3 CommunicationChallengesinaDiverse,GlobalMarketpl.docx

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3 Communication Challenges in a Diverse,
Global Marketplace
LEARNING OBJECTIVES
After studying this chapter, you will be able to
1
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Discuss the opportunities and challenges of intercultural
communication.
2
ections/p7001012451000000000000000001bb4#P700101245100
0000000000000001BBA)
De�ine culture, explain how culture is learned, and de�ine
ethnocentrism and stereotyping.
3
ections/p7001012451000000000000000001b�b#P700101245100
0000000000000001BFF)
Explain the importance of recognizing cultural variations,
and list eight categories of cultural differences.
4
ections/p7001012451000000000000000001c9b#P700101245100

0000000000000001CA0) List
four general guidelines for adapting to any business culture.
5
ections/p7001012451000000000000000001cc6#P700101245100
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Identify seven steps you can take to improve your
intercultural communication skills.
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COMMUNICATIONCLOSE-UP AT
Kaiser Permanente
kp.org (http://kp.org)
Delivering quality health care is dif�icult enough, given the
complexities of technology, government regulations, evolving
scienti�ic and medical understanding, and
the variability of human performance. It gets even more
daunting when you add the challenges of communication among
medical staff and between patients and
their caregivers, which often takes place under stressful
circumstances. Those communication efforts are challenging
enough in an environment where everyone
speaks the same language and feels at home in a single cultural
context—but they’re in�initely more complex in the United
States, whose residents identify with
dozens of different cultures and speak several hundred

languages.
The Oakland-based health-care system Kaiser Permanente has
been embracing the challenges and opportunities of diversity
since its founding in 1945. It made a
strong statement with its very �irst hospital when it refused to
follow the then-common practice of segregating patients by
race. Now, as the largest not-for-pro�it
health system in the United States, Kaiser’s client base includes
more than 10 million members from over 100 distinct cultures.
At the core of Kaiser’s approach is culturally competentcare,
which it de�ines as “health care that acknowledges cultural
diversity in the clinical setting, respects
members’ beliefs and practices, and ensures that cultural needs
are considered and respected at every point of contact.” These
priorities are woven into Kaiser’s
organizational culture, structure, and business practices.
Kaiser Permanente CEO Bernard J. Tyson
believes a culturally competentworkforce is
essential to the health provider’saim of serving
the diverse U.S. population.
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REUTERS/Mario Anzuoni
Delivering this standard of care requires a mix of skills and
knowledge that range from an awareness of medical issues of
concern to speci�ic cultures to language
�luency (and translation skills in more than 100 languages) to
the awareness needed to handle cultural traditions and values in
a sensitive manner. Kaiser’s
Centers of Excellence in Culturally Competent Care at facilities
around the country are a good example of the extent the
company takes to serve its diverse
clientele. Each center focuses on one or more cultures
prominent in a given locale, with a particular emphasis on
improving care outcomes for population
segments that have historically been underserved.
Kaiser believes that effectively serving a diverse client base
requires an equally diverse staff. As the chairman and CEO
Bernard J. Tyson explains, “The rich
diversity of our organization re�lects the diversity of the
people we serve each and every day.” Nearly half the executive
team are women, for example, and people
of color make up nearly 60 percent of the company’s workforce.
In addition to helping Kaiser communicate more effectively
with its customers, the strategic emphasis on diversity and
inclusion is good for businesses. Its target

market segments also happen to be among the country’s fastest-
growing demographic groups, and Kaiser’s ability to connect
with these audiences gives it an
important competitive advantage.1
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3.1 Understanding the Opportunities and Challenges of
Communication in a Diverse World
LEARNING OBJECTIVE
1 Discuss the opportunities and challenges of intercultural
communication.
Diversity includes all the characteristics that de�ine people as
individuals.
Kaiser Permanente (pro�iled in the chapter-opening
Communication Close-Up) illustrates the opportunities and the
challenges for business professionals who
know how to communicate with diverse audiences. Although the
concept is often framed in terms of ethnic background, a
broader and more useful de�inition of
diversity
ections/p7001012451000000000000000001e0f#P700101245100
0000000000000001E25) includes
“all the characteristics and experiences that de�ine each of us

as individuals.”2
ns/p7001012451000000000000000001e0f#P7001012451000000
000000000001ED4) As one example, the
pharmaceutical company Merck identi�ies 19 separate
dimensions of diversity, including race, age, military
experience, parenting status, marital status, and
thinking style.3
ections/p7001012451000000000000000001e0f#P700101245100
0000000000000001ED6) As
you’ll learn in this chapter, these characteristics and
experiences can have a profound effect on the way
businesspeople communicate.
MOBILE APP
Culture Compass offers insights into more than 100 countries
around the world.
Intercultural communication
ns/p7001012451000000000000000001e0f#P7001012451000000
000000000001E35) is the process of
sending and receiving messages between people whose cultural
backgrounds could lead them to interpret verbal and nonverbal
signs differently. Every attempt
to send and receive messages is in�luenced by culture, so to
communicate successfully, you need a basic understanding of
the cultural differences you may
encounter and how you should handle them. Your efforts to
recognize and bridge cultural differences will open up business
opportunities throughout the world
and maximize the contributions of all the employees in a
diverse workforce.

OPPORTUNITIES IN A GLOBAL MARKETPLACE
You will communicate with people from many other cultures
throughout your career.
Chances are good that you’ll be working across international
borders sometime in your career. Thanks to communication and
transportation technologies,
natural boundaries and national borders are no longer the
impassable barriers they once were. Local markets are opening
to worldwide competition as
businesses of all sizes look for new growth opportunities
outside their own countries. Thousands of U.S. businesses
depend on exports for signi�icant portions of
their revenues. Every year, these companies export hundreds of
billions of dollars’ worth of materials and merchandise, along
with billions more in personal and
professional services. If you work in one of these companies,
you may well be called on to visit or at least communicate with
a wide variety of people who speak
languages other than English and who live in cultures quite
different from what you’re used to. Among the United States’s
top 10 global trading partners, only
Canada and Great Britain have English as an of�icial language;
Canada also has French as an of�icial language.4
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000000000001ED8)
Not surprisingly, effective communication is important to cross-
cultural and global business. In a recent survey, nearly 90
percent of executives said their
companies’ pro�its, revenue, and market share would all
improve with better international communication skills. In
addition, half of these executives said
communication or collaboration breakdowns had affected major

international business efforts in their companies.5
ns/p7001012451000000000000000001e0f#P7001012451000000
000000000001EDA) The good news here
is that improving your cultural communication skills could
make you a more valuable job candidate at every stage of your
career.
ADVANTAGES OF A DIVERSE WORKFORCE
The diversity of today’s workforce brings distinct advantages to
businesses:
A broader range of views and ideas
A better understanding of diverse, fragmented markets
A broader pool of talent from which to recruit
Even if you never visit another country or transact business on a
global scale, you will interact with colleagues from a variety of
cultures and with a wide range of
characteristics and life experiences. Many innovative companies
are changing the way they approach diversity, from seeing it as
a legal requirement (providing
equal opportunities for all) to seeing it as a strategic
opportunity to connect with customers and take advantage of the
broadest possible pool of talent.6
ns/p7001012451000000000000000001e0f#P7001012451000000
000000000001EDC) Smart business
leaders recognize the competitive advantages of a diverse
workforce that offers a broader spectrum of viewpoints and
ideas, helps businesses understand and
identify with diverse markets, and enables companies to
bene�it from a wider range of employee talents. “It just makes
good business sense,” says Gord Nixon,

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the CEO of the Royal Bank of Canada.7
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REAL-TIME UPDATES
LEARN MORE BY VISITING THIS
WEBSITE
Looking for jobs at diversity-minded companies?

DiversityWorking.com (http://DiversityWorking.com)
connects job searchers with companies that recognize the
value of diverse workforces. Go to
www.real-timeupdates.com/bct14 (http://www.real-
timeupdates.com/bct14) and select Learn More in the Students
section.
Diversity is simply a fact of life for all companies. The United
States has been a nation of immigrants from the beginning, and
that trend continues today. The
western and northern Europeans who made up the bulk of
immigrants during the nation’s early years now share space with
people from across Asia, Africa,
Eastern Europe, and other parts of the world. Across the United
States, the term minority as it is traditionally applied to
nonwhite residents makes less and less
sense every year. Non-Hispanic white Americans now account
for about 60 percent of the overall U.S. population, but that
�igure will drop below 50 percent in
two or three decades. Caucasian Americans already make up
less than half the population in hundreds of cities and
counties.8
ns/p7001012451000000000000000001e0f#P7001012451000000
000000000001EE0)
However, you and your colleagues don’t need to be recent
immigrants to constitute a diverse workforce. Differences in
everything from age and gender
identi�ication to religion and ethnic heritage to geography and
military experience enrich the workplace. Immigration and
workforce diversity create advantages
—and challenges—for business communicators throughout the
world.

REAL-TIME UPDATES
LEARN MORE BY EXPLORING THIS
INTERACTIVE WEBSITE
Take a closer look at how the United States is
changing
The U.S. population is aging and becoming more diverse; dive
into the details with this interactive presentation. Go to
www.real-timeupdates.com/bct14
(http://www.real-timeupdates.com/bct14) and select Learn
More in the Students section.
THE CHALLENGES OF INTERCULTURAL
COMMUNICATION
Today’s increasingly diverse workforce encompasses a wide
range of skills, traditions, backgrounds, experiences, outlooks,
and attitudes toward work—all of
which can affect communication in the workplace. Supervisors
face the challenge of connecting with these diverse employees,
motivating them, and fostering
cooperation and harmony among them. Teams face the challenge
of working together closely, and companies are challenged to
coexist peacefully with business
partners and with the community as a whole.
A company’s cultural diversity affects how its business
messages are conceived, composed, delivered, received, and
interpreted.
The interaction of culture and communication is so pervasive
that separating the two is virtually impossible. The way you
communicate is deeply in�luenced by
the culture in which you were raised. The meaning of words, the
signi�icance of gestures, the importance of time and space, the

rules of human relationships—
these and many other aspects of communication are de�ined by
culture. To a large degree, your culture in�luences the way you
think, which naturally affects the
way you communicate as both a sender and a receiver.9
ns/p7001012451000000000000000001e0f#P7001012451000000
000000000001EE2) Intercultural
communication is much more complicated than simply matching
language between sender and receiver; it goes beyond mere
words to beliefs, values, and
emotions.
Culture in�luences everything about communication, including
Language
Nonverbal signals
Word meaning
Time and space issues
Rules of human relationships
Elements of human diversity can affect every stage of the
communication process, from the ideas a person deems
important enough to share to the habits and
expectations of giving feedback. In particular, your instinct is
to encode your message using the assumptions of your culture.
Members of your audience, however,
decode your message according to the assumptions of their
culture. The greater the difference between cultures, the greater
the chance for misunderstanding.10
ns/p7001012451000000000000000001e0f#P7001012451000000
000000000001EE4)
Throughout this chapter, you’ll see examples of how
communication styles and habits vary from one culture to

another. These examples are intended to illustrate
the major themes of intercultural communication, not to give an
exhaustive list of the styles and habits of any particular culture.
With an understanding of these
major themes, you’ll be prepared to explore the speci�ics of
any culture.
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3.2 Developing Cultural Competency
LEARNING OBJECTIVE
2 De�ine culture, explain how culture is learned, and de�ine
ethnocentrism and stereotyping.
Cultural competency requires a combination of attitude,
knowledge, and skills.
Cultural competency

ns/p7001012451000000000000000001e0f#P7001012451000000
000000000001E15) includes an
appreciation for cultural differences that affect communication
and the ability to adjust one’s communication style to ensure
that efforts to send and receive
messages across cultural boundaries are successful. In other
words, it requires a combination of attitude, knowledge, and
skills.11
ns/p7001012451000000000000000001e0f#P7001012451000000
000000000001EE6) Kaiser Permanente,
pro�iled at the beginning of the chapter, is a good example of a
contemporary organization that values cultural competency so
highly that it makes it a high-level
strategic imperative.
Achieving cultural competency can take time and effort, but the
good news is you’re already an expert in culture—at least the
culture in which you grew up. You
understand how your society works, how people are expected to
communicate, what common gestures and facial expressions
mean, and so on. The bad news is
that because you’re such an expert in your own culture, your
communication is largely automatic; that is, you rarely stop to
think about the communication rules
you’re following. An important step toward successful
intercultural communication is becoming more aware of these
rules and the way they in�luence your
communication.
REAL-TIME UPDATES
LEARN MORE BY READING THIS
INFOGRAPHIC

How not to behave in 15 countries
These brief and occasionally humorous pointers will help keep
you out of trouble. Go to real-timeupdates.com/bct14
(http://real-timeupdates.com/bct14)
and select Learn More in the Students section.
UNDERSTANDING THE CONCEPT OF CULTURE
Culture is a shared system of symbols, beliefs, attitudes, values,
expectations, and behavioral norms.
Culture
ections/p7001012451000000000000000001e0f#P700101245100
0000000000000001E21) is a shared
system of symbols, beliefs, attitudes, values, expectations, and
norms for behavior. Your cultural background in�luences the
way you prioritize what is important
in life, helps de�ine your attitude toward what is appropriate in
a given situation, and establishes rules of behavior.12
ns/p7001012451000000000000000001e0f#P7001012451000000
000000000001EE8)
You belong to several cultures, each of which affects the way
you communicate.
Actually, you belong to several cultures. In addition to the
culture you share with all the people who live in your own
country, you belong to other cultural groups,
including an ethnic group, possibly a religious group, and
perhaps a profession that has its own special language and
customs. With its large population and long
history of immigration, the United States is home to a vast array
of cultures (see Figure 3.1

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ns/p7001012451000000000000000001e0f#P7001012451000000
000000000001EEA) In contrast, Japan is
much more homogeneous, having only a few distinct cultural
groups.14
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000000000001EEC)
Members of a given culture tend to have similar assumptions
about how people should think, behave, and communicate, and
they all tend to act on those
assumptions in much the same way. Cultures can vary in their
rate of change, degree of complexity, and tolerance toward
outsiders. These differences affect the
level of trust and openness you can achieve when
communicating with people of other cultures.
You learn culture both directly (by being instructed) and
indirectly (by observing others).
People learn culture directly and indirectly from other members
of their group. As you grow up in a culture, you are taught by
the group’s members who you are
and how best to function in that culture. Sometimes you are
explicitly told which behaviors are acceptable. At other times
you learn by observing which values
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work best in a particular group. In these ways, culture is passed
on from person to person and from generation to generation.15
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Cultures tend to offer views of life that are both coherent
(internally logical) and complete (able to answer all of life’s big
questions).
In addition to being automatic, culture tends to be coherent; that
is, a culture seems to be fairly logical and consistent when
viewed from the inside. Certain norms
within a culture may not make sense to someone outside the
culture, but they probably make sense to those inside. Such

coherence generally helps a culture
function more smoothly internally, but it can create disharmony
between cultures that don’t view the world in the same way.
Finally, cultures tend to be complete; that is, they provide their
members with most of the answers to life’s big questions. This
idea of completeness dulls or even
suppresses curiosity about life in other cultures. Not
surprisingly, such completeness can complicate communication
with other cultures.16
ns/p7001012451000000000000000001e0f#P7001012451000000
000000000001EF0)
Figure 3.1 Language Diversity in the United States
Language is one of the distinguishing factors of population
diversity. This chart shows the trend in the relative ranking of a
number of languages other than
English spoken in the United States since 1980.
Source: “Top Languages Other than English Spoken in 1980 and
Changes in Relative Rank, 1990-2010,” U.S. Census Bureau, 14
February 2013, www.census.gov (http://www.census.gov) .
OVERCOMING ETHNOCENTRISM ANDSTEREOTYPING
Ethnocentrism is the tendency to judge all other groups
according to the standards, behaviors, and customs of one’s own
group.
Ethnocentrism
ections/p7001012451000000000000000001e0f#P700101245100
0000000000000001E29) is
the tendency to judge other groups according to the standards,

behaviors, and customs of one’s own group. Given the
automatic in�luence of one’s own culture,
when people compare their culture with others, they often
conclude that their own is superior.17
ns/p7001012451000000000000000001e0f#P7001012451000000
000000000001EF2) An even more
extreme reaction is xenophobia
ns/p7001012451000000000000000001e0f#P7001012451000000
000000000001E41) , a fear of strangers
and foreigners. Clearly, businesspeople who take these views
are not likely to communicate successfully across cultures.
Stereotyping is assigning generalized attributes to an individual
on the basis of membership in a particular group.
Distorted views of other cultures or groups also result from
stereotyping
ns/p7001012451000000000000000001e0f#P7001012451000000
000000000001E3D) , assigning a wide
range of generalized attributes to an individual on the basis of
membership in a particular culture or social group. For instance,
assuming that an older colleague
will be out of touch with the youth market or that a younger
colleague can’t be an inspiring leader would be stereotyping age
groups.
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Cultural pluralism is the acceptance of multiple cultures on
their own terms.
Those who want to show respect for others and to communicate
effectively in business need to adopt a more positive viewpoint
in the form of cultural
pluralism
ections/p7001012451000000000000000001e0f#P700101245100
0000000000000001E1D) —the
practice of accepting multiple cultures on their own terms.
When crossing cultural boundaries, you’ll be more effective if
you move beyond simple acceptance
and adapt your communication style to that of the new cultures
you encounter—even integrating aspects of those cultures into
your own.18
ns/p7001012451000000000000000001e0f#P7001012451000000
000000000001EF4) A few simple habits
can help:

You can avoid ethnocentrism and stereotyping by avoiding
assumptions, withholding judgment, and accepting differences.
Avoid assumptions. Don’t assume that others will act the
same way you do, use language and symbols the same way you
do, or even operate from the
same values and beliefs. For instance, in a comparison of the 10
most important values in three cultures, people from the United
States had no values in
common with people from Japanese or Arab cultures.19
ns/p7001012451000000000000000001e0f#P7001012451000000
000000000001EF6)
Withhold judgment. When people act differently, don’t
conclude that they are in error or that their way is invalid or
inferior.
Acknowledge distinctions. Don’t ignore the differences
between another person’s culture and your own.
Unfortunately, overcoming ethnocentrism and stereotyping is
not a simple task, even for people who are highly motivated to
do so. Moreover, research suggests
that people often have beliefs and biases that they’re not even
aware of—and that may even con�lict with the beliefs they
think they have.20
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…

Physical and Mental Health
Not really, but…..
◦ Higher likelihood of suffering from chronic diseases
and illness
◦ Lack of exercise or mobility can lead to weaker
muscles and bones
The degree to which a chronic health problem
produces behavior changes in your ability to
perform the necessary tasks for daily living.
◦ Eating
◦ Bathing
◦ Shopping
◦ Preparing meals
◦ Managing money
◦ Get outside
◦ Dressing
◦ Toileting
Nearly ½ million deaths a year
Heart attack, cancer, and stroke all connected
to smoking
Associated with COPD – chronic obstructive
pulmonary disease (emphysema and
bronchitis)
Has been a decline in smoking, across

genders and races
Most important lifestyle influence on health
after not smoking, especially as we age
Regular exercise leads to
◦ stronger muscles and muscle control
◦ fewer backaches and joint problems
◦ more control over weight
Regular mild exercise (walking 30 mins/day)
more effective long term than occasional
intense exercise
Informal and unpaid care provided to a
dependent person
◦ By family members, other relatives or friends
Most caregivers are women
Helps to hasten recovery from injury and
illness
Positive effect on physiological and mental
health systems
Emotional support related to reduced risk of
mortality after serious injury or illness
Elderly who are directly cared for by family
members more likely to live longer
Women are more likely to live longer than
men, but…

◦ Greater risk of disability
◦ Diminished quality of life as they age
◦ Higher rates of debilitating diseases than men
Men are at greater risk of cancer, heart disease, and
stroke
◦ Women have higher rates of depression
African Americans, Hispanics, and Native
Americans have poorer health than whites
◦ Likely also related to SES, lack of healthy food
access, and other factors that are connected to race
and longevity
Alzheimer’s Disease
Parkinson’s Disease
Depression
All have mental and physical components.
All are related to aging but not necessarily a
condition of aging.
AgingDoes aging make you unhealthy?Functional StatusEffect
of SmokingEffect of ExerciseCaregivingSocial Support
SystemsGendered HealthHealth and RaceMental Health and
Aging
A Healthy Aging Program for Older Adults: Effects on Self-
Efficacy and Morale

Matthew Scult, BS,
Graduate Student, Center for Cognitive Neuroscience, Duke
University, Durham, NC, USA
Vivian Haime, BS,
Clinical Research Coordinator, Benson-Henry Institute for Mind
Body Medicine
Jolene Jacquart, BS,
Clinical Research Coordinator, Benson-Henry Institute for Mind
Body Medicine
Jonathan Takahashi, MD, MPH,
Resident Physician, Department of Family Medicine, University
of Wisconsin-Madison, Madison,
WI, USA
Barbara Moscowitz, MSW, LICSW,
Program Director of Senior HealthWise, Geriatric Medicine
Unit, Massachusetts General Hospital,
Boston, MA, USA
Ann Webster, PhD,
Director of Mind Body Program for Successful Aging, Benson-
Henry Institute for Mind Body
Medicine, Massachusetts General Hospital, and Associate in
Psychiatry, Department of
Psychiatry, Massachusetts General Hospital and, Instructor in
Medicine, Harvard Medical School,
Boston, MA, USA
John W. Denninger, MD, PhD, and
Director of Research, Benson-Henry Institute for Mind Body
Medicine, Massachusetts General
Hospital and Instructor in Psychiatry, Department of Psychiatry,

Massachusetts General Hospital
and Harvard Medical School, Boston, MA, USA
Darshan H. Mehta, MD, MPH
Medical Director, Benson-Henry Institute for Mind Body
Medicine, Massachusetts General
Hospital and Instructor in Medicine, Department of Medicine,
Massachusetts General Hospital
and Harvard Medical School, Boston, MA, USA
Abstract
Correspondence: Darshan Mehta, MD, Benson-Henry Institute
at Massachusetts General Hospital, 151 Merrimac Street, 4th
Floor,
Boston, MA 02114Tel: 617-643-6046, Fax: 617-643-6077,
[email protected]
Financial Disclosure: This work was supported by the Harvard
Catalyst at the Harvard Clinical and Translational Science
Center, the
National Center for Research Resources, and the National
Center for Advancing Translational Sciences at the National
Institutes of
Health (Award #UL1 RR 025758 and financial contributions
from Harvard University and its affiliated academic healthcare
centers).
The content is solely the responsibility of the authors and does
not necessarily represent the official views of Harvard Catalyst,
Harvard University and its affiliated academic healthcare
centers, or the National Institutes of Health.
HHS Public Access
Author manuscript
Adv Mind Body Med. Author manuscript; available in PMC
2015 May 19.

Published in final edited form as:
Adv Mind Body Med. 2015 ; 29(1): 26–33.
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Context—As of 2012, 810 million people were over the age of
60 worldwide, accounting for 11
percent of the population. That number is expected to rise to 2
billion by 2050 or to 22 percent of
the overall population. As a result, a growing need exists to
understand the factors that promote
mental and physical health in older populations.
Objectives—The purpose of this study was to develop a healthy

aging program for older adults
and to measure the changes from baseline to the end of the
program in participants’ relevant
psychosocial outcomes; ie, self-efficacy and morale.
Design—The study’s Healthy Aging Mind Body Intervention
(MBI) was adapted from the
Relaxation Response Resiliency Program (3RP) at the Benson-
Henry Institute for Mind Body
Medicine (BHI), which incorporates elements from the fields of
stress management, cognitive-
behavioral therapy, and positive psychology. That program was
modified with examples and
exercises targeted to an older population, and evaluated in the
current, single-arm, pilot study.
Setting—The program took place at the Massachusetts General
Hospital (MGH).
Participants—The 9-week Healthy Aging MBI was developed
for participants aged 65 and
over. Fifty-one older adults from the surrounding community
participated in the study’s groups.
Intervention—A new intervention group began the program
every 3 months, with a maximum of
12 individuals per group. For each group, the MBI consisted of
weekly, 90-minute sessions for 9
consecutive weeks, directed by a psychologist. The program
included sessions that taught

participants: (1) a variety of methods to elicit the relaxation
response (RR), (2) the practice of
adaptive coping and cognitions, (3) behaviors necessary to
create a healthy lifestyle, and (4)
methods of building social support.
Outcome Measures—The research team chose to focus on 2
psychological variables of interest
for aging populations: morale and self-efficacy. The study used
2 questionnaires to measure those
outcomes, the Philadelphia Geriatric Center Morale Scale
(PGCMS), a multidimensional measure
of the psychological state of older people, and the Coping Self-
Efficacy Scale (CSES), a measure
that addresses the multiple dimensions of self-efficacy.
Results—Data from 5 intervention groups were combined for
the current analysis. Forty-six
participants enrolled and completed questionnaires. Of those
participants, 41 attended at least 7
out of the 9 sessions. Significant increases in self-efficacy and
morale were observed for program
completers. After a highly conservative sensitivity analysis, the
change for the measure of self-
efficacy remained significant, and the change for the measure of
morale trended toward
significance.

Conclusions—The study’s healthy aging program appears to be
a feasible intervention for older
adults, with the potential to increase levels of self-efficacy and
morale in participants. Further
research is warranted to determine its effects on other
psychosocial outcomes and healthcare
utilization in aging populations.
Keywords
Mind-body; successful aging; psychosocial; self-efficacy;
morale
Scult et al. Page 2
2015 May 19.
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As of 2012, 810 million people were over the age of 60
worldwide, accounting for 11
percent of the population. That number is expected to rise to 2
billion by 2050 and to
represent 22 percent of the overall population, with older adults
surpassing the number of
children.1 As the world population ages, demand will increase
for the management of
chronic conditions and of needs for long-term care.2 Given a
forecasted shortage of
healthcare providers, the increase in demand for these services
represents a growing public-
health concern.2 Many chronic conditions, such as diabetes and
hypertension, can be
managed with the help of behavioral interventions.3–5 In the
context of efforts to meet
patients’ care needs while slowing growth of healthcare
spending, an imminent interest
exists in exploring interventions that promote self-care in older
populations so that they can

better prevent, manage, and cope with mental and physical
ailments.6–7
INNOVATION: THE HEALTHY AGING PROGRAM
Benefits
Healthy aging programs combine insights from programs for
chronic-disease management
and mind-body interventions (MBIs), with the goal of
improving self-care for older adults.
Some studies have demonstrated the value of interventions for
improving self-care through
mind-body techniques in older adults,8 but most have tended to
focus on the use of MBI for
participants with a single medical condition, such as chronic
back pain or hypertension.9,10
For example, an intervention in 1577 Medicare patients found
that individuals who had
myocardial infarctions or who had received cardiac procedures
demonstrated significantly
lower hospitalization rates after completing a multicomponent
MBI. The findings for the
intervention group also showed trends for yearly savings in the
cost of care and lower
overall rates of mortality when compared to those of control

participants.11
Initial studies with heterogeneous populations have also been
encouraging. One such
multicomponent intervention found decreases in self-reported
sleep difficulties, pain,
anxiety, and depressive symptoms compared to a control group
as well as changes in the
health locus of control beliefs, which describe a patient’s
beliefs about their ability to control
their health.12 It was found that stronger beliefs of ability to
control health outcomes, for
example beliefs about ability to control stress levels and coping,
were related to greater
positive health behaviors. At a one-year follow-up, the study’s
intervention group
maintained its benefits related to sleep and locus of control and
also showed an increase in
health behaviors; such as engaging in exercise, maintaining
good nutrition, having
interpersonal support and utilizing stress management
techniques.12
Another study enrolled patients with chronic diseases in a
community-based, self-
management program that taught exercise, relaxation

techniques, nutrition, sleep
management, strategies for emotional regulation, and methods
for health-related
communication and decision making. The program resulted in
improved health behaviors
and status as well as fewer hospitalizations and fewer days of
hospitalization compared to
waitlisted controls.13 Results were maintained at a 2-year,
follow-up evaluation, including
evidence that the program reduced healthcare costs.14
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2015 May 19.
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The studies discussed above have demonstrated that programs
for chronic-disease
management have the potential to reduce both use of the
healthcare system and healthcare
costs, while they improve patients’ health; however, further
research is needed to test the
effectiveness of healthy aging interventions more broadly
applicable to the promotion of
self-care in older adults.
Conceptual Basis
Healthy aging programs have been inspired by group MBIs that
focus on elicitation of the
relaxation response (RR). The RR is a physiological state that is
characterized by decreased
heart rate, blood pressure, rate of breathing, and muscle tension.
Regular elicitation of the
RR has been shown to be an effective therapeutic strategy for a
wide range of stress-related
and chronic diseases, including immunological, cardiovascular,

and neurodegenerative
diseases,15 and has also been shown to aid in improving
attention in older adults.16 RR-
based MBIs also appear to be effective in decreasing symptoms
in patients suffering from
depression and anxiety.17,18 Furthermore, elicitation of the RR
has been shown to have
profound effects on physiology, including altering the genetic
expression of gene families
involved in oxidative stress, energy metabolism, and
inflammation,19 which can impact
processes related to chronic diseases.
In addition to elicitation of the RR, healthy aging programs are
based on promoting other
aspects of resiliency.20 One aspect is physical activity. Regular
physical activity is
particularly important for the physical and mental health of
older adults.21 Previous studies
have shown that regular physical activity can produce long-term
health benefits, such as
improved cognitive function, better sleep quality, lower risk of
falls and broken bones,
increased positive well-being, and improved quality of
life.22,23 Regular physical activity

has also been shown to reduce the risk of some age-related
diseases and disabilities; eg,
balance problems or difficulties walking, as well as to manage
many chronic conditions,
such as arthritis, heart disease, and chronic pain.24,25
Another component of resiliency that is important for aging
populations is having a sense of
purpose in life and a strong social network. Several studies
among aging populations have
suggested high levels of social activity and support are related
to greater physical health,26
life satisfaction, and happiness27 as well as to better physical
and cognitive functioning,
greater overall well-being, and reduced mortality.28,29 One
study found that friendship
identity, the meaning attributed to oneself in the role as friend
(i.e. “As a friend I am…”
“social”, “confident”, “happy”, “open”, “warm”, “successful”,
“interested”), predicted well-
being more than income or marital status.30 A sense of purpose
has also emerged as an
important factor for aging populations. Another study found that
adults aged 50 and older

who were highly engaged in work or volunteer activities,
reported greater psychological
well-being than those who were not involved.31
A Program for Older Adults
The new Healthy Aging MBI was developed for participants
aged 65 and over. It was
designed to be accessible to a broad population, and for that
reason, was implemented at a
low cost and through a community-care setting. It was
implemented in collaboration with
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2015 May 19.
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MGH Senior HealthWISE, a free hospital-based community
benefit program designed to
enhance the health and well-being of older adults in the
neighborhoods surrounding MGH.
The goal of HealthWISE is to improve health management
through education and support,
as well as provide opportunities for socialization, exercise and
connection to community
resources for individuals over the age of 60.
The new program was adapted from the Relaxation Response
Resiliency Program (3RP) at
the Benson-Henry Institute for Mind Body Medicine (BHI),20
which incorporates elements
from the fields of stress management, cognitive-behavioral
therapy, and positive
psychology. The current research team modified that program
by creating examples and
exercises targeted to an older population. Overall, the new
program was developed to

promote skills that could enhance the psychosocial variables
that are important for the health
of older populations: self-efficacy and morale.
Self-efficacy—Self-efficacy, a person’s belief in his or her
ability to influence life
events,32 has been associated with increased self-care among
older persons,33 as well as
with improvements in older persons’ ratings of their healthy
aging.6 Self-efficacy has also
been found to act as a mediator of changes in health behaviors
and in use of the healthcare
system.14,34 For older adults, self-efficacy has also been
related to increased energy, better
sleep, and decreased pain and discomfort as well as with overall
satisfaction with life.33
Improving self-efficacy in aging populations is an important
goal because self-efficacy has
been associated with increased resilience against development
of depression35 and with
better overall health.36
Morale—Another important psychosocial factor, morale has
also been positively associated
with healthy aging. Morale is a multidimensional construct that
includes the amount of
anxiety experienced, an individual’s attitude toward his or her

own aging, and the level of
acceptance or dissatisfaction with social interactions.37,38 A
better state of morale has been
shown to be negatively associated with functional disability and
positively associated with
strength of social network and level of activity.39 Furthermore,
it has been shown to be an
independent predictor of physical-health outcomes, such as
decreased incidence of stroke40
and overall mortality.41
In its current, single-arm, pilot study, the research team
evaluated the feasibility of the new
Healthy Aging MBI and recorded self-reported levels of self-
efficacy and morale. The team
hypothesized that participants would demonstrate increases in
self-efficacy and morale
relative to their baseline assessments after completing the
groups.
METHODS
Participants
To obtain participants, the current study’s MBI program was
advertised via the
Massachusetts General Hospital’s (MGH’s) newsletter. The

group facilitator also gave a
public lecture previewing the program at MGH. Subjects were
recruited from individuals
participating in the MGH Senior HealthWISE program. Patients
were screened for their
ability to participate in the program (attend session, follow
instructions, do home practice).
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Also, it was ensured that patients had an established primary
care provider, in case of any
acute medical issues to be addressed.
An initial intake assessment was conducted by an internal-
medicine physician and a
psychologist. Participants were required to be 65 or over, have
no acute psychiatric or
medical condition that would substantially interfere with group
participation, and be able to
speak and understand English. Approval for the use of human
participants was obtained
from the Partners Human Research Committee. Participants
were informed in the written
consent about the nature of the study. Fifty-one older adults
participated in the groups.
Intervention
A new intervention group began the new MBI program every 3
months, with a maximum of
12 individuals per group. Five groups of 8–12 individuals
participated in the intervention.
For each group, the program consisted of weekly, 90-minute
sessions for 9 consecutive

weeks, directed by a psychologist. Each session had one or two
central themes and multiple
sub-themes. The program included sessions that taught
participants: (1) a variety of methods
to elicit the RR, including breath focus, single-pointed focus,
imagery, contemplation, chair
yoga, and mindful awareness, which all involve repeatedly
bringing the attention gently
back to either the breath, an imagined scene, movement or one
of the senses; (2) the practice
of adaptive cognitive coping and cognitions; eg, optimism and
acceptance, (3) behaviors
necessary to create a healthy lifestyle; eg, recommendations for
nutrition, exercise, and
restorative sleep; and (4) methods of building social support.
Details of the program are
provided in Table 1.
Throughout the course of treatment, participants were asked to
elicit the RR at home each
day, through development of a consistent mind-body practice.
They were instructed to use
the provided CD, recorded by the psychologist, to practice a
meditation for 20 minutes daily.
Self-monitoring diary sheets were provided to participants to

help them keep a record of
their daily meditation practice. Participants also completed brief
homework activities that
reinforced the concepts learned during group sessions. The
group’s facilitator collected the
diary sheets and written homework each week and handed them
back the following week
with written comments.
In addition to focusing on elicitation of the RR and increasing
resiliency, the new program
also focused on increasing self-efficacy and morale as well as
promoting healthy lifestyles.
Two practices for achieving healthy lifestyles, (1) mindful
eating, which involves slowly
eating and being aware of the sensations associated with each
bite, (2) and physical activity
was promoted through chair-yoga sessions. Chair yoga involves
a sequence of stretches that
participants perform while seated that brings attention to
physical activity in a non-
judgmental and accessible manner. Participants were also
encouraged to incorporate regular
physical activity into their days. In addition, participants
engaged in experiential exercises

related to mindful eating during group sessions and explored
food choices that promote
resilience.
Through the group-based approach, participants also explored
ways in which to develop the
healthy aspects of social support. Participants were asked to
keep daily appreciation
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journals, in which they wrote about people and events in their
lives that they were thankful
for. They would also begin sessions by sharing “news and
goods,” recent positive events,
with the group. Participants were asked to explore and
challenge patterns of distorted or
irrational automatic thoughts that were prevalent in their lives
through the use of diary
entries and worksheets. Participants also were encouraged to set
goals and to discover
meaning and purpose in their lives by taking up new hobbies, by
volunteering, or by
learning something new. Finally, group exercises promoted
humor, empathy, and social
support.
Sessions followed a regular structure and included time for
didactic, experiential, and
discussion portions. During the first portion, the psychologist
handed back diary sheets and
then used the sheets to encourage group members to share their
entries and reflections. The
second portion consisted of eliciting the RR with a 15-minute

guided meditation led by the
psychologist.
Outcome Measures
The current study focused on 2 psychological variables of
interest for aging populations that
are related to concepts of resiliency and self-care: morale and
self-efficacy.
The Philadelphia Geriatric Center Morale Scale (PGCMS).38—
This scale has 17
items and was designed as a multidimensional measure of the
psychological state of older
people. The 3 dimensions of morale measured by the PGCMS
are agitation, attitude toward
own aging, and lonely dissatisfaction, the last of which
describes depressive mood in
relation to social interactions.38 Each item is binary, with one
response indicating high
morale and the other low morale. For each item, the high-morale
responses receive a score
of 1, and the low-morale responses receive a score of 0. Scores
range from 0–17, with scores
below 9 suggesting low morale. The mean PGCMS score in the
original validation study of
928 men and women aged 70 to 90 years was 11.35 ± 3.76.37

The Coping Self-Efficacy Scale (CSES).42—This 26-item scale
addresses the multiple
dimensions of self-efficacy, including problem-focused coping,
a focus on changing
problematic aspects of stressful events, emotion-focused
coping, responses focused on
changing emotional responses to stressful events, and social
support. It is also intended to
measure changes in coping self-efficacy following an
intervention. Participants respond to
the question, “When things aren’t going well for you, how
confident are you that you
can…?” by assigning a rating from 0–10 to specific stress-
coping activities, with 0
indicating no confidence and 10 the highest confidence. Scores
range from 0–260, with
higher scores indicating greater self-efficacy. The mean CSES
score in a community-based
validation study of 182, mostly Caucasian, college-educated
British men and women, aged
18 to 66 years, was 159.6 ± 41.0.43
Statistical Analyses
The data from the 5 intervention groups were combined for the
purpose of analysis.

Analyses were run using SPSS Statistics 17 (SPSS Inc.,
Chicago, IL, USA). Descriptive
statistics were used to examine groups at baseline. Changes in
morale and self-efficacy were
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tested using paired t-tests on pre- and postintervention data.
Mean imputation was used to

complete instruments with missing data for the CSES, and
missing items were coded as a 0
for PGCMS, in alignment with the methods used in previous
studies.38,42 If questionnaires
were missing >20% they were marked as not-completed.
After completing a primary analysis, a highly conservative
sensitivity analysis was
conducted to account for those participants who dropped out, in
line with recommendations
for clinical trials by the National Research Council.44 As a
sensitivity analysis, the research
team conservatively assumed that participants who were missing
postintervention data
accrued no benefit from the intervention. Participants who
dropped out of the study or did
not fill out pre- or postintervention instruments were given a
pre-post change score equal to
the largest observed decrease of all participants, which would
indicate a worsening score. A
Wilcoxon signed rank test was used for the sensitivity analysis.
Of note, the sensitivity analysis includes the pre-test data from
one participant who dropped
the group and enrolled at a later date, at which time both pre-

and post-test data were
collected. Since pre-test data was collected twice from this
participant, and this was a
feasibility study, the original pre-test data was included in the
sensitivity analysis with a
post-test score that was conservatively computed using the
largest observed decrease
(worsening) in the group. This was so as to mirror the analyses
of data from participants
who dropped the group entirely.
RESULTS
Participants
Of the 51 older adults who participated in the groups, 46 elected
to fill out questionnaires.
Of those 46 participants, 41 (89.1%) attended at least 7 out of 9
(78%) sessions.
Participants’ ages ranged from 66 to 91 years, with an average
age of 75.5 ± 6.7. As shown
in Table 2, the majority of participants were female (76.1%)
white (89.1%), and retired
(74%). Sixteen of the participants were widowed (34.8%); 10
were divorced or separated
(21.7%); 9 were single (19.6%); 7 were married (15.2%); and 4

did not report statuses
(8.7%).
Psychosocial Outcomes
At baseline, participants reported a mean ± standard deviation
of 10.73 ± 4.15 on the
PGCMS and 163.33 ± 43.73 on the CSES. The scores on both
the PGCMS and the CSES
increased significantly among completers of the intervention;
ie, the pre- to postintervention
change was: (1) PGCMS, 1.68 ± 2.94, p = 0.001; (2) CSES,
33.90 ± 36. 30, p < 0.001 (Table
3).
Five participants who completed the PGCMS pre-test did not
complete the post-test. Of
those participants who completed both pre- and post-test the
largest observed decrease was a
worsening of 4 points. Therefore, for the sensitivity analysis,
this value of −4 was
conservatively used as the change score for these 5 participants.
Similarly, 7 participants
who completed the PGCMS pre-test did not complete the post-
test. Of those participants
who completed both pre- and post-test the largest decrease was

a worsening of 17 points.
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Therefore, for the sensitivity analysis, this value of −17 was
conservatively used as the
change score for these 7 participants.
After the sensitivity analysis, the CSES pre-post change was
still significant (p<0.001), and

the PGCMS trended toward statistical significance (p=0.064).
Excluding the extra pre-test
data from the subject who enrolled at a later date, however,
would lead to an overall change
in PGCMS from pre- to post-intervention would also remain
significant (p=0.036).
DISCUSSION
As the percentage of older adults increases, demand grows for
effective, accessible,
preventive-care options as does the need to understand factors
that promote mental and
physical health in older populations. The present study provides
the theory and outline of a
new Healthy Aging MBI program that was developed
specifically to meet the needs of older
adults. The high retention and response rates in the study
suggest that the program can be a
feasible intervention for use among aging populations.
The study also has shed light on important psychosocial factors
related to self-care.
Statistically significant improvements in self-efficacy and
morale were observed after the
program, with self-efficacy maintaining significance after a

highly conservative sensitivity
analysis. The results represent meaningful improvements, with
the overall group showing an
mean increase from 10.73 ± 4.15 to 12.41 ± 4.15 (15.7%) and
from 163.33 ± 43.73 to
197.23 ± 39.80 (20.8%) in PGCMS and CSES scores,
respectively.
Numerous studies have noted the importance of psychological
variables in improving both
quality of life and objective health outcomes.45,46 In
particular, self-efficacy has been used
as a theoretical framework to explain the utility of other
interventions,47 and interventions
that have been shown to improve self-efficacy are related to
subsequent change in health
behaviors.48 Additionally, an interaction has been shown
between self-efficacy and change
in physical performance, suggesting a buffering effect for self-
efficacy against functional
decline when older adults are faced with diminished physical
capacity.49
While self-efficacy remained significant after the sensitivity
analysis, morale did not. That
finding may be interpreted in the strictest sense as an indication

that participants might not
have …
/
2 Collaboration, Interpersonal Communication, and
Business
Etiquette
LEARNING OBJECTIVES
1
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List the advantages and disadvantages of working in teams,
describe the characteristics of effective teams, and highlight
four key issues of
group dynamics.
2
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00000000000000016F4)
Offer guidelines for collaborative communication, identify
major collaboration technologies, and explain how to give
constructive feedback.
3
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000000000000000177E)
List the key steps needed to ensure productive team
meetings.
4
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Identify the major technologies used to enhance or replace
in-person meetings.
5
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Identify three major modes of listening, describe the
listening process, and explain the problem of selective listening.
6
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Explain the importance of nonverbal communication, and
identify six major categories of nonverbal expression.
7
ections/p70010124510000000000000000018d0#P700101245100
00000000000000018D4)
Explain the importance of business etiquette, and identify
four key areas in which good etiquette is essential.
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You probably have been on a lab team or other project team that
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000000180E
0101245100000000000000000188d#P700101245100000000000
0000001891
010124510000000000000000018d0#P700101245100000000000
00000018D4
http://mybcommlab.com/
http://www.cemex.com/
/
An innovative collaboration platform helps the
global cement company Cemex operate with

the agility and �lexibility of a small
company.
Pressmaster/Shutterstock
To stay competitive and pro�itable and to minimize the
environmental effects of its operations, Cemex knew it needed
to accelerate the pace of innovation.
Company leaders �igured the way to do that was to enable
better collaboration, and the way to do that was to enable better
communication.
The company’s response to this multilayered challenge is a
comprehensive online collaboration platform called Shift, which
combines social networking,
wikis, blogs, a Twitter-like microblogging system, social
bookmarking, videoconferencing, a trend-spotting tool called
Shift Radar, and more. A custom mobile
app lets employees access the system wherever their work takes
them.
By connecting people and information quickly and easily, Shift
helps overcome the barriers of geography, time zones, and
organizational boundaries.
Employees and managers can tap into expertise anywhere in the
company, workers with similar responsibilities can share ideas
on improving operations,
and problems and opportunities can be identi�ied and brought
to management’s attention in much less time.
Technology is only part of the solution, however. Many
companies that have implemented social platforms struggle to
get employees to change ingrained
behaviors and use the new tools. By getting top-level executives
on board early, Cemex achieved nearly universal adoption, with
95 percent of employees

using Shift and forming more than 500 online communities
based on technical specialties and shared interests. That level of
engagement is paying off in
numerous ways, such as launching a new global brand of ready-
mix concrete in one-third the expected time, nearly tripling the
company’s use of renewable
energy, and reducing carbon dioxide emissions by almost 2
million metric tons.
Perhaps most impressive, Shift has lived up to its name by
shifting the entrenched hierarchical culture of a large, old-
school company to a more agile and
responsive social business that is better prepared to face the
future in its highly competitive markets. As Gilberto Garcia,
Cemex’s innovation director, puts it,
social collaboration “can make a big company look like a small
company” by connecting people and ensuring the free exchange
of ideas.1
ns/p700101245100000000000000000198f#P7001012451000000
000000000001AAA)
0101245100000000000000000198f#P7001012451000000000000
000001AAA
/
2.1 Communicating Effectively in Teams
LEARNING OBJECTIVE
1 List the advantages and disadvantages of working in teams,
describe the characteristics of effective teams, and highlight
four key issues of
group dynamics.

The interactions among the employees at Cemex (pro�iled in
the chapter-opening Communication Close-Up) represent one of
the most essential elements of
interpersonal communication. Collaboration
ns/p700101245100000000000000000198f#P7001012451000000
000000000001998) —working
together to meet complex challenges—is a prime skill expected
in a wide range of professions. No matter what career path you
pursue, it’s a virtual
guarantee that you will need to collaborate in at least some of
your work activities. Your communication skills will pay off
handsomely in these interactions
because the productivity and quality of collaborative efforts
depend heavily on the communication skills of the professionals
involved.
Collaboration—working together to solve complex problems—is
an essential skill for workers in nearly every profession.
A team
ections/p700101245100000000000000000198f#P700101245100
00000000000000019DA) is a unit
of two or more people who share a mission and the
responsibility for working to achieve a common goal.2
ns/p700101245100000000000000000198f#P7001012451000000
000000000001AAC) Problem-
solving teams
ections/p700101245100000000000000000198f#P700101245100
00000000000000019C8)
and task forces

ections/p700101245100000000000000000198f#P700101245100
00000000000000019D4)
assemble to resolve speci�ic issues and then disband when their
goals have been accomplished. Such teams are often cross-
functional, pulling together
people from a variety of departments who have different areas
of expertise and responsibility. The diversity of opinions and
experiences can lead to better
decisions, but competing interests can cause tensions that
highlight the need for effective communication. Committees
ns/p700101245100000000000000000198f#P7001012451000000
00000000000199B) are formal
teams that usually have a long life span and can become a
permanent part of the organizational structure. Committees
typically deal with regularly recurring
tasks, such as an executive committee that meets monthly to
plan strategies and review results.
Team members have a shared mission and are collectively
responsible for their work.
ADVANTAGES ANDDISADVANTAGES OF TEAMS
When teams are successful, they can improve productivity,
creativity, employee involvement, and even job security.3
ns/p700101245100000000000000000198f#P7001012451000000
000000000001AAE) Teams are often
at the core of participative management
ns/p700101245100000000000000000198f#P7001012451000000
0000000000019C5) , the effort to
involve employees in the company’s decision making. A
successful team can provide a number of advantages:4

ns/p700101245100000000000000000198f#P7001012451000000
000000000001AB0)
Effective teams can pool knowledge, take advantage of diverse
viewpoints, increase acceptance of solutions the team proposes,
and achieve
higher performance.
Increased information and knowledge. By pooling the
experience of several individuals, a team has access to more
information.
Increased diversity of views. Team members can bring a
variety of perspectives to the decision-making process—as long
as these diverse
viewpoints are guided by a shared goal.5
ns/p700101245100000000000000000198f#P7001012451000000
000000000001AB2)
Increased acceptance of a solution. Those who
participate in making a decision are more likely to support it
and encourage others to accept it.
Higher performance levels. Working in teams can unleash
new levels of creativity and energy in workers who share a
sense of purpose and
mutual accountability. Effective teams can be better than top-
performing individuals at solving complex problems.6
ns/p700101245100000000000000000198f#P7001012451000000
000000000001AB4)
ETHICS DETECTIVE
Solving the Case of the Missing Team
When the company president assembled the team to �ind
creative solutions to the company’s cash �low problems, few

people thought it would succeed.
Through plenty of hard work, however, you and your colleagues
have found new sources of investment capital. Now it’s time to
present your
accomplishments to the board of directors, and your entire team
has been looking forward to this meeting for weeks. Because
appearing in front of the
board can be a major career boost, the team planned to present
the results together, giving each person a few minutes in the
limelight.
0101245100000000000000000198f#P7001012451000000000000
000001998
0101245100000000000000000198f#P7001012451000000000000
0000019DA
0101245100000000000000000198f#P7001012451000000000000
000001AAC
0101245100000000000000000198f#P7001012451000000000000
0000019C8
0101245100000000000000000198f#P7001012451000000000000
0000019D4
0101245100000000000000000198f#P7001012451000000000000
00000199B
0101245100000000000000000198f#P7001012451000000000000
000001AAE
0101245100000000000000000198f#P7001012451000000000000
0000019C5

0101245100000000000000000198f#P7001012451000000000000
000001AB0
0101245100000000000000000198f#P7001012451000000000000
000001AB2
0101245100000000000000000198f#P7001012451000000000000
000001AB4
/
However, Jackson Mueller, the chief �inancial of�icer and
leader of your team, had a surprise for you this morning. He’d
received word at the last minute
that the board wanted a short, concise presentation, and he said
the best way to comply was with a single presenter. No one was
happy about the
change, but Mueller is the highest-ranking employee on the
team and the only one with experience presenting to the board.
Disappointment turned to dismay as you and your teammates
watched from the back of the conference room. Mueller deftly
compressed your 60-
minute presentation down to 20 minutes, and the board
showered him with praise. However, he never introduced any of
the other team members, so
your potential moment in the sun passed without recognition.
ANALYSIS
1. Did Mueller behave unethically by not introducing you and
your colleagues to the board? Explain your answer.
2. Later, you complain to a colleague that by stressing “my
team” so often, Mueller actually made the presentation all about
him, not the team. But

one of your colleagues argues that the team’s assignment was to
solve the problem, not to score career points with the board, so
that goal
shouldn’t have been such a top priority. Explain why you agree
or disagree.
Although teamwork has many advantages, it also has a number
of potential disadvantages. At the worst, working in teams can
be a frustrating waste of time.
Teams and business leaders need to be aware of and work to
counter the following potential disadvantages:
Teams need to avoid the negative impact of groupthink, hidden
agendas, excessive costs, and employee overload.
Groupthink. Like other social structures, business teams can
generate tremendous pressure to conform with accepted norms
of behavior.
Groupthink
ns/p700101245100000000000000000198f#P7001012451000000
0000000000019B3) occurs
when peer pressure causes individual team members to withhold
contrary or unpopular opinions. Teams af�licted with
groupthink can be so
focused on protecting group harmony that they oversimplify
problems, ignore information that threatens consensus, and fail
to consider risks and
negative consequences.7
ns/p700101245100000000000000000198f#P7001012451000000
000000000001AB6)
Hidden agendas. Some team members may have a hidden
agenda

ns/p700101245100000000000000000198f#P7001012451000000
0000000000019B6) —a
private, counterproductive motive, such as a desire to take
control of the group, to undermine someone else on the team, or
to pursue a business
goal that runs counter to the team’s mission.
Cost. Aligning schedules, arranging meetings, and coordinating
individual parts of a project can eat up a lot of time and money.
Overload. Some companies have embraced collaborative work
approaches to such an extent that they’re overloading employees
with team
assignments. Moreover, as a company’s best contributors gain a
reputation for helping others and getting things done, they often
�ind themselves
assigned or invited to even more team efforts. As a result, team
activities can take up so much of a person’s day that individual
responsibilities get
pushed to nights and weekends, leading to exhaustion and lower
productivity.8
ns/p700101245100000000000000000198f#P7001012451000000
000000000001AB8)
CHARACTERISTICS OF EFFECTIVE TEAMS
The most effective teams have a clear objective and shared
sense of purpose, have a strong sense of trust in each other,
communicate openly and honestly,
reach decisions by consensus, think creatively, know how to
resolve con�lict, and believe that their work matters.9
ns/p700101245100000000000000000198f#P7001012451000000
000000000001ABA) Teams that
have these attributes can focus their time and energy on their
work, without being disrupted by destructive con�lict (see page
41

ns/p7001012451000000000000000001620#page_41) ).
Effective teams have a clear sense of purpose, open and honest
communication, consensus-based decision making, creativity,
and effective
con�lict resolution.
REAL-TIME UPDATES
LEARN MORE BY READING THIS
ARTICLE
Google’s research into effective teamwork
Google used its world-class data analysis capabilities to identify
�ive factors that most effective teams consistently exhibit. Go
to real-
timeupdates.com/bct14 (http://real-timeupdates.com/bct14)
and select Learn More in the Students section.
In contrast, teams lacking one or more of these attributes can
get bogged down in con�lict or waste time and resources
pursuing unclear goals. Common
reasons for dysfunctional team efforts include management
expectations that are either unclear or not accepted by all team
members, a reluctance by team
members to prioritize team goals over their personal goals,
reward systems that don’t recognize team contributions, and
leadership that tolerates negative
0101245100000000000000000198f#P7001012451000000000000
0000019B3
0101245100000000000000000198f#P7001012451000000000000
000001AB6

0101245100000000000000000198f#P7001012451000000000000
0000019B6
0101245100000000000000000198f#P7001012451000000000000
000001AB8
0101245100000000000000000198f#P7001012451000000000000
000001ABA
01012451000000000000000001620#page_41
http://real-timeupdates.com/bct14
/
and counterproductive behaviors.10
ns/p700101245100000000000000000198f#P7001012451000000
000000000001ABC)
GROUP DYNAMICS
Group dynamics are the interactions and processes that take
place within a team.
The interactions and processes that take place among the
members of a team are called group dynamics
ns/p700101245100000000000000000198f#P7001012451000000
0000000000019B0) . Productive
teams tend to develop clear norms
ns/p700101245100000000000000000198f#P7001012451000000
0000000000019BF) , informal
standards of conduct that members share and that guide member

behavior. Group dynamics are in�luenced by several factors:
the roles team members
assume, the current phase of team development, the team’s
success in resolving con�lict, and the team’s success in
overcoming resistance.
Assuming Team Roles
Each member of a group plays a role that affects the outcome of
the group’s activities.
Members of a team can play various roles, which fall into three
categories (see Table 2.1
ns/p7001012451000000000000000001620#P7001012451000000
000000000001677) ). Members
who assume self-oriented roles
ns/p700101245100000000000000000198f#P7001012451000000
0000000000019CE) are motivated
mainly to ful�ill personal needs, so they tend to be less
productive than other members. “Dream teams” comprising
multiple superstars often don’t perform
as well as one might expect because high-performing
individuals can have trouble putting the team’s needs ahead of
their own.11
ns/p700101245100000000000000000198f#P7001012451000000
000000000001ABE) In addition,
highly skilled and experienced people with dif�icult
personalities might not contribute, for the simple reason that
other team members may avoid interacting
with them.12
ections/p700101245100000000000000000198f#P700101245100
0000000000000001AC0)

Far more likely to contribute to team goals are members who
assume team-maintenance roles
ns/p700101245100000000000000000198f#P7001012451000000
0000000000019DD) to help
everyone work well together and those who assume task-
oriented roles
ns/p700101245100000000000000000198f#P7001012451000000
0000000000019D7) to help the
team reach its goals.13
ns/p700101245100000000000000000198f#P7001012451000000
000000000001AC2)
Allowing for Team Evolution
Teams typically evolve through a number of phases on their way
to becoming productive. A variety of models have been
proposed to describe the evolution
toward becoming a productive team. Figure 2.1
ns/p7001012451000000000000000001620#P7001012451000000
000000000001692) shows how one
commonly used model identi�ies the phases a problem-solving
team goes through as it evolves:14
ns/p700101245100000000000000000198f#P7001012451000000
000000000001AC4)
Teams typically evolve through a variety of phases, such as
orientation, con�lict, brainstorming, emergence, and
reinforcement.
TABLE 2.1 Team Roles—Functional and
Dysfunctional

Dysfunctional: Self-Oriented Roles Functional: Team-
Maintenance Roles Functional: Task-Oriented Roles
Controlling: Dominating others by exhibiting
superiority or authority
Withdrawing: Retiring from the team either by
becoming silent or by refusing to deal with a
particular aspect of the team’s work
Attention seeking: Calling attention to oneself and
demanding recognition from others
Diverting: Focusing the team’s discussion of topics
of interest to the individual rather than of those
relevant to the task
Encouraging: Drawing out other members by
showing verbal and nonverbal support, praise,
or agreement
Harmonizing: Reconciling differences among
team members through mediation or by using
humor to relieve tension
Compromising: Offering to yield on a point in
the interest of reaching a mutually acceptable
decision
Initiating: Getting the team started on a line
of inquiry
Information giving or seeking: Offering (or
seeking) information relevant to questions
facing the team
Coordinating: Showing relationships among
ideas, clarifying issues, and summarizing
what the team has done
Procedure setting: Suggesting decision-
making procedures that will move the team
toward a goal

0101245100000000000000000198f#P7001012451000000000000
000001ABC
0101245100000000000000000198f#P7001012451000000000000
0000019B0
0101245100000000000000000198f#P7001012451000000000000
0000019BF
01012451000000000000000001620#P700101245100000000000
0000001677
0101245100000000000000000198f#P7001012451000000000000
0000019CE
0101245100000000000000000198f#P7001012451000000000000
000001ABE
0101245100000000000000000198f#P7001012451000000000000
000001AC0
0101245100000000000000000198f#P7001012451000000000000
0000019DD
0101245100000000000000000198f#P7001012451000000000000
0000019D7
0101245100000000000000000198f#P7001012451000000000000
000001AC2
01012451000000000000000001620#P700101245100000000000
0000001692
0101245100000000000000000198f#P7001012451000000000000

000001AC4
/
1. Orientation. Team members socialize, establish their roles,
and begin to de�ine their task or purpose. Team-building
exercises and activities can
help teams break down barriers and develop a sense of shared
purpose.15
ns/p700101245100000000000000000198f#P7001012451000000
000000000001AC6) For
geographically dispersed virtual teams, creating a “team
operating agreement” that sets expectations for online meetings,
communication
processes, and decision making can help overcome the
disadvantages of distance.16
ns/p700101245100000000000000000198f#P7001012451000000
000000000001AC8)
2. Con�lict. Team members begin to discuss their positions and
become more assertive in establishing their roles.
Disagreements and uncertainties
are natural in this phase.
3. Brainstorming. Team members air all the options and fully
discuss the pros and cons of each. At the end of this phase,
members begin to settle
on a single solution to the problem. Note that although group
brainstorming remains a highly popular activity in today’s
companies, it may not
always be the most productive way to generate new ideas. Some
research indicates that having people brainstorm individually
and then bring

their ideas to a group meeting is more successful.17
ns/p700101245100000000000000000198f#P7001012451000000
000000000001ACA)
4. Emergence. Consensus is reached when the team �inds a
solution that all members are willing to support (even if they
have reservations).
5. Reinforcement. The team clari�ies and summarizes the
agreed-on solution. Members receive their assignments for
carrying out the group’s
decision, and they make arrangements for following up on those
assignments.
Figure 2.1 Phases of Group Development
Groups generally progress through several stages on their way
to becoming productive and reaching their objectives.
Sources: B. Aubrey Fisher, Small Group Decision
Making: Communication and the Group
Process, 2nd ed. (New York: McGraw-Hill, 1980), 145–
149; Stephen P. Robbins and David A.
DeCenzo, Fundamentals of Management: Essential
Concepts and Applications, 4th ed. (Upper Saddle River,
N.J.: Prentice Hall, 2004), 334–335; Richard L. Daft,
Management, 6th ed.
(Cincinnati: Thomson South-Western, 2003), 602–603.
You may also hear the process de�ined as forming, storming,
norming, performing, and adjourning, the phases identi�ied by
researcher Bruce Tuckman when
he proposed one of the earliest models of group development.18
ns/p700101245100000000000000000198f#P7001012451000000

000000000001ACC) Regardless of
the model you consider, these stages are a general framework
for team development. Some teams may move forward and
backward through several stages
before they become productive, and other teams may be
productive right away, even though some or all members are in
a state of …
Peer Post 1 to respond to:
Donella Anderson
YesterdayMay 6 at 4:46pm
Describe the difference between the terms “ethical dilemma”
and “ethical lapse”.
Ethical dilemma is choice that you make that may or may not be
clearly right or wrong.
Ethical lapse is making a choice that you know for certain to be
unethical.
Provide an example from your life, or of someone you knew,
who was faced with
an ethical dilemma in the workplace. Explain an alternative
solution to the
dilemma. Then think of a time where you or someone you knew
demonstrated an
ethical lapse. Describe the situation and the decision. Then
provide an alternative
solution to the situation.
I can recall when I first joined the military being at a party
with a group of friends and

tons of other people I didn't know and watching many people at
the party drinking and
dancing. I recall being offered a beer and declining due to my
age, I was only 18. I was
looked at as being a "good two shoes' because I didn't want to
break the rules and
underage drink. A few days later while at work the party came
up and our supervisor
started asking probing questions. Who was at the party, when
did y'all leave? It was
very odd, so we thought. The next morning when we were all
called to our leaderships
office and "asked" about the party; this time they read us our
Miranda rights. It seems
one of the party goers, who was underage left the party hit three
cars and ran the gate
(didn't stop for security at the entrance) and was now
hospitalized. A total of 15
personnel from my job went to disciplinary review board where
we have to explain our
action or inaction and all the details of the party and of course
provide names of any
other person that was in attendance. Personally, I knew I
should have left as soon as I
saw the party heading the wrong way and when I seen my friend
underage drinking
(and take them with me). It is not taken lightly to receive a
DUI/DWI in the military and
in hindsight I should have been more proactive and making
sure we are all safe and we
all could have avoid the entire situation.

PEER POST 2 to respond to:
Nataliya Hampton
10:42amMay 7 at 10:42am
Week one is on a roll classmates and instructor,
Describe the difference between the terms
“ethical dilemma” : “a choice between alternatives that may not
be clearly right or clearly
wrong”
“ethical lapse” : “is making a choice you know to be
unethical.”
Difference: a dilemma would be that technically there is no
right or wrong answer, while
in a lapse you no something is wrong but still do it.
Provide an example of ethical dilemma: There were 2
opportunity that came up for
career growth for an employee. One was to be a Leader on the
floor of the unit the
employee worked on, and the other was to work with
coordinating patient care for
people coming in from down range. Yes this is a hospital
setting. Both would give the
employee growth but it was a hard decision for the leadership
above the employee to

decide which one would be best for the growth of the person.
Since neither option was
right or wrong, it was a hard decision to make.
Provide an example of ethical lapse: In the food industry Food
temps and Fridge
temps are to be monitored on a schedule and regular bases, it’s
wrong to pencil wipe
these numbers on a document but it happens for food safety, no
one wants to get food
poisoning
Alternate solution: To develop a habit and routine to make sure
staff is properly
completing temp checks with quality checks and if a time frame
was missed to leave it
as missed to identify that maybe further training needs to be
completed.
Reference:
Bovée, C. L., & Thill, J. V. (2018). Business communication
today (14th ed.). Retrieved
from https://content.ashford.edu/
PEER POST 3 to respond to:

Azayen Loyo
1:46amMay 7 at 1:46am
Hello,
The difference between an ethical dilemma and ethical lapse is
in the clarity of the
outcome that choice will bring. According to Bovee and Thill
(2018), the difference
between an ethical dilemma and an ethical lapse is a question of
clarity.
First, an ethical dilemma is when it is unclear whether a choice
is equally right or equally
wrong. I recall being in a situation during one of my first jobs
when a customer asked
me if I could share my client's contact information. I worked at
a car wash in a building
where the cars are washed in an Eco-friendly setting. This
customer, who was also a
tenant, stated his company offered a significant discount to all
tenants, and he wanted
to share this with them. Initially, I thought it would be a good
idea, but my manager
enlightened me with the legal aspect of the matter and customer
confidentiality. My age
and lack of experience combined with a good sales pitch made it
difficult for me to
determine that this was wrong. Instead, I thanked the guy for his
intentions and offered
an idea to have the building manager send an email to tenants to
make employees
aware of the products and discounts.
Second, an ethical lapse is an intentional choice made knowing
the outcome is

unethical. I experienced an ethical lapse in the workplace. My
current employer
prohibits actions like accepting gifts from clients. Knowing
this, I witnessed my
colleague accepting tickets to a game from a client, and
immediately I knew I had to
report it. It put me in an awkward position because I didn't want
to get my colleague in
trouble. I decided to approach my colleague with the mindset
that she might not have
realized these high valued tickets were considered gifts. After
bringing it to her attention
and sharing my perspective, she decided to return the tickets.
As employees, we share
the responsibility of maintaining the company's reputation and
integrity by making the
right ethical decisions. Regardless of how minimal or not an
ethical lapse is, it is not
justified.
Bovee, C. L., and Thill, V. J. (2018). Business Communication
Today (14th ed.). Pearson
Education, Inc.
https://content.ashford.edu/books/Bovee.7626.18.1/sections/cov
er
/
1 Professional Communication in a Digital,
Social, Mobile World
LEARNING OBJECTIVES

1
ns/p7001012451000000000000000001084#P7001012451000000
000000000001088)
Explain the importance of effective communication to your
career and to the companies where you will work.
2
ns/p70010124510000000000000000010d4#P7001012451000000
0000000000010D8)
Explain what it means to communicate as a professional in a
business context.
3
ns/p7001012451000000000000000001163#P7001012451000000
000000000001167)
Describe the communication process model and the ways
social media are changing the nature of business
communication.
4
ns/p7001012451000000000000000001219#P7001012451000000
00000000000121D)
Outline the challenges and opportunities of mobile
communication in business.
5
ns/p7001012451000000000000000001270#P7001012451000000
000000000001274)
List four general guidelines for using communication

technology effectively.
6
ns/p7001012451000000000000000001390#P7001012451000000
000000000001395)
De�ine ethics, explain the difference between an ethical
dilemma and an ethical lapse, and list six guidelines for making
ethical
communication choices.
MyBCommLab®
Improve Your Grade!
More than 10 million students improved their results using
(http://mybcommlab.com) for simulations,
tutorials, and end-of-chapter problems.
JetBlue
twitter.com/jetblue (http://twitter.com/jetblue)
If you have ever worked in retail, customer service, or a similar
job, you know what a challenge it can be to make sure each
customer has a great
experience with your company. Imagine the challenge of
keeping 35 million customers happy. That’s how many
passengers JetBlue carries every year
—an average of roughly 95,000 customers per day.
As a relatively new airline, taking its �irst �light in 2000,
JetBlue has always tried to differentiate itself from the older
carriers in the business. A great
example is its pioneering use of Twitter as a customer service
platform. JetBlue joined Twitter in 2007, only a year after the

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