eISSN: 1989-9742 © SIPS. DOI: 10.7179/PSRI_2024.46.07

http://recyt.fecyt.es/index.php/PSRI/

Versión en español: https://recyt.fecyt.es/index.php/PSRI/article/view/108787/81394

Reflective practice in professional training: adapting evidence-based programmes to local contexts

Práctica reflexiva en la formación de profesionales: adecuación de programas basados en evidencia en contextos locales

Prática reflexiva na formação de profissionais: adequação de programas baseados em evidências em contextos locais

Alícia BORREGO-TARRAGÓ https://orcid.org/0000-0001-5589-5073

Lucía GONZÁLEZ-PASARÍN https://orcid.org/0000-0001-9080-8043

Laura SEGARRA-AYLLÓN https://orcid.org/0009-0005-6338-9257

M. Àngels BALSELLS https://orcid.org/0000-0003-3283-8222

University of Lleida

Received date: 18.VII.2024

Reviewed date: 29.IX.2024

Accepted date: 05.XI.2024

CONTACT WITH THE AUTHORS

Lucía González-Pasarín: Universitat de Lleida, Departamento de Ciencias de la Educación, Avda. de l’Estudi General, 4, Lleida 25001, España. E-mail: lucia.gonzalez@udl.cat

Introduction

Socio-educational intervention with at-risk families is a scientific, social and professional challenge driven by the adoption of Recommendation 19 of the Committee of Ministers to member states on policy to support positive parenting (Council of Europe, 2006). This recommendation defines positive parenting as ‘parental behaviour based on the best interests of the child that is nurturing, empowering, non-violent, and provides recognition and guidance, which involves setting of boundaries to enable the full development of the child’ (p. 3). Since this recommendation was made, new perspectives on family intervention have emerged which have adopted an ecological, inclusive and participatory approach (Balsells et al., 2019).

Supporting families using this new approach presents multiple challenges. These include managing a wide variety of family situations that may have an impact on a child’s welfare, recognising that every family possesses strengths that can be built upon, diversifying actions to address the unique needs of each family, and providing resources and support to enhance their capabilities (Rodrigo et al., 2010). Promoting this parenting approach also emphasises the need to foster the active engagement and participation of mothers, fathers and children throughout the intervention process. According to Lacharité et al. (2021), this participatory approach involves families taking a leading role both in understanding their parenting practices and in making decisions about the family work plan, the activities conducted, and how actions and decisions are evaluated. All this calls for action in organising services within this framework, implementing practices and programmes grounded in scientific evidence, and developing interprofessional skills to apply these practices and programmes effectively.

Rodrigo et al. (2015) found that the organisation of family support services should encompass attributes such as proximity and accessibility, flexible scheduling to suit family needs, cultural adaptability, and suitable spaces to ensure confidentiality and respect. Additionally, establishing interdisciplinary teams, coordinating intervention timelines, and articulating resources have been found to be best practices to consider in family support (Balsells et al., 2022).

According to the quality standards established by the European Family Support Network (EurofamNet, https://eurofamnet.eu/) (Özdemir et al., in press), a well-structured and systematic strategy is necessary for the implementation of evidence-based programmes in the area of positive parenting. These programmes are developed on a solid theoretical foundation and designed to be replicable and effective, with detailed content and clear procedures, all documented in a protocol or manual. Their goal is to provide capacity-building interventions that are relevant, accessible and adaptable to the diverse family needs and contexts (Rodrigo et al., 2023).

The implementation of these programmes also requires a careful balance between fidelity and flexibility. Fidelity in programme implementation entails adhering to the theoretical and methodological principles of the programme. Flexibility refers to the ability to adapt the programme to the specific characteristics of the local environment and the participating families as needed, while ensuring that the core elements of the programme remain intact. To support this, the manual should specify which criteria must be strictly followed to maintain the programme’s design quality standards and efficacy, and which elements may be adjusted without compromising on the core criteria (Barrera et al., 2017; Rodrigo et al., 2023). Furthermore, ongoing training and support for professionals are essential to ensure the correct application of the programme’s techniques and approaches. Lastly, implementation should have the support of the broader ecology, both institutional and community-based, as this is a critical factor in the programme’s sustainability (Fixsen et al., 2005; Gottfredson et al., 2015).

Regarding the evaluation of the implementation process, EurofamNet has proposed a multi-faceted methodological approach to achieve alignment between scientific evaluation standards and the practical and political realities guiding the selection of family support programme evaluation strategies (Almeida et al., 2022; European Family Support Network, 2020). This approach considers both professional practice and scientific criteria, with the aim of selecting scientifically rigorous and context-sensitive strategies (Almeida et al., 2022; Fives et al., 2017). Consequently, the implementation should assess both the process and the outcomes, as together these can help identify areas for improvement and adjustment of interventions to meet the evolving needs of families and local contexts. The results of these evaluations provide guidance for researchers, practitioners, policymakers and institutional stakeholders, fostering continuous innovation and improvement in family support services (Rodrigo et al., 2023).

In Spain, family care and support services and programmes are delivered by interdisciplinary teams comprising professionals from psychology, social work, social education, pedagogy and medicine (Pascual et al., 2019). These teams require interprofessional skills that go beyond traditional disciplinary perspectives. Research is advancing in analysing these competencies within the family support framework. Examples include the interprofessional competency guide (Rodrigo et al., 2021), which classifies competencies and micro-competencies related to service characteristics and organisational culture, the family engagement process, and the implementation of evidence-based practices and programmes. The catalogue of professional skills (Mešl et al., 2023) also emphasises that qualities such as accuracy, empathy, warmth, and authenticity among professionals can be associated with greater family satisfaction and, to a lesser extent, positive outcomes. Essential technical skills for professionals include empowering and enabling families, acquiring effective communication skills that reduce parental resistance and promoting real change. Other noteworthy skills include planning, decision-making, problem-solving, flexibility and adaptation to family needs, collaboration with other services and time management. Additionally, essential specific knowledge encompasses an understanding of the family context, equality and diversity. The acquisition and development of these competencies require professional training. Implementation quality depends on adequate training and quality-focused continuous professional development. The role of professionals is therefore central in evidence-based programmes (Hidalgo et al., 2023).

Reflective practice is an effective training strategy, as it recognises that professionals personally construct knowledge and intervention methods, which guides their work with families (Canavan et al., 2016). Given that professional practice relies on both explicit and implicit theoretical knowledge, alongside experience-based insights gained through practice (Jiménez et al., 2020), reflective practice fosters an ongoing dialogue between new knowledge, and personal processes and practices. This approach to training entails providing family support professionals with the necessary resources and training, fostering a culture of evaluation and promoting service innovation. Such training is rooted in sharing experiences, which result in enhanced understanding of situations. This complex practice not only involves words, knowledge and skills, but also offers profound insight into situations arising from experience, active listening and shared reflection (Lüthi & Zuntini, 2021). It can be affirmed that professional training through reflective practice is well-suited for acquiring the competencies needed to work within the positive parenting approach. However, as noted above, this approach also requires other changes in service organisation and adapting evidence-based programmes to different circumstances. This raises questions such as: How does reflective practice contribute to implementing an evidence-based programme? Can it facilitate changes in applying the parenting approach other than by helping professionals acquire competencies for implementation?

Rationale and objectives

These questions were answered by engaging in participatory research and reflective practice with the social services of the Lleida City Council to implement the ‘Comprehensive Care Programme for At-Risk Children, Adolescents, and Families’ (Balsells et al., 2024). The Programme was formulated following the eight quality standards defined by the European Family Support Network (EurofamNet): Defined Theoretical Model, Clearly Stated Objectives, Protocolised Manual, Guided by Evidence, Developmentally Appropriate to the ages and characteristics of children and adolescents as well as the skills of parents, Adaptable to the needs, characteristics, and expectations of the group, Participatory, and Capacity-building orientation (Bernedo et al., 2023; Özdemir et al., in press).

It is a psychoeducational programme aimed at better addressing the needs of children and adolescents through a predominantly participatory approach that involves all family members in building a shared understanding of each child’s parental ecology. A work plan is agreed upon in a participatory manner, which balances group and community-based methodologies with individual and family-focused approaches. This provides suitable support for family needs so they can fulfil their parenting responsibilities. The Programme uses a community approach and shared social responsibility that is supported by family cooperation, inter-institutional spaces and universal resources. The Programme’s aim is for both parents and children to reflect together on the needs of the children, reaching an agreement with the lead professional on the appropriate actions and goals to pursue at each stage.

Each meeting with the family is approached as a dialogue in which the professional adopts an exploratory stance on the family’s situation. Each family employs an experiential approach and uses open-ended questions to reflect on their model. This process helps them recognise both the strengths and gaps in how they support each child’s development and address individual needs (Balsells et al., 2023).

The objectives of this research were:

– To analyse how an evidence-based programme was adapted after a process of reflective practice.

– To identify strengths and limitations in the application of the methodology of the family intervention Programme.

– To observe changes in service organisation arising from a sustained process of reflective practice.

Methodology

Design

Relying on implementation science theory, a qualitative, participatory and improvement-orientated methodology was employed which was grounded in reflective practice. Reflective practice is a formative strategy involving a cyclical process of analysis, reflection and construction (Urrea-Monclús et al., 2024). This process draws on knowledge derived from personal and professional experience, considering the context and reflection on one’s own practice. When reflection is shared with other professionals, it deepens analysis, facilitates the sharing of knowledge and promotes its integration (Fuentes-Peláez et al., 2021).

Participants

The study participants comprised a group of 60 professionals from the Municipal Social Services and the Department for Social Action and Innovation of the Lleida City Council. Of these, 55 were women (92.6 %) and 5 were men (7.3 %). Regarding qualifications, the majority held degrees in social education (46; 76.6 %), with the remainder having qualifications related to the fields of social sciences and social services, primarily social integration (7; 11.6 %).

Procedure

This study started with a research contract between the Department for Social Action and Innovation of the Lleida City Council and the research team of the Abel Martínez Chair of Education and Adolescence at the University of Lleida (UdL), aimed at designing and evaluating a comprehensive support programme for children, adolescents and their families, based on the evidence-supported approach of positive parenting. The programme drew on three international initiatives.1

The study received approval from the Research Ethics Committee of the University of Lleida (CERT07) and an agreement was signed between the Lleida City Council and the Abel Martínez Chair of Education and Adolescence at the University of Lleida (UdL), which also established data protection measures. Social service professionals were informed of the study’s objectives, their right to anonymity and the confidentiality and/or protection of their personal data.

The programme was designed and implemented in four phases:

Phase One: A training day was held using reflective practice to discover the current approach to family intervention and reflect on the paradigms/perspectives/methodologies of socio-educational intervention. This culminated in a report on positive parenting best practices, which served as the basis for the co-design of the programme. The training spanned 20 hours and involved 25 professionals working directly with families, as well as heads of Social Services and Child Protection Services. These sessions also included three professionals from the research team, who facilitated the sessions.

Phase Two: The programme was co-designed based on the scientific evidence and analysis from the previous phase. Training was also provided for all professionals who were to implement the programme through reflective practices. This training also spanned 20 hours and involved a total of 54 professionals, of whom 47 were social educators and 7 were social integrators.

Phase Three: The programme was implemented by social services professionals trained in the previous phase. The professionals were organised into four groups, with weekly reflective practice sessions facilitated by the research team from the UdL. The aim of these sessions was to evaluate, modify, adjust, and ultimately, adapt the programme to the local context. This phase lasted for one year and included a total of 38 weekly two-hour sessions with each of the four groups of professionals, held in various facilities of Lleida’s Social Services. Two researchers from the team led these support sessions.

Phase Four: The results from the previous phases were validated in a final plenary session. This two-hour session involved all professionals engaged in the process and entailed a comprehensive review of the findings to ensure the consistency and validity of the results and conclusions drawn.

Instruments

Two instruments were used to collect data:

– Field Journal (FJ) of the support sessions. At the end of each session, two researchers completed this journal jointly, which resulted in four field journals corresponding to each of the four municipal groups. These journals documented detailed observations made by the researchers, as well as significant interventions and reflections of the participating professionals through reflective practice. Each session recorded information on: materials used, the number of sessions, professionals required to implement the programme, contextual resources utilised, other professionals involved in implementation, challenges and solutions encountered, model strengths and personal reflections from the professionals.

For identifying information about reflective practice, two variables were monitored: the municipal area where the follow-up took place and the session number, coded as follows: e.g., FJ2(group)e8(session number).

– Follow-up Diary (FD) for each programme implementation session. Completed by direct-service professionals after each family intervention session, this diary was hosted on the Typeform platform (www.typeform.com), used for data collection. For each entry, two variables were monitored: the family number and the follow-up diary entry number on this platform. This generated the following identification code, e.g., FD1(family)e8(entry number).

Results

The participation of social services professionals in this research facilitated the identification of reflective practice as a formative strategy that contributes to: (1) adapting the programme design to the context while ensuring quality standards are maintained; (2) the internalisation of the programme’s methodology by professionals; and (3) enabling organisational changes that support the incorporation of new structures.

1) Adaptation of the Programme design to the professional and family context

Our findings indicate that reflective practice with professionals facilitated the development of a design tailored to the contextual realities of those initially engaged in the Programme. Professionals reported that the case load for each team member, along with the intensity of work required for each family, often exceeded team capacity, particularly during Phases 1 and 2. To address this, the primary adaptation introduced was to differentiate two levels of intervention (medium and high) (Figure 2).

The initial proposal used what is now referred to as a high-intensity intervention. The development of the medium intensity option retained the general principles of the Programme and the use of the Triángulo P+ cycle (Figure 1), but reduced the duration of the individual-family intervention process from one year to six months.

An emerging result of adapting the initial Programme design into two intensities is that it made it possible to reach out to families that met the criteria for high-intensity intervention but faced significant barriers to committing to the associated demands. Professionals identified that the medium-intensity proposal served as a good entry point for these families, as it helped them gain confidence with the professional and understand the participatory, strengths-based approach.

Today, professionals mentioned that the high intensity of the model seems too long for some families, and it is difficult to hold sessions on a weekly basis. FJ1e20

Professionals explained how working with the families’ needs extends beyond the original high-intensity expectations (…) They mentioned the difficulty in reconciling the lack of consistency from families with the regular commitment required by the Programme. FJ3e24

2) Internalisation of the Programme methodology

The continuous and sustained reflective practice throughout the research process enabled the professionals to both acquire the necessary competencies to implement the Programme methodology and to assess its limitations and potential.

The professionals attributed the main methodological change to steps 1 and 2 of the Programme, which specifically required the acquisition of new professional competencies. These steps of the Triángulo P+ cycle aimed to build a shared vision with families regarding their situation, identifying strengths and areas for improvement in their parenting practices. As a result, the interviews shifted from being problem-focused to being based on guided reflection and experiential methodology. The professionals’ own participation in reflective practice helped them to experience and acquire the reflective methodology that they later employed with families during meetings.

Today, the professionals pointed out that one of the strengths of the Triangle is that it enables parents to engage in reflection (from a perspectivist standpoint), without judging what they do, addressing each need, how they address it and how they convey it to their children. They emphasised that this understanding and self-awareness helps them to make changes in their daily lives. FJ3e24

In today’s session, the professionals also mentioned the usefulness of the Triangle as a visual tool to explore the children’s needs and how parents respond to them. They noted that it functions like a map–a guide for conversation and joint exploration. FJ1e20

The professionals highlighted the significant value of the Triangle as a tool for both the family and themselves. They emphasised that it serves as a guide for exploration and, above all, for changing the parents’ perspective, enabling them to begin talking about themselves, about their family, and not about their problems. FJ3e24

The professionals identified the involvement of children and adolescents in the process and in all individual-family meetings as a strength. However, they also acknowledged the difficulties in scheduling family meetings within the families’ daily routines, especially due to the children’s academic activities and the parents’ work schedules. During the reflective practice sessions, the role of the professional when working with families struggling to engage in the Programme was questioned. Seeking their collaboration was not a requirement but rather an objective. Reflecting on this aspect provided professionals with an opportunity to redefine their role in family participation and realise that being proactive with families is an essential characteristic of the proposed socio-educational intervention.

A couple of professionals discussed the challenges they faced in scheduling sessions that explored the family’s needs, as well as difficulties in working with one of the parents. (…) They explained the difficulty caused by the absence of the mother and how it was impossible to hold family meetings with her for some time. FD4e13 The professionals emphasised the importance of choosing a more appropriate time for the session, as the child kept yawning. They spoke to the family and suggested changing the time for the session and are awaiting confirmation from the school about the availability of space and time for the session to take place at midday. FD1e430

Ultimately, more time, practice and reflection are needed for the adaptation of the P+ Triangle cycle methodology to be crystallised.

3) Organisational changes

The process of change instigated by the Programme’s implementation initially met with reluctance on the part of the professionals, who felt that they were facing greater challenges. Transforming the obstacles identified during reflective practice sessions into organisational changes highlights that the duration and consistency of reflective practice, along with the motivation of all participants, are essential for overcoming the perceived challenges.

Today, in the session with families, one of the professionals said that at the start of the process they were scared of the unknown and uncertain about how the process would unfold. This made them hesitant about the change and the new model. However, these feelings gave way to being motivated and having greater expectations, as they observed that efforts led to improvements in the families’ parenting practices. FJ1e23

Constant participation in reflective practice by direct family support professionals, mid-level managers in the department, and service coordinators helped establish a triple mechanism and iterative dialogue between parties. This made it possible to collect evidence of the Programme’s implementation; the necessary organisational changes for proper application were identified; and the responsibility for providing support to at-risk children and families was shared across structures and the wider context. The dynamics that ensured were crucial because, on one hand, professionals found the motivation to request and commit to the new methodology, and on the other hand, institutional leaders kept their motivation and willingness to implement organisational changes that allowed for the inclusion of new structures.

The professionals implementing the Programme identified several elements that were key to its sustainability:

They mentioned the need to hire more professionals and relieve them of certain administrative tasks (…) they also stated that ‘the full package is not complete.’ There is training, the model is there, but the support and shared responsibility from the context are lacking, as well as truly all-encompassing and fully-accessible spaces and resources for families. FJ4e18

They added that the Programme should not be perceived merely as a social services programme but as a child welfare programme run by the City Council. FJ2e19

To address these challenges, institutional leaders initiated various actions, such as an interdepartmental roundtable involving professionals from other departments with decision-making responsibilities regarding resources that shape family ecology (education, health, recreational activities…). Collaboration with schools has been enhanced to ensure their involvement in the family support Programme, providing physical and temporal spaces for family intervention sessions without disrupting academic schedules. In this regard, direct family support professionals noted:

Communication with the school and the ability to use their spaces is the perfect solution to include the school in the work with the Triangle methodology. FD1e402

Discussion and conclusions

Reflective practice with professionals mirrors the steps of the experiential methodology proposed for family intervention. Just as with families, what drives change, and the acquisition of new competencies is professionals’ reflection on their practice and the integration of elements from the new intervention methodology. For professionals to acquire new competencies, this reflection must shift from how current professional practice and family interactions are structured to how they could be improved. This, in turn, enables professionals to internalise the new work model and its principles, ultimately leading to a paradigm shift in family support and accompaniment from a positive parenting perspective. As Máiquez et al. (2000) stated, ‘experiential learning thus requires opening and closing the loop of the change process, from strengthening awareness to real-life growth and testing of personal resources’.

Furthermore, for competencies to be applied effectively, changes in thinking and procedures must be supported by structural changes in the system and the family ecology (Minuchin et al., 2009). Another finding of this study is the importance of the alignment and collaboration among all agents involved in the new methodology for supporting at-risk children and families: professionals, researchers, institutional leaders and contextual agents. This alignment was possible through the creation of shared meeting spaces and the use of reflective practice with different professionals and contextual agents who participate from within their roles and positions of responsibility. This enables decision-makers to view reflective practice as an indispensable element of professional practice that should be promoted. However, despite its relevance, there is still a need to raise awareness of the usefulness of this methodology in promoting professional practices, in which excessive bureaucratisation has a negative impact on reflective practice (Ferguson, 2018). This awareness is also necessary because the formative trajectory stems from the academic model, a professional tradition that is one-directional. Thus, introducing this type of reflective methodology entails transgressing the boundaries of this academic tradition to assume active roles and dynamics. In this context, there is a recognised need for training to acquire reflective competencies and interprofessional and transdisciplinary perspectives when working with and for families. Reflective practice is a formative methodology that is based on personal and professional experience within the particular context and reflection on one’s own practice, which, when socialised, allows for deeper reflection, sharing and integration of knowledge (Fuentes-Peláez et al., 2021). While training focuses on professionals, it is the responsibility of institutional agents to remove the obstacles that arise in relation to new family work models (Minuchin et al., 2009). Thus, policy-makers and institutional agents must advocate for the transition towards family– and community-based quality services and care; and take the necessary steps to ensure support and accompaniment for families to fulfil their caregiving and educational roles, appropriately responding to the needs and rights of children and adolescents, as outlined in European recommendations on positive parenting and child protection (European Commission, 2024; Council of Europe, 2006). Collaboration between stakeholders in practice, research and policy is key to the success of these initiatives, in order to provide a coherent and integrated approach to supporting families and promoting their positive development (Churchill et al., 2024; Rodrigo et al., 2023). Additionally, as Cortés-González et al. (2023) asserted, understanding interdisciplinarity as a strength in public policy and social action is also crucial for sustaining and ensuring the positive outcomes of such practices.

In line with this, some limitations were identified in the research process. Firstly, the lack of stability within social services professional teams and the high staff turnover rates. Secondly, the lack of continuous attendance at reflective practice sessions, particularly during times of work overload, sick leave or other work-related issues. Both factors limited the scope of reflective practices, as not all professionals could consistently engage in the complete process. Thirdly, there remains a persistent belief that scientific knowledge is that which originates from the research community and that such knowledge is objective and universal. These positions create complexities in the interaction between the practitioner-researcher and the academic researcher concerning the validation of certain knowledge or beliefs.

In this regard, with respect to the research domain, reflective practices have led the research team to reconsider their role as researchers and the position of scientific knowledge versus practical knowledge. The researcher ceases to be a mere transmitter of knowledge with the illusion of ‘objectivity.’ As Hordge-Freeman (2018) stated: ‘they are encouraged to be more transparent about how their research decisions are informed by and, in turn, inform their relationships, identities, and (emotional) experiences, as well as to share when and why changes in their approaches became necessary.’ The research methodology proposed in this study therefore highlights the importance of critically reflecting on aspects such as: positioning the researcher’s experience; reconsidering power dynamics during interactions with professionals; and fostering flexibility, which implies methodological self-awareness (Hordge-Freeman, 2018).

Implications for practice

The practical implication arising from this study is the need to introduce all professionals involved in family support to reflective practice and promote their training in such practice so that it can become embedded within organisational culture. This methodology is ideal for the acquisition of professional competencies and for promoting engagement in evidence-based practices that are better aligned with the needs and characteristics of families, thereby facilitating the integration of a positive parenting approach.

Contributions

Funding

This research is part of project R&D PID2022-137305NB-C21, and is developed under the protection of the research agreement between the Department of Social Action and Innovation of the City Council of Lleida (Spain) and the Chair of Education and Adolescence “Abel Martínez” from the University of Lleida (UdL).

Conflict interest

The authors declare that there is no conflict of interest.

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