactive conflict

management involves working through task and

interpersonal disagreements among team members

(Marks et al., 2001)

Tuckman (1965), McGrath (1991), Morgan et al. (1993), Marks et

al. (2001), Wheelan (2005), Bushe and Coetzer (2007), Kuipers

and Stoker (2009)

Mutual performance monitoring and

backup behaviour

Assisting team members to perform their tasks.

Assistance may occur by providing a teammate

verbal feedback or coaching, helping a teammate

behaviorally in carrying out actions, or assuming

and completing a task for a teammate (in Marks et

al., 2001)

Wellins et al. (1991), Hut and Molleman (1998), Kozlowski et al.

(1999), Marks et al. (2001), Salas et al. (2005), Kuipers and

Stoker (2009)

Motivating and confidence building

Generating and preserving a sense of collective

confidence, motivation, and task-based cohesion

with regard to task accomplishment (based Marks

et al., 2001).

Hut and Molleman (1998), Marks et al. (2001), Kuipers and

Stoker (2009)

Task management

Multi-functionality Developing multi-functionality to support job

enlargement (Hut & Molleman, 1998)

Wellins et al. (1991), Dunphy and Bryant (1996), Van Amelsvoort

and Benders (1996), Hut and Molleman (1998), Kuipers and

Stoker (2009)

32

Table 4. (continued)

Key aspects Description Authors

Work communication

Exchanging task related information (Morgan et

al., 1993)

Wellins et al. (1991), Van Amelsvoort and Benders (1996),

Wheelan (2005), Kuipers and Stoker (2009)

Decision-making and control

Joint performance of managerial tasks (Kuipers &

Stoker, 2009)

Wellins et al. (1991), McGrath (1991), Dunphy and Bryant

(1996), Van Amelsvoort and Benders (1996), Hut and

Molleman (1998), Bushe and Coetzer (2007), Kuipers and

Stoker (2009)

Delegated management and support tasks

Carrying out and arranging routine support

activities (i.e. plan and organize team meetings )

(Kuipers & Stoker, 2009)

Wellins et al. (1991), Dunphy and Bryant (1996), Van

Amelsvoort and Benders (1996), Hut and Molleman (1998),

Kuipers and Stoker (2009)

Performance management

Tracking task and progress toward goal

accomplishment, interpreting system information

and transmitting progress to team members in

order to increase team performance (Marks et al.,

2001)

Wellins et al. (1991), Morgan et al (1993), Dunphy and Bryant

(1996), Van Amelsvoort and Benders (1996), Hut and

Molleman (1998), Marks et al. (2001), Kuipers and Stroker

(2009)

Boundary management and improvement

Continuous improvement activities Identifying opportunities and developing plans for

improvement and innovation (Salas et al., 2005)

Wellins et al. (1991), Morgan et al. (1993), Dunphy and

Bryant (1996), Van Amelsvoort and Benders (1996), Hut and

Molleman (1998), Kozlowski et al. (1999), Marks et al.

(2001), Salas et al. (2005), Kuipers and Stoker (2009)

External relations

Handling of relations with other teams or

individuals who provide inputs or receive outputs

from the team (in Hut & Molleman, 1998)

Wellins et al. (1991), Dunphy and Bryant (1996), Van

Amelsvoort and Benders (1996), Hut and Molleman (1998),

Bushe and Coetzer (2007), Kuipers and Stoker (2009)

Advanced management and support

activities

Carrying out and arranging non-routine support

activities (i.e. personnel selection, annual

appraisal) (Kuipers & Stoker, 2009)

Wellins et al. (1991), Dunphy and Bryant (1996), Van

Amelsvoort and Benders (1996), Hut and Molleman (1998),

Kuipers and Stoker (2009)

33

Summarizing, the tentative model will be built around an integrated perspective brought forward by

the non-sequential models of team development. The above defined three development processes (and

their underling key aspects) will be used to incorporate the idea of a series of processes. The three

development processes are proposed to follow one another in a variety of possible patterns or to take

place simultaneously over time, depending on internal and external factors. This perspective thus

criticizes the often suggested sequential phases for describing SMTs’ development pattern.

2.5. Factors

The next and final step in constructing a tentative model concerns the explicit identification of the

factors that influence SMTs’ development pattern. In the literature, 13 articles were found that

empirically investigated the impact of various factors. These factors, as shown in Table 5, can be

divided into four levels: (1) individual level, (2) team level, (3) organizational level, or (4)

environmental level factors. The factors at the individual and team level can be considered as internal

factors, while the factors at the organizational and environmental level represent external factors.

Below, the specific factors of each of these four levels are explored more elaborately.

1. Individual level

The factors at this level are specifically related to SMT development. The first factor, individual

human capital, reflects the level of team members’ skill and learning abilities. In the literature, it is

found that a deficiency of these abilities inhibits the development towards self-management, especially

with respect to the development processes ‘task management’ and ‘boundary management and

improvement’ (Balkema & Molleman, 1999; Kuipers & de Witte, 2006). This line of reasoning

corresponds to Van Amelsvoort and Benders (1996) and Dunphy and Bryant (1996), who indicated

that SMT development processes last longer when team members’ initial skill levels are low, and

when different skills and considerable training efforts are needed. Resultantly, it can be suggested that

individual human capital is pre-requisite for SMT development.

The second individual level factor pertains team member attitudes towards working in SMTs.

As has been stated in the previous sections, SMTs have increased authority with respect to several

areas of decision making. However, not all team members may prefer autonomous decision making

because they have different psychological needs and motives; some members desire challenging jobs

and prefer autonomous decision making, while others do not want to become multifunctional and

prefer limited jobs (Balkema & Molleman, 1999). Besides these kind of needs, some aspects of SMTs

may threaten the social identity of individual team members. Job enlargement and job enrichment, for

example, may lead to perceived lowering of status differences, which causes motivational problems

and negative attitudes towards self-management. This assertion was supported by Balkema and

Molleman (1999), who observed that some of the higher-status team members were afraid to become

redundant and believed that other lower-status team members were not capable of solving the more

34

complex tasks. Together, these arguments suggest that individual team members may have different

attitudes towards working in SMTs, or to what Van Amelsvoort and Benders (1996, p. 168) referred as

“varying degrees of acceptance”, which may enhance or seriously restrict SMT development.

2. Team level

There are several team level factors that influence on the development of SMTs. The first factor,

psychological safety, is defined by Edmondson (2004, p. 241) as “a team-level concept describing

individuals’ perceptions about the consequences of interpersonal risks in their work environment”.

Both O’Leary (2016) and Raes et al. (2015) showed that team psychological safety invokes (self-

managing) team development because it allows individual team members “to feel comfortable enough

to give their opinion, ask question, and engage in shared decision making which allows them to learn

with, from and about each other” (O’Leary, 2016, p. 33). This results, according to O’Leary (2016), in

knowledge co-generation and power sharing, which in turn results in other emergent aspects of SMT

development, like shared goals and an understanding of team roles and responsibilities.

Next, team turnover has been conceptualized as “a type of membership change that involves

the departure and/or arrival of a formally designated member or members” (Van der Vegt et al., 2010).

Research suggests that high team turnover (also referred to as team instability) complicates the

development of interpersonal relations, goal orientation and shared decision-making (Wellins et al.,

1991; Cashman, Reidy, Cody, & Lemay, 2004; O’Leary, 2016). This can, for example, be explained

by the finding that newly arrived team members are often hesitant to immediate engage in discussions,

which in turn makes it difficult to build a climate of psychological safety (O’Leary, 2016). In addition,

team turnover was found to drain on the team’s energy and emotional strength since it is associated

with continuous periods of adjustments and feelings of disappoint (Cashman et al., 2004).

The final team level factor, team size, is identified as a crucial factor in the studies of Wheelan

et al. (2003) and Wheelan (2009). Both studies found that as size increases, cohesion and intimacy

descend. Furthermore, larger teams were less developmentally advanced and members of such teams

perceived their team to be more competitive, less unified and more argumentative. It is for this reason

that team size is suggested to be negatively associated with the development of SMTs. This impact

may even be greater with respect to SMTs because such teams are more heavily engaged in

coordination activities, which were found to be perceived as substantially more difficult in larger

teams (Hut & Molleman, 1998).

3. Organizational level

Two organizational level factors were identified, namely (1) management style and (2) training and

time investments. With respect to management style, both Hut and Molleman (1998) and Balkema and

Molleman (1999) emphasized that management must provide SMTs with ‘opportunities’ (i.e. authority

and decision-making responsibilities) for self-management. However, mangers may seriously restrict

these opportunities, if they do not alter their role when organizations try to implement SMTs. In other

35

words, they continue to display top-down management styles instead of adopting the role of a

facilitator and coach (Hut & Molleman; 1998; Balkema & Molleman, 1999). These top-down

behaviors inhibit the decentralization of authority and decision-making responsibilities, which in turn

negatively affects the development of ‘boundary management and improvement’ (Hut & Molleman,

1998; Kuipers & De Witte, 2006). Furthermore, it is indicated that top-down management behaviors

create distrust or even hostility towards management. Team members may, for example, become

suspicious about the attitude of management to implementing SMTs, and feel incompetent in

managing themselves (Hut & Molleman, 1998). Resultantly, it can be stated that managers can

enhance SMT development by using appropriate management styles.

Second, SMT development can be affected by providing or withholding material support in

the form of training and time investments. Wellins et al. (1991, p. 219) referred to this as “lack of

attention or maintenance” and pointed out that “without training and development, team functioning

and cohesiveness can gradually erode”. Other authors reported similar findings and concluded that

training, and regular, dedicated time for team development contributes to highly effective teams

(Morgan et al., 1993; Chang et al., 2004). Furthermore, Dunphy and Bryant (1996) and Van

Amelsvoort and Benders (1996) concentrated on training investments with regard to team members’

individual human capital. They reasoned that investments in time and training are required to ensure

that team members are capable of performing the more diverse and complicated tasks that are

associated with multi-functionality and increased responsibilities.

4. Environmental level

The final factor concerning SMT development, requisite for self-management, relates to Morgan’s

(1986) principle of ‘requisite variety’ (see section 2.1.2.). Balkema and Molleman (1999) explain that

low levels of variety of work processes will be more efficient to control by standardization. In this

respect, the need for local authority and decision-making seems to be low and, hence, the requisite for

self-management. However, if organizations have to deal with dynamic and complex environments,

the tasks will be predominately non-routine and unique in nature. In such situations it is more difficult

to find solutions in the form of standardized work processes, which makes it more desirable to allocate

authority and decision-making responsibility to SMTs (i.e. high requisite for self-management)

(Dunphy & Bryant, 1996; Hut & Molleman, 1998; Balkema & Molleman, 1999). A low level of

requisite for self-management thus ensures that it is less important to decentralize local authority and

decision-making responsibilities, which in turn hinders SMTs in their development towards full self-

regulation.

36

Table 5. Factors that influence SMTs’ development pattern

Factors Description Influence Authors

Individual level

Individual human capital The level of team members’ skill and learning

abilities

+ Dunphy and Bryant (1996), Van Amelsvoort and Benders

(1996), Balkema and Molleman (1999), Kuipers and de

Witte (2006)

Team member attitudes

Team member attitudes towards working in

SMTs. These attitudes are shaped by

psychological needs and motives (Balkema &

Molleman, 1999)

+/-

Van Amelsvoort and Benders (1996), Hut and Molleman

(1998), Balkema and Molleman (1999)

Team level

Psychological safety A team-level concept describing individuals’

perceptions about the consequences of

interpersonal risks in their work environment

(Edmondson, 2004)

+ Raes et al. (2015), O’Leary (2016)

Team turnover A type of membership change that involves the

departure and/or arrival of a formally designated

member or members (Van der Vegt et al., 2010)

- Wellins et al. (1991), Cashman et al. (2004), O’Leary (2016)

Team size

Number of team members

-

Hut & Molleman (1998), Wheelan et al. (2003), Wheelan

(2009)

Organizational level

Management style

Training and time investments

The behavioral tendencies managers use to direct

SMTs

The degree to which management invests in team

training and dedicated time for team development

+/-

+

Hut and Molleman (1998), Balkema and Molleman (1999),

Kuipers and de Witte (2006)

Wellins et al. (1991), Morgan et al. (1993), Dunphy and

Bryant (1996), Van Amelsvoort and Benders (1996),

Cashman et al. (2004)

Environmental level

Requisite for self-management The need for local authority and decision-making.

This need is determined by the level of

environmental variety and complexity

+ Dunphy & Bryant (1996), Hut and Molleman (1998),

Balkema and Molleman (1999)

37

Summarizing, the tentative model will be based on eight factors that were distinguished on the level of

the individual, the team, the organization or the environment. In doing so, the open system ideas put

forth by some non-sequential models are adhered to.

2.6. SMT development: a tentative model

One of the central objectives of this study is to clarify the development pattern of SMTs by designing

a model. By combining the insights of the literature review (Table 4 and 5), it was possible to

construct a tentative non-sequential model of SMT development (see Figure 1).

Time

Figure 1. A tentative non-sequential model of SMT development

The tentative model adopts McGrath’s (1964) input-process-output (I-P-O) model to provide a clear

overview of SMT development. The I-P-O model is an open system approach and posits, in line with

results from the literature review, that a variety of inputs (factors) influence processes (development

processes), which in turn contribute to team outputs. Here, SMT effectiveness is considered as an

output, since SMT development is aimed at reaching a state of effective functioning. However, one

should not that the I-P-O model is not without limitations. One such limitation stems from the

Individual level Individual human capital

Team member attitudes

Team level Psychological safety

Team turnover

Team size

Organizational level Management style

Training and time investments

Environmental level Requisite for self-management

Team management

Goal orientation

Planning and coordination activities

Conflict management

Mutual performance monitoring and

backup behavior

Motivating and confidence building

Task management

Multi-functionality

Work communication

Decision-making and control

Delegated management and support

tasks

Performance management

Boundary management and

improvement

Continuous improvement activities

External relations

Advanced management and support

activities

Factors Development Processes Output

SMT effectiveness

38

underlying assumption that it considers team functioning as static and follows a linear progression

from inputs through outputs (Ilgen, Hollenbeck, Johnson, & Jundt, 2005). This study has moved

beyond this by visualizing the processes more loosely than originally designed. In the tentative model,

SMTs are suggested to develop backwards and/or forwards along a series of three processes - (1) task

management, (2) team management, (3) and boundary management and improvement - that may

follow one other in a variety of possible patterns or may occur simultaneously over time, depending on

eight factors.

As a next step, the tentative model needed to be assessed and, if necessary, expanded and/or modified

in order to answer the research question of this study. To this end, retrospective interviews and SMT

observations were performed. Results are reported in chapter 4.

39

3. Methodological framework

This chapter outlines the methods that were used to assess the tentative model of SMT development in

the mental healthcare practice. The research context is presented in section 3.1, followed by an

overview of strategies for data sampling. Eventually, section 3.4 and 3.5 describe each of the main

strategies for data collection and analysis: retrospective interviews and SMT observations.

3.1. Research context

This study was performed at Geestelijke Gezondheidszorg Eindhoven en de Kempen (GGzE), a

mental healthcare organization located in the south of the Netherlands. GGzE has approximately 2.100

employees and offers mental healthcare to more than 20.000 patients (children, adults and elderly)

with complex psychiatric or psychosocial disorders in a year. The majority of these health care

services are on ambulatory basis (fulltime treatment as in inpatient care) and, if necessary, on

clinically basis (part-time treatment as in outpatient care) (GGze, 2016).

From 2014 onwards, GGzE initiated the transition towards self-management as a means of

empowering their employees. Frameworks and conditions were set up by the Board of Directors, but

teams could direct their own transition towards self-management. Subsequently, GGzE reorganized its

traditional structure on 1 January 2016. Since then, all 100 primary healthcare teams have been

officially self-managed and accompanied by a team advisor. Moreover, the divisional structure has

been replaced by an organizational structure of 11 units. The 11 units have been facilitated by an

integral or dual management, who, in turn, has received assistance from the Executive Board (GGzE,

2016). To evolve SMTs, the self-management process facilitator applied a (self) diagnostic

questionnaire (Kommers & Dresen, 2010) based on the Phase model of Van Amelsvoort (2000).

Results from this questionnaire ascertained that some SMTs are more developmentally advanced than

others, which makes GGzE an appropriate setting to carry out this study.

3.2. Sample strategy

A non-probability convenience sampling strategy was followed to recruit primary healthcare SMTs for

the observational part of this study. The researcher applied this sample strategy because she was

dependent on SMTs that we were inclined to gain insights in their level of self-management. This

form of non-probability sampling was therefore an appropriate alternative, even though it does affect

the generalizability of the study (Ritchie & Lewis, 2003). The observational data sample, eventually,

yielded 13 SMTs from 6 different units. For the retrospective interviews, all 13 team advisors were

selected to ensure that the sample meets the requirements for diversity and representation (Ritchie &

Lewis, 2003). Additionally, the self-management process facilitator was selected for the retrospective

40

interviews. She has more in-depth knowledge about the overall development of the SMTs, which was

a valuable contribution to the creation of a comprehensive representation.

3.3. Data collection

3.3.1. Retrospective interviews

Following the literature review, retrospective interviews were used mainly to gain more insight in the

actual practice of SMT development in mental healthcare. A retrospective approach was utilized as it

provided an acceptable methodology for mapping out development patterns (Huston, Surra, Fitzgerald,

& Cate, 1981). The interviews deployed a semi-structured format, guided by the tentative model of

SMT development. This allowed to keep an open mind to new information that was not yet

incorporated in the model. In general, respondents were asked to (1) recall the SMT development

pattern for each process (i.e. team management, task management, boundary management and

improvement), (2) to indicate if (and how) the identified factors influenced this development pattern

and (3) to identify any other factors that caused SMT to develop (see Appendix III). The interviews

averaged 60 minutes in time and were audio-recorded for the convenience of transcribing.

3.3.2. SMT observations

In order to achieve methodological triangulation, additional data was gathered by observing SMTs.

These observations were considered to be a valuable data source as it offered the opportunity to obtain

an insider perspective, or what Bryman (2008) refers to as ecological validity; studying phenomena in

its natural context. The SMT observations were carried out of several feedback meetings. During these

feedback meetings, SMT members discussed the visualized results from a (self) diagnostic

questionnaire of Kommers and Dresen (2010) in order to identify its own strengths and weaknesses

(see Appendix VII for an example). That is why the observations allowed to infer conclusions with

regard to SMTs’ development pattern, even though their nature was predominantly cross-sectional.

The questionnaire of Kommers and Dresen (2010) is based on the Phase model of Van Amelsvoort

and Benders (1996) and consists of 16 items that are congruent with the 13 key aspects found in the

literature (see Appendix VI). It is for this reason that the observations were guided by a semi-

structured format that addressed the 16 items of Kommers and Dresen’s (2010) questionnaire. The

emphasis was also on factors which respondents themselves mentioned, in order to obtain the most

reliable picture. During the observations, the researcher acted as a non-participant and took detailed

field notes of SMT members’ dialogues and informal talks (see Appendix VIII). The observations

averaged one hour in time and were overt, meaning that all SMT members were informed about the

study and knew why the observer was there.

41

3.4. Data analysis

In order to analyze data from the retrospective interviews correctly, audio-recorded interviews were

verbatim transcribed. After transcribing, raw data of both the transcripts and the observational field

notes were directly uploaded to NVivo11. NVivo11 was then used to enable systematic theoretical

codding by opting Boeije’s (2010) Spiral of Analysis. In detail, this meant that raw data was

transformed into theoretical sensitive results by three types of coding; thematic, axial and selective

coding. The first step, thematic coding, was concerned with reading all the documents and

highlighting fragments of text that signified SMT development and influencing factors. Consequently,

the relevant fragments were compared and divided into categories that were labeled with a code. This

resulted in a coding scheme. The second step involved a more abstract categorization of the selected

quotes. Several rounds of coding were employed, resulting in a specification of properties and

dimensions of a category (axial coding). The final step entailed selective coding, where core categories

were selected and connections between categories were established (Boeije, 2010) (see Appendix IV

and IX). The themes that emerged from this analysis are discussed in the next chapter. Themes are

only discussed when they were brought forward by at least three interview respondents and SMTs.

Quotes are translated from Dutch. The original quotes can be found in Appendix XI.

42

4. Results

This study aims to clarify the development pattern of SMTs in mental healthcare as well as factors that

influence these patterns. To this end, a tentative model was developed in chapter 2. This model

considered SMT development as a non-sequential pattern of three processes - (1) task management,

(2) team management, (3) and boundary management and improvement - that is largely the result of

eight internal and external factors. In this chapter, the tentative model is assessed in the mental

healthcare practice, and eventually expanded. Results from the retrospective interviews and SMT

observations are described jointly, according to SMTs’ development pattern and its influencing

factors.

4.1. SMTs’ development pattern

Interview respondents confirmed the three defined development processes of the tentative model - (1)

team management, (2) task management, and (3) boundary management and improvement - and their

13 underlying key aspects: “Everything what they are doing comes really back in here. I am not

missing anything.” (respondent 2). The overall development of the first process, team management,

was found to have room for improvement due to two key aspect that remained behind in almost all

SMTs: (1) ‘conflict management1’ and (2) ‘mutual performance monitoring and backup behavior

1’

(see Appendix V and X). Interview respondents explained this by the fact that the general level of

psychological safety was low, as reflected by the following quote: “Providing feedback sounds so

scary.” (SMT 6D) (see section 4.2). The second process, task management, was emphasized to be

crucial for the primary process, and received therefore much attention from SMTs. The key aspect

‘performance management2’ constituted an exception to this; both the retrospective interviews and

SMT observations revealed that also the development of this aspect remained behind in all SMTs (see

Appendix V and X). Respondent 13 explained why: “They are still searching for outcomes and results

they want to achieve. If this is not even clear, it is hard to manage performance” and “They are not

developmentally advanced enough to manage their performance. To do this, it is very important that

you stick to agreements, provide feedback to each other, and expect significant changes. These steps

must all precede.” In this respect, it seems that key aspects such as ‘goal orientation1’, ‘decision-

making and control2’ and ‘mutual performance motoring and backup behavior

1’ must be present in

order to be able to move to ‘performance management2’, thereby providing some support for the

linear-progressive models of team development. Next to this, other reasons that were mentioned to

prevent SMTs from developing ‘performance management2’ are: deficit individual human capital,

high perceived workload, and limited information sources (see section 4.2). Finally, the overall

development of the third process, boundary management and improvement, was found to be highly

1 Team management 2 Task management

43

dispersed: some SMTs were already developmentally advanced in ‘external relations3’ and ‘advanced

tasks3’, while other SMTs perceived these activities as “a bridge too far” (respondent 10).

Apart from the above mentioned key aspects ‘conflict management1’, ‘mutual performance

monitoring1’ and performance management

2’, no predefined, unitary development pattern could be

detected. Individual SMTs appeared to have its own strengths and weaknesses, and developed each of

the three processes in a variety of possible patterns or simultaneously over time, either up or down (see

Appendix V and X). The following quotes reflect this very clearly: Respondent 6, for example,

indicated that SMTs initially concentrated on multiple key aspects, like ‘goal orientation1’ and

‘planning and planning and coordination activities1’ and ‘work communication

2’: “I think that they all

started with setting clear goals” and “… establishing a structure of tasks and responsibilities, who

does what? how do we communicate with each other?”, while other respondents noticed that these key

aspects still needed to be developed, like respondent 1: “If you're talking about goal setting, who does

what, and the distribution of tasks and roles in a team, then is there not yet really paid attention to”.

Respondent 2, on the hand, stressed that SMTs first developed ‘decision-making and control2’: “That

was one of the first things they all agreed on; how do we make decisions during a meeting?, whereas

respondent 13 observed that the development of this key aspect was currently taking place: “I think

they are becoming more and more aware of the importance of joint decision-making … I see that they

are struggling with that” (respondent 13). These findings thus suggest that SMTs do not develop

along a particular pattern, thereby supporting the tentative non-sequential model.

4.2. Factors

The retrospective interviews and SMT observations yielded a wide range of internal and external

factors that explained the various development patterns of the three processes. As a consequence, the

tentative model was found to be too narrow in its focus. It, however, still formed a useful way to

organize the various factors. An overview of these factors is presented by Table 6 (see next page).

Following this table, the results regarding the factors are described more elaborately per level:

individual, team, organization and environment.

1 Team management 2 Task management 3 Boundary management and improvement

44

Table 6. Factors that influence SMTs’ development pattern

1. Individual level

First, individual human capital was considered to enhance the development of task management and

boundary management and improvement. In particular, interview respondents most frequently

mentioned that SMTs ability to develop ‘multi-functionality2’, ‘performance management

2’ and,

‘advanced management and support activities3’ was hindered by deficit skills. Respondent 5 illustrated

this by an example about personnel selection (advance management and support activity3): “I have

experienced this in SMT 4Q. … They asked me: ‘Could you help us with that?’ and they said

afterwards: ‘How were we suppose to know that? If we had to do this alone, we would select a totally

different candidate, we do not know this’.” The development of ‘multi-functionality2’, however, was

found to be relatively restricted. This especially with regard to multidisciplinary SMTs since such

teams are composed of members from different healthcare professions with varied but complementary

experience, qualifications, and skills. Respondent 12 reported this as follows: “These teams are

dealing with, for example, a community psychiatric nurse, a living support assistant, a psychologist, a

psychiatrist. These disciplines are totally different. They are not able to perform each other’s task”.

2 Task management 3 Boundary management and improvement

Factors Influence Source(s)

Individual level

Individual human capital + Retrospective interviews

Team member attitudes

Perceived workload

+/-

-

Retrospective interviews, SMT observations

Retrospective interviews, SMT observations

Team level

Psychological safety + Retrospective interviews, SMT observations

Team turnover

Team size

Nature of the task

Bureaucratic history

∩

∩

+/-

-

Retrospective interviews, SMT observations

Retrospective interviews, SMT observations

Retrospective interviews

Retrospective interviews

Organizational level

Management style

Material support

Social support

+/-

+

+

Retrospective interviews, SMT observations

Retrospective interviews, SMT observations

Retrospective interviews

Environmental level

Requisite for self-management ?

45

The retrospective interviews and SMT observations also showed that team member attitudes

influence SMT development. Interview respondents mentioned that most SMT members were highly

motivated to carry out tasks related to the primary process, whereas regulatory tasks, like ‘mutual

performance monitoring1’ and ‘delegated management and support

2’, were perceived as particularly

disturbing and time-consuming: “Everybody who works with patients, just wants to work with

patients. They do not want to deal with the surrounding ballast of healthcare” (respondent 9). These

perceptions were indicated to cause negative attitudes towards self-management; SMT members asked

critical questions and/or were not eager to take up regulatory tasks. On the other hand, several

interview respondents mentioned that almost every SMT had one or two members with positive

attitudes, who were the driving forces. They carried out several regulatory tasks and enjoyed the

additional challenges and responsibilities. This was also brought forward in three SMTs (SMT 3J, 6B

and 10B). One members of SMT 6B mentioned for example: “It is always the same members who

assume responsibility for tasks. I think it is a pity, I would like to participate with more members.” In

this respect, it can be suggested that positive team member attitudes ascertain that key aspects are

picked up, which in turn positively impacts on all three development processes.

An additional factor that appeared to constrain SMT development is high perceived workload.

Both the retrospective interviews and SMT observations revealed that SMT members had to cope with

heavy workloads because they did not have sufficient time to perform the various tasks. Resultantly,

operational tasks demanded all the attention and SMT members could not find the time for regulatory

tasks, like ‘goal orientation1’,‘delegated management and support

2’, ‘performance management

2’, and

‘continuous improvement3’. One member of SMT 3P illustrated this as follows: “I think that we are

working really hard. We just keep going without thinking.” Therefore, perceived workload is also

considered as a factor that influences each of the three development processes.

Figure 2. Results of individual level factors

1 Team management 2 Task management 3 Boundary management and improvement

Individual human capital (+)

Management style

Material support

Social support

Team management

Goal orientation

Planning and coordination activities

Conflict management

Mutual performance monitoring and

backup behavior

Motivating and confidence building

Team member attitudes (+/-)

Perceived workload (-)

Material support

Social support

Task management

Goal orientation

Planning and coordination activities

Conflict management

Mutual performance monitoring and

backup behavior

Motivating and confidence building

Boundary management and improvement

Planning and coordination activities

Conflict management

Mutual performance monitoring and

backup behavior

Motivating and confidence building

46

2. Team level

On the team level, five factors were observed to affect the development pattern of SMTs. The first

factor, psychological safety, was considered very important, both by interview respondents and SMT

members. It was pointed out that high levels of psychological safety allowed SMT members to feel

comfortable enough to perform several key aspects of all three development processes (i.e. ‘mutual

performance monitoring and backup behavior1’, ‘conflict management

1’, ‘work communication

2’,

‘decisions-making and control2’ and ‘advanced management and support

3’). One SMT member

illustrated this as follows: “I feel myself safe …, due to this I dare to do more, like conducting job

interviews.” (SMT 4J). Nonetheless, most interview respondents stressed that the overall level of

psychological safety within SMTs was low. SMT members were often reluctant to discuss problems,

ask critical question, and/or provide each other with feedback, because they believed that any of this

would be perceived as destructive rather than constructive. These behaviors especially inhibited the

development of ‘conflict management1’ and ‘mutual performance monitoring and backup behavior

1’,

as noted by respondent 5: “Everybody wants to remain at the club, so they hardly dare to be critical.

That is something I have noticed, a small amount of feedback has been given.”

Next, interview respondents and SMT members stated that the development of team

management and task management can be seriously stagnated or even declined by high team turnover.

The reason is that SMTs with high turnover needed to be continuously engaged in periods of ‘goal

orientation1’, ‘planning and coordination activities

1’, ‘conflict management

1’, and/or ‘decision-making

and control2’, which makes it extremely difficult to achieve progression. The following quote reflected

this most clearly: “The circumstances are constantly changing due to turnover. … We are floating

instead of travelling.” (SMT 2C). At the same time, it was also emphasized by interview respondents

that new SMT members could offer alternative ideas and viewpoints (i.e. the factor individual human

capital). This indicates that the overall influence of team turnover on SMTs’ development processes is

not negative, but rather inverted U-shaped.

A similar effect was found for team size. Results of the retrospective interviews and SMT

observations showed that large SMTs encountered more difficulties with developing ‘goal

orientation1’, ‘work communication

2’ and ‘decision-making and control

2’. However, it was also

stressed that team size should neither to be too small in order to guarantee that a SMT is able to

perform the key aspects of all three development processes, as stated by respondent 8: “I think that the

literature considers a team of 12 till 15 members as most ideal. I agree with that because team

member roles and tasks could be allocated appropriately. This is complicated for small teams.”

Although nature of the task was not elaborated in the team development literature, it derived

exhaustive attention during the retrospective interviews. Two attributes that determined the nature of

1 Team management 2 Task management 3 Boundary management and improvement

47

the task were found to have a substantial impact on SMT development, namely (1) type healthcare

service and (2) nature of patient population. The first attribute, type of healthcare service, basically

distinguished care on ambulatory and clinical basis. Interview respondents observed that these types of

healthcare services positively impacted on ‘boundary management and improvement’ since SMTs in

the ambulatory care were much more developmentally advanced in managing ‘external relations3’ than

SMTs in the clinical care. They explained this by the fact that SMTs in the clinical care needed to have

continuous contact with their patients, whereas SMTs in the ambulatory care needed to work with

entire communities. Hence, the task of SMTs in the ambulatory care not only required the

consideration of individual patients, but also family members and many non-medical organizations,

such as municipalities and chain partners: “Teams of unit 4 are located in the city of Eindhoven or

surrounding villages, and are funded by the municipality. These teams are therefore firmly rooted in

society.” (respondent 8). Furthermore, some interview respondents mentioned that type of healthcare

service also influenced on the development of ‘team management’. Primary tasks in ambulatory care

were indicated to be more individualistic in nature and demand less continuity, which ensured that

SMTs in ambulatory care could more easily develop ‘planning and coordination activities1’.

Respondent 13 explained this as following: “That is a totally different way of working. It makes a

great difference, for example with scheduling or creating a duty list together. Everyone just makes

their own schedules and appointments in the ambulatory care, while you just have to make sure that

there is 24 hours a day a workforce available in clinical care. This requires more effort from an

organizational point of view.” The second attribute, patient population, related to the severity and

complexity of patients’ psychiatric or psychosocial disorder. Interview respondents stated that the

most severe and complex patient population was assessed and treated by SMTs from unit 8, 9 and 10.

Their population not only required long-term, specialist treatment, but was also involved with the

criminal justice system. This made their primary tasks substantially more difficult as they must

constantly remain aware of SMT members and patients safety, conform to strict guidelines and could

not afford any mistakes. Hence, respondents believed that supervision was vital for these SMTs, as

stated by respondent 3: “The purchase, the different judicial measures, the safety aspect, you cannot

assign this to different teams. … You need to give these teams more central support to guide this

properly.” Respondents, however, did not indicate that these SMTs were not able to self-regulate their

behavior. SMTs from these units were rather observed to develop less far along each of the three

development processes.

The final identified team level factor is SMTs’ bureaucratic history. Several interview

respondents emphasized that prior team experiences influenced how easily SMTs developed, since

SMT members were not used, uncertain, or even afraid to perform the higher share of responsibilities

when they were previously directed by a severe top-down management style. Respondent 3 explained

1 Task management 3 Boundary management and improvement

48

why: “If you are really used to a supervisor who did everything for you, it would have given you less

food for thought. But when an organisation asks: ‘Hey, start thinking on your own’, yeah, that is a

major shock.” (respondent 3). Therefore, SMTs that were previously directed by a more facilitating

management style and/or did not have a team coordinator were observed to move quicker through

each of the three development processes.

* Nature of the task

** Overall influence on SMTs’ development processes

Figure 3. Results of team level factors

3. Organizational level

Next to the factors at the individual and team level, some factors at the organizational level were

deemed important as well. A factor that was mentioned explicitly by interview respondents and SMTs

is management style. Interview respondents stressed that it is essential that managers, the Executive

Board, as well as the Board of Directors provide room for self-management. However, most of them

were indicated to find it difficult to let go control and trust SMTs in making the right decisions,

especially when the financial results were disappointing or when SMTs had to deal with an increased

number of serious untoward incidents. As a result, management inhibited or declined the

decentralization of several regulatory tasks and, hence, each of the three development processes. The

quote of respondent 10 reflected this very clearly: “One team, for example SMT 9E, actually said to

their manager: ‘Give it all to us, we want to do it, give us that responsibility’… However, their

manager said: ‘No, I do not trust it, I want to control it. If you are sick, you call me. And your annual

appraisals? Start doing core business first’.” In turn, these top-down management styles demotivated

and frustrated SMT members, and/or made them suspicious about the opportunity to become self-

managed, like a member of SMT 3P:“I believe that many decisions are still made externally. They are

imposed and I feel myself therefore less responsible.” Interestingly enough, two of the more well-

developed SMTs (SMT 4J and 9E) were observed to be less concerned about the imposing demands of

their manager: “The framework is small, but we look at other possibilities when something does not

Team turnover** (∩)

Team size** (∩)

support

Social support

Team management

Goal orientation

Planning and coordination activities

Conflict management

Mutual performance monitoring and

backup behavior

Motivating and confidence building

Psychological safety (+)

Nature of patient population* (+/-)

Bureaucratic history (-)

Task management

Goal orientation

Planning and coordination activities

Conflict management

Mutual performance monitoring and

backup behavior

Motivating and confidence building

Boundary management and improvement

Planning and coordination activities

Conflict management

Mutual performance monitoring and

backup behavior

Motivating and confidence building

Type of healthcare service* (+/-)

Social support

49

work. We can agree without doing anything.” (SMT 4E). This might suggest that that top-down

management styles mainly restrict less-developmentally advanced SMTs.

With regard to material support, the results revealed, next to (1) training and time

investments, another form that is critical for SMT development, namely (2) information sources. First,

lack of time investments were found to be a major obstacle for all three development processes.

According to interview respondents, management undertook too many organizational changes at once,

making SMT members feel pressured and hindering them in paying adequate attention to different key

aspects. Training investments were also deemed important as it ensured that SMT members learned to

work effectively together, and obtained diverse skills to perform several key aspects. The second form,

information sources, was found to be necessary for SMTs to be able to manage itself and, hence, to

develop all three development processes. Interview respondents and SMTs emphasized two explicit

forms of information: (1) financial figures to enable ‘performance management2’, and (2) clear

frameworks about, for example, the (amount of) room for self-management and total number of full-

time equivalents to prevent SMTs from struggling with expectations of the management.

Interview respondents also contended that social support by the (1) team advisor and (2)

support staff influences SMT development. First, team advisors were mentioned to play a crucial role

in fostering all three development processes. They not only helped SMTs by giving information and

asking reflective questions, but also paid attention to SMT member development by individually

coaching them. Moreover, team advisors were found to act as ‘linking pins’ by providing connections

between SMTs and passing relevant information from the SMT to higher-level management and vice

versa. Next to these findings, team advisors were found to apply different roles. Some tried to act as a

coach, while others assumed a more directive role when the situation called for this, like respondent 5:

“If a team thinks: ‘we do not have to do that’ and there is an absenteeism rate of 10%, I, as a team

adviser, have to say: ‘listen, you can say what you want, but you have an absenteeism rate of 10%,

how are you going to solve this?” Here, it is clearly emphasized that a directive role was crucial to

ensure that SMT members paid attention to important key aspects (and thus influenced SMT’s

development pattern). Interestingly, the role of these team advisors changed along with the

development of the SMTs, since they adopted the role of a coach once SMTs became more

developmentally advanced:“ I am guiding, very directional, but I think that I am able to let them go

when everything is embedded. And I see it happening in that way. My role is employed differently.”

(respondent 4). Secondly, members of the support staff, such as HR, finance and ICT, were also

indicated to be relevant actors. They were found to be particularly valuable for developing ‘task

management’ and ‘boundary management and improvement’ as they could offer support and transfer

their own experience, especially with regard to those tasks that SMTs had taken over from staff

departments (e.g. ‘performance management2’ and ‘advanced management’ and support

3’).

2 Task management 2 Task management

50

* Social support

Figure 4. Results of organizational level factors

4. Environmental level

Because all SMTs needed to deal with highly dynamic and complex environments, no specific

influence of requisite for self-management on SMT development could be detected. Interestingly,

however, interview respondents emphasized that the high requisite for self-management hindered

SMTs in their development, because it was too much to effectively regulate; SMTs were often

confused, did not know how to take appropriate action, or even paralyzed when confronted with

changes in their environment: “I wonder whether it has a positive impact on the level of self-

management. …If teams are well-advanced in their process and something suddenly changes, they

have to adjust their entire process again. Teams often find this very difficult. …Sometimes they really

start panicking.” (respondent 2). Since this finding is rather unexpected, a possible implication is

discussed in chapter 6.

4.3. Summary of the results

To put it briefly, the results of the retrospective interviews and SMT observations provided support for

the tentative non-sequential model. SMTs at GGzE were found to develop backwards and/or forwards

along a series of three processes - (1) task management, (2) task management, and (3) boundary

management and improvement - that followed one other in a variety of possible patterns or occurred

simultaneously over time. However, an exception was found for the key aspect ‘performance

management2’. The development of this key aspect was found to evolve at some point in a later

developmental period because certain other key aspect needed to be resolved first, thereby providing

some support for the linear-progressive models of team development. Furthermore, the various

development patterns were found to be largely the result of the factors of the tentative model; they all

influenced, at least, two development processes. The influence of the environmental factor, requisite

3 Boundary management and improvement 2 Task management

Support staff* (+)

Management style

Material support

Social support

Team management

Goal orientation

Planning and coordination activities

Conflict management

Mutual performance monitoring and

backup behavior

Motivating and confidence building

Management style (+/-)

Material support (+)

Team advisor* (+)

Social support

Task management

Goal orientation

Planning and coordination activities

Conflict management

Mutual performance monitoring and

backup behavior

Motivating and confidence building

Boundary management and improvement

Planning and coordination activities

Conflict management

Mutual performance monitoring and

backup behavior

Motivating and confidence building

51

for self-management, could unfortunately not be empirically examined. Next to these, four additional

factors were found to cause changes in the way how SMTs develop as well, namely: perceived

workload, nature of the task, bureaucratic history and social support.

52

5. Conclusion

The primary goal of this study was to contribute to the team development literature by empirically

examining the development pattern of SMTs in mental healthcare as well as the factors that impact on

these patterns. This goal was translated into the following research question: What is the development

pattern of SMTs in mental healthcare and which factors influence these patterns? To formulate a

preliminary answer to this question, several team development models have been reviewed; the

criticisms levelled at them have been discussed and key aspects that were found across all the common

models were identified, together with some influencing factors. In doing so, a tentative model of SMT

development was proposed. This model suggested that the development of SMTs does not take place

in phases. It is rather a non-sequential pattern in which SMTs develop along 13 key aspects that can be

grouped into three processes: (1) team management, (2) task management, and (3) boundary

management and improvement. Empirical results supported the non-sequential approach of the

tentative model. SMTs were found to develop each of the three processes in a variety of possible

patterns or simultaneously over time, either up or down. However, the development of the aspect

‘performance management2’ provided some support for the linear-progressive models of team

development. This aspect was found to develop in a later developmental period because SMTs needed

to resolve some other key aspects (i.e. ‘goal orientation1’, ‘mutual performance motoring and backup

behavior1’, and ‘decision-making and control

2’) first, before they were able to move to ‘performance

management2’.

Next to this, the non-sequential model adhered to an open system perspective by suggesting

that the development patterns of SMTs are largely the result of eight internal and external factors.

Empirical results supported the influencing role of many of these factors, but also provided ideas for

improvement (i.e. four additional factors). Overall, the following factors were found to influence

SMTs’ development pattern: individual human capital, team member attitudes and perceived

workload on the level of the individual, psychological safety, team turnover, team size, nature of the

task, and bureaucratic history at the level of the team, and management style, material support and

social support at the organizational level. The influence of one environmental level factor, requisite

for self-management, could unfortunately not be empirically examined.

To conclude, the answer to research question is that SMTs in mental healthcare develop along

a non-sequential pattern of three processes - (1) task management, (2) team management, (3) and

boundary management and improvement - that is largely the result of 12 internal and external factors.

These 12 factors include: individual human capital, team member attitudes, perceived workload,

psychological safety, team turnover, team size, nature of the task, bureaucratic history, management

style, material support, social support, and requisite for self-management. The expanded tentative

model, based on the empirical results, is depicted on the next page (Figure 2).

1 Team management 2 Task management

53

Time

* Only found in literature review

** Found to evolve in a later developmental period (other key aspects must be resolved first)

Figure 5. A non-sequential model of SMT development

Individual level Individual human capital

Team member attitudes

Perceived workload

Team level Psychological safety

Team turnover

Team size

Nature of the task

Bureaucratic history

Organizational level Management style

Material support

Social support

Environmental level Requisite for self-management*

*

Team management

Goal orientation

Planning and coordination activities

Conflict management

Mutual performance monitoring and

backup behavior

Motivating and confidence building

Task management

Multi-functionality

Work communication

Decision-making and control

Delegated management and support

tasks

Performance management**

Boundary management and

improvement

Continuous improvement activities

External relations

Advanced management and support

activities

Factors Development Processes Output

SMT effectiveness

54

6. Discussion

This final chapter contains a discussion of the most important results. Section 6.1. highlights the

theoretical implications, followed by an exploration of the research results regarding how SMTs in

mental healthcare practices can be developed. Section 6.3. ends this chapter by presenting the

limitations of this study and highlighting some promising directions for further research.

6.1. Theoretical implications

The results of this study leave some room for discussion. Three themes warrant our attention in

particularly, namely: (1) SMTs’ development pattern, (2) the non-sequential model of SMT

development, and (3) SMTs in mental healthcare.

6.1.1. SMTs’ development pattern

Overall, the study results provided additional support for the non-sequential models of SMT

development. Whereas linear-progressive models specifically state that team development should go

through the full range of phases or stages, results of this study show that SMTs can reach effective

functioning by different combinations and patterns of three development processes: (1) team

management, (2) task management, and (3) boundary management and improvement. On top of that,

results indicate that ‘team development’ is apparently not just an upward trend; it is a dynamical

pattern is which SMTs develop backwards and/or forwards on each of the three processes. Although

these findings suggest that phase theories are not suitable for describing development patterns, they

are not meant to cast doubt on them. They rather extent the current stream of literature by focusing on

naturally occurring permanent SMTs in mental healthcare. Teams in this context were found to be

open systems where the observed patterns of development are largely the result of intragroup factors

and the environment in which they are embedded. Since linear-progressive models rarely

accommodated such influences, it seems that these models are still very helpful for proposing

development patterns of self-analytic groups (e.g. therapy and laboratory groups) where contingencies

are often absent or strictly controlled (Chidambaram & Bostrom, 1997). For this reason, the various

development models are not incompatible, but need to be viewed as explaining similar phenomena

from different perspectives. This implies that researchers and practitioners need to make allowances

for the influence of these perspectives, and abandon the use of a single, overarching model of team

development in favor of multiple models tailored to particular contexts.

Interestingly to note is that this study provided some support for the linear progressive models

of team development. This with respect to the key aspect ‘performance management2’, which was

found to occur in a later developmental period. A possible explanation for this may lie in the

2 Task management

55

organizational context of the SMTs that were studied. Speckbacher (2003) noted that ‘performance

management is much more difficult to apply in mental healthcare as these organizations are built

around their mission and intangible outputs, which are hardly measurable, and they serve a multitude

of constituencies whose goals and needs may be quite heterogeneous. Therefore, it seems obvious why

SMTs of this study needed to be more developmentally advanced to manage their performance.

6.1.2. The non-sequential model of SMT development

The non-sequential model depicts the overall concept of SMT development as an integrative approach

towards factors, development processes and an output of teamwork. The approach is based on

McGrath’s (1964) I-P-O model, which has often been used by a vast majority of team effectiveness

research (Mathieu, Maynard, Rapp, & Gilson, 2008). Generally, research in this area is congruent with

two development processes of the non-sequential model as it conceptualizes team effectiveness as a

function of both “teamwork” processes (i.e. team management) and “taskwork” processes (i.e. task

management) (Mathieu et al., 2008). I-P-O effectiveness models, and even a relatively large

proportion of the overall team research do not distinguish an external directed team process (Fox &

Cooper, 2013). However, research on inter-organizational relationships does acknowledge the third

development process, boundary management and improvement, and explains why organizations need

to manage their boundaries with other organizations in their environment (Aldrich & Herker, 1977).

The theoretical arguments were based on viewing organizations from an open-system and resource-

dependence perspective; organizations needed to engage boundaries with their environments for

gaining power and control over important resources, to protect themselves from disruptive

environmental forces and to dispose of key outputs and risks (Drach-Zahavy, 2011; Stock, 2006). It

can thus be indicated that two separate areas of research are converging in understanding how each of

the three processes contribute to SMT development.

In terms of factors of the non-sequential model, each of the factors at the level of the

individual, team, organization (and environment) were found to impact on, at least, two development

processes. However, one problem with regard to these factors is that it remains still unclear which

factors are most crucial to developing SMTs or whether all factors are equally important. Such

information seems especially indispensable for providing practical recommendations on developing

SMTs in the mental healthcare practice. In addressing this issue, Cohen and Baily’s (1997) approach

could be considered. They depicted environmental and organizational factors as drives of the team

and compositional inputs, thereby embracing the multilevel nature of teams; individual are nested in

teams, which in turn are nested in organizations, which exist in environments (Klein & Kozlowski,

2000) This might thus suggest that factors at the environmental and organizational level weight higher

in developing SMTs, because they influence individual and team level factors more so than reverse.

Since this is largely assumed and not observed directly (Kozlowski et al., 1999), future research is

necessary to draw implications on this.

56

Although the various factors might vary in their importance, it is showed by the non-

sequential model that a SMTs’ entire context is crucial for SMT development. This is congruent with

an often repeated warning considering implementing SMTs. Several studies show that the change

toward this new way of working is not so much regarded as a matter of just ‘implementing’ them (like

a blueprint) (e.g. Sips & Keunen, 1996; De Leede, 1997; Stoker, 1998). Rather, the entire organization

in terms of, for instance team member attitudes, team size, the nature of a team’s task, management

style, and support activities, need to fit the concept and level of self-management. Results of this study

show that this fit is not static, but dynamic in nature due to SMTs’ development towards higher levels

effectiveness and changing circumstances (e.g. team turnover, increase in the perceived workload).

Hence, SMT development needs to be considered as a continuous process of reflection on the current

situation, identifying factors that are open for improvement, and trying to realize those improvements

to achieve an optimal fit that stimulates development. This approach is compatible with the

development perspective towards organizational design and change, a more communicative and

dynamic approach than the theories of planned change (Cummings & Worley, 2014).

6.1.3. SMTs in mental healthcare

It is widely believed that raising the level of self-management enhances the chances of an

organization’s success (Tjepkema, 2003; Van der Zwaan & Molleman, 1998). However, it has to be

emphasized that the feasibility of self-management and its potential flexibility benefits appear to be

more limited than today’s generalizations has told us. In this study, three important features of the

mental healthcare context were found to disallow self-management or, at least, hinder its practices to

some degree, namely: (1) its environment and work processes, (2) its individual human capital, and

(3) its organizational culture. The first two constraints will be addressed by the STSD theory in which

the concepts of self-management and flexibility play a central role.

Study results indicated with respect to the first feature that SMTs are not universally feasible

in all situations. In the literature review, it was emphasized by STSD theory that predictable stable

work environments and standardized production processes can hardly benefit SMT development (i.e.

low requisite for self-management). Neither do extremely turbulent environments favor it, as showed

by the empirical results of this study. Furthermore, the work processes of SMTs in long-term,

specialist forensic care (i.e. the most severe and complex patient population) were found to have

limited potential for self-management. This finding is congruent with Yun, Faraj, Xiao and Sims’

(2003) observation of medical trauma teams, who observed that when a patient was severely injured,

decisions must be made quickly with limited time for thorough joint-decision making, and a higher

level of expertise was needed. Therefore, under these conditions, a directive leadership style was

found to be more effective than an empowering leadership style. Together, this implies that tasks with

complicated work processes match better the traditional hierarchical arrangements.

57

In terms of mental healthcare’s individual human capital, practical limits exist for STSD’s

principle of ‘redundancy of functions’. This with regard to multidisciplinary mental healthcare SMTs

since specialized skills, and sharp, institutional work rule restrictions, like licensing requirements,

were found to prevent SMT members from becoming effectively multiskilled2. In this respect, it can

be argued that the principle ‘redundancy of functions’ is not an appropriate solution for increased

flexibility in all situations (see also Dunphy & Bryant, 1996). The creation of multiskilled SMT

members to increase flexibility can still be considered under the particular conditions of

monodisciplinary SMTs or tasks that involve low skill complexity. Under other conditions, like

multidisciplinary mental healthcare SMTs, it is more feasible to maintain specialized tasks.

The third feature, organizational culture, can be addressed by Edmondson (2004). She

attributed the overall low sense of psychological safety (as found in this study) to the culture of

healthcare. According to her, individual vigilance - an industry norm that encourages healthcare

professionals to take personal responsibility to solve problems as they arise - is explicitly developed

and highly valued in healthcare organizations. This, consequentially, creates barriers to a

psychological safe atmosphere, because it is considered as a weakness to seek help and rude to bother

other busy members to let them know something has gone wrong. Based on this, it can be suggested

that also the culture in mental healthcare can create serious barriers to the development of effective

functioning SMTs.

The above discussion emphasizes that mental healthcare organizations not necessarily benefit

from implementing SMTs. This does not mean that one, in case of the three features, should simply

disregard the concept of self-management. Some features might be to overcome (see section 6.2) and

certain self-management principles could still be deployed in combination with the bureaucratic

principles for organizations.

6.2. Practical implications

At first, rather general advice for advisors, managers and policy makers in mental healthcare is that

they, based on the results of this study, should not stimulate SMTs to develop in a structured and

predefined linear order (except of ‘performance management2’). SMTs’ development should rather be

continuously evaluated in order to analyze the results and, subsequently, put an emphasis on those key

aspects that match the vulnerability of the SMT. Furthermore, it is recommend that advisors, managers

and policy makers take into account the influencing role of intragroup factors and the environment in

which they are embedded. They should do this continuously through the lens of the non-sequential

model of SMT development, and in that way uncover and evaluate important factors for their own

specific situation: are they adequate for developing effective functioning SMTs? In doing so, their

understanding will be sharpened of those factor that are worthwhile to consider, maintain, or can be

2 Task management

58

improved. This, however, should not solely be a task of advisors, managers and policy makers. Active

involvement of SMT members is also necessary in order ensure that sufficient room for self-

management is provided.

The second important implication of this study concerns the role of management. The study

results indicate that managers are very important actors in SMT development, since they may

dramatically undermine the decentralization of regulatory tasks by top-down management styles.

Managers should therefore alter their role into a facilitator: they coordinate the work of the SMT by

output control and assists teams in realizing the desired output (Molleman & Van der Zwaan, 1994).

This role includes behaviors such as: leading by example, informing, coaching, participative decision-

making, and showing concern for the SMT (Arnold, Arad Rhoades, & Drasgow, 2000). Since this may

be very difficult, especially when managers are not experienced in these behaviors, it seems advisable

that managers receive training. For instance by off-the-job training or by creating training situations in

which both the manager and the SMT participate. In that way, the SMT and the manager can build

their new roles together. Yet, it is important to note that managers should consider SMT development

as a gradual process, since results indicated that SMT development takes time, and if management

gives a SMT a very high workload, it will not be able to gain control over different tasks. This implies

that managers’ traditional role of a supervisor should gradually evolve into the role of a facilitator,

whereby, over time, an increased number of regulatory tasks are handed down to the SMT (with

‘performance management2’ in the long run). To achieve this, an ongoing process of communication is

required, in which managers make agreements with the SMT about the frameworks for self-

management.

Nevertheless, one should not solely assume that all SMTs can deal with the same amount of

authority and decision-making responsibilities over time. For each SMT, the nature of the task (in

terms of type of healthcare service and patient population) need to be considered thoroughly and,

based on this, decided if one opt ‘total’ self-management or less far-reaching forms of self-

management. In doing so, four degrees of self-management can be considered, namely: (1) team

makes decisions autonomously, (2) team makes decisions together with management, (3) team gives

advice on this matter, and (4) team has no influence (Van Amelsvoort & Scholtes, 1994). It is, in

principle, possible to decide how much authority will be handed down to the SMT for each key aspect

of the non-sequential model separately.

Next, the results of this study suggest that to develop SMTs successfully, psychological safety

needs to be created in the organizational culture. The previous research of Edmondson (2004) shows,

on the one hand, that managers and advisors can do this by being aware that people instinctively try to

avoid being seen as ignorant, incompetent, negative, or disturbing. On the other hand, because SMT

members are particularly aware of and influenced by the behavior and expectations of the leader,

2 Task management

59

managers and advisors should exemplify the desired behavior. They should be accessible and open to

questions, show commitment to the SMT, ask questions themselves, admit mistakes, demonstrate

criticism and self-criticism, and engage in the behavior of giving and asking for feedback. In addition,

SMT members can also become proficient in gathering feedback and reflecting upon their

performance by the use of guided team techniques, such as after-action reviews, debriefing, and team

self-correction (SmithJentsch, Cannon-Bowers, Tannenbaum, & Salas, 2008).

Finally, managers and policymakers should carefully consider team size in order to stimulate

SMT development. Team size should be large enough to execute primary as well as regulatory tasks.

But study results do not suggest that one should simply throw new members at SMTs as a way of

improving their effectiveness. Rather, it should carefully deliberated at what point adding new

members will make it more rather than less difficult for the SMT to foster work communication, good

quality of decision-making, and enable every team member to have insight into the decisions that are

made. The same goes for team turnover. A certain level of attrition or small amount of rotation of

members among SMTs may be desirable in order to facilitate SMT development as a result of the

dissemination of new experiences.

6.3. Limitations and future research

There are a number of limitations that must be taken into account. First of all, the study was conducted

in only one organization, which might limits the generalizability of the findings. Because of this, and

the exploratory nature of the study, it would be advisable to follow-up with more large-scale empirical

studies, aimed at validation and generalization of the non-sequential model of SMT development. In

such follow-up, it would also be possible to examine the weighting of the different factor to discover

which one are most important and the effect of organizational level factors, such as culture, structure,

and extent of change (e.g. downsizing) on SMT development. The specific sample of this study did

not allow these more fine-grained analyses to be conducted, which ensures that the non-sequential

model might not yet provide a comprehensive overview. Moreover, in such follow-up it could be

investigated whether the findings of this study are generalizable to other care delivery settings as well.

One might investigate, for instance, whether SMTs in mental healthcare face comparable

developmental challenges as SMTs in hospitals and/or residential care centers. In doing so, a general

approach to SMT development in healthcare might be created. Another limitation of this study is the

retrospective nature of the interviews. Results may have been affected by memory recall issues of the

respondents and the way in which they filtered their memories based on current beliefs (Menard,

2007). This, in turn, could have negatively impacted the recall of some SMT development aspects

more than others. A more suitable method for further research might therefore be a longitudinal study

in which quantitative data is collected at different points over time. In such longitudinal study, the

period of nine months (to which this study was also limited) needs to be extended in order to achieve

more in-depth analysis of the three development processes. The final set of limitations arises from the

60

SMT observations. These observations might not only have been biased by the expectations of the

researcher, but the presence of the researcher could have influenced SMT members’ behavior due to

social desirability biases as well. Besides, it is also possible that some SMT members were afraid to

talk openly in the presence of other members.

Next to the future research directions derived from the limitations, other possible directions for

moving the literature forward could be suggested as well. First, future research in (mental) healthcare

should identify relationships between the three development processes and performance criteria to

ensure that SMT development is not a goal in itself, but a means to achieve certain desired outcomes

(Kuipers, 2005). In this respect, the contribution by authors such as Dunphy and Bryant (1996) might

be useful as they made a connection between development of SMTs and two aspects of organizational

performance: (1) quality of working life (with indicators like satisfaction, involvement, absenteeism

and sick leave) and (2) business performance (such as product quality, productivity, costs and delivery

precision). Second, although current literature indicate team size, team turnover and requisite for self-

management are important factors for SMT development, much ambiguity still remains on their

influence. Therefore, more elaborate consideration of their effect on SMT development is needed in

future research. Finally, as mentioned in section 6.1.1, researchers should adapt and tailor SMT

development models in order to produce findings that are useful to specific organizational contexts. In

doing so, research will provide a new body of literature that managers, policymakers and advisors can

use to help improve SMT effectiveness.

61

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Appendices

Content

Appendix I Search table

Appendix II Author Matrix

Appendix III Topic list

Appendix IV Hierarchical coding scheme retrospective interviews

Appendix V SMT development pattern retrospective interviews

Appendix VI Questionnaire Kommers & Dresen (2010)

Appendix VII Example visualization Kommers & Dresen (2010)

Appendix VIII Example SMT observation

Appendix IX Hierarchical coding scheme SMT observations

Appendix X SMT development pattern SMT observations

Appendix XI Translated quotes

69

Appendix I: Search table

Date

Search term

Database Number

of results

Useful results

04-05 TOPIC: (“group

development” OR “team

development”) AND

TOPIC: (“self-managing

team*” OR “self-managed

team*”)

Web of Science 6 Marks, M. A., Mathieu, J. E., &

Zaccaro, S. J. (2001).

Dunphy, D., & Bryant, B.

(1996).

04-05 TOPIC: (“group

development” OR “team

development”) AND

TOPIC: (“self-directed

team*”)

Web of Science 1

04-05 TOPIC: (“group

development” OR “team

development”) AND

TOPIC: (“self-regulated

team*” OR “self-organized

team*” OR “self-

organizing team*)

Web of Science 0

04-05 TOPIC: (“group

development” OR “team

development”) AND

TOPIC: (“self-led team*”

OR “self-leading team*”)

Web of Science 0

04-05 TOPIC: (“group

development” OR “team

development”) AND

TOPIC: (“Semi-

autonomous team*” OR

“autonomous team*”)

Web of Science 1 Kuipers, B. S., & De Witte, M.

C. (2005).

04-05 TOPIC: (“develop”) AND

TOPIC: (“self-managing

team*” OR “self-managed

team*” OR “self-directed

team*” OR “self-regulated

team*” OR “self-organized

team*” OR “self-

organizing team*" OR

“self-led team*” OR “self-

leading team*” OR “Semi-

autonomous team*” OR

“autonomous team*”)

Web of Science 33

TOPIC: (“development”)

AND TOPIC: (“self-

managing team*” OR

“self-managed team*” OR

“self-directed team*” OR

“self-regulated team*” OR

“self-organized team*” OR

“self-organizing team*"

OR “self-led team*” OR

“self-leading team*” OR

“Semi-autonomous team*”

OR “autonomous team*”)

Web of Science 78

70

11-05 TOPIC: (“team

development”)

Web of Science 218 O’Leary, D. F. (2016).

Raes, E., Kyndt, E., Decuyper,

S., Van den Bossche, P., &

Dochy, F. (2015).

Kuipers, B. S., & Stoker, J. I.

(2009).

Cashman, S. B., Reidy, P.,

Cody, K., & Lemay, C. A.

(2004).

Morgan Jr, B. B., Salas, E., &

Glickman, A. S. (1993).

13-05 TOPIC: (“group

development”)

Web of Science 233 Wheelan, S. A. (2009).

Wheelan, S. A., Davidson, B.,

& Tilin, F. (2003).

Gersick, C. J. (1988).

McGrath, J. E. (1991).

14-05 (“group development” OR

“team development”) AND

(“self-managing team” OR

“self-managing teams” OR

“self-managed team” OR

“self-managing teams”)

Google Scholar 1.670 Hut, J., & Molleman, E. (1998).

14-05 (“group development” OR

“team development”) AND

(“self-directed team” OR

self-directed teams”)

Google Scholar 3.380 Van Amelsvoort, P., &

Benders, J. (1996).

14-05 (“group development” OR

“team development”) AND

(“self-regulated team” OR

“self-regulated teams” OR

“self-organizing team” OR

“self-organizing team” OR

“self-organizing teams”)

Google Scholar 253 Balkema, A., & Molleman, E.

(1999).

14-05 (“group development” OR

“team development”) AND

(“self-led team” OR “self-

led teams” OR “self-

leading team” OR “self-

leading teams”)

Google Scholar 63

14-05 (“group development” OR

“team development”) AND

(“Semi-autonomous team”

OR “semi-autonomous

teams” OR “autonomous

team” OR “autonomous

teams”)

Google Scholar 457

14-05 (“team development”) Google Scholar 36.000 Salas, E., Sims, D. E., & Burke,

C. S. (2005).

Tuckman, B. W., & Jensen, M.

A. C. (1977).

71

Snowballed articles

From Kuipers and Stoker (2009): Wellins, R. S. (1991), De Leede, J., & Stoker, J. I. (1996),

Kuipers, B.S., & de Witte, M.C. (2006).

From Marks et al. (2001): Kozlowski, S. W. J., Gully, S. M., Nason, E. R., & Smith, E. M.

(1999).

From Wheelan (2009): Wheelan, S.A. (2005).

14-05 (“group development”) Google Scholar 35.300 Tuckman, B. W. (1965).

Bushe, G. R., & Coetzer, G. H.

(2007).

72

Appendix II: Author matrix

Bibliographic

information

Research question

or research aim

Types of

teams/groups

Variables or

hypotheses

Research design

Main findings

Conclusion

Balkema, A., &

Molleman, E. (1999).

To which stage have

the teams been

developed and what

are the barriers to

further

development?

Self-

organizing

teams in a

production

organization

4 Potential barriers: opportunities, attitudes,

abilities and requisite

6 Cluster tasks: individual

routine tasks, machine-

related tasks, shift related

tasks, communication tasks,

sophisticated tasks and

external tasks

Barriers to the

development of

self-organizing

teams were studied

in 3 teams by

means of

questionnaires and

observations.

Individual routine tasks: the

requisite to do these tasks and

the ability to do them are both

high. Although some workers

want to learn more tasks, from a

management point of view there

is no high need to develop the

skills of the workers further.

Machine-related tasks: the

categories ``requisite'' and

“attitude” are not barriers to the

further development of this

group of tasks. The maintenance

group (opportunities), the

presence of temporary workers

(abilities) and the complexity of

a few of these activities

(abilities) may limit the level of

self-organization.

Shift related tasks: The grocos

seem to be the major barrier to

the development of the teams

with respect to shift-related

tasks (opportunity). On the one

hand, this seems to reinforce a

passive role of the team

members (attitude), but on the

other hand, distributing them

among several workers may

enlarge the need for

coordination and interfere with

daily work. If the size of the

shift is large, these tasks are

perceived as rather complex

The development of self-

organizing teams stopped

somewhere near the transition

from stage 2 to 3, seems to be

correct. This study has shown

that the most significant barrier

to the full development of self-

organizing teams is the requisite

for self-organization. Moreover,

the development of teams up to

this limit seems to be mainly

obstructed by the opportunities

team members get to do certain

control tasks. The attitudes and

abilities of the workers are an

important but somewhat less

significant issue.

73

(ability). Requisite is no barrier.

Communication tasks:

Requisite is no barrier. The shift

system diminishes the

opportunity to do these tasks

and seems to be the major

obstacle.

Sophisticated and external

tasks: categories “opportunity”,

“ability”, and “requisite” form

barriers to the further

development of this part of self-

organization. The attitudes of

the workers seem to be no

obstacle.

Bushe, G.R., &

Coetzer, G.H. (2007).

The authors

reconceptualize the

theory of group

development and

offer an integrated

theory of group

development

applicable to work

groups and a pencil-

and-paper method

for assessing the

stage of

development of a

group.

Self-regulating

student project

teams

Two phase model of

group development:

1. Membership

2. Competence.

H1: Congruence in images

of the actual and the ideal

group at the midpoint will

be associated with more

effective teams.

H2: Convergence in images

of the actual and the ideal

between the beginning of

the group and the midpoint

will be associated with

more effective teams.

H3: Convergence in images

of the actual and ideal

between the midpoint and

the end of a team’s life will

have a negligible

association with team

effectiveness.

52 teams (208

undergraduate

students enrolled

in a 13-week

course).

3 time points of

measurements; at

each measurement

point each group

member was asked

to complete the

group state

questionnaire.

H1: supported

H2: supported

H3: supported

H4: supported

H5: supported

H6: supported

H7: supported

A group will not do much to

resolve issues of the competence

phase until the membership

phase has found some

resolution. In teams with a finite

life, the psychology of time and

the need for task completion

mean that membership issues

have to be resolved sometime in

the first half of the group’s life

for it to manage competence

issues quickly enough to be

effective.

Additional understanding to

developmental dynamics in task

teams: 1. what seems to happen

is that groups develop a level of

congruence in group states early

on that does not change that

much over the group’s life; 2. the more the group has struggled

successfully to resolve the

74

H4: Congruence in images

of the actual and the ought

group at the end of the

group’s life will be

associated with more

effective teams.

H5: Convergence in images

of the actual and the ought

between the midpoint and

the end will be associated

with more effective teams.

H6: Convergence in images

of the actual and ought

between the beginning and

the midpoint of a team’s

life will have a negligible

association with team

effectiveness.

H7: The amount of

congruence in images of the

actual and the ought at the

end of a team’s life will be

related to the amount of

congruence between images

of the actual and the ideal at

the midpoint.

membership phase, the more

members believe the group will

become competent and the more

competence phase issues get

resolved; 3. by the midpoint an

alignment begins to take place in

the magnitude of congruence in

the actual-ought group state that

ultimately reflects how

developed the group will

become and therefore how

effective it will be.

Cashman, S. B.,

Reidy, P., Cody, K.,

& Lemay, C. A.

(2004).

This article reports

the results of a

longitudinal study of

an intervention to

enhance

interdisciplinary

team functioning in

a primary care

setting.

Inter-

disciplinary

health care

teams in a

health care

center

H: With training and

regular, dedicated time for

team development,

members of the project

team would over time

express values consistent

with highly effective teams.

The SYMLOG

was used to

measure and

analyse changes in

one project team

over time.

SYMLOG was

administered at

baseline and at 2

points in the

future,

approximately 1

First year: the SYMLOG

assessment depicted and team

members corroborated a

positive change and movement

in a direction that resulted in

members feeling stronger bonds,

greater commitment to helping

one another, and deeper

understanding of team

development. Team members

were developing skills that

helped them work more

Hypothesis supported.

There are specific, identifiable

properties that tend to generate

strain and render sustainable

team development difficult.

These include: (a) the

heterogeneity of team

composition, (b) role conflict

and role overload, (c) constraints

placed on members by the larger

organizational structure, and (d)

members’ lack of knowledge

75

and 2 years after

the start of team

training and

development.

effectively together, and they

were addressing issues of role

conflict and overload (all three

dimensions of the model, i.e.,

task orientation, friendliness,

and dominance were improved).

Second year: project team

members’ responses to the

SYMLOG questions reflected

the frustrations they had begun

voicing about institutional

constraints and disappointment

regarding valued members

leaving the team.

about the process of team

development. Additionally,

methods for reducing team

turnover are needed to ensure

that interdisciplinary teams grow

and flourish.

De Leede, J., &

Stoker, J. I. (1996).

Semi-

autonomous

groups in

manufacturing

companies

Exploratory

multiple case-

study (N=11) of

companies with

semi-autonomous

groups.

Semi-autonomous groups turned

out to have different

characteristics; characteristics

that appeared in stage 3, but also

characteristics of phase 4, while,

on the other hand, they did not

have essential characteristics of

phase 1.There is no link

between the ' age ' of the semi-

autonomous group and the

degree of maturity of this

group.

The development process of

semi-autonomous groups is not

linear. The normative character

of the phase theories might

partly explain this.

Dunphy, D., &

Bryant, B. (1996).

This paper advances

a classification of

team attributes

which is intended to

facilitate team

design and

development.

Potentially

applicable to

all teams in

organizations

3 generic team attributes

that create an agenda for

team development:

1. Breath of technical

expertise (multiskilling)

2. Degree of self-

management

3. Degree of self-leadership

It draws on the

existing research

literature on teams

and on case studies

of team

organization

undertaken by the

authors.

Organizations are unlikely to

extensively multiskill all team

members for the following

reasons: it is not necessary to

multiskill everybody to

maximize operational

flexibility; the competency

levels required for some tasks

may require specific and intense

training over a long period;

individual have varying

aptitudes for different task;

This paper develops the model

of Stace and Dunphy (1994)

further by arguing for a

rationalization of team training

and development costs by

prioritizing the development of

attributes which will contribute

most to organizational

performance. The model

assumes that a high performance

fit has been achieved between

team context, team objectives

76

increasing the degree of

multiskilling decreases the need

for interdependence.

and team design. Once the

design is determined, the

planning of team development

should optimize the depth and

breadth of technical, self-

managerial, and self-leadership

skills.

Gersick, C. J. (1988). What does a group

in an organization

do, from the

moment it convenes

to the end of its life-

span, to create the

specific product that

exists at the

conclusion of its last

meeting?

University

faculty and

student teams,

community

groups,

business

groups

8 task forces from

6 different

organizations.

Their life spans

varied in duration

from 7 days to 6

months.

Data was collected

by observing team

meetings

The data revealed that teams

used widely diverse behaviors to

do their work; however, the

timing of when groups formed,

maintained, and changed the

way they worked was highly

congruent:

Phase 1 (the first half of a

group’s calendar time): an

initial period of inertial

movement whose direction is set

by the end of the group’s first

meeting.

Transition (midpoint of their

allocated calendar time):

groups undergo a transition,

which sets a revised direction.

Phase 2: a second period of

inertial movement

Completion: the team makes a

final effort to satisfy

expectations

Groups develop through the

sudden formation, maintenance,

and sudden revision of a

framework for performance; the

developmental process is a

punctuated equilibrium. The

specific issues and activities that

dominate groups' work are left

unspecified in the model, since

groups’ historical paths are

expected to vary.

Hut, J., & Molleman,

E. (1998).

The objective of this

study is to gain

insight into the

viability and the

applicability of our

model and to find

relevant factors that

facilitate or hinder

Self-

organizing

teams in an

production

organization

Model of team

development aimed at

empowerment:

4 Stages: shifts the

attention from routine

(stage 1) to non-routine

(stages 2, 3 and 4), from

Sample: 5 teams,

ranging from 4 to

15 members.

Data was collected

by a questionnaire

that measured the

level of job

Development progress

corresponds with the sequence

in which developments were

introduced. The job enlargement

(stage 1) is the most developed

feature in all the teams, and

team enrichment is the second

most developed feature (stage

We conclude that Morgan's

principles, as well as the

sequence in which we have put

them, are helpful in developing

empowered teams. However,

they should not be used as an

end in itself.

77

the empowerment of

teams in a field

setting.

individual (stages 1 and 2)

to group (stages 3 and 4),

and from inward-oriented

(stages 1, 2 and 3) to

outward-directed activities

(stage 4).

Stage 1. Job enlargement

Stage 2. Job enrichment

Stage 3. Teamwork

Stage 4. Developmental

learning/boundary

management

enlargement, job

enrichment,

teamwork and

developmental

learning/boundary

management.

2). Overall, the stage 3

characteristics are less and the

stage 4 qualities are the least

developed. However, stage 1

has not been developed to the

maximum level and teams seem

to be working on elements from

other stages at the same time.

Group dynamics: Homogeneity

of the team on the issues that are

related to the development of

empowerment facilitates

empowerment (homogenous

attitudes and no existence of

subgroups)

Role of the management: The

experiences of team 4 show that

the development of

empowerment “takes time”, and

if management gives a team a

very high workload, it will

become frustrated. The behavioral style of middle

and lower management is

important. These managers

should display a good mix of

team and task oriented behavior.

Their style should, like the

mentor in team 3, be

participative and facilitative in

nature.

Kozlowski, S. W. J.,

Gully, S. M., Nason,

E. R., & Smith, E.

M. (1999).

This paper

constructs a theory

of team

development that

incorporates the

basic elements and

principles of prior

Newly formed

teams Literature review Normative model of team

compilation: the overall

process of compilation is one of

linear progression and dynamic

variation (i.e., cyclical

entrainment) in the intensity of

team tasks as attention is shifted

Team compilation is viewed as

an emergent multilevel

phenomenon. Eventually, teams

develop towards self-regulating

and adaptive entities.

78

team development

research.

to the development of more

complex knowledge and skills.

4 phase transitions:

1. Team formation

2. Task compilation

3. Role compilation

4. Team compilation

Kuipers, B. S., & De

Witte, M. C. (2005).

Our study

concentrates on two

research questions:

1. How do teams

develop?

2. What is the

impact of team

development on

team performance?

(not relevant for this

study)

Semi-

autonomous

teams in a

production

organization

We follow Hut &

Molleman (1998), in which

team development is

viewed as ‘empowerment’

of a team ‘in several stages’

over time.

Stage 1: Job enlargement

Stage 2: Job enrichment

Stage 3: Co-operation

Stage 4: High performance

This study

commenced with a

large survey of 43

teams in the final

assembly area. The

questionnaire was

similar to the

original questions

conducted by Hut

(1996).

The average team score at t0 are

rather low at each stage; all are

less than one-third of the

reachable level, and high

performance in particular is

lagging. Only five teams show

the step pattern Hut &

Molleman described in their

1998 study. At T1, The team

scores for each of the stages

improved, and job enrichment

even reached a slightly higher

level than job enlargement. 10

teams showed a stairway

pattern.

At all four ‘stages’ the teams

seemed to develop at the same

time and in no specific order.

It appeared that all teams

experienced varied development.

The averages team scores

exhibited a slightly linear

development of the dimensions,

as also described by Hut &

Molleman (1998). The

individual figures of each team,

however, revealed a completely

different picture; very few teams

exhibited a linear pattern. This

contradicts the strict theory of

team development in subsequent

phases, as hypothesized by Van

Amelsvoort & Scholtes (1994)

and Van Amelsvoort & Van

Amelsvoort (2000). Moreover,

the stages approach employed by

Hut & Molleman (1998) is

questionable.

Kuipers, B.S., &

Witte, M.C. (2006).

To what extent

affect the position of

responsibilities in

the team-based

organization team

responsiveness?

Production

teams in the

automotive

industry

H1: There is a positive

relationship between the

proximity of expertise and

authority for a regulation

task to a team and a team’s

responsiveness, with

expertise and authority

located closer to the team

resulting in higher levels of

responsiveness.

H2: There is a positive

36 team managers

and 109 teams in

the automotive

industry were

surveyed

Team

responsiveness: Team development

questionnaire of

Kuipers (2005)

H1: Not supported

H2: Supported (for the

delegation of expertise, the

delegation of authority only

shows a sig. positive effect for

boundary management)

The delegated number of

regulation tasks is more

important than the location of

the specific tasks in the

organization. It is suggested that

increasing the number of

delegated tasks, in particular

increasing the expertise can

enlarge team responsibilities.

However, it seems that a few

specific tasks should not be

79

relationship between the

number of regulation tasks

that is fully delegated to the

team and the team’s

responsiveness.

Location of

authority: interviewing team

managers

delegated to the team.

Kuipers, B. S., &

Stoker, J. I. (2009).

This paper

investigates 1) if

team development

can be described in

3 general team

processes and 2)

how these team

processes influence

team performance

(not relevant for this

study)

Self-managing

teams in a

production

organization

Based on an extensive

review of team

development literature, we

propose, that team

development can be

described in 3 general team

processes (instead of linear

phases).

1. Internal relations

2. Task management

3. Relations and

improvement

At 1-year

intervals, 3 sets of

data were collected

using

questionnaires

distributed among

more than 150

self-managing

teams. Teams

included were

production teams

(75%) and service

and support teams

(25%).

Data was collected

by questionnaires,

which originates

from Hut &

Molleman (1998),

the Work Groups

Effectiveness

Model by

Campion et al.

(1993), De Leede

& Looise (1999)

and Kuipers & De

Witte (2005).

Factor analysis confirmed the 3

general team processes. An

inspection of the outcomes for

the teams did not suggest any

linear pattern in the

development of the 3 processes.

Rather, each team seemed to

have its own strengths and

weaknesses, further supporting

the idea of parallel processes.

This study supports the idea that

the various team processes occur

simultaneously as teams

develop. Whereas phase theories

specifically state that team

development should go through

the full range of phases, our

results show that high

performance levels can be

reached by different

combinations and patterns of the

team processes.

Marks, M. A.,

Mathieu, J. E., &

Zaccaro, S. J. (2001).

Our purpose in this

article is to advance

future studies of

team effectiveness

by taking a detailed

look at the concept

Our

framework

pertains best

to fit project,

production,

service and

Teamwork processes (vs

taskwork, emergent states

and more permanent team

traits and characteristics).

Transition phases

Relevant

background

literature is

reviewed and

synthesized.

Different team processes are

critical at different phases of

task execution The nature of

these process changes as teams

move back and forth between

action and transition phases.

We have identified the context

domain for team processes. It

includes 10 lower order

processes that map into 3 higher

order processes: action phase

processes, transition phase

80

of team process. action/perform

ing teams

Action phases

Team performance episodes

Teamwork processes 1) mission

analysis, 2) goals specification

and 3) strategy formulation and

planning evaluation occur more

frequently in transition phases.

4) monitoring processes towards

goal, 5) system monitoring, 6)

team monitoring and back-up

responses and 7) coordination

activities are likely to dominate

the action phases of goal

accomplishment. Interpersonal

processes occur throughout both

transition and action phases,

and typically lay the foundation

for the effectiveness of other

processes. It includes 8) conflict

management, 9)

motivating/confidence building

and 10) affect management.

processed and interpersonal

processes.

McGrath, J. E.

(1991).

This article attempts

to integrate ideas

from those separate

presentation into a

single systematic

theoretical

statement, takin into

account other

research and theory,

especially work in

that new, temporally

orientated tradition.

Project teams

or work teams

(group tasks)

TIP theory: Teams engage

in four modes of group

activity:

Mode I: inception

Mode II: technical problem

solving Mode III: conflict

resolution

Mode IV: execution

Social entrainment:

synchronization of various

processes over time among

group members. Occurs at

various levels.

Theory is based on

a substantial body

of work that is

done in recent ears

within a

continuing

program of

research on

temporal factors in

individual, group,

and organizational

context.

P1: Groups are assumed to be

complex, intact social systems

that engage in multiple

interdependent function, on

multiple concurrent projects,

while partially nested within,

and loosely couples to,

surrounding systems.

P2: All group actions involves

one or another of four modes of

group activity.

P3: The four modes of activity

are not a fixed sequence of

phases, but rather, are a set of

alternative kinds of activity in

which the group and its

members may engage.

P4: Behavior in work group

Several propositions of the

theory imply that major shifts in

the pattern of group activity will

follow from (1) changes in a

group membership, (b) changes

in the type and difficulty level of

the projects an task the group is

undertaking and (c) changes in

operating conditions (such as

time limits, connections to other

units) under which the group is

working.

81

shows many forms of complex

temporal patterning, including:

1) temporal aspects of the flow

of work in groups which raise

issues of scheduling,

synchronization, and time

allocation; 2) problems of

efficiently matching periods of

time with bundles of activities;

and 3) entrainment processes

leading to patterns of

synchronization, both of group

members behavior with another,

and of group behavior with

external events.

P5: All collective action entails

(at least) three generic temporal

problems that both

organizations and individual

must reckon with.

P6: a temporally efficient flow

of work in groups requires

complex matching of bundles of

activities to particular periods of

time.

P7: One major form of temporal

patterning is social entrainment.

P8: In TIP theory, group

interaction processes refers to

the flow of work in groups at

micro level.

P9: In TIP theory, it is assumed

that at any point in interaction, a

group has a current purpose or

objective that can be regarded as

it focal task.

P10: Each act can be regarded

as either germane to the group’s

current ‘focal task’ or not

82

germane to it.

P11: acts have situated, rather

than generic, meanings in

relation to the modes, functions

and paths of group activity.

P12: Various aspects of the

flow of work in groups are

reflected in different forms of

aggregation of acts.

Morgan Jr, B. B.,

Salas, E., &

Glickman, A. S.

(1993).

Whether teamwork

and taskwork

activities occur

throughout team

development and

whether these

activities occur in a

similar (or different)

pattern at different

levels of

development.

Navy

command

information

center teams

The TEAM model

describes a series of

developmental stages

through which newly

formed, task-oriented teams

are hypothesized to evolve:

1. Forming (forming)

2. Storming

3. Norming

4. Performing-I

5. Reforming

6. Performing-II

7. Conforming

2 Lines of development:

taskwork skills and

teamwork skills

The data reported

in this study were

collected as part of

a comprehensive

investigation of the

development of 13

tactical decision-

making teams.

A questionnaire

measured the

perceptions of the

individual’s and

team’s

performance

characteristics (the

levels of current

motivation, job

knowledge, role

clarity,

communication,

cooperation,

coordination, and

power

relationships).

Initially, team members were

concerned with acquiring skills

associated with both the

assigned tasks and with working

effectively with other team

members.

Two factors were identified in

the pre-midterm and midterm

sessions: taskwork and

teamwork.

A single large factor emerged in

the final two sessions of

training. This factor loaded

heavily on a variety of items

associated with both teamwork

and taskwork.

After an initial orientation to the

various aspects of the task, team

members learn to perform

assigned tasks while also

working to enhance the quality

of their interpersonal

interactions. Following the

midterm session of training, the

factors related to these separate

kinds of activities merged into a

single factor. This suggests that

teams matured to a point at

which their task- and team-

related activities became

indistinguishable with respect to

their relationship to team

performance.

O’Leary, D. F.

(2016).

What impact did and

emerging climate of

team psychological

safety have on the

Change

management

teams in the

healthcare

Interprofessional team

Members are:

- interdependent

- share a team identity

Action research:

Data collection

occured over 2

years, before,

Data analysis revealed that the

development process was

catalyzed and supported by TPS

which created an environment

Within a team space,

configurations that facilitate

interprofessional work are based

on a climate of trust and safety

83

development of

interprofessional

teamwork?

Why were there

different levels of

team psychological

safety at each

facility?

setting - understand team roles

- integrate work practices

- clear goals for which they

share responsibility and

are

collectively committed

Team psychological safety

(TPS): A team climate

where people respect and

trust each other and are

comfortable being

themselves

during and after

the cycles: field

notes, semi-

structured

interviews, group

discussions and

questionnaires.

which cultivated power sharing

and knowledge creation.

Power sharing: with an

emerging climate of TPS,

individuals became more

comfortable in asserting

themselves in meetings,

engaging in shared decision-

making, volunteering for

responsibility and assigning

responsibility for others.

Knowledge co-generation: in

team meetings increasingly

characterized by a climate of

TPS, participants began to feel

secure enough to verbalize their

tacit knowledge. This led to co-

generation of knowledge about

team roles; members became

more aware of what others did

within the facility, how they did

it, and how they coordinated

with others to do it.

Organisational norms:

Organisational norms dictated

how professionals engaged with

each other at each facility and,

thus, in team discussions.

Stability in team membership:

having a stable core ensured that

interpersonal relations and trust

could develop. This had an

impact on TPS allowing it to

grow with each meeting.

Individuals who join the team

were often hesitant to

immediately engage in

in a core group of team

members.

TPS can catalyze knowledge co-

generation and power sharing

which in turn can result in the

emergence of attributes of

interpersonal teamwork such as

shared identity, an understanding

of team roles and

responsibilities, shared goals and

shared responsibilities.

Open communication and shared

decision-making is more

difficult to achieve within teams

embedded in hierarchical

organizations where shared

decision-making is not an

organizational norm.

Interprofessional teamwork is

more likely to develop if there is

a core team members who

commit to meeting regularly as a

team.

84

discussions.

Raes, E., Kyndt, E.,

Decuyper, S., Van

den Bossche, P., &

Dochy, F. (2015).

1. Do teams in later

phases of

development exert

more team learning

behaviors than

teams in earlier

phases of

development?

2. Are psychological

safety and social

cohesion mediators

for the relationship

between group

development and

team learning?

Teams in

different

professional

contexts

(profit and

non-profit)

H1: Teams situated in

phases 3 and 4 will display

more learning behaviors

than teams situated in

phases 1 and 2.

H2: Team psychological

safety will be higher in

teams situated in phases 3

and 4 than in teams situated

in phases 1 and 2.

H3: Group potency will be

higher in teams situated in

phases 3 and 4 than in

teams situated in phases 1

and 2.

H4: Psychological safety

and group potency will

mediate the relationship

between development

phases and team learning

behaviors.

Data were

collected from 168

individuals

working in 44

teams.

Psychological

safety, group

potency and team

learning behaviors

were measured

using scales from

the Team Learning

& Behaviors-

Questionnaire.

Group

development was

measured using

items from the

Group

Development

Questionnaire.

H1: Supported

H2: Supported

H3: Supported

H4: Supported

Teams foremost characterized

by the trust and structure phase

and work and termination phase

showed more team learning

behaviors than teams with higher

scores on the dependency and

inclusion phase and

counterdependency and fight

phase. This indicates that teams

do not yet learn as a team, but

rather as fragmented individuals

in the first two stages of their

group development.

Team learning behaviors are

higher in the latter phases of

group development, because

these latter phases are also

characterized by higher

psychological safety and group

potency.

Salas, E., Sims, D.

E., & Burke, C. S.

(2005).

The purpose of this

article is to (a)

clearly describe and

define each of the

components of the

“Big Five” and its

coordinating

mechanisms; (b)

provide research

propositions

surrounding the

“Big Five”; and (c)

to address issues of

the phase of the

team task and team

maturity on the

5 core components that

promote team effectiveness,

which we submit as the

“Big Five” in teamwork:

1. Team leadership

2. Mutual performance

modeling

3. Backup behavior

4. Adaptability

5. Team orientation

Coordinating

mechanisms:

1. Shared mental models

2. Closed-loop

communication

We conducted an

extensive review

of the literature of

the past 20 years.

This review

included both

empirical studies

and theoretical

models of team

effectiveness.

The “Big Five” and its

coordinating mechanisms will

vary in importance or

prominance in the early

development stages of the team

(e.g., team leadership,

communication), whereas other

core components will gain

prominence later in team

development as teams proceed

through phases of the team task

(e.g., performance monitoring,

backup behavior). We also

expect that the phase of team

performance may also affect the

importance each dimension play

We have provided a theoretical

model of the interrelations

among the “Big Five”

dimensions and their subsequent

research propositions. We have

proposed that these dimensions

are commonly occurring in

many other models of teamwork

and must be manifested during

any team task that can be

suggested.

85

manifestation on the

importance of each

of the “Big Five”

components.

3. Mutual trust in team performance.

Tuckman, B.W.

(1965).

The purpose of this

article is to review

the literature dealing

with the

developmental

sequence in small

groups, to evaluate

this literature as a

body, to extrapolate

general concepts

about group

development, and to

suggest fruitful areas

for further research.

Therapy

groups

T-groups

Natural- and

laboratory

groups

Proposed developmental

sequence:

Stage 1. Group structure:

testing and dependence;

Task activity: orientation to

the task.

Stage 2. Group structure:

intragroup conflict; Task

activity: emotional response

to task demands.

Stage 3. Group structure:

development of group

cohesion; Task activity:

open exchange of relevant

interpretations.

Stage 4: Group structure:

functional role relatedness;

Task activity: emergence of

solutions.

Literature review

of 50 articles

dealing with the

developmental

sequence in small

groups.

The suggested stages of groups’

development are highly visible

in therapy-group studies, T-

group studies, and natural- and

laboratory group studies.

However, the fit is not perfect.

Model summary:

1. Forming

2. Storming

3. Norming

4. Performing

Setting specific differences and

within-setting differences may

affect temporal change as

regards the specific content of

the stages in the developmental

sequence, the rate of progression

through the sequence, or the

order of the sequence itself.

Group duration, group

composition and the specific

nature of the task would be

expected to influence the amount

and rate of development.

Tuckman, B. W., &

Jensen, M. A. C.

(1977).

The purpose of this

review was to

examine published

research on small-

group development

done in the last ten

years that would

constitute an

empirical test of

Tuckman (1965).

Literature review

of 22 articles

primarily

concerned with

empirical research.

Most literature has been

theoretical in nature; those

articles describing empirical

research were not primarily

concerned with testing already

existing models. Only Runkel et

al. (1971) set out to test

Tuckman’s hypothesis. Their

conclusions were supportive of

Tuckman’s four-stage model,

but their results may not be

reliable because of the

researchers’ methodology.

Research that agreed with a life

cycle model viewed separation

A major outcome of this review

has been the discovery that

recent research posits the

existence of a final discernible

and significant stage of group

development-termination.

Because the 1965 model was a

conceptual statement determined

by the literature, it is reasonable,

therefore, to modify the model to

reflect recent literature. The

model now stands: forming,

storming, norming, performing,

and adjourning

86

as an important issue throughout

the life of the group and as a

separate and distinct final stage.

Van Amelsvoort, P.,

& Benders, J. (1996).

A model for the

development of

self-directed work

teams is described

and discussed.

Self-directed

work teams in

production

organizations

Phase 1: Bundling of

individuals (multiskilling,

tea meetings, feedback

performance)

Phase 2: Groups

(managerial tasks, analysis

of performance)

Phase 3: Team (team-

building, productivity

appraisal, individual

appraisal, goal setting)

Phase 4: Open team

(External relations,

appraisal of team leader and

support staff)

Securing an appropriate

work environment for

teams is an absolute

prerequisite for putting self-

directed works teams to

work.

By means of a so-

called quick scan

the way teams

develop in

practices was

investigated

workshops held

from 1992 – 1994

described the

status quo of 267

teams in 23

organizations.

In 29% of the cases, teams had

just been established, whereas

63% of the teams were in the

second phase. For the time

being, activities such as goal

setting, appraisal of individual

and team productivity and

managing external relations are

still the domain of a team

leader. Only 8& of the teams

have entered the third phase and

none the fourth.

The transition from the second

to the third phase proves to be

rather difficult, which may be

explained by a number of

reasons:

1) The third phase focuses on

psychological group-dynamic

processes, which are difficult to

handle; 2) Traditionally, team

members are selected on their

technical skills rather than on

their social and learning skills;

3) It’s hard to break through the

established division of labour;

4) Entering phase three requires

a change in the reward system,

which is often hard to achieve.

The length of the team

development process differs

considerably between

organizations and may even

vary within a particular

organization A variety of

Practical experiences with this

model show that it cannot

remove all obstacles, but instead

functions as a guideline for

developing teams.

87

reasons may account for this: 1)

Differences in initial skill levels

and differences in required skill

levels; 2) The investment in

training; 3) The quality of

internal relationships; 4) varying

degrees of acceptance of the

new organizational structure.

Wellins, R.S.,

Byham, W.C., &

Wilson, J.M. (1991).

Six key factors of

team development

are compared as

they relate to the

stages of team

development.

Self-directed

work teams

As teams mature, they pass

through four stages of

development:

Stage 1: Getting started

Stage 2: Going in circles

Stage 3: Getting on Course

Stage 4: Full speed ahead

Key factors in team

development:

1. Commitment

2. Trust

3. Purpose

4. Communication

5. Involvement

6. Process orientation

Our book is based

on four general

sources of

information:

1. A national

survey of more

than 500

organizations

2. Interviews with

28 organizations

3. Review of the

literature

4. Experience

Stage 1: Team is a diverse

collection of individuals, its

members are not clearly linked

by goals.

Stage 2: Individuals begin to

feel more comfortable as they

develop a better sense of what a

team is an how they are

expected to work together in

that team.

Stage 3: The team becomes

more goal focused and develops

routines for handling crises.

Stage 4: Teams constantly

strive to be proactive by

anticipating demands,

demonstrating the need for

additional resources etc.

However, team development is

not necessarily a linear process.

We observed teams slip for

various reasons: 1. New

members; 2. Team trauma; 3.

Crisis of faith; 4. Lack of

attention or maintenance.

Teams mature and evolve over

time. Paying attention to these 6

factors might or might not make

the journey to empowered work

team shorter, but it probably will

make the ride smoother.

Wheelan, S.A.

(2005).

Providing a

framework for

understanding how

group patterns and

member behaviours

Work groups We expected that as time

passes, groups will change

from simple to complex

systems, from limited to

diverse capabilities, and

Review of group

development

literature

Phase 1: Dependency and

inclusion: High anxiety,

uncertainty and politeness

among team members. Team

members are concerned with

Most groups will move in the

direction of increased

effectiveness and productivity.

Some groups will not mature.

88

change across time from dependent to

interdependent cultures

The overall goal of group

development is to create an

organized unit capable of

working effectively and

productively to achieve

specific ends.

issues such as being accepted,

reducing uncertainty and setting

boundaries, and will therefore

tend to defer to a 'leader'.

Phase 2: Counter dependency

and fight: Marked by conflict,

power struggles, search for

identity and definition of roles

among team members. The team

is still working on the

development of an appropriate

social structure.

Phase 3: Trust and Structure:

Marked by more mature

negotiation processes between

team members, presence of

team goals, structure within the

team, procedures, roles and

division of labour among team

members. Information is shared

more freely and many more

opportunities to learn arise.

Phase 4: Work and

productivity: Marked by team

members feeling comfortable

with the habitual sharing of

information between team

members. There is a good sense

of where the knowledge and

expertise lies within the group.

Phase 5: Termination

Group development does not

occur in a vacuum because

group behaviour is a function of

its internal process and

contextual environment (e.g.

design of the work group tasks

and organizational support)

Wheelan, S. A.

(2009).

RQ1. Are there sig.

differences in

certain individual or

organizational

demographics in

these small and

large work groups

Middle

management

and project

teams (profit

and non-

profit)

Wheelan (2005)

Stage-1: Dependency and

inclusion

Stage-2:

Counterdependency and

flight

Stage-3: Trust and

There were 239

work groups in

this study that

have been meeting

for six months or

more.

Data were

RQ1: Number of months that

the group has been meeting not

sig. related to GDQ scale scores;

number of males and females in

a group not sig. related to GDQ

scale scores; whether the group

was operating in a for-profit or a

It seems logical to conclude that

work-group size is an important

factor in both group

development and group

productivity. Groups of 3 to 6

members have a much better

chance of reaching the higher

89

that might account

for differences in

member perceptions

of group

development,

effectiveness, and

productivity?

RQ2. Are there sig.

differences between

member perceptions

of group

development, group

effectiveness, and

productivity in small

and large work

groups?

structure

Stage-4: Work and

productivity

collected from

each of the groups

at its work site.

Team consultants,

trained to

administer the

Group

Development

Questionnaire

(GDQ) collected

the data.

non-profit organization was not

sig. different.

RQ2: GDQ scale I) Members of

groups that contained 9 or more

members perceived more

dependence on the leader,

inclusion, and safety issues than

did members of smaller groups;

GDQ scale II) Members of

groups that contained 9 or more

members perceived more

conflict with the leader and

among members than did

members of smaller groups; GDQ scale III) Members of

groups that contained 9 or more

members perceived less trust

and less structure and

organization within the group

than did members of smaller

groups; GDQ scale IV)

Members of groups that

contained 9 or more members

perceived less focus on work in

their groups than did members

of smaller groups.

Members of larger groups

perceived their groups as less

effective and less productive

than members of smaller groups

did.

stages of group development

than larger groups.

Wheelan, S. A.,

Davidson, B., &

Tilin, F. (2003).

The purpose of this

research was to

investigate the

relationship between

the length of time

that work groups

had been meeting

Work groups

in different

contexts

(profit and

non-profit)

Wheelan (2005)

Stage-1: Dependency and

inclusion

Stage-2:

Counterdependency and

flight

Stage-3: Trust and

2 Sets of groups:

the first set

consisted of 26

work groups, the

second set 88 work

groups.

There were sig.correlations

between the length of time that a

group had been meeting and the

number of dependency, fight,

and work statements that an

individual in a group of a

particular duration made.

The findings of this study are

consistent with the traditional

models of group development

and cast doubt on the cyclic

models and Gersick’s

punctuated equilibrium model.

The traditional models of group

90

and the verbal

behaviour patterns

and perceptions of

group members

about their groups.

structure

Stage-4: Work and

productivity

Data were

collected during a

regularly

scheduled meeting

and members

completed the

Group

Development

Questionnaire

(GDQ).

Individuals who made more

dependency and fight statements

and fewer work statements

tended to be in groups that had

been meeting for less time.

Members of Stage 3 groups

made sig. more counter-

dependency and flight

statements compared with

members of Stage 4.

There were sig. correlations

between the length of time that a

group had been meeting and

member perceptions of group

development. Members of older

groups tended to perceive those

groups to have sig. fewer of the

characteristics of a Stage-2

group and sig. more of the

characteristics of Stage-3 and

Stage-4 groups. Members of

older groups perceived their

groups to be more productive.

Sig. difference was noted in the

length of time that groups at

different stages had been

meeting. Stage-1 groups had

been meeting sig. less time than

Stage-3 and Stage-4 groups.

No sig. correlations were noted

with regard to group member

age, gender, education, or length

of service and individual

perceptions of group

development. Individuals in

larger groups were more likely

to perceive their group as

development posit that early in

group life, members are more

dependent and

counterdependent, engage in

more conflict, flight, and less

work. Members also are

described as more guarded in the

early stages. The results of this

study supported those

propositions in both the behavior

of group members and in their

perceptions of group processes.

Both the verbal behaviors of

members and their perceptions

of group interaction changed sig.

across time.

91

having more of the

characteristics associated with

the first two stages of group

development and fewer of the

characteristics associated with

the fourth stage of group

development. Members of larger

groups also perceived their

group to be less productive.

92

Appendix III: Topic list

Stage one: Arrival

Stage two: Introducing the research

Bedanken voor de tijd en medewerking;

Introductie: Onderzoeker stelt zichzelf voor en introduceert het onderwerp: De ontwikkeling

van zelforganiserende teams en de factoren die bijdragen aan deze ontwikkeling.

Overige zaken:

- Toelichten dat het een retrospectief interview is (om teamontwikkelingen in kaart te

brengen wil ik in kaart brengen hoe teams zich vanaf 01-01-2016 (evt. nog daarvoor)

tot heden ontwikkelt hebben);

- Toelichten dat er zijn geen goede of fouten antwoorden zijn en dat het onderzoek

anoniem is;

- Toestemming vragen om het interview op te nemen.

Stage three: Beginning the interview

Toelichten wat er onder de begrippen zelforganiserende teams en teamontwikkeling verstaan wordt

1. Van welke teams bent u teamadviseur?

Stage four: During the interview

2. Ziet u op dit moment veel verschillen in de

mate waarop teams effectief functioneren? Zo

ja, welke teams functioneren wel en niet

effectief?

Toelichten dat teams zich volgens de literatuur ontwikkelen op 3 processen

3. Op welke manier hebben de effectief

functionerende teams zich ontwikkelt op het

proces team management?

93

4. Op welke manier hebben de effectief

functionerende teams zich ontwikkeld op het

proces taak management?

5. Op welke manier hebben de effectief

functionerende teams zich ontwikkeld op het

proces boundary management en verbetering?

6. Zit er een bepaalde volgorde in de manier

waarop effectief functionerende teams deze drie

processen ontwikkeld hebben? Of hebben deze

teams de processen tegelijkertijd of in

verschillende volgordes ontwikkeld?

7a. Dragen de key aspecten volgens u allemaal

bij aan de ontwikkeling van een effectief

zelforganiserend team?

7b. Denkt u dat er naast de key aspecten van

deze processen nog andere belangrijke aspecten

zijn waarop zelforganiserende teams zich

ontwikkelen tot een effectief functionerend

team?

Toelichten dat de focus nu ligt op factoren die teamontwikkeling beïnvloeden: Hoe komt het dat

teams zich hebben ontwikkelt tot een effectief functionerend zelforganiserend team? Kan dit ook

verklaren waarom de overige teams zich niet hebben ontwikkelt tot een effectief functionerend

zelforganiserend team?

8. In hoeverre kan dit verklaart worden door de

kennis en vaardigheden van de individuele

teamleden? Waarom?

94

9. In hoeverre kan dit verklaart worden door de

houding van de individuele teamleden tegenover

zelforganisatie? (Beïnvloeden teamleden ook

elkaars houdingen?) Waarom?

10. In hoeverre kan dit verklaart worden door de

mate van psychologische veiligheid in de teams?

Waarom?

11. In hoeverre kan dit verklaart worden door de

mate waarop teams te maken heeft met verloop

van teamleden? Waarom?

12. In hoeverre kan dit verklaart worden door de

omvang van de teams? Waarom?

13. In hoeverre kan dit verklaart worden door

team training?

95

14. In hoeverre kan dit verklaart worden door de

gedragingen van het management en directie?

15. In hoeverre kan dit verklaart worden door de

requisite voor zelforganisatie van deze teams?

Waarom?

16. Zijn er nog andere factoren die de

ontwikkeling van zelfsturende teams

beïnvloeden?

Stage five: Ending the interview

17. Zijn er volgens u nog zaken die belangrijk zijn voor dit onderzoek die nog niet zijn behandeld?

Stage six: After the interview

Bedanken voor deelname aan het onderzoek

Vertellen dat de transcripten toegestuurd worden ter bevestiging

Eventuele reflectie op het interview

96

Appendix IV: Hierarchical coding scheme retrospective interviews

Team mangement Elkaar motiveren

Elkaar feedback geven en ondersteunen

Doelen stellen

Coordineren en plannen Klinische vs ambulante SMTs

Conlict management Ambulante SMTs

Taak management Routine ondersteunende managementtaken Teamoverleg

Resultaten en prestaties sturen Klinische SMTs - Ambulante SMTs

Multifunctionaliteit Klinische SMTs - Ambulante SMTs - Overtijgende taken

Gezamelijke besluitvorming Afstand nemen afdeling - Besluiten naleven

Delen van taakgerelateerde informatie Klinische vs ambulante SMTs

Boundary mangement en verbetering

Activiteiten gericht op continue verbetering Taak van management

Non-routine ondersteunende managementtaken Werving en selectie - Jaargesprekken voeren

Externe relaties Klinische SMTs - Ambulante SMTs - Relaties met andere teams - Relatie met mangement

Development pattern Context beinvloedt development pattern

Team management als basis

Compleet overzicht

Verschil tussen SMTs Effectieve SMTs

Minder effective SMTs

97

Teamgrootte Groot team

Klein team

Taken en verantwoordelijkheden splitsen

Team training Teamfase profiel

Psychologische veiligheid Veiligheid naar management toe

Team turnover Klinische SMTs

Verloop positief effect

Teamsamenstelling Persoonlijkheid

Verhouding man-vrouw

Kennis en vaardigheden Ontbrekende kennis

Jongeren en ouderen van elkaar laten leren

Opleidingsniveau Statusverschillen

Team management vaardigheden

Rol teamadviseur Verschil tussen teamadviseurs

Te vrijblijvend

Aansluiten bij mate van zelforganisatie

Sturing noodzakelijk

Gaandeweg sturing minder noodzakelijk

98

Ondersteunende diensten Directere rol naar zorgteams toe

Belemmerende procedures

Goed benaderbare ondersteunende diensten

Verkeerde organisatiestructuur Afstand tussen SMT en teamadviseur te groot

Manager te grote span of control

Teamadviseur ingezet als assistent

Geschiedenis Gewend aan top-down sturing

Angst vooor het nemen van initiatief

Hoge werkdruk Keuzes maken

Tijd nemen voor verandering Te veel organisatorische veranderingen

Transitie naar zelforganisatie Plotselinge tranistie SMTs worden gedwongen

Geen plotselinge transitie

Geen koers

Leerafdeling

Samenwerking behandelaren

Privé omstandigheden

Incidenten/crisis

Marktwerking in de zorg

Requisite voor zelforganisatie Belemmerend voor zelforganisatie

99

Werksoort Unit 4 vs unit 8,9,10

Unit 8,9,10 Sturing noodzakelijk - Verantwoordelijkheden forensische zorg - media aandacht

Houding Houding klinische SMTs

Weerstand tegen veranderering Weerstand enkele teamleden - Eigen verandertempo

Veranderende houding Meer ruimte - Teamleden veranderen elkaars houding

Wantrouwen

Gewend aan top-down sturing

Initiatief durven nemen

Psychologische behoefte en motivatie

Focus op client

Kartrekkers Kartrekkers ervaring met leiding geven

Management, directie, RvB Top-down sturing Financiele situatie - Frustratie van SMTs - Geen voeding met zelforganisatie - Minder belemmerend wanneer SMTs verder ontwikkeld zijn

Verschil tussen managers Duidelijke kaders - Onduidelijke kaders - Management geeft ruimte

Consistente visie

SMTs vertrouwen

SMT betrekken en informeren

Luisteren naar SMTs

Waardering uiten

Management ander beeld SMTs

Beinvloeding door management

Nieuw managementteam

100

Appendix V: SMT development pattern retrospective interviews

Als eerste ontwikkeld

In ontwikkeling

Ontwikkeld (geen bepaalde tijdsperiode benoemd)

Nog niet ontwikkeld

Ontwikkeling afhankelijk van internal factors

Niet benoemd

Interview respondent

Development processes 1 2 3 4 5 6 7 8 9 10 11 12 13 14

Team management Goal orientation Planning & coordinating activities Conflict management Mutual performance monitoring and backup behavior Motivating and confidence building Task managment Multi-functionality Work communication Decision-making and control Delegated management and support tasks Performance management Boundary management and improvement Continuous improvement activities External relations Advanced management and support activities

101

Appendix VI: Questionnaire of Kommers & Dresen (2010)

Enquête Zelforganisatie .

Naam:

Nummer:

Afdeling:

Leiding:

Teamadviseur:

Datum:

Kenmerken van het team .

Hieronder volgen stellingen over 16 kenmerken van het team. Bij deze stellingen worden per

teamkenmerk (het dik gedrukte woord) vier omschrijvingen gegeven. Wij willen je vragen om per

teamkenmerk de omschrijving aan te vinken die het meest herkenbaar is voor wat er in je team gebeurt

(er is dus maar een optie per teamkenmerk mogelijk).

1. Doelacceptatie

A. Teamleden zijn overwegend op hun eigen werk gericht. Team doelen leven nog niet echt.

B. Teamleden ervaren dat ze afhankelijk zijn van elkaar en het team meerwaarde heeft voor het

realiseren van de teamdoelen.

C. De teamleden voelen zich gezamenlijk verantwoordelijk voor de team doelen. Teambelang

staat voor eigen belang.

D. Het team voelt zich mede verantwoordelijk voor het algemeen belang van de organisatie.

2. Invloed bij het opstellen van teamdoelen

A. Teamdoelen worden door de manager en/of organisatie bepaald.

B. Teamdoelen worden door de manager bepaald, na overleg met het team.

C. Teamdoelen worden door het team bepaald, in afstemming met de manager.

D. Team stelt in samenspraak met alle relevante omgevingspartijen zelf de nieuwe doelen vast.

3. Resultaatsturing

A. Het team heeft een duidelijk teamdoel (missie) en dat is bij de teamleden bekend.

B. Er zijn concrete (meetbare) doelen geformuleerd die gaan over de uitkomsten van het zorg en

dienstverlening proces en resultaten worden teruggekoppeld.

C. Bespreken van de resultaten is vast punt op het teamoverleg en wordt door het team

zelfstandig opgepakt.

D. Over de teamresultaten wordt verantwoording afgelegd aan de manager en andere relevante

omgevingspartijen om als team te leren. Verantwoording is wederzijds.

4. Analyseren en verbeteren van resultaten

A. De manager stuurt de individuele teamleden op de

resultaten. Teamresultaten zijn nog geen onderwerp van gesprek in het team.

B. De resultaten worden samen met de manager geanalyseerd en dit is een prikkel voor reflectie

en verbetering.

C. Het team weet hoe het de resultaten kan beïnvloeden en haalt de doelen.

D. Het team verhoogt uit eigen ambitie het niveau van de doelen, afgestemd op de behoeften van

cliënten.

5. Duidelijkheid over verwachtingen van taken en rollen

A. Iedereen kent zijn eigen taak en kan die los van de anderen uitvoeren. Er is beperkt inzicht in

de taken van de anderen.

102

B. Teamleden kennen elkaars taken en rollen. De verwachtingen bij deze taken en rollen worden

met elkaar besproken.

C. Het team bespreekt en bepaalt welke competenties nodig zijn bij het uitvoeren van de taken en

rollen, zodat de teamdoelen kunnen worden behaald en het team optimaal kan functioneren.

D. Het team heeft inzicht in wat er nodig is aan (toekomstige) competenties gezien de

ontwikkelingen in de omgeving.

6. Effectieve verdeling taken en rollen

A. De taak- en rolverdeling sluit aan bij wat men gewend is.

B. Binnen het team wordt voor elkaar ingesprongen (Bijv. om verzuim te voorkomen).

C. De teamleden helpen elkaar en springen zo nodig voor elkaar in. Er is goed inzicht in elkaars

kwaliteiten en er wordt optimaal gebruik van gemaakt om tot het beste resultaat te komen.

D. Er wordt optimaal (effectief en efficiënt) gebruik gemaakt van de verschillende kwaliteiten in

en buiten het team.

7. Zelfstandigheid bij rol- en taakverdeling

A. De taken worden door de manager verdeeld. De

assistent centrummanager en/of teamcoördinator is coach van de individuele teamleden.

B. De taken worden door het team in overleg met de manager verdeeld.

C. Het team verdeelt geheel zelfstandig taken en rollen. Teamleden coachen elkaar. Verschillen

in kwaliteiten worden openlijk besproken.

D. Het team stemt zelf ook af met de andere teams over optimale inzet van teamleden.

8. Leren

A. Leren is een individuele aangelegenheid.

B. Teamleden wisselen actief kennis en ervaring uit en de persoonlijke ontwikkeling wordt op

elkaar afgestemd.

C. Het team ontwikkelt een gezamenlijke manier van leren. Leren gebeurt van elkaar en in

interactie met elkaar.

D. Het leren is een continu proces, waardoor het team en de teamleden zich voortdurend kunnen

aanpassen op de nieuwe eisen uit de omgeving.

9. Teamoverleg

A. De manager zorgt voor regelmatig teamoverleg

(plannen, voorzitten en notuleren).

B. Het overleg gaat over onderwerpen die door de teamleden worden aangedragen. Teamleden

bereiden zich voor op het overleg.

C. Teamleden bereiden de onderwerpen van het overleg voor en regelen het teamoverleg zelf

(agenda, voorzitten en notuleren).

D. Het team regelt, evalueert en verbetert het teamoverleg zelf. Het overleg is zinvol, efficiënt en

doet recht aan de verschillen binnen het team.

10. Besluitvorming

A. De manager heeft een centrale rol in de besluitvorming. Zij hebben een belangrijke

inhoudelijke bijdrage en hakt knopen door.

B. De manager begeleidt het proces van besluitvorming en helpen het team tot besluiten te

komen. De besluitvorming is duidelijk.

C. De besluitvorming procedure is helder en geaccepteerd en wordt door het team zelf geregeld.

Teamleden hebben allen inbreng en besluiten hebben draagvlak.

D. De besluitvorming is effectief en efficiënt. teamleden nemen op basis van onderling

vertrouwen besluiten met verantwoording achteraf.

103

11. Planning en coördinatie

A. Coördinatie/planning van de dagelijkse zaken gebeurt vooral door de manager.

B. Meerdere teamleden nemen coördinatie/planning taken met betrekking tot de dagelijkse gang

van zaken op zich.

C. Voor de coördinatie- taken is het hele team verantwoordelijk, dus verdeeld over de teamleden.

De verdeling sluit aan bij de kwaliteiten van de teamleden.

D. Het team is mede verantwoordelijk en zorgt zelf voor een goede coördinatie op teamniveau,

ook voor de niet dagelijkse zaken, zoals beleidszaken e.d.

12. Zelfstandigheid

A. De teamleden zijn zelfstandig in hun primaire taak, in de uitvoering van het zorg en

dienstverlening proces.

B. Het team regelt grotendeels (meer dan 80%) zelf de dagelijks voorkomende regeltaken, zoals

dagelijkse planning, medicatie enz.

C. Het team is verantwoordelijk voor en heeft een werkwijze voor het verbeteren van het zorg en

dienstverlening proces.

D. Het team is verantwoordelijk en heeft een werkwijze voor: Het zorg en

dienstverleningsproces, de kwaliteit, eigen ontwikkeling, planning, deelbudgetten, werving en

selectie, etc.

13. Omgaan met meningsverschillen of conflicten

A. Meningsverschillen en of conflicten zijn er schijnbaar niet en worden uit de weg gegaan.

B. De manager zorgt dat meningsverschillen of conflicten worden opgelost. Hij/zij is hierbij

vooral bemiddelaar.

C. Conflicten of meningsverschillen worden door de teamleden onderling en op volwassen wijze

opgelost.

D. De teamleden gaan confrontaties niet uit de weg, conflicten en meningsverschillen worden

benut om van te leren.

14. Openheid

A. Op verschillende zaken rust nog een taboe (bijvoorbeeld je zwakte laten zien, persoonlijke

onderwerpen enzovoort). Verschillen worden nauwelijks besproken.

B. Er is beginnende openheid. Zaken die moeilijk bespreekbaar zijn worden aangekaart, zij het

nog onhandig of voorzichtig. Er is respect voor verschillen.

C. De sfeer in het team is veilig. Iedereen kan en durft alles te bespreken dat van belang is voor

het team functioneren. Verschillen worden besproken en benut.

D. De sfeer in het team is open en ook tussen het eigen team en andere teams zijn alle zaken goed

bespreekbaar. Ook verschillen met anderen buiten het team worden besproken en benut.

15. Sociale steun

A. In principe is iedereen op zichzelf aangewezen. Je moet je eigen boontjes doppen.

B. Er is oog voor elkaar (zowel in werk als in privésfeer), maar als er meer inspanning gevraagd

wordt (bijvoorbeeld taken overnemen), dan gebeurt dat niet vanzelfsprekend.

C. Binnen het team heeft iedereen oog voor elkaar (zowel in werk als privésfeer) en helpt elkaar

actief door lastige periodes heen (bijvoorbeeld taken overnemen).

D. Zowel binnen het team, als buiten het team (bijv. andere GGzE-collega’s) is elkaar helpen in

lastige periodes vanzelfsprekend.

16. Aanspreken op gedrag

A. Aanspreken op gedrag gebeurt beperkt door de manager/teamadviseur.

B. Teamleden spreken elkaar af en toe aan op het gedrag, maar vinden het nog wel moeilijk.

104

C. Teamleden spreken elkaar op een volwassen en respectvolle manier aan op het gedrag.

D. Het team spreekt ook anderen buiten het team op een volwassen en respectvolle manier aan op

het gedrag.

105

Appendix VII: Example visualization Kommers & Dresen (2010)

Score verdeeld naar 16 onderwerpen

33%

17%

67%

67%

50%

17%

17%

50%

0%

50%

0%

0%

50%

0%

0%

0%

67%

0%

17%

17%

33%

83%

33%

0%

17%

33%

83%

100%

0%

50%

33%

83%

0%

17%

0%

0%

0%

0%

33%

33%

83%

17%

17%

0%

50%

17%

67%

17%

0%

67%

17%

17%

17%

0%

17%

17%

0%

0%

0%

0%

0%

33%

0%

0%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Doelacceptatie

Invloed bij het opstellen van teamdoelen

Resultaatsturing

Analyseren en verbeteren van resultaten

Duidelijkheid over verwachtingen van taken en rollen

Effectieve verdeling taken en rollen

Zelfstandigheid bij rol- en taakverdeling

Leren

Teamoverleg

Besluitvorming

Planning en coördinatie

Zelfstandigheid

Omgaan met meningsverschillen of conflicten

Openheid

Sociale steun

Aanspreken op gedrag

Score per onderwerp

Teamgemiddelde is fase: 2,2

26,0% 40,6% 21,9% 11,5%

0,0% 10,0% 20,0% 30,0% 40,0% 50,0% 60,0% 70,0% 80,0% 90,0% 100,0%

Totaalscore Team

Fase 1

Fase 2

Fase 3

Fase 4

106

Appendix VIII: Example SMT observation

Datum: 25-10-2016

Team: 3J

Aantal aanwezig teamleden: 7

Score: 1,7

Team development aspects Observations

Resultaatgerichtheid

Doelacceptatie Teamleden zijn vooral op hun eigen werk gericht. Dit “zit heel erg in

het werk, je bent solistisch bezig en hebt je eigen caseload”. Het enig

teamdoel is dat het team in een verandertraject zit en zich moet gaan

focussen op een andere cliëntenpopulatie. “Hier zit nog veel ruis”.

Invloed

Team ervaart weinig invloed: “We hebben als team weinig invloed.

Wat er komt is dan niet helder, het zijn meer losse flodders”. Het

management wordt als belemmerend ervaren: “Dan maken wij een

plan, stoppen we daar veel tijd in en wat later wordt er weer een ruk

aan het stuur gegeven en moeten we een andere kant in”.

Resultaatsturing

Het stuurt nog niet op team overstijgende taken: “ik blijf op 2 benen

hinken, cliëntgebonden liggen we op koers, maar administratief niet”/

“zo ver zijn we nog niet”.

Taken en rollen

Duidelijkheid over verwachtingen

+ Effectieve verdeling van taken

en rollen

Het team heeft een klein begin gemaakt met de verdeling van taken en

rollen: “we hebben iedereen gevraagd wat hij leuk vond en waar dat

hij affiniteit mee had” / “maar we zitten nog zo in het begin, dan kun

je elkaar niet meteen gaan aanspreken”. Verder ervaart het team een

beperkte mate van functionaliteit: “ik heb mijn eigen caseload, maar

als ik ergens vastloop kan in niet bij mijn collega’s van andere

disciplines terecht”. Een ander teamlid voegt hieraan toe: “elkaar

overnemen is beperkt, alleen bij crisissen en bijvoorbeeld langdurige

ziekte.

Zelfstandigheid

Teamoverleg Het team regelt het teamoverleg zelf. Dit is alleen geen gezamenlijke

verantwoordelijkheid. Een teamlid zegt bijvoorbeeld: “Ik laat het een

beetje gebeuren, het is teamlid X haar taak”. Een ander teamlid beseft

wel dat dit voor problemen kan zorgen: “het is interessant wat er gaat

gebeuren als teamlid X weggaat. 2 weken geleden was teamlid X

afwezig en had ze gevraag wie de notulen wilde maken, maar niemand

heeft dat gedaan”.

Besluitvorming Het team ervaart dat het management veel invloed heeft in het

besluitvormingsproces. Dit wordt zo ervaren omdat verschillende

opdrachten vanuit het management liggen: “en dat komt omdat er 2

opdrachten liggen, aan de ene kant moeten we een zelforganiserend

team worden, maar we moeten ons ook gaan oriënteren op een andere

doelgroep” / “het derde proces is dat we hetzelfde moeten blijven doen

met minder man. dan loopt de werkdruk behoorlijk op, dan zit je vast

als team”. Een teamlid voegt hieraan toe: “het wordt onder het mom

van zelforganisatie bij het team neergelegd, maar als je geen tijd hebt

kun je geen plan maken. We zijn hartstikke druk met ons werken,

zorgen dat er geen doden vallen”.

Onderlinge relaties

Omgaan met conflicten Meningsverschillen worden nog uit de weg gegaan. Dit wordt omdat

“ik denk dat je elkaar moet vertrouwen, in een beginnend team kun je

dit nog niet verwachten”.

107

Openheid Openheid is nog niet aanwezig: “we komen hier niet aan toe, het is

zakelijk, hopatee aan de slag”/ “als er iets is, zou ik geen tijd hebben

om het op tafel te leggen”. De vraag ‘durf je dat?’ wordt gesteld.

Aanspreken op gedrag

Aanspreken op gedrag komt nauwelijks voor. Dit omdat “ Mensen die

ik niet goed ken, daar ga ik niet tegen zeggen: ik denk dat je het beter

zo kunt doen. Voor mij is dat het begin”.

Overige observaties Het team heeft een onzekere toekomst omdat een aantal ZTB’er

misschien overgeplaatst dienen te worden naar eenheid 4. Ook gaan er

4 personen uit het team weg: “als ik denk over een paar maanden, dan

zijn we geen team meer”.

Ondanks deze onzekerheid, de hoge werkdruk en de onduidelijke

kaders is het team gemotiveerd om aan de slag te gaan. Er worden

plannen gemaakt om met elkaar uit eten te gaan, zodat men elkaar echt

kan leren kennen. Ook een teamkantoor zou volgens hun moeten

bijdragen aan de versterking van de onderlinge relaties.

108

Appendix IX: Hierarchical coding scheme SMT observations

SMT

Score

Aantal aanwezig personen

Type team

Team mangement Elkaar motiveren

Elkaar aanspreken en feedback geven

Elkaar ondersteunen / sociale stuen

Doelen stellen

Coordineren en plannen

Conlict management

Taak management Routine ondersteunende managementtaken

Resultaten en prestaties sturen

Multifunctionaliteit

Gezamelijke besluitvorming Besluiten naleven

Boundary mangement en verbetering

Activiteiten gericht op continue verbetering

Non-routine ondersteunende managementtaken

Externe relaties

109

Werkdruk

Omgaan met kaders

Management Top-down sturing

Management geeft ruimte

Beinvloeding door management

Individuele verschillen

Pscyhologische veiligheid

Team turnover

Houding Kartrekkers

Initiatief durven nemen

Weerhoudende rol enkele teamleden

Discussies

Teamfase profiel

Groupthink

Groot team

Klein team

Teamadviseur

Onzekere toekomst

110

Appendix X: SMT development pattern SMT observations

In ontwikkeling

Ontwikkeld

Nog niet ontwikkeld

Ontwikkeling afhankelijk van individual human capital (monodisciplinair/multidisciplinair)

Niet benoemd

SMT

Team development aspects 2C 2E 3J 3P 4E 4J 4O 6B 6C 6D 6I 9E 10B

Team management Goal orientation Planning & coordinating activities Conflict management Mutual performance monitoring and backup behavior Motivating and confidence building Task management Multi-functionality Decision-making and control Delegated management and support tasks Performance management Boundary management and improvement Continuous improvement activities External relations Advanced management and support activities

111

Appendix XI: Translated quotes

Nederlands English

Waar ze mee bezig zijn komt hier echt in terug, ik

mis hier niks in.

Everything what they are doing comes really back in

here. I am not missing anything.

Aanspreken klinkt meteen zo eng. Providing feedback sounds so scary.

Ze sowieso nog zoekende zijn in wat überhaupt hun

prestaties en resultaten moeten zijn, dan is het ook

lastig om daar op te sturen als je dat nog niet eens

helder hebt.

They are still searching for outcomes and results they

want to achieve. If this is not even clear, it is hard to

manage performance.

Ze zijn qua ontwikkeling nog niet zo ver dat het ze

lukt om prestaties en resultaten te sturen. Want dan is

het juist heel erg van belang dat je jezelf houdt aan

de afspraken die er gemaakt zijn, dat je elkaar daarop

aanspreekt en verandering verwacht. En dat zijn

allemaal stapjes die daaraan vooraf gaan.

They are not developmentally enhanced enough to

manage their performance. To do this, it is very

important that you stick to agreements, provide

feedback to each other, and expect significant

changes. All these steps must precede.

Een brug te ver. A bridge too far.

Ik denk dat ze allemaal begonnen zijn met heldere

doelen stellen. ... zijn de verantwoordelijkheden, wie

doe er wat, hoe communiceer we met elkaar?

I think they all started with setting clear goals .…

establishing a structure of tasks and responsibilities,

who does what? how do we communicate with each

other? Als het gaat over doelen stellen en wie doet wat en

hoe zit de verdeling van taken en rollen in een team,

dan is daar nog niet echt de aandacht voor.

If you're talking about goal setting, who does what,

and the distribution of tasks and roles in a team, then

is there not yet really paid attention to.

Dat was een van de eerste dingen waar ze allemaal

afspraken over maakten; hoe nemen we nou

besluiten in vergadering?

That was one of the first things they all agreed on;

how do we make decisions during a meeting?

Ik denk dat ze zich er steeds meer van bewust zijn

dat gezamenlijke besluitvorming van groot belang is

… vind ook wel dat ze daar echt mee stoeien.

I think they are becoming more and more aware of the

importance of joint decision-making … I see that they

are struggling with that.

Ik heb het in team 4Q mee gemaakt. … Die vroegen

dat ook aan mij ‘kun jij ons daarbij helpen?’ En die

zeiden na het proces ‘Ja, hoe moesten wij dit nu

weten? Als wij dit alleen hadden moeten doen, waren

we totaal bij een andere kandidaat uitgekomen, want

wij weten dit niet..

I have experienced this in SMT 4Q... they asked me:

‘could you help us with that?’ and they said

afterwards: ‘how were we suppose to know that?’ If

we had to do this alone, we would select a totally

different candidate, we do not know this.

Die teams hebben te maken met, bijvoorbeeld,

SPV’er, een woonbegeleider, een psycholoog, een

psychiator, dat zijn natuurlijk hele aparte disciplines.

Die kunnen elkaars werk niet overnemen.

These teams are dealing with, for example, a

community psychiatric nurse, a living support

assistant, a psychologist, a psychiatrist. These

disciplines are totally different. They are not able to

perform each other’s task.

Iedereen die met cliënten werkt die wil alleen maar

met cliënten werken en die wil die ballast die daar

rondom heen zit eigenlijk er niet bij hebben.

Everybody who works with patients, just wants to

work with patients. They do not want to deal with the

surrounding ballast of healthcare.

Het zijn altijd dezelfde mensen die taken naar zich

toe trekken. Dat vind ik jammer, ik zou graag met

meer mensen willen participeren.

It is always the same members who assume

responsibility for tasks. I think it is a pity, I would like

to participate with more members.

Ik denk dat we heel hard werken. Verstand op nul en

gewoon doorgaan.

I think that we are working really hard. We just keep

going without thinking.

Ik voel me veilig…, hierdoor durf je meer te doen,

bijvoorbeeld met sollicitaties.

I feel myself safe …, due to this I dare to do more,

like conducting job interviews.

Iedereen wil graag bij de club blijven horen. Dat

maakt dat ze eigenlijk nauwelijks kritisch zijn. Dat

merk ik wel, er wordt weinig feedback gegeven.

Everybody wants to remain at the club, so they hardly

dare to be critical. That is something I have noticed, a

small amount of feedback has been given.

De omstandigheden wisselen steeds door

personeelswisseling. …We zijn nu aan het drijven in

plaats van op reis.

The circumstances are constantly changing due to

turnover. … We are floating instead of travelling.

112

Volgens mij is uit de literatuur 12 tot15 is het ideale

team. Dat denk ik ook dat dat zo is. Dan kan je de

teamrollen en taken goed verdelen. Kleinere team is

daar is dat wel ingewikkeld.

I think that the literature considers a team of 12 till 15

members as most ideal. I agree with that because team

member roles and tasks could be allocated

appropriately. This is complicated for small teams.

Teams van unit 4 zitten in de stad Eindhoven of in de

dorpen hier omheen en krijgen een financiering via

de gemeente. Dus die staan echt met twee benen in

de maatschappij.

Teams of unit 4 are located in the city of Eindhoven or

surrounding villages, and are funded by the

municipality. These teams are therefore firmly rooted

in society.

Dat is een hele andere manier van werken. Dat

scheelt wel veel ook met roosters maken, samen een

dienstlijst vormgeven. Bij ambulant maakt iedereen

gewoon zijn eigen agenda en die maakt zijn eigen

afspraken en klinisch moet je gewoon zorgen dat er

24 uur lang altijd een bepaalde bezetting is. Dat vergt

organisatorisch gewoon veel meer.

That is a totally different way of working. It makes a

great difference, for example with scheduling or

creating a duty list together. Everyone just makes their

own schedules and appointments in the ambulatory

care, while you just have to make sure that there is 24

hours a day a workforce available in clinical care. This

requires more effort from an organizational point of

view.

De inkoop, de verschillende justitiële maatregelen,

het veiligheidsaspect, dat kan je niet allebei bij

verschillende teams neerleggen. …dan moet je teams

toch wel meer centraal ondersteunen om dat in goede

banen te leiden.

The purchase, the different judicial measures, the

safety aspect, you cannot assign this to different

teams. … You need to give teams more central

support to guide this properly.

Als je echt gewend bent geweest dat de

leidinggevende alles voor jou deed, dan ben jij als

team veel minder aan het denken gezet. Op het

moment dat een organisatie nu van jouw vraag ‘hee,

ga zelfs eens denken en ga ook eens wat doen’. Ja,

dan is dat een aardverschuiving.

If you are really used to a supervisor who did

everything for you, it would have given you less food

for thought. But when an organisation asks: ‘hey,

start thinking on your own’, yeah, that is a major

shock.

Eén zo’n team, bijvoorbeeld 9E, die zegt eigenlijk

wel tegen die manager ‘geef het maar allemaal aan

ons, wij willen het doen, geef ons die

verantwoordelijk maar. … Maar de manager zegt

‘nee, ik vertrouw dat niet, ik wil het in de hand

hebben, dus als je ziek bent, bel je mij, en jullie

jaargesprekken? Ga eerst maar een core business

doen’.

One team, for example SMT 9E, actually said to their

manager: ‘Give it all to us, we want to do it, give us

that responsibility’…However, their manager said:

‘No, I do not trust it, I want to control it. If you are

sick, you call me. And your annual appraisals? Start

doing core business first’.

Ik vind dat er nog best veel van buitenaf besloten

wordt. Het is dan opgelegd en ik voel me dan toch

minder verantwoordelijk.

I believe that many decisions are still made externally.

They are imposed and I feel myself therefore less

responsible.

Het kader is klein, maar als het niet lukt, kijken we

naar andere mogelijkheden. We kunnen ja zeggen en

nee doen.

The framework is small, but we look at other

possibilities when something does not work. We can

agree without doing anything.

Als het team zelf nadenkt ‘wij hoeven dat niet’ en je

hebt een verzuim van 10%, dan moet je toch als

teamadviseur zeggen van ‘luister eens, jullie kunnen

roepen wat je wil, maar je hebt een verzuim van

10%, hoe gaan jullie zorgen dat het omlaag gaat?

If a team thinks: ‘we do not have to do that’ and there

is an absenteeism rate of 10%, I, as a team adviser,

have to say: ‘listen, you can say what you want, but

you have an absenteeism rate of 10%, how are you

going to solve this?”

Ik ben wel richtinggevend, heel sturend, maar ik

denk dat als het uiteindelijk staat, ik ze wel los kan

laten. En dat zie ik ook gebeuren. Mijn rol wordt ook

anders ingezet.

I am guiding, very directional, but I think that I am

able to let them go when everything is embedded. And

I see it happening in that way. My role is employed

differently.

Ik vraag me af of het positief werkt op de mate voor

zelforganisatie. … Als teams goed op weg zijn in

hun proces en er dan ineens weer iets verandert dan

moeten ze eigenlijk hun hele proces weer opnieuw

gaan inrichten. Dit is voor teams vaak heel lastig

merk ik. …Dan slaat soms ook echt paniek toe.

I wonder whether it has a positive impact on the level

of self-management. …If teams are well-advanced in

their process and something suddenly changes, they

have to adjust their entire process again. Teams often

find this very difficult. …Sometimes they really start

panicking.