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About this book

Many students and practitioners are familiar with critical reflection but struggle to make space for it in their everyday practice. This book provides an accessible and practical introduction not only to doing critical reflection, but to being critically reflective.

• It demonstrates how reflective capacity can be developed in different practice contexts and applied productively to supervision, teamwork and interprofessional working.

• It outlines the different theoretical underpinnings and methods of critical reflection, exploring the use of visual images, writing techniques and group meetings.

• It is rich with engaging case studies and questions for the reader that will help them to make critical reflection an integral part of their everyday practice.


This book is an ideal guide to dealing with challenge and change across a range of social and healthcare services, including social work, nursing, youth and community work, counselling and allied healthcare professions.

Table of Contents

Introduction

Introduction

Abstract
Those who work in health, education and social care are faced with increasing challenges in the complexity of their practice and the context in which they operate. Critical reflection provides a theoretical approach to help understand these challenges as well as a process for engaging constructively with the dilemmas and issues that inevitably arise in professional practice. Essentially, critical reflection encourages practitioners to identify the underlying assumptions and values that influence their practice and to consider how they can act in line with their preferred assumptions and values. Being able to name these most deeply held values reminds practitioners of the underlying or fundamental reasons for their participation in this kind of practice. This, in itself, can be restoring and energizing as well as challenging and sometimes even painful. The sense of working from fundamental values reinforces the integrity inherent for practitioners in their practice or what they might name as the meaningful or spiritual dimension. Practitioners have affirmed that a critically reflective approach frequently grounded and centred them, taking them to a place where they were reminded of their sense of altruism and hope about their work. While this did not necessarily resolve the dilemmas of practice, it frequently enabled practitioners to engage more actively with them, seeing new perspectives and possibilities for change either for themselves or in their practice.
Fiona Gardner

Introducing Critical Reflection Theory and Processes

Frontmatter

1. What is Critical Reflection?

Abstract
My intention in this chapter is to outline briefly the range of current ideas or perspectives about critical reflection and reflective practice with the aim of clarifying the differences between these. In the second part of the chapter I will define how I am using critical reflection in this book, explore principles that I see as connected to being critically reflective and identify the culture of critical reflection that is the background to the examples used here.
Fiona Gardner

2. Theoretical Underpinnings

Abstract
There are many theoretical frameworks that can contribute to being critically reflective. The main aim of this chapter is to detail the four theories that Jan Fook and I have used as the primary underpinning blocks for critical reflection (Fook and Gardner, 2007). Practitioners and their organizations also often have particular theories they use to complement critical reflection, such as a psychodynamic or narrative approach (Stedmon and Dallos, 2009). To illustrate how this might be done, I will also explore how understandings of psychodynamic theory and of spirituality and meaning relate to these theories: where they complement and reinforce them and/or where they differ. Why this particular combination? This reflects my own interests and preferences. Both personally and professionally, I use the theories from critical reflection complemented by psychodynamic and spirituality theory, and find them an effective combination of ideas for thinking about my own practice, in running critical reflection workshops, supervision and critical reflection workshops, and supervision and spirituality workshops of various kinds. In this chapter, I will briefly summarize these approaches, then focus on the four main theories of critical reflection, including psychodynamic and spirituality theory and their contribution.
Fiona Gardner

3. Practicing Critical Reflection

Abstract
While being critically reflective is ideally an attitude to practice, it is also helpful to actively use critical reflection in a focused way to explore specific experiences in a particular context. Given that practitioners have different personalities and preferences and operate in a variety of contexts, it is important to identify a variety of ways in which people can practice critical reflection. These are also useful of course in learning how to critically reflect, a skill that develops with practice. This chapter outlines a variety of processes for critically reflecting that can be used on your own, in supervision, in pairs and in groups, within and outside organizations, formally and informally. Chapter 6 considers the use of critical reflection in supervision in more detail.
Fiona Gardner

Critical Reflections in Organizations

Frontmatter

4. Organizational Context

Abstract
The organizational context is generally named by practitioners as a major influence on and often a major challenge to their capacity to be critically reflective. Practitioners are generally employed in an organization of some kind, funded by government and/or other sources. Even those in private practice have some kind of organization they connect to, even if one person is the manager as well as the practitioner. When practitioners are asked to bring a specific experience to use in training, many bring an experience that relates to how the organization impacts on them and their practice. This might include the organization limiting their capacity to work in ways they see as more effective or creative, being in conflict with organizational values and processes or feeling uncomfortable about specific actions or attitudes of colleagues or managers. It is important to recognize that practice is partly or sometimes largely about how you manage the organization and its dynamic as much as how you carry out the specific professional tasks you are trained for. Frequently, being able to accomplish these professional tasks depends on your skills in negotiating organizational life.
Fiona Gardner

5. Critical Reflection and Organizational Learning

Abstract
Being critically reflective encourages an attitude of identifying what is of value, what works and what doesn’t in practice and in organizational life more generally. Individuals and groups engaging with their experiences identify not only what they might want to change in their own attitudes or practice, but also what wider changes, including organizational changes are desirable. This raises questions about how the organization can learn from these reflections: how can individuals or groups influence organizational culture or processes. Is it enough that individuals or groups change or seek change in their own practice? Will this in itself bring about organizational change? Does this individual learning need an organizational culture of learning to be influential? Or alternatively, does an organization need its own broader reflective processes and structures? What difference does it or might it make if an organization formally endorses or uses a critically reflective approach? Does it or would it make it easier to be critically reflective if the organizational culture embodies the attitudes and concepts of organizational learning? This chapter engages with these questions initially by exploring related literature on organizational learning. This is followed by identifying ways that individuals, groups and organizations can more consciously use critical reflection to foster being critically reflective at an organizational level.
Fiona Gardner

6. Supervision and Team Work

Abstract
It can be hard to be critically reflective on your own. Assumptions and values can be so deeply embedded that it is challenging to unearth them, to ask yourself the kinds of questions that elicit feelings and thoughts that are uncomfortable. This chapter explores the use of supervision in developing and maintaining a critically reflective stance to practice. First, ideas about supervision in general are explored, including the development of common themes about supervision across disciplines. Traditional ways of thinking about supervision are identified: the combination of accountability, support and educational roles in a one-to-one relationship between a more senior staff member and a more junior one. Instead thinking about supervision as how professional practice is effectively supported can lead to more flexible and creative arrangements: asking how supervision needs can be negotiated to suit the individual and the organization. The aim here is to encourage practitioners to think more broadly about their own assumptions about how they are supervised and how they are supported to be critically reflective in their organization and what their preferences might be. The differences between individual, group and peer supervision are explored as well as the benefits of these for individual practitioners and for changing organizational culture towards being more critically reflective.
Fiona Gardner

Critical Reflection and the Broader Professional Context

Frontmatter

7. Ethical Issues

Abstract
The ethics of practice are confronting for all professional disciplines in their practice as well as in general organizational life (Banks, 2008; Jensen, Royeen and Purtilo, 2010; Laabs, 2011). These dilemmas are often expressed by practitioners as stresses or conflict, sometimes conflict with service users, but more often with colleagues or managers. This may relate to simply having a colleague that is experienced as being difficult to work with or a specific disagreement or dispute that is named as an ethical or moral difference. The possible scope of these is endless and to some extent what is ethically challenging is subjective: some people will experience a particular issue as an ethical dilemma that others see as straightforward. For some workers, the resulting stress leads to ongoing discomfort or for some, burnout and leaving the organization and/or the profession. Critical reflection can provide a process for identifying ethical issues and unearthing assumptions and values that may contribute to feeling ‘stuck’ with them, accessing other ways of seeing what is happening and finding ways to either resolve, manage or live with the conflict.
Fiona Gardner

8. Managing Uncertainty, Change and Conflict

Abstract
Uncertainty, change and conflict are inevitable aspects of organizational life. ‘Professionals practice in an uncertain and ever-changing world and they need to develop creative, innovative and proactive approaches to professional practice (Titchen and Higgs 2002, p. 288). For many practitioners, the rate of change in organizations and society generally means they feel they are living with constant instability. Being critically reflective can enable practitioners to acknowledge their and their organization’s assumptions and preferences about uncertainty and how to develop strategies to live with it. When uncertainty becomes specific change, practitioners will face different challenges and again being critically reflective encourages assumptions about change to surface, altering those that are unhelpful and developing strategies to work constructively with change — or to oppose it. Critical reflection enables people to unearth the values that are influencing their practice and Oliver and Keeping (2010, p. 103) suggest these can act as a ‘beacon to guide us and help us make sense of challenges to our identity during times of change’. This chapter will also take further the issues in relation to conflict partly explored in Chapter 4, identifying how critical reflection can generate strategies for managing or resolving conflict.
Fiona Gardner

9. Interprofessionalism and Critical Reflection

Abstract
Being able to work constructively and actively with a range of other professional disciplines is an expectation of practice for most workers. The quality of practice, in a variety of settings, depends on recognizing and valuing what each discipline brings. This needs to happen across disciplines as well as between organizations and both can be challenging. One of the benefits of being critically reflective is that it is increasingly seen as part of professional practice across many disciplines. With common training and agreement about how critical reflection is understood, staff from a wide range of disciplines can use critical reflection as a common language. The process of critical reflection can also help with identifying different professional assumptions and what these might mean for effective team work. Specific examples from healthcare organizations will be used here to illustrate how being critically reflective can engender mutual understanding and lead to changed work practices.
Fiona Gardner

10. Embedding Critical Reflection in Individual and Organizational Practice

Abstract
These can be daunting times for practitioners in health and human services. Expectations are high: professional training emphasizes holistic and highquality practice. Practitioners are generally extremely motivated to contribute to the wellbeing of individuals and communities, to act as agents of change according to their own and the values of their professional discipline. However, they are confronted with considerable challenges: the current economic and political climate, which stresses outcomes rather than processes, the increasing complexity of the issues individuals, families and communities are facing and the uncertainties of constant change, combined with expectations to move towards interprofessional practice. The organizations where practitioners are based have their own sets of issues to manage: the pressures of less income combined with greater expectations including the creation of learning cultures, demonstrating effectiveness according to what may be experienced as sometimes inappropriate funding strategies and managing practitioners overwhelmed by levels of change and uncertainty. The organizational culture will reflect these and some cultures are better than others at retaining a climate of supporting workers whatever the prevailing context.
Fiona Gardner
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