Using Reflective Questions to Empower Parents – A Table Talk Wednesday Recap

Written by Julie Higginbotham, Senior Case Coordinator, Mecklenburg County CDSA

The sun was out, and we were raring to go for this month’s Table Talk Wednesday event as we talked about using reflective questions with families as we’re providing supports.  We had Maria Kosuda, Speech-Language Pathologist with the CDSA, and Sarah Turza, Developmental Specialist with the CDSA, facilitating this conversation.  The great thing about having them available to guide us is that they are both involved in our Master Coaching project here at the CDSA, so we knew we were in good hands.  We have been focusing a lot here lately on evidence-based practices and finding the best way to increase parents’ confidence and competence with their children.  Reflection is characteristic of an effective coaching process with families and caregivers.  Just as a quick reminder, reflective coaching includes asking Awareness, Analysis, Alternatives, and Action questions, and more details about each of these can be found in this CASEtool from FIPP.  With some return attendees and new faces in the discussion, we started off by listing some of the qualities of reflective questions.

Reflective questions are:

• Open-ended.
• A great starting point for getting a conversation going with a family.
• Helpful to increase parents’ capacity to come up with their own solutions.
• Useful so we can figure out what a parent already knows and/or has already tried.

The group then moved on to talking about our own experiences with using reflective questions and how it’s working out when we do.  Here were some thoughts…

• Instead of jumping in and giving suggestions, we should ask what the parent thinks first.
• Sometimes parents’ body language will shift as if they’re uncomfortable with trying to come up with their own answers at first.
• It’s important to establish a relationship with the family so they feel more comfortable with how you are gathering information, particularly on the front end.
• We have to be careful and ask questions in a way that is more conversational, rather than implying that the family is doing something wrong.
• Families need an intro into what we want to do and how we want to do it – this helps with their confidence and participation, and if we talk about empowering parents in the beginning, we can get much better results.
• Parents get much richer information and support from us when we are using reflective questions.

One of the most important thoughts that jumped out to me was that there is a misconception about how this should look – we aren’t there to drill parents with questions.  Folks commented that there was an initial feeling in shifting to this interaction style that we couldn’t share information with families, but instead only ask questions to lead parents and caregivers where they needed to go.  Maria talked about a feeding assessment with a family where the mother had tried everything that Maria would have suggested up front – but she only knew that because she was asking questions about how things were going up to that point. Once Maria understood what the parent knew and what she had tried, she could begin problem-solving with the parent for some additional strategies. She could have gone in and just shared information and strategies, but what would have that parent gotten out of that interaction?  Not much….

One person made a fantastic statement about how reflective questions can help bring out parents’ resourcefulness.  How often do we sit with parents and really call attention their efforts and how good they are at meeting their needs, whether that means supporting their children’s development or something else?  I love that part of my job, and the point was made that reflective questions can help curb our own “stuff” that might lead to our making judgments that aren’t quite accurate.  There’s a level of respect in honoring what the family brings to the table and understanding that the parents truly are the experts on their children.

We moved on to talking about reflective questions more specifically from a provider’s standpoint – service coordinators certainly experience these too, but often in a different way because that role is a more global support for families, as opposed to the role the providers play in targeting the outcomes and making progress in those daily routines.  One provider commented on how she is working on adjusting her work to involve the parents more by asking reflective questions and listening to what the parents are already doing.  She has been so used to asking questions to get information she needed and providing more direct support to children, and she’s incorporating more of these coaching concepts into her work.  Some food for thought included….

• It’s hard not to share all of the information we know.
• We get to share the information we have learned in school and over the years, just in a different way.
• Parents get frustrated when they feel like they can’t do something, and it can make it worse for them if we can.
• Reflective questions help get parents more involved and can improve relationships.
• When parents ask a question, we don’t have to answer immediately. We can ask what the parent thinks first, then work together to see how that information translates into the family’s daily routines.
• It’s normal to feel like we’re stuttering around as we try to reframe questions in the moment when we’re talking to families and trying to do this the way we know the evidence says is most effective…and thankfully, Maria assured us all that this does not require the additional assistance from a Speech-Language Pathologist!

This made me think about something else that has always troubled me.  Because I was writing so fast that my paper was smoking a little, I didn’t get to bring it up to see what the group thought.  I guess that’s what happens when you put a group of brilliant people in one room to share their thoughts.  🙂  Anyway, I often hear folks say that they are unsure of their role as early interventionists if they can’t share the knowledge that they bring to the table.  It occurred to me during this conversation that, with Maria’s example, she knew that the mother had done everything she could because she was the professional – she knew what she was hearing and knew where to go next because she brings lots of education and experience to the table.  When we are using reflective questions, we know what we’re listening for, and when we hear a gap somewhere, we have a better idea of how to coach a family through to the next step.  That might not be super enlightening to everyone, but it sure gave me a new way to talk to my colleagues about why they are so valuable in this whole scheme.

I really loved this conversation because it gave families credit for feeling like they aren’t supposed to have the answers.  It also gave us the same credit for trying to figure out how we each fit into this big picture of reflective questioning and coaching interactions.  We recognized that there are always things to keep in mind, especially meeting families and ourselves where we are so we can move forward together.  With all of this in mind, the CASEtool on using reflective questions has a great guide on the last page that gives examples of each kind of reflective question to get you going – take a look and let us know how that’s working for you!

Join us on June 17, 2015 for our next Table Talk Wednesday event – we’ll be talking about Diversity with a Difference as we discuss how we use coaching interactions with families when there are other mental health or learning disabilities to consider.