Preventing burnout with reflective practice groups (with Shane Puxley)

[00:00:05] Bronwyn: Hey, mental workers. You're listening to the Mental Work podcast, the podcast about working in mental health for mental health workers. I'm your host, Bronwyn Milkins, and today we are talking about reflective practice groups as a burnout prevention tool.

Burnout is real bad, in case you haven't heard about it, and it's actually a really significant concern for mental health professionals. I had a quick look around at the stats and there's lots of studies which show that up to 84% of mental health professionals in Australia reported experiencing it in 2022. So that was a few years ago. That was some data that was collected from a large sample of healthcare professionals, and that's a lot that's eight out of 10 healthcare workers are going to experience burnout, which is a significantly negative experience.

You're gonna have exhaustion, increased mental distance from your job. You are gonna have feelings of negativity and cynicism, and it also leads to reduced professional efficacy. It's like you're not able to do your best work if you're in a burnt out state, which makes sense.

In this episode, we're going to explore how reflective practice groups can help prevent burnout and help mental health workers connect, validate their experiences, and gain the tools to navigate the demands of their roles. Here to help us out is a former guest, and I'm very glad to have them back on the podcast, and their name is Shane Puxley.

Hi Shane.

[00:01:25] Shane: Hi, Bron. Thanks for having me.

[00:01:27] Bronwyn: It's such a pleasure to have you back. The previous episode you were on was titled, what does a Community Psychologist Do? And at the time you were a registrar and now you are fully endorsed.

[00:01:39] Shane: That's right. That's right.

[00:01:41] Bronwyn: Congratulations.

[00:01:43] Shane: Thank you. Yeah, it's, it's, um, it's a club that I'm happy to be part of.

[00:01:47] Bronwyn: Yeah, it's a very cool club. I've heard it's very exclusive.

[00:01:52] Shane: Uh, perhaps it's certainly a club where people are very passionate about what they do and it's nice to connect with like-minded folk.

[00:02:00] Bronwyn: Yeah. That is so cool. And Shane, could you please remind listeners who you are, and the question I have for you today is tell us something wholesome that has happened to you recently.

[00:02:10] Shane: Yeah. So I'm Shane Puxley, as I spoke about at length in the previous episode, um, community psychology is my passion. I think we also talked about music and all sorts of other fun things as well. Something wholesome that's happened recently was, um, my brother had his first child.

[00:02:29] Bronwyn: Aw.

[00:02:29] Shane: Um, I'm an uncle to, to Lucas, little Lucas, who's at the time of recording, nine days old.

[00:02:37] Bronwyn: Wow. Oh, such a little, little baby.

[00:02:41] Shane: Yeah. So it was pretty exciting to hold him and, a pretty amazing experience to have someone so small and, it, it's hard to, it's hard to talk about without getting misty-eyed, I think.

[00:02:51] Bronwyn: Oh, totally. It's like, I'm just trying to imagine, Yeah. What a joyous experience to you that is so wholesome.

[00:02:57] Shane: Yeah. Thank you. It was, yeah, a bit of a tricky question, but I mean, it's hard to top that really.

[00:03:03] Bronwyn: No ab-, absolutely, definitely. Well, thank you so much for coming on again. So we're going to be talking about reflective practice groups, and I think the first thing is, what is a reflective practice group and how does it differ from supervisional therapy?

[00:03:18] Shane: Some of your listeners may be interested in pursuing their board approved supervisor training at some point, and the term reflective practice is a really common thing that's talked about in that space, and that can be a little bit confusing when we think about reflective practice groups.

There's this, uh, excellent training series from the women at Think Well Consultancy and through Take Two as well, where they talk about reflective practice as a noun and a verb. So today we're talking more about the noun, the event of a reflective practice group. I'm going to a reflective practice session. Um, whereas all psychologists will use the skills of reflective practice day in, day out. So, you know, apologies for starting on a slightly confusing note.

[00:04:04] Bronwyn: No, no, no. That makes sense. Okay. So, uh, reflective practice as the verb is like every day I am going to be reflectively practicing on my practice. So I'm gonna be thinking what happened in that interaction just then, and a few other questions about that. And then the noun is the, the group, the event. So we are refle- ref- going to be reflecting. Is that right?

[00:04:30] Shane: So in the community sector, you'll have people talk about, it'll have it in their diaries as reflective practice. I'm going to reflective practice. And so it's a space, it's an event, it's a fortnightly session.

[00:04:42] Bronwyn: What drew you to reflective practice groups as opposed to some other way of exploring how we do our work?

[00:04:52] Shane: It's like a lot of things in our career, it was, um, accidental. Uh, I think that reflective practice groups, has been facilitating a reflective practice group, has been part of my role across the last 10 years. And I think in Victorian not-for-profit or community sector organizations, it's a fairly common undertaking to have one of these sessions as, as part of the the fortnight.

Um, in 2019, I took the opportunity to move into a consultancy role supporting youth workers and social workers who care for the children in our residential care settings. And, working in this non-direct client-facing role was really suitable to my training in community psychology. And at one point in 2020, I saw myself facilitating nine of these groups per fortnight. And it was, yeah. But it was, yeah, that, that's how most people respond.

Um, and there is some reluctance for some clinicians to hold these spaces. There's a sense that working in a group, uh, that's unpredictable and sometimes clinicians find these spaces quite difficult to facilitate that. It's a very different part of the work from the direct client facing work where there's a lot of training and experience and you know, sometimes we only get a chance to look at group work from a theoretical lens in our training.

Um, and so in 2020... When you think about the out-of-home care sector, there's a an enormous turnover of staff at the best of times. But there was something, there was certainly something about that year that made things quite different in Melbourne, and I had this project with the leadership team at this organization to think about, well, how do we show staff that they matter? How do we show them that they're valued when they're being asked to go in their full PPE and go to work and, and do this work with the most vulnerable and traumatized young people in our state?

Um, and I guess I had this sort of epiphany that it wasn't about some sort of top down acknowledgement. It wasn't about the organization, um, who, whose hands were tied in terms of what they could and couldn't offer, um, financially and, and, and practically. It wasn't about what a top down leadership role could offer these people to show they were mattered and... that they mattered and that they valued it was about what their peers showed them in these reflective groups. And um, yeah, there's something really wonderful about being privy to that and being close to that experience.

[00:07:15] Bronwyn: Yeah, maybe can you tell us what goes down in a reflective practice group? Because, I've never been in one that's called Reflective Practice Group, but I wonder if some of the experiences that I have had in supervision and maybe listeners have had in supervision overlaps with it? Yeah, so could you take us through what one looks like?

[00:07:36] Shane: Absolutely, and you, you're so right. It's so much more aligned with a supervision group or even an individual supervision in some ways than a therapy space. You know, therapy is about, about wellbeing, about change, uh, uh, reflective practice groups about practice development and enhancing skills and, and cohesiveness and connectedness with peers.

One of the most common ways that these groups are structured is with this Gibbs Reflective cycle and it... the vague premise is, let's not rush to solutions. Let's, let's sit with it. Let's sit with the messiness. You know, these, these roles are so fast paced and, and for psychologists, sometimes your roles can be really fast paced.

And this is an intentional hour per fortnight, or 90 minutes per fortnight, where you've got someone facilitating a space where the goal is to slow down, to pause, to talk about, well, what's happened? How have we taken some meaning from that? What was good or bad about the experience? What might we do differently in the future? But being very intentional not to rush to that solution focused perspective until perhaps the last sort of quarter or 20% of the, of the, of the time allocated.

I think when people are in, uh, resource scarce, fast-paced environments, they're being asked to constantly problem solve and to just do, keep doing. And there's something about a reflective space that gives us a chance to pause and to consider and to, to realize that a lot of the concerns people are bringing have a lot of overlap with their peers. So they get that sense of, of, um, of belonging.

[00:09:19] Bronwyn: It sounds like it can be a pretty vulnerable space.

[00:09:23] Shane: Yes, uh, certainly. Um, and like any group, it would go through different, um, iterations. It was, you know, the, the forming, storming, norming, performing, adjoining cycle. And so at different times it's more vulnerable than others. I think it's very important that a facilitator has the ability to induct new members to a group to make sure that they can sort of get a sense of the pace. Um, gosh, I think about primary school, Bron, when there was the jump rope for heart when there...

[00:09:53] Bronwyn: Yes, I remember that!

[00:09:55] Shane: ...that huge rope where two people would be standing 15 meters apart and swinging the rope around, and the person would stand there with their hands in front of their chest like a T-Rex and waiting for that time to jump in.

Um, well let's, let's give the new person in the group a chance to be that, that person waiting to sort of check the pace of things and the, the norms of how we do things around here and, and offer and, and generally nominate someone else that's a more, um, longer term attendee to, to help you with inducting that person into the group norms.

[00:10:29] Bronwyn: Yeah. Okay. So it can be a vulnerable space. It's a space of reflection. Something else I picked up in your description was that it's a place for connecting. So you mentioned that sometimes people and workers in these groups, they have the experience where they're like, huh, maybe I'm not the only one experiencing this.

[00:10:47] Shane: Yeah. And, and I guess the more often I saw that. That was when I had the 'Aha' movement in terms of considering it as a preventative space for burnout. Um, you know, when you think about the different aspects of burnout and how it's described, that that diminished sense of professional efficacy... to say the quiet parts out loud, to talk about the, the, the difficult things in, in the work and to realize that it's, it's not this private anxiety that people have to marinate in that to actually share it with their peers and to realize that, oh gosh, even that person that seems hyper competent and experienced is sitting with the same anxieties as the, as the grad student or the, the early career psych. And it's just this sense of, um, you, you just watch the group bond over, over, over these discussions, the vulnerability.

[00:11:43] Bronwyn: That really resonates with me. I think there's, uh, I wonder if there's been no better moment for like me in supervision where I've said the quiet part out loud and I've been like, I'm struggling with this. And then somebody else is like, you know, I'm struggling with that too. And you're like, wow. Yeah, exactly as you said. And it's because I think with burnout, the starting stages, at least for me, and I guess I've heard this from other people as well, is that you automatically jump to blaming yourself and you're like, I'm not cut out for this work. And then so hearing that reflected in somebody else and being like, "Hey, I'm actually struggling with this too", can be very validating. I wonder if there's been some remnant of that in your experiences facilitating these groups.

[00:12:26] Shane: Oh goodness. Absolutely. Absolutely. And, look, these, these groups aren't a primary prevention space. I think there's certainly things around workplace culture or even, a more wider cultural context about the role that work plays in our lives that we need to consider as more if we're looking at burnout from a primary prevention perspective.

But this idea of secondary prevention, that there's foreseeable risks of doing this work and that to... validating and connecting with peers that are going through the same difficulties that, um, I, I guess that my, my hope is that the more we can think about it through a preventative lens, the less we have this, um, I dunno if it's unspoken or sometimes people do say this, that it's a rite of passage to burn out. Um, I wish that wasn't the case.

[00:13:18] Bronwyn: Yeah.

[00:13:19] Shane: -Have to be the case?

[00:13:19] Bronwyn: -so too. I, I don't think it does. Like, I mean, one tagline I came up for the podcast quite early on was that I wanted to help early career psychologists skip the burnout, um, because it did seem like it was inevitable, um, that you had to go through this as a rite of passage, whereas I would hope it's not.

[00:13:39] Shane: Yeah. So if there's foreseeable ways that we can try and reduce that risk. I'm not sure we can eliminate it, but reduce and try to prevent and use the tools that we have available to us. Well, you know, I feel like that...

It was interesting when I did the board proof supervisor training, something that really sat me down in my seat and made me think was this idea that self-care is an ethical imperative. Um, that really floored me. You know, I think that reaching for sweet, salty, or fatty food on a Friday after a long week is sort of, you know, just a way to cope. But when you frame it in terms of, oh, am I being an ethical clinician? Am I being an ethical supervisor? If I can't look after myself and I'm sitting in spaces trying to hold people through their own difficulties, is that, is there an ethical question about self-care?

And I guess that was really sh- that shone a light on me in terms of. It's funny, the hooks that get into us, but that, that, that shone a light in terms of, no, there definitely is something at an individual level to be mindful of, to keep us safe. But with burnout, we need to be so mindful that, you know, it is largely around organizational culture, around organization and program structure. You know, how do we, how do we as psychologists not just get caught in these, reactive spaces where we're trying to support people once they've already, um, being impacted. How do we get a seat at the table when we're doing this program design and, and thinking about about wellbeing from the get go?

[00:15:13] Bronwyn: It's interesting that that scraped you do. So has that led to you being like, okay, reflective practice groups, we need to commit to doing this more? Like as organizations, as psychologists?

[00:15:28] Shane: Yeah, well, I mean, it certainly led to me, wanting to write more about this topic and read more about this topic and, wave my advocacy flag for this space. It's something that I enjoy facilitating and I'm, it really lights me up when I get opportunities to hold these spaces. But yeah, I do believe in it from a research, but also an experiential, anecdotal experience that this stuff works.

[00:15:56] Bronwyn: Mm. Is that something that you've seen studies on or have you measured it yourself, or could you tell us the ex- experiential stuff, like what you've noticed about the benefits?

[00:16:08] Shane: Yeah. Well, some people just directly telling me that I... they're in a rough spot until these spaces gave them an outlet and a connection piece and made them realize that they weren't so alone with their fears around incompetence.

And I guess the trickiness with burnout across the helping profession is that that's a benefit and also a drawback that sometimes, um, well good people burn out people that are, I mean, um, Gordon Parker and colleagues, Gordon Parker, the founder of the Black Dog Institute, they wrote this amazing book about burnout in 2021. Um, and they drill down to the individual level in terms of personality construct and how that can be linked to, to burnout. And they talked about dutiful, dutifulness conscientiousness and perfectionism as as personality traits that are linked to burnout. And so, you know, the on only conclusion to take from that is, well, good people burn out, people that stay back late, that do the extra yard. Yeah, so I mean, the research is tricky when we think about it from a preventative lens because, yeah, that's not as easy to measure perhaps?

[00:17:20] Bronwyn: No, I, I was just thinking about how you would measure that. And here's my, uh, 30 second research design. I think what you would need to do would be to grab. Okay. Same sample of healthcare professionals in the same setting. And you just follow one group, naturalistically. So you just measure their burnout at month one, month six, and then month 12. And then you give the other group of matched professionals, the Reflective Practice groups, and see if there's a difference in their burnout scores. Um, but that would be a really expensive study and like yeah, really committed. That's a, that's a big ask like. Undertaking to do, and it doesn't sound like anybody's done it.

[00:17:59] Shane: No, and, and this, um, yeah, the, the burnout book from, from 2021 from Sydney was they, they had their own measure because they talked about-

[00:18:08] Bronwyn: Is that the [inaudible] one?

[00:18:12] Shane: Uh, oh gosh, I'm not sure. I think they call it this, the Sydney Burnout Measure.

[00:18:14] Bronwyn: Yeah, no. Okay. I know the, I'm familiar with that one because I was looking for burnout measures and I was like, surely this Maslac one from like 30 years ago isn't the most up-to-date burnout measure. So a few years ago I was looking at them and I could find the Oldenberg one, but I think that's pretty old as well. And then I found this Sydney one a few years ago, and I was like, yes, finally an updated construct of burnout. Um, so yes, I'm familiar with the one you're talking about and I like it.

[00:18:40] Shane: And the key thing they add to it is this fourth dimension, right? So you've got the world Health Organization talking about the emotional exhaustion, the reduced pre, uh, professional efficacy, um, and the, the, the mental distance to one's work. And the, the fourth dimension that they added with, quite a lot of, validity and reliability, I believe is this idea of cognitive impairment.

[00:19:05] Bronwyn: Yes. That's the one I remember. Yeah.

[00:19:07] Shane: Yeah. Uh, gosh. I just think about for psychologists, sort of, you know, this is an early career psychology space and a lot of listeners are still in that churn of the, of the competitiveness of trying to get to that next part of the career. And, you know, it's really ripe for inter intersecting with, with these constructs. And that's why, rather than just saying, oh, this is this inevitable path we're all on. Well, what are some of the ways we can slow that? Or, or, or, or intervene.

[00:19:37] Bronwyn: Yeah, absolutely. It's such an important space when you frame it like that because cognitive decline is not something to laugh at. It's like, it's really serious. It's like your attention is shot, your memory is shot. Like, that's bad.

[00:19:50] Shane: I saw this amazing study, um, out of India and it was before and after the harvest, and they found that when people were sort of at the end of their year that, you know, the harvest was 11 months ago, they were sort of running low on, on resources in the family and the community that after a successful harvest, people's IQ scores were boosted by, I, I believe it was 12 points on average. And so-

[00:20:18] Bronwyn: Amazing.

[00:20:19] Shane: You're talking about jumping from one category to the other. And, um, you know, when you think about the role that chronic stress plays, because acute stress is great, right? Like, we wouldn't do this work if we weren't excited by moments of problem solving and supporting people through tricky ins- instances.

But that chronic stress is tricky and that cognitive impairment that comes with that mental load. Um, well, yeah, of course you're going to feel this level of, um, ineffectiveness in your work day to day because you're probably, you're possibly impacted.

[00:20:54] Bronwyn: Yeah. I mean, I usually say to clients it's like our bodies weren't built to perpetually sprint away from lions. It's like we could muster up the energy in one encounter perhaps, but yet we're not supposed to be for kilometers on end sprinting away. We we're just not built for it.

[00:21:12] Shane: No, and I guess that's where my comm psych lens thinks about, well, why do we expect that of employees? Why do we design workplaces and industries where that level of, um, commitment, I guess is how they'd frame it. But, you know, that's, that's a lot to ask of people and, and a lot to ask of ourselves.

[00:21:33] Bronwyn: It is. Do you have an answer for that? I mean, like, it's a big question and it's probably mean to ask if you have an answer, but I'm just interested.

[00:21:41] Shane: I suppose in, in line with this discussion, we're thinking about levels of prevention and, gosh, in terms of primary prevention, um, there's a feller on my Instagram feed walking the length of Australia to raise awareness for universal basic income. Um, you know, what are these more societal, primary prevention things that can, you know, even things like the urban sprawl and people living in fresh food deserts and being asked to sort of commute for such long periods of time, you know, we can easily say, well, you know, managing burnouts around getting time and nature and cardio exercise and eating a balanced diet and social connection. And then people are sitting in their cars for 90 minutes each way to work. Well, that makes those other four things hard to access.

So yeah, just thinking about it from a wider, you know, what sort of community do we want to build? Do we want walkable cities? Do we want, um, cycling infrastructure? So, you know, this is right on the limits of psychology now, where, but this is sort of, you know, if we think about primary prevention, it probably has to be a bigger discussion than just designing optimal workplaces.

[00:22:51] Bronwyn: Yeah, absolutely. I completely agree. It's, it's so funny hearing you say that because uh, it's just so annoying. Like with our training, well, my training as a psychologist, it's so individual focused. And so that's the lens that I automatically look at through. And then I remember you and you have a community systems approach and I'm like, oh yeah, all this other stuff exists and like that sounds like a good explanation.

As you're talking, I was thinking back to a time when I was working and I was traveling about 60 minutes there and back to get to work, and my office was a small room with no windows and there was no walkable spaces around it. And I remember how miserable I was at that office compared to another office where it was a 10 minute commute. I could go for a walk at lunch and I had a window in my room. And that was just like a basic difference.

[00:23:35] Shane: Absolutely. And I can see how that relates to the individual and the community. Um, where humans are, house plants with more complex emotions is one of my favorite.

[00:23:45] Bronwyn: Yeah, it's so true. I need to be watered.

[00:23:50] Shane: Gimme some oxygen and and sunlight.

[00:23:52] Bronwyn: Yeah, absolutely. Um, but yeah, it's, it's also those, those broader social context, like you said, like food insecurity or health insecurity. Um, not having access to walkable spaces. And I think of the mental health industry as well, and it's like, you know, always trying to squeeze more from an underfunded place.

[00:24:13] Shane: Oh, totally. Totally. And I guess that's why when I think about this in my own writing and my own sort of journey on considering burnout prevention, I, I do think about it through those ecological levels. You know, thinking about it from, all right, what, what can we do as individuals? If self-care is an ethical imperative, then what, what steps can I take that are in my locus of control?

But then also thinking about, well, well, what does that look like in a family system? You know? What about, people that live in that sandwich generation where they're caring for children and caring for their parents, or, um, women that are being asked to work long hours because of interest rates and all sorts of societal, cultural pressures. But then still having the, the expectation to do all the domestic labor at home. I think it would be a trap to only think about burnout in the workplace context. I think that's probably a limitation of the World Health Organization's conceptualization that if we think about those dutiful, perfectionistic and conscientious traits, well, they don't get switched off when people have a sick parent or a sick child or, um, you know, the burnout's real across all spheres.

[00:25:23] Bronwyn: Yeah, I completely agree. It's something I've been interested in over the past two years actually, because you're right. So the World Health Organization and in the ICD 11, they define burnout as an occupational syndrome. So purely coming from work, um, but the ways that I'm seeing burnout symptoms crop up in people is through like parental burnout. It's like you're working a 24 7 job, uh, without remuneration. And it's hard. It's, it can be very hard to be a parent.

Um, but it's not, it's almost, it's the scenario of where the wording around it is not commonplace that I feel like people find it difficult to validate their own experiences and they're like, this should be easier and it's me that is the problem. I think there's a lot of validity to having the words outside of occupational syndrome to different facets of our lives that cause these burnout symptoms.

[00:26:17] Shane: Absolutely. Absolutely. Of course, you know, Gordon Parker and colleagues from the Black Dog Institute will, um, they conceptualize burnout as a gray dog, not a black dog. That there's, there's, there's actually a lot more hope that... gosh, some of the symptoms are eely, similar to depression, a major depressive episode. Um, but the remedies are more e- easily, well, not easily, but there, there, there's more of a roadmap for a quicker turnaround perhaps.

Um, but again, like I, I hear myself and I'm, I'm talking about the evidence available to us and I'm, I'm coming from this place of how to respond once it's already a thing, and, um, yeah, I guess my real hope in starting this conversation and um, is just considering, well, where do we get upstream, slightly? Where do we start to sort of put some, some preventative measures in place so that people don't have to go to this dark place?

[00:27:15] Bronwyn: I think it'd be awesome. I think we could learn a lot from the sectors that you've been in. So you've delivered these groups in forensic educational context, it sounds like, youth- to youth workers, social workers. Is that right?

[00:27:25] Shane: Yeah.

[00:27:27] Bronwyn: And what if you, what have you observed about delivering these groups in these different contexts? Like what have you learned from these experiences?

[00:27:35] Shane: It certainly differs a according, um, to the sector. Uh, I've, I've got one at the moment with, with. Other psychologists, which is a really cool experience. Um, but you just have to respect the norms and the expectations across these different settings. So thinking about that community readiness model in terms of, well, how ready is this particular group, um, which often linked to the sector they work in to, to reflect in this deep vulnerable way?

So I have this experience with a, with a primary school where, I must admit, I, I, I spoke about the benefits of holding a reflective practice space across the school term, and I suspect that the principal that possibly prime their staff for more of a, a structured debrief space. Um, and sometimes there's, there's overlap in how these models are, how these models are built. So often they're, you know, if you think about in a, in a nursing ward, you know, as a post-traumatic debrief space, which, you know, we know has all sorts of limitations to it.

But I remember sitting in this school and, um, being a little bit overwhelmed by the level of. Emotion, uh, to, to, to reflect in a way that is probably par for the course for a lot of community sector workers. They've, they've sort of had that, that training and that experience that, you know, to do the work well. We have to be aware of what we're bringing and, um, I guess boundaries and countertransference and these concepts.

And... but I think it's also a rite of passage for clinicians to be humbled when they're facilitating these spaces. I think if anyone goes in hot with jargon, with too quick to complex psycho-ed, that we can often not meet people where they're at. Um, and so just sort of going in gently and, like any, I spoke earlier about the forming, storming, norming, performing, uh, et cetera.

And, in that forming stage, be prepared to be, uh, quite a hands-on facilitator to show you're working to speak more often, then as the group becomes established, you get a chance to really fade back and just get the group to, um, regulate itself and to to, to have its own, um, rhythms.

[00:29:58] Bronwyn: Yeah. It, I guess what strikes me is that it really sounds in these groups that you're giving participants a space to voice how they are truly feeling, like you said earlier, to voice, I guess what, what hasn't been spoken about.

[00:30:11] Shane: I'm aware that it's because I'm so interested in this space and I've done it for so long. There's a risk that I'm trying to speak at, at an inaccessible level. Um, but on a very practical level, the way the group would start is me acknowledging the, the traditional owners of where we are. Um, inducting any new member to the group. Going through this check-in process where we go around in a circle and we talk about how someone's fairing and any particular topics they'd like to bring to the group. I then go through an informal agenda of themes that have come up in people's individual check-ins, and then as a group we process those themes.

And then as a facilitator, I really step back and the group starts to connect over these particular topics. And then I'll finish by, by checking out, you know, what, what do people take from this? What would they like to, to do about it? Um, so that, that's on a very practical level, how it's held.

[00:31:06] Bronwyn: Yeah, but I really like that and I don't think that that's inaccessible as well. I think that's very accessible and it, I, I'll give you the contrast to I guess how I've had group supervision early on as a psychologist.

It would be, okay, we have enough time today to discuss one to two cases and maybe 10 minutes we can dedicate towards admin, and that was my supervision for years. There was no reflective space. So yeah, to me that's like a novel alternative that that could be really, really beneficial.

[00:31:36] Shane: I couldn't agree more. And I, that has also been my experience and, um, to try and elevate those spaces. Sometimes you'd get a facilitator that's willing to, to share a journal article a week in advance, so there can be some sort of deeper focus on a, a practice topic or something. But yeah, the, the case review format, um, on a personal level, it feels a bit tired at times.

[00:32:02] Bronwyn: Yeah, I agree. Um, I mainly focus my supervision now about transference countertransference how I'm feeling and about my reactions. Like literally I write down my reflections and then I use that as the starting point for supervision. That's how I prefer to do it nowadays and I find that it's much better for me again, like, you know, n equals one, but I've found that it's been a much better burnout prevention tool than the other type of supervision that I received for years.

[00:32:28] Shane: I'm glad to hear it.

[00:32:30] Bronwyn: Yeah, so I'm pro, I am pro reflective groups. This sounds amazing and I think just many people aren't exposed to the power of groups. But groups are really powerful and I love them. I love groups. I just find that they're amazing spaces where people can feel not alone with their experiences, that they can see themselves reflected in other people or work out what they wanna do through interacting with other people, try out new stuff. I don't know if you feel similarly about groups.

[00:32:56] Shane: Oh, absolutely. You know, there's so many people that speak about groups in this aspirational sense. Wouldn't it be great if we could dot, dot, dot. And so the, the privilege I feel to be facilitating these groups and to, to see them work, you know, in my, in, in my n of one experience, the jury's out they work.

But then when you think about it from a bean counter's perspective and, and how these organizations structure financially. I can, I can see that it would be a very quick summation of, oh, do I have x amount of people offline from the direct client work for this hour and pay the facilitator? And all of a sudden it looks like this huge financial impost on the organization.

And I, I get a bit frustrated because that seems like, you know, not to create a straw man. I've heard this argument articulated before. I get a sense that that's a little bit shortsighted to, to look at our time and, our wages in terms of time being the only resource. But what about energy and staff turnover? And what about offering our clients trauma informed care because they get more consistent, predictable, and long lasting staff?

You know, if these spaces can actually do what it says on the tin, then yes, there is a, there is a a cost in these discrete blocks of time, each fortnight. Um, and sometimes they have to push it out to every four weeks, which is not ideal, but if, if it's practical, um, then it has to be done. But I, I suspect that the return of investment, if we, if we zoom out in terms of onboarding new staff and, you know, all of those extra costs, um, I, I suspect it probably is cost effective.

[00:34:38] Bronwyn: Yeah, I remember seeing a report, gosh, this must have been over 10 years ago, but there has been costing about investment in mental health. And my recollection is that it produces more, so for every dollar you invest in the mental health sector, you get a dollar 50 back. And that's in return for people being able to live their lives the way that they want to, um, and to have, have relationships, be able to participate in work, participate in their community. So it's a worthwhile investment. And yeah, I do wonder whether having these reflective spaces could be similar.

[00:35:10] Shane: I suspect a lot of people would read that same report and take from that, oh, let's have an EAP program, which of course there's a place for that. I, I've definitely accessed EAP and I would urge the listeners to utilize the, the, the tools that are given to you to manage this work. There, there is also a reactive component to being in this work. Is it just about EAP or are there some some prevention measures we can be looking at too?

[00:35:39] Bronwyn: I reckon us as psychologists, as mental health professionals, we are wanting to go towards prevention. Like we see the, the consequences of poor mental health every day. And yeah, I reckon as a sector we want it.

How do we get the decision makers to listen? Like have you had difficulty putting across like, Hey, let me come in here and do these reflective practice groups. It'll be a good prevention. Have you had pushback, or have people in those positions been like, okay, let's give this a go.

[00:36:06] Shane: Uh, not moment to moment, but they don't always get up. You know, sometimes there's the, you know, in, in the discussion with someone, there's, there's, um, a sense that it would be a good idea, but there's, I, I guess unforeseen difficulties. I think the most resistance these groups face in my anecdotal N of one experience is that the management class can have a sense that it's a venting space and that it's a, it's a blaming space for the managers and...

[00:36:32] Bronwyn: uh, okay. They're gonna bitch about us.

[00:36:35] Shane: Well, totally, that's the, again, the fear that's sometimes unspoken or sometimes very overtly spoken about and I really feel for leaders in these, in these orgs because they're often quite bureaucratically structured and they're sort of in that, you know that, that equation around burnout, where it's about job demand, job ambiguity, versus control and, you know, the Michael Marmots' Whitehall study, um, where they looked at, oh, it's not people at the top of the tree in the C-suite that are having heart disease. It's people that are squeezed in that middle management space where they've got this sense of lots of expectation, but not a huge amount of control on how they, how they, how they execute.

Um, so yeah, I can see that those people that are already possibly quite... the possibly candidates for burnout themselves might feel like, oh, just a venting space to complain about all the stuff that we can't change anyway. Well, that's also on the facilitator to make sure the group doesn't go that direction.

[00:37:35] Bronwyn: Yeah, I was just putting my, trying to put myself in their shoes as well, and I'm like, oh yeah, so they'll... Are they thinking that these groups could be okay. They're gonna draw out how they're actually feeling. Like say the quiet things in their head out loud. And then they're gonna be motivated to put in a work cover claim, so like a psychological injury claim. And then that's gonna open a whole can of worms and we don't wanna deal with those HR issues.

[00:37:58] Shane: Gosh. Perhaps, I mean-

[00:38:01] Bronwyn: I was just going to worst scenario.

[00:38:02] Shane: I find that a challenging notion, um, because perhaps one of the la- well you've talked about primary and secondary prevention, but you know, even tertiary prevention is to actually pause for that hour of fortnight and just say, oh my goodness, I'm really struggling, you know? My, I've had all this unexplained illness. I'm sore. My relationships are in trouble. I'm using sweet salt or fatty food or drugs or alcohol to cope.

And then people have these spaces where they might realize, oh my goodness. So this is a, a stronger emotional reaction to the work than I was expecting. Or, um, maybe this is time to, to use some of those entitlements around leave.

And, um, so I, I, I look at that as a real feature, um, that, that people might actually be able to get the support they need before... because I think that burnout can be looked at as a sliding scale. I don't think it's an absolute that you're burnt out or you're not burnt out. You know, I, I think about, how do we intervene as those symptoms start to pop up?

Uh, I use the pro qual, the professional quality of life index, um, every six months in supervision. And I go through where I'm at on these metrics and okay, what do I need to bolster in my life? What do I need to challenge, um, in terms of how things are going?

[00:39:24] Bronwyn: It's interesting what you consider as a feature, it might be perceived as a risk by organizations. Maybe that would be a tension that we need to navigate in the future if we're to, I guess, increase the usage of these reflective practice spaces to prevent burnout.

[00:39:41] Shane: Again, we can argue depending on who we're speaking to, we can articulate the rationale according to their interests. So if it's from, you know, a dollars and cents cents and we can talk about, well, actually to support people to either, um, mitigate some early onset burnout symptoms or to recover from a burnout episode is far cheaper for an organization than to, pay out their leave and to, there could be a work cover situation or, and then onboard someone new with all the training and things that that encompasses.

Um, so you could articulate it in a very financial way. Um, you know, I, I generally try to appeal to the better angels of people's nature that, well, if you are part of the problem, well please be part of the solution.

[00:40:29] Bronwyn: Absolutely. Yeah. So, when we're thinking about early career mental health workers who want to have more of a reflective space in their day-to-day work, is there anything that they can do to advocate for themselves or advocate to their workplace to have more of that space?

[00:40:47] Shane: Yeah. So be clear on what they want from it. What they think they want from it. You might find there's, there's different experiences once it starts. I guess like any change management be, be clear on the logic, how it's value aligned with the worker as an individual, but also the org's stated public values and any flow on, uh, benefit. So, um, you know, it will enhance my practice. It will improve the team connectedness. I guess be sensitive to the audience you're pitching it to and what they might be interested in.

[00:41:20] Bronwyn: And is there a way that early career mental health workers can be more reflective into their day-to-day lives. Like if it's not possible from a systemic perspective to introduce reflective practice groups, is there questions or, or practices they can be doing to help themselves reflect more?

[00:41:36] Shane: Yeah, it's a very good question. I'd suggest people take it to their individual supervisors, um, if they're not quite sure.

[00:41:44] Bronwyn: That's a, that's a really good, Yeah. Yeah, Good suggestion.

[00:41:47] Shane: Yeah, it's, it's interesting. These groups are brilliant. They're in addition to having a good individual supervisor. Um, so that, that's my, that's my flinch reaction.

[00:41:59] Bronwyn: I think that's a really good suggestion as well, because I've noticed my reflective practice over the years... I think it, I, I think it's a good suggestion because it's so personalized, how you reflect and what you do and what you ask yourself.

I remember trying to make this, um, I, I asked a question on Facebook and I was like, everybody, give me your questions that you use to ask yourself in reflective practice. And I got like 50 questions that people ask themselves, and I'm like, okay, I can't ask myself all of these, and that works with that person. I just ended up working out that their questions might not be the questions for me and I need to come up with my own mini list of ways that I reflect and what questions make sense to me. So-

[00:42:40] Shane: Do you have any suggestions for the listeners? Do you have any suggestions that work for you?

[00:42:44] Bronwyn: Um, I guess the question I ask myself is, what happened there? What was that about? What, what happened in me and what was my reaction to that situation and what part of me was being activated in that moment? Um, and just getting curious with myself. So that's how I kind of interrogate myself gently and I think about how can I be curious about this and what happened, um, rather than judgmental or critical.

[00:43:13] Shane: I really relate to that, that undergraduate idea of a hot cognition. Whoa. Why did that one burn? What's going on there?

[00:43:21] Bronwyn: Yeah. But I know from the questions I gathered, I know some people ask themselves like, what did I miss in this situation because I was so focused on this? And they ask themselves all sorts of other questions to help interrogate themselves. Um, and so yeah.

[00:43:37] Shane: Which is interesting, right? Because you think about that perfectionism and it's linked to burnout. You know, there's a, there's a sense in that question of, of, um, of not doing it well enough and yeah, I, I, I, I, I suspect that's a big part of, of all of our makeups, um, to, to be doing this work and to have got where we've got. Um, but I like the idea of the, the gentler, more curious approach than-

[00:44:03] Bronwyn: Yeah.

[00:44:04] Shane: -ambitious.

[00:44:05] Bronwyn: Yeah. And like yeah. Punitive. Yeah. Kind of critic approach. Yeah, me too. But I think taking it to your individual supervisor to work out how you can reflect well as a person in your role and in the systems you work in could be really helpful.

Shane, is there anything that we haven't talked about which you wanna make sure that listeners take away?

[00:44:24] Shane: That's not something we haven't talked about, but I do want people to go away thinking about that notion of prevention rather than always reacting. I think that reflective practice are an additive. I, uh, a way to mitigate the foreseeable risks of working in a helping profession and that they're not the only approach to that. There, there might be other ways that we can, can think about. I don't know.

I think about in those 2020 lockdowns, doing sort of different activity based, um, exercise based things with my colleagues, you know, that I guess my bias in, uh, from a -com community psychology lens is that, that there is power in group belonging and there is power in, um, in connecting with others. And this is just one way to do that. But it's a way that I think is a shared language within the sector and it might be, um, something that you could, could advocate for.

[00:45:21] Bronwyn: Absolutely. I think that's really exciting. I, I love this lens that you're bringing to listeners of this prevention space. I just think it's, it should be less novel than it is, but it is novel, so I'm like, oh, this is really exciting.

[00:45:33] Shane: There's probably some public health professionals that are say, oh, this is our bread and butter!

[00:45:38] Bronwyn: Yeah.

[00:45:38] Shane: You know? But you know, how do we, yeah, how do we bring it? We've got the skills. We've got the skills. It's just not a lens. We often get a chance to use.

[00:45:48] Bronwyn: Yeah. And so you're presenting this idea at a conference coming up, is that right?

[00:45:52] Shane: Yeah. Um, the Complex Needs Conference, uh, in Melbourne late March. Uh, and so I'm, I'm really looking forward to talk about this in the, in a, in a setting that's looking at, how do we remedy some of our challenging systems, uh, relating to justice and children in care and, I just wanna zoom out that, that one layer, that one ecological layer, there'll be so many presentations coming from a lived experience and from a direct client care lens and from a risk and recidivism lens. So sort of a forensic psych angle.

Um, but what about just zooming out that one layer to the, the people entrusting to be carers and to be in this helping profession and if we, if we know that trauma informed care is about consistency and predictability, well, perhaps this is one angle we can offer to try and reduce staff turnover, um, keep staff's morale high and keep their, their practice on this continuous improvement loop. And I suspect that it goes some of the way to, um, to better outcomes for the, for the direct clients.

[00:47:03] Bronwyn: Totally. I couldn't agree more. Like, preach. I hope it goes, I hope it goes really well, and I think you'll have a really captive audience. I think we should talk about more. So I'm glad that we're able to talk about it today. Um, Shane, thank you so much for coming onto the podcast. I really appreciate your insights and your work in this area. It's really wonderful work. So thank you.

[00:47:24] Shane: Thanks for having me.

[00:47:25] Bronwyn: No worries.

And listeners, thank you so much for listening. I hope you got a lot out of today's conversation. A lot of things to think about and take away with you. If you did like today's episode, do share it with a friend or colleague. Telling people about the podcast is the best way to increase listenership to the podcast. So do put it in your mate's ears. Thanks so much for listening. Have a good one and catch you next time. Bye.