Trust and psychological safety – how safe is your environment?

trust and psychological safety

Jamie Morley discusses the importance of a safe environment and offers strategies to build trust and psychological safety in your dental team.

Trust and psychological safety are the foundation of any high-performing team. They are essential.

These words might seem a bit ‘soft’ and like I’m suggesting that a good team is one where people are nice to each other. This is not what I mean when I talk about trust and psychological safety.

I use the two terms together because they can mean the same thing depending on how you define them. Trust can be seen from the perspective of, ‘I trust that this person will do what they say they will do.’ But there is a different type of trust within the context of a team.

Trust and safety

In his book, ‘The Five Dysfunctions of a Team’, Lencioni talks about the kind of trust where the individuals in the team know that they can share difficult topics, be open about mistakes, admit weaknesses, share successes, ask for help, be themselves, challenge teammates and generally be vulnerable. This is because they don’t feel that there will be any negative inter-personal consequences for doing so.

One study actually showed that we experience as intense a response from this social threat as from a physical threat, (Lieberman & Eisenberger, 2009). If people feel safe to do these things they can take action to improve their own performance or the overall performance of the team.

If individuals in the team do not feel this way, if they don’t have this trust and feeling of safety, what happens? The team will not be able to improve their performance because they will not feel able to have constructive open discussions when things go wrong. They will not bring their honest feelings to the surface. Rather, a blame game will occur. This means that experiences cannot be learned from and the team will not improve.

Apportioning blame can also reduce individuals’ trust in themselves and in others, worsening the situation. Where threat is at play, our cognitive ability in terms of decision making, solving problems and collaboration is reduced, (Elliot, 2008).

Confidence to speak up

This kind of team dynamic can have some serious consequences. Ultimately, people will not speak up when things are being done wrong. This will affect the whole team and the organisation. In the context of running a dental practice, this can be disastrous.

In high-risk sectors such as healthcare, where you are operating on patients, there are typically specific and strict instructions and standards for how things must be done, often set out by an authoritative and experienced figure. You may even be that person. It is agreed that things must be done a specific way. Yet nobody is perfect and people will make mistakes.

Let’s say you have been doing something wrong, something which has negative consequences for the patient. If a colleague saw this, wouldn’t you want to know? Do you not think it is vital, for the patients’ sake, that you are made aware? If people don’t feel they are in an environment in which it is safe to do so, they will not speak up, even if you ask them to. They might fear the consequences in terms of their career, and the emotional consequences of speaking up, perhaps of being made to feel stupid, or ashamed.

These emotional consequences are extremely powerful as they trigger immediate and strong negative feelings. They will prevent people from speaking up.

Psychological safety

The term ‘psychological safety’ has been used to describe an environment in which these fears are not present. In her book ‘The Fearless Organization’, Amy Edmondson describes the importance and impact of this kind of environment in significant detail. There is growing evidence supporting the idea that a feeling of psychological safety is the most important dynamic of a team and underpins all aspects of its performance and interactions.

A research study by Google, named Project Aristotle, looked at specifically what makes a high-performing team. The researchers looked at 130 different teams across Google to see what factors were most important to performance. The single biggest factor by far was psychological safety.

No organisation can afford to have a culture of fear. In a dental practice, it can have critical consequences for the patients and the practice. To create an environment of psychological safety, be genuinely open and curious about what your team are saying to you. Listen to what they say and ask questions. Ensure the team are also behaving in the same way with each other. Notice and be aware of feelings and emotions that arise in you and in others.

Get to know each other

You will be able to tell when someone is genuinely concerned about something. When mistakes happen, don’t sweep them under the carpet, call them out. This is not about making an individual feel terrible or ashamed, it is about working out what went wrong. Help them and others to learn from the mistake and avoid the same thing happening again. Do the same when issues arise or there is something that is not being said. Bring it to the surface and discuss it openly. These things tend to be like an iceberg, where there is very little on the surface – you have to bring it up into the open to get the full picture.

Encourage and create an environment where people get to know each other as people, where they understand each other’s strengths, weaknesses, hopes and fears, and the context of their lives. This develops empathy and understanding between team members, which helps to build trust.

Probably most important is that when somebody shows vulnerability – and how this manifests may be different for different people – they are not laughed at, ridiculed, dismissed or made to feel embarrassed or ashamed. Instead, people should show empathy, show that they want to understand, be present with that person and show genuine curiosity.

As a result, the person will feel that it is safe to show vulnerability again in the future. As a result, a culture of psychological safety will build.

Jamie Morley is the author of Lead Your Dental Practice available at

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