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Reflective Supervision & Trauma Informed Care

Every one of these children have experienced trauma, and each, in their own way, is trying to cope with the ongoing reminders they face daily. Supporting them in this healing process are dedicated relatives and foster parents who, in turn, are supported by child welfare caseworkers. Day after day, caseworkers patiently listen to dozens of these stories, see the wounded children and try to help their caregivers with tools and strategies. Day after day, caseworkers return to their desks to write up casenotes and other reports documenting their encounters with the smallest victims of trauma. The cumulative impact of this daily exposure to trauma can cause workers to experience secondary traumatic stress (STS) which impacts their own personal and professional well-being.

Staff turnover has long been highlighted as a challenge facing child welfare agencies. There is a growing recognition of the role that the STS workers experience as a result of this daily exposure to children’s trauma plays in not only in turnover, but in feelings of hopelessness, decreased effectiveness and lowered staff morale Supervisors serve in the critical role of educating and supporting such workers, improving morale and increasing effectiveness as they serve children and families on their caseloads. In trauma-informed systems, what tools and resources are available to supervisors to improve their success as they face these daunting challenges?

This is one of the questions that faced Yvette Bradford, Quality Improvement Director at Lutheran Children and Family Services (LCFS) in Philadelphia upon reviewing an internal evaluation citing the critical need for improved supervision within the agency. She recognized that addressing this challenge would require more than a new initiative or additional training for supervisors. It would require a complete culture change as the organization sought to become more thoroughly trauma-informed at all levels.  

The Chadwick Trauma Informed Systems Project (CTISP) in California has defined a trauma informed child welfare system as one in which:

. . . all parties involved recognize and respond to the varying impact of traumatic stress on children, caregivers, families, and those who have contact with the system. Programs and organizations within the system infuse this knowledge, awareness, and skills into their organizational cultures, policies, and practices. They act in collaboration, using the best available science, to facilitate and support resiliency and recovery.1

CTISP further notes that trauma-informed child welfare systems will recognize that 

Exposure to trauma is part of the child welfare job, and

Trauma has shaped the culture of the child welfare system, the same way trauma shapes the world view of child victims.

Reflective Supervision is an approach to supervision centered around the relationship between the supervisor and supervisee. The approach utilizes a variety of strategies including regularly scheduled meetings, reflective questions, creative thinking and collaborative problem solving to address case-related challenges and build worker skill, competence and confidence. Multiplying Connections has recognized Reflective Supervision as a practice that is highly consistent with trauma-informed systems change,2 and set out to support implementation of this practice within Philadelphia child welfare agencies, at the same time that Bradford was seeking approaches to improve the quality of supervision at LCFS.

As a result of conversations with June Cairns at The City of Philadelphia Department of Human Services and Leslie Lieberman of Multiplying Connections, Bradford decided to attend the June 2011 symposium sponsored by Multiplying Connections, Reflective Supervision as Trauma Informed Practice: The Time is Now along with three members of her staff. This proved to be the first step in a year-long intentional, thoughtful and strategic approach to implementing Reflective Supervision at LCFS as part of the desired culture change towards building a fully integrated trauma-informed system of care.

Since that June 2011 symposium, LCFS has successfully adopted and implemented Reflective Supervision into its in-home protective services, family reunification and refugee services and is moving towards agency-wide adoption of this practice. LCFS Supervisor Samantha Wascow notes, “Our agency is strongly committed to this.” The progress to-date at LCFS provides valuable lessons on how to achieve and sustain agency-wide practice change. Core elements of success have included:

A strategic and inclusive preparation process

Intensive training

Ongoing mentoring and coaching

 

1 The Chadwick Trauma-Informed Systems Project. (2012). Creating trauma-informed child welfare systems: A guide for administrators (1st ed.). San Diego, CA: Chadwick Center for Children and Families.
 
2 Anje van Buckelaer, M.D., Multiplying Connections. (2011) Using Reflective Supervision to Support Trauma-informed Systems for Children: A White Paper Developed by the Multiplying Connections Initiative. Philadelphia, PA.