Reflective Practice in Early Childhood Work: A Personal Story
Welcome back!
Reflective practice is probably the single most important element of my work and also one I had never encountered until entering the early childhood mental health world. In graduate school, we talked about our patient work but it wasn’t until I began working in child mental health that the notion of our own thoughts, feelings, and past experiences influencing our work became part of my normal weekly (even daily) conversation.
In this post, I’m sharing a bit about my personal journey with reflective practice. My next post will be a more structured “what is it” post.
Responding to a Client Crisis
Many years into my work, I was overseeing a therapeutic preschool program and had hundreds of hours of reflective supervision and facilitation under my belt (both receiving and providing it). We had an emergency at our school, details of which I’ll spare you, but a scary experience for one of our families. As the leader of the program, my team was looking to me to co-regulate them, figure out the details of our response and answer a million questions like ‘do we close school today’ to ‘what are we doing to make this child feel safe returning’ and ‘what are you going to do to make sure we feel safe to return.’ At this point, I had been working with childhood and family trauma for about a decade, I had worked directly with and supervised dozens and dozens of cases in which children experienced unspeakable trauma. Before this moment I felt completely prepared to navigate the aftermath of a highly stressful, potentially traumatic situation with a child. But in the moment, with all the questions flying at me I felt a bit of paralysis. I could make decisions but were they the right ones? There were lots of important actions to take, but which ones should be first? If I say this to my team, will they take it the way I intend the message or is there room for misreading?
In the height of the experience, my own stress response was active, making the highest functioning part of my brain much less effective than it typically was. Normally, it would be easy for me to think rationally through a complex situation, prioritizing people first, then procedure, immediate plans followed by medium term and long term plans for everyone’s healing. But, in the moment, I knew my cortex couldn’t make sense of this complexity in a way I trusted. So…what did I do? I turned to reflective practice. I reached out to my most trusted group of colleagues and mentors and one of them graciously offered to meet with me for an hour.
A Real-Life Reflective Session
Something I remember clearly from the hours after this scary thing happened was that I knew I was smart and conscientious enough to respond. My intellect wasn’t the problem, it was my state of arousal. When I reached out to a group of colleagues for support, I trusted them to understand that. When I met with my meteor, I wasn’t met with “why is she asking this, she’s a manager, she should know how to respond to crisis.” Instead I was met with a simultaneously human and scientific reaction- “I’m so glad you reached out, when something so frightening happens, it can be so hard to rationally make decisions that are best through everyone. What would be most helpful during our time together to help you feel like you can move forward.”
Through this opening, my mentor immediately told me
I understand that decision making in times of stress is much more difficult than during normal times
You have had a big stressor, a crisis, it’s normal to feel overwhelmed
You have control over how we spend our time even if you don’t have control of how this situation happened or continues
Reflective Practice is Non Judgmental
By withholding judgement, my mentor was able to co-regulate with me. Her stable, calm, attuned and understanding presence allowed me to begin to reach a much more regulated state. She communicated both directly and indirectly that she trusted my knowledge and experience and understood that in the height of a difficult situation, support is called for. If she had communicated any judgement, my lower brain would have responded to this as a threat, further diminishing my ability to think through a solution.
Reflective Practice Includes Co-Regulation
Often in reflective practice, the goal of the facilitator is to co-regulate the provider. During our conversation, my mentor asked questions like “how are you feeling now that you’ve shared this story with me.” By asking questions about how I, personally, was feeling, she allowed me to attend to the lower parts of my brain first.
In the moment, I felt my thoughts racing and my body tense. Once invited to tune into this, I noticed and shared that my breath was shallow, my heart was racing a bit. I realized I was anxious to find a solution and get back to my team with “answers” about what to do next.
Giving me space to begin to notice my body allowed me to become more in touch with my emotions. If I hadn’t noticed how tense I was, I may have proceeded to think and maybe act quickly, without fully considering my options and using the knowledge I have. After just a moment of internal reflection, I was more ready to move “up my brain” into the higher level areas.
Reflective Practice Includes Information Gathering
In reflective practice, there’s a certain amount of information about the situation at hand that the facilitator needs. Because this isn’t psychotherapy, it’s important to know what the clinical problem or question is.
Open ended questions allow the practitioner to tell the story or the case or situation they’re sharing. My mentor began with questions like
Tell me more about why you needed to meet today?
Tell me a little about the child we’re talking about. Help me understand his relationship with his mom.
What do you think your team is making of this event? Are they responding in a way you would have predicted or has the response been surprising?
Now that you’ve told me the story, is there anything else that you feel is important that you haven’t shared that would help me in our conversation?
Being asked these clear but open ended questions allowed me to begin to put the story in order and to organize my thoughts. Asking a question like, what else might be helpful for me to know was a way for my mentor to encourage me to pause and reflect on our conversation up to that point. This way of pacing our conversation not only got her the information she needed to support me but also contributed to my regulation, pausing me from moving too quickly and leaving things out and also structuring our talk enough that I didn’t have to “dump” information on her.
Reflective Practice Includes Strategic “Teaching”
As I shared the story of what happened and the choices I was considering for my response, my mentor was careful to elicit ideas from me, rather than generate ideas herself. At one point, she sensed I was stuck- I was describing what someone had recommended I do and told her it didn’t feel quite right but I couldn’t put my finger on why or what to do instead. Though the overall goal of reflective practice is to support the provider in generating their own solutions, there was a need to add a bit of scaffolding to support my thinking. She told me something I would have known at any other time- “children will react to high stress situations with changes in their behavior, routines, eating and sleeping patterns (etc) for about six weeks after it happens. Not until then would we start to determine if a post-traumatic stress response is atypical.” In other words- it’s normal for this mom and child to have disruptions for the next several weeks.
This bit of information, not new but out of my grasp in that moment was a lightbulb! She followed up by asking “how does this information change how you’re thinking about this situation?” After that, I was able to structure my plans in a much more organized way. I could think about what I needed to look for in the child, I realized that the response is not as urgent as I was feeling it needed to be and that observing and paying attention to the child (and my team) would be how I would generate a response that was attuned and matched to their needs.
Reflective Practice Ends with Generating a Plan Together
Now that I had settled, felt safe enough to discuss the details of my upcoming clinical and leadership work, and considered some important information about trauma processing, I was able to move into an organized conversation about how to proceed in supporting the family and my team. My cortex (the most advanced part of the brain) was online and working and we were able to decide on several strategies and approaches as well as timelines to accompany them.
In thinking back on this reflective opportunity, I realized that this mentor was someone who, if she had offered a full plan, I would have taken and implemented with very few questions asked. But she didn't! The plan we came up with was generated by me! I had the opportunity not only to leave our meeting with a plan for what to do but I gained the experience of planning in the midst of chaos. A skill I have used in my work many times since this meeting.
The power of reflective practice is in this- good reflective work provides the opportunity for empowerment in the most difficult circumstances because it allows us to generate solutions to our own problems in a supportive environment.
Come back next week for more of the nitty-gritty of reflective practice! As always, thank you for being here!
Disclaimer
The information provided on this blog is for informational purposes only. It is not intended to assess, diagnose, treat, or prevent any medical or mental health conditions. The content shared on this site should not be considered a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, mental health professional, or other qualified healthcare provider with any questions you may have regarding a medical or psychological condition. Never disregard professional advice or delay seeking it because of something you have read on this blog.
