Article

The Reflecting Team Model Used for Clinical Group Supervision Without Clients Present

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Abstract

An approach to group supervision, applying reflecting team, is described. Interview data showing how the approach is practiced recently are presented and analyzed qualitatively, and the results are discussed in relation to the original approach. The conclusion is that there are many pitfalls in using reflecting teams in supervision, and that following the original approach may guard against these pitfalls, but that some revisions may be needed. Supervisors, supervisees, and reflecting team members are all generally satisfied with the approach, but it remains to be established to what extent it contributes to therapist development.

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... According to Wong et al. (2022), it was evident that SOSp was effective in providing the space for supervisors to understand the various theories and approaches in supervision and critically examine one's supervisory practice. More specifcally, the use of a refecting team for a training programme on SOSp, discussed in the following section, is promising in developing supervisors through the encouragement of a search for a multitude of ideas rather than for a unilaterally right solution (Reichelt & Skjerve, 2013), as well as deepen the critical analysis of power relationships and the impact of the wider socio-cultural and political factors on supervisory practice. ...
... In similar vein, when refecting team is used during SOSp, it encourages the search for critical and supportive refection on a multitude of ideas rather than for the "right" solution for the case (Reichelt & Skjerve, 2013). In particular, a social constructionist perspective with focus on the way we co-create what we see and think through the use of language was adopted in the "live" supervision sessions (Philp et al. 2007;Rankine & Thompson, 2015). ...
... Based on the above illustration, the use of refecting team during supervision encourages the development of personal competencies of the practitioner (Reichelt & Skjerve, 2013) through a person-centred supervision approach (Bernard & Goodyear, 2009) that allows the practitioner to defne and pursue personal developmental goals (Reichelt & Skjerve, 2013). The refecting team as adapted by Prest et al. (1990) for the purposes of supervision could enhance the development of the supervisor and their supervisees, facilitating deeper refection on the infuence of global, local and personal voices and evaluate these through the lenses of core ideas such as human rights, social justice, empowerment, anti-oppression, social change and ethical principles (O'Donoghue, 2003). ...
... The final influencing aspect of the IRM is the reflective role taken by the presenting supervisee while receiving peer and instructor feedback. The supervisee receiving feedback is expected to engage in quiet reflection during the feedback process, which parallels the reflecting team process step of Reichlet and Skjerve's (2013) model and the reflective role of Kleist and Hill's (2003) reflective model of triadic supervision. Cox, Banez, Hawley, and Mostade (2010) introduced the process of reflecting teams in group work, and Reichlet and Skjerve expanded their use of Andersen's (1987) concept of reflecting teams to the group supervision format. ...
... The supervisor and supervisee process the observations from the groups' observations. It is important to recall the reflecting team/group members are not taking an all-knowing stance and, thus, offer reflections that may be helpful to the supervisee without the intent of offering solutions (Reichlet & Skjerve, 2013). Kleist and Hill (2003) extended reflection in supervision to a reflective model of triadic supervision. ...
... All participants discussed the reflective role in the IRM framework. Reichlet and Skjerve (2013) proposed using reflection in group supervision through reflecting teams. Within this reflective role, participants described mindful listening, during which they did not feel defensive of their work and looked forward to sitting quietly and listening to feedback without having the expectation of immediately responding. ...
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The authors conducted a phenomenological study of 10 practicum students' experiences of the integrative reflective model of group supervision. Six categories emerged: (a) intentional listening, (b) engaged in the process, (c) extension and application of the model, (d) personalization feedback, (e) mindful listening, and (f) dimensional feedback. An implication was students' openness to constructive feedback in group supervision.
... Each meeting was held for 2 h and followed a format based on Tom Anderson's reflecting team practice (Andersen, 1987). This process has been modified for supervision and described in detail elsewhere (Reichelt & Skjerve, 2013). The group was facilitated by a clinical psychologist with 20 years of general clinical experience and 2 years training and 7 years practice in the Open Dialogue approach. ...
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Tom Andersen's reflecting team approach invited family members to hear the dialogues between professionals in response to their stories. This study aimed to explore intersubjective reflexivity during reflecting team group supervision, by observing resonances between group members. Twelve hours of reflecting team group supervision was transcribed and analyzed using Systemic Functional Linguistics. Hallidayan transitivity analysis of selected sections of interaction focused on mental processes, and Martin and White's appraisal framework was used to explore the “engagement” between different voices at play in the conversations. We found the use of physical metaphor to express reflective experiences, multi‐voiced expressions to expand perspectives and possibilities, and dialogical patterns of relating between group therapy participants. Understanding dialogism from a linguistic perspective may offer insights into how reflective dialogues work and support understanding of fidelity for approaches which engage reflecting teams.
... Man kan ikke løse et problem med de samme tankene som skapte det. Dersom den etiske refleksjonsprosessen foregår i gruppe, er det mulig å aktivere reflekterende team (Reichelt & Skjerve, 2013) hvor veiledningsgruppen deler sine refleksjoner. Karis oppgave som veileder i gruppen er å lede og forløse samtalen. ...
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The aim of the article is to investigate how the use of supervision in ethical reflection can facilitate value-consciousness in religious organizations. In turn, this contributes to our knowledge about the role of values and purpose in such contexts. This conceptual article presupposes that all types of lead- ership and organizations are value-based since values are inherent in actions and interaction. Neutral zones void of values do not exist, which challenges organizations and leaders to attend to the question of which values influence and characterize them and their work, and be conscious about such dynam- ics. The author discusses how managerial efforts on explicating the coherence of acclaimed identity (values-for-practice) and realized behaviour (values-in-practice) is required due to developments inter- nal of religious organizations as well as a response to wider societal and cultural changes. The central concept in this article is value-consciousness applied through a practice perspective on religious or- ganizations. The article presents a model of supervision in ethical reflection and discusses its rele- vance in a church context. The author substantiate this as a concrete tool for explicating values in con- gregations and in the practice of church employees and leaders.
... Reflecting teams have been used for therapy, supervision, and training (Davis, 2012;Egeli, Brar, Larsen, & Yohani, 2014;Reichelt & Skjerve, 2013). The practice of reflecting teams is usually informed by a narrative and collaborative approach (Andersen, 1987(Andersen, , 1991(Andersen, , 1995Doan & Bullard, 1994;Friedman, 1995;Sparks, Ariel, Coffey, & Tabachnik, 2011), with a focus on offering shifts in language to create new possibilities and on minimizing the power difference between clinician and clients in favor of leveling the hierarchy so that reflections convey respect and fairness (Donovan, 2007). ...
Article
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Although the reflecting team has been widely used for 30 years, little research has compared clients’ and clinicians’ team experiences and whether or not there are differences in which types of reflections they find most helpful. Data were collected from 12 heterosexual couples’ consultations at an established teaching hospital reflecting team in northeast United States. Highly distressed couples were offered both spoken and written reflections, and their responses were assessed right after the consultation as well as in interviews 2 weeks later. The referring therapist and team members’ responses to the spoken and written reflections were also assessed. Data were analyzed using self-report questionnaires as well as a grounded theory methodology with 3 independent coders. Both clients and clinicians found the interview, spoken reflections, and letter very helpful. Several types of reflections were found to be equally helpful by both clinicians and couples, including “offering a different perspective” and “defining a problem as dyadic.” Clinicians found reflections such as metaphor and “casting difficulties in a positive light” more helpful than did the couples, whereas couples found the validation of their difficult personal experiences more helpful. With both spoken and written reflections, clinicians paid attention to what was both novel and validating, whereas couples focused more on what was confirmatory. Clinicians found the reflecting team intervention even more helpful than did couples, a finding discussed regarding the reflecting team as a powerful tool for therapists who seek hope when feeling stuck and overwhelmed in their work with highly distressed client systems.
... RTs are used in clinical work with numerous populations such as patients presenting with somatic complaints (Griffith et al., 1992), children (Lax, 1989), parental illness (Dale & Altschuler, 1999), and couples (Egeli, Brar, Larsen, & Yohani, 2014) to name a few. RTs have been used for live supervision (Cohen et al., 1998), as an adjunct to group supervision (Prest, Darden, & Keller, 1990;Reichelt & Skjerve, 2013), for training family therapists (Young et al., 1997(Young et al., , 1989, to create cohesion in multidisciplinary teams (Garven, 2011), and in the community (Swim, Priest, & Mikawa, 2013). One curious aspect of RTs is the lack of research about their effectiveness (Fishel et al., 2010) and about what makes a good reflection (Weingarten, 2016). ...
Article
Reflecting teams (RTs) represent both an epistemological stance and a therapeutic technique. Most commonly associated with narrative and systemic approaches to therapy, RTs offer an outsider perspective that can bring hope and alternative narratives and perspectives for therapists and clients to explore. Relational hope is a little researched concept in the field of couple therapy research. This study explores the experience of RTs in couple relationships and the aspects of the experience that couples describe as connected to a sense of hope for their relationship. The study also considers whether difference in attachment style shows any relationship with hope in couple relationships before and after the clients’ session with a reflecting team. Couples completed questionnaires about their attachment style, demographics, and relational hope and were given the option to complete an interview about their experience with the reflecting team within 1 month of their therapy session. Our findings suggest that RTs contribute positively to hope in couple relationships particularly for clients who present with an anxious attachment style. This direction for research is important because there is very little research about hope in couple relationships despite its importance (Merolla, 2014; Snyder, 2002) and there is no research about what aspects of a reflecting team contribute to hope in couple relationships. Analysis of interviews indicates a number of features of the reflecting team feedback that were valued by clients.
... Reflecting teams are used in the context of clinical work, of course, and with numerous populations, such as with couples (Egeli, Brar, Larsen, & Yohani, 2014), children (Lax, 1989), parental illness (Dale & Altschuler, 1999), and patients presenting with somatic complaints (Griffith et al., 1992), to name a few. Reflecting teams are used for training (Davis, 2012;Young et al., 1989); supervision (Par e, 1999;Reichelt & Skjerve, 2013;Reynolds, 2010;Roberts, 1997;Selicoff, 2006); and to create cohesion in multidisciplinary teams (Garven, 2011). Teams are used in therapy and in the community (Swim, Priest, & Mikawa, 2013). ...
Article
There are a great many useful articles on the dynamics and pragmatics of reflecting teams but few articles address what constitutes a good or inept reflection and why. I provide a conceptual model for thinking about what a good reflection does, distinguishing it from a nice reflection. With some further refinements in place, I then illustrate how reflections can be part of any relationship, not just clinical ones. We have opportunities to make them and to recognize when others make them to us. By using examples from my personal life-as a grandmother, daughter, radio listener, cancer survivor, and client-I attempt to ease the personal/professional binary, a project of mine for the last 35 years. In the second part of the article, I address how writing can serve reflection. Although best offered at the moment one is called for, it is never too late for a reflection. Writing allows people to offer reflections after the fact to those who have shared their stories. Sometimes, it is to ourselves we offer those reflections, when the reflector has long since dropped the thread of obligation or interest. I provide an example of working with iconic imagery to unpack meaning so that reflection can eventually take place, allowing integration to proceed, facilitating the strange becoming the familiar. © 2015 Family Process Institute.
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Tom Andersen and his pioneering work with reflecting conservations has had a lasting influence on the field of family therapy and mental health more broadly. Most family therapists are familiar with his contributions related to reflecting teams; however, fewer are familiar with his conceptualization of reflecting processes, which offer practical ways to approach therapeutic conversations to address challenging problems. This article provides a brief history of Andersen's career and reviews four key elements of his approach, including: (a) his way of being in relationship, (b) appropriately unusual comments, (c) inner and outer dialogs, and (d) ethics of dialogical relating. Finally, this article introduces readers to the context of the video that will be analyzed in the articles that follow in this special section.
Chapter
The reflecting team is a well-known and frequently used approach in the systemic supervision of groups. Such supervision can be facilitated both as live supervision and (retrospective) group supervision. This chapter will explore different uses of the reflecting team, both in pre-qualification and post-qualification supervision of family therapy and systemic practice. For example, the supervision group can be allocated different perspectives and roles, (for example, in family therapy, the perspective of the mother and the daughter; or in supervision of team process, the perspective of the psychologist and the manager, and so on) or different theoretical perspectives (for example, structural, narrative or solution focused, and so on) in the process of supervision. The supervisor can choose between many different positions both in live and in retrospective group supervision. Different positions will be described and discussed in relation to training and the development of students and qualified family therapists, the ethical issues and the impact for clients and on the therapy process. The chapter contains suggestions for exercises and activities and examples from practice will be given to illustrate the ideas and how they can be useful.
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Our primary aim is to outline an approach to supervision that integrates the reflecting team format with solution-oriented principles and methods. The article outlines the three stages of the approach, and provides a number of practical guidelines and sample questions and leads for each. A specific case example is then followed through the three stages. As well as contributing to practice in this emerging field, we hope also to contribute to discussions on the use of reflecting teams in general, by making some distinctions and clarifications that we have found helpful in formulating our approach. In particular, we distinguish pluralistic from theoretically aligned uses of reflecting teams, identifying our approach with the latter category. We explore the implications of this theoretical distinction for the development of practical guidelines.
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Describes the reflecting team family therapeutic method, in which live supervision incorporates the views of family members, trainees, and supervisor in an equitable, recursive, empowering way. Guidelines are provided to help the reflecting team move more quickly in therapy and address sensitive issues faster. A case example of a 22-yr-old incest survivor illustrates how observed reflections by team members contribute to increasing the trainee therapist's and client's options for change. Advantages (e.g., more face-to-face contact with families) of using the reflecting team as a training process are also discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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This paper is based on a qualitative study of supervision of inexperienced trainees. Eighteen supervisor-student dyads were interviewed listening to the same sequences of a tape from a supervisory session. They were also given a semi-structured interview relating to general aspects of supervision. The purpose of the study was to provide understanding of supervision that questionnaires may not make apparent, and to explore them in relation to supervision issues. It appeared that most supervisors had an ideal of a symmetrical position and tried to refrain from being didactic or instructive. This position was mostly appreciated by the trainees. The findings are discussed in relation to the emphasis on didactic training for inexperienced trainees in supervision literature, particularly with regard to possible contextual variables influencing how the trainee perceives and reacts to supervision.
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This book reviews the fundamentals of clinical supervision in the mental health disciplines. It should be useful to both the student of supervision and to the supervision practitioner as a professional resource. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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What happens when the barriers between therapists and clients are removed, when they all participate in a dialogue about change, and when therapists and clients even trade places? Operating within the reflecting team format, professionals meet clients without preexisting hypotheses. Together they engage in a conversation that becomes a search for the not-yet-seen and the not-yet-thought-of, as well as for alternative understandings of what has been defined as problematic. As clients and therapists trade places and various members of the entire group participate in conversations, the possibilities for change open wide. This book describes the evolution of this radical strategy in Tromsø, Norway, and its adaptation by various family therapists in the United States. It begins in Part I with a description of the setting in which the reflecting team developed and its history and evolution. Then basic concepts, practical considerations, and guidelines for practice are detailed. Part II contains Dialogues About the Dialogues, that is, reflections on the client-therapist-consultant-team dialogues that distinguish this innovative approach to therapy. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Describes a clinical project using multiple reflecting positions by the therapy team and the family system with the goal of generating new therapeutic stories. The reflecting team format is extended by adding a pre-session in which the reflecting teams address the family while they observe/listen behind a 1-way mirror. Also, a session and postsession reflecting format is used by the team with the family present. Within this framework, the reflecting questions suggest to the family that change is inevitable and that the family can solve the puzzle that brought them to therapy. Ultimately, the model is an application of the social constructionist/narrative perspective. A case example of a couple seeking marital counseling is provided. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
How do solutions develop? This question leads de Shazer to a provocative discussion of all the solution-related things that client and therapist do during a session, which ultimately points to a task that says, "Now that you know what works, do more of it." An innovation is de Shazer's computer analysis of therapy sessions, which provides a map for analyzing situations and finding solutions. Pieces of the computer program are highlighted with individual cases, enabling the reader to move easily from the map to the territory and back again. Both theoretically stimulating and clinically sound, de Shazer's investigation turns up clues with the potential to revolutionize the way psychotherapy is thought about and practiced. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The goal of the author in this chapter was to develop a metaphor of self-as-story in ways that extend both a cognitive constructivist emphasis on narrative coherence and a social constructionist emphasis on the dynamics of discourse. Drawing on developments in fields as diverse as cognitive psychology and literary criticism, the author argues that narration serves vital functions at both intra- and interpersonal levels and that these carry clear implications for an understanding of self-construction and its impediments. Thus, in constructing a narrative account of our experience and seeking an audience for it, we attempt not only to impart continuity to the story of our lives, but also to position ourselves with reference to others. In general, the act of narration can be viewed as a social performance, which if successful confers on its author a provisional fictional identity that meets with social validation. The author concludes by noting that he believes that a narrative perspective is well positioned to advance the contemporary self-understanding and that its more consistent application to the conceptualization of the self can contribute both depth and novelty to the evolving story of psychotherapy. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Couple and therapist perspectives about the use and process of reflecting team practice were analyzed using ethnographic research. A domain analysis was performed on postession interviews from both couples and therapists, and on field notes from each therapist. Seven couples and five therapists were interviewed at least twice over a 4-month period concerning their reactions to and perceptions of reflecting team practice. Six domains concerning reflecting team practice emerged from the analysis: (a)benefits of its use, (b) effects of gender, (c)recommended use, (d) contraindicated use, (e) the importance of creating spatial separateness between couple and team members, and (f) sequences of communication between the couple and team members that elicit change. The latter two domains described the process of reflecting team practice (i.e., steps in how it is used and how it is implemented). The role of ethnog rahy in reflecting team practice and in family therapy research is discussed.
Article
This paper presents results of two exploratory investigations concerning the effectiveness of the Reflecting Team (RT) approach, conducted in Vienna and in Gottingen. Fifty-nine families/couples participated in the RT approach in the two outpatient settings. Follow-up reports from 35 families – obtained on average 15 months after closure – indicated that this model may be considered effective as well as efficient: two thirds of all clients (who made up a heterogeneous group with regard to diagnostic criteria and stage of development of the identified patient) reported symptom improvement, and about 80% said they were very satisfied; these results were obtained with a fairly small number of sessions.
Article
Narrative therapy in the last 15 years has been utilized by many clinicians and yet there is a lack of research on therapists' experience of this approach. This ethnographic research explores the views and perceptions of eight narrative therapists who belonged to a narrative team in an outpatient clinic. These therapists were observed and interviewed. Five themes emerge from the data. The themes include a sense of success in reducing the clients' problems as well as some limitations of narrative therapy. Two recommendations for research and practice involve the use of narrative therapy without a team and the use of narrative therapy in addressing issues of family violence.
Article
From a social constructionist standpoint, foundational ontologies, such as materialism and phenomenology are hammered out of the discursive resources of the culture. Both generate their ‘sense of reality’ through rhetorical procedures. Thus, problems in epistemology are superfluous byproducts of simultaneously accepting two or more ontological posits (e.g., world and mind). In the constructionist view, 1) there is no transcendental means of justifying any given ontology, 2) new realms of reality are open to construction, and 3) important questions must be raised regarding the pragmatic consequences of competing reality posits.
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Estudio acerca de sobre los fundamentos teóricos de la psicoterapia, los procesos de cambios metodológicos, la evaluación de sus investigaciones como resultado de las prácticas terapéuticas y su prospectiva. Contiene: Parte 1. Fundamentación histórica, metodológica, ética y conceptual; Parte 2. Evaluación de los elementos de la eficacia terapéutica; Parte 3. Mejores acercamientos; Parte 4. Investigación sobre sus aplicaciones especiales en grupos específicos.
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From our earliest practice of family therapy at medical schools, private family therapy institutes, and public agencies, our work with difficult populations that do not respond to current treatment technologies has reminded us of the inadequacies of our theoretical descriptions and the limitations of our expertise. This work has influenced our current, evolving clinical theory as we move from thinking of human systems as social systems defined by social organization (role and structure) to thinking of them as distinguished on the basis of linguistic and communicative markers. Hence, for us, the social unit we work with in therapy is a linguistic system distinguished by those who are "in language" about a problem, rather than by arbitrary and predetermined concepts of social organization. We call the therapy system a problem-organizing, problem-dis-solving system.
Article
A "stuck" system, that is, a family with a problem, needs new ideas in order to broaden its perspectives and its contextual premises. In this approach, a team behind a one-way screen watches and listens to an interviewer's conversation with the family members. The interviewer, with the permission of the family, then asks the team members about their perceptions of what went on in the interview. The family and the interviewer watch and listen to the team discussion. The interviewer then asks the family to comment on what they have heard. This may happen once or several times during an interview. In this article, we will first describe the way we interview the family because the interview is the source from which the reflections flow. We will then describe and exemplify the reflecting team's manner of working and give some guidelines because the process of observation has a tendency to magnify every utterance. Two case examples will be used as illustrations.
Human systems as linguistic systems
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Anderson, H., & Goolishian, H. (1988). Human systems as linguistic systems. Family Process, 27, 3–12.
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Davidson, J., Lax, W. D., & Lussardi, D. J. (1991). Use of the Reflecting Team in the Initial Interview and in Supervision and Training. In T. Andersen (Ed.), The reflecting team: dialogues and dialogues about the dia-logues (pp. 134–156). New York, NY: Norton.
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The reflecting team in action
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Systemorientert konsultasjon i arbeid med familier
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The tree of knowledge
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Narrative therapy using a reflecting team: An ethnographic study of therapists' experiences. Contemporary Family Therapy: An Interna-tional
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Bruk av reflekterende team i veiledningsgrupper Reflekt-erende prosesser i praksis
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Supervision of inexperienced therapists: A qualitative analysis. The Clinical Supervisor
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Reflecting processes and ''supervision'': Looking at ourselves as we work with others
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Gruppeveiledning av familieterapeuter
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Defining psychotherapy supervision and understanding supervisor functioning
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