Reflective Supervision: How to Be and What to Do Learning

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Reflective Supervision How to Be and What to
DoLearning 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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Whyd 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

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Plan for today

• Explore the concepts foundations of reflective
  supervision
• Links to Triple Aim
• Administrative, clinical reflective supervision
• Small group discussion
• BREAK (400-415 ish)
• How do you know its working?
• Dyadic Experience
• Wrap up

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Video
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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

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How to be What to doKey Concepts in Reflective
Supervision

• Regularity
• Consistent meeting time
• No interruptions
• Slowing down
• Containment
• Partnering with supervisee to regulate anxiety
  emotions
• Serves the purpose of being able to reflect
  rather than react
• Remembering what was brought before

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How to be What to doKey Concepts in Reflective
Supervision

• Inquiry
• Curiosity
• Embracing complexity
• Wondering together tolerating now knowing
• Cultural Considerations of the work
• Direct advocacy teaching, not just process
• Reflection
• Bringing awareness
• Paying close attention to the supervisees
  thoughts, feelings distractions
• Experiences finding ones own answers
• Exploring whats missing ?

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How to be What to doKey Concepts in Reflective
Supervision

• Reciprocity and Collaboration
• Jointly setting the agenda
• Trust that what comes forward is what needs to be
  looked at
• Emotionally available supervisor/ emotionally
  open supervisee
• Parallel Process
• What happens between supervisor supervisee is
  information about what is happening for
  supervisee client, and client child.

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Safety Learning in Reflective Supervision

• A nurse's perspective

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Safety Learning in Reflective Supervision

• Foundation for dealing with vicarious trauma,
  reducing burnout, fighting turnover
• Insurance policy practitioners are aware of
  whats 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.

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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

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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.

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Table Talk Conversation

• What is your current experience with reflective
  supervision in your organization or practice?
• What aspects of a RS practice would be most
  challenging to implement?
• Which messages about RS would resonate most in
  your organization?

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Break

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Supporting Reflective Supervision why should
agencies organizations invest?

• Whats the research out there?
• Impacts of physical health
• Minimizing effects vicarious trauma
• In children adults , increased self-regulation
• Connection community and family supports
• Staff retention/ staff morale
• Knowledgeable and effective practitioners

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What might it take?

• Video

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Some Practice Considerations

• Group
• Community Infant Program Model/adapted from NCTSN
• Anxieties inadequacies minimized
• Increases relational capacity
• Team resilience
• Peer
• Facilitated/non-facilitated
• Small cluster
• Case consultation
• Consulting to a Clinical Team
• Promoting a team culture
• Job descriptions/interviews
• New employees

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Todays Reflection Supervision Experience

• Confidentiality
• Respect of each others process and starting
  place
• Heighten your awareness around how you are with
  another in a supervisory 11 interaction
• Notice your own tendencies
• _________________
• Each person will practice each role
• About 10 minutes a turn (we will let you know)

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RS Experience Reflections

• Getting centered
• What did you notice?
• How did that feel/ compare to other supervisory
  experiences?
• How might this kind of supervision support your
  work?
• What else do you need to know?

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Resources

• Reflective Supervision Rating Scale
• Informing agency practice
• Introduction to new supervisees
• Quality Checks
• Research
• Resource List
• CoAIMH Teach-In (www.coaimh.org)

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Wrap up

• How to be What to do
• Q A
• Whats next for RS
• Some last thoughts
• Jordana Ash jash_at_mhpcolorado.org
• Andrea Foote afoote_at_mhpcolorado.org