title: CENTRE: creating psychological safety in groups.
abstract: BACKGROUND
  Ten years of clinical and teaching experience has shown us that when teams or groups come together, it is often for a commonly understood and agreed upon purpose, but often without an agreed upon process of how to work together. Explicit guidelines in this regard promote psychological safety.
  
  
  BACKGROUND
  This article presents a method of developing agreements that can be used in a variety of settings to create psychological safety and cohesion. In our experience, agreements about how people join together seem to be developed implicitly. Assumption-based and implicit agreements can engender friction because unspoken or unclear agreements are not easily addressed because they are not universally understood.
  
  
  METHODS
  A literature review helped to identify key factors contributing to psychological safety and led to creating 'CENTRE' to help clinical teams apply these factors. We are now starting to evaluate its impact. We believe a tool such as CENTRE facilitates the development of explicitly articulated group formation and maintenance guidelines, thus reducing the risk of interpersonal discord.
  
  
  CONCLUSIONS
  We propose that a tool such as CENTRE be considered for a range of group situations, including clinical family meetings, teaching, professional teams and Balint-type groups. We are currently using this approach in clinical, academic and other professional environments. Findings from a survey of groups where CENTRE was used suggested that participants find the process useful. We believe a tool such as CENTRE can be used to help address relational issues, promote psychological safety, inclusion and trust among members, and reduce the risk of undeclared expectations and assumptions from dictating how groups function. Assumption-based and implicit agreements can engender friction because unspoken or unclear agreements are not easily addressed.
authors.affiliation: Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada.|Providence Health Care, Centre for Practitioner Renewal, Vancouver, British Columbia, Canada.
authors.forename: Douglas
authors.initials: D
authors.lastname: Cave
authors.affiliation: Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada.|Providence Health Care, Centre for Practitioner Renewal, Vancouver, British Columbia, Canada.
authors.forename: Hilary
authors.initials: H
authors.lastname: Pearson
authors.affiliation: Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada.|Providence Health Care, Centre for Practitioner Renewal, Vancouver, British Columbia, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Whitehead
authors.affiliation: Providence Health Care, Centre for Practitioner Renewal, Vancouver, British Columbia, Canada.
authors.forename: Sherin
authors.initials: S
authors.lastname: Rahim-Jamal
mesh_terms: D004501:Education, Medical / Q000379:methods*; D006126:Group Processes; D006801:Humans; D012449:Safety; D013337:Students, Medical / Q000523:psychology; D013663:Teaching / Q000523:psychology*