A home visitor's experience

The team focused on strengths, asking, "What do you bring to this situation?" and "What do you think is going well during your visits?" It was difficult for Laura to describe her own strengths, but with the help of the group, a long list was soon generated. Laura was amazed to discover that she could also identify several capacities of the mother and the baby, and that some things were actually going very well. She shared that her frustrations and feelings about not do doing her job well had probably been interfering with her ability to see the beautiful things in the baby's and Mrs. S's relationship. As the team continued to explore the strengths of all involved, including the social worker, Laura become visibly relaxed and more able to focus on the complexities of the situation.

The team helped Laura consider different interpretations and feelings by asking, "Why do you think Mrs. S interacts this way with her baby?" and "How do you feel about being asked to report on the mother's behavior?"

Ecological Considerations diagram, Figure 3
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Special thanks
The Portage Project would like to thank the following infant/Family programs: 

Bridges for Families, Madison Wisconsin; 

Department of Community Programs, Adams County, Wisconsin; 

Renewal Unlimited, Early Head Start of Portage, Wisconsin; 

Winnebago County Department of Community Programs,

Children's Development Center and 

Early Intervention Services.

The team helped Laura examine possibilities and develop questions. They asked, "What do you need to know more about to better understand this situation?" and "What next steps might be helpful?" During the next few weeks, several changes occurred. During individual supervision, Laura described no longer dreading the home visit, and said that she and Mrs. S had connected in a more meaningful way. She told of how they had talked about the Birth to Three program, and clarified her involvement with other agencies. Mrs. S began to ask questions about the baby's behavior and development, and shared her fears that this baby might also be taken away. At a team meeting, Laura shared that the previous case discussion had influenced the way she thought about herself and her work. She told how it helped her to remain open-minded and curious about what she sees and feels rather than being judgmental Laura also took steps to clarify her involvement with the social worker and expressed her discomfort at being asked to monitor and report on the family situation. She was able to describe the strengths-based, family-centered philosophy of her program, and the ways that she was supporting Mrs. S in her interactions with the child.

Laura's story reflects the complex situations encountered daily by providers serving children and families. The agency Laura works for has been participating in the development of the Reflective Practice Model for Professional and Organizational Change with the Portage Project. The interactions described among Laura and her co-workers highlight a case discussion process developed and used in the Model. This process, and other strategies described in this article, are designed to support individuals, teams and supervisors to take a reflective approach to thinking and talking about their interactions with children and families.

The Portage Project, a national and international training project rooted in relationship-based direct ser-vice work with children and families, has had the unique opportunity to listen and talk to people around the country doing similar work. Providers and supervisors describe how their work challenges core beliefs and professional traditions, and often causes them to rethink their view of help-giving. For example, a therapist taught to do one-on-one therapy with children shared her ambivalence and discomfort as she tried to be sensitive to the family's agenda for their child's development. She spoke of the challenges of working in the family's natural environment, and of the skills required to act as a consultant to other professionals. Similarly, an Early Head Start teacher shared the difficulty of defining what she could and couldn't do when working in someone else's territory while supporting a child in a child care center. A supervisor in a Birth to Three program spoke of feeling isolated and somewhat unsure about how to interact with staff who, only a short time before were her peers.

Working with families and young children of ten evokes significant emotional responses from service providers, challenging their personal beliefs and values, and requiring them to use skills that may not have developed through study or previous work experiences. Few programs that serve families in non-clinical settings have a tradition of supervision and team meetings that help staff reflect on their work from the dynamic of underlying personal and professional values, beliefs, and history. Supervisors are often promoted from the ranks of direct service because of their skills working with children, families and teams. Few receive training and ongoing support to help them define their new role, or to successfully navigate the complex learning relationship between supervisor and supervisee.

Traditional models of supervision, training, and technical assistance that once met the needs of individuals working within well defined professional boundaries may no longer adequately support providers and supervisors who are implementing family-centered, commununity-based service delivery models.
 

A reflective approach to training

The Portage staff began to use a reflective approach to training in an effort to loosen and nurture the soil before planting the seeds. Unspoken conflicting beliefs and values sometimes made it difficult for participants to explore, much less embrace, other ways of thinking about or doing their work. Previous training experience and adult learning theory suggest that learning takes place in the context of relationships. Adults learn best when they feel valued for their knowledge, view the training content as functional, and are psychologically comfortable and secure. The reflective training approach facilitates a dialogue among participants. It acknowledges and gives permission for a structured discussion of differing values and beliefs, honors existing knowledge and skills, and offers multiple ways of thinking about the work of intervention. A set of core perspectives that include being family centered, thinking ecologically, using a strengths based approach, having a relational focus, and being reflective, act as filters through which ideas, actions and feelings can be explored during training.

In the reflective approach to training, the relationship of the presenter and participant parallels that of the home visitor and caregiver. The presenter's primary responsibility is to help participants create and maintain a safe environment in which meaningful dialogue can occur. The presenter listens, observes and acknowledges the experience and expertise of the participants, uses inquiry as a way to encourage reflection, problem solving, and self-understanding, and offers information grounded in research, law, and field experiences. The presenter strives to read cues and attend to the strengths and capacities of the participants, engaging them in a relationship similar to the one they are encouraged to develop with children, families and other professionals.

The new perspectives and strategies practiced during training establish a fragile hold within an individual's intervention repertoire, and are at the mercy of many outside forces. They need to be protected and encouraged in order to grow and flourish. The Portage staff understood that training was functionally a one-time event. Training processes may offer heightened awareness and expanded perspectives, but the ideas and strategies learned are rarely integrated into a program's service system unless given consistent support over time.

Many programs provide staff with training events and knowledgeable inservice speakers, and supply books and journals for professional libraries, but few have a consistent and systematic way to help staff share what they have learned with their team members, or encourage the integration of new approaches into existing program practices. As Portage staff began to attend more to the difficulties of integrating knowledge, skills and attitudes gained from training opportunities into the daily work with children and families, the question was raised, "What would help organizations and leaders nurture new ways of thinking, and support the professional development of their staff?" Addressing this question, along with several others raised during training and technical assistance opportunities, and providing direct service led to the development of the Reflective Practices Model. The model describes a process for supporting professional and organizational change that goes beyond single event training workshops.

The Portage Project staff, in collaboration with an Early Head Start program and three Birth to Three programs in Wisconsin, have worked together to develop and field-test reflective practice approaches that support supervisors and practitioners to reflect on their work with families, teams, and other professionals. Reflective practice approaches help providers and supervisors to:

• examine beliefs and program mission in light of literature, research and experiences across multiple profes-sional fields of study;

 
• explore if and how program practices reflect program mission and beliefs;

 
• explore how personal history, culture and experience affect relationships with families and other profession-als;

 
• move from single event thinking to thinking about patterns and systems;

 
• use observation, listening, and inquiry as an approach to understanding relationships;

 
• develop a common language and a shared vision of the work; and

 
• influence organizational practices and policies.

A reflective practice model for professional and organizational change

A supervisor's experience

This process of reflecting on our work has been all about change. In the beginning, if anyone would have told me that, I might have gone running off, but it's made change a natural, unavoidable event. I tell people it's a little like magic in that it goes beyond words. Our program staff have always been able to talk about our philosophy and mission, but now we have looked into the mirror and have seen that who we were didn't always "match up" with who we thought we were. We said we believed one thing, but at times our actual practices were very different. We couldn't live with that- we had to change to match up. We continue to find out what we truly believe about our work and why we believe it. We are striving to carry out those beliefs in our everyday practices. Our philosophy and mission haven't changed that much, but the way we are with families, how we interact with them and with each other, what we see as our job, and how we see ourselves --- that's what has changed.

The Reflective Practice Model for Professional and Organizational Change highlights the processes and activities found to be most helpful by participants and program staff involved in training and model development. There are three prerequisites, or key elements, needed to effectively implement the Model. These are:

• a commitment to develop and maintain trust and security within the group;

 
• allocation of time and place for regularly scheduled, staff meetings; and

 
• support for activities that encourage and teach ways to reflect on the work at all levels of the organization.

The Core Perspectives act as a lens through which ideas, actions, and feelings are explored. They provide a filter for the dialogue that occurs during group and individual interactions. The Core Perspectives are the same as those discussed in the training process mentioned earlier. They include: being family-centered, thinking ecologically, using a strengths-based approach, having a relational focus, and being reflective. They guide observation, listening, and inquiry, helping staff to consider their relationships from multiple perspectives. The development and assimilation of reflective practice methodology occurs through the Discovery, Engagement, and Integration phases of the Reflective Practice Model (see Figure 1 ) 71k.
 

Phase I : Discovery

Check In is an example of a simple strategy used to build and support trust and security. Check In is done regularly at the beginning of a staff meeting, and offer each participant two or three minutes to share something about their life or work experiences. The experiences that are shared indicate the group's "emotional temperature," providing a snapshot of a person's current state, and alerting the team to special concerns or celebrations. A home visitor observed:

I was having a particularly frustrating day from the time I woke up until I come to the staff meeting. It helped to have a couple of minutes to share how difficult my children were to get out of the house that morning, that a family called and said I shouldn't come because they were being evicted, and that I felt I had 20 things to do that day. I felt my team members cared about me and understood why I wasn't particularly talkative at the meeting.

The Check In process helps to build a bond among team members and allows them to find common ground in both their personal and professional lives. A team member commented:

I had difficulty getting to know others on the team because we are spread out in five sites. Check In was often the only time I was given personal information that helped me understand my team. That has helped me begin to build relationships with others while becoming part of the group.

Phase II: Engagement

The Experience Based Case Discussion Process can be used by individual team members for internal self-reflection, by larger groups, and by supervisors during individual supervision. When done with a group, the process requires a facilitator and a recorder. The facilitator's role is to guide the discussion and inquiry, while the recorder writes down important group contributions. This written document is given to the person who presented the case, when the discussion is completed. The discussion format outline (Figure 2) is used only as a guide, as the conversation may flow from one phase to another out of sequence. The facilitator assures that all areas are touched upon in the discussion, and that the presenter is able to fully explore the issues. A note of caution: the Experience Based Case Discussion process is deceptively simple, and the group and facilitator must keep in mind that it can open the door to significant and unexpected self-disclosure. At times, the discussion may need to be redirected to individual supervision.
 

Figure 2

Experience Based Case Discussion

Purpose: Understanding the experience

a) Telling the Story (facts, presenting issues, involvement, personal experiences)

b) Acknowledging and clarifying facts and feelings

c) What do you want the group to help you think about?

Phase 11

Purpose: Exploring and sharing the collective knowledge and experience of the group

a) Strengths and capacities: What's working? How does it happen?

b) Possible interpretations: Why are things happening this way?

c) Developing questions: What do you need to know more about to understand the situation or to clarify your feelings and involvement?

Phase III

Purpose: Summarize discussion and identify possible next steps

a) Summary- key discussion points, strengths and capacities, what's working, possible interpretations and questions

b) Possible next steps

c) Generalize experience to group learning

Phase III: Integration

An organization's experience

As a "first wave" (original cohort of grantees) Early Head Start Program, we had federal regulations and a strong lead organization, but we did not have our own culture or history to define our work. One challenge to our program was to find a way to fit in with the existing policies and practices of our lead organization. We collaborated with the Portage Project to implement a training and reflective practice model for our program. We struggled to define our beliefs and values and to create a sense of team with the newly hired professionals. The organization provided consistent meeting time and facilitated reflection on our work with families. Through these efforts a common language and shared vision of the work developed. Opportunities were provided for administrators and Head Start staff to examine our beliefs and practices through observations and discussions with the Early Head Start staff. The Early Head Start professionals felt that spending time together to reflect on their interactions with families was crucial for the development of their professional skills. As the administration and leaders of the program observed these meetings they began to explore the possibility of integrating this type of meeting into the practices of the larger organization. They eventually made the commitment to allow Head Start teachers and home visitors consistent time to reflect on their work with families. Early Head Start activities have influenced the organizational practices of the Head Start agency as a whole.
 

The Discovery, Engagement, and Integration phases of this model do not occur in a linear progression. Rather, individuals and groups will experience a continual cycling from one to the next and back again. Some activities, or strategies, will be useful in different ways at different stages of the organization's development. A good example is the use of "Professional Mapping," a tool that can be used at various times to help staff discover their individual strengths, challenges, and support systems as they relate to their work. This mapping process can facilitate the development of individual and organizational goals, which will then form the basis of action planning to accomplish the desired outcomes. These activities will, in turn, support ongoing individual and institutional learning, which will prompt the formulation of new goals and objectives. A staff member recalled:

I recently went through Professional Mapping with a member of our reflective practices team. During the questioning process I had a powerful insight into how personal issues related to my family of origin were influencing how I formed relationships with certain types of families. Without sharing the intimate details of my family history, I alerted her to the connection, and we talked about ways to use this insight to enhance my approach and develop healthier relationships with families without becoming enmeshed in their emotional needs. An added benefit was that discovering and sharing this connection between my personal history and the work, helped me develop a great partnership with a colleague and lets us give "reflective nudges" when needed.

There are many factors that influence growth and learning within organizational relationships. Key considerations that affected how the Reflective Practice Model was offered and received by individual programs include: individual professional development, relationships within the organization, and program supports and resources. Organizational history, structure and culture, as well as the broader community and political agenda represent additional influencing dynamics (See Ecological Considerations diagram, Figure 3) 17k.

What we' ve learned

The Portage staff is in a continuous learning relationship with practitioners and supervisors, using the Reflective Practice Model. Through this relationship, the following key points were evident:

• Learning occurs in the context of relationships; without a 'secure base," learning is compromised. 

 
• Collaborative reflection on the work at all organizational levels provides the maximum potential for change in practices. 

 
• Practitioners and supervisors are dealing with multiple complex relationships and issues. They do not want "to make difficult decisions alone," and they are seeking reliable support to help them do their work. 

 
• Integration of reflective practice strategies into program routines promotes beneficial individual and organizational growth and change. 

 
• Consistent opportunities to be together and talk about the work brings unresolved issues into clearer focus for both individuals and the organization. To maintain a secure and safe environment during times of challenge, a clear statement of program goals is needed, as is a definition of the decision making and communication paths available for staff. 

 
• Supervisors need a consistent time and place to meet with other supervisors to talk about their relationships and responsibilities with their staff. 

For more information about ZERO TO THREE and  resources visit the 0-3 web site at: 

http://www.zerotothree.org