Best Practice Guidelines for Reflective Supervision/Consultation
Purpose of Guidelines
(1) To emphasize the importance of reflective supervision and consultation for best practice,
(2) To better assure that those providing reflective supervision and consultation are appropriately trained.
For the purposes of this document, reflective supervision/consultation refers specifically to work done in the infant/family field on behalf of the infant/toddler’s primary care-giving relationships.
Distinguishing Between Administrative Supervision, Clinical Supervision and Reflective Supervision/Consultation
Supervisors of infant and family programs are generally required to provide administrative and/or clinical supervision, while reflective supervision may be optional. Put another way, reflective supervision/consultation often includes administrative elements and is always clinical, while administrative supervision is generally not reflective and clinical supervision is not always reflective.
Concerned with oversight of federal, state and agency regulations, program policies, rules and procedures. Supervision that is primarily administrative will involve the following content:
Writing of reports
Explain rules and policies l Coordinate
Clinical supervision/consultation is case-focused but does not necessarily consider what the practitioner brings to the intervention nor does it necessarily encourage the exploration of emotion as it relates to work with an infant/toddler and family.
Supervision or consultation that is primarily clinical will most likely include many or all of the administrative content that are listed above, as well as the following:
Discuss the diagnostic impressions and diagnosis
Discuss intervention strategies related to the intervention l Review the intervention or treatment plan
Review and evaluate clinical progress
Reflective supervision/consultation goes beyond clinical supervision to shared exploration of the parallel process, i.e., attention to all of the relationships, including that between practitioner and parent, between parent and infant/toddler, and between practitioner and supervisor. It is critical to understand how each of these relationships affects the others.
Of additional importance, by attending to the emotional content of the work and how reactions to the content affect the work, reflective supervision/consultation relates to professional and personal development within one’s discipline. Finally, there is often greater emphasis on the supervisor/consultant’s ability to listen and wait, allowing the supervisee to discover solutions, concepts and perceptions on his/her own without interruption from the supervisor/consultant.
The components of reflective supervision/consultation include:
Form a trusting relationship between supervisor and practitioner
Establish consistent and predictable meetings and times
Ask questions that encourage details about the infant, parent and emerging relationship
Remain emotionally present
Integrate emotion and reasonFoster the reflective process to be internalized by the supervisee
Explore the parallel process and allow time for personal reflection l Attend to how reactions to the content affect the reflective process
Reflective supervision/consultation may be carried out individually or within a group. It may be the responsibility of the agency/program supervisor or a reflective supervisor/consultant may be contracted from outside the agency or program.
If the supervisor or consultant is contracted from outside the agency program, he or she will engage in reflective and clinical discussion, but will discuss administrative content only when it is clearly indicated in the contract.
If the reflective supervisor operates within the agency or program, then he/she will most likely need to address reflective, clinical and administrative content. When discussions related to disciplinary action need to occur, it is the direct supervisor who addresses them. When the direct supervisor is also the one who provides reflective supervision, it is preferable to schedule a meeting separate from the reflective supervision time; however, some supervisors choose to address disciplinary concerns during the individual clinician’s regular reflective supervision meeting. Disciplinary action should never occur within a group supervisory/consultation session.
Peer supervision (defined as colleagues meeting together without an identified supervisor/consultant to guide the reflective process), while valuable for many experienced practitioners, does not meet the reflective supervision/consultation criteria for endorsement as specified in this guide.
In all instances, the reflective supervisor/consultant is expected to set limits that are clear, firm and fair, to work collaboratively, and to interact and respond respectfully.
In sum, it is important to remember that relationship is the foundation for reflective supervision and consultation. All growth and discovery about the work and oneself takes place within the context of this trusting relationship. To the extent that the supervisor or consultant and supervisee(s) or consultee(s) are able to establish a secure relationship, the capacity to be reflective will flourish.
“When it’s going well, supervision is a holding environment, a place to feel secure enough to expose insecurities, mistakes, questions and differences.” Rebecca Shahmoon Shanock (1992).
Reflective supervision is “the place to understand the meaning of your work with a family and the meaning and impact of your relationship with the family.” Jeree Pawl, public address.
“Do unto others as you would have others do unto others.” Jeree Pawl (1998).
Best Practice Guidelines for the Reflective Supervisor/Consultant
Agree on a regular time and place to meet
Arrive on time
Protect against interruptions, e.g. turn off phone, close door
Set the agenda together with the supervisee(s) before you begin
Remain open, curious and emotionally available
Respect supervisee’s pace/readiness to learn
Ally with supervisee’s strengths, offering reassurance and praise, as appropriate
Observe and listen carefully
Strengthen supervisee’s observation and listening skills
Suspend harsh or critical judgment
Invite the sharing of details about a particular situation, infant, toddler, parent, their competencies, behaviors, interactions, strengths, concerns
Listen for the emotional experiences that the supervisee is describing when discussing the case or response to the work, e.g. anger, impatience, sorrow, confusion, etc.
Respond with appropriate empathy
Invite supervisee to have and talk about feelings awakened in the presence of an infant or very young child and parent(s)
Wonder about, name and respond to those feelings with appropriate empathy
As the supervisee appears ready or able, encourage exploration of thoughts and feelings that the supervisee has about the work with very young children and families as well as about one’s response(s) to the work
Encourage exploration of thoughts and feelings that the supervisee has about the experience of supervision as well as how that experience might influence his/her work with infants/toddlers and their families or his/her choices in developing relationships.
Maintain a shared balance of attention on infant/toddler, parent/caregiver and supervisee
Reflect on supervision/consultation session in preparation for the next meeting
Remain available throughout the week if there is a crisis or concern that needs immediate attention
Engage in reflective supervision/consultation with your own identified mentor/consultant
Best Practice Guidelines for the Reflective Supervisee/Consultee
Agree with the supervisor or consultant on a regular time and place to meet
Arrive on time and remain open and emotionally available
Come prepared to share the details of a particular situation, home visit, assessment, experience or dilemma
Ask questions that allow you to think more deeply about your work with very young children and families and also yourself
Be aware of the feelings that you have in response to your work and in the presence of an infant or very young child and parent(s)
When you are able, share those feelings with your supervisor/consultant
Explore the relationship of your feelings to the work you are doing
Allow your supervisor/consultant to support you
Suspend critical or harsh judgment of yourself and of others
Reflect on the supervision/consultation session to enhance professional practice and personal growth
Requirements for Reflective Supervision/Consultation for Endorsement Applicants
Applicants for Endorsement at Level II should seek reflective supervision/consultation from someone who is Endorsed at Level III and/or Level IV (Clinical).
Exception to this general rule: A bachelor’s prepared Level II applicant may seek reflective supervision/consultation from a master’s prepared person who has earned Level II endorsement if there is no one at Level III available to provide this, and if the master’s prepared Level II professional seeks reflective supervision/consultation while providing supervision to others.
Applicants for Endorsement at Level III are expected to seek reflective supervision/consultation from someone who has earned Endorsement at Level III or Level IV (Clinical).
Applicants for Endorsement at Level IV are expected to seek reflective supervision/consultation from someone who has earned Endorsement at Level IV (Clinical). Additionally, if applicant is providing reflective supervision, at least half of the time spent in supervision must maintain a focus on the applicant’s role as a reflective supervisor.
Professionals seeking Renewal of Endorsement at Level III are expected to obtain a minimum of 12 hours of continuing reflective supervision/consultation per calendar year. If endorsed professional is providing reflective supervision/consultation to others, it is expected that half of these hours are dedicated to the provision of reflective supervision/consultation.
Professionals seeking Renewal of Endorsement at Level IV-C are expected to obtain a minimum of 12 hours of continuing reflective supervision per calendar year. These professionals are also expected to include 3 hours of didactic training on reflective supervision/ consultation in their continuing education renewal hours. After being endorsed as an Infant Mental Health Mentor for 3 years or more, this is no longer a requirement but remains a best practice recommendation.
CT-AIMH recommends that those who provide reflective supervision/consultation to others seek individual or group supervision/consultation from a person who has earned endorsement at Level IV (Clinical). This supervision should be reflective, regularly scheduled and offer a focus on the complexity of supervising others who provide relationship-based services to infants, toddlers and their families.
Reflective supervisors/consultants who have not earned Endorsement® or cannot meet the standards as defined in the guidelines above are invited to contact the CT-AIMH Central Office to inquire about training and participation in reflective supervision or consultation groups (see below).
Number of RS/C Providers
As in relationship-focused practice with families, reflective supervision/consultation is most effective when it occurs in the context of a relationship that has an opportunity to develop by meeting regularly with the same supervisor/consultant over a period of time. Therefore, CT-AIMH expects that Endorsement® applicants will have received the majority of the required hours from just one source with the balance coming from no more than one other source.
Building Capacity for Reflective Practice
CT-AIMH recognizes that in many regions there are few supervisors/consultants who meet the qualifications specified above. If an Endorsement® applicant is having difficulty finding supervision/consultation to promote or support the practice of infant mental health or if a program has difficulty finding someone to provide reflective supervision/consultation to guide and support staff who are applicants for Endorsement®, CT-AIMH can be a resource.
CT-AIMH invites Endorsement® applicants and supervisors/consultants to contact the CT- AIMH central office to assist in finding supervisors/consultants who are endorsed and available to work with them or to discuss the standards for best practice presented in this guide. Rapidly changing technology makes it possible to connect through the Internet, by telephone conference, or face to face.
Please note: Peer supervision (defined as colleagues meeting together without an identified supervisor/consultant to guide the reflective process), while valuable for many experienced practitioners, does not meet the reflective supervision/consultation criteria for endorsement as specified in this guide.
References and Suggested Resources
Bernstein, V. (2002-03). Standing Firm Against the Forces of Risk: Supporting Home Visiting and Early Intervention Workers through Reflective Supervision. Newsletter of the Infant Mental Health Promotion Project (IMP). Volume 35, Winter.
Center for Mental Health Services, Substance Abuse and Mental Health Services Administration and Services, U.S. Dept. of Health and Human Services. (2000). Early childhood mental health consultation. Washington, DC: National Technical Assistance Center for Children’s Mental Health, Georgetown University Child Development Center.
Fenichel, E. (Ed.). (1992). Learning Through Supervision and Mentorship to Support the Development of Infants, Toddlers and their Families: A Source Book. Washington, D.C.: Zero to Three.
Bertacci, J. & Coplon, J. The professional use of self in prevention. 84-90.
Schafer, W. The professionalization of early motherhood, 67-75.
Shahmoon Shanock, R. (1992). The supervisory relationship: Integrator, resource and guide, 37-41.
Foulds, B. & Curtiss, K. (2002). No Longer Risking Myself: Assisting the Supervisor Through Supportive Consultation. In Shirilla, J. & Weatherston, D. (Eds.), Case Studies in Infant Mental Health: Risk, Resiliency, and Relationships. Washington, D.C.: Zero to Three, 177- 186.
Heffron, M.C. (2005). Reflective Supervision in Infant, Toddler, and Preschool Work. In K. Finello (Ed.), The Handbook of Training and Practice in Infant and Preschool Mental Health. San Francisco: Jossey-Bass, 114-136.
Reflective Supervision: What is it? (November, 2007). Journal for Zero to Three, Vol. 28, No. 2.
Eggbeer, L., Mann, T. & Seibel, N. (2007). Reflective supervision: Past, present, and future.
Heffron, M., Grunstein, S. & Tiemon, S. (2007) Exploring diversity in supervision and practice.
Schafer, W. (2007). Models and domains of supervision and their relationship to professional development.
Weatherston, D. (2007) A home based infant mental health intervention: The centrality of relationship in reflective supervision.
Weigand, R. (2007) Reflective supervision in child care: The discoveries of an accidental tourist.
Wightman, B., Weigand, B., Whitaker, K., Traylor, D., Yeider, S. Hyden, V. (2007) Reflective practice and supervision in child abuse prevention.
Parlakian, R. (2002). Look, Listen, and Learn: Reflective Supervision and Relationship-Based Work. Washington, D.C.: Zero to Three.
Pawl, J. & St. John, M. (1998). How you are is as important as what you do. In Making a Positive Difference for Infants, Toddlers and their Families. Washington, D.C.: Zero to Three.
Shahmoon Shanok, R., Gilkerson, L., Eggbeer, L. & Fenichel, E. (1995). Reflective Supervision: A Relationship for Learning. Washington, D.C.: Zero to Three, 37-41.
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