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
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