reflective practice and supervision: defining and …reflective practice and supervision: defining...
TRANSCRIPT
Reflective Practice and Supervision: Defining and Connecting
Elesia Hines, PsyD, HSPPSteve Viehweg, LCSW, ACSW, IMH-E® (IV), CYC-P
Riley Child Development Center – Indiana LENDIndiana University School of MedicineRiley Hospital for Children at IU Health
Disclosures
Elesia Hines has no relevant disclosures.
Steve Viehweg is a co-author of Tackling the Tough Stuff: A Home Visitor’s Guide to Supporting Families at Risk (2016)
Objectives
• Participants will be able to… – Recognize key components and principles of
reflective practice/ consultation– Define reflective supervision/consultation and
how it differs from other forms of supervision– Explain the roles of the supervisee/participant and
the supervisor/consultant
REFLECTIVE PRACTICE
Reflection
• One of many mindfulness skills
• Allows focus on the present
• Increases awareness of one’s own feelings and responses
• Results in better decision making, increased sense of effectiveness, and enhanced ability to take in and make use of new information
Tomlin
Reflective Practice
A way of working that encourages one to:
• Think about implications of interventions while doing the work
• Slow down, filter thoughts, carefully choose words and actions
• Attain a deeper understanding of things that effect our work
• Spend time thinking about work and related experiences in order to make good decisions about future steps
Heffron & Murch, 2010
In reflective practice we:
• Think differently so we can act differently
• Apply knowledge and skills
• Integrate in a meaningful way new knowledge and strategies
Gatti, Watson, & Siegel, 2011
Tomlin
Professional Use of Self
• Being aware of your own internal experience
• Recognizing that families have experiences that may be different from yours, but are just as valid
• Being willing to consider how your experience affects your behavior with others– Recognize judgments, intolerances, wishes– Know your triggers or hot buttons, fears– Suspend certainty (Jeree Pawl)
Heffron, Ivins, & Weston, 2005
Tomlin
The more you know about another's story, the less fearsome and more human that person becomes. It is
equally true that the better we understand our own stories, the more
human we become. - Parker Palmer
Relationships
• Our work requires taking multiple perspectives – Thinking about and “holding” each family
member’s experiences and feelings– Considering contexts, cultures, communities,
individual differences
• Awareness– What do we bring to the interaction?
Why attend to relationships?• Relationships are the vehicle through which most
important learning occurs
• Needs for relationship continue throughout our lives!
• A supportive relationship can lead to learning and growth at any age
• Very important in early childhood work: Research shows that parents who feel trust and support from a provider are more likely to be engaged and do things that are needed by their children (Daro & Harding, 1999)
Tomlin
Relationships in I/EC Work
Relationships that matter in early childhood work include:
• Parent-child• Parent-provider• Provider-supervisor
Parallel Process
“Describes the interlocking network of relationships between supervisor,
supervisees, families, and children”
Heffron & Murch, 2010
Parallel Process
Parent-Child
Professional-Parent
Supervisor-Professional
Tomlin & Viehweg, 2016
Why attend to parallel process?
“The success of all interventions will rest on the quality of provider-family relationships, even when the relationship itself is not the focus of the intervention.”
Kalmanson & Seligman, 1992, p. 48
Through increased understanding and awareness of parallel process, the practitioner…
• Takes time to consider what has been done, said, felt, and thought
• Increases the ability to respond with empathy, attunement, and support
• Slows down (and helps the family slow down)• Considers other possible meanings and responses• May be better able to restore disruptions in
relationships
Source: What is Reflective Practice? By Tina Dorow, LCSW. Illinois Children’s Mental Health Partnership Reflective Practice Guide
Key Components of Reflective Practice
• Contemplation• Self-awareness• Curiosity• Professional/personal development• Compassion
REFLECTIVE SUPERVISION/CONSULTATION
Types of supervision
• Administrative supervision– Focused hiring, training, oversight of paperwork,
explanation and enforcement of agency rules and policies, monitoring of productivity and staff evaluation.
• Clinical supervision/consultation– May be a necessary requirement for licensure in a given
discipline; most likely includes many or all of the administrative objectives as well as:
• Review of casework; review, discuss and evaluate diagnostic impressions, treatment planning, intervention strategies and clinical progress; give guidance/advice and teach.
Reflective Supervision/Consultation
• “A collaborative partnership for professional growth that improves program quality and practice by cherishing strengths and partnering around vulnerabilities to generate growth.” (Shahmoon-Shanok, 1991)
• Or more, simply, “a relationship for learning”
You Can’t Do This Alone
RS/C includes a reflective component that allows the participant to have time and support to:
• Consider his or her own responses to the work
• Link those responses back to previous experiences
• Consider how those responses may guide future action
• Wonder about what is happening for the parents and baby/child
• Consider a variety of possible links between all of these factors
(Heffron & Murch, 2010; Shahmoon-Shanok, 2010; Weatherston & Barron, 2010)
Tomlin & Viehweg, 2016
Reflection, Reflective Supervision
• Use of reflection, especially with a trusted supervisor or mentor, can build skills, combat barriers to relationships, and protect the provider
• “We need reflective supervision to save our patients from ourselves” (David Peters)
Primary Objectives of Reflective Supervision/Consultation
• Acknowledgement that very young children have unique developmental and relational needs
• Form “a safe relationship for learning”
• Provide an intentional partnering relationship
• Use process as the approach to problem-solving
• Promote ‘professional use of self’
• Provide a safe place to explore issues of culture and diversity (Stroud, 2010)
Heffron & Murch, 2010
Building Blocks of Reflective Supervision/Consultation
• Reflection
• Collaboration
• Regularity(Parlakian 2001)
Reflection
• Stepping back and taking the time to wonder what the experience really means• What does it tell us about the family?• What does it tell us about ourselves?
• Allows us to examine our thoughts and feelings and the experience
• Can help us identify the best interventions for the family
Collaboration• Emphasizes sharing the responsibility and control of power
• Allows supervisors and mentors a chance to learn from (and teach) staff
• Allows supervisors to recognize opportunities to share responsibility and decision-making
• Characterized by reciprocal expectations of each partner
• Open communication
Regularity
• Should have a reliable schedule and sufficient time must be allocated
• Should be protected from cancellation and rescheduling
• Supervision is an investment in the professional development of staff• It takes time to build a trusting relationship and to
discuss ideas, thoughts, and emotions
Supervisee/Participant Role
• Arrives on time and remains open and emotionally available• Comes prepared to share the details of a
particular situation, home visit, assessment, experience or dilemma
• Asks questions that encourage thinking more deeply about one’s own work with very young children and families and also oneself.
Supervisee/Participant Role
• Increases awareness of the feelings experienced in response to one’s work and in the presence of an infant or very young child and parent(s)/caregivers• As the supervisee is ready and able, shares those
feelings with the supervisor/consultant
Supervisee/Participant Role• Allows the supervisor/consultant to provide support and
takes responsibility for telling the supervisor what kind of support feels helpful
• Remains curious and open to new interpretations of and possibilities for the work
• Suspends critical or harsh judgment of self and of others
• Reflects on supervision/consultation session to enhance professional practice and personal growth
Supervisor/Consultant Role
• Active listening and thoughtful questioning (supervisee does this as well)
• Help the participant to answer his/her own questions
• Provide support and knowledge needed to guide the decision-making process
Supervisor/Consultant Role
• Provide an empathetic, nonjudgmental ear• Difficult issues can be discussed without fear
of judgement, disclosure, or ridicule• Respect each participant’s pace/readiness to
learn and reflect
Supervisor/Consultant Role
• Listen for the emotional experiences that the participant is describing when discussing the case or response to the work– Ex: anger, impatience, sorrow, confusion,
ambivalence, pleasure, etc.– Wonders about, names, and responds to these
feelings with appropriate empathy
Supervisor/Consultant Role
• Invite the participant to have and talk about feelings awakened in the presence of an infant or very young child and parent(s)• Wonder about, name and respond to those feelings
with appropriate empathy
• Maintain a shared balance of attention on infant/toddler, parent/caregiver and supervisee
Supervisor/Consultant Role
• Encourage exploration of thoughts and feelings that the supervisee has about… – The work with very young children and families – One’s response(s) to the work– The experience of supervision/consultation– How the experience might influence his/her work
with infants/toddlers and their families
What does this look like?
How do I get it?
Summary
• Relationship is the foundation for reflective supervision and consultation
• All growth and discovery about the work and oneself takes place within the context of this trusting relationship
• Much like the real work for children and families takes place between sessions, we too learn when we pause and reflect on the work
“Stepping back from the immediate, intensive experience of hands-on work and taking the time to wonder what the experience really means.”
Parlarkian, R., 2001
IMH IN INDIANA
Indiana’s IMH Endorsement• Competency-based credential for the infant and early childhood
workforce
• Endorsement indicates that the holder is knowledgeable and has skills and experience in supporting infants and young children and their families.
• Four categories that include all infant-toddler workers
• Managed by the Alliance for the Advancement of Infant Mental Health (MI) and implemented by Infancy Onward – Indiana’s IMH Assoc
• 27 state IMH associations are part of the Endorsement to date (plus 2 international associations – Ireland and Australia)
• Active research being conducted
EndorsementInfant Family Associate
Infant Family Specialist
Infant Mental Health Specialist
Infant Mental Health Mentor: Clinical, Policy, or Research Faculty
Education CDA or Associate’ s or 2 years early childhood experience
Master’s or Bachelor’s degree
Master’s or postgraduate degree
Master’s, postgraduate, doctorate, postgraduate, MD, OD, JD
Work Experience
2 years in the infant, early childhood, and family field
2 years in the infant, early childhood, and family field
2 years post-Master’s providing infant mental health services
3 years post Master’s in infant, early childhood, and family field
Indiana Examples
Healthy Families workers, child care provider, Early Head Start home visitor
First Steps provider, Infant Toddler Specialist, Early Head Start workers and Head Start teacher, DCS workers, nurses
Community Mental Health Center therapists, private practice providers, nurse practitioners
University Faculty, physicians, judges
Resources
State: Infancy Onward (https://www.infancyonward.org/)
National: Alliance for the Advancement of Infant Mental Health (https://www.allianceaimh.org/)
National: Zero to Three (https://www.zerotothree.org/)
International: World Association for Infant Mental Health (https://www.waimh.org/)
Online RS/C Groups
To sign up for a group, please contact Becky Gee with Infancy Onward:
Thank you!!
Elesia Hines – [email protected]
Steve Viehweg – [email protected]
Please be sure to complete the survey!
References and Recommended Readings
• Gatti, S.N., Watson, C.L., & Siegel, C.F. (2011). Step back and consider: Learning from reflective practice in infant mental health. Young Exceptional Children, 14, 32-45.
• Heffron, M.C., Ivins, B., & Weston, D.R. (2005). Finding an authentic voice-Use of self: Essential learning processes for relationship-based work. Infants & Young Children, 18(4), 323-336.
• Heffron, M. C, & Murch, T. (2010). Reflective supervision and leadership in infant and early childhood programs. Washington, DC: ZERO TO THREE.
• Kalmanson, B., & Seligman, S. (1992). Family-provider relationships: The basis of all interventions. Infants & Young Children, 4(4), 46-52.
• Parlakian, R. (2001). Look, listen, and learn: Reflective supervision and relationship-based work. Washington, DC: ZERO TO THREE.
References and Recommended Readings
• Scott Heller, S., & Gilkerson, L. (Eds.). (2009). A practical guide to reflective supervision. Washington, DC: ZERO TO THREE
• Shahmoon-Shanok, R. (1991). The Supervisory relationship: Integrator, resource and guide. Zero to Three 12(2), 16-19.
• Shahmoon-Shanok, R. (2010). Reflective supervision and practice. Zero to Three, 31(2), 4–5.
• Weatherston, D.J. & Barron, C. (2009). What does a reflective supervisory relationship look like? In S. Heller & L. Gilkerson (Eds.), A practical guide to reflective supervision (pp. 61-80). Washington, DC: ZERO TO THREE.
• What is Reflective Practice? By Tina Dorow, LCSW. Illinois Children’s Mental Health Partnership Reflective Practice Guide. Accessed at http://icmhp.org/wordpress/wp-content/uploads/2016/01/ReflectivePracticeGuideR04-03-15.pdf