Scotland UWS COER - Identity and Inter-professional Working

Introduction

Reflective Thinking

Empowerment and Self-regulating Efficacy

• Motivational Interviewing

The Reflective Practitioner: Professional knowledge

• Reflection-in-Action
• Critical Reflection and Dialogue
• Reflective Models

References         

Read the following literature review and answer the critical questions in Section 5.

Introduction     

This section will provide information on theories and approaches that are important for this COER. We will begin by presenting information about ‘Reflective Thinking’ (Dewey, 1933) an approach that is useful for activities such as introspection. We will also describe how an assets based organisation, Centrestage, have used introspection in the process of staff development.

Reflective thinking and introspection have also been extended to be used in ‘reflective practice’ (Schön, 2011) and can be used in approaches of ‘reflective writing’ to record and capture ‘learning incidents’. Critically reflecting on learning incidents enables practitioners to gain insights to situations where they might attempt to do something differently the next time a similar situation occurs, or repeat a course of action which proved to be successful in a previous attempt (Brown, 2006; Ghaye and Lillyman, 2006; 2010; Gibbs, 1988; Mezirow, 1991; Mezirow and Taylor, 2009; Parrott and Schulkin, 1993).

We will also present information about other assets based approaches used to empower young people and as part of a staff development strategy by exploring aspects of identity through art as an assets based approach A-B-A. We will then present information about other assets based approaches used by Centrestage to enhance both the progress of the young people they work with and as part of their professional development strategy – which involves exploring peoples strengths and talents; using Motivational Interviewing (Miller and Rollnick, 1995); and the theory of empowerment (Bandura, 1977; 1986; 1997) used to enhance peoples self-regulated efficacy and self-esteem to give them confidence to make changes in their lives. Finally, we will consider ways in which the concept of becoming a reflective practitioner can help professionals exchange ideas and practices in order to become inter-professional through shared experience.

Reflective Thinking

We believe reflective thinking is an important part of how practitioners learn and is also a useful tool for both personal and professional develop. Think of ways you could use the process of reflection to improve aspects of your daily practices at work through introspection by either: having a written internal dialogue with yourself and reflecting periodically about your thoughts and experiences, or by capturing your feelings and thoughts on paper by using rich pictures or art as a form of empowerment through self-expression. Do you think keeping a reflective log or diary or capturing your thoughts and feelings in a picture would be useful ways to help practitioners realise their assets based strengths?            

Reflection is an analytical form of thought and a process which involves the examination of facts, which conclusions are drawn from, based on reflective thought and evidence which supports it. It is important to recognise that knowledge and skills potentially can be recontextualised from one experience and applied to other situations, but this is dependent on whether there are enough common aspects from both experiences to enable recontextualisation and new  knowledge generation and the application of acquired knowledge from one situation to another. This process of reflective thinking deals with subject matter which often presents obstacles, problems and confusion, while other parts of the subject matter present solutions and provide insights and intellectual stimulation. Reflection then, as a process, is about identifying relations by searching until a relation is established as accurately as the conditions allow for it to be defined (Dewey, 1933, pp. 47, 67, 72, 77).

There are six important states of thinking which contribute to reflective activity they are: (1) ‘suggestions’, which can lead to potential solutions; (2) ‘intellectualisation’, of the difficulties which have been directly experienced into a ‘problem’ to be solved; (3) ‘hypothesis’, employing suggestions to direct observation for the purposes of collecting factual material; (4) ‘reasoning’, the mental expansion of the idea in which reasoning is a part of the inference being made; (5) ‘testing’, the hypothesis by employing some form of action; and (6) ‘prediction’, looking into the future by making forecasts (Dewey, 1933, pp. 107, 117).

Empowerment and Self-regulating Efficacy

It could be argued that processes of reflective thinking and activity are important prerequisites to processes of empowerment and to improved efficacy! Empowerment is the process of becoming more confident and especially when a person or group of people begin to take control of their lives through exercising a degree of autonomy and self-determination in a responsible way (Rappaport, 1981; Rappaport and Seidman, 2006). A person’s confidence can be increased through ‘self-regulating efficacy’ which is the belief in one’s own capabilities to organise and execute the courses of action required to manage prospective situations (Bandura, 1977; 1997). Self-efficacy is the belief in yourself to take the appropriate action in a given situation and has been used successfully as an analytical tool in social work, education, psychology and health work.

Bandura (1986) defined self-efficacy as being a humans own judgment or assessment of being capable of performing a particular task or activity. Bandura distinguished self-efficacy belief as being unlike self-esteem in that self-esteem reflects how humans feel about their own self-worth or value. Moreover, that self-efficacy is a reflection of how confident humans are about performing specific tasks such as being able to solve a complex maths problem. This means that humans can hold high self-efficacy belief about being able to perform an activity in one area but hold low self-efficacy belief about being able to perform an activity in a different area. An example of having high and low self-efficacy would be high self-efficacy belief in one’s own ability to solve complex maths problems, which may not coincide with holding a high self-efficacy belief about being able to perform a piece of complex music to a similar high standard as solving a complex maths problem. This is because self-efficacy is specific to the activity being undertaken. Self-efficacy has been used as an effective performance-based measure of a learner’s perceived capability, motivation and capacity to undertake tasks (Bandura, 1977, p. 191).

Think of ways that you might empower someone to achieve a goal or to complete a task which they thought they were not capable of doing. There is an example on page 3 'The artefact' where the Centrestage practitioner uses art styles of graffiti and symbolism to work with the young people  and encourage them to produce their own work.

Motivational Interviewing

Motivational interviewing has been used in counselling as a method to engage disempowered individuals by increasing intrinsic motivation within a person(s) to change their behaviour. Within the area of social psychology and social counselling ‘motivational interviewing’ makes use of exploring a person’s ambivalence which has been reported to be an important factor in assisting the process of change (Miller and Rollnick, 1995).

The basic five principles of motivational interviewing, principles that focus on empowering people, that make this approach different from more traditional (deficit based) approaches are it supports an asset based approach to working with people, in that it allows practitioners to:

(1) Express and Show Empathy Toward Clients: practitioners express and demonstrate empathy when discussing behaviours, thoughts, attitudes and life events that clients regularly engage in. By expressing empathy, build rapport and trust.

(2) Support and Develop Discrepancy: in the interview process clients give reasons for changing their behaviour – instead of viewing counsellors as authority figures with the right answers. For example, clients might decide to stop drinking alcohol to build healthy relationships with their children. If clients are exhibiting behaviours and making choices that take them away from their goals, counsellors gradually point out this gap between behaviours and goals to clients.

(3) Deal with Resistance: when clients resist changing their behaviour, counsellors do not confront the client’s resistance. Instead, the counsellors avoid struggling to get client’s to see their point of view. As discussions continue, counsellors work with their clients to get them to see and examine different viewpoints, allowing their clients to choose which points of view they want to stick with. Resistance, when it occurs, is a sign for counsellors to alter their approach to the talk therapy.

(4) Support Self-Efficacy: Clients are made to feel that they are capable of achieving the change they want. This principle involves counsellors discussing and pointing out previous behavioural and life successes clients have experienced. For example, counsellors may remind clients recovering from drug addiction that they have kept a job for two years and have been drug-free for six months. Current or previous strengths and skills clients possess are also discussed, thereby increasing the clients’ belief that they can change.

(5) Developing Autonomy: Counsellors demonstrate to their clients that the authentic power for them to change comes from within, not from the counsellor. This emphasises the thought that there is no one way to achieve the change that clients want. It is also expressed to clients that they are ultimately responsible for changing their behaviour. Additionally, counsellors listen as clients develop a list of action steps they can take to change their behaviour (Miller and Rollnick, 2002).

Think of ways in which a manager or trainer might use motivational interviewing with a team of practitioners as part of a focus group or staff professional development workshop to initiate change or with community groups to work through issues.     

The Reflective Practitioner: Professional knowledge

Schön (2011) stated that there are two main elements for specialisation within a given profession. They are: (1) the substantial quantity of knowledge within a particular field which a specialist affirms they can command; and (2) mastery over techniques of production and application of knowledge to solve problems. This ‘application’ of knowledge has been linked to ‘professional knowledge’ and is viewed as a higher hierarchy of ‘general principles’ which are set at the highest level with ‘concrete problem solving’ being set at the lowest. Professional knowledge consists of two parts: (1) an underpinning science component which informs the practices which it is based upon; and (2) a skills and technique component which determines the level of proficiency of the performance which utilises the underpinning theory and applied knowledge (pp. 22-24).

Reflection-in-Action

One of the traits of being a professional is developing the ability to take a varied base of knowledge and turn it into a professional service which has been adapted to meet the needs of a client: a process which Schön termed ‘divergent thinking skills’ (Schön, 2011, pp. 45-46). Reflection-in-action is a concept described by Schön as a spontaneous and instinctive performance of human actions carried out in day-to-day practice. Describing this form of knowledge can be difficult because the knowledge is ‘tacit’. It is tied to our choice of action and feelings about and towards the things we are working with. Moreover, the performance of a professional is dependent on the concept of tacit knowing-in-action. Knowing-in-action has been described as the idea that a kind of knowing is inherent in intelligent action (Schön, 2011, pp. 49, 50).

Schön argued that phrases such as: “‘thinking on your feet’, ‘keeping your wits about you’, and ‘learning by doing’” all indicate that humans are not just capable of thinking about doing but have the capacity to think about doing something whilst doing it: a process he called ‘reflection-in-action’ (Schön, 2011, p. 54). Reflection-in-action is reliant on experience of the unexpected. This means that when results of an action are based on intuitiveness and spontaneous performance and the outcome is what was expected we tend not to think any further about it. However, if the performance results in an unexpected outcome this may prompt a response involving a process of reflecting-in-action. This process involves a focus on the results of an action, on what was involved in the action and on the tacit knowledge associated with and in the action (Schön, 2011, p. 56). Reflections of practitioners can be employed to generate new understandings about situations of ambiguity and distinctiveness which they have experienced, reflecting on projects they have undertaken and on situations they have lived through (Schön, 2011, p. 61). Furthermore, they may reflect on their practice whilst in the middle of it. Schön (2011, p, 62) describe this process as: “the art through which practitioners sometimes cope with the troublesome ‘divergent’ situations of practice” (Schön, 2011, p. 62).

Critical Reflection and Dialogue

Critical reflection has been defined as asking questions about the validity and reliability of suppositions held deeply by humans based upon their previous experiences. It is often portrayed as something which occurs after an awareness of conflict has emerged with respect to an individual’s thoughts, feelings, and actions which can cause perspective transformation (Mezirow and Taylor, 2009, p. 6). An important element of reflection is engagement in dialogue with the self and with others. Mezirow (Mezirow, 1991, p. 77) identified dialogue as being an essential medium through which transformation occurs and develops. They explain that it differs from everyday discussion because it is most often found in transformative learning when there is reason to call into question the clarity, trustworthiness, accuracy and authenticity of what is being argued or to question the integrity of the individual presenting the argument (Mezirow, 1991, p. 77).

Brown (2006, p. 732) found that individuals seldom change through a rational process of ‘analyse-think-change’, but instead are more prone to change in what he called a ‘see-feel-change sequence’. This involves ‘affective knowing’ which consists of developing an awareness of the importance of our feelings and emotions in the reflective process which is innate in critical reflection. Parrott and Schulkin (1993, p. 56) pointed out that physiological processes of cognition and emotion are linked through an interdependent relationship. Furthermore, emotions are inherently cognitive and are important for anticipating future needs, preparing for future actions, and preparing for thinking certain types of thoughts, ideas and strategies.

Reflective Models

The iterative reflective model has been used in reflective practice for healthcare professionals to reflect upon their everyday practices. This model is based on the idea that the reflective process is more effectively understood and followed as a ‘Cycle’. It can provide a deeper understanding of experience and a fuller grasp of knowledge and skills from working around the model in a continuous ‘clockwise’ cycle. Gibbs (1988) provides a cyclical model shown in Figure 7 which contains six steps or phase points, with each step on the cycle being associated with a key reflective question (Ghaye and Lillyman, 2006, p. 23).

The Reflective Cycle

With usage, the iterative model can provide signposts for individuals to map progress or to work on emerging issues and problems. The iterative reflective cycle model is a work-in-progress form of model where the user decides when to cease repeating the cycle when they are satisfied with the outcome of their reflections. According to Ghaye and Lillyman, (2006) the ‘action plan’ step has the potential to generate: “new actions, encounters and situations that can be understood by asking the question ‘what happened?’” (p. 24). Ghaye and Lillyman (2010) reported that using reflection can empower individuals and summarised seven aspects of reflective empowerment with regards to nursing practice. They are: (1) reflection is fundamental to experiential learning and development of practical knowledge; (2) reflection will help individuals to work towards better practice; (3) reflective practice has been identified as necessary for effective nursing; (4) reflective practice will bring about benefits; (5) all healthcare professionals can be reflective practitioners; (6) reflective practice models enhance professional status; and (7) reflective practice enhances each healthcare professional’s knowledge (Ghaye and Lillyman, 2010, p. 60).

The Reflective Cycle proposed by Gibbs (1998) could be used as a means to capture practitioner insights and knowledge could be exchanged between different disciplinary groups to promote interprofessionalism and to create a common language between different professions. As part of the activity in section seven you will be asked to contribute to a collaborative Wiki where you can use the reflective cycle to help you think about your answers. This reflective process should help you to put into practice many of the concepts and ideas discussed previously about asset based approaches A-B-As for the purposes of promoting interprofessionalism and to create a repository of shared experience with others.      

References

Bandura, A. (1997). Self-efficacy: The exercise of control. New York: Freeman.

Bandura, A. (1977). Self-efficacy: Towards a unifying theory of behavioural change. Psychology Review. Vol. 84, pp. 191-215.

Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory: Englewood Cliffs. NJ: Prentice Hall.

Brown, K. (2006). Leadership and social justice and equity: Evaluating a transformative framework and andragogy. Educational Administration Quarterly. Vol. 43, No. 5, pp. 700-745.

Dewey, J. (1933). How we Think: A Restatement Of The Relation Of Reflective Thinking To The Educative Process, D.C. Health and Company, USA.

Ghaye, T., and Lillyman, S. (2006). Learning Journals and Critical Incidents: Reflective practice for health care professionals. Second Edition, Quay Books A division of MA Healthcare Ltd.

Ghaye, T., and Lillyman, S. (2010). Reflection: Principles and Practices for Healthcare Professionals. Quay Books A division of MA Healthcare Ltd.

Gibbs, G. (1988). Learning by Doing: A guide to teaching and learning methods. Further Education Unit. Oxford Polytechnic: Oxford.

Mezirow, J. (1991). Transformative dimensions of adult learning. San Francisco: Jossey-Bass.

Mezirow, J., and Taylor, W. T. (2009). Transformative learning in Practice: insights from Community, Workplace, and Higher Education. Jossey-Bass A Wiley Imprint.

Miller, W. R., and Rollnick, S. (2002). Motivational interviewing: Preparing people to change addictive behaviour (2nd ed.). New York: Guilford Press.

Miller, W. R., and Rollnick, S. (1995). What is Motivational Interviewing? Behavioral and Cognitive Psychotherapy. Vol. 23, No. 4, pp. 325-334.

Parrott, W. G., and Schulkin, J. (1993). Neuropsychology and cognitive nature of the emotions. Cognition and Emotions. Vol. 7, pp. 43-59.

Rappaport, J. (1981). "In praise of paradox. A social policy of empowerment over prevention" (PDF). American Journal of Community Psychology. 9 (1): 1–25 (13). doi:10.1007/BF00896357 [Available at] https://grow.ie/wp-content/uploads/2012/03/In-Praise-of-Paradox-A-Social-Policy-of-Empowerment-Over-Prevention-.pdf

Rappaport, J and Seidman, E., eds. (2006). Handbook of Community Psychology. ISBN 978-0618196043.

Schön, D.A. (1987). Educating the reflective practitioner. San Francisco: Jossey-Bass.

Schön, D. A. (2011). The Reflective Practitioner: How professionals think in action. (First published in 1983) Ashgate Publishing Limited.