A Discussion Paper for

Social Workers
interdisciplinary teamwork
INTRODUCTION ..............................................................................................................................2

TEAMWORK ....................................................................................................................................2
SOCIAL WORK AND TEAMWORK ............................................................................................................2
Social works contribution to teamwork ........................................................................................3
Social work skills and knowledge .................................................................................................4
INTERDISCIPLINARY TEAMWORK...............................................................................................4
MULTIDISCIPLINARY VS. INTERDISCIPLINARY TEAMWORK .......................................................................4
THE BENEFITS OF INTERDISCIPLINARY TEAMWORK.................................................................................5
Benefits to clients .........................................................................................................................5
Benefits to team members............................................................................................................5
Benefits to the organization ..........................................................................................................5
STAGES OF INTERDISCIPLINARY TEAM DEVELOPMENT ............................................................................5
IT IS NOT ALWAYS EASY: CHALLENGES ASSOCIATED WITH INTERDISCIPLINARY
TEAMWORK ....................................................................................................................................6
CLASHING PROFESSIONAL CULTURES ...................................................................................................6
POTENTIAL PROBLEMS WITH ROLES ......................................................................................................6
GROUP THINK AND TYRANNY OF THE GROUP .........................................................................................7
INTERDISCIPLINARY TEAMWORK AND DEPROFESSIONALIZATION .............................................................7
MAKING INTERDISCIPLINARY TEAMS WORK ...........................................................................7
HOW YOU CAN CONTRIBUTE TO EFFECTIVE TEAMWORK .......................................................................8
As a team member .......................................................................................................................8
As a leader....................................................................................................................................8
HOW ORGANIZATIONS CAN CONTRIBUTE TO EFFECTIVE TEAMWORK ........................................................9
CONCLUSION .................................................................................................................................9

REFERENCES ...............................................................................................................................10
INTRODUCTION
The April 1, 1998 establishment of Health and Community Service Boards
heralded the beginning of a profound change in the way that the majority of
social workers in Newfoundland and Labrador will practice their profession. The
creation of a community governed health and social services system is seen as a
means of improving the efficiency and effectiveness of the community health and
social service systems. It is expected that increases in efficiency and
effectiveness will be achieved, in part, by concentrating on improving
professional collaboration through interdisciplinary teamwork.

As with any change in practice, this new reality requires thought, adaptability and
creativity on the part of all affected professions. This paper reviews some of the
central concepts and issues related to teamwork. We emphasize the word
reviews because the profession has attributes that give social workers some
preparation for this change. Social work values, ethics, skills, knowledge and
competencies prepare social workers for effective team participation and
leadership. Ultimately this paper is intended to be a tool to help social workers
prepare for interdisciplinary teamwork in the interest of improving the interaction
between various disciplines, thereby maximizing the quality of service to clients.

The major questions this paper is designed to address are:

What are the strengths of the profession as interdisciplinary teamwork
expands?
What is the difference between multidisciplinary and interdisciplinary
teamwork?
What are the personal and organizational conditions required for an
interdisciplinary approach to work?
What are some of the challenges associated with interdisciplinary
teamwork?

TEAMWORK
Currently the concept of team is very popular. While being analagous to
sports, it has been widely embraced in the business, nursing, medical, social
work and other human service literature. In light of the wide range of
professions and disciplines which discuss team and teamwork, it is likely that
the concept means different things to different disciplines and professions. In the
human service literature regarding teamwork there is discussion of teams that
are interdisciplinary, multidisciplinary, transdisciplinary and intradisciplinary.
While sharing a commitment to working together, these types of teams differ with
respect to the type of decision-making used and the degree of collaboration. The
two types of teams that are most commonly discussed in the literature are
interdisciplinary and multidisciplinary. Later in this paper these, these two types
of teams which are often confused are discussed.

Social work and teamwork

Regardless of the colloboration model used by a given team, the need for
teamwork is built upon the assumption that no one profession or discipline has all

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 of the necessary skills and knowledge to meet the complex needs of clients.
Mariano (1989) supports this perspective when he says: (human problems)
result from the interaction of a number of physical, psychological, spiritual, and
environmental factors, and thus cross the traditional boundaries of helping
disciplines. It follows that effective teamwork seeks to serve the whole person
by integrating the knowledge and skills of various professional disciplines. The
literature regarding teamwork (e.g.,Garner, 1994) suggests that helping
professions which work independently can provide inferior services to the same
client because clinical decisions are made based upon incomplete information.
This inconsistency can confuse clients and act as a barrier to their therapeutic
goals.

The notion of teamwork is not new to social workers. Social workers in the
health care field have been working in partnership with members of other
disciplines for most of this century and there is a vast body of literature dating
back to 1909 reflecting these efforts (Carlton, 1984). In Newfoundland and
Labrador there is also a long history of working collaboratively as part of teams
and with networks of individuals from varied orientations to address social
problems. In 1920 the Colony's first social worker, Edith Haslam, established the
earliest child welfare services in close association with nurses, midwives, and
volunteers (Stirling, 1997). In the late 1930's Stella Burry, founder of Emmanuel
House, developed networks of support, (including religious leaders, politicians,
journalists and volunteers), who worked together to establish and deliver
services. From the early teams at the Waterford Hospital to the child protection
teams that operate in many centres today, the notion of teamwork is not new to
social workers in this province.

Social works contribution to teamwork

Social workers have been recognized in the literature as playing a critical role on
teams (e.g., Roseblum et. al., 1996). Some of the factors that support the
importance of social work on teams include:

Social work values and ethics: When the professions belief in

client dignity and self-determination comes alive on a team, clients
rights become a fundamental consideration in the teams intervention.
Social work theory: Of equal importance to teamwork is social
works person-in-environment framework in which clients are viewed
within the fullness of their environments. Among other benefits, this
emphasis on the intimate relationship between client well-being and
social support helps teams to be more client-centered while working
with the clients environment.
Characteristics of the profession: Dana (1983) points out that there
are long held characteristics of social work that are easily transferred
to working with teams. These include:
1. begining where ones colleagues are,
2. respecting differences in values, knowledge and prolem-solving
styles,
3. willingly sharing ones own knowledge values and skills even
when they may conflict with those held by others,

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 4. having the capacity to work through, rather than avoiding,
conflict,
5. being open to the ideas and insights of others.

Social work skills and knowledge

While the authors are not aware of any BSW programs that offer a course
designed to prepare practitioners specifically for teamwork, the group work
theory and skills and the content of Social Work in Health course which are
included in the generalist curriculum, are directly applicable to understanding and
working with teams. For example, knowledge of the stages of group
development and group dynamics, and being able to view the group as greater
than the sum of its parts, help social workers increase team effectiveness
(Abramson, 1989). All of the skills that social workers use with groups are also
critical for maximizing team functioning. Some of these skills include:

interpersonal conflict resolution

communication monitoring the impact of
problem-solving group process on achieving
ethical decision outcome
making appreciating interpersonal
organizing differences
facilitating outcome and process
contracting evaluation.

INTERDISCIPLINARY TEAMWORK
Interdisciplinary teamwork is the type of teamwork that is most popular in North
America both in terms of practice and representation in the literature.

Multidisciplinary vs. interdisciplinary teamwork

Discussions of interdisciplinary teamwork often reflect confusion regarding the
difference between multidisciplinary and interdisciplinary teamwork.

Multidisciplinary teamwork involves professions working independently towards

their common goal of serving clients. While disciplines might pursue the
common goal of assisting a client, the work does not occur through a
collaborative process that involves professionals working together to reach
consensus on intervention goals and strategies.

Interdisciplinary teamwork is defined by Carlton (1984) as: practice by two or

more practitioners from two or more fields of learning and activity, who fill distinct
roles, perform specialized tasks, and work in an interdependent relationship
toward achievement of a common purpose (p.129). The primary difference
between multidisciplinary and interdisciplinary teamwork is the genuine and
continuous collaboration that is required and the manner in which the disciplines
involved in the care of a client transform each other without losing their own
essence or core (OPTSQ, 1996).

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The benefits of interdisciplinary teamwork
The recent literature points to a wide range of benefits flowing from
interdisciplinary teamwork focusing on the benefits experienced by clients, team
members and the organization. The following lists are a synthesis of benefits
found in work of McGrath (1991), the OPTSQ (1996) and Carlton (1984).

Benefits to clients
more holistic, client-centered service,
more relevant service based upon a more accurate assessment of need,
clients are less likely to get harmed by being drawn into problems of the
system,
clients have access to more resources in a manner that is more effective.

Benefits to team members

development of shared values with respect to intervention,
professional identities become more highly integrated,
facilitates the integration of novices by seasoned professionals,
increasing workplace satisfaction by:
3 allowing for greater professional development and more appropriate
use of intervention skills,
3 providing intellectual stimulation and mutual support,
3 promoting the respect and acknowledgement of individual specialties.

Benefits to the organization

ensures the consistency and quality of services provided by the organization,
more efficient use of staff resources through:
3 improved collaboration between professionals,
3 specialists enabled to concentrate on specialist skills,
3 more effective use of paraprofessional staff.

Stages of interdisciplinary team development

In a review of the groupwork and teamwork literature there are many models of
group/team development. One comprehensive framework developed by
Tuckman (1984) which is used in both work with groups and teams is presented
in the table below. As the team evolves, it is helpful for members to have an
understanding of the common characteristics associated with each
developmental stage. Knowing what to expect can help social workers facilitate
the teams growth into a functional group.

Table 1: Stages of team development

Stage Description
Forming Members explore the boundaries of the group/team while trying
to determine the teams purpose.
Team members make the transition from individual to member
status.
Storming Conflict and uncertainty evolves within the team.
Members question their involvement in the team.

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 Norming Members begin to establish team boundaries and ground rules
necessary for the team to work effectively.
A sense of team cohesion develops behind a collectively
shared goal.
Performing Members accept one anothers strengths and weaknesses and
roles.
The teams sense of we-ness evolves to the point where
members understand the complementary nature of roles

IT IS NOT ALWAYS EASY: CHALLENGES ASSOCIATED

WITH INTERDISCIPLINARY TEAMWORK
It is important that all professionals be able to identify some of the common
pitfalls associated with teams so they can prevent them from being barriers to
effective, efficient and ethical service delivery. This section describes some of
the potential problems associated with teamwork. This analysis reflects
challenges identified in the literature and the authors own contentions.

Clashing professional cultures

Social workers who work as part of teams often describe the frustration of
dealing with medically trained professionals who they perceive as not sharing an
orientation towards the clients right to self-determination. At its core, this
frustration is about clashing professional cultures.

As with any professional education, social work education is about more than
acquiring skills and knowledge. It is a process of socialization through which
professionals acquire a unique culture, language, and values. Despite having a
significant impact on team functioning, the problems associated with differences
between professional cultures are rarely discussed. Indeed, as Abramson and
Mizrahi (1989) point out communication difficulties that arise on teams are
usually ascribed to interpersonal dynamics rather than being viewed as
interprofessional in nature. The challenge facing social workers, and all team
members, is to recognize the potential impact of clashing cultures on client care.

Potential problems with roles

The literature identifies a variety of potential problems associated with roles.
Some of these include:
Role competition: There is often subtle competition between professions
such as social workers, occupational therapists and nurses regarding turf
issues. This competition relates to the allocation of responsibilities and
benefits (i.e., whose assessment will be dominant and who will be the
primary counsellor or therapist).
Role ambiguity and overlap: The presence of role overlap, particularly
in an age of multiskilling, can also cause interdisciplinary tensions. Part
of the tension relates to the fact that each discipline must sacrifice some
degree of autonomy in order for collaboration to take place.
Role definition: Social workers and other team members often define
the social work role on the team differently. Abrahamson and Mizrahi

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 (1989) reviewed a number of studies on teamwork in which social
workers described their role as providing counseling to clients while the
physicians did not see this as a social work function.

Group think and tyranny of the group

In the literature regarding interdisciplinary teams, there is a great deal of attention
paid to the necessity to identify more strongly with ones team rather than ones
profession. The dark side of this kind of emphasis is the potential for what has
been called group think (Gambrill, 1990) and tyranny of the group (Malcom,
1971).

Group think is a subtle process through which group members come to think
alike and uncritically. The unconscious rule people follow in decision making is
if the group agrees with this, it must be true. When practicing on
interdisciplinary teams, this process can lead to invalid plans and decisions being
adopted.

Tyranny of the group is the direct and indirect pressure group members feel to
conform. This pressure is exerted as a means of reaching consensus and as a
means of ensuring positive interprofessional relationships. Tyranny of the group
can lead members to minimize differences and not consider alternative
assessments or intervention plans. Ultimately, this pressure to conform may lead
to decisions that are not in the best interest of clients.

Interdisciplinary teamwork and deprofessionalization

The trends towards multiskilling and the erosion of discipline-specific
supervision provides evidence that employers and policy makers have carried
some of the assumptions underpinning interdisciplinary practice to their illogical
conclusion. The assumption that team members can acquire the skills and
knowledge of other team members is flawed. By acting as if professional skills,
knowledge and competencies are interchangeable (the metaphor of professional
as machine), organizations demonstrate a suprising lack of appreciation for the
strengths associated with having diverse and complementary professional
cultures interacting. No where has this lack of appreciation been more evident
that in the Canadian institutional health care system where social work
practitioners are often supervised by non-social workers.

The call to action for social workers is to find ways to demonstrate their expertise,
and the unique value of their contribution to the teamwork process.

MAKING INTERDISCIPLINARY TEAMS WORK

In order for the potential pitfalls of interdisciplinary teamwork to be minimized, it is
important to be aware of and understand the characteristics of effective teams.

The literature offers many lists of the characteristics of effective teams (e.g.,
Larson and LaFasto, 1989). In reviewing these lists, it is evident that successful
teamwork depends on the active interplay of team dynamics and structure,
quality of members and leaders, and organizational support for teamwork.

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How You Can Contribute to Effective Teamwork
Social work education helps prepare social workers for interdisciplinary
teamwork. The generic practice skills associated with social work can enhance
team functioning; however, in order to maximize team effectiveness, social
workers need to be aware of the specific skills that they can bring to a team as a
member or leader.

As a team member
As a team member, you can play many roles within the team setting. Team
members can be a source of leadership (Abramson, 1989), can support the team
leader in his or her role, can facilitate team identity, can support problem solving,
and can work towards goal achievement. Social workers are skilled in all of
these areas, and can enable the team to work effectively by facilitating
communication, cooperation, compromise, and coordination within the team
(Skidmore,1995).

As a team member you can enhance team effectiveness by:

maintaining a sound professional identity and making competent
professional judgements reflecting social work values,
monitoring and evaluating team dynamics and encouraging the team
to look at important issues which are affecting its functioning,
supporting other team members who challenge the group or who
question group norms,
assisting the team to attain a sense of cohesion through positive
reinforcement of other members,
adding to the creativity of the team by freely expressing new ideas
which can stimulate others thinking while modeling respect for
differences within the team,
defining ones own area of expertise while respecting the role and
specialty of other disciplines on the team,
maintaining strong critical thinking skills.

Essentially, team members, similar to team leaders, should be attuned to both

the socioemotional and task aspects of team process. In order to do this, social
workers must possess a sound professional identity and able to define ones
specialty area and specificity.

As a leader
As a leader, you can enhance team functioning through the purposeful use of
skills. In addition to the generic skills of conflict resolution, consensus building,
and being able to monitor group process and dynamics, Abramson (1989)
suggests that as a team leader, social workers enhance team functioning by "(a)
creating an atmosphere in the team that is conducive to problem solving; (b)
identifying obstacles to problem solving; and (c) developing an administrative
structure for the team" (p. 53).

Creating a collaborative team atmosphere

acting ethically and professionally at all times,

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 creating a sense of shared vision among team members,
empowering team members to contribute to the team by facilitating and
supporting the open and rational discussion of difference,
modelling an optimistic view for the potential for effective teamwork and
problem solving and establishing standards of excellence,
mediating differences between members by supporting and promoting the
active and equal participation of all team members.

Identifying barriers to problem solving

creating member's identification with the team as a whole while
respecting each members professional values,
tuning-in to the power of language and attempting to eliminate the use of
discipline specific jargon,
monitoring and evaluating group process and dynamics and challenging
the team or individual members when needed,
tuning-in to members feelings prior to team meetings.

Developing an administrative structure of the team

contracting and, if needed, re-contracting the team's purpose, roles, and
norms,
ensuring that the team has appropriate physical space and scheduling,
preparing agendas for regular team meetings,
formal orientation for new members.

How organizations can contribute to effective teamwork

If the staff of an organization is expected to work in teams, the agency must
support teamwork. Organizations can support interdisciplinary teamwork by:

providing adequate resources must be provided to each team,

creating an organizational culture and structure that holds teamwork as the
norm and establishes strandards of excellence regarding team effectiveness,
respecting and valuing each discipline within the organization and its
contribute and role in effective teamwork,
ensuring that the organizations structure values each discipline equally by
avoiding a hierarchial structure which values one discipline over another,
establishing and reinforcing clearly defined routes of communication and
accountability,
supporting team identity and the identity of each profession.

CONCLUSION
Meeting clients needs requires shared professional responsibility and
many diverse skills (Levin and Hebert, 1997, p. 94).
Social workers who strongly identify with the professions skills, knowledge,
values and ethics will make a very important contribution to the teamwork
process. The strength of social work practice is found in its emphasis on viewing
client needs as existing within context of the social environment. It is this unique

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 perspective and the associated emphasis on client empowerment, that enables
social workers to contribute in the best interest of clients.
Social workers, as all professionals, must have confidence in the value of their
participation on the team. It is critical that social workers have a strong sense of
professional identity so that the unique perspective of social work practice can
contribute to the teams decision making process in the best interest of clients.
This is a great challenge for social workers whose identities have often been
formed by the nature of their employment, the culture of an organization or their
position title. The risks of not having a clear sense of the values, skills and
knowledge of the profession are described by Carlton (1991): When the
protection afforded by commitment to the profession weakens, or is surrendered
by clinical social workers capitulation to the knowledge, ethics, or procedures of
other disciplines, confusion of purpose and a devaluaing of the social work
contribution to the joint undertaking may result (p. 130). Social workers must
also be mindful of the need to market themselves at the organizational level by
demonstrating the added value of social work as part of the interdisciplinary
team.
If social workers are to play a vital role on interdisciplinary teams, they must be
prepared to capitalize on areas where expertise is acknowledged and further
advance areas of practice which have been traditionally underdeveloped or
misunderstood. This may involve challenging the assumptions held of other
team and organizational members. Social Workers should take pride in their
preparedness for interdisciplinary teamwork and have confidence in their
potential contribution to increasing the quality of service received by clients .

REFERENCES

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45-63.

Abramson, J. S., & Mizrahi, T. (1996). When social workers and physicians
collaborate: Positive and negative interdisciplinary experiences. Social Work,
41(3), 270-281.

Carlton, T.O. (1984). Clinical social work in collaborative health care practice. In
Clinical Social Work in Health Settings: A Guide to Professional Practice with
Exemplars. (pp.124-141) NewYork: Springer Publishing Comp.

Gambrill, E. (1991) Enhancing the quality of case conferences and discussions.

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Garner, H. G. (1994). Critical issues in teamwork. In H. G. Howard, & F. P.

Orelove (Eds.), Teamwork in human services: Models and applications across
the life span (pp. 1-18). MA: Butterworth-Heinemann.

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Garner, H. G. (1994). Multidisciplinary versus interdisciplinary teamwork. In
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Levin, R., & Herbert, M. (1997). The social workers domain: Perceptions of
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Malcolm, A. (1993). The Tyranny of the Group. Toronto: Clarke Irwin.

Mariano, C. (1989). The case for interdisciplinary collaboration. Nursing

Outlook, 37, 285-288.

McGrath, M. (1991). Introduction. In Multidisciplinary teamwork. (pp. 1-14).

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Skidmore, R. (1995). The dynamic nature of teamship. In Social work

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Stirling, T.B. (1997). Voluntarism in the 1920's: The child welfare association
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