Reflective and Relationship-Based Strategies in Practice

Sara Beth Martin, RN, MPHSeptember 19, 2012

Learning Objectives

Define reflective and supportive practice as it relates to home visitation programs

Demonstrate reflective and supportive strategies through behavior rehearsal

Relationships matter.

“All learning takes place in the context of relationships and is critically affected by

the quality of those relationships” (Norman-Murch, 1996).

re·flec·tion  (r -fl k sh n) n. 1. The act of reflecting or the state of being reflected.2. Something, such as light, radiant heat, sound, or an image, that is reflected.3. a. Mental concentration; careful consideration.b. A thought or an opinion resulting from such consideration.4. An indirect expression of censure or discredit: a reflection on his integrity. 5. A manifestation or result: Her achievements are a reflection of her courage. 6. Anatomy a. The folding of a membrane from the wall of a cavity over an organ and back to the wall.b. The folds so made.

The Reflective Cycle (Gibbs, 1988)

Helps us to look at an event, understand it, and learn from it

Awareness of the impact of our preconceptions and personal beliefs of our understanding of events and our reaction to them

Thinking about Supervision

Think about one of your first positive employee-supervisor relationships.

What is one positive quality of this supervisor?

How does this relate to reflective practice?

Reflective Supervision is….

A collaborative relationship for professional growth that improves program quality and practice by cherishing strengths and partnering around vulnerabilities to generate growth

Stepping back from the immediate experience to sort through thoughts and feelings about what one is observing and doing with children and families

Three Building Blocks of Reflective Supervision

Reflection Collaboration Regularity

Reflection

Requires a foundation of trust and honesty Safety, calmness, and support Is NOT therapy or venting Focused on experiences, thoughts, and feelings

directly connected with work Supportive of professional development and

growth Empathetic, nonjudgmental ear of the

supervisor

Collaboration

Sharing of responsibility and control of power

A chance to learn from as well as teach staff

Reciprocal expectations of each other

Requires open communication-in both directions

Regularity

Regularity of interactions Reliable schedule with sufficient time allocated Protection from cancellation, rescheduling, or

procrastination Investment in professional development of the

staff and the future of the program Recognition that it takes time to develop a

trusting relationship, to collaborate, and to share ideas, thoughts, and emotions

What is Reflective Leadership?

Leading through relationships How we lead, how we treat others, how

we interact, how we resolve conflict, and how we provide feedback

Trust, support, and growth Careful observation, flexible response,

and self-awareness

Careful Observation

Skilled at deciphering the meaning of behaviors

Behaviors including tone of voice, body language, reactions, etc.

“Why might this be happening?”

Flexible Response

Requires leaders to know their staff

Approach individuals in a way that reflects his or her needs, strengths, and areas for development

An expression of mutual respect

Self-Awareness

Ability to know one’s self, strengths, and limitations

An interest and commitment to exploring one’s own feelings, thoughts, and reactions

Activity: Leadership Self-Assessment Tool from Zero to Three

Self-Awareness Assessment Tool

What are your thoughts on this tool?

How might this affect your professional practice?

Any other comments?

How can we incorporate reflective practice and strategies

into home visiting?

Application

You are a home visitor. You have knowledge, skills, and a lot of experience under your belt. You’re going to visit a client who is pregnant, has a BMI of 34, and has been recently diagnosed with gestational diabetes.

Based on past experience, you plan to propose a diet, a food diary, and a schedule of visits. You complete the visit, talk with the client, and agree to the plan.

One week later…second visit….nothing’s happened. No change. Very disappointing….frustrating…..

Reflection in Practice

You look back at what you did and wonder what you could have possibly done differently and why did this mother not take your advice. You have a chat with your colleagues.

Have they experienced this? What would they have done? Any ideas?

The Reflective Cycle (Gibbs, 1988)

Reflection in Practice

At the next meeting, the client admits to sneaking snacks and sugary drinks.

Looking back, you realize that your earlier intervention (diet, food diary, and visits) had limited value.

You were coming at it from a direction that did not see all aspects of the situation.

Yes, you can help the client to make changes however there are different strategies to try.

And the cycle begins again, driven by reflection….

References About Gibbs reflective cycle. Oxford Brookes

University, 2011. 10 Aug 2012. <http://www.brookes.ac.uk/services/upgrade/a-z/reflective_gibbs.html>.

Parlakian, R. (2001). Look, listen, and learn: reflective supervision and relationship-based work. Washington, D.C.: ZERO TO THREE.

Seibel, N.L., Britt, D., Gillespie, L.G., & Parlakian, R. (2009). Preventing child abuse and neglect: Parent-provider partnerships in child care. Washington, DC: ZERO TO THREE.