Reflective Practice (RP) in Home Visiting

Public health agencies and tribal communities provide home visits to pregnant and parenting families in order to build protective factors and reduce risk. Essential to the effectiveness of this intervention is the capacity of the home visitor to engage families in a relationship that encourages new learning and growth. Reflective practice is considered a “best practice” approach and defines the qualities of relationship that effectively promote healthy development in children.

What is Reflective Practice

Reflective Practice is the discipline of regularly “stepping back” to consider the meaning of what has transpired in relationships, and to examine one's professional and personal responses to these interactions for the purpose of determining further action. Although there are times when an immediate answer or action is required, much of the work with parents requires helping them to stop and think about their interactions. By engaging the parent in conversations - wondering about what might be happening - the parent experiences being reflective with another person. They also become involved in the process of discovery of new ways of thinking about parenting and relationships.

Reflective Supervision is the process of examining, with someone else, the thoughts, feelings, actions and reactions evoked in the course of working closely with young children and their families. The essential features of this supervisory relationship are reflection, collaboration, and regularity of occurrence. (Gilkerson & Shamoon-Shanok, 2000).

Who Benefits

Practitioner: The home visitor engages the parents as a partner in the discovery of new learning and understanding about their babies in order to support and enhance their health and well-being.

Supervisor: The supervisor's developmental and strength-based approach to the supervision is grounded in principles of infant mental health, including the value of relationship and the mutual sharing of knowledge and understanding. The goal of reflective supervision is enhanced understanding of the meaning of relationships and each person's response to the ongoing interactions in order to identify further action.

Timing

An essential aspect of reflective practice is the regularity and dependability of relationships at all levels; ultimately, the goal is that over time trust develops and in the safety of that relationship new learning occurs. This happens through regular, consistent time together. Most evidence-based home visiting programs require individual reflective practice for an hour or more per week.

Benefits of Reflective Practice

Programs implement reflective supervision in order to improve the effectiveness of their staff in using a reflective approach to engaging families. The consistent, reliable experience of reflective supervision enhances understanding of boundaries and roles, and clarifies goals and areas of intervention. This increased sense of effectiveness enhances staff members' sense of competence and job satisfaction, reduces burn out and staff turnover.

Building Capacity for Reflective Practice

To build capacity for Reflective Practice in your program requires more than attending training. It is a process that unfolds over time. Many LPH FHV programs have found the following mentoring approach to be a strategy for success:

• Home visiting team participates in introductory trainings on Infant Mental Health and Reflective Practice.
• Supervisors receive 18-24 months of regular 1:1 reflective consultation from reflective practice mentor (approximately 2 hours per month per supervisor)
• Supervisor and Reflective Practice Mentor co-facilitate monthly reflective practice case conference with FHV team (approximately 2 hours per month per team)
• Supervisors provide regular individual reflective practice supervision to their team members

Learn More About Reflective Practice

The following are recommended:

• Endorsement - Minnesota Association for Children's Mental Health: Information about Infant Mental Health Endorsement and other professional development
• Center for Early Education and Development: Professional Development
• A Practical Guide to Reflective Supervision, Edited by Sherryl Scott Heller and Linda Gilkerson
• Reflective Supervision and Leadership, Mary Claire Heffron and Trudi Murch