BUILDING CAPACITY IN REFLECTIVE PRACTICE: A TIERED MODEL OF STATEWIDE SUPPORTS FOR LOCAL HOME-VISITING PROGRAMS.

This preliminary study examines an initiative to further develop capacity in reflective practice among public health home visitors and their supervisors. A Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Expansion Grant to the Minnesota Department of Health funded the development of a tiered structure to support reflective practice within county public health agencies throughout the state. Study data revealed a general consensus among individuals at all levels of the county programs that state supports were adequate to implement reflective practice. Although there were no significant changes in home-visitor and supervisor scores on a standardized measure linked to reflective functioning and reflective practice, a majority of home visitors and supervisors perceived that their knowledge and skills in reflective practice had increased during the evaluation period. A standardized measure of employee burnout did not reveal significant changes in either "depersonalization" (indicating burnout) or "personal accomplishment" (a mitigating factor in burnout) subscales; however, home visitor "emotional exhaustion" subscale scores did increase over the evaluation period. In contrast to the subscale results, home visitors reported a sense of accomplishment in their reflective work and that they value "releasing" emotions in a safe environment during reflective supervision.