Reflecting Team Process Research Articles

"Always opening and never closing": How dialogical therapists understand and create reflective conversations in network meetings.

Tom Andersen’s reflecting team process, which allowed families to witness and respond to the talk of professionals during therapy sessions, has been described as revolutionary in the field of family therapy. Reflecting teams are prominent in a number of family therapy approaches, more recently in narrative and dialogical therapies. This way of working is considered more a philosophy than a technique, and has been received positively by both therapists and service users. This paper describes how dialogical therapists conceptualise the reflective process, how they work to engage families in reflective dialogues and how this supports change. We conducted semi-structured, reflective interviews with 12 dialogical therapists with between 2 and 20 years of experience. Interpretative Phenomenological analysis of transcribed interviews identified varying conceptualisations of the reflecting process and descriptions of therapist actions that support reflective talk among network members. We adopted a dialogical approach to interpretation of this data. In this sense, we did not aim to condense accounts into consensus but instead to describe variations and new ways of understanding dialogical reflecting team practices. Four themes were identified: Lived experience as expertise; Listening to the self and hearing others; Relational responsiveness and fostering connection; and Opening space for something new. We applied these themes to psychotherapy process literature both within family therapy literature and more broadly to understand more about how reflecting teams promote helpful and healing conversations in practice.

A systematic review and meta‐synthesis exploring client experience of reflecting teams in clinical practice

There is a dearth of readily available evidence on the impact of reflecting teams in family therapy. A synthesis of the literature was needed to provide clarity and insight into client experience of the process. A systematic search of the reflecting team literature was conducted and 11 papers using qualitative methodologies were identified. The findings of these studies were synthesised using meta‐ethnography. Three themes were identified; ‘unusual and strange’; ‘unique conversations’ and ‘therapeutic environment’. The reflecting team process was unanticipated and unique, but it could be helpful where people were made to feel safe and understood. Reflecting teams, while initially received as an odd and unusual experience, are typically found to be an effective and helpful approach within family and couples therapy. Extra considerations should be taken to ensure that clients feel able to engage with the process, avoiding it becoming overwhelming and unhelpful.Practitioner points Higher levels of self‐awareness and uncertainty are present for the family when first presented with the reflecting team. A strong rapport with the lead therapist can support family engagement with the team. Reflecting teams were experienced as more effective when they represent a diverse group of professional, ethnic and cultural backgrounds. Hope and validation are vital parts of creating a therapeutic space which is effective in introducing difference to a family.

“I Think It Just Helped Me See:” Incorporating Attachment into Reflecting Teams

ABSTRACT Historically, hope has been studied from a cognitive, not experiential, lens and rarely from an attachment perspective. The aims of this research were to explore how couples experience hope when using a reflecting team (RT) as part of their counseling process as well as if their experience of hope differed based depending on their attachment style. To examine these questions, couples (n = 13) completed attachment measures as well as participated in interviews assessing their experience of hope in relation to the reflecting team. The research was methodologically directed by interpretative phenomenological analysis (IPA), which draws on the participants’ meaning-making of the reflecting team process. Participants’ attachment strategies impacted which interventions used by the reflecting teams were most relevant and powerful in inducing hope.

Systemic Reflecting Team Training: Perceptions and Experiences of South African Educational Psychologists

There is limited research on the application of systemic family therapy in developing countries. This qualitative study explored the perceptions and experiences of 12 educational psychologists and a family therapy trainer, who have worked within a systemic reflecting team using Tom Andersen’s method of training and supervision. The semi-structured interview findings suggested positive perceptions of systemic intervention, despite various challenges experienced in its implementation within the South African context. The educational psychologists identified their reflecting team experiences as being beneficial for both their professional development and current practices. Future research which investigates the reflecting team process in action is recommended.

Accessible polyvocality and paired talk: how family therapists talk positive connotation into being

In this article we identify one particular way in which the reflecting team process is used by family therapists. We show that reflecting teams draw upon occasions in the main session to intensify and extend positivity in the reflecting session. This analysis identified positive connotation as a device by which a hopeful orientation is established. Videos of family therapy sessions were obtained and transcripts of these sessions made. Excerpts with hope and positivity were identified and conversation analysis was used to gain insight into the organization and function of this talk. In addition, therapist interventions occurring during the main therapy session and which were reworked in the reflecting session were identified and analyzed. Sixteen examples of this paired talk are presented, and two exemplars are analyzed in full. Main session interpretations of talk and the reflecting team second versions (a device identified as paired talk) were found to work together as a resource for the construction and reinforcement of positive connotation in family therapy.Practitioner points Positive connotation is constructed through therapists’ talk; this study shows in close detail how positive connotation is ‘talked into being’. There is little opportunity for family members themselves to ratify or challenge these constructions. Practitioners could engage family members by gaining feedback on the constructions of positive connotation.

Intersections Between Hope and Vulnerability in Couples’ Experiences of the Reflecting Team Process

Couple therapists have asserted that hope and vulnerability are active forces in the therapeutic process. However, no research has been published that examines clients’ experiences of hope and vulnerability when participating in couple therapy. To address this gap in the literature, the authors conducted in-depth interpersonal process recall interviews with six clients (three couples). Interviews focused on their underlying experiences of hope and vulnerability during the reflecting team process. The authors present clients’ descriptions of where these experiences overlap. Using the information provided by clients, they make suggestions regarding attending to hope and vulnerably during the reflecting team process.

Making Meaning

The reflecting team (RT) process was once a common practice in couple and family therapy training programs. This qualitative case study utilized the interview process to gain understanding about a couple’s perspective of the RT process. Categories constructed included (a) characteristics of the RT and (b) reactions to reflections. These findings underscore the need for additional research that specifically addresses these themes and aims to help counselor educators and counselors in training better understand and serve their clients. While this study supports many of the previous research findings, it adds the elements of encouraging listening, fostering hope, and facilitating engagement in the reflective process.

Couples’ Experiences of Hope When Participating in the Reflecting Team Process: A Case Study

Hope is believed to be influential to therapeutic change. However, no studies have explored couples’ experiences of hope during participation in a reflecting team process. This exploratory case study attends to this gap in the research literature. Three couples reported on their experiences of hope in relation to participating in the reflecting team process as part of their couple therapy. Themes related to hope were identified during three separate stages of the intervention: anticipating, participating in, and debriefing the reflecting team process. Reflecting team experiences related to hope included: seeking new perspectives, maintaining a positive momentum, identifying strengths, normalizing difficulties, presenting inspiring possibilities, providing support, highlighting growth, and strengthening resolve. These findings serve as a foundation for attending to clients’ hope as an active force during the reflecting team process.

A Reflective Look at Reflecting Teams

This article reviewed existing literature and research on the reflecting team process. There is a dearth of empirical research that explores the reflecting team process and the outcome of counseling that uses reflecting teams. Implications of using reflecting teams for counselors, counselor educators, and clients will be discussed. A call for further empirical research will also be explored.

Creating Dialogic Contexts for Multidisciplinary Clinical Reviews: The Reflecting Team Process

When multidisciplinary teams review their work, it is common for clinicians to hypothesise about their clients from the perspective of their role or theoretical model. The outcome of this review process may depend on the team's views. Here the epistemological position taken by team members about reality and objectivity can lead to starkly different pathways. There can either be a dialogue about different hypotheses, with the team jointly constructing new meanings; or, conversely, there can be a monologic exchange based on competition between different hypotheses. This paper explores why teams may struggle with coordinating different theoretical approaches and models. It suggests the dialogic nature of a reflecting team process offers one approach for helping teams to find ways of ‘putting their differences to work’. Ideas for implementing this process within multidisciplinary teams are illustrated with comments provided by teams who have begun to experiment with this approach.

Review of the Reflecting Team Process: Strengths, Challenges, and Clinical Implications

This review article explores the development of reflecting teams and its significance in present-day family therapy. Beginning with an historical overview of the reflecting team model, as formulated by Tom Andersen, further discussion considers the advantages and the challenges of the model. The article outlines implications for clinical practice, which build on Andersen's vision of family therapy that is collaborative, inclusive, and client centered.

Using an adapted reflecting team approach to learn about mental health and illness with general nursing students: An Australian example

This paper describes how a reflecting team informed by outsider-witness practices was used in a classroom with a small group of Australian general nursing students to explore their understandings of mental illness and people with mental illness. The reflecting team process helped students to go beyond the media stereotypes of mental illness and the people who suffer from mental illness. It helped them develop new understandings of the lives of people who experience mental illness. The process also enabled students to learn more about stigma and its debilitating effects, to speak about it and to monitor their own language use, and to identify and explore their preferred interpersonal approaches in future practice settings when dealing with people showing signs of mental distress.

Use of the Reflecting Team Process in the Training of Group Workers

Group work trainees have benefited from experiential instructional methods that allow them to participate in actual group experiences. The reflecting team process can serve as one such instructional method. It provides an experiential component that allows group work students to participate in actual group experiences, with particular focus on group process. This article describes two methods for the use of reflecting teams in the training of group workers. The authors explain the procedures they followed in the application of reflecting teams to group work training and discuss their observations of and recommendations for the use of such teams.

The Fit Between Reflecting Teams and a Social Constructionist Approach

Andersen's (1987) conception of using reflecting teams in therapy is an exciting and challenging innovation that invites a departure from traditional models. A team of therapists works collaboratively to offer clients a wide range of narratives and viewpoints from which to choose, based upon the notion that realities and meanings are co-constructed through conversation. Using a social constructionist orientation, the reflecting team literature is interpreted according to its conception of certain elements, in particular language and knowledge, meaning, problems and change, power, the self, and reflexivity. Ideas are suggested for engaging in a reflecting team process with clients, emphasizing that a social constructionist stance offers a richer experience of reflecting team practice in therapy.

“Treasured Awakenings:” Reciprocity and the Reflecting Team Process

Abstract In this article we review a case in which videotaped conversations were exchanged between a reflecting team and a family over a six-month period of therapy. A follow-up interview three years after working together further elaborates the meaningfulness for this family of their reflecting team experience. In this case, exchanges between the family and the reflecting team were seen by clients and therapists as playing a significant role in facilitating change by all parties involved. Examining this recursivity elucidates ideas about partnering with families in ways that can transform our clinical practices and our lives.

Adding Written Reflections to the Reflecting Team

The benefits of letter-writing in couples and family therapy are reviewed, noting the previous absence in the use of letters as part of a reflecting team format. The authors discuss their experience on a reflecting team at Massachusetts General Hospital and the rationale for the addition of letter-writing to the reflecting team process. A case vignette involving a couple who received several team letters is discussed in light of their reports that the letters facilitated their ability to hold onto dual perspectives, remind them of positive changes they had made and serve as an ongoing shared record of the consultations. Also mentioned are the benefits for the therapist: the letter as a touchstone when the therapy goes awry and the freedom the therapist experienced during the spoken reflections, knowing she would later receive a written account. The benefits of using the letter to facilitate the teaching of the reflecting team are also highlighted.

The reflecting team as a reflection of second order therapeutic ideals

The reflecting (R.T.) team is examined within its theoretical, therapeutic and training contexts. A distinction is made between the reflecting team technique (R.T.T.) and the reflecting team process (R.T.P.), in order to explore whether or not the practice of team reflection is consistent with the requirements of the second order family therapies, the theoretical development which supported the R.T.'s emergence and subsequent popularity.The critique of the R.T.P. suggests that although this therapeutic process does represent attempts towards increasing acceptance of complexity, reduced attempts to control, collaboration, interconnectedness and contextual respect, there is little room for complacency either theoretically or practically.

Consulting with an assertive outreach service using a reflecting team approach

This paper gives an account of applying a reflecting team process to our work with members of an Assertive Outreach Service. We discuss how we introduced this framework to the team and some of our reflections about our work together.

Back and Forth and Beyond

The Journal invited Tom Andersen, author of major pioneering work on the reflecting team, and his colleagues, to offer comment on The Reflecting Team Process in Training. We thought such a north‐south dialogue was in keeping with the spirit of reflecting teams, and the team members in Melbourne and Tromsø agree — Editor.

The Reflecting Team Process In Training

The process of evolution of a reflecting team in live supervision sessions is discussed. Theoretical ramifications for systemic training of systemic family therapy are explored and feedback from trainer, trainees and client families about the use of the reflecting team is presented.