Infant Mental Health
Reflective Supervision Guidelines
BEST PRACTICE GUIDELINES FOR REFLECTIVE SUPERVISION/CONSULTATION
Reflective supervision/consultation, for the purposes of endorsement, as defined by MAIECMH, is a distinctive form of competency-based professional development that is provided to multidisciplinary practitioners working in the infant/family field on behalf of very young children’s primary caregiving relationships. Reflective supervision/consultation is a practice emerging from the multidisciplinary field of infant mental health, which acknowledges that very young children have unique developmental and relational needs and that all early learning occurs in the context of relationships. The intent of this document is to emphasize the importance of reflective supervision and consultation for best practice to better assure that those providing reflective supervision and consultation are appropriately trained.
Reflective supervision/consultation is distinct from administrative supervision and clinical supervision due to the shared exploration of the parallel process. That is, attention to all of the relationships is important, including the relationships between practitioner and supervisor, between practitioner and parent, and between parent and infant/toddler. It is critical to understand how each of these relationships affects the other. Of additional importance, reflective supervision/consultation relates to professional and personal development within one’s discipline by attending to the emotional content of the work and how reactions to the content affect the work. 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 primary objectives of reflective supervision/consultation include the following:
- Acknowledgement that very young children have unique developmental and relational needs and that we are biologically ‘wired’ to be aroused in their presence; working with young children and their families is relationship-based, which requires us to engage our emotions as well as our intellect; the past affects the present.
- Form “a safe relationship for learning where strengths are supported and vulnerabilities are partnered.” Rebecca Shamoonh-Shanok
- Provide an intentional partnering relationship between the supervisor/consultant and practitioner which promotes the relationship between the practitioner and the child, the practitioner and the parent, and the parent and the child (parallel process as an organizing principle–“Do unto others as you would have others do unto others.” Jeree Pawl 1998).
- Provide a validating, partnering relationship that offers a ‘holding environment’ for “learning that our own feelings and behaviors are important sources of information and have a major impact upon interventions.” Alicia Lieberman
- Use process as the approach to problem-solving; create a shared process of inquiry using open-ended questions to facilitate the supervisee’s own insights and reflections, rather than solution-focused advice-giving; facilitate the ability to “tolerate ambiguity and embrace complexity.” Heffron & Murch
- Promote ‘professional use of self’—“All the ways in which the quality of the professional’s interactions with the client can influence the intervention outcomes.” Heffron & Murch
- Provide a safe place to explore issues of culture and diversity–a relationship to discuss issues of difference across race/ethnicity, gender, individuals with disabilities, religious belief, class, educational status and professional culture. Stroud (2010)
Distinguishing Between Administrative, Clinical and Reflective Supervision/Consultation
Many supervisors of infant and family programs are 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 and clinical supervision are not always reflective.
Administrative supervision relates to the oversight of federal, state and agency regulations, program policies, procedures, standards, quality assurance and safety. Supervision that is primarily administrative will be driven to achieve the following objectives: hiring, training, oversight of paperwork, explanation and enforcement of agency rules and policies, monitoring of productivity and staff evaluation.
Clinical supervision/consultation, while case-focused, is not necessarily reflective. Clinical supervision 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 may be a necessary requirement for licensure in a given discipline, and will most likely include many or all of the administrative objectives that are listed above as well as the following objectives: review of casework; review, discuss and evaluate diagnostic impressions, treatment planning, intervention strategies and clinical progress; give guidance/advice and teach.
Reflective supervision/consultation may be carried out individually or within a group. Reflective supervision/consultation may mean different things depending on the program in which it occurs. A reflective supervisor or consultant may be hired/contracted from outside the agency or program, and may be offered to an individual or group/team in order to examine and respond to case material using a reflective lens. If the supervisor or consultant is contracted from outside the agency or program, he or she will engage in reflective and clinical discussion, but address administrative objectives only when it is clearly indicated in the contract.
If the reflective supervisor/consultant operates within the agency or program, then he/she will most likely need to address reflective, clinical and administrative objectives (often referred to as “mentoring and monitoring” or M&M supervision” Heffron & Murch). 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, some schedule a meeting separate from the reflective supervision time. Others choose to address disciplinary concerns during the regular reflective supervision meeting. Disciplinary action should never occur within a group supervisory/consultation session. In all instances, the reflective supervisor/consultant is expected to set limits that are clear, firm & 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. 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
Best Practice Guidelines for the Reflective Supervisor/Consultant
- Is able to apply the MAIECMH competencies to promote the supervisee’s professional development in the infant-early childhood-family field
- Agrees on a regular time and place to meet; consistency is a key element of reflective supervision
- Arrives on time and remains open, curious and emotionally available
- Protects against interruptions, e.g. turns off phone, closes door
- Sets the agenda together with the supervisee(s) before meetings begin
- Respects each supervisee’s pace/readiness to learn
- Allies with supervisee’s strengths, offering reassurance and specific feedback that promotes professional growth related to the competencies
- Observes and listens carefully, attending to both the process and the content of what is shared
- Strengthens supervisee’s observation and listening skills
- Uses a reflective process of gentle inquiry to explore the internal experiences of the infant, child, parent and fellow practitioners as appropriate to increase awareness, keep the multiple perspectives in mind and consider alternative approaches to the work
- Suspends harsh or critical judgment
- Invites the in-depth sharing of details about a particular situation, infant, toddler, parent, their competencies, behaviors, interactions, strengths, concerns
- Listens for the emotional experiences that the supervisee is describing when discussing the case or response to the work, e.g. anger, impatience, sorrow, confusion, ambivalence, pleasure, etc.
- Wonders about, names and responds to these feelings with appropriate empathy
- Invites the supervisee to have and talk about feelings awakened in the presence of an infant or very young child and parent(s)
- Wonders about, name and respond to those feelings with appropriate empathy
- As the supervisee appears ready and willing, encourages 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, as the supervisee appears ready or able
- Encourages 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
- Maintains a shared balance of attention on infant/toddler, parent/caregiver and supervisee
- Reflects on supervision/consultation session in preparation for the next meeting
Best Practice Guidelines for the Practitioner Receiving Reflective Supervision/Consultation
- Uses the MAIECMH competencies to guide/facilitate one’s own professional development in the infant/early childhood/family field
- Agrees with the supervisor or consultant on a regular time and place to meet
- Arrives on time and remain open and emotionally available
- Comes prepared to share the details of a particular situation, home visit, assessment, experience or dilemma
- Asks questions that encourages thinking more deeply about one’s own work with very young children and families and also oneself.
- Increases awareness of the feelings experienced in response to one’s work and in the presence of an infant or very young child and parent(s)/caregivers
- As the supervisee is ready and able, shares those feelings with the supervisor/consultant
- Explores the relationship of one’s own feelings and the work one is doing
- Allows the supervisor/consultant to provide support and takes responsibility for telling the supervisor what kind of support feels helpful
- Remains curious and open to new interpretations of and possibilities for the work
- Suspends critical or harsh judgment of self and of others
- Reflects on supervision/consultation session to enhance professional practice and personal growth
Best Practice Guidelines for Those Who Provide Reflective Supervision/Consultation to Endorsement Candidates
It is in the best interest of practitioners who promote infant mental health, as well as the young children and families they serve, if the reflective supervisor/consultant meets the following standards**:
- Has earned the MAIECMH Endorsement or meets all of the qualifications for endorsement as an Infant Mental Health Specialist at Level III or an IMH Mentor (Clinical) at Level IV.
- Specifically, has received a minimum of 30 clock hours of training specific to the MAIECMH Competency Guidelines and related to the practice of infant mental health.
- Specifically, has received a minimum of 50 clock hours of reflective supervision/consultation within a minimum of one year and a maximum of two years while working with or on behalf of infants, toddlers and their families.The following exception is made if a supervisor/consultant provides reflective supervision/consultation to bachelor’s prepared candidates working toward endorsement as an Infant Family Specialist at Level II and meets the following standards:
- Is master’s prepared and has earned the MAIECMH Endorsement as an Infant Family Specialist at Level II.
- Specifically, has received a minimum of 30 clock hours of training specific to the MAIECMH Competency Guidelines and related to the promotion of infant mental health.
Specifically, has received a minimum of 24 clock hours of reflective supervision/consultation within a minimum of one year and a maximum of two years while working with or on behalf of infants, toddlers and their families.
MAIECMH recommends that those providing reflective supervision/consultation participate regularly in individual or group reflective supervision/consultation while providing supervision/consultation to candidates working toward endorsement as Infant Family Specialists, Infant Mental Health Specialists or Infant Mental Health Mentors at Levels II, III and IV.
Reflective supervisors/consultants who have not earned endorsement or cannot meet standards as defined in the guidelines above are invited to contact the MAIECMH Office (651-644-7333) to inquire about training and participation in reflective supervision/consultation groups (see below).
**Infant mental health services that meet Level III specialized work criteria are provided by professionals whose role includes intervention or treatment of the infant/toddler’s primary caregiving relationship (i.e. biological, foster, or adoptive parent), including diagnosis of mental illness in families members as appropriate; these experiences are critical to the development of a specialization in infant mental health. Infant Family Specialist, Level II, is broader and includes practitioners whose work experiences come solely from programs that provide education/support/consultation to infant and early childhood care providers or whose intent is primarily to educate parents.
Building Capacity for Reflective Practice
MAIECMH recognizes that in many regions there are few supervisors/consultants who meet the qualifications for endorsement (as specified above). If an endorsement candidate has difficulty finding a supervisor/consultant who meets the qualifications, MAIECMH can be a resource for the names of individuals from around the state who have earned endorsement, who meet the standards and are qualified to provide reflective supervision/consultation to promote or support the practice of infant mental health. If a program has difficulty finding someone to provide reflective supervision/consultation to guide and support staff who are candidates for endorsement, MAIECMH can be a resource, too.
MAIECMH invites endorsement candidates and supervisors/consultants to contact the MAIECMH office (651-644-7333) 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 phone 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.
Reflective Supervision and Consultation: 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 2002 to 2003. 22003.
- Bertacchi, J. & Gilkerson, L. (2009). How can administrative and reflective supervision be combined? In S. Heller & L. Gilkerson [Eds.] A Practical Guide to Reflective Supervision. (pp. 121-131). Washington D.C: ZERO TO THREE
- Bertacci, J. & Coplon, J. (1992). The professional use of self in prevention. In Fenichel, E. (Ed.). Learning Through Supervision and Mentorship to Support the Development of Infants, Toddlers and their Families: A Source Book. pp. 84-90. Washington, D.C.: ZERO TO THREE
- 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 (monograph). Washington, DC: National Technical Assistance Center for Children’s Mental Health, Georgetown University Child Development Center.
- Eggbeer, L., Mann, T. & Seibel, N. (2007). Reflective supervision: Past, present, and future. ZERO TO THREE, Vol. 28, No. 2. ( November, 2007)
- 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.
- 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. Pp. 177-186 Washington, D.C.: ZERO TO THREE
- 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, pp. 114-136
- Heffron, M.C. & Murch, T. (2010). Reflective Supervision and Leadership in infant and early childhood programs. Washington D.C: ZERO TO THREE
- Heffron, M., Grunstein, S. & Tiemon, S. (2007) Exploring diversity in supervision and practice. ZERO TO THREE, Vol. 28, No. 2. ( November, 2007)
- Heffron, M., Ivins,B. & Weston, D. (2005). Finding an authentic voice. Use of self: Essential learning processes for relationship-based work. Infants and Young Children, Vol.18, No. 4, pp323
- Heller, S. & L. Gilkerson [Eds.] A Practical Guide to Reflective Supervision.Washington D.C: ZERO TO THREE
- Korfmacher, J. & Hilado, A. (2008). Creating a workforce in early childhood mental health: Defining the competent specialist. Research Report. 2008, No.1. Herr Research Centerr for Children and Social Policy at the Erikson Institute
- Michigan Association for Infant Mental Health. (2002, 2011). MI-AIMH Endorsement for Culturally Sensitive, Relationship-focused Practice Promoting Infant Mental Health® and MI-AIMH Competency Guidelines
- New Mexico Association for Infant Mental Health. (2012). Reflective Supervision and Consultation Defined. www.nmaimh.org
- 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.
- Schafer, W. (2007). Models and domains of supervision and their relationship to professional development. ZERO TO THREE, Vol. 28, No. 2. ( November, 2007)
- Schafer, W. (1992). The professionalisation of early motherhood. In In Fenichel, E. (Ed.). Learning Through Supervision and Mentorship to Support the Development of Infants, Toddlers and their Families: A Source Book. pp. 67-75. Washington, D.C.: ZERO TO THREE
- Shahmoon Shanock, R. (1992). The supervisory relationship: Integrator, resource and guide. In Fenichel, E. (Ed.). Learning Through Supervision and Mentorship to Support the Development of Infants, Toddlers and their Families: A Source Book. 37-41. Wash., 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, p. 37-41.
- Stroud, Barbara. (2010). Honoring diversity through a deeper reflection: Increasing cultural understanding within the reflective supervision process. ZERO TO THREE, Vol. 31, No. 2. (November 2010)
- Weatherston, D. (2007) A home based infant mental health intervention: The centrality of relationship in reflective supervision. ZERO TO THREE, Vol. 28, No. 2. ( November, 2007)
- Weigand, R. (2007) Reflective supervision in child care: The discoveries of an accidental tourist. ZERO TO THREE, Vol. 28, No. 2. ( November, 2007)
- Wightman, B., Weigand, B., Whitaker, K., Traylor, D., Yeider, S. Hyden, V. (2007) Reflective practice and supervision in child abuse prevention. ZERO TO THREE, Vol. 28, No. 2. (November, 2007)
Minnesota Association for Infant & Early Childhood Mental Health (MAIECMH)
c/o MACMH, 165 Western Avenue N., Suite 2, St. Paul, MN 55102
651-644-7333 or toll-free 1-800-528-4511