4C Building Reflective Capacity in Supervision and Consultation

Transcription

1 4C Building Reflective Capacity in Supervision and Consultation Part 2: The Notion of Reflection in Relationship Based Practice : What, Why, and How?

2 Overview Introduce you to a different notion of reflection One used in relationship based work Evidence that reflection in professionals and parents is important Practice listening for reflection How we promote reflection

3 What is reflection? When you hear the word reflection what do you think of? Why is it important? Parents: Increase sensitivity and empathy (Slade et al.) Early Child Care Providers: Increase promotion of children s social emotional competence More on this later.

4 What is reflection Begins with the ability to talk and think about mental states Thoughts Feelings Beliefs Intentions (Fonagy; Slade; Jurist; Steele & Steele)

5 What is reflection. Reflection takes discussion of mental states to a new level Understanding the complexity mental states Linking mental states to behavior Developmental aspects of mental states Mental states in relation to others (Fonagy; Slade) What does this stance buy you? As a parent As a home visitor As a supervisor

6 Why is reflection important? Adult Attachment Thoughts, Feelings, Behaviors in Relationships Reflective Functioning Child Outcomes

7 The Evidence: Attachment, reflection, and Service Provision Clinical case managers Therapist comfort with closeness & client rating of an emotional bond (Friedlander, 1996) Attachment anxiety is related with early therapeutic alliance that declines over time (Sauer et al., 2003) Attachment anxiety is negatively related to empathy (Brennan et al., 1998) Insecurity is associated with negative countertransference behaviors (Ligiero & Gelso, 2002) Attachment avoidance less depth to intervention and perceive less dependency needs in the client (Dozier et al., 1994)

8 The Evidence: Attachment, reflection, and Service Provision Home Visitors Attachment security Associated with fidelity to the curriculum Home visitors ability to establish a trusting relationship Attachment insecurity Increased levels of subjective distress and negative engagement Lower levels of self efficacy Emotional exhaustion & depersonalization (anxiety) Less job satisfaction and turnover (avoidance) (Burrell et al., 2009)

9 The Evidence: Attachment, reflection, and service provision Teachers Security Better conflict resolution strategies (Morris Rothschild & Brassard, 2006) Reflective Functioning associated with behaviors that promote children s SEC (Stacks et al., 2011)

10 In Sum.. Service providers who have insight and empathy for the mental experience of self and other will Deliver the program as intended Support children s social emotional development and school readiness Foster trusting relationships with clients Use the clinician parent relationship to support parent s development of reflective functioning and sensitivity.

11 From knowing to hearing. Now that you know what reflection is lets practice listening for it. Your ability to hear reflection helps you foster reflection in your supervisees, which helps foster reflection in their clients.

12 What is reflection. Reflection takes discussion of mental states to a new level Understanding the complexity mental states Linking mental states to behavior Developmental aspects of mental states Mental states in relation to others (Fonagy; Slade)

13 High, Medium, and Low Reflection some examples High: Mental state language and indications that Aware that mental states are not always clear, dependent on development, and related to other mental states Mental states underlie behavior and that parents and children perceive situations differently Thoughts and feelings change over time The interviewer can be affected by what is being said

14 High, Medium, and Low Reflection some examples Low: Some/no use of mental state language Vague responses Incoherent Derogating/negative Not answering the question Third person Direct discourse Doesn t reflect mixed emotions or uncertainty

15 How Can we Promote Reflection in Teachers? Virmani, 2011 Reflective supervision, but NOT administrative supervision Administrative supervision focuses on the rules, procedures, monitoring, evaluation, and help with what to do

16 The WSU Dual Title Degree in IMH Training in reflective practice Education Social Work Nursing Currently graduate options, but also offer courses to undergraduates Reflection is built into every course Example: case studies, observations Careful questioning 1 year of reflective supervision/seminar while placed or working with young children.

17 Elements of Reflective Supervision Regularity Time is consistent, supervisor is fully available (no phones or interruptions) Collaboration (not evaluation) Sharing power Supervisor bears the responsibility for bringing an agenda, analyzing her work, and contributing meaningfully to her own evaluation

18 Elements of Reflective Supervision (Parlakian, 2001) The experience of good supervision is like finding a fellow traveler on a challenging journey, a companion worthy of trust who has visited similar destinations. This fellow traveler knows many routes to the shared goal, but is open to discovering a different path, a path we walk together, often with me in the lead, except I miss the flowers to smell or stumble and can t find my way. Then the supervisor is there to guide, even to prod a little to bolster my courage and help me to regain my footing and focus, to helm me find my strength. Shahmoon Shanok (1992)

19 Elements of Reflection Supervision (Parlakian, 2001) Reflection about what one is observing, doing, and feeling Allows the practitioner/educator to discover his/her own belief, ideas, actions and interactions Simultaneous doing, learning, and coming to know

20 What happens in Reflective Supervision (Gilkerson & Shamoon Shanok, 2000) Preparation Shift from present preoccupations Move to a place where you are fully open to another and to take in the state of another Clear mind and create a private space Greeting Brief greeting and making a personal connection Help make the transition to a calm space

21 What happens in Reflective Supervision (Gilkerson & Shamoon Shanok, 2000) Opening the Dialogue and Creating the Agenda Some use a ritual way of starting the session Transition from the greeting and personal information to the supervisory session Listen carefully and attentively Supervisee leads the conversation Gathering Information When an issue has been identified don t rush in with a solution Try to understand what was said, observed and felt by supervisee and others Helps for the supervisee to become aware of attitudes and reactions

22 What happens in Reflective Supervision (Gilkerson & Shamoon Shanok, 2000) Formulating the hypothesis Supervisor and supervisee begin to share tentative ideas about what is going on and what might be helpful Considering next steps Helps contain and organize what was learned in the session Gives direction how might you approach this situation next time? Closing Supervisor makes a statement that conveys appreciation for the work that was done together Confirms next appointment

23 How to Learn More about Reflective Supervision MI AIMH & MPSI are good resources Participating in Reflective Supervision Trainings Supervision of Supervision