Professional quality of life in home visitors: Core components of the reflective supervisory relationship and IMH‐E^® Endorsement^® engagement

Abstract

Infant and early childhood home visiting models are gaining prominence as effective programs for families. Most U.S. state infant mental health associations (IMHAs) recommend reflective supervision (RS) and Infant Mental Health (IMH‐E®) Endorsement® as components of home visitor professional development. These efforts may promote workforce professional quality of life. It is unknown whether a workplace policy to provide RS improves the likelihood that best practice guidelines, especially core components of a reflective supervisory relationship, are experienced by the workforce. We sought to investigate associations between home visitor well‐being indicated by professional quality of life (i.e., burnout, secondary traumatic stress, compassion satisfaction) and a workplace policy providing RS, consistent experience of core components of a reflective supervisory relationship, and engagement in endorsement. We also examined differences in consistently experiencing core components of the reflective supervisory relationship in home visitors who reported having a workplace policy for providing RS and those who did not, and for home visitors engaged or not engaged in the endorsement process. A Workplace Supports Survey was designed to investigate these associations; we report findings from a sample of home visitor respondents (N = 139). A policy to provide RS was not associated with professional quality of life. However, analyses suggest an association between a policy to provide RS and consistently experiencing core components of a reflective supervisory relationship. Unanticipated positive associations between engagement in endorsement and burnout and secondary traumatic stress were also found. Finally, engagement in endorsement was associated with less consistent experience of these core components. Implications for future inquiry about the purposes of RS and IECMH Endorsement® as strategies to promote workforce development and well‐being are discussed.

Reflective supervision and consultation and its impact within early childhood‐serving programs: A systematic review

“…Although results from these studies are heterogenous, there is some evidence to suggest receiving RS/C may be positively associated with well‐being and negatively associated with secondary traumatic stress, burnout, and related constructs. For instance, two cross‐sectional studies found that experiencing a high‐quality reflective supervision relationship was associated with lower levels of secondary traumatic stress and burnout (Begic et al., 2019; Eaves et al., 2022), lower levels of intention to quit (Begic et al., 2019), and higher levels of compassion satisfaction (Eaves et al., 2022) among home visitors. In a cross‐sectional study of providers spanning many early childhood settings, those who had received no reflective supervision reported higher levels of internalizing symptoms compared to providers who had received at least one year of reflective supervision (Morelen et al., 2022).…”

“…A study conducted by Eaves et al (2022) provided more nuance to this finding. They found that having a workplace policy supporting the provision of reflective supervision was not directly related to secondary traumatic stress, burnout, or compassion satisfaction in home visitors; however, having a workplace policy was associated with more consistently experiencing core components of a reflective supervisory relationship, which in turn was associated with each of these outcomes (Eaves et al, 2022). Interestingly, participants who reported higher quality reflective supervision and spent more time in group supervision perceived their workplace as having a better learning culture (Julien-Chinn & Lietz, 2019), suggesting a possible bidirectional effect of reflective supervision and workplace culture.…”

“…The need for agency support and a workplace culture that valued reflective practice and supervision was the most prominent theme (Barron et al, 2022b;Eaves et al, 2022;Russ et al, 2020;Williams et al, 2019). A study conducted by Eaves et al (2022) provided more nuance to this finding. They found that having a workplace policy supporting the provision of reflective supervision was not directly related to secondary traumatic stress, burnout, or compassion satisfaction in home visitors; however, having a workplace policy was associated with more consistently experiencing core components of a reflective supervisory relationship, which in turn was associated with each of these outcomes (Eaves et al, 2022).…”

“…Agency or program support of RS/C was the factor identified most frequently in implementation studies. Eaves et al (2022) offers additional context for this idea: having a workplace policy to provide RS/C is associated with a greater likelihood of experiencing a positive reflective supervision relationship, and that relationship in turn is associated with well-being. In other words, agency or program policy makes it more likely that RS/C is taking place, though is not on its own sufficient in ensuring quality.…”

“…Exploring how RS/C is associated with outcomes for professionals of color-who may be navigating issues of racial discrimination and structural inequities in addition to the stress that often accompanies caregiving professions, especially for women-is a critical next step for determining the role that RS/C may play in reducing stress and bolstering well-being, especially for populations who have been oppressed (Eaves et al, 2022). While there have been long-standing efforts to understand how RS/C may be a culturally responsive practice, much work remains as it is unclear whether and how RS/C can help supervisors and supervisees reflect on their social identities and issues of power, privilege, and bias (Noroña et al, 2012;Stroud, 2010).…”