reflective supervision: how to be and what to do learning & development in the practice of...

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Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana Ash, LCSW, IMH-E (IV)® Colorado Behavioral Health Care Council, September 2012

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Page 1: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

Reflective Supervision: How to Be and What to Do

Learning & Development in the Practice of Reflective Supervision

Andrea Foote, PsyD, IMH-E (IV)®Jordana Ash, LCSW, IMH-E (IV)®

Colorado Behavioral Health Care Council, September 2012

Page 2: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

Why’d we start this way?

• Reflective practice is cornerstone of clinical practice for administration, supervisors, clinicians, other practitioners. – Without it we are acting without full awareness

of the vast majority of information and communication available to us

• Mindfulness and self awareness can be seen as the foundation for the reflective relationship

• Reflection as the foundation for safety & learning

Page 3: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

Plan for today

• Explore the concepts & foundations of reflective supervision

• Links to Triple Aim• Administrative, clinical & reflective supervision• Small group discussion– BREAK (4:00-4:15 ish)

• How do you know it’s working?• Dyadic Experience• Wrap up

Page 4: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

Video

Page 5: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

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Definition

• Reflective supervision is an ongoing communication process that regulates and understands the flow of emotion, information and experience.

• Reflective supervision occurs between two or more individuals whereby the developing relationships serve as the vehicle for acceptance, trust and respect and a mindful service delivery

• The supervisor is a trained, skillful and experienced professional who creates a safe space from which a supervisee can learn and reflect about their work.

Janet Dean, LCSW

2010

Page 6: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

How to be & What to doKey Concepts in Reflective

SupervisionoRegularity

oConsistent meeting timeoNo interruptionsoSlowing down

oContainmentoPartnering with supervisee to regulate

anxiety & emotionsoServes the purpose of being able to reflect

rather than reactoRemembering what was brought before

Page 7: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

How to be & What to doKey Concepts in Reflective

Supervisiono Inquiry

o Curiosityo Embracing complexityoWondering together & tolerating now knowingo Cultural Considerations of the workoDirect advocacy & teaching, not just process

oReflectiono Bringing awarenesso Paying close attention to the supervisee’s

thoughts, feelings & distractionso Experiences finding one’s own answerso Exploring what’s missing ?

Page 8: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

How to be & What to doKey Concepts in Reflective

SupervisionoReciprocity and Collaboration

o Jointly setting the agendaoTrust that what comes forward is what needs

to be looked atoEmotionally available supervisor/ emotionally

open supervisee

oParallel ProcessoWhat happens between supervisor &

supervisee is information about what is happening for supervisee & client, and client & child.

Page 9: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

Safety & Learning in Reflective Supervision

• A nurse's perspective

Page 10: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

Safety & Learning in Reflective Supervision

• Foundation for dealing with vicarious trauma, reducing burnout, fighting turnover

• Insurance policy: practitioners are aware of what’s being acted out non-consciously or through lack of awareness with clients: Enactment is our unresolved behavior patterns acted out

• Pays off administratively and clinically.10

Page 11: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

Critical Distinctions or A Relationship for All Kinds of Learning

• Administrative – Performance Evaluations– Productivity– Agency/Organizational Expectations

• Clinical– Case formulation– Diagnosis and Treatment Goals– Transference & Counter-transference

• Reflective

Page 12: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

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Compelling Forces

• Reflective supervision strives to continuously integrate compelling forces such as reflection and direct advocacy.

• The provision of attuned guidance is measured by the need to stay in inquiry.

Page 13: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

Table Talk Conversation

oWhat is your current experience with reflective supervision in your organization or practice?

oWhat aspects of a RS practice would be most challenging to implement?

oWhich messages about RS would resonate most in your organization?

Page 14: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

Break

Page 15: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

Supporting Reflective Supervision: why should agencies & organizations invest?

oWhat’s the research out there?o Impacts of physical healthoMinimizing effects vicarious traumao In children & adults , increased self-regulationoConnection community and family supportso Staff retention/ staff moraleo Knowledgeable and effective practitioners

Page 16: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

What might it take?

• Video

Page 17: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

Some Practice Considerations

o Groupo Community Infant Program Model/adapted from NCTSNo Anxieties & inadequacies minimizedo Increases relational capacityo Team resilience

o Peero Facilitated/non-facilitatedo Small cluster

o Case consultationo Consulting to a Clinical Team

o Promoting a team cultureo Job descriptions/interviewso New employees

Page 18: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

Today’s Reflection Supervision Experience

• Confidentiality• Respect of each other’s process and starting

place• Heighten your awareness around how you are

with another in a supervisory 1:1 interaction• Notice your own tendencies • _________________• Each person will practice each role• About 10 minutes a turn (we will let you

know)

Page 19: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

RS Experience Reflections

oGetting centeredoWhat did you notice?oHow did that feel/ compare to other

supervisory experiences?oHow might this kind of supervision

support your work?oWhat else do you need to know?

Page 20: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

Resources

oReflective Supervision Rating Scaleo Informing agency practiceo Introduction to new superviseesoQuality ChecksoResearch

oResource ListoCoAIMH Teach-In (www.coaimh.org)

Page 21: Reflective Supervision: How to Be and What to Do Learning & Development in the Practice of Reflective Supervision Andrea Foote, PsyD, IMH-E (IV)® Jordana

Wrap up

• How to be & What to do • Q & A• What’s next for RS

• Some last thoughts• Jordana Ash

[email protected]• Andrea Foote

[email protected]