You are a healthcare leader or a clinical practice owner who is overworked, overwhelmed, and caught up in the doing of your business.

And, your job, by and large, should be focused on creating the vision of your business, and leading your team to execute on your mission.

Whether you’re a physician, clinician, or a physical therapist, you’re extremely good at doing what you do. That’s part of the problem.

In your mind, it’s often easier to just do things to get them done because you’re extremely efficient at doing them. They’re activities that are ingrained into your daily routine, so they are hard to delegate to someone else.

But in order to stop the overwhelm, you absolutely must learn to lead more and do less. Keep reading to learn more about how to do just that.  


Growing a strong team inside your business matters.

A strong team is your most valuable business asset. Because, without them, your clients won’t get the services you provide delivered properly.

In healthcare, for example, the patient is generally the focus of what you do. 

This is why you chose healthcare as a profession in the first place. You want to help people get better and be the best they can be. 

Healthcare providers, leaders, owners and teams spend a significant amount of time, energy and resources to develop, nurture and maintain strong relationships with your patients. You cherish the fact that they continue to support your business and become loyal, faithful fans. 

Because you take the time to develop trust, openness, honesty, accountability, commitment and even have difficult conversations, your patients see outstanding outcomes and results. 

However, the gap in your skills shows up because you struggle to shift those skills to developing and growing your team. 

Since your team members are your most important asset, what’s the hangup? 

Instead of making the shift, you find managing, leading, developing, and retaining your people a challenge. 

Now, you can use this guide to take you through the steps to tackle this simply and painlessly. You can use it to uncover hidden talents and grow high-performing teams. 

Instead of never acting on all the information you’ve gathered about what to do and why, this guide delivers the “how” so you can implement and see lasting results.


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I’m Judy Cirullo, a Physical Therapist and a former practice owner who decided to pursue executive leadership coaching in addition to my clinical career. 

Why did I pursue coaching?

Because I owned four successful practices over a 40-year span, I personally experienced the challenges of retaining, developing, and mentoring staff. I knew I needed help getting myself out of the doing and into the leading of my own business. 

So, while I was an active practice owner and practitioner, I decided to invest in my coaching certification so I could learn the skills to become a better leader and relieve the feelings of burnout plaguing me.  

After making the choice to invest in my personal development, I created a framework to develop staff into successful leaders and to produce productive team members to help my business thrive. 

The result?

Ultimately, I became an absentee owner while continuing to develop and grow all of my team members. 

Healthcare leaders, CEOs, entrepreneurs, and business owners seek me out today to help them do the same. I help them adopt my framework that transitions them from being stuck in the overwhelm of doing into developing other team members to do for them. 

My framework allows them to lead, grow, and scale their business instead. 


  • Uncover the clues that show your team is not as strong as you might think
  • Learn the five behaviors critical to strong teams 
  • Know how to Identify and develop emerging leaders 
  • Develop the most effective competency for leaders and their teams


Take it all in or brush up on the points that matter to you most. Click on an icon image below to read up on a specific topic, or just read through the guide from start to finish.


Truth be told, healthcare executives, managers, and front-line employees are swamped.

With all of the strategic initiatives to execute and daily fires to fight, there’s rarely enough time to do everything required.  

One of the most important initiatives to execute is learning to be a leader for your team. 

Knowing how to keep everyone engaged, working cohesively, and demonstrating strong behaviors critical to a high-performing team is not a luxury. It’s a requirement for your business to thrive. And, it takes expert leadership to make that happen.

Most teams generally don’t struggle with all three of these factors, but a shortcoming in just one of them can create a struggle with the rest of them. 

In fact, when I first meet with leaders or owners about their teams, the initial response I usually get when I ask about these factors is, 

“We all get along great. We don’t have any issues.”  

That is a red flag moment to me. 

If as the leader you feel that everything is going great, my concern is that you haven’t asked your team if they feel the same way.  

When you take the time to ask the questions I’ll talk about in the next section,  you might find some roadblocks holding your team back from the next level of high performance and efficiency. 

Check out this list of top 10 challenges most healthcare leaders and their teams report.

  1. Lack of trust
  2. Unproductive meetings
  3. Lack of accountability among team members including the owner or leader
  4. Being  “me” focused
  5. Few opportunities for growth and development 
  6. Lack of honesty or openness 
  7. Fearful of or avoiding conflict
  8. Afraid to admit mistakes
  9. Low engagement or buy-in
  10. Poor or ineffective communication 

Now, take those challenges and complete this table.

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First, complete this from your perspective as the leader of your team.

Afterwards, and without sharing your results with your team, have each person complete their own copy of the table.

Having these results on hand will prepare you for the next part of this discussion. 


Growing and building strong cohesive teams takes time and effort, but it doesn’t have to be difficult or complicated. 

Patrick Lencioni outlined an excellent process to do so in his best selling book, The Five Dysfunctions of a Team. It’s an excellent read. 

However, implementing the tools Lencioni shares until they are embedded into the daily life of your employees and the business as a habit is when the magic happens.  

I’ve witnessed many teams read this book and try to move so quickly through the “pyramid of behaviors” that they don’t develop the components and actions of the behavior from the bottom up. 

I see those same teams try to work on accountability without developing trust and addressing conflict first. As a result they

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In other words, to become a cohesive and strong team. the leader and each member of the team must understand that each behavior builds on the previous one and cannot be skipped to move up the pyramid. 

Each level relies on the level below, they are connected and cannot work in isolation. 

The five critical behaviors in Lencioni’s pyramid are trust, conflict, commitment, accountability, and results. I’ll expand on each one more below. 

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Trust is the first of the behaviors that must be developed as the foundation to developing a high-functioning team. 

Without deep trust among all team members, including the leaders, the other four behaviors will not be possible to attain and further, maintain.

Trust is a feeling that has to be earned. It can’t be dictated. 

Trust is environmental and as a leader, you set the tone and determine the environment for your team.

Since everything else in growth and development teams relies on trust, exploring the difference between trust and distrust is an excellent place to start this discussion.

Research now shows us that there are neural networks in our brain for both trust and distrust. Different chemical reactions occur when we are in each state. 

Depending on the conversations you hold, you’ll activate one neural

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There’s quite a striking difference between trust and distrust, and it’s one you must gap to build strong teams.

Distrust occurs in the primitive brain, known as the amygdala. When you feel threatened, unsafe, challenged, unsupported, ambiguous about your position, etc., your amygdala is triggered, which produces cortisol.  

On the other hand when you feel connected with others and safe to discuss things that might be new or different, you become more engaged, accountable, productive, and efficient. Trust occurs in the PFC (prefrontal cortex). When you feel trust, you produce oxytocin. 

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When team members and their leader are genuinely open and honest with each other they begin to build trust. They begin to engage, share and collaborate without fear and more easily.   

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Assess Team Trust

Answer the following three questions from Patrick Lincioni’s Team Assessment to assess the behavior of trust in your team. Review each statement and rate your team according to the following scale. 


  1. Team members quickly and genuinely apologize to one another when they say or do something inappropriate or possibly harmful to the team.
  1. Team members openly admit their mistakes and their weaknesses.
  1. Team members are aware of or know about other team members’ personal lives and are comfortable or interested with each other.

Afterwards, share and discuss what the responses mean and how they impact your team individually and collectively. 

It’s common to see the majority of teams scoring question 2 the lowest, with question 3 not far behind. This begs the question, “How willing are we to be open, transparent and vulnerable?” 

Vulnerability based trust is required for the survival of any team. More importantly, the leader must demonstrate it first.


Nobody likes conflict.

It takes time, energy, can be risky, and distracts you from your daily routine. 

But because people don’t like conflict, it shifts them away from the foundation of trust. Because, trust is required in order to deal with conflict easily and successfully. 

Avoiding conflict is a huge blind spot in effectively leading your team, which makes your team ineffective at leading each other. 

Left unresolved conflict avoidance erodes your team and your business. Blind spots like this keep you in an unresolved conflict mode which causes stagnation.

Blind spots in business occur in conversations. 

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A conversational blind spot happens when you are so stuck in your perspective that you fail to listen to contributions from others. 

You then try to persuade others that you are right which causes conflict to develop. When you refuse to see beyond our own point of view, you are creating conflict. 

Productive Conflict 

High-functioning teams have debates. They challenge each other. Everyone contributes. They throw all their ideas out there to be heard. People feel safe in this type of discussion. Groups like this shift and work together when they have discussions like this.

Characteristics of productive conflict include:

  • Focusing on ideas and concepts
  • Devoid of personal attacks
  • No fear of speaking and sharing openly working from a place of trust
  • Engaging in passionate, deep debate which can feel uncomfortable at times
  • Setting a goal to discover the best or most creative solution possible

Teams who engage in these types of conflict can make decisions without getting bogged down in argument. They also won’t have one person dominate a meeting.

Awkward silences may occur during the debate. However, this type of team has no need to agree on something just to end a discussion. 

It may not feel completely harmonious when your team participates in this type of conflict. Most of the time though, the direction toward the solution becomes clear because of the debate.

When there is trust, team members engage in unfiltered, constructive debate of ideas. 

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Assess Team Conflict

Answer the following three questions from Patrick Lincioni’s Team Assessment to assess the behavior of conflict in your team. Review each statement and rate your team according to the following scale. 


  1. Team members are passionate and unguarded in their discussion of issues when they are together. 
  1. Team meetings are compelling, not boring, engaging and not overly transactional.
  1. During team meetings, the most important and the most difficult issues are put on the table to be resolved.

Afterwards, share and discuss what the responses mean and how they impact your team individually and collectively. 

The majority of teams most commonly have the lowest score for question 2, with question 3 following closely behind. 

What is missing from your meetings?  As a leader you are still missing trust. Be sure to invite input so your meetings don’t become one-sided. 

Try reframing the concept of conflict from fear and risk-filled into an opportunity to challenge the status quo, to develop deeper relationships among team members, and to be a bridge to the next level.


When I coach leaders and their teams, this is the statement I hear most often,

“I wish my team had more buy into where we are going.” 

What I figure out that they’re really looking for from their team is engagement, motivation, and commitment to the mission of the business over their own goals or personal agendas.  

Commitment is not necessarily about consensus.

But, clarity and buy-in are the keys to commitment. 

In other words, people need to understand where they are heading, along with why and how their work contributes to the vision, mission, and direction of the business. 

Team members need to be able to weigh in, in order to buy in

Two of the biggest reasons teams lack buy-in are the desire for a consensus and the need for certainty.

Which may also be what you, as the leader of your team, believe is important too. It’s not surprising that those who you lead mirror this sentiment then, is it?

That’s why it’s important for you to drill down to what each of these terms means in context. 

Consensus: High-functioning teams recognize and ensure that everyone’s ideas are genuinely heard and considered. As a result, commitment develops within the team to support the direction or decision made by the group even when agreement is not unanimous. 

Certainty: High-functioning teams understand that making a decision is better than no decision. Whether it’s right or wrong, not deciding creates ambiguity. Team members see indecision as waffling which further erodes any chance at commitment. 

When you lack commitment to making clear decisions, your team will erode and impact your business.  This ambiguity leads to lack of confidence and fear of failure, both signs of distrust.

There are two simple tools you can use to create team commitment. They’re often overlooked or dismissed primarily because they do take time and practice to become effective. 

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Cascading Conversations

As a leader how often do you assume that your team understands what you mean? What is most important? How they fit into the business? What they contribute? 

If you’ve ever thought you explained this to them well enough, but you’ve had to do so more than once, you’re failing to bridge their comprehension gap.

You need to reconsider your style of communicating information to your team.  

Think about what you’re communicating, how detailed the information is, how often you’re communicating, and if it makes sense to others.  

Cascading communication is about reviewing the key decisions made with your leaders and managers to decide what information needs to be shared with the rest of your team.

Prioritizing the order and timeline of disseminating the information is key. 

Everyone involved in delivering the messages to the rest of the team must agree that their conversations will be consistent across the board and delivered on time. 

To be effective, cascading communication must be completed after each meeting. Otherwise, the rest of the team receives inconsistent messages which affects commitment.

Clarity of Expectations 

If your team members are not clear on all of your expectations of them, you will never get buy-in.

Be sure to include clear expectations regarding behavior, policy, procedures, productivity, and other assigned tasks or required contributions. 

Lack of clarity may show up after being on the job for some time, but expectations need to be defined upon hiring and onboarding each team member. 

Assess Commitment

Answer the following three questions from Patrick Lincioni’s Team Assessment to assess the behavior of commitment in your team. Review each statement and rate your team according to the following scale. 


  1. Team members know what other team members are working on and how they contribute to the collective purpose and the good of the team.
  1. Team members leave meetings confident that their peers are completely committed to holding the line on the decisions agreed upon during the meeting, even if there was (and still is) disagreement.
  1. Team members end discussions with clear specific resolutions and calls to action. 

Afterwards, share and discuss what the responses mean and how they impact your team individually and collectively. 

Teams tend to have the lowest score for question 1, followed closely by 2.  

Based on those results, it would be prudent to have all team members in different areas shadow each other or share with others what they do in their position.  

Noteworthy: When I started having my team do this in my practice it improved both commitment and connection with each other ten-fold.

When team members are able to actively debate, challenge and share with each other, they are more likely to be committed and supportive of the decisions they make as a team.

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Everyone struggles with holding each other accountable from time to time.

It’s an especially relevant challenge I hear about from leaders because accountability is one of the behaviors that elevates their stress level. 

Leaders often feel like they are accountable for everyone and their team members are not accountable for their own actions and behaviors. 

A frequent trend is for one of the team leaders to be frustrated because some of the team members are not following the same guidelines and policies that others are. They tell me that they are uncomfortable bringing this up to those individuals because it might cause conflict.  

Once again, tust, fear of conflict, and commitment are all impacted by not holding each other accountable. Lack of accountability causes the team to struggle and stresses out the person in charge.

When everyone is committed to a clear plan of action, they are better able to hold one another accountable. This is also known as peer to peer accountability. 

Peer to peer accountability works when team members are willing to challenge each other on behavior or performance that isn’t up to agreed upon standards or that hurts the team.

Team members don’t wait for the team leader to hold others accountable. As a result, the team learns how to hold the leader accountable as well. 

High-functioning teams are clearly committed, trust each other, and are confident in holding each other accountable for the standards, behaviors and rules they’ve established for their team. 

Rules of Engagement  

Rules of engagement are determined collectively by the team and facilitated by the leader. It’s a process that allows the team to establish ground rules for meetings or for the business as a whole.  

Once established, the team members agree to hold each other accountable for the behaviors and rules they defined. 

This is how strong teams shift accountability from always being the leader’s responsibility. But, in order for it to work, it requires everyone’s involvement. 

One of the most common rules of engagement teams establish in meetings, for example, is showing respect for each person when they are speaking. It is the leader’s job to ask clarifying questions on what “respect” behaviors look like in action. Those answers then become part of the definition in the rules.

Assess Accountability

Answer the following three questions from Patrick Lincioni’s Team Assessment to assess the behavior of accountability in your team. Review each statement and rate your team according to the following scale. 


  1. Team members call out one another’s unhelpful or unproductive behaviors.
  1. Team members are deeply concerned about the prospect of letting down their peers.
  1. Team members challenge one another about their plans and approaches.

Afterwards, share and discuss what the responses mean and how they impact your team individually and collectively. 

The majority of teams have the lowest score in question 1, with question 3 close behind.

If your team scores the same, it’s a clue that they don’t have buy-in on the behaviors being identified. Either that, or they lack trust, conflict, and commitment so they’re not comfortable holding others accountable.

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In healthcare, everyone understands how important patient results and outcomes are. 

Each team member has their own metrics and goals that are required for their position. Many teams share the metrics (KPIs – Key Performance Indicators) to show how each team member’s metrics impact the bottom line. 

This is critical in healthcare. Every healthcare worker knows, “No margin, no mission.”

Team members need to make collective results their top priority, even when it is easy to get side-tracked and be more focused on their own goals.  

Building the team with the foundational traits of trust, conflict, commitment, accountability first, achieving results happens because of everyone’s work collectively. 

Acknowledgement and Praise

Who doesn’t love praise for their work?

Praise initially falls on the owner or leader to model for the team. Even though most teams report their successes at staff meetings, unconditional, spontaneous acknowledgment at different times can carry more weight and more value to individual team members. 

To be most effective, praise should be unexpected, but regular, both for the team and each individual. That type of recognition becomes exponentially effective when it also acknowledges support of the mission and core values of the business. 

Acknowledgment and praise, both from leaders and between team members, regularly and unconditionally, is a benchmark of high- performing teams.

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Assess Results

Answer the following three questions from Patrick Lincioni’s Team Assessment to assess the behavior of results in your team. Review each statement and rate your team according to the following scale. 


  1. Morale is significantly affected by the failure to achieve team goals. 
  1. Team members are slow to seek credit for their own contributions but quick to point out those of others.
  1. Team members willingly make sacrifices ( budget, PTO, coverage for their peers, etc) in their area of expertise for the purpose and/or good of the team. 

Afterwards, share and discuss what the responses mean and how they impact your team individually and collectively. 

Teams report the lowest score for question 1, followed closely by 2.  

As a leader, if your team scores similarly, consider whether you’re making it clear to your team members how their individual goals and achievements impact the team collectively. Ensure they realize not only the positive impact for meeting their goals, but the negative impact that ripples out to the team when their goals are not met.

For a team to excel, all members must put team goals ahead of their individual goals. This is a challenge for all leaders to create and to facilitate this balance.


Now that you understand the five behaviors high-performing teams demonstrate, it’s time to find and develop future leaders in your team to instill them.


Turnover is costly.

It affects you, other team members, and your overall business performance. 

You also should know how difficult it is to recruit the ideal team players you need to provide the professional services your business offers.

The strongest organizations have a system in place to identify and develop emerging leaders. But in healthcare, leaders and CEOs are not sure where to start this process. 

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You might think an emerging leader is a Millennial, or someone from Gen Z, but it’s not just a generational consideration.

Emerging leaders are people in your organization who have high potential and are top performers. They may be individual team members, managers, or other program leaders. 

Simply put, emerging leaders are people who are, or will be, in some leadership role at some point. So, if you want to retain these team members, you need to invest in their personal and professional development. 

Give emerging leaders and other valuable employees a good reason to stick with your team.


How does now strike you?

Most healthcare leaders, CEOs, and business owners tend to wait until everything is in “perfect” order and the business is stable. However, until you shift your mindset about when you need leaders, it will have a negative impact on growth, retention, and even your potential exit strategy.

According to Deloitte’s Global Human Capital Trends, 89% of organizations say developing leaders is a big focus. However, they’re stuck when it comes to identifying who those emerging leaders are.  

Bridging generational gaps with your team has its own set of demands. Things to consider are differences in attitudes, priorities, and goals. This pushes most business owners and CEOs to seek out new ways to retain, develop and grow employees. Specifically, developing current team members who already support you into leaders is the most viable play for the long-term success of your organization.


Every employee wants clarity and understanding of how they fit into your organization.

The evolving generations – primarily generations  X, Y, and Z – are also looking for growth and development opportunities. 

Top words and phrases that emerging generations share about what they want in their workplace include the following, listed in the order of priority.

  • Support for business leaders or senior managers
  • Growth
  • Coaching
  • Work-life balance
  • Mentoring
  • Training
  • Values
  • Purpose 

As a leader and CEO it’s important to consider the values your emerging leader in an emerging generation holds so you can choose how to develop them appropriately. 

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Your job as a leader is to set expectations for your team’s behavior. 

Become the model for what you would like to see, hear, and experience in your team and your business. 

The most effective way to model behavior, set expectations, and drive better performance is through coaching. And truthfully, anyone can learn to become a good coach over time.

Some things to consider when coaching is a tool you decide to utilize are:

  • Coaching mastery is a teachable skill 
  • Anyone on your team can coach anyone else
  • Coaching is not transactional or dictating
  • Coaching is inquiring and asking curious questions
  • Coaching builds connections, relationships, trust, and accountability 
  • Coaching encourages conflict, supports commitment, and achieving results 

Following are a few simple examples to help you practice coaching in day to day conversations with anyone, anywhere, at any time.

Use these scenarios to shift that feeling of stress you may feel as a leader of your team to be the one who’s accountable for everyone else on your team. 

These exercises will empower your employees to jump on board with the transition or culture shift you’re leading into growing a strong team.


When talking with your team about a challenging issue facing your business, showing your vulnerability and willingness to ask for help is a great place to start.

“ We are having this problem in this area. I’ve put some thought into this, but I don’t know what to do. I really need your help to identify the problem and help create a solution.”

Developing stronger relationships with employees and acknowledging their needs or accomplishments unrelated to work is another area to explore.

“I noticed that you’re running out of the office everyday right at the end of your shift. This doesn’t seem like you. How can I help you so you don’t have to hurry?”  

Creating an opening for a safe discussion with the employee allows for additional conversation.This creates a connection with the employee allowing you to have a conversation with lasting impact.

Potential conflicts about tasks that aren’t being done correctly or in a proper time frame is another coachable moment.

Your employee isn’t tracking new referrals as instructed. Ask the following questions.

“Tell me how the tracking system is working for you on the new referrals?” 

“What barriers or obstacles are getting in your way of completing this log?”

Then, conclude your discussion with,

“Let’s make sure you’re clear on why this tracking system is important. Perhaps I wasn’t clear enough on the process.”

For additional questions you can use to shift your conversations into coachable moments that produce meaningful discussions, click here

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You realize your most important business asset is your employees. 

To review, here is the list of elements required to build and grow an effective team inside your business.

  • Top 10 challenges to building a high-performing, cohesive team
  • Five behaviors all high-function teams have in common
  • How to develop emerging leaders to engage, grow and retain a high quality team
  • Ways to improve your coaching skill set as a leader and a team


Dennis sought out my services initially because he was tired of working in the weeds all the time. He was stressed and wanted to grow his business, but he had a small staff and was always the one putting out fires running the day to day ops. 

First, Dennis invested in executive leadership coaching for himself. You can learn more about the benefits of that program here

He was so motivated by the positive changes happening as he became a better leader, he decided to identify and invest in developing his own emerging leaders. Now, his team is stronger and more effective than ever. 

In fact, his practice has tripled. 

Dennis claims that enrolling his emerging leaders into my Leadership Development Group Program is a major contribution to the successful growth of his practice. 


Leadership development group coaching is a tool I created to help you create a high-performing, cohesive team of your own.

It’s the same tool I used to turn my last PT practice into an environment where every person on my team understood their value and their contribution to the success of my business. 

In short, business owners who are ready to recapture growth and redefine the way they do business develop emerging leaders to help them execute on those goals.

They are tired of the status quo. Overwhelm is no longer where they want to live. All they want is to have a strong team behind them who can deliver on the vision they have for the business.

Are you ready to drive that vision by investing in team members who want your business to succeed as much as you do?

There’s only one way to know for sure.

Take action and book a complimentary strategy session with me

We’ll have an honest conversation on whether I feel I can help you improve your business environment with leadership development group coaching. And, you’ll leave with action steps you can take immediately following our call to strengthen relationships with every member of your team.


1. Pentland, A (2012). The New Science of Building Great Teams. Harvard Business Review April Issue
2. Glaser, J. and Glaser, R (2014). The Neurochemistry of Positive Conversations. Harvard Business Review June Issue
3. Autry, A. (2019). Employee engagement & Loyalty Statistics: The Ultimate Collection.
4. Dimoka, A. (2010). What Does the Brain Tell Us About Trust and Distrust? Evidence from a Functional Neuroimaging Study. MIS Quarterly  
5. Lencioni, P. The Five Dysfunctions of a Team