By Melissa M. Sweetman, OTD, OTR/L

Conflict is inevitable; it occurs at home, in the workplace, among friends, and even sometimes among strangers. Tension between people may arise due to a variety of situations, such as differing opinions, values, beliefs, or preferences.1 It is of critical importance that leaders be cognizant of the potential for conflict, aware when conflict does arise, and have a plan for managing and resolving it prior to the onset of long-standing negative repercussions.

The potential for conflict abounds in rehabilitation environments. The demands of insurance companies and third-party payors often lead clinicians to feel a sense of conflict between what is reimbursable and what is clinically indicated. Closely related to this situation are the perceptions of conflict between high productivity expectations versus top-quality therapy interventions. The potential result is a disagreement between managers and clinicians who have not yet been able to determine how to accomplish both optimal productivity and optimal quality. Conflict can arise between colleagues when one clinician believes the other is not being held accountable for departmental rules, not pulling equal weight on the team, not providing services deemed to be the best for the client, etc. Additionally, conflict can easily arise between the clinician and the client due to personality differences or a failure of the clinician to utilize a client-centered approach to care. Of course, there are many other causes of conflict that can arise within a therapy setting; it is not possible to avoid all types of conflict in all environments.

Outcomes of Conflict

Runde and Flanagan, who are experts on the topic of conflict, describe conflict as a process that begins with a precipitating event or difference between two parties and moves in one of two directions: toward what they label the “high road” or the “low road.”2 The low road is followed when destructive behaviors dominate, therefore leading to greater levels of tension and prolonged conflict. Conflictual situations may lead to negative interpersonal relationships and can breed anger and resentment, which in turn may lead to poor job performance and working relations.2,3 Conflict in the workplace may have lasting effects, including “diminished team morale, decreased customer/patient satisfaction, the tarnished reputation of the organization, …and emotional costs for those involved in the conflict.”4

Alternately, when the high road is followed, constructive behaviors are predominant, tensions lessen, and the conflict is resolved. In some circumstances, conflict can lead to creativity and increased job performance.2 Other positive outcomes of conflict include a more effective decision-making process, stronger relationships, and an improvement to the general morale and emotional tone of the environment.2 Furthermore, research shows that some types of conflict in the workplace can energize employees and lead to improved job satisfaction.5


Conflict Styles

There are many existing frameworks for managing conflict and a variety of methods to assess conflict management styles. “Personality traits, conflict resolution styles, and emotional intelligence are some of the key determinants of how conflicts are resolved.”6 Thomas and Kilmann developed a classification to detail one’s conflict style based on the level of importance of one’s own needs versus those of someone else.2

Competing. This particular style of conflict management involves a high level of importance of one’s own needs and a low level of importance of others’ needs. A person who utilizes this strategy seeks to “win” the conflict, thereby ensuring that the other person “loses.” It is a highly contrary style of behavior and relies upon one’s use of power, rank, control, money, or even physical force.6

Avoiding. Avoidance behavior is simply that:
Avoiding the conflict altogether. One who employs this method of conflict management feels no sense of importance toward either his own needs or those of the other person. This style is often characterized by procrastinating, discounting, or withdrawing from difficult situations.6

Accommodating. This conflict management style describes one who has a low perception of importance of his own needs, but feels a high sense of importance of others’ needs. While accommodating people are open to others’ beliefs, opinions, or suggestions, it is often at their own expense. In other words, accommodators may neglect themselves in lieu of accepting someone else’s perspective. This style often shows evidence of “selflessness, generosity, or charity.”6

Compromising. One who compromises when dealing with conflict has equal mid-level concern regarding both parties’ needs.3 This style describes one who will work to find a solution that pleases both parties.5

Collaborating. The collaborating style involves one who has a high regard for the needs of both parties. He seeks to find a solution that is equally pleasing to both sides. It is a highly cooperative style in which one person is “willing to explore a disagreement to learn from others’ insights.”6

When selecting a conflict management style, it is important to consider the context, stakes, and people involved. None of these styles are inherently good or bad.2 For example, in some situations, avoiding a conflict may lead to the problem festering and growing. In other situations, temporarily avoiding the situation can allow tensions and emotions to settle, setting the stage for productive conflict resolution discussions. Alternately, using the accommodating style could strengthen relationships because the other person feels that his opinion is valued and heard; whereas, the person doing the accommodating could feel resentment for “giving in,” thus damaging the relationship over time.

Strategies for Conflict Resolution

When conflict occurs, it is important not to act reactively and quickly without proper consideration of the entire situation. Runde and Flanagan suggest a strategy that includes three basic steps: cool down, slow down and reflect, and engage constructively.2 Cooling down involves developing a sense of emotional self-awareness so that one may fully understand his own “hot buttons” that may elicit an emotional response. Additionally, cooling down involves taking time out to allow one’s emotions to settle so that the conflict can be addressed objectively. The second phase of approaching conflict requires that one slows down to reflect on the situation, including its full context and all involved parties. This process enables the parties in conflict to examine their own thoughts, emotions, and interests as they relate to the situation. By gaining a greater understanding of one’s own response to conflict, one will be better prepared to engage constructively as he negotiates a resolution from a neutral and open standpoint.

One generally chooses to utilize constructive conflict behaviors to facilitate understanding of the situation and to de-escalate emotions with the intention of resolving the conflict. These behaviors can take one of two forms: active or passive conflict behaviors. Both types of behavior aid in the resolution of conflict while eliminating as much damage as possible.

Active Constructive Behaviors: Active constructive behaviors are those “in which the individual responds to conflict by taking overt action that results in the reduction of the conflict or the tensions caused by it.”3 There are several different active constructive behaviors. These include listening for understanding, perspective-taking, creating solutions, expressing emotions, and reaching out.

Listening for Understanding. Listening for understanding is different from the simple act of listening. This skill is conducted with the intent of truly comprehending what the other person is trying to say without being concerned with formulating one’s own response.2 This involves listening openly and attentively, without bias or emotion, and “acknowledging, paraphrasing, reflecting, clarifying, questioning, and summarizing as well as using non-verbal communication skills.”7

Perspective-Taking. Perspective-taking is the act of truly trying to understand the situation from the other party’s perspective. By doing so, one can gain insights regarding the other’s position and it may serve to clear up any misinterpretations of the situation. Research shows that perspective-taking, in general, improved relationships and conflict resolution across the board. More specifically, those subjects who experienced the other person’s perspective were more likely to negotiate a resolution than those who just passively heard about the other person’s perspective.8

Creating Solutions. Conflict is not resolved by simply acknowledging it; conflicting parties must be willing to work together to identify potential solutions. A conflict competent leader successfully identifies and explores “multiple possibilities in ways that enable the selection of the best solutions.”2 The important concept here is that multiple possibilities for resolution are created. Kasser states, “Creating innovative solutions incorporates the skill to see things from multiple perspectives (inputs) rather than from a single perspective, as well as the skill to see multiple potential outcomes (outputs) rather than a single outcome.”9 This skill allows both parties to evaluate all of the possible solutions while taking into account each other’s perspectives for optimal resolution.

Expressing Emotions. Conflictual situations are often emotional situations. It is human nature that one may feel a rise of emotion when faced with a situation that involves conflict. How one handles that emotion can have a significant impact on the resolution of the conflict. It is best not to suppress the emotion, but instead, to express it in a calm, assertive manner.2 According to Runde and Flanagan, “It’s critical to deal with our conflict partners in honest, straightforward ways so that feelings can be described, not behaved.”2 To communicate emotions effectively:

  1. Name the behavior that is a problem;
  2. Name the emotion you feel when the behavior takes place;
  3. Name the need you have that is not being met because of the other person’s behavior;
  4. State in very concrete terms what you would like the other person to do.10

Taking each of these steps while openly, honestly, and calmly expressing one’s feelings will lead to a more trusting relationship that sets the groundwork for conflict resolution to occur.


Reaching Out. The act of reaching out for some people may be one of the most difficult active constructive behaviors. This involves setting aside one’s pride, and taking an active step to solve the conflict. This action “is intended to address the emotional harm caused during conflict, reduce tension between the parties in conflict, and enable the parties to fully re-engage in the conflict resolution process.”3 Reaching out is akin to waving the olive branch and offering up an apology.

Passive Constructive Behaviors. Passive constructive behaviors “are characterized by withholding comments or refraining from action. These behaviors usually result in the reduction of tensions associated with the conflict.”2 There are several passive constructive behaviors, including reflective thinking, delayed responding, and adapting.

Reflective Thinking. Reflection is the process of taking time to introspectively examine one’s own thoughts, feelings, and actions that may be related to the conflict in some way. It allows one to focus on his own perceptions of the context and his role in it. Reflective thinking slows down the process of conflict resolution so that solutions can be examined. It involves looking back at an event, analyzing the event, and thinking carefully about what that event personally means.11

Delayed Responding. Delaying a response is exactly what it sounds like—taking time away from the conflict, therefore delaying any sort of response to it. Different from reflective thinking, this type of time away from the conflict allows one to remove himself and his thoughts temporarily from the conflict. The point of a delayed response is to “calm down by virtue of disengaging from the tension and stress.”2

Adapting. The process of adapting relies heavily on the concept of flexibility. It requires that one be willing to adopt a new attitude and consider alternative solutions that one is naturally inclined to consider. Adapting requires that one approach the situation with an optimistic and flexible mind-set.2 One who adapts seeks the good in the situation and holds out hope that the situation can be resolved constructively.

Conflict is a complex and multi-faceted phenomenon that is inevitable. How conflict is handled can make the difference between construction and destruction, between positive outcomes and negative outcomes. The actions that one takes, active or passive, can facilitate the process of constructive conflict resolution. Additionally, how one communicates and manages emotions during times of conflict can either hinder or help the resolution process and the lasting outcomes of the conflict. Conflict communication that is respectful and founded upon a strong level of emotional intelligence has been proven to be most beneficial. RM

Melissa M. Sweetman, OTD, OTR/L, has been an occupational therapist for 21 years. For the majority of her career, she worked as a clinical and operational multi-state regional director in the post-acute and long-term care settings. She currently serves as a program director for the Post-Professional Doctor of Occupational Therapy Program at Rocky Mountain University of Health Professions in Provo, Utah. Additionally, she serves as the administration and practice management elective track director within the OTD program and as the president of the South Carolina Occupational Therapy Association. Her passion is leadership development, and she is currently in the process of earning a PhD in Leadership with a concentration in Educational Administration. For more information, contact


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