Whether we are in our first year of training as a hypnotherapist, in our third year of training as a psychotherapist, or whether we are a therapist of many years’ experience, Reflective practice is a process that we engage in, consciously or not, to ensure that we continue to learn. Reflective practice is a continuous cycle of self-observation and self-evaluation that helps us to understand our own actions and how these may impact on other people. (Brookfield, 1995)
In training, we learn that therapy, regardless of style, is about relationship. A positive and supportive relationship between client and therapist demands that we continuously consider the responses of both people in the therapy room. Understanding how our responses impact the course of therapy is a vital part of our professional journey.
Reflective practice helps us to relate our theory to our practice, and to process both in the field so that we continue to learn. Without reflective practice, it is debateable whether we can be a safe, ethical or effective therapist.
To help us understand the process of Reflective practice, there are several models that break this down, which can incorporate different tools such as journal writing, quiet reflection, or peer or supervisor discussion. It’s possible to reflect on virtually any aspect of our work, but perhaps most important to reflect when things don’t work out the way we hope or expect.
Reflective practice involves us being as honest as we can with ourselves. If things go wrong, we have a tendency to defend our position. However, we should be able to admit to ourselves and others that we may have made an error. When we can do this, we can take stock of what happened and do it differently from now on.
There are several models of Reflective practice. Most have developed as valuable tools in education (Gibbs) or healthcare such as nursing (Johns). The Gibbs model is influenced and adapted from Kolb’s model of experiential learning, (Kolb 1984), which in turn is highly influenced by research by Dewey and Piaget in the 1970s. Kolb’s model (Figure 1) centres on the transformation of information into knowledge which takes place after the situation has occurred and involves the practitioner reflecting to build on her experience and knowledge. (Sheilds, R.W., Aaron, D.,Wall, S 2015)
Figure 1: Adaptation of Kolb’s learning model
Gibbs’ (1988) model (Figure 2) is one of structured debriefing to facilitate the reflective process. This is most useful in therapy, where we are often engaged in quite abstract processes which can create a tendency to ‘wander off topic’ when discussing the process of therapy in supervision at a later date.
Both Kolb’s and Gibbs’ models acknowledge that there is much more to learning than, for example, taking the course in hypnotherapy and writing the essays. The majority of our learning comes from experience in the field. The reflective process allows us to focus on the aspects of an experience in order that we may learn from it. In this sense, we are always learning, and reflective practice is arguably the most important aspect of supervision, where the supervisee is given time and space to reflect in a supported way.
Let’s put this into an example. Let’s suppose a client has come to see us with an issue related to self-defeating behaviours. We could use either hypnosis or counselling or both, and we put together a focused treatment plan over eight sessions. After three sessions, the client says they are fine and cancels the following appointment, having no further contact with us. Let’s break down this issue using Gibbs Model:
Fugure 2: Gibbs Model of Reflection (1988)
Starting with a description of the event:
I felt confident when the client initially presented. He wanted help with an issue that I know well as my husband has had the same experience. I took the consultation, filled out the necessary forms, worked hard to build rapport with my client. Client seemed happy after the first session, reported little change after the second, but as I said to them, change takes time and we have eight sessions planned. Client cancelled the third session. I followed up to rebook but they said they felt fine and didn’t need to come anymore.
Now, we consider our feelings, without analysing, just describing:
Initially my feelings were positive, confident of success. However, when a member of my practice group suggested that the client might have made an excuse to leave because it wasn’t working, I felt frustrated and angry that the client hadn’t followed through. I was anxious and defensive and felt that the client wasn’t ready to change. I don’t like making mistakes.
Evaluation – what was good or bad about the experience – make value judgements:
Positives about the experience of the client ending therapy was that it forced me to think about it. Initially I was just blaming the client, but later I had to consider my part in this. Had I really done everything as well as I could? Negatives about the experience are that I got no feedback from the client, which could have been helpful for my practice.
Analysis – what sense can you make of the situation – bring in ideas from outside the experience to help you:
I contacted my supervisor at this point, who helped me see things more objectively. If I stop defending my position and take things back to basics, what of the Core Conditions? Did I work to truly understand my client’s experience, or did I make a quick value judgement based on my own experience? Did I believe that because my husband has a similar issue, his issue is exactly the same as my clients? Moreover, am I confusing my husband’s experience, with my experience of my husband’s experience?
Conclusions – what can be concluding in a general sense from the analyses you have undertaken?
I think I might have not fully engaged with the client and I stopped listening to them. I think I quickly decided what was happening for them, and then formed my treatment plan on that decision. Perhaps I failed to listen to what they were really saying
And what can be concluded about your own specific, unique personal way of working?
Perhaps I am still trying too hard to be right, to be perfect? It’s OK to leave the initial consultation not really knowing what to do next, or what plan to have in place. It’s OK to keep gathering information. I still have to work on my overwhelming need to ‘help’ someone who I think is more vulnerable than me. Perhaps my frustration with my husband’s inability to change was spilling over into my needing this client to change
Personal action plan – what will you do differently next time?
I’ll keep reminding myself to stay present with the client and to keep listening to them. If I think I am making assumptions, I’ll check those assumptions by asking the client if my understanding is correct. I’m working to keep understanding that each person’s experience is unique. I know better now that I probably lost the client’s trust and I was suggesting things to them that either had no meaning or weren’t useful – the client probably felt unheard.
Note that Gibbs’ Model, like other models, is a cycle, whereby the conclusion is not the ending, but the start of new learning.
For Reflective practice, there are several models that will serve the purpose, and all will bring something valuable to the process. Atkins and Murphy’s model of reflection (1994); John’s Reflective Model (1997) or Gibbs’ Model of Reflection (1998) are based on models of learning, where learning is recognised as occurring from experience reinforced by theory. Action is an important aspect of the models, resulting in us doing something different in the future. Reflection is only of value if it has the possibility of leading to action. Gibbs keeps action as a key aspect, even though the model can result in a fairly superficial analysis of an incident but this could be a good starting point. Later, we might decide to use a different model, like the Atkins and Murphy (1993) Model of reflection (Figure 3), which supports a deeper level of reflection with more emphasis upon the practitioner than the client.
Figure 3: Atkins and Murphy (1993) Model of Reflection
There is a difference between surface level reflection and a deeper level of thinking that involves self-analysis, metacognition and conscious control (Finlay 2008). Laboskey makes a distinction between ‘common sense thinkers’ who use a trial and error approach and ‘pedagogical thinkers’ who are more conscious of their actions, and will ask ‘what is my intuitive response to this and why am I feeling or acting in this way?’ (Laboskey 1993). The suggestion here is that the latter type of thinker takes a long term view of problem solving, remaining open to learning and recognising that there are no simple answers and conclusions are often tentative (ibid).
Considering the depth of the therapeutic relationship and the depth of the layers that we may be helping a client to uncover in respect of his presenting issue and goal for therapy, I suggest that those models that allow for pedagogical thinking would be more appropriate to our work as therapists. The therapeutic relationship as a healing relationship involves complex dynamics and we would be doing disservice to our clients if we are unprepared to explore our part in the creation and sustaining of these complexities. However, when we are starting our practitioners’ journey, the simplicity and structure of the Gibbs model is a good place to start.
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Brookfield, S. (1995). Becoming a Critically Reflective Teacher. . San Francisco: Jossey-Bass.
Finlay, L. (2008). Reflecting on reflective practice. Open University.
Gibbs, G. (1988). Learning by doing: A guide to teaching and learning methods. London: Oxford Polytechnic Further Education Unit.
Hawkins, P; Shohet, R. (2012). Supervision in the Helping Professions. New York: Open University Press.
Kolb, D. (1984). Experiential learning: Experience as the source of learning and development (Vol. 1). New Jersey: Prentice-Hall.
Laboskey. (1993). A conceptual framework for reflection in preservice teacher education. In G. a. Calderhead, Conceptualising reflection in teacher development. London: Washington Falmer Press.
Sheilds, R.W., Aaron, D.,Wall, S. (2015, February 2nd). What is Kolb’s model of experiential education, and where does it come from?, Questions and Answers on Adult Education, . Retrieved from Ontario Institute for Studies in Education, Univeristy of Toronto.