Access Type

Open Access Dissertation

Date of Award

January 2019

Degree Type


Degree Name



Social Work

First Advisor

Carolyn J. Dayton


The infant mental health (IMH) field has identified reflective supervision (RS) as a clinically-supported, best-practice supervisory strategy to support professionals working with high-risk infants and their families, yet there is a paucity of empirical evidence to corroborate this view. This dissertation used a qualitative, cross-sectional, grounded theory design to investigate supervisee perspectives of RS. Semi-structured focus groups and individual interviews with 50 IMH professionals who were receiving reflective supervision were collected and analyzed with the goal of developing a deeper understanding of how supervisees operationalized RS and whether and how it impacted outcomes. Supervisees described essential components of RS as feeling safe within the RS relationship, developing trusting relationships with their RS supervisor, consistency and predictability of the RS sessions, nonjudgmental responses from their supervisors, and the commitment of both the supervisor and supervisee to be present and emotionally available to the RS experience. Data also suggest a number of variables that influence the supervisee experience of RS. These variables include: supervisee and supervisor constructs, relational constructs, and contextual constructs such as agency support of RS. Four professional wellness outcomes, including burnout and professional efficacy and three personal growth outcomes including reflective capacity were described as influenced by RS. Supervisees described five practice behaviors influenced by RS, including the capacity to bring up difficult topics with families and becoming better observers of family dynamics. In summary, supervisees described that when they feel safe and trust their reflective supervisor, they feel more comfortable expressing their vulnerability and sharing difficult experiences within RS. This promotes growth in their capacity to be reflective about, and responsive to, their professional and personal needs, as well as the needs of the families they serve. Furthermore, data suggest a developmental and ecological theoretical perspective of the supervisee’s experience in RS. Their experience and understanding of RS results from a complex interaction between qualities and characteristics of the individuals and the settings in which RS is implemented. This theoretical model expands our understanding of RS by including the supervisee perspective and offers a way to organize the RS experience. Results from this study will inform future RS training, provision, and access through empirical research and implementation recommendations.

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Social Work Commons