Reflective Supervision

Reflective supervision is different from administrative supervision, which focuses on accountability (e.g., hiring, orienting, monitoring, and evaluating). Reflective supervision is a mutual process in which a home visitor and supervisor learn together about the child, the family, the home visitor’s work, and all the relationships involved, including that of the home visitor and the supervisor. The process of reflection — of stepping back and wondering about the many factors within, between, and around the individuals — can yield new perspectives and insights that improve the quality of the work. (See Reflective Practice in the Home Visitor’s Online Handbook.)

Reflective supervision is relationship based (Fenichel, 1992).[1] You and the home visitor engage in a reciprocal process in which you each grow to trust the other over time. Your empathy for and validation of each home visitor leads to a solid supervisory relationship. Reflective supervision is also:

• Reflective. Supervision is used as an opportunity for home visitors to reflect on what they are doing during home visits, their reactions and feelings in relation to their work, and their challenges and accomplishments.
• Regular. Supervision occurs on a consistent basis, preferably during a regular meeting time. It should be a protected, uninterrupted time when you do not take phone calls, check email, accept visitors, or perform other tasks.
• Collaborative. You and the home visitor have mutual respect for each other and benefit from each other’s expertise.
• Safe. You provide a supportive environment for home visitors, respond to them in a nonjudgmental manner, and maintain confidentiality.

Supervisor strategies for reflective supervision include self-reflection, collaboration, and active listening, which are explored following a discussion of reflective supervision structure.

Structure of Reflective Supervision

Reflective supervision needs to occur on a regular schedule, ideally on the same day and at the same time every week. The session usually lasts one hour. The space must be private. However, the schedule should not be rigid. If a highly emotionally charged event occurs, the supervisor should be available to schedule an extra session.

The ideal reflective supervision session integrates the following steps:

1. Prepare. Take time to get ready for the meeting and review notes from previous meetings. Anticipate topics that might be on the home visitor's mind based on past discussions.

2. Greet and reconnect. Set the tone for your time together by asking how the home visitor is doing. Use active listening and pay attention to the home visitor’s verbal and nonverbal cues. Make sure you also pay attention to your own nonverbal cues.

3. Set the agenda. Plan together how you will spend the supervisory time. Prioritize what needs to be accomplished during your time together.

4. Gather information. Explore with the home visitor how he or she is approaching the work. Use verbal anecdotes, videos of home visits, or exploratory questions to view all sides of an interaction, event, or situation. Listen for content (what happened), process (how it happened), and unspoken issues (feelings or experiences that may affect the home visitor or family).

5. Enlighten through "teachable moments." Look for opportunities for professional development such as education on child development, discussion of boundary issues, or lessons from research. Use role-plays or open-ended questions to enhance skills and explore different perspectives.

6. Resolve issues raised by the home visitor. Help the home visitor develop hypotheses about the situation, and do some joint problem solving. Focus on the home visitor’s skills, for example, their knowledge of child development and skills in helping parents recognize learning.

7. Provide information. You may need to offer concrete resources or recommend clinical intervention. In some cases, your goal will be to create comfort with ambiguity when no clear answer to a problem is apparent.

8. Address accountability issues. If you are also the administrative supervisor and cannot have separate sessions, this is where you might address administrative issues. For example, has the home visitor completed the required number of home visits? Is the home visitor able to attend to all the families with whom he or she is working? Does the home visitor maintain appropriate documentation?

9. Reach closure. Review the session and set a tentative agenda for the next meeting. Give the home visitor strategies to enhance skills, and end with a positive affirmation of the home visitor, such as empathy in the face of a challenging home visit, praise for a specific job well done, or acknowledgment of his or her commitment to the work.

Supervisor Strategies

The work of reflective supervision, which occurs in the relationship between the supervisor and the home visitor, requires time and positive experiences for trust to develop. It requires a willingness to both think and feel deeply about the home visitor’s and the child’s and family’s experiences, as well as your experiences with the home visitor. This understanding of how relationships affect relationships is called the “parallel process” and can support supervisors as they engage with home visitors about their established relationships with families.[2]

Many people believe the best first step is to participate in reflective supervision yourself, with an experienced provider. Whether you take that route or not, self-reflection, collaboration, and active listening are a few key strategies that will help you begin.

Self-Reflection
Reflection helps home visitors think about the experience of the child and family, and it helps you understand the experience of each home visitor, child, and family. This understanding can lead to strategies that deepen and strengthen the relationships of everyone involved. The process is one of wondering together about the history, feelings, and expectations that each person might bring to the event. New understandings or strategies can emerge from mutual exploration — but it is not your job to provide solutions to problems! The shared respect between you and the home visitors creates a space where, together, you may find alternatives for resolving challenges.

The ability to self-reflect is an important part of being able to reflect with home visitors. Self-reflection goes hand in hand with self-awareness. Self-awareness comes from understanding that your past experiences (personal and professional), culture, values, and expectations can influence how you listen to and interact with home visitors as you share their experiences and ask questions. You may also find that you have difficult feelings or strong reactions to what home visitors tell you.

The following strategies can support self-reflection[3]:

• Look within to notice what is going on. Try to identify:
  • Strong feelings such as anger, frustration, irritation, impatience, and helplessness
  • Desires to fix problems or to rescue the home visitor from his/her situation with a parent/family
  • Physical responses such as rapid breathing, fast heartbeat, muscle tightness, and discomfort/pain; difficulty focusing on what the home visitor is saying or doing
  • Difficulty thinking clearly
• Then try to listen to what the feeling is telling you. For example, is it telling you:
  • Something about yourself? The home visitor? The family?
  • Something about your relationship with the home visitor?
  • Something about how it feels to be in the home visitor’s situation?

Acknowledging these feelings and insights does not mean that you must disclose them to the home visitor. Sometimes just the act of identifying and acknowledging can help you move past uncomfortable feelings and respond to the home visitor instead of your own emotions. However, sometimes self-disclosure can deepen your relationship with the home visitor. You might follow up self-disclosures and empathetic statements with open-ended questions to help the home visitor think about his/her approaches and next steps.

Collaboration
Collaboration involves mutuality, respect, and open communication between you and each home visitor. It is a partnership in which you and the home visitor bring your best, collective thinking to identify strengths or address concerns about the families and children being served.

The following strategies support the creation of a collaborative relationship:

• Identify your responsibilities as well as the home visitor’s. You might do this through a supervisory contract (verbal or written). Power is shared in this process; it is mutual, although not necessarily equal.
• Use joint decision-making about the home visitor’s work and mutual performance assessments.
• Use silence and waiting to demonstrate your respect for the home visitor’s thought process.
• Ask clarifying and reflective questions.
• Acknowledge and respect the home visitor’s observations and reflections.
• Offer your own insights.
• Plan your sessions and next steps together.
• Follow through on any commitments you make to find resources, contact others, or check in after a particular home visit.

Active Listening
Active listening means putting all distractions aside to be fully present and tuned in to what the home visitor is saying. It involves creating a distraction-free environment to focus attention on the home visitor. An active listener seeks to fully understand the home visitor’s experiences, questions, and concerns.

The following strategies can support active listening:

• Stop. Home-based supervisors often multitask. Stopping in a reflective supervision session means just that: Stop other work, turn your cell phone off or put it on vibrate, and turn the computer screen away so that you can pay full attention to the home visitor. Close the door, and hang a “Do not disturb” sign on it. This shows the home visitor that you are focused on her and value the time you spend together.
• Look. In active listening, looking involves not only eyes but face and body, too. Be aware of your own nonverbal cues as a listener as well as a speaker.
  • Face the home visitor directly.
  • Make eye contact (if this is culturally appropriate).
  • Observe the home visitor’s nonverbal cues. Keep in mind that home visitors’ temperaments, cultures, and experiences with reflective supervision may influence their nonverbal behaviors.
• Listen. Listening is more than just hearing words. It also involves listening to how the words are said. How does the home visitor sound? What is the home visitor’s tone of voice? Does it match what the home visitor says? If you think there are conflicting messages between what a home visitor says and how she says it, seek clarification.
• Respond. Let the home visitor know you are listening and understand. You can demonstrate this through nonverbal means such as nodding your head, leaning forward (toward the home visitor), touching the home visitor’s hand or arm (if personally and culturally appropriate), smiling, and saying, “Mm-hmm.”

Use some of the following in-the-moment starting places to respond to what the home visitor shares[2]:

• Noticing and describing. Recognize when home visitors can notice and describe the thoughts, feelings, intentions, beliefs, and motivations (mental states) of the family, the child, and themselves. If they are aware and able, you can explore these observations and perceptions more fully.
• Empathizing with and acknowledging feelings. Feelings are always present, even though they are not always recognized or discussed, during interactions in a family home and in supervisory meetings. You can ask questions that prompt awareness of mental states and pay attention to whether this helps home visitors enhance their perception of an interaction.
• Making connections. Support home visitors to consider the emotions, thoughts, beliefs, motivations, and intentions that might guide the behavior or interaction that they are describing. Ask clarifying questions to show interest and reinforce understanding. Support home visitors to make connections between what might have been going on in the parent’s, child’s, and their own mind in the situation they describe.
• Recognizing and normalizing reflection challenges. Recognize that individuals can have conflicting mental states, such as feeling anger at their feelings of helplessness within a situation. Use the established collaborative environment to explore strong emotions and strategies to help regulate feelings as well as potential miscommunications and misunderstandings of behaviors of the family. Share your own experiences of reflection challenges to help normalize the challenges that home visitors may encounter.

Experience It

Brenda Jones Harden, PhD, Institute for Child Study, University of Maryland, discusses the necessity for regular reflective supervision to support the home visitor.

Last Updated: June 27, 2024