Creating a Structure for Reflective Practice

Supporting the Growth of Reflective Practice

Reflective practice is a way of engaging in service delivery that spans disciplines and systems. Reflective practice as described by Schon, Dewey, and others encourages perspective taking, examination and awareness of self, and the development of critical thinking skills needed to make decisions that help tailor services to individual needs.

Reflective practice is promoted as a key element in delivery of effective services to diverse populations of infants, children, and families. Reflective practice improves engagement with clients and helps practitioners see differences and strengths that might not ordinarily be perceived. Reflective practice helps to access the “how” of doing things that includes unconscious or unspoken processes. Some describe reflective practice as the bridge from theory to practice. In other words, reflective practice offers processes that help practitioners take concepts that they know and believe and apply them to real-life situations fraught with complexity.

In describing reflective practice, Schon talks about the distinction between reflection in action and reflection on action. Reflection in action is the capacity to think, consider, and reflect in the moment. Reflection in action includes a well-developed ability not to act immediately even when there are pulls to do so. Reflection on action is the creation of a space alone or with others to look back on something that has happened and consider motivations, consequences of any action taken, pacing, and personal presses that may have been present.

The creation of space and time to reflect back often allows the practitioner to remember essential details, drill down into a process, and consider what might be altered in the next encounter. In this way, the reflective process is a tool for continuous professional growth as well as service improvement as the practitioner thinks, analyzes, and is supported in taking what has been learned from self reflection and applying it in the next encounter. The willingness to engage in this reflection on action is an indicator of a provider’s interest in honing intervention skills, self-knowledge, and scope of practice.

Infant and early childhood programs have had a strong focus on the use of reflective practice and the kinds of organizational structures that support this practice approach. These structures may include regularly scheduled individual supervision/facilitation meetings, team meetings, or group sessions. Reflective practice can take place in both informal and formal ways. In many settings, reflective practice becomes a way of doing business not only in service delivery, but also in the administration of the program and in the support of staff. Ideally, agencies provide enough space and support for the regular practice of reflective process skills so that these become second nature to staff and are infused into informal exchanges and program practices

High quality supervision is closely linked to effective program implementation drivers described by Fixsen, Blase, and others working on program implementation research. These researchers have shown repeatedly that implementation of high quality programs is connected to a strong support structure that is carrying out a variety of roles and making sure that clients are getting the services described and promised in the program description. We believe that by developing the quality of reflective supervision skills, programs invest in better outcomes for communities served.

Reflective Practice Facilitation: Skills to Hold the Processes

In most programs, more formal structures such as individual reflective supervision or team meetings blend reflective practice elements with administrative supervision and mentoring to provide reflective practice facilitation on an ongoing basis. This blending of the reflective process elements with the nuts and bolts of service delivery is considered one of the most challenging skill sets to acquire. Reflective supervision can occur in either a blended model with reflective and administrative elements or in a model that separates  these functions.

Advancing Clarity About Reflective Practice Facilitation Competency

The group that worked on the Revised California Training Guidelines and Personnel Competencies for Infant-Family and Early Childhood Mental Health (Guide PDF) from 2007–2009 firmly embraced reflective practice and reflective supervision in both training and service environments considering this practice as a critical element in competency development. Ironically, there were no specific competencies for this activity that had been described as central to learning about working with infants and young children. To address this deficit, a set of competencies and an endorsement system for supervision were developed by group members and published in 2009, the Revised California Training Guidelines and Personnel Competencies for Infant-Family and Early Mental Health, Revised.

These standards were drawn from descriptions and writings in the field and influenced heavily by the early work of Emily Fenichel and others that describe reflective supervision as characterized by regularity, collaboration, and reflection. Standards were set in California for group size, and the California competencies outline specific skills and abilities for supervisors to learn about, practice, and master. Because “supervision” has a legal connotation in many settings, the term “reflective practice facilitation” has been adopted. The term reflective practice facilitation is synonymous with the term reflective supervision.

The California Center’s Commitment to Competency in Reflective Practice Facilitation

The California Center has a strong commitment to promoting quality reflective practice facilitation processes across systems. The endorsement system is inclusive of infant family and early childhood mental health specialists and transdisciplinary infant family and early childhood practitioners in order to provide a strong message that reflective practice facilitation must be central in all disciplines and sectors.

Because of this strong commitment, the California Center is in the process of developing reflective practice facilitation training materials including DVDs that will be available in the summer of 2012. Watch this website for details.

Posted by Leadership Team member: Mary Claire Heffron, PhD
Mary Claire Heffron

References

Dewey, J. 1933. How We Think. Boston: D.C. Heath and Company.

Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, F. 2005. Implementation Research: A Synthesis of the Literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network.

Schon, D. 1983. The Reflective Practitioner: How Professionals Think in Action. London: Temple Smith.

Schon, D. 1987. Educating the Reflective Practitioner. San Francisco: Jossey-Bass.

Changing the Name: Transdisciplinary Mental Health Practitioners

We Listened to Your Comments: Changing the Name of Mental Health Core Providers to Transdisciplinary Mental Health Practitioners

After careful review of the Mental Health Core Provider endorsement category and consideration and discussion of feedback from the field, the Leadership Team of the California Center determined that the name of the category should be changed to more accurately capture the training, experience and type of work of these transdisciplinary practitioners with infant-family and early childhood mental health training and experience.

This highly skilled group of practitioners includes professionals from multiple health and human service, developmental and education disciplines who provide direct services to pregnant women, infants, toddlers and preschoolers and their families. These practitioners have the most frequent contact with infants and very young children and their families and are the most likely individuals to provide promotion and preventive mental health interventions. These transdisciplinary practitioners infuse infant-family and early childhood mental health principles into their disciplinary practice and also are likely to partner with and make referrals to Infant-Family and Early Childhood Mental Health Specialists.

Therefore, to better reflect the skills and training of professionals working in multiple systems, we have changed the name of the Mental Health Core Provider category to Transdisciplinary Mental Health Practitioner.

Some Transdisciplinary Mental Health Practitioners will be endorsed as advanced based on their experience, training, knowledge and other related degrees or certifications.  Those candidates previously endorsed as Mental Health Core Providers will be reviewed and receive a new endorsement either as a Transdisciplinary Infant-Family or Early Childhood Mental Health Practitioner or an Advanced Transdisciplinary Infant-Family or Early Childhood Mental Health Practitioner.

Posted by Leadership Team members:
Karen Moran Finello, PhD and Patsy Hampton, MRA
Karen Moran Finello Patsy Hampton

Please contact the Center if you have any questions, info@cacenter-ecmh.org.