Describe how you would communicate with members of your team within your own discipline who exhibit traits of each of the four types of people. Incorporate the concepts from The Johari Window.

Members of the interprofessional team on a geriatric unit (physician, nurse, physical therapist, occupational therapist, and social worker) are meeting to discuss patient safety on the unit. During the previous quarter, falls increased by 10%. Analysis of the incident reports indicates that an examination of the fall prevention program that is offered jointly by nursing, physical therapy, and occupational therapy is indicated. The team is meeting with the goal of designing a revised fall prevention program for the unit. The proposed program will need to be based in the most current evidence, ensure the safety of the patients, and be cost effective. All four styles of communication noted previously in this chapter—action oriented (physician and physical therapist), process oriented (occupational therapist), people oriented (social worker), and idea oriented (nurse)—are represented. The leader (in this case, it is the physical therapist) is an identified action-oriented communicator. In preparation for the first meeting, she reviews strategies for adjusting her communication style to the team members and prepares her opening remarks. Her remarks might vary depending on how she perceives the other members of the group. She lists pointers for addressing the others based on their communication styles, along with alternate statements for each type.


Focus on the results first.

State your best recommendation.

Emphasize the practicality of your idea.

At the first meeting, if the other members are action oriented, the physical therapist might say, “The purpose of this group is to address the increased number of falls on the unit this last quarter. We need to revise the fall prevention program that is currently offered. I recommend that we construct a program around the three components that have been identified in the literature. Developing a fall prevention program that includes exercise, fall prevention, and environmental components is the most effective focus.”


State the facts.

Present your thoughts in a logical manner.

Include options with pros and cons.

Do not rush the person.

If the other members are process oriented, the physical therapist might say, “The purpose of this group is to address the increased number of falls on the unit this last quarter. We need to revise the fall prevention program that is currently offered. One option that we may choose to pursue is to do a literature review on the efficacy of fall prevention and develop a custom program for our unit. We may also explore the option of purchasing existing modules. What are your thoughts?”


Allow for small talk at the beginning of a session.

Stress the relationship between the proposal and the people concerned.

Show how the idea worked well in the past.

Show respect for people.

The physical therapist might say to such a group, “The purpose of this group is to address the increased number of falls on the unit this last quarter. Each of you has been chosen for this team because of your demonstrated commitment to patient safety. You are the experts in the day-to-day care of our patients. One area that we may need to consider is a revision of the fall prevention program that we currently offer. Institutions that are similar to ours have reported great success in reducing patient falls using a combination of exercise, addressing fear of falling, and modifying the environment.”


Allow enough time for discussion.

Do not get impatient when they go off on tangents.

Be broad and conceptual in your opening.

The physical therapist could address this type of group by saying, “As key staff members on this geriatric unit, you have demonstrated your commitment to patient safety. I have asked each of you to be a member of this team because we have yet another safety concern. The purpose of this group is to address the increased number of falls on the unit this last quarter. We need to revise the fall prevention program that is currently offered. Yes, the plan for tornado drills has been effective. Is there anything that we learned during the development and implementation of the tornado drill policy that we can bring to the creation of a fall prevention program?”

By acknowledging the presence of a variety of communication styles and adjusting her approach, this leader has demonstrated respect for team members and hopefully avoided potential problems in team communication at the beginning of this important project.

The Johari window.
The model is represented as a square that is divided into four window panes or perspectives.

Quadrant 1: Open/free area—what is known by the individual person and also known by others

Quadrant 2: Blind area—what is known by others but unknown to the individual

Quadrant 3: Hidden area—what is known by the individual and consciously hidden from others

Quadrant 4: Unknown area—what is unknown to both the individual and others

The panes/areas expand and contract to reflect the proportion of individual or group knowledge about an area. In newly formed groups, for instance, the open area is small since newly assembled groups of people know relatively little about one another. As groups mature, the open area increases as more information is shared and more cooperation and collaboration ensue. If open areas remain diminished, the group may be vulnerable to misunderstanding, mistrust, and confusion, and delay progress toward maturity. The ultimate goal for team members is to increase the size of the open area and decrease the size of the other areas through positive communication. The blind area is also known as the “bad breath area” because an individual is unaware of something that is known by everyone else. In the case of an individual, this could be a habit such as constantly glancing at a cell phone during a meeting—unaware that the other members of the group perceive this as disrespectful. Asking for and providing constructive feedback reduces this area.

While it is appropriate to use discretion when disclosing personal or private information, feelings and information related to work proves only be helpful if they are allowed into the open area. The process of disclosure—exposing relevant information and feelings—reduces the hidden area and further expands the open area. So a group member might disclose that he/she feels disrespected when someone is checking a cell phone during a meeting or conversation. The unknown area contains information such as unconscious needs, motivations, or inherent abilities that are unrecognized by the individual or the group (Figure 3-2). By examining the unknown area, individuals begin to understand that perceptions of present situations may be rooted in past experiences and the insecurity or anger that may have been experienced during a difficult childhood may be a hot button that is easily triggered by a difficult interaction in the present.

FIGURE 3-2 Feedback and self-disclosure and the Johari window.

Data from Luft, J., Ingham, H. (1950). The Johari window, a graphic model of interpersonal awareness. Proceedings of the Western Training Laboratory in group development. Los Angeles, CA: UCLA.

With the realization that our perceptions of present situations are formed through the lens of our own life experiences, we begin to seek information from others in order to construct a more complete picture. The ability to separate our perceptions from actuality allows us to become emotionally independent, no longer bound by automatic negative responses to triggers or hot buttons, and better able to make strategic choices regarding our actions and reactions.

If the unknown area is not reduced, the group runs the risk of not being able to leverage all of an individual’s talents. In addition, the individual runs the risk of not realizing his/her true potential—bound by old ways of knowing and reacting and reducing the chances of self-actualization and motivation to become engaged in the group’s work. This type of awareness can be sparked through self-discovery, observations by others, and methods of inquiry that encourage mutual discovery. Leaders and members who use positive communication to facilitate self-discovery, solicit and provide constructive feedback, and foster the free flow of information create a psychologically safe environment that engenders creativity, productivity, and sustained high performance.




























































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