La práctica reflexiva en los programas basados en el hogar

Reflective Practice in Home-Based Programs

Randi Hopper: Hello, and welcome, everybody. Thank you for jumping in and joining our webinar for today. See there's a lot of people on from different positions and across the country with lots of experience. So, we're going to jump right into our webinar, Reflective Practices in Home-based Programs. My name is Randi Hopper, and I'm from the National Center on Early Childhood Development, Teaching, and Learning, and today I'm presenting with my good friend, Ms. Donna Ruhland, who's also from our National Center DTL, and we're going to jump right in today to get us started off on the different webinar features that are here for you.

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Alright. So, let's get started, OK? So, for today's session, we're really looking at by the end of this presentation, you really should be able to explore what reflective practice is and why it's important, look at how your own experiences and beliefs really influence your work with families, and you can also share strategies that support developing skills in reflective practice, along with reviewing several of the resources that support reflective practice over time. Alright. So, we're going to start off with a poll question.

We want to see what best describes you. OK, So, when you think about reflection—alright, reflection of any type—whether it's personal or professional, what reflection ... How often do you engage in reflection? Do you consistently engage in reflection, often engage in reflection, sometimes engage in reflection or you do not engage in reflection? So, take a moment to kind of think about what you do on a personal level and see. We're taking a ... We're looking that a lot of people are either consistently or often engaging in reflection.

Some people are sometimes, and so far, we ... Nobody has answered that they do not engage in reflection at all. So, I'm seeing a lot of people in the group chat putting in their answers. And so, what I'm going to do is, I'm going to push the results of our poll to the audience so you can see. So, I think that between those who answered in the poll itself and those who answered in the group chat, we're seeing a lot of people are either consistently or often engaging in reflection, and we really want to take a look at this in terms of the fact that reflection itself is a part of reflective practice. So, sometimes we don't really look at it in terms of, "Oh, I'm actually engaging in this whole system of reflective practice. I'm just reflecting on my experience," but really they are one and the same.

Alright. So, we're going to move forward, and throughout our presentation today, we're going to talk about our home visitor named Maria. So, Maria works for the ADC Community Action Agency. She's been a home visitor for nine years and has always taken pride in the work that she has done with families and her ability to set healthy boundaries with her families. This is critical to her work in the small community that she serves. Now, recently Maria has been assigned a young family consisting of a single mom with her two children under the age of 3. Maria felt for this mom and found herself often going to extra lengths to help her. She also found herself worrying about the young mom over the weekend and had to stop herself from calling her to make sure she was OK.

Now, does Maria's experience sound familiar to you? Maybe this has happened to you personally or something that you—someone you know. So, we're going to keep Maria in our mind, OK, as we go through, and we're going to ... Oh, you know what? And I'm seeing, as we go through before, I see that some people didn't see our poll at the beginning, and I'm sorry for that. You know what, we're going to have one more poll so you do get a chance to engage with it, and we'll see if we can work out to see what happened while we go through? But thank you for those who ... Even though you may not have seen it, you did put in your answers into the group chat, and we really appreciate that, for being able to engage with us. That was some quick problem-solving on your end.

Alright. So, we want to make sure that we're on a ... We are on something that says, "What is reflective practice?" Now, if you haven't gotten to this slide or something like that, make sure you use that F5 button to refresh your browser because that may have been a small issue, too. But as we go through, we really want to talk about what is reflective practice. Reflective practice allows for you to manage those strong emotions and reactions and build an awareness of the meaning of the events to other people. We talk about current practices and choices that are made and the contextual effects and their impacts.

So, as we go through, we really want to take a look at, as your reflection increases, so does the quality of your work, whether it is small, everyday moments that go especially well or especially poorly. It really helps to consider how best to go about your work and how reflecting with someone in a supervisory role or in a peer role can help us understand the difficult, and often emotional, experiences that we encounter in our work over time. So, the first place that we go to for reflective practice is, we talk about self-reflection and reflective supervision. So, we take our time to reflect, which is to stop and think about what has happened, what is about to happen, what is happening and what should have happened.

So, this is essential in creating and maintaining positive goal-oriented relationships between ourselves and with our families. So, self-reflection is often ... Is an important part of our own continuous improvement process to understand why and how we make the choices that we do. So, taking the time to look at ourselves and our work gives us the opportunity to acknowledge the strengths and the challenges that we have and to identify ways to improve our skills. So, some key considerations for self-reflection are to observe and remember what happens with children, families, and staff.

So, as we record children's progress, when we look at our contacts and communication between staff members and parents and the information that we share between each other. When we look at this opportunity, we understand what does and does not work, OK? And remembering and reflecting on our observations is helpful when we think about ways to improve on ourself.

So, sometimes this is where we take a look at recording. So, recording our reflections either in a confidential notebook or maybe via voice on your phone, Something that allows you to live in the moment, to record that thought as it's live in your head. We also want to think about our own experiences and the way they affect our work. So, this may be the most difficult part when it comes to self-reflection because we often take action with children and families because they're familiar or they're comfortable with us, and it can be difficult to question what we already know and what we think is right versus allowing that interaction with that parent to be very holistic and have it be family-driven.

So, through this self-reflection, we really allow ourselves to understand our personal reaction, so how the professional situation makes us feel and our professional reaction. So, this is how we choose to respond professionally in action and words, and these are two separate things. So, we also want to take into ... And think about the perspectives of others, OK? So, we can only live in our own head, and we can only address things in how we think that we receive them. So, we want to take time to wonder about how others, other individuals' experiences may influence how they respond or behave in certain circumstances.

So, keeping in mind that sometimes wondering about others can be similar to making assumptions about them. We tend to rely on what we've learned and experienced in past circumstances, so taking this into account is important to allow enough space in your reflections and your interactions to acknowledge that you don't know everything, and you're not sure what always motivates someone else, and so, this is a key point when we engage with families is because we're coming from one perspective, and they're coming from a different perspective. We also want to take stressors into account because that is a big factor when it comes into the behavior or perspective of others. OK?

Now on the flip side, we talk about reflective supervision, and so, this is an opportunity that is structured. It's a structured way for staff to be supported by their supervisor and be able to enhance their work with families. And so, there really are three key aspects of reflective supervision. There is reflection, collaboration, and regularity. The reflection really describes the environment of the session, so a safe space to allow for you to share, for you to be able to explore, and this is focused on what we call the supervisee. This is focused on the individual. You're exploring your experiences, feelings, thoughts about your work. Now, collaboration is described in open communication.

This is a two-way communication in which the supervisor and the supervisee are able to work together. Now, this is key that this is a confidential open space because that builds the best collaboration. This involves curiosity. It involves active listening on the part of the supervisor, and we don't want to have an area of judgment. We want to be free from judgment, and we want to make sure that we're listening to really what they're saying in this. Regularity involves the schedule, OK, the dedication of time on both parties.

So, we want to make sure that this time for reflective supervision is a structured, consistent time, and if we're having trouble finding that time between a supervisor and a supervisee schedule, we need to take a look at that as in, does it need to be a different day, a different time? Do we need to meet in a different place so that we can really make sure that that time is built-in and it's dedicated and important? And while this time is being ironed out and made sure it's consistent, supervisees can also make sure that they reach out to their peers. Home visitors are a learning group together, and so, home visitors have strength in numbers and knowledge. And so, this is very helpful to be able to talk to your peers about what's happening or what you're experiencing.

Now, we also have a handout, and so one of our handouts that's in our resource box today is our PFCE reflective practice handout. So, we want to take ... So, if you haven't downloaded that already, you should download it and take a look at it. We talked about the opportunity to model effective strategies while we're building relationships with families and how to behave when the staff models what they want to happen and interact with the family. So, that handout really helps you to be able to build relationships and move forward.

Now, after I've shared that information, and I know it was a lot of information about self-reflection and reflective supervision, let's circle to Maria, who I introduced, you know, just a slide or two ago. And so, let's think back to her, and Maria engaged in some self-reflection about her family, and she identified why this particular family resonated with her so much. It occurred to her that this family really reminded her of her own childhood experiences growing up with a single father and siblings and that ... The challenges they faced. And though she wanted to help this family through their challenges, she knew she needed to remain professional and consistent in her interactions with all the families on her caseload.

So, at her next reflective supervision session, she discussed the family with her supervisor and shared her self-reflection. Maria's supervisor actively listened to what she had to say, asked open-ended questions for clarification and summarized what they understood. And so, Maria shared how she could reestablish professional boundaries for herself, and her supervisor shared how they could support her efforts. So, with that, those are kind of the steps that a home visitor ... They lived in the moment. They reflected on what they saw about this family. They reflected on their own perspective, and then they engaged in reflective supervision, that open conversation piece.

Alright. So, we're going to move forward, and we're going to talk about the parallel process, OK, and what we call ripple effects. And so, with this, we want to take a look at this quote. So, "Do unto others as you would have others do unto others." Now, sometimes we take a look at this, and we ... Sometimes you've heard that saying as, "Do unto others as you would have others do unto you," right? But when we take a look and we think ... When we think about this, "Do unto others as you would have others do unto others." Let's think about this scenario, OK, which is sometimes all too familiar for people.

So, think about how you feel when you're stuck in traffic. You put on your blinker, and you try to move into the next lane, right? You see a space, but the car behind you speeds up, right, and doesn't let you in. So, you keep going. You finally get over, and further up the road, you see that same car that didn't let you in is now trying to get over into your lane. So, what are you most likely to do? Now, some may feel that you push right past them, right? They deserved it. They didn't let you in. But if we think back to our statement, we would let them in in the hopes that they would then let someone else in front of them in the future.

OK? So, when we talk about that parallel process, we're really talking about how people are treated really affects how they then go and treat others, and as a home visitor, it's important to understand this because we're interacting with parents because what we do with them, we want them to then influence how that parent then treats their children and engages with their children. And we want parents to then be with their children, OK? So, this is where we go into ... The same goes for how we look at the supervisor relationship, this reflective relationship. OK? So, creating this environment that really supports reflection and comfortable sharing, we need to go into the fact that we're establishing regular and protected time, right, that shows respect between a supervisor and a supervisee or even peer sharing.

And then when we go, we talk about sharing the power, right? Reflective supervision and reflective practice is all about how we are making ... We're identifying our own situations that are happening and we're pushing forward. We're making sure that we're making decisions based on what's going to be best for those involved. So, sharing the power really goes into dialogue and also, being able to listen to others and hear what they have to say. So, these other points that we have up here, accentuating the positives, we're really focusing on positive aspects of the conversation, strength-based approaches, listening without judgment. So, this goes into making sure that you're really listening to what other people are saying rather than putting your own spin on it or looking at it with your own perspective, thinking that you know what's best. Modeling healthy ways to manage conflict, right.

So, we really want to work on ways that we can talk to people when you're not in agreement, or you really want to make sure that you're taking a look at things in a way that is going to be constructive, a professional space in which to talk to either staff or with peers. Time for reflection. Just like we want to make time for reflective supervision, you want to make time for your own reflection, for your own intentionality and how you record the things that happen with you over the day. Understanding that there are people that are there to help you. You do not have to do this alone—at all.

You're not the only home visitor out there doing home visits. There are so many. There are so many coaches that are helping. There are so many supervisors that are out there. There are so many people out there who have past home visitor experience that you are definitely not alone, and so this is ... It's key to make sure that you ask for support if you need it. OK? And the same thing with establishing some healthy boundaries. So, we know that being reflective and supportive of others can be emotional work, and self-care is so essentially important and that's a key part of reflective practice.

And I've told this to others as we've gone around and done training is that really you carry your own bucket. Your own bucket is filled with your own water, and that is your stress. That is personal, and when you listen to others and you start carrying others' weight and their stress, they're putting rocks in your bucket, and it just makes it heavier, and it makes your water overflow. And really you want to help people carry their own buckets, so I hope that that's a good visual for you and that kind of resonates with you a little bit. So, let's think back to Maria. So, she went through and she did her own self-reflection. She went through her reflective supervision, and then ...

And so, what we want to do is, we want to say, "Maria felt that she was able to share information about her caseload, her self-reflections and to identify plans for her next steps because she and her supervisor had established this reflective environment where she really felt free of judgment. Her supervisor demonstrated that they were listening and that the decisions they made were ones that they made together." OK? Alright. So, let's push forward because we want to make sure that we hit all of our information today. So, these are really just benefits of reflective practice. So, you'll see that there are benefits for supervisors, benefits for home visitors, and benefits for families. So, this reflective practice really stretches across the board.

So, those benefits for ... You'll see that that positive constant is along all three of those things. That positive constant is that that base, that secure base that we have, and so supervisors are that base for home visitors. Home visitors are the base for families. Families are that base for the child. You see these are very similar in how there's a benefit across the board. But I want you, as we're looking at this, I really want you to be able to share. So, what additional benefits do you see, do you think there are for home visitors, supervisors, and family? And so, go ahead and enter your information into the group chat, and make sure that you label whether the benefit is for a supervisor, the benefit is for a home visitor, or the benefit is for the family, or maybe there's something that benefits everybody.

Alright. So, I see we have a question in the group chat about how many sessions or times should a supervisor and home visitor should have to reflect. Well, you know what, when it comes to reflective supervision, this becomes a program-by-program basis, really, and so how many times they meet may depend on the relationship that they have, and it also might depend on the length of the program year.

So, that's something. And, you know what, if you're a member of MyPeers, that's a really good question to post there to see what other programs are engaging with. I'm seeing that supervisors should be available. The benefit is for everybody. Benefit is for family getting the best service. Yeah. Collaboration benefits, families to show growth. The parallel process benefits everybody. These are some great ones. Alright. Thank you so much. Oh, I think I saw a question.

OK, and I see that's benefiting ... reflecting honestly. Reflecting honestly is really key. And so, but that also goes into the relationship and environment that is built between the supervisor and the supervisee when it comes to reflective supervision. So, having an open environment that they know is safe to share really helps build that relationship, for sure. Alright. So, I'm going to push forward just to make sure that we're moving through, and right before I hand it off to Ms. Donna, and so, I really want to take a moment to take a look at this, how programs can really support.

And so, I'm going to ask you another question. I know some of you are still answering the benefits question, but I'm actually going to put up another question up here about the ways that your program supports reflective practice. So, I'm going to put this up here, and while you're answering that question, I'm going to tell you about the bullet points that are on the screen, OK? So, the examples that we have up here are really about using data to inform intentional planning for reflective supervision, and this is where we talk about sometimes programs will put up staff surveys about information that they want to be supported on or what they need to be reflective, and then identifying some trends for reflection, whether in challenges that are faced.

 Common resources and opportunities for growth are really important as well as identifying some training and professional development opportunities. So, those are some ways that data is involved, and then giving people a lot of opportunities to be reflective. This allows, you know, allowing time within the day for staff to be reflective, building that into their planning time. Creating a quiet reflection space for staff is sometimes helpful, and then also providing reflective supervision preparation sessions.

So, giving time to get ready for that reflective session becomes really helpful, Then when we talk about promoting staff wellness—because reflective practice really goes into promoting wellness—we want to talk about things like mindfulness, like stress management training, yoga, which is actually a practice, so it's a part of reflection. So, this is ... Yoga becomes a part of that reflective practice. the same with healthy eating and the recognition of stress. So, I'm seeing there are some great additions here when we talk about the ways that programs are supporting you, having these be vital, having reflective practice sessions be consistent, scheduled over the course of the week or month, making sure that they have preparation time, also, being cheerleaders. I see that. A lot of surveys go into it, meeting monthly as a group, monthly with your supervisor. All of these are great ways that your program is already supporting you. And so, some of these ideas really will allow you to just go back to your programs and see if there's other things that you can bring in. Alright. So, what I'm going to do is, I am going to take a break from talking. I've done a lot of talking this first bit, and I'm going to hand it over to Ms. Donna Ruhland who's going to take us through some strategies to help support our reflective practice. 

Donna Ruhland: Thank you so much, Randi, and thanks for the great information. So, we're going to specifically look at some of those effective practices, and this slide may look familiar to you. We're going to cover a couple of different slides before we jump into the strategy, revisit these two next slides from our April webinar. And these show research-based, effective home-visit practices, and those were reviewed back in April, but for today, we're going to focus on the fourth bullet about establishing a collaborative relationship with the parent to support the child's ongoing development, and then you can see that in bullet four there. And this next slide again from our webinar in April.

Today we're going to revisit the stuff that you found about. These steps are in the context of effective home-visiting practices to build relationships with families and promote children's learning in the home. But these same steps on the slide are very similar to the structure of the reflective supervision between a home visitor and her or his supervisor.

Reflective supervision is collaborative, that collaborative relationship that promotes reflection and identifying a potential opportunity for change for staff. We can see here that supporting collaborative partnerships with parents also provides an opportunity to engage in reflective practice with the family, reflecting on how well an activity went, what the parent observed and what they think they may want to do in the future. That encourages the parent to be in the moment with their child and find their own solutions to challenges that may occur.

So, it's that parallel process that Randi mentioned, but we're seeing that then in the work with families. So, these steps can also be applied loosely to challenges within the home. Home visitors may ask parents the following when they discuss a challenge. Excuse me. First, what happened, and how did you feel about it? How do you see it impacting your daily life and your family and bringing that back to the child? What aspects are within your control and what aspects are not? What next steps within your control can you take to change the situation? Because not everything is within everyone's control.

As we move forward to discuss these strategies to help home visitors to develop skills and reflective practice, we'll refer back to these steps and help to establish collaborative partnerships for families and talk about that in our discussion. So, the first strategy we're going to really zero in on is active listening. You know, these effective strategies use good communication skills, and one of those good skills is active listening. And although people always have the best of intentions, sometimes we all hear what we want to hear rather than what is actually being said. I want to share one of our favorite quotes related to acknowledging what is said and how it's received, and we're going to put this in the chat So, you can see it as well. Takes a moment to really decipher it.

So, the quote is from Alan Greenspan, and it's, "I know you think you're understanding what you thought I said, but I'm not sure you realize what you heard is not what I meant." So, just take a moment and ponder that. It's up in the chat box. You can use the arrows to go back to it. So, that really tells us clear communication is just so vitally important. And a key strategy in that is to help develop skills in reflective practice is this active listening.

This directly supports reflective supervision and collaborative relationships with families, as it is all about information-sharing and responding. And there are four steps to remembering active listening, and you see that in the little blue arrows on your slide. Those four steps are stop, look, listen, and respond. So, first in stop. Stop what you are doing and pay attention to the speaker. This tells the speaker you are focused on them and that they are important. You know, in our busy multi-tasking way of just surviving in the world, giving that attention is truly a gift to the person we are listening to.

And then with look, make eye contact and face the speaker directly, and do that within their comfort, of course, and thinking about cultural differences around eye contact and that. And then maintain supportive, attentive body language and facial expressions. When you are considering your body language too, think about barriers.

If you're holding a clipboard up between you and the parent, then that is a visual barrier, so you really want to have an open kind of way of a stance or a way of being with the person who's speaking. You also need to watch for nonverbal cues from the speaker that tell us their thoughts and feelings, and tone and affect all comes into that. When we listen, listen to what is being said while paying attention to the words, the tone, body language, and affect.

So, what they're telling us in all of those different ways of communication. The speaker may be communicating several messages at once, and if you are unsure about a message, then discuss it with the speaker, reflect it back and say, "This is what I'm hearing," and then respond. Respond in a way that shows that you've been listening, and you understand what is being shared. Reflect back what has been shared with you and ask probing questions for more information as needed. This is always a great way to make sure that you're on the same page with the person. If you're not, they'll let you know and say, "No, that's not what I meant."

Another helpful technique is mindfulness or being mindful about things, and there are various definitions for mindfulness. You've probably heard that term quite a bit lately, and I'd like to share one with you—it's in that first bullet—so we can have a similar understanding for our discussion. So, paying attention in a particular way, on purpose, in the present—in the present moment—and non-judgmentally.

So, there's an emphasis there on the non-judgmentally as an important part of the definition. In other words, this represents accepting versus judging one's self and others, and that's important in self-reflection, that we just listen to our own thoughts and do that in a non-judgmental way as well. Mindfulness can be described as living with curiosity or being open to others around us. Mindfulness can also be described as a mirror of what's happening in the present moment. When we are present in the moment with parents and accepting, we are able to support reflection on what is happening right then and how parents are feeling, how they feel about it.

These reflective moments influence the work we do with families and the collaborative relationship we build together. So, some things that come up when we think about mindfulness, being fully present again and focusing attention, and that might be awareness around specific things. If you're being mindful reflecting yourself in your car between visits, it might be just focusing on your breathing and just what's happening around you, hopefully not when you're driving. And then acceptance and non-judgment. We experience life clearly as it happens without an emotional charge. Awareness.

We learn how to experience life clearly as it happens by feeling our present moment experience without analyzing it. And then calm. This requires us to notice something and not to think about what it means right away, not to analyze right away, but quieting your thoughts, emotions, and reactions. So, these types of practices help develop attention while encouraging kindness, compassion, and self-knowledge, and that's internal as well. Mindfulness promotes physical and mental well-being. It can help people recognize unhealthy patterns of thinking. So, what we'd like you to do in the chat box right now is share some of the ways that you practice mindfulness in your role right now.

So, after hearing our definition and some of the points, just put into the chat box how you practice mindfulness now. And while you're doing that, I'm going to give you some important things to remember about mindfulness. It's not a religious practice but a way of being. It's not a set lesson or curriculum, but an approach to life. It's not only about relaxation but also about actively engaging the body.

So, you know, really feeling the sensations and where you're at. It's not about only positive thinking, but also impacts executive function and other high-level brain capacities. You're really connecting with that, and then not numbing out or blanking out. It's the opposite. It's really noticing what your mind is doing at all times and helps us see, you know, helping yourself see those thoughts more clearly.

So, increased awareness, noticing what we are thinking and when we're thinking it. So, we have some great ... Walking and listen to quiet music, breathing, reflecting, noticing everything that's outside, the different colors, meditation, trying to shut down my inner corrective voice. I work on that one as well, the inner critical voice, and thinking about paying attention to cues and other ways of being fully present. Those are all awesome ideas, and just because of time, we'll continue on. I'd love to keep reading those. Another technique, or effective strategy that we can use, is motivational interviewing.

Now, motivational interviewing is a collaborative conversation to learn about and strengthen an individual's motivation for changing behavior. These principles and strategies may be used to enhance relationships and help staff effectively partner with families during challenging experiences. An example of that might be when a parent may understand that smoking in the house is harmful to their family members, but they continue to do so, or a parent may want to stop drinking, but at the same time they don't want to.

So, motivational interviewing is really highlighting that individuals are ambivalent. They may have mixed feelings about changing, and, you know, there's many pros and cons for consideration when you're looking at a major change or even small changes. Motivational interviewing can help families independently make a decision about their behaviors without being pressured into a decision by someone else. It gives them the power over their own life. It puts them in the driver's seat, in control.

So, home visits. Visitors can use this approach to assist families as they reflect on their behaviors and support establishing those collaborative relationships. Any change that a family chooses to make will be supported by the relationship that, you know, the home visitors help build with them.

Some of the principles of motivational interviewing, first respecting the parent's feelings, carefully listening to their needs and struggles. Then second, learn what the parent's goals or hopes for the future are for themselves and their families, and then show them how their current behaviors don't match up to their goals. Third, do not argue with parents who are unsure about or unwilling to change, no matter how much you know it will help. This will only increase their resistance to change.

We humans are funny people. When you get that push, then the resistance starts. Instead, help caregivers understand how their behaviors don't match up to their goals. Fourth, a family's resistance to change is oftentimes just a way to let you know that they have a different perspective on the situation. Accept this resistance and use it as a starting place to find a solution that works for the family.

And then fifth, self-efficacy is a critical component of behavior change. When a person feels confident in themselves to change, the more likely they will change. Recognize that family strengths help to bring these to the forefront in all discussions and really help their family to look at the situation and understand.

So, five strategies for motivational interviewing, let's look at these. The first, ask open-ended questions. This helps you to understand the family's point of view and about particular stressors or behaviors. Second, listen reflectively to demonstrate that you've accurately heard what the family's concerns are. You're restating those, saying what they mean. This helps you not to assume.

And then third, summarize. After a while, communicate back what you've heard from the family. This lets them know that you are listening. Fourth, affirm. Validate the family's experiences and feelings. This lets them know that you understand or respect them. And then—statements. This is the key point. Engage a family in the process of change. Help them realize how life might be better if they change their behaviors. When families have identified how they can better—agree with them by nodding your head or saying affirming statements when you hear those statements coming out. This will help motivate them to identify even more positive behaviors.

OK? And Randi talked a little bit about so many people out there helping us. One friend that we all have is BETH, and you may not have known that you have BETH as a friend, but you do, and BETH is a great friend to have when things get stressful. We all know that deep breathing can help lessen stress and anxiety by breathing slower and more deeply from your stomach or your diaphragm. You signal your nervous system to calm down. When you are calming down, calming your mind is more clear then to reflect on the situation and what to do next. So, BETH is a four-step approach. This stems directly from our mental health friend, cognitive therapy, and has been shown to be effective.

So, you'll see the acronym on the slide, BETH. "B" is belly breath. Take a slow, deep abdominal breath. And then "E" for emotions, take a look at your emotions by asking, "What am I feeling right now?" And the "T" in BETH, thoughts. Take a look at your thoughts by asking, "What negative thoughts am I having right now? Are you being too self-critical?" And then "H," helpful response, "How can I rephrase my negative thoughts? What is a more helpful response?"

So, that is our friend, BETH. And we will be ...

[Video begins] 

Narrator: Commitment to ongoing improvement, professional development for staff and support from leadership are all critical. 

Man No. 1: One of the ways that we incorporate the research into practice is by providing direct supports to the staff in terms of training, but we know that training alone according to the research isn't enough, that really they need the opportunity to put that into practice. 

Narrator: Part of the evidence-based approach is encouraging reflective practice in both staff and families. Leadership helps staff reflect on their work and learn about how they can be most effective. 

Woman No. 1: In what ways are they becoming more aware of what they know and how they know it and why they're doing it? Because that's the evidence around, is what you're doing effective? 

Woman No. 2: What happens when you give your baby a bath at home? What does she do? 

Woman No. 3: She splashes and plays, and she cries when she gets ... 

Narrator: Staff help families reflect on their goals and their progress. 

Woman No. 1: It's very different than advice-giving. It's really engaging parents and thinking about what it is that's happening, thinking about what it is they'd like to have happen, thinking about why it's happening that way. When those two things are happening, the outcomes that we can expect are increased parent knowledge, skill and self-attribution. 

Narrator: The approach works for the staff. 

Woman No. 4: It's wonderful to be able to know that I can help them on many different levels. 

Maria Southers: When they say, "Oh, I get it! If I play with him and I respond when he asks for my input, then he's learning." Yes, exactly! That, to me, it makes my day. 

Narrator: And for the families. 

NikkiLee C.: I think it helps to open, to broaden your mind towards different play ways. It's more just, see what her interests are, and I think that's important. 

Tosha P.: Ms. Holly comes and sees us every Thursday. She's very creative and opening up my mind on what else I can do with Zachariah. 

Tamisha M.: When I first had her, I really didn't know what I was doing, but now I'm more confident.

[Video ends] 

Randi: Alright. Well, we're going ... We only have about nine more minutes. And so, we want to do this little role-play with you real fast, and between Donna and myself, and we really want you to listen to this short dialogue between a parent and a home visitor, taking into mind everything that we've heard and really think about it in terms of how effective this interaction is, and then we're going to have a little poll question right after, OK? So, we're going to get it started off, and this is a parent and a home visitor talking about a young preschooler named April. 

Donna: OK, and I am the home visitor. How did you and April do with the block activity that we planned at our last home visit? 

Randi: Well, I really tried to stack them with her, but she wanted to ... All she wanted to do was knock them down. I would stack them, you know, a few, hand them to her to try, and then she would just knock them over again. 

Donna: Hmm. Can you tell me about what you observed her doing when she knocked them down? Could you tell how she was feeling about the activity? 

Randi: Well, she would sit still and watch me stack them, and she would smile when I handed her the block, and then she would laugh when she knocked over the blocks. 

Donna: Hmm. How did you feel about her knocking over the blocks? What did you do? 

Randi: Well, first I wanted to be upset that she really wasn't doing the activity, but she was participating, and she seemed to be enjoying it, so I continued to stack them, and she continued to knock them down. 

Donna: Hmm. What do you think you could do next time you try the activity to expand on her learning? 

Randi: Well, I think I could talk to her about the colors of the blocks and maybe count while I'm stacking them. 

Donna: That's a great idea. 

Randi: Alright. And so, I'm going to push this forward to a poll, and what we really want to know is, really take a look and answer this based on what you just heard. So, "I think this reflection was highly effective." "I think this reflection was moderately effective." "I think this reflection was a little effective," or, "I think this reflection was not effective at all." So, go ahead and select which one you think is best, and we're only going to give you about 30 seconds because we definitely want to give you some time to fill out the evaluation and for us to go through some resources at the end.

Alright. So, I'm going to push this forward to all of you, So, you should be able to see it now. And so, a lot of you thought this either was highly effective, or you thought it was moderately effective. Some people thought it was not effective at all, and that's OK, and then some thought it was a little effective. Now, depending on where you are in that relationship with that family, we would probably say this is more toward moderately effective, and here is why.

So, definitely that home visitor was engaged. They were reflecting on the moment. They were reflecting on the activity. They were able to identify additional ways to promote the learning. However, that home visitor, we didn't connect it back. We didn't connect it back to either the child's goal, the home visit and planning, to expand what the child was learning during the exchange and that we had the parent ... They acknowledged being upset when the parent couldn't see, you know, but we ... But you know what? That home visitor didn't acknowledge that at all. And I see that some people are saying that they can't see the results. Make sure that you press F5 to refresh your screen if you're having some trouble.

But we are going to be pushing forward, OK? So, they're going to disappear in just a second. Alright. So, let's go over some resources super quick so you still have some time for the evaluation. So, this is the Motivational Interviewing Suite, and if you haven't been on it on ECLKC just yet, you should definitely go in and look at it. It has amazing videos for you to look at along with some resources to really see if this is a viable option for you to work with families and use this.

We also have our Family Connections. This is a mental health consultation, and what we want to take a look at is the fact that when we talk about mental health, we're talking about our social and emotional well-being, so when you ask somebody how they are today, you're checking on their mental health. So, this is really good because, as you see those bullet points on the way down, self-reflection in parenting and self-reflection as a professional tool. Those are some key parts of the Family Connection piece. You also see some mental health resources. Again, we're looking at social-emotional well-being.

So, these are some key resources for staff, families, and children, along with some PFCE resources focused on relationship-based conversations, making sure it's a lot of perspective-taking, especially in the relationship-based competency. It's a good place to take a self-reflection piece. Alright. So, summarizing and putting it all together for today, we've heard a lot. We've seen a lot, so really looking back to our objectives, what is reflective practice, why is it important, knowing how your own experiences and beliefs influence your work, strategies to support developing those skills and reflective practice, as well as some resources.

So, what we're also going to do is, we're going to push forward to share with you, if you're not already a member of MyPeers, you should definitely join and have some conversations with us along with members across the country. And if you haven't seen this resource yet, this one is great. It is Text 4 Home Visitors.

So, this sends you some effective practices and some key information. Remember that you have a copy of these slides that you're able to download so you have all those links to the resources and numbers, and we're going to push forward and say, "Thank you so much."

Cerrar