Icdl socal inst reflective practice m delahooke

Reflective Practice in DIR速 November 20, 2009 Southern CA Regional Institute

The work we do  Challenging, rewarding  We often bear the brunt of parent’s concerns about    

their kids Engenders feelings of competency and sometimes insecurity The major stress reducing “tool” in DIR Clinician’s tool bag is reflective practice It allows us to travel the clinical DIR road as we grow and learn along the way It also gives us a window into the parent and child’s subjective experience– using our own experience

Reflective Practice  Better “experienced” than taught  Reflective practice is not a part of many

professional training programs  Survey of audience: Many of us have not had training/education in reflective practice in college or graduate school.

Reflective Practice  Can be defined as an individual or small group

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integrative experience that supports the practitioner to: Reflect on the experiences, thoughts and feelings involved in working with children and families Explore ways to apply relevant theories/ knowledge bases to clinical situations and to clinically problem solve (promote learning) Experience an appreciation for the importance of relationships which are at the core of working with children and their families Adapted from the CIF&ECMH workgroup, 2009

Reflective Tutoring  Is one of the primary contexts for DIR® learning and

professional development across disciplines  Helps us learn more about ourselves, apply the model with awareness, gauge our effectiveness with families, and problem solve what is working (and not working) in our cases  Supports the discussion of goals and measure progress towards achieving them  Brings content and process together in clinical thinking

Reflective Supervision  Reflective supervision exists to provide a respectful,

understanding and thoughtful atmosphere where exchanges of information, thoughts, and feelings about the things that arise around one’s work can occur.  This supervisory relationship sets a major tone that reverberates throughout the system  The practitioner’s experience in supervision affects the interactions she has with the patient and family  adapted from Parlakian, 2001

This is a parallel process  “Do unto others as you would have others do

unto others”  “Don’t just do something, stand there!”  Jeree Pawl

Three Building Blocks—Reflective Supervision  Reflection—Taking time to wonder what the

experience really means  Collaboration—Sharing responsibility and control of power  Regularity—Sufficient time allowed with a reliable schedule  Zero to Three: National Center for Infants,

toddlers, and Families, Fenichel

FAQ’s  I can work with a child and see improvement in

balance, fine motor, etc without talking about my feelings.  I can use speech strategies and get the child to talk.

Why do I have to reflect? Feelings just get in the way of my work.  I don’t really like to think about feelings (of sadness or anxiety) I just work through it.  And I certainly wouldn’t want to talk about it especially to a supervisor at work! Why do I have to pay a DIR mentor anyway? I can talk to my friends if I want to.

DIR and Reflective Practice  In DIR®, we ask all disciplines to “jump in” to

reflective ways of thinking regardless of training and background. This is asking a lot!  In mental health, reflection is part of the “culture” of the discipline  Education, medicine, PT, OT : Where does reflection fit in the cultures of our disciplines?  DIR is a COMPLEX model to learn, and support is gained by reflective supervision as we all will feel “over our heads” from time to time!

Guidelines for Reflective Group Process.. Feder, 2009                    

Guidelines for Reflective Process* 1.The purpose of the group is to allow the presenter to engage in problem solving.

2. The group's job is to allow the presenter to do this.

3. The presenter gives a brief vignette, perhaps with video, and states the problem or problems she wants to work on.

4. The group uses reflective comments to help the presenter think about the problem.

5. The group must avoid giving direct advice and opinions to allow the presenter to problem solve.

6. Group members will naturally think about similar situations and may share those with the presenter.

7. The group leader will often follow the affect or emotional themes as a way to guide the process, e.g., wondering about the presenter's feelings related to the problem and thinking about the child's or parent's feelings too.

8. The group leader manages time and concludes the moment by checking in with the presenter to see if there has been any shift in the presenter's thinking that might help in solving the problem presented. *Adapted from Guidance from Anne McLevie ‐Spooner 100709 (any omissions or misstatements are mine and mine alone – J. Feder)

All Kinds of Group Process Type of group Social – parties, luncheons, etc.

purpose pleasure

rules Culture & etiquette

leadership host

process Experience sharing and deepening of relaitonships

Athletic competition

Pleasure,

Rules, etiquette

Captains, umpires

Athletic training

Fitness, readiness

Trainers, captains

Clubs

Pleasure - facilitated

Training requirements, etiquette Structure -etiquette

sublimation of natural aggression “, hope

Classes

learning

Structure, etiquette

Teachers, administrators

12 Step

Management of addiction

Structure and etiquette

Leaders - colunteer

Therapy

Internal emotional change

Structure, etiquette

Therapist(s), leaders

Various, support, insight oriented (universality, etc.)

Group interview

Demonstrate competence

Assertiveness, etc.

Employers

Competition for jobs, alliance and intrigue in an hour

Reflective Processing

Problem solving

Structure and etiquette

Leaders

Allow presenter to reflect, all benefit and deepen understanding

ICDL Presentation groups

Demonstrate competence, including process of problem solving

Structure and etiquette

faculty

Faculty and members facilitate presenter in showing work and problem solving within frame. Not a competition.

Host, leader

Interest-driven, semistructured Didactic – relatively passive Evocative, repetition, substition of group for addiction

What it is…  What it is:  Stepping back from the intense experience

of hands-on work to wonder about it.  Focusing on experiences, thoughts and feelings directly connected to the work.  Time to analyze one’s work, problem solve, scaffold, acquire new knowledge or see things in a different light.

What it is not  Therapy  Socializing  Performance evaluation  One way relationship  Questions, discussion??

A Reflective Facilitator ď Ž Has the ability to consider and address

issues of culture, including the impact of racism, class, immigration-related issues, socioeconomic issues, etc. on families, practitioners and the practitioner-reflective practice facilitator relationship.

2  Expands practitioner’s understanding of how to

create a feeling of reciprocity and comfort/friendliness with a family by allowing for normal everyday social interactions without losing a sense of purpose and safety about role and reason for involvement with the family (e.g., the ability to consider the costs and benefits of accepting offered tea and cookies on a home visit, ability to understand parents’ worry that their children’s developmentally inappropriate needs/behaviors will reflect badly upon them, etc.).

4 ď Ž Works with the practitioner to understand that

personal characteristics, clinical context, culture, style and professional role may unconsciously influence the interactive process with families. ď Ž Helps the practitioner learn to observe and reflect on individual behavior and the interactive exchange with others, reflect on these processes and attribute relational meaning.

Reflective Practice Demonstration