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An exploration of reflective practice amongst marriage and family therapy candidates

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An exploration of reflective practice amongst marriage and family therapy candidates

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Content Running head: REFLECTIVE PRACTICES AND MFT CANDIDATES

AN EXPLORATION OF REFLECTIVE PRACTICE AMONGST MARRIAGE AND FAMILY
THERAPY CANDIDATES

By

Michelle Y. Tehrani

A Dissertation Presented to the
FACULTY OF THE USC ROSSIER SCHOOL OF EDUCATION
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF EDUCATION

May 2017

Copyright 2017 Michelle Y. Tehrani
REFLECTIVE PRACTICES AND MFT CANDIDATES 2
Dedication
This dissertation is dedicated to my mother, Athena, who has provided me endless
support and guidance throughout my life. Like her name, she symbolizes strength, wisdom, and
courage. It was almost 15 years ago, during a routine evening walk we would take around our
neighborhood when my mother talked to me about obtaining my doctorate. That evening,
because of her, I set this goal…to attain a doctorate degree. You have shaped me into the
woman I am today, and for that I am forever grateful.“Thank you” is simply not enough. I love
you mom. “Girls rule…”

REFLECTIVE PRACTICES AND MFT CANDIDATES 3
Acknowledgements
I would like to acknowledge my Dissertation Committee Chair, Dr. Paula Carbone. I
greatly appreciate your guidance and support throughout the dissertation process. I would also
like to thank my other committee members, Dr. Jenifer Crawford, and Dr. Mary Andres, for your
knowledge and expertise during this journey.
I would also like to acknowledge my colleagues and fellow “Ghostbuster” team
members, especially my direct supervisor Karen Carlson, for encouraging me to apply to this
program. Thank you for your flexibility during the last three years. I would not have been able
to make it through this program without you all.
Next up, my fellow T.A.M. members, Tsuilei Mace and Amy Hodge. I like to believe
that it was not an accident that we sat next to each other the first night of class. Thank you for
helping me push through the past three years, especially those long nights we spent writing in
201A. Most of all, I appreciate the friendship we have created throughout this journey.
I would also like to acknowledge my friends and family who have cheered me on during
this program. Thank you for your encouragement as I furthered my education. I really
appreciate the moral support through this process.
Finally, I would like to acknowledge my better half, Stephen. I remember being hesitant
to submit my application to the Ed.D. program and you helped me push that “send” button three
years ago. Thank you for always supporting me and being my biggest cheerleader. Your
positivity helped me when I needed to push through most. I love you.

REFLECTIVE PRACTICES AND MFT CANDIDATES 4
Table of Contents
Dedication ................................................................................................................................... 2
Acknowledgements ..................................................................................................................... 3
Abstract ........................................................................................................................................... 6
Chapter One: An Exploration of Reflective Practices amongst Marriage and Family Therapy
Candidates ....................................................................................................................................... 7
Background of the Problem ........................................................................................................ 9
History of Children’s Mental Health ...................................................................................... 9
Availability of Mental Health Services................................................................................. 12
Statement of the Problem .......................................................................................................... 13
Purpose of the Study ................................................................................................................. 16
Limitations and Delimitations ................................................................................................... 18
Definition of Terms................................................................................................................... 19
Organization of the Study ......................................................................................................... 22
Chapter Two: Literature Review ................................................................................................. 23
History of Reflection in Public Schools in the United States ................................................... 25
Current State of Reflection in Education .................................................................................. 31
Current State of Reflection in Mental Health ........................................................................... 36
Current State of Reflection towards Equity and Access in Mental Health ............................... 43
Reflective Framework ............................................................................................................... 47
Summary ................................................................................................................................... 52
Chapter Three: Methodology ....................................................................................................... 54
Methods..................................................................................................................................... 55
Sample and Site Selection ..................................................................................................... 56
Data Collection ..................................................................................................................... 59
Data Analysis ........................................................................................................................ 64
Researcher Biases/Positionality ................................................................................................ 66
Chapter Four: Findings ................................................................................................................ 68
Sites and Participants ................................................................................................................ 70
Valleyridge Charter Schools ................................................................................................. 70
Focus Group .......................................................................................................................... 71
Individual Interview Participants .......................................................................................... 73
Observations ......................................................................................................................... 74
Results for Research Question One .......................................................................................... 76
Reflective Terminology ........................................................................................................ 77
Integration of Reflective Practices in Traineeship ................................................................ 79
Discussion Research Question One .......................................................................................... 85
Results for Research Question Two .......................................................................................... 86
Perceived Effects of Reflection ............................................................................................ 87
Role of Collaboration in Traineeship .................................................................................... 95
Discussion Research Question Two........................................................................................ 100
Summary ................................................................................................................................. 101
Chapter Five: Discussion ........................................................................................................... 102
Overview of Current Study ..................................................................................................... 102
REFLECTIVE PRACTICES AND MFT CANDIDATES 5
Discussion of Findings ............................................................................................................ 104
Implications for Practice ......................................................................................................... 108
Limitations .............................................................................................................................. 110
Recommendations for Future Research .................................................................................. 111
Conclusion .............................................................................................................................. 112
References ................................................................................................................................... 114
Appendix A: Participant Handout .............................................................................................. 126
Appendix B: Interview Participant Information Form............................................................... 127
Appendix C: Interview Protocol ................................................................................................ 128
Appendix D: Focus Group Protocol .......................................................................................... 131
Appendix E: Observation Protocol ............................................................................................ 133

REFLECTIVE PRACTICES AND MFT CANDIDATES 6
Abstract
This qualitative study examined the reflective practices of Marriage and Family Therapy (MFT)
candidates during their clinical traineeship. Since the implementation of the Individuals with
Disabilities Education Act (IDEA) (2010), the number of professionals providing mental health
services in educational settings has increased, resulting in shortages of trained professionals such
as MFTs (Mellin, 2009). As part of professional development, reflective practices were useful in
allowing mental health practitioners to identify, process, and interpret clinical
experiences. Participants in this study were second year masters level MFT candidates who were
completing their clinical traineeship hours for graduation in a K-12 educational setting. Three
observations of group clinical supervision, a focus group interview, three individual interviews
with MFT candidates, and collection of artifacts were conducted to gather data. A reflective
framework based upon Schön (1992), Valli (1997), Rodgers (2002), and Farrell (2012) was
utilized to analyze the data. Four overall themes emerged from the data: the reflective
terminology and definitions used by MFT candidates and clinical supervisors varied, there was
an overall expectation for MFT candidate reflection in the traineeship process, perceptions
regarding effects of reflection, and the MFT traineeship process was highly collaborative in
nature. The implications for practice based on the findings included creating a clear definition of
reflection within the MFT traineeship program, developing trainings on reflective practices, and
monitoring candidate progress towards the utilization of reflection. Areas for further research
were also identified.

REFLECTIVE PRACTICES AND MFT CANDIDATES 7
Chapter One: An Exploration of Reflective Practices amongst Marriage and Family Therapy
Candidates
1

This paper addressed the problem of students receiving inconsistent levels of mental
health services from service providers in a K-12 school setting. The evidence highlighted that
while mental health services were available in the school setting, there was still an ongoing
question of what the services entailed as well as the educational impact (Kataoka, Rowan,
&Hoagwood, 2009). Although there are evidence-based treatment modalities that have been
effective in addressing psychological disorders, they are not always utilized in a school setting.
Kataoka et al. (2009) further acknowledged that there is a mismatch between mental health
treatment interventions that are proven effective and the utilization of such interventions within
school settings. Furthermore, while there is a consensus on integration of education and mental
health as an overarching goal, there is little agreement on how that process will occur (Atkins,
Hoagwood, Kutash, &Seidman, 2010).
This problem is important to address due to the estimated one in ten students who have a
significant mental health problem that impairs functioning in the school, home, and community
environments (Stagman& Cooper, 2010). Students with mental health issues face many
challenges compared to students with differing disabilities. For example, they are at a higher
risk of poor school attendance, developing problems at school, and being suspended or expelled
than students with other types of disabilities (Stagman& Cooper, 2010). Additionally, Breslau,
Lane, Sampson, and Kessler (2008) found that the presence of psychological disorders were
associated with early school termination. While not all in-school incidents resulting from
psychological distress or conflict result in a decrease in academic achievement, a student who is

1
Chapter was co-written by Tsuilei L. Mace and Michelle Y. Tehrani, with each contributing
equally to the work.
REFLECTIVE PRACTICES AND MFT CANDIDATES 8
showing the same level of achievement with decreased educational time is nonetheless not
learning at their highest capacity; their preparedness for future educational aspirations can
therefore be compromised by the decreased educational time (Burdick-Will, 2013). Counseling
services provided in the school setting have shown to correlate with student improvements in the
areas of social and emotional wellbeing, in addition to overcoming a barrier to achieving
academic success (Carlton & Weiss, 1994). Counseling service providers in the school setting
include various professionals with mental health training, including Marriage and Family
Therapists (MFT) (United States Government Accountability Office [GAO], 2013).
Mental health professionals often undergo significant amounts of training prior to
providing direct mental health services, including completing a master’s degree. Marriage and
Family Therapists in California are further required to complete a traineeship during their
training in order to receive supervision to acquire and receive feedback on their clinical skills
(California Board of Behavioral Sciences [CA BBS], 2015). Additionally, the supervision MFT
candidates receive includes teaching of specific techniques and strategies to foster professional
development. Reflection is commonly used in professional settings to increase awareness and
efficacy of professional practices (Rizq, Manminder, Salvo, Spencer, Varnaseri, & Whitfield,
2010). As reflective practices have been found to be helpful in understanding experiences in
order to build on both previous and new knowledge professionals gain, a question arises
regarding the application of those practices with MFT candidates (Pack, 2011).
This qualitative study investigated the training MFTs received while obtaining their
professional degrees, with the hope of developing consistency in educational mental health
services. The focus of the study was to identify the existing knowledge MFTs had about
reflective practices. With the use of 2nd year MFT candidate interviews, focus group interviews
REFLECTIVE PRACTICES AND MFT CANDIDATES 9
of clinical supervisors, observations of clinical supervision, and collection of artifacts, this study
aimed to better understand the relationship between reflective practice and the training MFTs
receive during traineeship.
Background of the Problem
History of Children’s Mental Health
There is history of children’s mental health needs going unmet. Table1 depicts
significant events and the subsequent policies that were enacted to address children’s mental
health in the United States in the last century. The White House held the first Conference on
Children in 1909, which highlighted the concern of children with emotional disturbances (Joint
Commission on the Mental Health of Children [JCMHC], 1969). Although there was discussion
of the issue at the conference, little action was taken to address identified concerns. By 1966, an
estimated 1.4 million children under 18 years of age were in need of psychiatric care, with
approximately 27,000 children hospitalized in county or state institutions (JCMHC, 1969).
Table 1. Significant events and policies in children’s mental health: 1909-2013
Year Event
1909 White house holds First Conference on Children
1966 NIMH estimates 1.4 million school aged children need psychiatric care
1969 Joint Commission on the Mental Health of Children
1975 Education for All Handicapped Children Act
1999 Columbine High School shooting in Colorado
2003 President’s New Freedom Initiative
2012 Sandy Hook Elementary shooting in Newtown, Connecticut
2013 Passing of Assembly Bill 114

REFLECTIVE PRACTICES AND MFT CANDIDATES 10
As such, there was a 60-year gap between the initial mention of children’s mental health
in 1909 and when an action plan to address the problem was finally discussed again in
1969. Zeng et al. (2013) found that when Congress developed the Joint Commission on Mental
Health of Children in 1969, research in the area of current mental health need and access
accelerated. Congress further enacted the Education for All Handicapped Children Act in 1975,
now known as the Individuals with Disabilities Education Act (IDEA), to include emotional
disturbance as an additional category to qualify for special education services. The President’s
New Freedman Initiative was subsequently created in 2003 to improve mental health services in
schools through school-based services. The initiative focused on five distinct areas: reducing
mental health stigma, suicide prevention, expanding and improving existing mental health
services in schools, and the prevention, identification, and treatment of co-occurring mental
health and substance abuse disorders (Mills, Teessch, Ross, & Peters, 2006).
Violence in educational settings has also increased awareness of the need for mental
health services within schools. In 1999, the Columbine High School shooting in Colorado
thrusted the issue of mental health once again to the forefront of the nation, with an emphasis at
examining both schools and mental health. Mental health research in the aftermath of the
shooting focused significantly on risk factors for youth violence, as well as prevention methods
in educational settings and school discipline (Crepeau-Hobson, Filaccio, & Gottfried,
2005). According to the National Center for Education Statistics (2015), 26 homicides occurred
inside school settings nationwide during the 2011-2012 school year. The 2012 school shooting
in Sandy Hook Elementary School in Newtown, Connecticut further accentuated the need for a
different approach to creating safer schools, such as including elements of balance,
connectedness, communication, support, and a specific focus on mental health needs
REFLECTIVE PRACTICES AND MFT CANDIDATES 11
(Interdisciplinary Group on Preventing School and Community Violence, 2013). As a measure
to integrate mental health in education, the State of California deemed school districts
responsible for addressing the mental health needs of students with the approval and passage of
Assembly Bill 114 in 2011 (California Department of Education [CDE], 2015).
Mental health needs of children have also become more complex in nature and scope.
Research has shown that children who are diagnosed with two or more mental health problems
are also becoming more common (Mellin, 2009). An estimated 32% of children age 13 through
17 are more likely to be diagnosed with co-occurring disorders, with the most frequent diagnoses
being attention deficit hyperactivity disorder and mood disorders (Warner &Pottick, 2004). In
addition, Miller and Eisenberg’s (1988) study focused on the importance of empathy in children,
identifying a relationship between the lack of empathy with externalizing and antisocial
behavior. Lastly, Feshback and Feshback (1987) found a correlation between social-emotional
affective factors and a child’s academic performance, particularly with girls. The authors found
between the ages of eight and nine, a child’s depressive affect negatively correlated with
academic performance, and a child’s empathy towards peers was found to positively correlate
with reading and spelling achievement.
Mental health services for students with social-emotional needs are a long-standing
problem and continues to show urgency in addressing the demand. United States Department of
Health & Human Services [USDHHS] (1999) found that while a large number of children have
mental health needs, only an estimated 30% of individuals receive any mental health care.Of the
children who received mental health services, a majority received services in an educational
setting. Approximately 70% received services through school, 40% were serviced within the
mental health sector, 16%were serviced by child welfare programs, 11% by healthcare providers,
REFLECTIVE PRACTICES AND MFT CANDIDATES 12
and 4% obtained services within the juvenile justice system (USDHHS, 1999).
As such, counseling services in school can play a significant role in enhancing social,
academic, and behavioral outcomes for children with mental health needs. Students who receive
social-emotional mental health services in general show decreases in both truancy and
suspension rates (Ballard, Sander, &Klimes-Dougan, 2014). The integration of mental health
providers and teachers allow for a holistic view on student functioning and allow for
collaborative consultation, which is crucial to implementation of student mental health
interventions (Atkins et al., 2010). School based services play a large role in early detection of
student psychological issues, implementation of direct mental health services on campus to
students, and referrals to various types of community based services and programs (Atkins et al.,
2010). Therefore, school based mental health services are often the main gateway to
psychological services from varying providers across sectors to those in need of psychological
support (Williams & Chapman, 2015).
Availability of Mental Health Services
The increase in student mental health needs brings forth the question of availability of
services, as well as quality of services, and the knowledge and competencies of service
providers. The increased attention to mental health services for children has led to a shortage in
service providers across sectors. These shortages of mental health providers have appeared
across various settings including private practice providers, community mental health agencies,
public mental health systems, as well as hospitals (Mellin, 2009). Thomas, Ellis, Konrad,
Holzer, and Morrissey (2009) found that approximately 77% of all counties across the United
States had a significant shortage of mental health providers, and approximately 96% of United
States counties had some unmet mental health need. Furthermore, an estimated 8% of all United
REFLECTIVE PRACTICES AND MFT CANDIDATES 13
States counties had such a significant shortage of providers that only half of their overall mental
health needs were met. In the school setting, mental health professionals divert their services
away from sustained support and focus more on crisis interventions and other forms of
psychological testing, which are less effective for prolonged positive outcomes (Atkins et al.,
2010). This results in a reactive service model rather than a proactive aligned systemic
approach.
There is a history of K-12 schools fulfilling a role in addressing emotional and behavioral
needs of children. Early mental health issues are often first identified in school settings due to
the unique position of school staff, campus mental health professionals, and faculty (Stein et al.,
2012). The professionals within the school setting are able to identify at-risk student, assess their
need, and refer them for mental health services (Stein et al., 2012). Additionally, educational
settings provide greater access to mental health services when compared with the referral process
and ongoing treatment options in specialty treatment settings (Stein et al., 2012). Consequently,
there is an expanding interest in student mental health programs in the United States.
Statement of the Problem
Students with mental health needs are receiving inconsistent levels of counseling services
within the urban school setting. Schools have sustainably played an imperative role in
addressing social, emotional, and behavioral needs of children because it is often the initial
setting in which mental health issues are observed in children (Stein et al., 2012). Additionally,
there is an increase in students with two concurrent mental health needs (Mellin, 2009; Warner
&Pottick, 2004). While counseling services have been shown to improve the outcomes of
students with psychological problems, there are concerns regarding the quality of services. The
increase in childhood mental health concerns has resulted in a general shortage of mental health
REFLECTIVE PRACTICES AND MFT CANDIDATES 14
providers across the United States (Atkins et al., 2010; Thomas et al, 2009; Mellin, 2009). This
results in situations where education systems recruit providers of varying levels of competency
and knowledge. Additionally, when in the school setting, mental health service providers are not
always focused on a proactive model but instead are sometimes directed towards crisis
management and immediate intervention, which is less beneficial for long-term success (Atkins
et al., 2010).
With the passing of Assembly Bill 114 in 2011, the State of California deemed school
districts responsible for addressing the mental health needs of special education students (CDE,
2015). Counseling and behavioral support services, provided by school-based mental health
professionals (such as licensed clinical social workers, licensed MFTs, and mental health
counselors) were subsequently offered and provided to students eligible for special education
under the eligibility of emotional disturbance. This service is intended to assist their
development of appropriate ways to manage their behaviors (Reddy, Newman, De Thomas, &
Chun, 2009; Reddy & Richardson, 2006; United States Government Accountability Office
[GAO], 2015).
Emotional disturbance (ED) is one of thirteen special education eligibility categories
identified by the Individuals with Disabilities Education Act (IDEA). Within this legislation,
there is a federal criterion for determining if a student qualifies for special education in the area
of emotional or behavioral disturbances (Raines et al., 2012). Special education eligibility under
emotional disturbance occurs when one or more of the five characteristics from the list of criteria
are exhibited over a long period of time and to a marked degree that negatively affects a child’s
educational performance (U.S. Department of Education, 1998). Thorough examination of the
student’s emotional and behavioral function is required in order to qualify a student to receive
REFLECTIVE PRACTICES AND MFT CANDIDATES 15
special education services. When a student qualifies for special education, related services can
be provided in order to ensure the student is benefiting from special education (IDEA,
2015). Counseling is a related service provided to students with a social and/or emotional barrier
to achieving academic success (IDEA, 2015). IDEA (2015) states that qualified personnel such
as social workers, psychologists, guidance counselors, or MFTs should provide counseling
services.
Marriage and Family Therapy programs generally require candidates to learn and
implement various therapeutic methods. D’Aniello and Perkins (2016) note that many Marriage
and Family Therapy programs shifted the target of instruction to prioritize the systematic
development of various models rather than focusing on one specific model. Although MFT
programs have emerged to teach candidates various therapeutic techniques, the majority of
programs focus on identifying the differences between each approach rather than building on the
skills and strategies within the model (D’Aniello& Perkins, 2016). Furthermore, there is a lack
of knowledge regarding therapeutic approaches most effective in treating the needs of
individuals (Hines, 1996). With that, the training candidates receive in different programs is not
consistent due to the lack of standard guidelines identifying effective approaches to meet the
objectives of those receiving therapy and counseling (Hines, 1996).
Within the varied models mentioned above, reflective practice is beneficial for mental
health professionals, including MFT candidates, to build on prior knowledge and promote
professional growth. Similar to research on the effectiveness of reflective practice across
multiple professions, reflective practices are also incorporated in clinical settings with students
who have significant social and emotional needs (Raney, 2014). While working to meet the
diverse needs of students, reflection allows providers to reflect on their own personal
REFLECTIVE PRACTICES AND MFT CANDIDATES 16
issues. This engages the provider in recognizing and responding to student needs in a proactive
and effective manner (Larrieu& Dickson, 2009). Moreover, these practices allow MFTs to
reflect on their own experiences in an effort to construct new knowledge and establish more
effective services to students with social and emotional needs (Leung, 2007).
There is significant diversity in the various kinds of reflections that MFTs
practice. Reflective practices can appear as inner-conversations and can include addressing the
therapist’s concerns, attending to the client’s story, monitoring the therapeutic process, and
handling the therapist’s own experiences (Rober, 2010). For novice therapists, reflections
revolve around four primary axes: reflection about oneself, reflection about the therapeutic
process, reflections of emotions regarding the client, and reflection regarding the session overall
(Frediani&Rober, 2016). Fife and Whiting (2007) emphasized the role of reflection in assisting
Marriage and Family Therapists gain insight into their values and beliefs, which are crucial in the
professional development process.
Purpose of the Study
This study examined how graduate students described their engagement with reflective
practices while obtaining a degree in Marriage and Family Therapy. There are increasing
numbers of MFTs in K-12 schools, despite the historical utilization of primarily school
psychologists and social workers, who provide school-based counseling services to students with
social and emotional needs to meet the high demand for such service providers. Schools are
attempting to recruit service providers with various educational backgrounds, credentials, and
licenses to meet the demand (Mellin, 2009). As more MFTs become service providers to
students with social and emotional needs, focus on training and preparation is not only prudent
but also necessary in ensuring qualified and competent student care. As such, this study
REFLECTIVE PRACTICES AND MFT CANDIDATES 17
explored the existing knowledge Marriage and Family Therapist candidates had regarding
reflective practices, which past literature has shown to develop and strengthen professional skills
(Rizq et al, 2010; Norton, Russell, Wisner &Uriarte, 2011). The goal of this study was to
develop a better understanding of the role of reflective practices in the training MFTs receive
while obtaining their professional degrees.
The following research questions were examined during the study:
1. How are Marriage and Family Therapy candidates describing the reflective practices they
use in a traineeship program within a K-12 educational setting?
2. How are MFT candidates’ perceptions of reflective practice impacting their ability to
consistently support students with social and emotional needs within the school setting?
This study employed a qualitative inquiry approach. The methods included observations
of clinical supervision, collection of artifacts, second year MFT candidate interviews, and a focus
group interview of clinical supervisors. The population was selected based on availability of
qualified MFT candidates who were working towards the completion of their degree program
and were providing services to students within a K-12 setting. Artifacts, such as weekly group
supervision agendas, were collected to pinpoint any reflective components built into clinical
group supervision. Interviews were conducted to gain an in-depth personal insight of MFT
candidates in regards to reflective practices. The focus group interview of clinical supervisors
provided information regarding the training and supervision aspect of the MFT candidate
traineeship. The participants were observed during their weekly group supervision in order to
see how the candidates received, practiced, and/or processed reflective strategies. These
methods provided the detailed information necessary to understand the nature of knowledge of
reflective practices amongst second year MFT candidates. As reflective practices have been
REFLECTIVE PRACTICES AND MFT CANDIDATES 18
found to assist in further development of skills, it was intended for this study to uncover further
methods to improve clinical practice to address social and emotional needs of students in a K-12
setting.
Limitations and Delimitations
There was a limitation in the sample selected for the study. The sample was selected
based on convenience in accessibility. Convenience sampling was selected based on availability
of participants, time, and location (Merriam, 2009). All the participants were MFT candidates
who were completing their traineeship hours atValleyridgeCharter Schools. There was a
limitation in the variability in training received because the study only examined MFT
candidates at Valleyridge Charter Schools. There was also a limitation of educational
backgrounds since all participants had received a bachelor’s degree. Additionally, there was a
limitation in the potential for participants to experience cognitive dissonance. Festinger (1957)
devised the term cognitive dissonance to describe the incongruence of novel concepts or ideas
from pre-existing knowledge or beliefs. Within this study, the presence of cognitive dissonance
may have created a social desirability bias, which may have influenced participant responses to
interview questions. This may have occurred because based on social desirability participants
may phrase their response based on what they think the researcher is looking for in the study
(Saldana &Omasta, 2017).
Credibility and trustworthiness are important factors in presenting accurate data
analysis. This study employed various methods to address potential limitations. To begin,
triangulation was one strategy used to ensure credibility. Triangulation involves using different
research methods to compare findings with one another (Merriam, 2009). The data collection
methods utilized in this study included observations, interviews, and collection of
REFLECTIVE PRACTICES AND MFT CANDIDATES 19
artifacts. Various methods were used in order to increase the validity of the study. Another
strategy to ensure credibility was member checking, the participants affirmed the data analysis
and interpretations to reduce misinterpretations and ensure validity (Merriam, 2009). Within
member checking, the truthfulness of participants is monitored to ensure accurate and truthful
responses, and provided the opportunity for the researcher to affirm the analysis was accurate
with what the participants meant (Merriam, 2009). Additionally, researcher position was utilized
to engage the researcher in critical self-reflection in regards to the assumptions, worldview,
biases, theoretical orientation, and relationship to the study that may influence the study
(Merriam, 2009). Furthermore, detailed descriptions were written to contextualize the study so
that the readers would be provided with a comprehensive understanding of the research context
(Merriam, 2009).
The delimitations of the study were in the areas of population, setting, methodology and
instrumentation. The methodology and instrumentation utilized were to provide an in-depth
understanding of the participant’s understanding of reflective practices, to observe their ability to
engage in reflection, and to afford insight into the built-in components of reflective practice in
their coursework.
Definition of Terms
The terms below were used throughout the study:
ED: Emotional Disturbance
● The U.S. Department of Education (1998) defines emotional disturbance (ED) as follows:
● (i) Emotional disturbance means a condition exhibiting one or more of the
following characteristics over a long period of time and to a marked
degree that adversely affects a child's educational performance:
REFLECTIVE PRACTICES AND MFT CANDIDATES 20
● (A) An inability to learn that cannot be explained by intellectual,
sensory, or health factors.
● (B) An inability to build or maintain satisfactory interpersonal
relationships with peers and teachers.
● (C) Inappropriate types of behavior or feelings under normal
circumstances.
● (D) A general pervasive mood of unhappiness or depression.
● (E) A tendency to develop physical symptoms or fears associated
with personal or school problems (U.S. Department of Education,
1998, p. II 46).
IDEA: Individuals with Disabilities Education Act (IDEA)outlines the rights and regulations for
students with disabilities in the United States who require special education services in the least
restrictive environment (IDEA, 2015)
IEP: Individual Education Plan (IEP)A written statement for each child with a disability that is
developed, reviewed, and revised in a meeting. It includes (IDEA, 2015)
LRE: Least Restrictive Environment (LRE) To the maximum extent appropriate, children with
disabilities, including children in public or private institutions or other care facilities, are
educated with children who are not disabled, and special classes, separate schooling, or other
removal of children with disabilities from the regular educational environment occurs only when
the nature or severity of the disability of a child is such that education in regular classes with the
use of supplementary aids and services cannot be achieved satisfactorily (IDEA, 2015)
MFT: Marriage and Family Therapists [MFTs] are mental health professionals trained in
psychotherapy and family systems, and licensed to diagnose and treat mental and emotional
REFLECTIVE PRACTICES AND MFT CANDIDATES 21
disorders within the context of marriage, couples and family systems (American Association of
Marriage and Family Therapists [AAMFT], 2015). The practice of Marriage and Family
Therapy will mean that a service performed with individuals, couples, or groups wherein
interpersonal relationships are examined for the purpose of achieving more adequate, satisfying,
and productive marriage and family adjustments. This practice includes relationship and pre-
marital counseling (CA BBS, 2015). Additionally, the application of marriage and family
therapy principles and methods includes, but is not limited to, the use of applied
psychotherapeutic techniques, to enable individuals to mature and grow within marriage and the
family, the provision of explanations and interpretations of the psychosexual and psychosocial
aspects of relationships, and the use, application, and integration of the coursework and training
required by Sections 4980.37, 4980.40, and 4980.41 of the California Business and Professions
Code (CA BBS, 2015).
Reflective Practice: Reflective practice has been described as challenging, focused and critical
assessment of one’s own behavior as a means towards developing one’s own craftsmanship
(Osterman&Kottkamp, 1993).
Related Services (RS): Related Services include transportation and such developmental,
corrective, and other supportive services as are required to assist a child with a disability to
benefit from special education, and includes speech-language pathology and audiology services,
interpreting services, psychological services, physical and occupational therapy, recreation,
including therapeutic recreation, early identification and assessment of disabilities in children,
counseling services, including rehabilitation counseling, orientation and mobility services, and
medical services for diagnostic or evaluation purposes. Related services also include school
health services and school nurse services, social work services in schools, and parent counseling
REFLECTIVE PRACTICES AND MFT CANDIDATES 22
and training (IDEA, 2015).
Organization of the Study
The study is organized into five chapters. It examined the use of reflective practices
amongst 2nd year Marriage and Family Therapy candidates who were working with students
with mental health needs. Chapter one provides an introduction to the study, explains the
purpose, and details the significance. Chapter two presents a literature review of reflective
practices utilized by mental health providers. Chapter three provides the research methodology,
including the research design, population and sampling procedures, and the instruments used in
the study. Chapter four presents the findings of the research, highlighting the emerging themes
and connects it to the research. Chapter five presents the conclusion of the study, the
implications for practice in the mental health field, and the recommendations for future studies.

REFLECTIVE PRACTICES AND MFT CANDIDATES 23
Chapter Two: Literature Review
2

In 2011, the California Department of Education passed Assembly Bill 114, which
assigned the responsibility of providing special education and related services to students with
disabilities to individual school districts (California Department of Education [CDE],
2015). Related services include any services a student with disability may require in order to
benefit from special education (Individuals with Disabilities Act [IDEA], 2015). Mental health
counseling services are included within related services for those students who have a social
and/or emotional barrier to learning. Counseling and behavioral support services, provided by
school-based mental health professionals (such as licensed clinical social workers, licensed
marriage and family therapists [MFT], and mental health counselors), are often offered and
provided to students eligible for special education under emotional disturbance to assist in their
development of appropriate ways to manage their behaviors (United States Government
Accountability Office [GAO], 2013; Reddy & Richardson, 2006; Reddy, Newman, De Thomas,
& Chun, 2009).
However, students are not receiving consistent levels of service from service
providers. Santiago, Kataoka, Forness, and Miranda (2014) conducted a study examining mental
health clinicians working within special education systems in school settings. The study
explored clinician characteristics, provided services, and work environments. The findings
showed that services varied substantially among clinicians about the intervention formats, types
of treatments provided, and duration of treatment. Overall, clinicians who had specialized
trainings, younger and less experienced clinicians, and clinicians who work cooperatively in their
work setting with less intensive role loads reported employing a higher quality of care with

2
Chapter was co-written by Tsuilei L. Mace and Michelle Y. Tehrani, with each contributing
equally to the work.
REFLECTIVE PRACTICES AND MFT CANDIDATES 24
special education students (Santiago et al., 2014). Reflective practices, as part of training, can
encourage MFT candidates to establish skills as cognizant, proactive, and responsive
professionals (Leung, 2007).
Reflection is a process that provides an individual with an opportunity to examine and
understand the effects their experiences have on personal and professional
development. Reflective practice plays a vital role in consciously evaluating actions and
identifying changes to improve overall performance. While there are various methods to
engaging in reflective practice, the principal ideas are generally agreed upon and elaborated
below in the literature review (Tannenbaum, Hall, & Deaton, 2013). Reflection can be used as a
tool to continuously self-monitor one’s own behavior in order to make modifications and
improvements to future actions (Banoobhai, 2012; Chalikandy, 2014; Tannenbaum et al.,
2013). Schmidt & Adkins (2012) explored counseling student and faculty understandings into
the nature of reflection and beliefs about the implementation of reflective practice. Reflection
played a role in enabling comfort with differences in experiences, understanding perspective-
taking abilities, and gaining a greater awareness of personal development (Schmidt & Adkins,
2012).
The goal of this study was to analyze the reflective practices of graduate student
candidates obtaining a degree in Marriage and Family Therapy to discover the training they
received in regards to reflective practice and how they utilized these practices to improve the
counseling services they provided to students with social and/or emotional needs. For this study,
reflective practice was defined as the active and persistent assessment of an individual’s behavior
and experience that is focused, challenging, and analytical as a step in constructing and
developing professional opinions, identity, and skills (Chalikandy, 2014; Dewey, 1938; Hatton &
REFLECTIVE PRACTICES AND MFT CANDIDATES 25
Smith, 1995; Osterman, 1990). The following research questions will be examined during the
study:
1. How are Marriage and Family Therapy candidates describing the reflective practices
they use in a traineeship program within a K-12 educational setting?
2. How are MFT candidates’ perceptions of reflective practice impacting their ability to
consistently support students with social and emotional needs within the school
setting?
This review is organized into five sections. First, is the overview of the history of
reflection in United States public schools. Second, the current state of reflection is identified in
education. Third, the current state of reflection described within the context of mental
health. Fourth, is the current state of reflection towards equity and access in mental
health. Finally, a review of the reflective practice framework is presented as it relates to
Marriage and Family Therapists providing mental health counseling services to students with
social and emotional needs.
History of Reflection in Public Schools in the United States
Reflection in academic settings originally arose out of an interest in analyzing various
methods to inform and improve educational practices amongst educators. Literature on the topic
of reflection evolved through time and different theorists. As a pioneer of the reflective practice
movement, Dewey (1938) started the conversation regarding the examination of progressive
education by learning through doing. Schön (1992) added to Dewey’s (1938) theory of inquiry
by emphasizing the practice of reflecting upon one’s work. Later theorists, like Valli (1997),
Rodgers (2002), Farrell (2012), further expanded upon existing literature on reflection to include
diversifying reflective methods and stages, applicability of reflection towards specific tasks
REFLECTIVE PRACTICES AND MFT CANDIDATES 26
including learning and skill advancement. Concepts advanced from simply understanding that
experience and education are not mutually exclusive, to multiple forms of reflective practice,
which include interpretation, analysis, and exploration of solutions to problems of varying
complexity (Dewey, 1938; Schön, 1992).
Dewey’s (1938) pioneering concepts of progressive education helped form the base for
the use of reflection in education. The aim of progressive education was for the learner to
identify the elements that influence their learning process. Subsequently, Dewey (1938)
highlighted three distinctive stages in recognizing the learning elements: observing surrounding
conditions, recalling past experiences, and analyzing recalled and observed
information. Rodgers (2002) added to the stages by including intelligent action, described as the
meaning one makes based on the experiences that they have encountered. Through the process
of reviewing past experiences (can also be referred to reflective reviewing), an individual can
then learn about the consequences of past action. It is prudent to note that reflective review
includes the process of creating meaning from experiences. This further aids in the development
of tools to help deal with future problems.
There is also the importance of allowing learners to review and reflect upon their own
actions and learning experiences. Occurring in brief intervals after a response to a
situation, “quiet reflection” involves focusing on thought and refraining from further action; this
process aids in the development of reflective practice and impulse control (Dewey, 1938).
Problems have previously occurred with learners when there was quick and immediate action
taken without first thinking about the situation, and creating a clear purpose.
The teachers of any profession play a vital role in helping learners identify the purpose
and the meaning of specific actions and experiences. Dewey (1938) stressed that teachers should
REFLECTIVE PRACTICES AND MFT CANDIDATES 27
not be idle and passive, but rather active and ready to engage and assist learners as needed. The
connection of educational information from the teacher to a learner’s experiences allows material
taught to be more relevant to the learner and therefore further facilitates the learning
process. Furthermore, reflecting on learned material provides an opportunity for a learner to
make their own meaning out of the material and make further connections to other concepts or
experiences.
Schön (1992) built on the pioneering work of Dewey (1938) on the theory of inquiry.
Schön added to the theory of reflection with the interactive implementation of reflective practice
between teachers and students. By reflecting on one’s own work, learners are able to reorganize
their experiences of the situation at hand, thereby assisting in creating meaning and making
stronger connection between concepts.
Perhaps the highlight of Schön’s (1992) theory of reflection was the notion that reflective
practices assist in slowing down a learner’s action in order to explore what pre-structures are in
place. Described as a guide to how one perceives a situation, pre-structures can potentially
change the way learning occurs. The specific reflective practices Schön (1992) identified are
knowing-in-action, reflection-in-action, reflection-on-action, and engaging in
deliberate reflective conversations with a situation. Knowing-in-action consists of following an
everyday pattern of actions to identify structures that exist in order to formulate quick
assessments. This triggers routine problem solving skills to address the situation. Reflection-in-
action involves the decelerated process of pausing and thinking about what has happened, this is
also known as the “stop and think” approach, which built upon Dewey’s (1938) concept of quiet
reflection. An individual abstains from action and mentally focuses on the overt action without
engaging in further activity during the process of quiet reflection (Dewey, 1938). There is a
REFLECTIVE PRACTICES AND MFT CANDIDATES 28
differentiation between reflection-in-action and reflection-on-action. While reflection-in-action is
thinking during practice, reflection-on-action occurs before or after practice and utilizes a
learner’s metacognitive processes (Ferry & Ross-Gordon, 1998). Lastly, reflective conversations
about a situation involve conscious inquiry on the uncertainties of a situation, and exploring the
possibility of change.
As such, the practice of teaching can be seen as a reflective conversation between teacher
and student. Although this conversation occurs in both verbal and nonverbal forms, the central
purpose is for the teacher to assist the student in processing and making sense of unfamiliar
situations and concepts. Additionally, reflective practices, such as Schön’s (1992) concept of
reflection-on-action, can also be utilized when faced with a situation that is unexpected, or when
encountering an unexpected outcome to an action. Schön (1992) proposed that teachers should
therefore be examining problems from a student’s standpoint. The development of reflective
inquiry processes is idiosyncratic to the specific teacher and student collaborative relationship.
Such reflective practices can be utilized to assist in the identification of potential solutions in
novel situations for learners.
Reflective practice allows teachers the ability to recognize that instruction should be
developed based on a learner’s process and therefore can never be scripted (Rodgers,
2002). Models and assessment tools have been developed to identify the level of reflection
practitioners engage in (Larrivee, 2008; Rodgers, 2002). Larrivee’s (2008) assessment tool
affords users to have a better understanding of their own ways of thinking, as well as
acknowledging different approaches, perspectives, and viewpoints. This assessment tool is
useful in assessing the development of reflective practitioners as reflective habits are achieved
through a building process, as certain skills (such as distinguishing between issues of practicality
REFLECTIVE PRACTICES AND MFT CANDIDATES 29
versus values and beliefs) have to be acquired first. While this tool assists teachers in
discovering the different ways by which they think, it emphasizes the need for consultation and
collaboration to learn about different perspectives and viewpoints.
Similar to Schön’s (1992) concepts of specific reflective practices, Larrivee (2008)
identified four levels of reflection: pre-reflection, surface reflection, pedagogical reflection, and
critical reflection. At the pre-reflection or non-reflection level, teachers respond in an automatic
fashion whereby they do not put conscious effort into identifying alternative responses. Surface
level reflection focuses on implementing approaches to address preappointed goals about
predetermined professional skill standards and objectives. Pedagogical reflection attempts to
understand the connection between planned interventions and actual practice. Lastly, critical
reflection examines the professional, personal, social, ethical, and political implications of an
individual’s actions with the goal of ascertaining the full range of ramifications.
There was unanimity that reflection is a strategy which can continuously support
individuals in identifying solutions to indeterminate situations in order to develop and improve
skills in all professional fields (Hammer & Stanton, 1997; Tannenbaum et al., 2013). While
analyzing the reflective practices within the nursing profession, Clark, James, and Kelly (1996)
verified the purpose of reflection as understanding the experiences that one encounters within
economic, social-political, practical, self-knowledge, and technical arenas. Reflection was tied
to professional and personal development, and attainment of professional experience. The
acquisition of professional experience entails processes that build from concrete experiences to
application of abstract concepts to future experiences (Clark et al., 1996). In business settings,
success is created when reflection is encouraged on a day-to-day operational basis, which aids
institutionalization of reflective processes (Hammer & Stanton, 1997). Although it does take
REFLECTIVE PRACTICES AND MFT CANDIDATES 30
time to stop and think about the actions, events, and experiences, which are taking place, the
outcome is significant. The ultimate goal of reflective practice is to implement the use of what
Dewey (1938) previously referred to as intelligent action; reflection should occur in thoughts of
abstract tasks first, with subsequent reflection occurring after experimentation with the task at
hand.
Despite the identified benefits of reflective practices, various models highlight the
occasional challenges to application of reflective practices to practitioners across diverse
fields. Throughout the literature, there is often a gap between researchers in education and the
practitioners who are out in the field; reflective theories can be interpreted in overly simplistic
ways and do not necessarily equate to reflective practice (Schön, 1992; Zeichner, 1994;
Tannenbaum et al., 2013). Beauchamp (2015) identified gaps in empirical studies that examine
reflection, specifically noting inconsistent definitions of reflection, gaps between theory and
practice, and the tendency for reflective approaches to be narrow in scope. Furthermore,
Beauchamp (2015) also noted clear performance differences based on individual versus
collaborative reflection processes, and a lack of linkage and realistic applicability for use in
teacher education. Although theorists, most notably Schön (1992), identified strategies to bring
about systematic reflection, there is still a gap in actual implementation of the devised strategies
(Zeichner, 1994).
There is also evidence that indicates due to the lack of practicality of reflective practices,
unclear definitions, and absence of direct links to improved performance reflective practice may
not be completely beneficial. Danielowich (2007) examined the reflective practices and beliefs
of four different teachers and found that while reflection occurred, there was a lack of clarity in
how teachers would improve their practice to devise concrete strategies to achieve their desired
REFLECTIVE PRACTICES AND MFT CANDIDATES 31
goals. The study also noted the frequency in which reflection is emphasized as a tool without
clear indications of how to use that tool to improve practice. The inclusion of reflection as a
focus of teacher education has been identified as doing more harm than good due to the failure of
teacher educators to indicate the meaning of reflection and absence of modeled reflective
practices (Russell, 2013). Akbari (2007) found no evidence signifying improvements in student
or teacher performance because of reflective practices. However, Belvis, Pineda, Armengol, and
Moreno (2013) evaluated a teacher education program to determine the effectiveness in teaching
reflective practices. Results indicated that some of the teacher education objectives were met,
and the implementation of an action plan, which delineated the specific incorporation of
reflective practices, would ensure the transfer of knowledge to practice.
The pioneering development of reflection as a method of addressing inquiry in education
paved the way for more specific types of reflection (Dewey, 1938; Schön, 1992; Rodgers,
2002). Although there have been varying conclusions regarding the impact of reflective
practices across time, the majority of research indicates a positive correlation with regards to
performance (Banoobhai, 2012; Carlson & Perry, 2005). Current research on reflection and
reflective practices build upon the foundational works of Dewey (1938) and Schön (1992), and
provide both critiques as well as modifications to meet the needs of today’s educators.
Current State of Reflection in Education
Explicit instruction on reflective practices is a crucial component in the training of
educational and mental health professionals. Valli (1997) expanded on the reflective
frameworks of Dewey (1938) and Schön (1992) to include five types of reflective practice within
teaching: technical reflection, reflection-in-action, reflection-on-action, deliberative reflection,
personalistic reflection, and critical reflection. Valli (1997) suggested that collective and
REFLECTIVE PRACTICES AND MFT CANDIDATES 32
simultaneous use of the reflective practice results to the best outcome. Engaging in these
techniques allows for: analysis of one’s own performance, identification of significant events
which occur, recognition of multiple perspectives, finding a link between personal and
professional roles, and political interpretations of one’s workplace.
According to Valli (1997), there are two types of reflection: content and quality. First,
content refers to what the individual considers significant. Secondly, quality focuses on how the
individual processes the thought. The individual who is able to process multiple perspectives
and opinions shows more advanced functioning when compared against those who separate
situations into right or wrong. Beauchamp (2015) added the concept of anticipatory reflection,
which addresses future concerns that are associated with the significance of focusing on the
development of self and one’s own identity.
Williams and Grudnoff (2011) emphasized the importance of deliberate and specific
teaching of reflection and reflective practice with pre-service student teachers compared and
contrasted with the perceptions of experienced teachers. The study introduced the same model
of reflection to 12 beginning teachers and 12 experienced teachers. The study introduced
Smyth’s model for personal and professional empowerment to teach the participants the
components of critical reflection. Smyth’s model includes four steps: describe, inform,
confront, and reconstruct. Within the first step of describe, an individual should provide a
thorough narrative of the problem. For the next step, inform, the individual will collaboratively
consult with other professional peers to gain varying perspectives on the problem. The third step
is confront, which entails an examination of the problem through various lenses such as political
and contextual. The last step is reconstruct, in which the individual takes into consideration
other professionals’ perspectives in conjunction with actions to address future problem
REFLECTIVE PRACTICES AND MFT CANDIDATES 33
reoccurrence. Data collected via semi-structured interviews indicated that both groups began to
utilize reflective practices as an analytical tool to make changes to their teaching
practices. Findings indicated that novice teachers were able to utilize Smyth’s model to apply
the use of reflection in their growing professional experiences in the classroom environment.
For experienced teachers, Smyth’s framework provided additional perspectives on skills and
increased structure for reflection (Williams &Grudnoff, 2011).
Fife and Whiting (2007) also highlight the significant role reflection plays in the
professional development process of mental health professionals, specifically MFTs. In a study
examining the implications of individual values on professional practice, recommendations were
made highlighting the need to explore values through reflection not only in training programs but
also in ongoing practice. The understanding of one’s values provides opportunities for therapists
to be more aware of their own biases and blind spots. This allows therapists to administer steady
services to clients without unexpected enmeshment of their therapeutic issues.
The insight that MFTs obtain about their own values through reflective practices assist
them in remaining value-neutral for their clients to maintain an ethical role in practice, thus
continuing professional growth. These findings have implications towards the current concern
regarding both the use of MFT candidates in educational settings to provide social-emotional
support, as well as their initial training. Reflective practice can play a crucial role not only on
the professional growth of MFT candidates, but also on repercussions on the quality of services
to students with social-emotional needs (Fife & Whiting, 2007).
Reflection is most beneficial when conducted in a systematic manner. Although Dewey
(1938) identified the benefits of reflective practice, a conundrum existed regarding the specific
practices that would be conducted. Numerous authors since Dewey (1938) have argued that the
REFLECTIVE PRACTICES AND MFT CANDIDATES 34
effectiveness of reflection exists only in the presence of systematically rigorous practices. Since
reflection is a specific and systematic method of thinking, there exists opportunities for
additional assessment, rehearsal, and perfection of techniques (Mezirow, 1981). Farrell (2012)
further found that reflection is used as a form of metacognition within the field of education, and
through examination of his own experiences as a teacher, identifies the use of reflection in
advancing skills. Fundamentally, routine thoughts that are guided by motives such as habit,
impulsivity, and power, are not equivalent to reflective practices. As such, reflective thought,
when conducted systematically and combined with teaching experiences, promotes professional
growth.
As MFT candidates receive their first clinical training during their traineeship, the use of
reflective practices may provide guidance in rehearsal of techniques as a method of helping build
clinical skill. However, it is the systematic nature of reflective practices, which shows and
promotes the most professional growth. Williams (1995) also noted that it was the routine and
consistent process of internalized thinking of one’s own practice that could enable a clinician to
become their own self-consultant in practice.
Reflective review of concepts allow for more meaningful interpretations and experiences.
Mezirow (1981) discussed the concept of critical reflectivity in which knowledge and awareness
of why we attach meanings to reality is the most significant aspect of adult learning. As such,
critical reflectivity plays a big part in how adults learn and change perspectives, and significant
implication on the method by which adult learners, specifically educators, learn through use of
reflective practice. Additionally, in Zeichner’s (1994) review of the development of reflective
practices in the school setting revealed that reflection of one’s own experiences is a crucial
component for educators to understand their methods of teaching and to advance in their field of
REFLECTIVE PRACTICES AND MFT CANDIDATES 35
work.
While education in reflective practice is promising, it is not necessarily certain that it will
result in reflective behavior. As literature has demonstrated the benefits of reflective practice
use, Schönexamples exist. For example, Williams and Grudnoff (2011) found that while expert
teachers indicate the knowledge and usefulness of Smyth’s steps of reflection, it did not
necessarily result in reflective behavior. Jaeger (2013) notes that while there are opportunities
for reflection to be a transferrable skill and therefore effectively utilized in classrooms to
improve student learning, such opportunities are not always capitalized upon effectively. While
reflective practices such as Donald Schön’s (1992) reflection-in-action are encouraged in teacher
education programs, they are built into activities at the conclusion of a teaching task and not
always utilized during practice. It is during the clinical supervision of MFT candidates where
tools such as Schön’s (1992) reflection-in-action can be incorporated to facilitate reflective
practice in the process of building professional clinical skills.
As such, while there is significant potential for reflective practices to enhance and
support reflection in practice and professional growth, that potential is not often realized (Jaeger,
2013). Belvis et al. (2013) evaluated a teacher education program to determine the effectiveness
in teaching reflective practices. A mixed-methods study was conducted with 284 participants
who partook in a training activity where they were asked to reflect on their own educational
practices in small groups. Results from surveys, reports and interviews were analyzed in the
areas of learning, transfer and impact. The Holistic Model was used to evaluate the transfer of
knowledge and the impact of training on participants. The study found that reflective practice
was applied in an individual fashion and was not incorporated in the school culture.
However, outcomes improved in instances where the school culture supported teachers in
REFLECTIVE PRACTICES AND MFT CANDIDATES 36
implementing novel concepts, and the teachers did not have an extraneous workload (Velvis et
al., 2013). Additionally, there was no significant evidence of the effects that teacher reflection
had on student learning outcomes. Due to their current professional duties, teachers are already
by nature reflective in their practices (Edwards & Thomas, 2010). The authors noted the claim
that teachers need to practice and incorporate reflective practices is therefore redundant and not
productive. The authors made an argument for the need to have context-specific reflective
processes aimed at particular aspects of improving educational outcomes (Edwards & Thomas,
2010). MFT candidates have the opportunity to implement context-specific reflective practices,
which aim to foster skills during clinical supervision. Therefore, it is imperative to incorporate
models and structure for the cultivation of reflective practice amongst practitioners.
Reflective practices are generally used to support the decision-making processes of
professionals. The overall goal of reflection is to enhance professional practice of individuals
within educational settings and therefore improve student access to education. Literature in this
section thus far has discussed experiences and tribulations of professionals in school settings as a
whole, with MFTs as a subset of those professionals that experience different professional
preparation and development. Although reflection encourages flexibility of teaching skills with
educators, MFTs are required to adapt their practices continually to provide services that fit with
the client’s idiosyncratic needs (LaTorre, 2005). Additionally, there is a need to utilize reflective
practices to identify biases and value conflicts that may jeopardize the effectiveness of
interventions to students receiving mental health services in the school setting.
Current State of Reflection in Mental Health
As within education, clinical mental health practice and supervision is also inherently
reflective in nature. In a study examining organizational reflective practices to provide support
REFLECTIVE PRACTICES AND MFT CANDIDATES 37
to mental health clinicians, Raney (2014) noted that clinical supervision and practice are
reflective in nature. A case study was conducted to identify the mindfulness practices and
leadership principles of a community mental health center. Furthermore, mindfulness practices
were an ongoing practice that required an individual to be aware of their surroundings, as well as
experiences within one’s body and mind. Individuals who utilized mindfulness practices
facilitate detailed reflective processes as they had rich recollections of situations and actions.
The study noted clinical practice utilizes reflective properties to ensure effectiveness in working
with various populations (Raney, 2014).
Although clinical supervision and practice are considered reflective in nature, the term
“reflective practices” are used interchangeably with various terms throughout empirical literature
on mental health. For example, Osterman (1990) used the term “self-awareness” to describe the
reflective process of looking at one’s performance, which in turn manufactures growth
opportunities as well as professional development. This process was reminiscent of Schön
(1992), who identified the concept of reflection-on-action as reviewing one’s action and
processes. Kottler and Jones (2003) stated that reflection both described and was a component of
“self-supervision,” which is the process of examining one’s own experiences, awareness of when
one should seek consultation, as well as a means by which therapists generate client
interventions. Raney (2014) further used the term “mindfulness” to discuss the process of being
aware of one’s actions and their environments. This is akin to Schön’s (1992) concept of
reflection-in-action and knowing-in-action, which requires awareness within a situation in order
to identify potential for change. The term “self-monitoring” was also used to describe the
process of reflecting on one’s cultural competence, personal and professional life circumstances,
countertransference issues, limitations, and values (Kottler& Jones, 2003). Additionally, the
REFLECTIVE PRACTICES AND MFT CANDIDATES 38
process of reflectivity was described as a meaningful engagement in questioning oneself,
focusing on the purpose and goals of therapy, and how therapy itself works (Nelson &Neufeldt,
1998).
The therapeutic process plays a role in creating an inherent reaction on behalf of the MFT
to reflect on the session with the client. The therapeutic process typically begins with a client
seeking help and the therapist facilitating an openness and willingness to explore the client’s
story (LaTorre, 2005). Nelson and Neufeldt (1998) emphasized the “reflective practitioner”
concept, in which a clinician routinely reflects on information encountered in client therapy
sessions. Additionally, MFTs continuously assess the boundaries between their personal and
professional selves in an effort to build up self-awareness (Osterman, 1990; Protinsky& Coward,
2001). The ability for the therapist to step back and reflect on the therapeutic conversation with
their client provides an opportunity to become aware of personal observation and feelings that
could either benefit or hinder the interaction (LaTorre, 2005; Kottler& Jones, 2003).
Reflection was identified as a standard inclusive concept for best practices in the field of
infant and family mental health. Weatherston, Kaplan-Estrin, and Goldberg (2009) conducted a
study examining the competency guidelines for an infant mental health program. In the
competency guidelines created by the authors, reflective practice was specifically highlighted as
a skill area. Furthermore, the authors noted the importance of reflection in promoting continuous
curiosity and commitment to examination of personal thoughts and feelings, values and concerns
during a clinician’s work with young children and their families (Weatherston et al., 2009).
Reflective supervision is able to highlight many complex levels of feeling and
behaving. Larrieu& Dickson (2009) examined the effectiveness of clinical supervision of mental
health pre-licensed professionals. The study found that the supervision process is reflective in
REFLECTIVE PRACTICES AND MFT CANDIDATES 39
nature, and it illustrates the value of reflection completed in a context of a trusting relationship
between supervisor and MFT candidate. As such, it provides an avenue to assist therapists in
facilitating healthy and gratifying interactions for families desiring to help in righting
interactions with their children. Additionally, the use of reflection with practitioners allowed for
building an understanding of their own personal issues, enabling them to recognize and respond
to client’s needs in an effective and validating manner (Larrieu& Dickson, 2009).
Reflection is a valuable practice to emphasize in the education of counselors, therapists,
and mental health professionals when it is done in an active manner in a safe environment
conducive to professional growth. Leung (2007) found that once social work practitioners are
able to reflect on their practice experiences they will be better able to construct new knowledge
and develop new ways of solving problems within larger institutional contexts. The reflective
learning process involves doubt, hesitation, and ambivalence. Similar to Dewey’s (1938) quiet
reflection, this process allows mental health professionals a time to pause and refrain from
engaging in extraneous activities, which may not contribute or strengthen their professional skill
development process. Griffith and Frieden (2000) emphasized the need for reflection amongst
clinicans to build upon their competence as mental health professionals. Due to the lack of
training in the area of reflection, social workers made more mistakes after graduating from their
education program when compared with individuals still enrolled. It is suggested that
individuals still enrolled in their education program receive scaffolds and guidance in utilizing
reflective practice more frequently than when individuals are on their own post graduation
(Leung, 2007).
Students in the field of mental health are able to gain a greater awareness of their own
personal development. Schmidt & Adkins (2012) note that providing reflective experiences
REFLECTIVE PRACTICES AND MFT CANDIDATES 40
throughout counseling curriculum forces students out of their comfort zones and not only
facilitates but enhances the reflective processes greatly. The purpose of the study was to explore
counseling students’ and faculty’s understandings of the nature of reflection, specifically
purposeful critical thinking, and beliefs about reflective practice best taught and learned. The
study revealed that reflection plays a role in enabling comfort with dissonance invoking
experiences, and extends perspective taking abilities. Furthermore, it is also important for
faculty to examine and improve on their own system of inquiry using reflective practices to
improve professional skills. Norton, Russell, Wisner &Uriarte (2011) found that having faculty
examine their own system of inquiry helped them improve their own clinical skills, which
assisted in being good reflective practitioner role models for their students. As faculty served as
good reflective role models, they also created rich learning environments that facilitated the
development of reflective practice skills in their students.
Reflective practices allow mental health practitioners to identify, process, and interpret
field experiences in an effort to build on their prior knowledge and facilitate professional
growth. Rizq, Manminder, Salvo, Spencer, Varnaseri, and Whitfield (2010) conducted a
thematic analysis based upon participants’ fieldwork experiences in a reflective practice
group. Participants completed reflective papers written in the context of clinical work that was
done in the reflective practice group over an 8-month period. The reflective papers showed
several experience-based themes such as training and preparation, undertaking clinical work, and
professional development and career plans (Rizq et al., 2010). The reflective group and papers
provided opportunity for participants to discuss and elaborate on their experiences. Rizq et al.
(2010) also indicated all of their participants expressed being caught off guard with the
complexity in the types of clinical cases assigned early in their professional careers. As MFT
REFLECTIVE PRACTICES AND MFT CANDIDATES 41
candidates are beginning their clinical practice in traineeship, these findings have significant
implications towards the MFT candidate training process.
Leung (2007) conducted a qualitative study using in-depth reflection-based interviews of
three different mental health service providers in Hong Kong, China. Participants were involved
in a continuous process of reflection through self-dialogue and interaction. The three main
themes of participant accounts were to value conflict in practice, unawareness of self, abuse of
power in practice. The use of reflection is encouraged in order to develop conscious, proactive,
and responsive professionals (Leung, 2007). More specifically, Pack (2011) noted the effects of
case reflections in the field of social work. Case reflections include self-critique reflections,
which are guided by student feedback. This method allowed social work educators to portray a
more realistic picture of practice for students (Pack, 2011). Modeling reflective practices for
graduate students who are learning to become social workers provides them an opportunity to
learn various strategies and tools that will assist them in developing skills to facilitate continuous
professional growth. This current study will further examine and clarify the specific
development and nature of reflective practices with MFT candidates in the United States, with
the intention of adding to the body of existing literature regarding the benefits of reflective
practice.
Reflective practices facilitate increased introspection of mental health professionals
regarding the efficacy of their practices, as well as examination of their professional
development. Literature has identified the benefits of utilization of reflective practices in
developing perspective taking as well as processing complex and difficult experiences. As
mentioned previously, literature notes that clinical supervision is generally reflective in nature,
and reflective supervision is able to explore different levels of behavior and emotion (Raney,
REFLECTIVE PRACTICES AND MFT CANDIDATES 42
2014; Larrieu& Dickson, 2009). Additionally, reflection is valuable when conducted in a safe
environment for therapists, counselors, and other mental health professionals. Individuals who
seek to pursue careers in counseling (such as MFT candidates) are typically more aware of their
own professional development and the use of reflective practices allow for the strengthening of
those metacognitive processes which advance clinical skills.
While there is literature that explores and discusses the benefits and helpfulness of
reflective practice for mental health practitioners, there is a void in the research body with
regards to several factors. Wigg, Cushway, and Neal (2011) noted in their review of literature
that there is little research on how reflective practices are used in practice, how reflection
changes the way in which practitioners work, and whether or not reflective practice has any
bearings on the services itself. Furthermore, Fisher, Chew, and Leow (2015) highlighted a
general lack of consensus as to how researchers measure the use of reflection, as well as how
reflection is utilized in practice by clinicians.
These findings are particularly relevant in the current state of education, as mental health
professionals (with MFTs included) are called upon to provide services to students with
significant mental health concerns. Without appropriate quality mental health services, students
experience symptoms that can result in the lack of access to their educational curriculum at
school. The lack of access has the potential to create significant gaps amongst those who are in
need of social and emotional support within the K-12 school setting. The training that MFT
candidates receive in regards to reflective practice can cultivate awareness of the complexity of
student social-emotional needs, and potentially begin conversations regarding the need of
students.
REFLECTIVE PRACTICES AND MFT CANDIDATES 43
Current State of Reflection towards Equity and Access in Mental Health
Student with special needs who qualify under the eligibility of “emotional disturbance”
experience greater difficulties obtaining equal access to educational curriculum. Individuals with
Disabilities Education Act (IDEA) mandates that students with disabilities are given access to
the general curriculum in the least restrictive environment (Individuals with Disabilities
Education Improvement Act, 2004). Special education services were subsequently tailored with
the goal supporting students’ placement in the least restrictive educational environment. IDEA
brought about change to the standards and criteria by which students qualify for a variety of
services, such as mental health, thereby changing the landscape of special education services.
Emotional Disturbance (ED) is one of thirteen special education eligibility categories
identified by IDEA. The criterion for emotional disturbance has been under much scrutiny since
the language found in the definition allows the assessor to interpret the results using their own
judgment and subjectivity (Blanchett, 2006; Hart, Cramer, Harry, Kliger, &Sturges, 2010;
Cullinan, Harniss, Esptein, &Ryser, 2002). A credentialed school psychologist typically
conducts the assessment. Although school psychologists are trained to interpret results in a
scientific and data based manner, it is difficult to guarantee their own social, cultural, or
interpersonal perspectives have not influenced outcome of the assessment (Hart et al., 2010).
While MFT candidates in their traineeship setting are not responsible for special
education assessments, they are however providing services to students with social-emotional
needs. MFT candidates as service providers have frequent contact with students and would be
able to quickly observe student responses to a particular placement or change in placement. It is
therefore imperative for MFT candidates to be cognizant of social-emotional changes in the
student, highlighting the importance of the use of reflective practice in bringing forth their
REFLECTIVE PRACTICES AND MFT CANDIDATES 44
awareness of their practice and of how the student presents. Furthermore, it is important to take
into consideration the viewpoints of all individuals working directly with these students. With
that, a collaborative decision can be made to determine whether there is a necessity to assess a
student for special education services. In the collaborative setting, individuals can address the
possible negative ramifications for erroneously assessing for special education.
Raines, Deveer, Kamphaus, and Roach (2012) identified the negative implications of
inappropriate placement of students in special education. African American students are about
1.5 times more likely to receive special education services compared to same-age students of
other racial and ethnic groups; they are approximately 2.86 times more likely to be identified has
intellectually disabled and 2.28 times more likely to labeled with an emotional disturbance (U.S.
Department of Education, 2010). The unnecessary placement of students in special education
can have a far-reaching and detrimental effect on a student’s social, emotional, and academic
development. In addition, students who are misplaced in special education may suffer social
isolation, have lower self-esteem, and disenfranchisement from quality education (Raines et al.,
2012).
Gage (2012) found that girls who are identified as special education students with
emotional disturbance are more likely to exhibit internalizing behaviors such as anxiety, shyness,
withdrawal, and hypersensitivity towards others. They are also more likely to be arrested for
offenses such as running away from home more so than their typically functioning peers. All of
the symptoms aforementioned can affect a student’s access to in-class instruction in a general
education setting, as it diverts student attention away from curriculum and the school setting
(Gage, 2012). Additionally, high school graduation is a difficult goal to attain for you with
mental and emotional difficulties (Stompolis, Vishnevksy, Reeve, Munsell, Cook, & Kilmer,
REFLECTIVE PRACTICES AND MFT CANDIDATES 45
2012). School-based programs have been designed with the intention to aid children and young
adults with social-emotional issues and concerns, however students with these special needs are
often excluded from standardized education assessments which hinders the evaluation of the
program’s success. Furthermore, students with emotional disturbance, who have a social-
emotional need, may require additional services to have access to the general education
curriculum in order to achieve academic success. However, many school do not provide such
services, which further increases, the attainment gap for students with special needs (Strompolis
et al., 2012).
There is an increase in students that receive mental health counseling services in an
educational setting. Mental health counseling is defined as a related service provided to students
who exhibit deficits or problematic behaviors in social-emotional realms that impedes their
academic success within a school setting (USDOE, 2010). With the passing of the first federal
law mandating equal access to public education for children with a handicap (Public Law 94-
142) in 1975, a range of expanded agendas have been advocated with the goal to integrate
educational and mental health services (United States Department of Education [USDOE],
2010). Services such as full-service schools for children with severe social, emotional, and
behavioral issues, as well as school-based mental health programs, arose out of the advocacy
attempts. As policies and mandates came about, the creation of many school-based mental
health programs in schools resulted in a need for mental health professionals to provide
services. While school psychologists and counselors first provided services, eventually MFTs
were introduced into the educational setting.
Schools have historically played a significant role in addressing social, emotional, and
behavioral needs to children because it is often the earliest non-familial setting in which mental
REFLECTIVE PRACTICES AND MFT CANDIDATES 46
health issues are observed in children (Stein et al., 2012). Because teachers and school staff
spend significant portions of time with students during the day, problematic emotional and
behavioral issues can be noticed and reported earlier. The extended amount of time school staff
spends with students help in providing detailed accounts of concerning student behaviors. This
is beneficial in treatment because of their ability in not only detecting at-risk students, but also
tailoring services to ensure that student needs are met. Additionally, the professionals in the
school setting, particularly school psychologists and school based mental health counselors, have
the skill set to detect externalizing and internalizing problems early on (Bradshaw, Buckley,
&Ialongo, 2008).
Similarly, educational settings can also offer access to services and referrals to other
treatment settings (Stein et al., 2012; Bradshaw et al., 2008). Bradshaw et al. (2008) conducted a
qualitative study, which drew upon and analyzed data gathered as part of Johns Hopkins
Prevention and Intervention Center’s (JHPIC) 2007 examination of urban first graders and
mental health. Bradshaw et al. (2008) found that of the 678 total students in the JHPIC sample,
44.7% of students received some type of school-based service between the first and ninth grade.
Moreover, approximately 65% of the students continued to receive mental health services in the
ninth grade. These significant numbers of students who continue to require school-based
services demonstrate the importance of mental health practitioners in the school
setting. Furthermore, as the number of services increase, the quality of services as well as the
training and competency of the providers becomes increasingly relevant. As a component of
pertinent clinical process, reflective practice assists in the maintenance of the high level of
quality of care that students should be receiving (Leung, 2007).
Various factors contributed to the demand and referral bottleneck for mental health
REFLECTIVE PRACTICES AND MFT CANDIDATES 47
service providers in the school setting. Thomas, Ellis, Konrad, Holzer, and Morrissey (2009)
note that individuals with mental illness in the justice system, homelessness, and widespread
unmet need for mental health services are all systemic problems that has led to a shortage in
service providers. Mellin (2009) noted 32% of older children between the ages of 13-17 years
old are diagnosed with more than one mental health disorder. The responsibilities of mental
health professionals have diverted to testing and assessing students and responding to crisis
intervention rather than providing sustained support for students with social and emotional needs
(Atkins, Hoagwood, Kutash, &Seidman, 2009). With their attention focused on other duties, the
much-needed mental health services students require is inconsistent. These additional duties
impede the service provider’s position in providing students with mental health needs the
consistent and necessary social and emotional support.
As such, the growing number of children suffering needlessly because of their emotional,
behavioral, and developmental needs are not being met by the institutions that are created to
meet their idiosyncratic needs (Mellin, 2009). As literature has previously stated, reflective
practices have been shown to have influence on the professional development of mental health
clinicians. Therefore, as mental health needs continue to grow it is imperative for attention to be
focused on not only the services and those that are providing said services. Similarly, there
should also be a focus on the ongoing training process of those providers.
Reflective Framework
Various theorists have explored and developed models to identify the components that
constitute reflective practice. While most theorists focus on reflection within the realm of
educators and the teacher preparation process, elements of certain theories are applicable to other
professions, including mental health. This study utilized components from three specific
REFLECTIVE PRACTICES AND MFT CANDIDATES 48
theorists on reflection: Schön (1992), Valli (1997), Farrell (2012). As shown in Table 2.1, the
reflective framework used to guide this study begins with a specific event discussed in a clinical
consultation setting, such as clinical supervision.
Table 2.1: MFT Candidate Reflective Framework

It is during this consultation that the identification of skills used in the event is
discussed. This skills identification is also known as the process of reviewing steps taken, or the
clinical decision making process (Valli, 1997). The skills identification is also an extension of
Schön’s (1992) concept of reflection-on-action, as the MFT candidate would be referring back
on actions and steps taken to address a specific issue. Next, during critical thinking, MFT
candidates can identify successes and areas of improvement with the utilization of Valli’s (1997)
critical reflection. Valli (1997) noted the significance of critical reflection in improving the
REFLECTIVE PRACTICES AND MFT CANDIDATES 49
quality of services provided to underrepresented groups. During the deliberative reflection stage
individuals have the opportunity to consult with group members. This stage is based off Valli’s
(1997) view on deliberative reflection, which aims to achieve perspective taking and
identification of alternative solutions to address issues. Additionally, this stage draws upon
Valli’s (1997) personalistic reflection, which involves examining and having competence in
one’s own professional judgment as well as the suggestions and judgments of others. Rodger’s
(2002) notion of open-mindedness was incorporated in this stage since it requires one to put
aside their own beliefs and perspectives and have an unbiased understanding of the outlook
presented by group members.
In the second to the last step, MFT candidates will utilize the reflection application
process, which involves a testing of suggestions provided in the previous step. This is modeled
after Valli’s (1997) concept of hypothesis testing as a means of trying out suggested practices by
others. This process involves the connection of past and present ideas, as well as suggestions
from others, in the development and execution of a plan. It also utilizes components of Farrell’s
(2012) Stop-Look-Discover in which MFT candidates practice pausing in action to reflect on
appropriate next steps to a given task. This process can also be referred to as Reflection-in-
Action, which drives in the moment decision-making. Lastly, technical reflection occurs as the
MFT candidate reflects upon implemented strategies utilized for a specific scenario for
effectiveness. Drawing upon Valli’s (1997) concept of technical reflection, at this stage MFT
candidates explore the progress of their interventions with relation to goals, as well as
intervention adherence and fidelity.
Table 2.2 displays the steps of reflection for this framework along with the specific
reflective components and theoretical background by which the concepts were derived.
REFLECTIVE PRACTICES AND MFT CANDIDATES 50
Table 2.2: MFT Candidate Reflective Framework Components
Step of Reflection Reflective Components Theoretical Background
Setting Event
● Case consultation
● Examining one’s own inner voice
● Examining peer views on action taken
● Personalistic Reflection
(Valli, 1997)
Reviewing Steps
Taken
● Identification and review of events occurred during the
previous therapy session
● Reflection-on-action
(Schön, 1992)
Critical Thinking
● Identifying areas of improvement
● Identifying successes
● Identifying implications of actions taken
● Identifying socio-cultural and economic implications of
interventions and practice
● Critical Reflection
(Valli, 1997)
Deliberative
Reflection
● Examining multiple perspectives
● Identifying alternative strategies or techniques to address
issues
● Seek clinical suggestions from peer group
● Deliberative Reflection
(Valli, 1997)
● Personalistic Reflection
(Valli, 1997)
● Open-mindedness
(Rodgers, 2002)
Reflective
Application
● Connecting between past and present ideas
● Testing of peer suggestions
● Reflection-in-Action
● Stop-Look-Discover
● Reflection-in-action
(Schön, 1992)
● Stop-Look-Discover
(Farrell, 2012)
Technical
Reflection
● Determining if strategies utilized were effective
● Examining the progress of goals
● Examining if interventions were used appropriately
● Technical Reflection
(Valli, 1997)

Schön (1992) described reflection as a component of the concept of higher learning,
which utilizes complex cognitive tasks in order to build complex cognitive processes. Schön
(1992) built upon the work of Dewey’s (1938) seminal work on reflection by identifying three
specific components of reflective practice: knowing-in-action, reflection-in-action, and
conversation with the situation. Additionally, Valli (1997) identified five different orientations
within two specific dimensions of reflection: content and quality. The five orientations include
technical reflection, reflection-in-action and reflection-on-action, deliberative reflection,
personalistic reflection, and critical reflection.
Each of the orientations is meant for collaborative use, and assist in building reflective
REFLECTIVE PRACTICES AND MFT CANDIDATES 51
practices in professionals. Farrell (2012) discussed the use of reflection as a form of
metacognition within the field of education. Farrell (2012) described phases of reflective
thought within the “stop, look, and discover” method, which suggests that reflection should
occur in the moment. Farrell’s (2012) five phases include: suggestion, intellectualization,
guiding idea, reasoning, and hypothesis testing (Farrell, 2012).
Within the suggestion phase, potential solutions are developed to address a doubtful,
problematic situation. Next, during intellectualization, the problem is further analyzed. During
guiding idea, ideas are developed one at a time to address the problem. The initial idea can be
used as a working hypothesis that triggers observations and gathering of factual evidence. The
reasoning phase finds connects between past and present ideas. Finally, during hypothesis
testing, the refined idea is attained. Farrell’s (2012) reflective method added to Schön’s (1992)
reflection-in-action, also known as “stop and think,” which involves taking a moment to think
about what happened. Pausing before action therefore results in a significantly more meaningful
thought process, which aids in professional growth.
While Schön (1992) laid the groundwork for reflection in education, Valli (1997), Farrell
(2012), and other researchers have continued to build on the framework. Reflection is an
ongoing process, which enhances the professional growth of educators and practitioners. It is
with Schön (1992), Valli (1997), Rodgers (2002), and Farrell’s (2012) existing theories with
which this study explored the nature of reflective practices among MFT candidates providing
mental health counseling services in a K-12 educational setting. Table 2.2 explains the reflective
components and theoretical background linked with each step of reflection within the framework
used for this study.
There are previously developed reflective frameworks that are similar across varying
REFLECTIVE PRACTICES AND MFT CANDIDATES 52
professions. For example, Orlick (2000) developed a six-step procedure for athletes to develop
self-growth. The athletes began by identifying an area they wanted to improve. Other steps
included reflection on strategies that may have aided in self-growth in the area(s) they had
identified. In the end, this approach was intended to facilitate the development of self-
supervision (Orlick, 2000). Lowe (2000) also formulated a combination of several thought
processes into a sequence of reflection. The sequence began with self-supervision, then led to
therapy sessions with clients, back to self-supervision, next to collaborative case consultation,
back again to self-supervision, and finally to the next therapy session. This process is cyclical in
nature, and designed to merge the personal experiences of the clinician with the therapeutic
practices to form stronger clinical skills (Lowe, 2000).
This framework was utilized in the creation of individual interview protocols, focus
group protocols, as well as observation protocols, which is discussed in the methodology section
and included in the appendices. Furthermore, this framework guided the analysis of all
interview, focus group, and observation data.
Summary
Reflective practices have developed over time to support the diverse needs of
practitioners. With that, there have been conflicting views on the implementation and processes
of professional reflection. While researchers debate the effectiveness and process of reflection, it
is a fundamental component in enhancing teachers’ perceptions, decision-making, attitude, and
instruction. Teachers who engage in reflective practices are more likely to change their practice
to better meet the diverse needs of students with disabilities. Consequently, the lack of reflection
in education effects teacher’s decision-making processes hindering their ability to improve
general access to education. While practitioners working in mental health inherently incorporate
REFLECTIVE PRACTICES AND MFT CANDIDATES 53
reflection in their work, it further allows them to identify, process, and interpret field experiences
potentially leading to enhancement of their clinical skills.

REFLECTIVE PRACTICES AND MFT CANDIDATES 54
Chapter Three: Methodology
3

This study addressed the inconsistency in levels of mental health services from service
providers in a K-12 school setting. An estimated one in ten students have a significant mental
health problem that impairs functioning in the school, home, and community environments
(Stagman& Cooper, 2010). While mental health services are available for students in the school
setting, there is still an ongoing question of what the services entail as well as the educational
impact (Kataoka, Rowan, &Hoagwood, 2009). There is also a further concern of the inconsistent
levels of service from providers in the K-12 setting; not all clinicians provide the same quality of
services (Santiago, Kataoka, Forness, & Miranda, 2014). Nonetheless, reflective processes
provide a way to help therapists facilitate healthy and positive interactions with clients, as well as
construct new knowledge (Larrieu& Dickson, 2009; Leung, 2007). Given the influence
reflection can have on the quality and level of mental health services, we as researchers were
curious about the nature of those reflective practices in the training period of professionals,
namely those that can and may provide mental health services to individuals in a K-12 setting in
the future: Marriage and Family Therapy (MFT) candidates.
There were two overarching goals of this study. The first goal was to identify the
reflective practices of graduate students obtaining a degree in Marriage and Family Therapy. In
doing so, the study explored the existing knowledge Marriage and Family Therapists had
regarding reflective practices. A second goal of this study was to develop a better understanding
of the relationship between reflective practice and the training MFTs received while obtaining
their professional degrees, with the hope of eventually improving consistency in educational
mental health services. This study examined the following research questions:

3
Chapter was co-written by Tsuilei L. Mace and Michelle Y. Tehrani, with each contributing
equally to the work.
REFLECTIVE PRACTICES AND MFT CANDIDATES 55
1. How are Marriage and Family Therapy candidates describing the reflective practices they
use in a traineeship program within a K-12 educational setting?
2. How are MFT candidates’ perceptions of reflective practice impacting their ability to
consistently support students with social and emotional needs within the school setting?
Methods
This study employed a qualitative inquiry approach. Qualitative research designs are by
nature interested in figuring out how individuals understand their experiences and environments,
and what meaning do they attribute to their experiences (Merriam, 2009). The potential
meanings MFT candidates attributed to reflective practices may influence their clinical practice
with students and their professional development. This information was vital to better
understand the role reflection plays for MFT candidates who were providing counseling services
to students with social and emotional needs in a K-12 setting. No other inquiry approach
provided the level of detail and insight into MFT candidate perceptions, nor did other methods
allow for a comprehensive examination of reflective practices. The data in this study consisted
of rich descriptions to capture credible data via interviews and observations. Utilizing an
inductive method, concepts and theories derived from the collection of data (Merriam, 2009).
The design of this study, as with all qualitative research, evolved during the data
collection process (Merriam, 2009). This flexibility was necessary since researchers could not
control the findings in observations. The primary source of data collection in this study was the
use of MFT candidate interviews during their traineeships. Interviews were conducted to better
understand their perceptions of reflective practices in order to identify what could not be directly
noted via observations (Merriam, 2009; Patton, 2002). The study also involved observations and
review of artifacts. The artifacts the researcher collected included the weekly clinical
REFLECTIVE PRACTICES AND MFT CANDIDATES 56
supervision agendas, which detailed the items that were discussed during each meeting. The
artifacts shed light on whether or not reflective practices were highlighted as part of the training
agenda and curriculum. Both methods allowed the researcher to gain additional awareness of the
potential complexity of reflective experiences. Utilizing different data collection methods
provided not only different aspects of a topic of information, but also richer data descriptions
(Maxwell, 2013).
Sample and Site Selection
Site Selection. Valleyridge Charter School sites across Los Angeles were utilized for
data collection in this study. These sites were selected due to the traineeship program that is
offered to second year MFT candidates. The MFT candidates that participated in the traineeship
program provided direct mental health counseling services to students in the school
setting. Additionally, they received clinical group supervision at the various school
sites. During clinical group supervision, the MFT candidates participated in various training
topics, case consultations, and opportunities for clinical feedback.
The gatekeepers for this study included the Director of Clinical Services and the Clinical
Supervisors for the MFT candidates. As individuals who have the ability to grant access to a
research collection site or population, gatekeepers are crucial individuals to initiate contact with
early in the data collection process (Glesne, 2011). Initially, the Director of Clinical Services
was contacted through email to inquire about and gain access to the sites for this study. Next, a
face-to-face meeting was scheduled with the Director of Clinical Services to discuss the purpose
of the study, the research questions, and the methods of data collection. After meeting with the
Director of Clinical Services, the Clinical Supervisors for the MFT candidates were contacted via
email. The initial email described the purpose of the study and briefly described the participant’s
REFLECTIVE PRACTICES AND MFT CANDIDATES 57
involvement in the study. All emails will included a brief description of the topic of discussion,
why the sites were selected, what the findings will be used for, contact information of the
researcher for further questions and/or concerns, approximate observation and interview
durations, and a request for their participation (Bogdan&Biklen, 2007). Upon receipt of
interview participants’ consent via email, the date, time, and location of the initial observation
were set up and confirmed via email.
Observation participants. For this study, three total observations were conducted using
an observation protocol (Appendix E). There were six participants in each observation: five
MFT candidates and one clinical supervisor. There were no more than eight total MFT candidate
participants per observation because the California Board of Behavioral Sciences limits each
clinical supervision group to have no more than eight total individuals receiving supervision
(Madsen, 2016). The clinical supervisor moderated and guided the group supervision and
facilitated training topics based on the weekly agenda. The participants were selected utilizing a
purposeful, criterion based sampling based on the criteria that they must be a second year
masters level candidate in a MFT program, and currently completing a traineeship in a K-12
school setting that enabled them to provide mental health services for at least one school
year. The decision to use criterion-based sampling, otherwise identified as purposeful sampling,
allowed for the collection of information rich data (Merriam, 2009). Supervision groups were
held on a weekly basis for the purpose of student case consultation and collaboration with both
MFT candidates and clinical supervisors. The decision to utilize the groups for observations was
primarily due to the ability to use the collaborative nature of the groups to examine interactions
between supervisors and MFT candidates concerning development of clinical skill, review of
skill effectiveness, and potential use of reflective practices.
REFLECTIVE PRACTICES AND MFT CANDIDATES 58
Interview participants. There were three total interview participants. Interview
participants were selected using purposeful, criterion based sampling method for the same reason
as discussed above for observations (Merriam, 2009).All interview participants were MFT
candidates participating in the Clinical Counseling Program within ValleyridgeCharter Schools,
who fulfilled all aforementioned criteria. Furthermore, all interview participants had at least six
months of experience providing clinical services, which allowed for more information rich
interview data. The experience also controlled for the participants who are new and therefore
lacked opportunities to have sufficient clinical and supervision experiences. Researchers
approached participants in their clinical group supervision meetings and provided details of the
study in a 15 minute presentation with a handout (Appendix A) included: research goals,
research questions, purpose of the interview, duration of interviews, use of recording during the
interview, and the researcher’s contact information. All candidates present at the time of the
presentation were eligible to participate in the study because all clinical group supervision
individuals were second year MFT candidates providing support to students with social and
emotional needs in a school setting. Individuals interested in participating were asked to
complete a contact information form (Appendix B), which asked for a cell phone number, email
address, and availability. After the completion of the interview, each participant received a $5
Starbucks gift card as a token of appreciation from the researcher.
Focus group participants. There were four participants in the focus group. Participants
were selected using purposeful, criterion-based sampling. Focus group participants were
selected based upon the following criteria: role as a clinical supervisor within the
ValleyridgeCharter School organization, and supervision of MFT candidates in both group and
individual supervision. While Merriam (2009) stated that it is ideal to have focus groups that
REFLECTIVE PRACTICES AND MFT CANDIDATES 59
have between six and ten participants, as well as participants who are not familiar with each
other. The focus group participant make-up for this study was selected to provide the most
information specific to the Valleyridgetraining program. After the completion of the focus group
interview, each participant received a $5 Starbucks gift card as a token of appreciation from the
researcher(s).
Data Collection
This study collected data using observations, interviews and artifacts. Observations were
significant in qualitative research because it provided imperative information regarding the
behaviors or participants, what they did, how they did it, and with whom they did it
with. Observations allowed the researcher to interpret what they observed first hand (Merriam,
2009). Additionally, observations provided the researcher with information that an interview
could explore to gain further knowledge and data. The interview aimed to guide conversations
with the purpose of finding specific information. Interviewing informed the researcher about a
participant’s personal experience and their interpretation of their experiences (Weiss,
1994). Bogdan and Biklen (2007) noted that another type of data collection was using
documents or artifacts. Documents were used to further support the interviews and observations
conducted for data collection.
Data collection sequence. Data collection for this study began with artifact collection
and various clinical supervision forms. The researcher reviewed weekly group supervision
agendas to gain insight and understanding of the training topics, as well as the format and
structure of group supervision meetings. Next, the researchers observed the clinical group
supervision of MFT candidates. There were three observations. The observations were
conducted in order to gain a better understanding of the training MFT candidates receive. It is
REFLECTIVE PRACTICES AND MFT CANDIDATES 60
important to note that the reason the observations were conducted before the focus group and
interviews was to maintain an observer role. In this role, the researcher was present in the setting
where data collection was taking place, however the researcher had no involvement in the setting
(Merriam, 2009). Furthermore, conducting observations before focus groups and interviews
decreased the likelihood of response biases with participants, where they act according to their
perceptions of what the researcher is looking for. If interviews were conducted before
observations, it would be more likely that the participants would display the reflective practices
the researcher inquired about during the prior interview.
A focus group was conducted next with the four clinical supervisors to explore their use
of experiences of reflective practices in their own supervisory experiences. The focus group
facilitated exploration of supervisors’ observations of MFT candidates and their experiences of
reflection in both group and individual clinical supervisions. Lastly, individual interviews were
scheduled with MFT candidates who volunteered to participate in the study. During the
interviews, the researcher asked the participant to describe their perceptions of reflective
practice.
Artifacts. An agenda of weekly group supervision dates and topics, as well as various
clinical supervision forms, were provided at the beginning of the traineeship. The agenda listed
training topics to be covered for most meetings. Researchers collected and reviewed the group
supervision agenda to identify any potential reflective components built into clinical group
supervision. Document review, including the agendas, supported and helped facilitate
observations and interviews, which resulted in richer and more in-depth data (Bogdan&Biklen,
2007). The researcher collected the agenda written for the 2015-2016 year to learn about the
training materials that were discussed during clinical supervision and if there were elements of
REFLECTIVE PRACTICES AND MFT CANDIDATES 61
reflective practice. The use of the agendas also fulfilled the purpose of assisting the researchers
in developing interview questions inquiring about the potential use of reflective practices
encouraged or guided by clinical supervisors.
Observations. There were three separate observations of clinical group
supervision. Clinical group supervisions occurred on a weekly basis at a ValleyridgeCharter
School location and was facilitated and led by at least one clinical supervisor with five MFT
candidates in attendance. Each observation was approximately three hours long. In all three
observations, the researcher maintained an overt position and took field notes during the
observation. The researcher took an overt position by being forthcoming with the research
intentions with the participants. The overt role provided the researcher with more access to
participants in the setting they were planning on observing (Bogdan&Biklen, 2007). The
researcher filled the role of the observer in the meeting, which meant that they not participate in
the interactions of the meeting beyond the initial introduction to others in the group as an
observer. The purpose of each of the observations was to examine the interactions of the MFT
candidates, specifically looking to see if there were instances of critical reflection of a MFT
candidate’s actions in strengthening their clinical skills during the group supervision
process. Furthermore, the observations explored whether or not the candidates were encouraged
or otherwise guided to engage in reflective practices by the clinical supervisors or other means in
the group.
Focus group interview. Two researchers (Tsuilei L. Mace and Michelle Y. Tehrani)
conducted one focus group interview with four out of five clinical supervisors to ascertain
information regarding the training and supervision component of the MFT candidate
traineeship. The interview aimed to gain insight into what, if any, reflective practices clinical
REFLECTIVE PRACTICES AND MFT CANDIDATES 62
supervisors taught and encouraged MFT candidates to use during both group and individual
supervision. The researchers approached each of the five clinical supervisors within the
Valleyridgeorganization and provided an overview of the study, as well as the purpose of the
focus group. The researchers also clearly stated the duration of the focus group (approximately
30 minutes) and noted participation in the group would not be an evaluation of their job
performance. The researchers utilized a semi-structured focus group interview protocol
(Appendix D) to facilitate discussion amongst participants. The researchers gained consent from
the participants to record the focus group interview, and took brief notes, in order for more
accurate data collection. In the event any participant did not grant permission for the interview
recordings, the researcher would have taken detailed field notes as a means of data
collection. The online transcription program (www.rev.com) was used to transcribe the focus
group interview recording.
Interviews. Interviews were utilized as a data collection method to ascertain MFT
candidates’ use of reflective practices. Semi-structured interviews were conducted using the
interview protocol (Appendix C). Semi-structured interviews are common in qualitative
research. This interview methodology incorporated more or less structured questions and
provided the researcher the opportunity to be flexible while conducting the interview (Merriam,
2009). Flexibility was imperative during interviews to allow for follow up questions or probing
questions of participant responses. Because not all information provided could be obtained
through observations, interviews provided the opportunity to obtain rich detailed accounts of
individuals’ experiences. Additionally, interviews allowed for further examination of how MFT
candidates utilized reflective practices.
In an effort to increase the likelihood that the interviews would occur and to provide
REFLECTIVE PRACTICES AND MFT CANDIDATES 63
convenience to the participants, interviews were be conducted at a location selected by the
participant. Each individual interview was approximately one hour. The researcher gained
consent from the participant to record the interview, as well as take brief notes, in order for more
accurate data collection. In the event the participant did not grant permission for the recording of
the interview, the researcher would take detailed field notes as a means of data collection. An
online transcription program (www.rev.com) was used to transcribe the interview
recordings. Before beginning the interview process, the researcher also discussed
confidentiality, specifically noting that there were specific steps during the data analysis period
to protect participant identities. The pseudonyms of the participants, as well as the data
collection processes that they were participants of, are displayed in Table 3.1.
Table 3.1: Participant Information Table
Participant Focus
Group
Interview
#1
Interview
#2
Interview
#3
Observation
#1
Observation
#2
Observation
#3
Erica x x
Cindy x
Isabelle x
Stephen x
Jasmine x x x
Claire x x x x
Layla x x
Natalie x x x x
Tatiana x x x
Monique x x x x
Anna x

Maxwell (2013) stated that the rapport one builds with an interview participant could be
problematic. In an effort to increase participant comfort with the interview process and address
the potential power dynamic, the researcher explained the non-evaluative nature of the questions
and observations. Additionally, the researcher informed participants that there would not be
any judgments made on their performance as a MFT candidate at the school site.
REFLECTIVE PRACTICES AND MFT CANDIDATES 64
Memo. The researcher created a written memo immediately upon the conclusion of each
observation and interview. Memos were no longer than two pages and detailed any factors that
influenced the researcher’s positionality (Bogdan&Biklen, 2007). Furthermore, memos also
detailed any distinct reactions from the observation or interview, surprising findings, or potential
patterns emerging in the data (Lichtman, 2014). Memos were reviewed during the data analysis
process in conjunction with detailed field notes that contained observer comments. Data memos
were utilized during the data analysis process as they facilitated deeper thinking and analysis of
data (Maxwell, 2013).
Data Analysis
Data analysis began by creating a priori codes. Typically, preceding data collection, a
priori codes are already of interest before research has begun and created based on the literature
review (Harding, 2013). Next, the researcher reviewed interview transcripts and observation
notes. While reading through these documents, the researcher identified empirical
codes. Empirical codes were then created from the collected data (Harding, 2013). Next, the
researcher created categories based on the a priori and empirical codes that were written on the
transcripts and observation notes. In order to have a visual understanding of the codes listed, the
researcher created a chart listing the codes and the amount of times each code appeared in the
interviews and observations. It should be noted that the data analysis process began
collaboratively with input from both Tsuilei L. Mace and Michelle Y. Tehrani. Both researchers
created a priori together based upon the literature found on reflective practices. Empirical codes
were subsequently created independently based upon themes that emerged from the data
collected by the individual researcher. The analysis of all data collected occurred individually.
Finally, the researcher conducted a second cycle of coding. Miles et al. (2014) defined
REFLECTIVE PRACTICES AND MFT CANDIDATES 65
second cycle coding as pattern coding. By identifying the patterns, the researcher was able to re-
group the codes into smaller categories, which led to identification of themes in the data. During
the data analysis process, care was taken to maintain confidentiality of all research participants
by using pseudonyms in place of identifiable information. The raw research data was kept on a
password-locked computer and file names contained no identifiable information to maintain
participant confidentiality.
As a method to assist in data analysis, the researcher utilized memos to track the
development of ideas, as well as to document any countertransference that occurred throughout
the data collection and analysis process. Data memos provided an arena for the researcher to
track the data analysis process, and promote critical and conceptual thinking (Harding,
2013). Furthermore, memos helped facilitate analytic thinking about data patterns and prompted
researcher awareness of the data analysis process (Maxwell, 2013).
A priori codes. A priori codes were created based upon a review of literature on the
topic of reflective practice. Several pieces of literature that were instrumental in the creation of
the codes include Schön’s (1992) types of reflection, Valli’s (1997) work on types of reflection
in instructional practice, and Farrell’s (2012) framework of stages of reflection. Additionally,
Larrieu and Dickson’s (2009) description of the clinical supervision process as inherently
reflective in nature suggested that the guidance of the supervisor is crucial in clinician
development.
As such, the a priori codes were: field experience, professional development, reflection-
in-action, reflection-on-action, knowing-in-action, conversation with the situation, technical
reflection, deliberative reflection, critical thinking, reflection application, and reflection
definition/terminology.
REFLECTIVE PRACTICES AND MFT CANDIDATES 66
Researcher Biases/Positionality
Credibility and trustworthiness were important factors in conducting accurate data
analysis. Triangulation by method of data collection was one strategy used to ensure credibility
and to reduce the likelihood of biases occurring in data analysis (Maxwell, 2014). Triangulation
involved using different research methods to compare findings with one another (Maxwell,
2014). For this study, triangulation occurred through the process of using interviews,
observations, and gathering of artifacts (weekly clinical group supervision agendas). Miles,
Huberman, and Saldana (2014) noted findings are more dependable when they are drawn upon
from numerous independent sources.
Peer review and examination of data analysis developed credibility of the data and of the
study. Merriam (2009) described this strategy as discussions with peers regarding the process of
study and determining if findings in the raw data are consistent amongst one another. “If/Then”
statements tested the explanations in the study in order to warrant credibility. Miles et al. (2014)
explained “If/Then” statements as a means to describe expected relationships. In order to create
predictions; a large number of “ifs” need to be linked with a single major “then.” This strategy
was helpful when identifying themes throughout interviews and observations.
The researcher also discussed their position within the study. They engaged in critical
self-reflection on the assumptions, worldview, biases, theoretical orientation, and relationship to
the study that may have influenced the study (Merriam, 2009). Additionally, the use of data
memos throughout the data collection and analysis process further assisted in increasing
trustworthiness by improving data confirmability, as well as researcher reflexivity and researcher
effects (Merriam, 2009; Lincoln &Guba, 1985).
Furthermore, member checking addressed subjectivity. In the process of member
REFLECTIVE PRACTICES AND MFT CANDIDATES 67
checking, participants affirmed the data analysis and interpretations to reduce misinterpretations
and ensure validity (Merriam, 2009). Member checking monitored the truthfulness of
participants to ensure accurate and truthful responses.

REFLECTIVE PRACTICES AND MFT CANDIDATES 68
Chapter Four: Findings
4

The number of students that have a significant mental health need has seen a substantial
increase, which has implications for their functioning within the home, school, and community
settings (Stagman& Cooper, 2010). Subsequently, as a category of mental health providers,
Marriage and Family Therapists (MFT) providing school-based counseling services to students
with social and emotional needs have increased due to the high demand for services. Mental
health providers such as MFTs have extensive training prior to providing direct services,
however the services provided to students are not always consistent in quality (California Board
of Behavioral Sciences [CA BBS], 2015; Santiago, Kataoka, Forness& Miranda, 2014). This
study aimed to address the inconsistent levels of support and services the students with social
and emotional needs receive in educational settings. As reflective practices have been seen as
useful in the building of new knowledge upon past experiences, questions arise regarding the
utilization of those practices on the training of MFT candidates (Pack, 2011). The goal of this
study was to develop a better understanding of the role of reflective practices in the MFT
candidate training process while receiving their professional degrees. Furthermore, this study
examined how MFT candidates described their engagement with reflective practices while
obtaining a degree in Marriage and Family Therapy. Lastly, this study explored the existing
knowledge MFT candidates had regarding reflective practices.
Several authors were instrumental in the development of reflective practices in the United
States. First and foremost, Dewey (1938) pioneered the concepts of progressive education,
which formed the base for the use of reflection within education. Subsequently, Farrell (2012),
Schön (1992), Zeichner (1994), Valli (1997), and others contributed to the further expansion of

4
This introductionwas co-written by Tsuilei L. Mace and Michelle Y. Tehrani, with each
contributing equally to the work.
REFLECTIVE PRACTICES AND MFT CANDIDATES 69
the reflection concepts by adapting concepts to education and other fields, as well as creating
specific tools for reflection. Research in education has shown that the incorporation of reflective
practices helps ensure the transfer of knowledge into practice, and assists in therapist gaining
awareness of their personal values to improve professional practice (Belvis et al., 2013; Fife &
Whiting, 2007). Additionally, research has noted the importance of deliberate and specific
teaching of reflection and reflective practice in professional growth (Williams &Grudnoff,
2011). Expanding on previous research, Williams and Grudnoff (2011) also introduced Smyth’s
model of reflective practice in examining a problem, which encompasses the four steps of
describe, inform, confront, and reconstruct. Within mental health, the process of clinical
supervision has been found to be reflective in nature and the practitioners that are able to reflect
on their experiences tend to be better able to develop problem solving capabilities within larger
institutional contexts (Larrieu& Dickson, 2009; Leung, 2007). Furthermore, research showed
that different practices, such as mindfulness, were also able to facilitate reflective processes,
which helped facilitate better recollections of actions and events (Raney, 2014). Case reflections
in the field of social work, which can include self-critique reflections, result in a process that not
only elicits peer feedback but also provides realistic portrait of practice for students (Pack, 2011).
By providing reflective experiences throughout the educational process of counselors and
therapists, graduate students are forced to go outside of their comfort zones, which helps build
and enhance their reflective processes (Schmidt & Adkin, 2012).
This study utilized a qualitative inquiry approach. Data were collected from clinical
group supervision observations, individual interviews with MFT candidates, a focus group
interview with clinical supervisors, and collection of artifacts. The findings aimed to answer the
following research questions:
REFLECTIVE PRACTICES AND MFT CANDIDATES 70
1. How are MFT candidates describing reflective practices they use in a traineeship program
within a K-12 educational setting?
2. How are MFT candidates’ perception of reflective practice impacting their ability to
consistently support students with social and emotional needs within the school setting?
This chapter further provides an analysis of data from the current study that aimed to
explore the reflective practices of Marriage and Family Therapist Candidates providing school
based mental health services. The purpose of this comprised of three components. First, to
develop a better understanding of the role of reflective practices in the training MFTs receive
while obtaining their professional degrees. Second, to examine how graduate students describe
their engagement with reflective practices while obtaining a degree in Marriage and Family
Therapy. Last, to explore the existing knowledge Marriage and Family Therapist candidates
have regarding reflective practices.
The next section will describe information regarding the sites and participants in this
study. To begin, there is an overview of the Valleyridge Charter School Clinical Counseling
program. Following the synopsis is a description of the focus group interview participants, the
observation interview participants, and the individual interview participants. The findings for
this study will follow the sections introducing all of the participants who were observed and
interviewed while collecting data.
Sites and Participants
Valleyridge Charter Schools
5

Data used in this study were collected from different Valleyridge Charter School sites
across Los Angeles, as well as from the Valleyridge Clinical Counseling Program, which is

5
This section was co-written by Tsuilei L. Mace and Michelle Y. Tehrani, with each
contributing equally to the work.
REFLECTIVE PRACTICES AND MFT CANDIDATES 71
based out of the Valleyridgeoffices in Southern California. Currently, there are a total of 16
ValleyridgeCharter school campuses in Northeast Los Angeles, North East San Fernando Valley,
as well as in Rochester, New York. Clinical counseling services are offered to students at all
Valleyridge Charter schools. The clinical counseling program’s mission statement to the schools
is “to provide a comprehensive school based counseling program that provides mental health and
pupil services in an educational environment that links students and families, reducing barriers to
learning and improving overall emotional development” (ValleyridgeCharter School, 2016). In
order to meet the mental health needs of the students across all campuses Valleyridge partners
with local colleges and universities to recruit MFT candidates as clinical counseling service
providers. In turn, MFT candidates are offered individual supervision, group supervision,
professional development, and trainings. This aligns with the mission statement to the trainees,
which is “to educate, support, develop, and supervise professionals towards successfully
achieving their academic and vocational goals to better service the community”
(ValleyridgeCharter School, 2016).
Focus Group
6

The focus group participants included four of the five clinical supervisors from the
ValleyridgeClinical Counseling Program. There were three female participants and one male
participant in the focus group. Each of the participants had at least 4 years of supervision
experience, and have been with the ValleyridgeClinical Counseling Program for at least 2 years.
In addition to participating in the annual Clinical Counseling Program curriculum development,
each focus group participant facilitated at least one group supervision session per week.
Furthermore, the participants provided professional development trainings during each group

6
This section was co-written by Tsuilei L. Mace and Michelle Y. Tehrani, with each
contributing equally to the work.
REFLECTIVE PRACTICES AND MFT CANDIDATES 72
supervision session. Training topics include: self-injury, grieving, domestic violence, job
preparedness, special education services, community resources, and more. The participants were
also responsible for training MFT candidates on evidence-based practices, art therapy, music
therapy, sand tray therapy, and group planning theory.
Focus group participants also served as the individual supervisors for approximately five
to eight MFT candidates throughout the year. The focus group participant #1, Erica, had over 17
years of clinical experience in both community mental health and mental health within the
educational settings. Erica was a Licensed Marriage and Family Therapist and also a registered
art therapist who graduated from a private university in the Los Angeles area. Additionally, Erica
also served as an associate professor for a masters program at a private Los Angeles university.
Focus group participant #2, Cindy, had over 12 years of experience in the field of mental health
and a Licensed Marriage and Family Therapist who served as an adjunct faculty member at a
private Los Angeles university for the past seven years. Focus group participant #3, Isabelle,
was also a Licensed Marriage and Family Therapist, and had over 12 years of mental health
experience. Isabelle had worked with a variety of populations including adolescents, adults, and
groups and has experience with community mental health as well as nonprofit agencies. Lastly,
focus group participant #4, Stephen, was a Licensed Marriage and Family Therapist with over
four years of experience in the field of mental health. Stephen was also an adjunct faculty
member at a local private Los Angeles university within the field of counseling psychology.
Two of the four participants were fluent bilingual English and Spanish speakers, and at times
would assist in providing translation services for MFT candidates who worked with Spanish
speaking families.
REFLECTIVE PRACTICES AND MFT CANDIDATES 73
Individual Interview Participants
There were a total of three individual interviews with MFT candidates; each of the three
candidates participated in one individual interview. The interview participants were all MFT
candidates who participated in the group observations. Each of the candidates provided direct
counseling services to students attending various ValleyridgeCharter Schools. Amongst their job
duties, MFT candidates were required to attend weekly group and individual supervision,
provide direct service to students on their caseload, create treatment plans, write progress notes,
and provide crisis counseling services to any student in need at their traineeship site. In addition
to individual counseling services, MFT candidates were required to run group counseling
sessions and family therapy sessions.
Interview participant #1, Natalie, was completing her traineeship hours at a middle school
within the Valleyridgecharter schools. She was simultaneously working towards her Masters in
Marriage and Family Therapy at a California State University. She was required to complete
approximately 20-25 hours of counseling services at her school site. With that, she was able to
provide services to roughly 15-18 students. She described some of her responsibilities as,
providing services to “students who are suicidal, self-harming, writing child abuse reports…”
(Individual Interview 1, p. 1). She described her site as having a high need for counseling
services, “at XXX, there was a high need for counseling so me and the other counselor never
really had downtime” (Individual Interview 1, p. 1).
Interview Participant #2, Monique, was completing her traineeship hours at a school with
students between grades five and eight within the Valleyridgecharter schools. She was enrolled
in a master’s program in Clinical Psychology with an emphasis in Marriage and Family Therapy
at a private university in Southern California. Upon graduation from her master’s program she
REFLECTIVE PRACTICES AND MFT CANDIDATES 74
will be continuing her education and will be working towards obtaining her doctorate in Clinical
Psychology. She described her traineeship role as providing individual, family, and group
clinical counseling services at her site. Since her site was for students between the fifth and
eighth grade the students needs varied and therefore her counseling approach needed to adapt to
the specific students she was providing services.
Interview Participant #3, Claire, was completing her traineeship hours at a campus within
the Valleyridgecharter schools, which had middle school and high school students between sixth
and twelfth grades. Claire was enrolled in a master’s program in Marriage and Family Therapy
and Counseling at a private professional university in Southern California. Her responsibilities
as an MFT candidate at her traineeship site were to “mainly provide therapeutic services for
middle and high school students and their families” (Individual Interview 3, p. 1). The
therapeutic services included individual therapy, group therapy, family therapy, and crisis
counseling.
Observations
There were a total of six observation participants for each of the three observations
conducted, one clinical supervisor and five MFT candidates. The clinical supervisor, Jasmine,
during the observations was the only one who was not present for the focus group interview.
Jasmine has worked as a Licensed Clinical Social Worker for the past nine years. She has been a
clinical supervisor for the clinical counseling program at ValleyridgeCharter for almost five
years.
These observations were conducted at Spartan Charter High School, one of many
Valleyridgecharter school locations. All six of the observation participants were female. The
racial makeup of the observation participants included participants of Caucasian, Middle Eastern,
REFLECTIVE PRACTICES AND MFT CANDIDATES 75
and Hispanic backgrounds. The observation participants ranged between the ages of 20-40 years
old.
The observations were conducted during the three-hour weekly group supervision
meeting. Each of the observation participants was observed during a block of three hours for the
entirety of their clinical group supervision. The ValleyridgeClinical Counseling Program
provided clinical group supervision to satisfy MFT traineeship requirements of graduate
programs. The weekly group supervision included a community circle question (which guided
the MFT candidates to reflect on their counseling caseload) appreciations/reflections from the
week, informal and formal case presentations, and professional development trainings.
Group supervision was fluid in nature therefore observation participants were free to
attend different clinical supervision groups based upon their availability and location
convenience. All observation participants were students who had previously acquired Bachelor's
degrees and were currently in Master-level programs obtaining degrees within the field of
Marriage and Family Therapy. The individual interview participants (Claire, Natalie, and
Monique) were present for all three clinical group supervision observations. In addition to the
individual interview participants were Layla, Tatiana, and Anna. Tatiana was present for all
three clinical group supervision observations. However, Layla was present during the first two
clinical group supervision observations. Additionally, Anna was only present for the last
observation as she typically attended another clinical group supervision and needed to make up a
group supervision she had missed. Erica, one of the clinical supervisors from the focus group,
was also present for the last observation.
The majority of the clinical group supervision meetings had consistent agendas and
followed a pre-determined structure. The clinical group supervision structure and agendas were
REFLECTIVE PRACTICES AND MFT CANDIDATES 76
reviewed and amended as needed in the summer, prior to the beginning of every academic year.
Typically, the meeting began with a guided reflection question asked by the clinical supervisor.
Candidates would take a few minutes to reflect on the guided question then would share their
responses with the group. After this, the group as a whole would discuss individual cases and
complete case presentations, which at times included audio and video recordings of sessions.
Case presentation videos were recordings of an individual counseling session a MFT candidate
had with a student on their caseload. Other candidates would then provide feedback to one
another regarding their case presentations. They would identify successes and areas that the
presenter could make changes in their counseling approach. Following a short break was the
second half of group supervision. At this time, the clinical supervisor would provide a
professional development training on various topics, including but not limited to clinical
techniques, diagnostic issues, different interventions, theoretical orientation information, and job
preparation.
Results for Research Question One
Research question one asked how Marriage and Family Therapy [MFT] candidates
described the reflective practices they use in a their traineeship program within a K-12
educational setting. The data collected identified how MFT candidates described and defined the
reflective practices they utilized while completing their traineeship requirements at one of 16
ValleyridgeCharter school locations. The first theme described the various terms and definitions
MFT candidates used to explain their practices, such as self-supervision, self-care, and self-
awareness. While most participants did not directly use the term “reflective practice” they
described components of the reflective framework. However, in the fields of mental health and
clinical psychology the term “reflection” is often utilized as an intervention rather than a practice
REFLECTIVE PRACTICES AND MFT CANDIDATES 77
to assess one’s experiences in an effort to develop professional skills (Barnett et al., 2014). This
prior knowledge regarding reflection as an intervention could have affected the MFT candidate’s
awareness of reflection as a process to acquire clinical skill.The second theme that emerged
throughout the interviews and observations was the integration of these practices during their
traineeship. The clinical supervisors stated that there was an expectation for reflection as well as
opportunities for reflection during individual and group supervision.
Reflective Terminology
The individual and focus group interview data below depicted the MFT candidates’ and
clinical supervisors’ interpretations of reflective practice in relation to the clinical counseling
services provided to students with social and/or emotional needs in the K-12 setting. For this
study, reflective practice was defined as the active and persistent assessment of an individual’s
behavior and experience that is focused, challenging, and analytical as a step in constructing and
developing professional opinions, identity and skills (Chalikandy, 2014; Dewey, 1938; Hatton &
Smith, 1995; Osterman, 1990).
Alternative terminology. MFT candidates in this study used a variety of terms and
phrases to define and describe the reflective framework, although the phrase “reflective practice”
was rarely used. Claire used the terms “self-supervision” and “self-care” when describing her
interpretation of reflective practice. She stated, “I would define it as what you do to take care of
yourself and make sure that you’re meeting your needs so that you can help other people with
their needs” (Individual Interview 3, p. 3). Kottler and Jones (2003) described “self-supervision”
as a reflective practice where one processes their own experiences by which they determine the
need to seek consultation. While Claire’s description was not directly aligned with Kottler and
Jones (2003), they both focused on the idea that one should reflect to determine their own needs.
REFLECTIVE PRACTICES AND MFT CANDIDATES 78
On the other hand, Monique characterized reflective practice as “self-awareness.” She further
noted, “So being self-aware of the client’s needs as an individual and how I’m reflecting that in
therapy. Do I show the client that I really understand what he or she is coming in for?”
(Individual Interview 2, p. 2). Osterman (1990) supported the use of “self-awareness” to
describe reflection. He stated that awareness about the nature and effect of one’s performance
develops an awareness that creates opportunities for growth and professional development
(Osterman, 1990). Natalie defined reflective practice as an informal thought in her head, “It’s
like okay...I just had this experience, how did this go or is there something that I could have done
differently, how did it turn out when I did this?” (Individual Interview 1, p. 3). She further
explained, “I think it’s basically just kind of looking at what you’ve done and breaking down
how well it went, what you could have done differently, and how it may have impacted others
around you.” The focus group participant’s descriptions of reflective practice were aligned with
those of the MFT candidates. During the focus group interview, Erica indicated that they have
the MFT candidates “reflecting on all the different areas of their work” (Focus Group Interview,
p. 4). Isabelle further described that they encourage the candidates to reflect on their successes,
challenges, and areas of growth (Focus Group Interview, p. 4).
These descriptions aligned with Schön’s (1992) concept of “reflection-on-action” due to
the fact that the participants were describing reflection as a tool to refer back on actions and steps
taken to address a specific issue or situation. Furthermore, Osterman & Kottkamp (1993)
characterized “reflective practice” as challenging, focused and critical assessment of one’s own
behavior as a means towards developing one’s own craftsmanship. While the interview
participants did not directly use the term “reflective practice,” the components of reflection were
described throughout the individual and focus group interviews. Their interpretations of
REFLECTIVE PRACTICES AND MFT CANDIDATES 79
reflection coincide with the notion that these practices were instilled in an effort to better one’s
practice based on the clinical experiences that they have encountered.
Integration of Reflective Practices in Traineeship
The second theme that emerged was the notion that there was an expectation for MFT
candidates to use reflective practices throughout their traineeship. Although there was no formal
training on reflection provided to the candidates, there were components of reflection integrated
throughout their clinical training during both individual and group supervision. Raney (2014)
stated that clinical supervision is reflection in nature. Expectations for reflection were found in
artifacts such as the Individual Supervision Write-Up form and the Case Presentation Write-Up
form. Within these write-ups were questions that guided candidates to reflect on the clinical
services they provided to students. This information was then presented during individual and
group supervision in an effort to build upon candidates’ awareness on their clinical development
as well as gain perspectives from their colleagues and clinical supervisors. Therefore, although
they were not specifically trained in the area, candidates were provided with valuable tools that
could be utilized to reflect on the services they provided to students and their families.
Expectation for reflection. Throughout the traineeship program, there was an
expectation for candidates to reflect on their clinical work. The clinical supervisors claimed that
although no formal training on reflection was provided to the candidates, there was an
expectation for reflection that was incorporated throughout their weekly individual and group
supervision meetings (Focus Group Interview, p. 7). Weekly topics of discussion and
professional development trainings were listed on the Clinical Counseling Group Supervision
Calendar (Artifact #3) and the Clinical Counseling Summer Group Supervision Calendar
(Artifact #4). Topics included: self-care, coping with anxiety in session, being less critical,
REFLECTIVE PRACTICES AND MFT CANDIDATES 80
acknowledging successes, diversity of therapist, and more (Artifact #3 & Artifact #4).
Candidates were provided the Clinical Counseling Group Supervision Calendar during
orientation. During the focus group interview, Erica stated, “at orientation we do try to set forth
the expectation for the trainees to be as reflective in their learning process as
possible...throughout the year some are better at it than others” (Focus Group Interview, p. 4).
The expectation for reflection to take place forces students out of their comfort zone and not only
facilitates, but also enhances the reflective process greatly (Schmidt & Adkins, 2012). MFT
candidate Claire stated that while candidates did not receive training on reflective practices “it
was definitely discussed and harped on the importance of it” (Individual Interview 3, p. 3). One
reflective practice that was emphasized by the clinical supervisors was the ability for a MFT
candidate to compare their similarities and differences to the particular clients they were
providing services. Fife & Whiting (2007) noted that when therapists identify their own biases
and blind spots they are better able to provide steady services to clients.
Erica explained:
We always say to them, when you’re reflecting upon diversity issues...you are reflecting
on: What is the diversity of the client? What is your diversity? And, how is it that the
diversity you both bring it into sessions? How does that affect the therapeutic
relationship? (Focus Group Interview, p. 5)
The use of reflection for practitioners allowed for candidates to build a better understanding of
their own personal challenges (Larrieu & Dickson, 2009). As stated in the ValleyridgeClinical
Services Program Training Overview, one of the professional development topics that was
covered during weekly group supervision was in the area of cultural and diversity issues in order
for MFT candidates to “evaluate not only the client’s cultural and diversity issues but theirs as
REFLECTIVE PRACTICES AND MFT CANDIDATES 81
well” (Artifact #1, p. 3). Based on the Training Overview, this topic was significant for
candidates to be trained in because “self evaluation is key to remain unbiased and neutral”
(Artifact #1, p. 3). This enables MFT candidates to recognize and respond to their client’s needs
in an effective and more efficient manner (Larrieu & Dickson, 2009).
Another reflective practice, indicated by a clinical supervisor during the focus group that
was incorporated in the clinical counseling program was that all MFT candidates were obligated
to review transcripts of counseling sessions (Focus Group Interview, p. 5). It was required for
candidates to record and transcribe at least two counseling sessions. Then, the candidates would
bring the transcription of the session to an individual supervision meeting. During the
supervision meeting, the clinical supervisor and the MFT candidate would review the transcript.
While reviewing transcripts the candidates were expected to reflect upon their performance in
that session by questioning “why they asked the different questions that they did during session”
or “how did that impact the session” (Focus Group Interview, p. 5). Additionally, candidates
were asked to reflect on their similarities and differences with their clients. By doing so “they
are seeing how their perspective impacts the treatment they are providing” (Focus Group
Interview, p. 6). Schmidt and Adkins (2012) found that reflection plays a role in enabling
comfort with dissonance invoking experiences and extends perspective-taking abilities. Wilson
(2013) stated that reflection is internationally recognized as a key tool in ensuring that candidates
are prepared to address the uncertainties, challenges, and complexities they may encounter in
their professional career. With that, while MFT candidates did not receive formal training, they
were expected to reflect on their cases in an effort to build their clinical skills and develop
preparedness for their careers in mental health.
Opportunities for reflection in individual supervision. Clinical supervisors utilized
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tools to incorporate reflective practices during the mandatory one-hour weekly individual
supervision with the MFT candidate. As stated in the ValleyridgeClinical Services Program
description on the program’s website, during the weekly one hour individual supervision
meetings “written write-ups are due each week outlining celebrations/successes, areas needing
personal growth, critical evaluations of clinical skills, and case presentations” (Artifact #1, p. 2).
Clinical supervisor Erica described the purpose of individual supervision as giving guidance to
that specific MFT candidate, “on their strengths, challenges, what room they have for
improvement, and to talk specifically about their individual caseload” (Focus Group Interview,
p. 2). She further noted some of the reflective practices that were integrated within individual
supervision, such as “going over their individual supervision write-up, their case presentation
format, the giving of the pluses and deltas…” (Focus Group Interview, p. 7). Erica explained
that a “plus is what the trainee did well and delta is any kind of changes, things you’re curious
about, or questions you want to ask” (Focus Group Interview, p. 7). The Individual Supervision
Write-Up was a form that candidates were required to complete prior to their weekly meeting
with their clinical supervisor. This form acted as a guided reflection tool by asking questions
such as “What clinical skills challenged you this week? What are your areas of improvement?
What would you like to celebrate this week?” (Artifact #2, p. 1). Natalie further explained the
write-up could include “any crisis cases, any cases that we had questions about or we needed
advice on” (Individual Interview #1, p. 1). The Individual Supervision Write-Up was one
example of “technical reflection.” Valli (1997) describes “technical reflection” as one evaluating
their own performance based on an externally established criterion. When a student was referred
for counseling services in the school setting, there was a social or emotional need that was
impairing their ability to be academically successful. Natalie explained in an interview that the
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MFT candidate was responsible for designing treatment plans in order to help meet the needs of
the students on their caseloads (Individual Interview #1, p. 1). Treatment plans, as described on
the program’s website, included assessments of mental health status of students, short and long
term goals, identification of barriers to success, development of interventions to meet student’s
needs, assessing the role of the student, their school site, and the student’s family members, and
an evaluation of the outcomes of counseling (Artifact #1, p. 2). The Individual Supervision
Write-Ups were used for the candidate to evaluate their progress made based on the treatment
plan they had created for the students on their caseload. Therefore, each time the MFT candidate
met with the clinical supervisor for individual supervisor they discussed the progress students on
the candidate’s caseload had made toward meeting their short and long-term goals. During this
time, the supervisor provided feedback based on the information the candidate provided.
Feedback was given on intervention implementation; such as, interventions that could be used in
future sessions to better align clinical treatment with the student’s goals (Individual Interview
#2).
Opportunities for reflection in group supervision. The weekly group supervision
meetings had a structured format. Group supervision typically began with a community circle
question such as “What do they need to improve their case management skills?” (Artifact #5, p.
1). The community circle question guided the candidates to reflect on successes and areas they
may need to improve. During an observation of group supervision, the community circle
question the clinical supervisor asked was “how are things going at your school sites?”
(Observation #2, p. 4). After taking a few moments to reflect, each candidate answered the
community circle question. This type of reflection, as Mezirow (1981) states, is informal and
occurs when one becomes aware of a specific behavior or habit. Claire responded, “We’re
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testing this week and I’m starting to terminate with a few of my students. I am worried about the
crisis student who I had to report to Department of Children and Family Services [DCFS]. Do I
have to report if he continues disclosing information?” (Observation #2, p. 4). The Department
of Children and Family Services is contacted when there is suspected neglect and/or abuse of
children (Department of Children and Family Services, 2017). This question led to a group
discussion on law and ethics regarding child abuse reporting. By asking this question, Claire
gave her peers an opportunity to vicariously learn through her experience. This was one of the
benefits of group supervision Erica described during the focus group interview. Erica stated
during group supervision, “they’re not just learning and growing from their own individual
caseload, but the work of their peers and their caseloads as well” (Focus Group Interview, p. 2).
The vicarious learning process aids candidates to build collaboration with theirs peers that can
enhance their professional development in areas they would have not otherwise experienced
(Rizq et al., 2002). Natalie appreciated the opportunity to variouslylearn from her colleague’s
experience. She stated:
I learned a lot during group supervision because I was able to hear cases that I maybe
hadn’t gotten a chance to experience. Luckily I never had to make a child abuse report
but I heard from my peers what the process was like and how to navigate through it. And
even though I haven’t made a child abuse report, I have an idea of how the process looks
because of my peer’s experience. (Individual Interview #1, p. 3).
Therefore, due to the guided reflection question that occurred at the commencement of that
week’s group supervision one MFT candidate was able to learn through the experience of her
peer. This prior knowledge afforded candidates, such as Natalie, to be better prepared to handle
situations that may arise throughout their professional careers as Marriage and Family
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Therapists.
Obstacles to reflection. While there was an emphasis on the utilization of reflective
practices, the clinical supervisors and MFT candidates identified several obstacles that hindered
the use of reflection amongst the candidates. Clinical supervisor Stephen claimed that most
MFT candidates begin their traineeship feeling very anxious when reflecting on their work. He
said, “I think part of that is the fact that a lot of them are very young when they come into the
career” (Focus Group Interview, p. 6). Another common barrier was the potential for reflective
practice to lead to negative thoughts due to self-criticism. Natalie described an instance where
reflection affected her confidence. She said, “In the beginning there were times when it was
definitely hard to do it. As a beginner, I was more hesitant to take the time to reflect because I
was scared that I had done something wrong” (Individual Interview #1, p. 6). Similarly,
Monique stated:
Sometimes when I think about how a session went with a student, I start identifying all
the things I did wrong. Then I question whether or not I am really helping the student
meet their goals. Which leads me to think...should I even be in this program? (Individual
Interview #2, p. 4).
Additionally, Claire noted that sometimes it is the time required to reflect that gets in the way of
actually incorporating these practices. Danielowich (2007) described obstacles that may impede
one’s willingness to utilize reflective practices. One such obstacle may be the lack of clarity as
to how reflective practice should be utilized and the positive relationship between reflection and
the services that the MFT candidates were providing to their students (Wilson, 2013).
Discussion Research Question One
The MFT candidates in this study used various terms to describe reflection. They used
REFLECTIVE PRACTICES AND MFT CANDIDATES 86
terms such as “self-care,” “self-supervision,” and “self-awareness.” Although their terms varied,
their interpretations aligned with the definition of reflective practice that was used in this study,
which was to actively and persistently assess an individual’s behavior and experience in a
focused, challenging, and analytical manner. This was in order to construct and develop
professional opinions, identity and skills (Chalikandy, 2014; Dewey, 1938; Hatton & Smith,
1995; Osterman, 1990). Both MFT candidates and clinical supervisors stated that they did not
provide any formal training on reflection, however there were components of reflection
incorporated throughout the clinical program at ValleyridgeCharter School. Candidates had
opportunities to reflect during both individual and group supervision via the Individual
Supervision Write-Up form they completed prior to each individual supervision and the
community circle question at the beginning of each group supervision meeting. These tools
guided candidates to reflect on their clinical practices in an effort to further their professional
development and clinical expertise.
Results for Research Question Two
Research question two asked MFT candidates their perception of the impact reflective
practices had on their ability support students with social and emotional needs within the school
setting. The first theme that emerged was the perceived effects reflection had on their clinical
skills development during their traineeship. With the use of reflective practices, MFT candidates
explored the uncertainties that emerged during sessions with the students on their caseload.
They also used reflection to identify successes in their work with students and areas they needed
to improve, which lead to their growth as a MFT candidate. The second theme that manifested
was the role of collaboration during the weekly individual and group supervision meetings.
Collaboration was a critical component in the development of clinical skills amongst the MFT
REFLECTIVE PRACTICES AND MFT CANDIDATES 87
candidates.
Perceived Effects of Reflection
There were several perceived effects of reflective practices identified by the MFT
candidates and clinical supervisors. Some felt that reflective practices inspired change in their
clinical skills. Others noted the impact reflective practice had on the services they were
providing to students. Additionally, during both interviews and observations there were
conversations where candidates were reflecting on their actions during sessions. These reflective
conversations allowed candidates themselves, their colleagues, and clinical supervisors to
identify successes in sessions as well as areas where the candidate could further improve their
clinical skills.
Exploring the uncertainties of a situation. Through the utilization of reflective
practices, candidates were able to explore the uncertainties of a situation. Furthermore, they
were able to work through the possibility of change during client sessions. Schön (1992)
identified three components of reflective practice, one of which was conversation with the
situation. This reflective practice required one to take a moment to inquire about the
uncertainties the situation evoked. While thinking about the uncertainties, this reflection
encouraged one to further identify possible ways to resolve the situation they were reflecting on
(Schön, 1992). When describing her use of reflective practice, Natalie said, “it’s looking at how
something happened and whether if you had done something differently, how it would have
happened then” (Individual Interview #1, p. 4). This corroborated Schön’s (1992) description of
having a conversation with a situation because Natalie was illustrating the dialogue that would
lead to identifying the possibility of changing her therapeutic approach after taking time to
reflect on aligning the client’s needs with the treatment plan. Claire delineated a recent
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counseling session where she used the reflective practice. She said:
This student I was in session with was talking about harming himself. I wasn’t sure how
I could be of help, so I took a minute to think about it. Taking a moment to just pause,
and take a second to think about it was really helpful. It helped me from panicking. And
then I remember when one of my classmates was talking about how he handled a case
where the student was talking about self-harming. (Individual Interview #3, p. 4).
Claire’s description aligned with Schön’s (1992) reflection-in-action. When this reflective
practice is implemented, it requires one to stop and reflect about what is happening in the
moment (Schön, 1992). By taking a moment to pause and reflect, Claire was able to assess the
situation, identify her uncertainty with the direction she was leading the client, and in the end
better support her student in the clinical setting.
During an observation, the clinical supervisor was addressing concerns that candidates
had regarding their cases. The clinical supervisor, Jasmine, followed up on a case she had
learned about during an individual supervision meeting with Layla. She asked Layla to briefly
share information regarding the student with the group. Jasmine then asked Layla her treatment
plan for future sessions. Layla answered, “I’m not sure because I have noticed that he has been
doing better but when he talks about his parents it gets him worried and he expresses they get in
the way of his happiness.” After taking a minute to reflect, Layla began to think aloud. This
observation was aligned with Schön’s (1992) reflection-on-action. Reflection-on-action occurs
before or after practice and utilizes a learner’s metacognitive processes (Ferry & Ross-Gordon,
1998). Layla continued, “maybe I should have a session with his mom before I see him again.”
Jasmine reinforced her plan and together with the group they further discussed clinical
techniques that could be used in the family session (Observation #1, p. 1). The group
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supervision setting promoted clarity on the treatment plan Layla was devising for her student. In
group supervision, candidates had opportunities to collaborate with their colleagues. Rodgers
(2002) highlighted the importance of seeking multiple perspectives while reflecting on one’s
work in order to broaden conversations, rather than have narrow discussions. She found that
multiple perspectives created an environment for successful reflections amongst colleagues
(Rodgers, 2002). By reflecting on her session in the group setting, Layla was able to reflect back
on a session she was uncertain of and identify an intervention she would use to help meet her
student’s needs.
MFT candidates reflected on the uncertainties that occurred during a counseling session
by completing a Case Presentation Write-Up. The Case Presentation Write-Up was completed
prior to a formal case presentation that was conducted during group supervision. Clinical
supervisor Erica explained, “twice a year they have to do a formal case presentation in which
again, they are doing more reflective processing on a specific case” (Focus Group Interview, p.
5). Candidates completed the write-up when they are preparing to present a video or audio
recording of a counseling session; they had with a student, during group supervision. The Case
Presentation Write-Up (Artifact #6, pgs. 1-8) included:
● Student information
● Student’s genogram
● Student diagnosis
● Short-term, long-term, and family goals
● Student’s symptoms
● Review of student’s academics
● Case conceptualization based the theory that the MFT candidate was utilizing
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● Legal considerations
● Ethical considerations
● Possible impact of human diversity on therapeutic relationship
● Pluses and deltas
● Questions for the group regarding case
● Feedback received from peers
The questions candidates wrote for the group regarding the case required them to reflect back on
their session and inquire about the possibility to change their clinical approach in further sessions
to better meet the student’s short and long-term goals.
When describing the case presentation process, Monique explained “you’re turning to
your group members for advice and what the next step should be when you meet with your
student the following week. It’s helpful because you see the session through their perspective so
you’re able to find different ways to help your students” (Individual Interview #2, p. 5).
Monique’s reflection on her own work and the work of others allowed her to reorganize her
understandings of the situation at hand (Schön, 1992). Monique’s willingness to receive
feedback from her peers was aligned with Rodgers (2002) open-mindedness. With that, by
gaining multiple perspectives, MFT candidates were equipped with numerous clinical strategies
that could help in meeting their student’s counseling goals. These practices coincided with the
definition of reflective practice provided for this study because the candidates were actively
assessing their own behavior and experiences in an effort to develop professional opinions and
skills (Chalikandy, 2014; Dewey, 1938; Hatton & Smith, 1995; Osterman, 1990).
Successes and areas of improvement in service. Reflective practice allowed candidates
to determine the successes of mental health services provided to students on their caseload.
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Additionally, reflective practices provided opportunities for candidates to determine the areas
they needed to make improvements when working with students in the clinical setting. Zeichner
(1994) noted that reflection upon one’s own experiences is a necessary component in order to
better understand methods used and to identify the areas that needed to be improved on. This
practice aligns with Valli’s (1997) critical thinking. Critical thinking entailed identifying
success, areas of improvement, implications of actions taken, and identifying socio-cultural and
economic implications of interventions and practice (Valli, 1997). These components were
integrated throughout the traineeship program as evidenced by the topics covered during group
supervision (Artifact #3 & Artifact #4), the Individual Supervision Write-Up form (Artifact #2)
and the Case Presentation Write-Up form (Artifact #6).
The Clinical Counseling Summer Group Supervision Calendar, which specified specific
topics that were discussed during each meeting for the summer traineeship program, indicated a
meeting explicitly dedicated to “acknowledging successes” (Artifact #4, p. 1). Additionally, the
Individual Supervision Weekly Write-Up form incorporated questions that guided MFT
candidates to reflect on their strengths and weaknesses. The form required the candidate to
indicate successful interventions, positive interactions, personal growth, and areas for
improvement (Artifact #2, p. 1). Within the Case Presentation Write-Up form candidates
identified “pluses,” which were areas the candidate perceived the session to be successful and
aligned with the treatment plan. They also identified “deltas,” which were any areas that the
candidate was unclear of or had questions for their colleagues or supervisor during group
supervision.
Components of critical thinking were observed during group supervision when Claire
went over her case presentation. She began by giving background information on the client who
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was in the recorded session. Claire stated, “When XXX was first added to my caseload I
couldn’t get a word out of her. I almost thought she was a selective mute” (Observation #1, p.
5). She went on to describe the student’s short-term goals and the theoretical approach she
framed the treatment. She explained that this student was brought up during several individual
supervision meeting because she needed guidance from the clinical supervisor in how to address
the student’s needs when the student was refusing the participate. After watching the case
presentation video, Claire identified the pluses and deltas she had noted in her write up, which
were framed around her clinical skills. She stated:
After working with XXX over several weeks, I finally learned that I shouldn’t feel
pressured to have an ongoing dialogue. I mean, you all know how hard it is to get used to
the silence, but this kid taught me that a lot is said in the quiet moments. (Observation
#1, pg. 6).
This self-critique was voiced by another MFT candidate during an individual interview.
Monique expressed her viewpoint on reflection as “we get a lot of reflection from peers and
supervisors, but I think the most impactful is from within our self” (Individual Interview #2, p.
3). She went on to say that while feedback from supervisors and peers is imperative to building
clinical skills, “reflecting on our own strengths and weaknesses is really important because if you
don’t realize what you need to work on it’s going to be much harder to reach out for help”
(Individual Interview #2, p. 3).
Identifying successes candidates led to pinpointing areas where they appropriately
utilized their clinical skills to help their students meet their short term or long term counseling
goals. Furthermore, looking at their growing edges is significant for their development as
therapists who are still learning best practices to address the needs of the students on their
REFLECTIVE PRACTICES AND MFT CANDIDATES 93
caseload. By considering areas that need improvement, candidates would be able to develop
skills to respond more thoughtfully in the moment (Rizq et al., 2002).
MFT candidate growth. The use of reflective practices led to growth, which had a
direct impact on the effectiveness of the treatment, the MFT candidates provided to students on
their caseload. Reflection amongst mental health providers is indispensable and distinguishes
mediocre counselors from exemplary ones (Schmidt & Adkins, 2012). Furthermore, the practice
enhances critical thinking, reinforces learning throughout training, and is a means for substantial
professional development (Griffith & Frieden, 2000). Clinical supervisor Erica stated:
The reflective practice aspect, self reflecting, helps them to understand themselves a little
better and therefore provide better services for the clients. The more a trainee is
reflective, open, honest, and learning, and processing, how they’re working with clients,
it has a direction relation on the improvement of treatment. The clients on their caseload
get better treatment from that counselor because they are being more aware of how
they’re working with clients. (Focus Group Interview, pg. 6).
With that, the utilization of self-reflection can provide MFT candidates with opportunities to
learn and grow with each therapeutic interaction (La Torre, 2005). As stated by the clinical
supervisor, therewas a direct link between a candidate’s ability to reflect and the service they
provide to students in the counseling setting.
Furthermore, reflection on behalf of the MFT candidate in a therapeutic setting, can lead
to an enhancement in their participation in the therapeutic process (La Torre, 2005). Claire
identified a connection between self-care and the therapeutic services she was providing to
students. She found that taking care of herself allowed her to be more present with her clients.
She stated:
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I think the more you’re in this field, the better you learn what works for you in terms of
taking care of yourself. I think it’s just allowed me to be present with my clients, not be
focusing on outside stuff, things that are going on outside the counseling room. Because
I’m taking the necessary time to flush that stuff out and process that on my own time.
(Individual Interview #2, p. 7).
In an effort to reduce and avoid burnout, professional training was provided during group
supervision on “self-care” (Artifact #1, pg. 2). Monique recalled, “We talked a lot about self-
care…. about having a balanced life and separating work from our personal lives” (Individual
Interview #2, p. 6). Identifying strategies for self-care can reduce therapists feeling burned out
and therefore can lead to more effective treatment (Franco, 2015). Thus, by discussing methods
for candidates to care for themselves during group supervision have long-term effects on their
growth as MFT candidates.
Not only were MFT candidates utilizing reflection as a method to check on their self care
practices as clinicians, reflective practices were also used to assist in building awareness of
diversity and cultural competence as therapists. Candidates received training in the area of
cultural diversity (Artifact #4) in order for them to be able to identify how they differ or are
similar to their clients.Within the Case Presentation Write-Up form, MFT candidates were
guided to reflect similarities and differences in various areas of human diversity. This can
include similarities and differences in: physical appearance/attire, values and beliefs, upbringing,
education, language, birth order, disabilities, parental status/marital status,
acculturation/assimilation/birth place, gender, socio-economic status, religion, sexuality,
culture/ethnicity, and age (Artifact #6, p. 4-6).
During the focus group interview, Erica described the expectations for candidates’
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reflection on diversity. She stated:
We try to have them be very reflective on diversity, so when they talk about diversity
issues they’re not just focusing on how the client is diverse, on their ethnicity and
religion. We always say to them, when you’re reflecting upon diversity issues you can
apply it to any kind of subject area you’re looking at. (Focus Group Interview, p. 5).
By doing so, they would be able to identify how their similarities or differences impacted their
therapeutic relationship. Several professional development trainings were offered during their
traineeship to enhance their knowledge regarding culture and diversity issues. MFT candidate
Monique found that being culturally competent had an effect on the treatment she provided to
students. She noted that due to the population of students she worked with, having cultural
awareness was significant in order to better understand her students. MFT traineeship programs
are ethically and morally responsible for producing culturally competent therapists (McDowell et
al., 2003). Skills in this area are imperative for candidate’s professional development as they are
likely to provide services to individuals from various cultural backgrounds. While trainings were
provided to expand cultural awareness and participants were required to complete the Case
Presentation Write-Up form specifically identifying similarities and differences in human
diversity, this study did not find a significant outcome in regards to the impact of reflection and
cultural awareness.
Role of Collaboration in Traineeship
During individual and group supervision, candidates relied on reflective practice to
strengthen their clinical skills. These practices had a direct influence on the mental health
services they provided to students at their school sites. While participating in individual and
group supervision, candidates had opportunities to collaborate with their supervisor(s) and fellow
REFLECTIVE PRACTICES AND MFT CANDIDATES 96
MFT candidates. The process of collaboration facilitated comfort and built confidence in their
clinical skills. Rodgers (2002) developed a four-phase reflective cycle, in her work with teacher,
which included: presence in experience, description of experience, analysis of experience, and
experimentation. Within the “analysis of experience” phase teachers were challenged to think
based on multiple perspectives. This was intended to help build critical thinking skills. As such,
reflective practices incorporated during collaboration amongst MFT candidates and their clinical
supervisor during individual and group supervision with the intention to build clinical skills.
Furthermore, reflection could play a role in enabling comfort with dissonance invoking
experiences and extends perspective-taking abilities amongst candidates (Schmidt & Adkins,
2012).
MFT candidate - supervisor collaboration.MFT candidates expressed appreciating
individual supervision with their clinical supervisor because they were able to process cases and
receive feedback based on their supervisor’s perspective. Natalie expressed:
I’m so glad we got as much supervision as we did as trainees because I think that was the
most important and valuable thing for me. Knowing what I was doing and/or having
someone reflect on what I was doing or what they were seeing I had been doing. Kind of
seeing my growth through another person’s perspective was really important. And I
think it made me, helped me become better. (Individual Interview #1, p. 5).
Similar to Natalie, Claire also appreciated the opportunity to discuss cases with her supervisor
and getting feedback based on her perspective of the cases being reviewed (Individual Interview
#3, p. 2). By reviewing cases with her supervisor, Claire felt “a lot more at ease, a lot more
confident” (Individual Interview #3, p. 5). This perspective taking is similar to Valli’s (1997)
view on deliberative reflection, which aims to achieve perspective taking and identification of
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alternative solutions to address issues. As such, perspective taking during individual supervision
created feeling of support and assurance for candidates.
MFT candidate–MFT candidate collaboration.Similar to individual supervision,
candidate’s expressed an appreciation towards the perspective taking that occurred during group
supervision with their peers. Candidates were required to record a session with a student and
present the video or audio recording during group supervision. Along with the recording was a
Case Presentation Write-Up (Artifact #6). Throughout the Case-Presentation Write Up,
candidates were required to self-critique the counseling services they were providing through
different avenues. One area candidate’s self-critiqued was when they had to identify pluses and
deltas. As described earlier, a “plus is what the trainee did well and delta is any kind of changes,
things you’re curious about, or questions you want to ask” (Focus Group Interview, p. 7).
Therefore, they had to analyze and critique the successes or areas they thought they needed to
improve on prior to the group supervision meeting where they would be presenting their case
study video or recording as well as their Case Presentation Write-Up to their MFT candidates
and clinical supervisor.
Another opportunity for candidates’ to self-critique and receive feedback was when they
had to formulate questions for the group regarding the case presentation video. During the focus
group interview, Isabelle explained, “When they do their videos it’s not just the trainee who is
presenting and who is engaging in reflective practice of their own work with a client, it is the
whole group reflecting on that trainee’s work” (Focus Group Interview, p. 7). Included in
Artifact #6 were sample questions a candidate might have asked the group. For example, “Do
you think we shifted from question to question too rapidly? Were there some moments that I
should have stuck with longer or went deeper with?” (Artifact #6, p. 8). Pack (2011) stated that
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case presentations include self-critique reflections, which were guided by student feedback. For
the MFT candidates, they were required to self-critique prior to receiving feedback from their
peers. As observed during one of the group supervision meetings, Layla presented her case
video to the group. Prior to showing the video she posed the following question to the group: “In
the beginning I felt XXX was deflecting the questions I was asking, do you notice that too? And
if you do, was it because of the way I was asking? Was I being too aggressive?” (Observation
#2, p. 7). In doing so, Layla was able to pinpoint an area she may need additional support for her
peers and clinical supervisor. With that, she was able to utilize her peers and clinical supervisor
as resources to build her clinical skills.
Participants expressed feelings of anxiousness and support while presenting their case
video to their colleagues during group supervision. As explained by Claire:
We presented videos to the group at least twice throughout the year. It was definitely
nerve-racking though because you’re anxious about what your peers and supervisor
might say after watching your video. It’s pretty much the same as the write up in
individual supervision except now you have more people in the room to provide you
feedback. You get multiple opinions, which could be really helpful. You don’t have to
take all of it. You can pick and choose. But it’s nice to get a lot of different perspectives.
You see stuff from other points of view that you might have not considered beforehand.
(Individual Interview #3, p. 2).
Additionally, during an individual interview, Natalie described the case presentation as
“embarrassing” and “helpful.” She explained:
It was always helpful for me because I have four or five other perspectives of how I was
doing in session with the client and hearing that feedback was always really helpful even
REFLECTIVE PRACTICES AND MFT CANDIDATES 99
it was someone kind of critiquing me or letting me know that maybe you should have
done this differently. (Individual Interview #1, p. 3).
The case presentation procedure and the feedback candidates received were observed during a
weekly clinical supervision group meeting. Layla presented a video recording of a session with a
student to the group during supervision. Prior to showing the video, Layla gave an overview of
the student’s counseling goals. Additionally, she explained the therapeutic approach she took
during the session. She shared:
I tried to use CBT this session. I was trying to identify where his negative thoughts were
coming from because he had been very hard on himself during the last few sessions. For
example, during the last session he was talking about being labeled ‘sensitive’ and how
much that bothered him. (Observation #2, p. 7).
After watching the case presentation video, each of Layla’s colleagues provided feedback and
suggestions on their observation of her session with the student. This format was created so
every MFT candidate would have the opportunity to reflect upon someone else’s work. (Focus
Group Interview, p. 7). In response to the video Natalie suggested “maybe describing the
difference between being an extrovert and introvert will be helpful...there are a lot of cartoons
you can use to help identify the difference between the two which may be a fun activity for him”
(Observation #2, p. 8). Another candidate added, “It might be interesting to make a list of his
introvert and extrovert friends and their qualities so he can better identify what makes them
unique. Maybe that way he can appreciate his own qualities?” (Observation #2, p. 9).
Additionally, Layla’s peers identified clinical strategies she used appropriately, such as “I like
the way you had him play out the situation with the scenario...it seemed to help him externalize
how he was feeling” (Observation #2, p. 10). In this observation, the interactions seemed to be
REFLECTIVE PRACTICES AND MFT CANDIDATES 100
indicative of the collaborative model that Rodgers (2002) developed in her work with teachers
along with tenants of deliberative reflection (Valli, 1997). During the deliberative reflection
stage individuals have the opportunity to consult with group members, which aimed to achieve
perspective taking and identification of alternative solutions to address issues. While the video
case presentation may have provoked feelings of anxiety amongst the candidates, it allowed for a
more accurate exploration of what was going on during the session. This exploration led to
opportunities for the case presentation to be analyzed through the lenses of the MFT candidate’s
colleagues. With that, the candidate presenting their case video was then provided with feedback
and suggestions in alternative ways to guide their sessions with their clients in an effort to best
meet their client’s social and/or emotional needs, as well as build on their own clinical skills.
Discussion Research Question Two
The perceived effects of reflective practice on the clinical services that MFT candidates
provided to students within the school setting included: exploring the uncertainties of a
situation, identifying successes in clinical skill development and identifying areas that needed
further clinical development. When candidates accurately interpret their clinical work, they can
enhance their skills and performance (Griffith & Frieden, 2000). Therefore, all of these
consequently impacted the clinical growth of the candidate throughout their traineeship.
Further, the candidates felt that collaboration during their traineeship had a positive effect
on their development of clinical skills. Thus, collaboration inherently impacted the services they
provided to students with social and/or emotional needs. With collaboration, candidates were
able to share resources with their colleagues, consult with their clinical supervisors, reflect on
their clinical skills and build on their professional development as Marriage and Family
Therapists (Mills & Swift, 2015).
REFLECTIVE PRACTICES AND MFT CANDIDATES 101
Summary
The four major themes that surfaced when exploring the research questions highlight the
reflective practices of Marriage and Family Therapy candidates while completing their
traineeship within a K-12 school setting. The first set of themes that emerged were related to
how candidates described the reflective practices they used in their traineeship program within a
K-12 educational setting. The data showed that candidates used various terms, such as “self-
care,” “self-supervision,” and “self-awareness” to describe their reflective practices throughout
their traineeship. Even though they used various terms, the candidates’ interpretations were
aligned with the definition of reflective practice that was used for this study. The second theme
that surfaced in relation to the first research question was the expectation set forth by clinical
supervisors for MFT candidates to reflect throughout their traineeship. Although there was no
formal training provided to the candidates on reflection, there were tenants of reflection
integrated within the clinical program. Candidates were expected to reflect on their clinical
skills in an effort to build on their practices and clinical expertise.
The second set of themes highlighted the candidates’ perceptions around the impact
reflective practices had on their ability to support the students on their caseload. Candidates
described that with the use of reflective practice, they were able to identify successes in their
sessions and areas they felt they needed to build clinical skills. They expressed an appreciation
towards the collaborative model built within the clinical program. Candidates were able to
collaborate with the clinical supervisor and MFT candidate colleagues during the weekly
individual and group supervision meetings. Collaboration allowed for candidates to receive
feedback on their clinical development, which ultimately led to their growth professionally as
MFT candidates completing their traineeship.
REFLECTIVE PRACTICES AND MFT CANDIDATES 102
Chapter Five: Discussion
In 2011, Assembly Bill 114 was passed by the State of California, which deemed school
districts responsible for addressing the social, emotional, and psychological needs of students
(California Department of Education [CDE], 2015). School-based mental health services have
been beneficial in identifying at-risk students, assessing their needs, and referring them for
mental health services. Additionally, schools were typically the initial setting where mental
health concerns were observed and therefore lead to assessment and recommendation of services
based on the student's needs (Stein et al., 2012). Stagman and Cooper (2010) found that an
estimated one in ten students have a significant mental health need that impairs their ability to
function in their school, home, and community environments.
Counseling services have played a significant role in addressing the needs of students in
the school setting. Social workers, psychologists, guidance counselors, or Marriage and Family
Therapists (MFTs) were the clinical personnel who could provide counseling services to students
with a social and/or emotional barrier to achieving academic success (Individuals with
Disabilities Act [IDEA], 2015). However, there were concerns regarding the quality of
counseling services provided to students. The notable increase in students who were in need of
counseling services led to situations where schools would hire mental health providers with
varying levels of competency (Atkins, Hoagwood, Kutash & Seidman, 2010). With that, this
study aimed to address the inconsistent levels of support and services the students with social
and emotional needs receive in educational settings.
Overview of Current Study
This study focused on the counseling services provided by Marriage and Family therapy
candidates to students with mental health needs. MFT programs educate candidates in various
REFLECTIVE PRACTICES AND MFT CANDIDATES 103
therapeutic approaches and their implementation. However, much of the instruction is based on
identifying the development of various therapeutic approaches rather than focusing on one
specific model (D’Aniello & Perkins, 2016). Reflective practice has been identified as a model
for MFT candidates to utilize in an effort to build on prior knowledge, gain insight into their
values and beliefs, and further their professional development (Fife & Whiting, 2007). The goal
of this study was to ascertain the level of existing knowledge MFT candidates had regarding
reflective practices. Furthermore, this study examined how MFT candidates described their
engagement with reflective practices while obtaining a degree in Marriage and Family Therapy.
Additionally, this study aimed to develop a better understanding of the training MFTs receive
while obtaining their professional degrees with the notion of ultimately improving consistency in
educational mental health services.
This was a qualitative study, which analyzed data collected via observations, individual
and focus group interviews, and collection of artifacts. The study involved three observations,
one focus group interview, three individual interviews, and collection of six artifacts. The three
observations were conducted during the three-hour weekly group supervision meetings that
included MFT candidates and at least one clinical supervisor. The focus group interview
occurred one time for duration of 60 minutes. The participants in the focus group interview were
the clinical supervisors who provided individual and group supervision to the MFT candidates.
The individual interviews were conducted with three different MFT candidates. During the last
observation, candidates who were interested in participating in the individual interview were
asked to complete a form indicating their availability to meet. The last form of data collection
was the gathering of artifacts provided by the clinical director. Artifacts included a weekly
schedule for the group supervision, the clinical counseling summer group supervision calendar,
REFLECTIVE PRACTICES AND MFT CANDIDATES 104
the Individual Supervision Weekly Write-Up, the Case Presentation Write-Up, the group
supervision rubric, and an overview of the Valleyridgeclinical services program. These methods
were used to provide detailed information necessary to understand the nature of knowledge of
reflective practices among preservice MFT candidates (Merriam, 2009; Maxwell, 2013). All
findings aimed to answer the following research questions:
1. How are MFT candidates describing reflective practices they use in a traineeship
program within a K-12 educational setting?
2. How are MFT candidates’ perceptions of reflective practice impacting their
ability to consistently support students with social and emotional needs within the
school setting?
Discussion of Findings
The framework for this study was the MFT candidate reflective framework (Table 2.1).
It utilized components from three specific theorists on reflection: Schön (1992), Valli (1997),
Farrell (2012). The literature that was reviewed focused primarily on educational settings.
Components of these theories were applied to the field of mental health, specifically counseling
within K-12 settings. Furthermore, this framework was employed in the analysis of the data
collected via a focus group interview, individual interviews, observations and collection of
artifacts.
Four major themes surfaced in this study related to the use of reflection by MFT
candidates who were completing their traineeship requirements providing clinical counseling
services to students within k-12 settings. The first theme described how Marriage and Family
Therapy candidates were defining reflective practice. The second theme identified how
reflective practices were integrated within the traineeship program leading to an expectation for
REFLECTIVE PRACTICES AND MFT CANDIDATES 105
candidates to reflect on their work as clinical counselors. The third theme showed the perceived
effects reflection had on the clinical services the MFT candidates were providing to the students
on their caseload at their traineeship sites. The last theme highlighted the role of collaboration
throughout the traineeship program. MFT candidates had opportunities to collaborate with their
clinical supervisors during individual supervision. Additionally, candidates had opportunities to
collaborate with their clinical supervisors and MFT candidate colleagues during group
supervision.
The first two themes were aligned to how MFT candidates in this study described the
reflective practices they used in their traineeship program. The first theme was that MFT
candidates rarely used the term “reflective practice.” However, the terms and phrases they
utilized, such as “self-supervision,” “self-care,” and “self-awareness” aligned with the definition
of reflection used for this study.Gilroy (1993) and Rodgers (2002) noted variations in
terminology used to define reflection were based on the theorists who were defining the term.
Although MFT candidates who participated used diverse terms to define reflection, their
descriptions of the practice were similar to those described by researchers such as Osterman
(1990) along with Kottler and Jones (2003) who used alternative terminology to define
reflection. Osterman (1990) used the term “self-awareness” to describe the reflective process.
“Self-awareness” was conducted by looking at one’s performance in a given situation, which in
turn could lead to professional growth. Kottler and Jones (2003) defined reflection as “self-
monitoring,” where one would reflect on their cultural competence in addition to personal and
professional life circumstances. The terms the MFT candidates used described components of
reflective practice. The interpretations of reflection as described by the MFT candidates
included components of reflective practice. Moreover, their explanations of the term coincided
REFLECTIVE PRACTICES AND MFT CANDIDATES 106
with the concept of reflection as a tool to enhance both their skills and professional development.
Therefore, although they did not use the phrase “reflective practice” directly, MFT candidates
had an understanding of elements within reflection and the importance it had on furthering their
professional practice as clinicians. However, Beauchamp (2015) noted the importance of having
a clear definition of reflection in order for those who utilize the practice to have guidelines as to
what it would like when implemented. The lack of a uniform description of “reflective practice”
amongst the MFT candidates could create difficulties in understanding the full scope of the
reflection. Additionally, without a clear understanding, MFT candidates might not have
knowledge about the effects reflection could have on both their clinical skills and professional
development.
The second theme was the expectation for MFT candidates to reflect within the clinical
counseling traineeship program even though formal training on reflection was not provided on
reflection. Although MFT candidates were not trained on reflection, they were provided with
opportunities and were expected to reflect during their weekly individual and group supervision
meetings. They were required to complete the Individual Supervision Write-Up form (Artifact
#2) on a weekly basis prior to meeting with their clinical supervisor for individual supervision.
This form acted as a guided reflection tool because candidates were expected to focus on the
successes and challenges that arose during client sessions throughout the week. During the
weekly group supervision, candidates were expected to reflect at the commencement of each
session by answering a community circle question. These questions typically were asked by the
clinical supervisor in an effort to guide the MFT candidates to reflect on their clinical counseling
experiences from that week. While supervision is reflective in nature (Larrieu & Dickson, 2009;
Raney, 2014) the tools integrated during individual and group supervision, such as the Write-Up
REFLECTIVE PRACTICES AND MFT CANDIDATES 107
form and community circle question, were used to guide candidates towards utilization of
reflective practices to better the clinical services they were providing students. However, while
MFT candidates identified a perceived effect of reflection on the clinical treatment they were
providing to students, this was done so without specific training on the reflective tools they were
utilizing during their traineeship. These tools included the Individual Supervision Write Up,
Case Presentation Write Up and community circle questions during group supervision. Although
components of reflection were integrated throughout the traineeship program the MFT
candidates participated in, they were not provided with clear descriptions of the reflection
practices that were being employed. This could have impacted their awareness of the practice
and its potential effects on their clinical skills.
The perceived effects that reflection had on treatment was the third theme that emerged in
this study. This theme was aligned to the research question related to the candidate’s perception
on the impact reflective practice had on their ability to consistently support the students and
effect positive change while they were providing counseling services to within the K-12 school
setting. Participants felt they were able to use reflective practice to explore uncertainties that
may have occurred while in session with their student, identify successes in their counseling
session, and identify clinical areas that they need to improve; all ultimately leading to
professional development in the field. Additionally, the findings in this study indicated a link
between reflection and development of cultural competence among MFT candidates. In the field
of clinical counseling, an understanding of cultural diversity is imperative in order to recognize
culturally appropriate behavior without imposing one’s own values and beliefs on the client
(McDowell et al., 2003). This finding was important because with the utilization of reflection,
candidates could develop problem-solving skills, express personal thoughts and feelings, and
REFLECTIVE PRACTICES AND MFT CANDIDATES 108
further enhance their clinical and cultural skills (Leung, 2007; Schmidt & Adkins, 2012;
Weatherson et al., 2009).
The final theme was the role of collaboration among the MFT candidate, their clinical
supervisor, and MFT candidate colleagues. The MFT candidates noted collaboration with the
colleagues and clinical supervisor facilitated reflection on their clinical work with the students on
their caseload. Perspective taking played a significant role during individual and group
supervision because it allowed the MFT candidate to consult with their colleagues to gain
varying viewpoints on the clinical cases (Rodgers, 2002; Williams & Grudnoff, 2011). One way
the MFT candidates in this study collaborated with their peers was during the Case Presentations.
MFT candidates were required to present a video or audio recording of a counseling session
during group supervision. Results in this study indicated that although this brought about
feelings of anxiousness, candidates expressed an appreciation towards the collaborative nature of
group supervision. By identifying varying viewpoints on cases, MFT candidates were given the
opportunity to find different avenues to address the social and/or emotional needs of the students
on their caseload based on the lenses of their fellow MFT candidate peers. Thus, allowing MFT
candidates to further build on their clinical skills and help meet the mental health needs of their
clients.
Implications for Practice
The results of this study lead to three implications in regards to the ambiguity of training
on reflective practices in the clinical traineeship program the MFT candidates were participating
in. The first implication of this study relates to the lack of a clear definition for reflective
practice. The benefits of reflective practices are hindered due to unclear definitions and an
absence of modeled reflective practices showing direct links to improve professional
REFLECTIVE PRACTICES AND MFT CANDIDATES 109
performances (Russell, 2013). It was evident in this study that MFT candidates used components
of reflective practice. However, this was done so without specific guidelines on reflection,
which could impede the potential benefits of the practice. Therefore, MFT candidates should be
provided an explicit description of reflection and the potential effects it has on their development
as clinicians.
The second implication is in relation to the development of professional trainings on
reflection to MFT candidates throughout their traineeship. This study found that MFT
candidates were expected to reflect on their clinical counseling sessions. The expectation for
reflection was evidenced in the traineeship process via the Case Presentation Write-Up, the
Weekly Individual Supervision Write-Up, and the guided questions at the commencement of
each weekly group supervision meeting. While MFT candidates participated in the completion
of the various forms and contributed to the dialogue when answering the guided questions during
group supervision, the candidates were not aware of the specific reflective practices that were
incorporated throughout the clinical program. If candidates were trained in reflection their
clinical skills and ability to think during practice in order to trigger routine problem solving skills
to address a situation with a client in session can become more automated. Schön (1992)
referred to one’s ability to formulate quick assessments and problem solve to address a situation
as knowing-in-action. This practice could further develop their clinical counseling skills as
Marriage and Family Therapists.
The third implication involves creating long term and short-term goals for the MFT
candidates in an effort to track their development throughout their traineeship to ensure they are
using reflective practices in an effective manner. Zeichner (1994) found that reflection on one’s
own experiences was a crucial component in professional development. However, there is still a
REFLECTIVE PRACTICES AND MFT CANDIDATES 110
gap in the actual implementation of the devised reflection strategies (Zeichner, 1994). This
implication would require clinical supervisors to create long term and short-term goals for the
candidates highlighting different areas they are expected to develop in throughout the year. MFT
candidates in this study were required to create treatment plans for their clients. The treatment
plans included long term and short term goals based on the area of social and/or emotional need.
This implication suggests that the clinical supervisor for each MFT candidate should create long
term and short-term goals. These goals should be written at the beginning of the traineeship
program in order to identify the benchmarks that the candidate should be meeting throughout
their traineeship. One area could highlight the candidate’s use of reflection. Prior to beginning
the traineeship it would be interesting for supervisors to collect baseline information on the
candidate’s awareness of reflection and if they engage in the practice. Throughout the year,
clinical supervisors would monitor the candidate’s utilization of reflection. Therefore insuring
the MFT candidates were retaining the information taught during professional development
trainings and also correctly utilizing the reflective practices to further enhance their clinical
skills.
Limitations
There were three limitations to this study. The first limitation was in regards to the
sample of participants selected to partake in this study. Convenience sampling was utilized
based on the availability and access to participants (Merriam, 2009). The study had a relatively
small sample size. The second limitation was related to the traineeship program the MFT
candidates participated in. All of the participants were MFT candidates who were completing
their traineeship hours within the same traineeship program. Therefore there was no variability
in the training the candidates received during their traineeship. The third limitation was the
REFLECTIVE PRACTICES AND MFT CANDIDATES 111
education backgrounds of the MFT candidates. All of the MFT candidates who participated in
this study had received a bachelor’s degree and were reaching master’s degree completion in the
field of Marriage and Family Therapy. Due to these limitations the following recommendations
were made for future research.
Recommendations for Future Research
The results of this study highlighted a need for future research on the topic of reflection
amongst MFT candidates. This study focused on candidates completing their traineeship
requirements within one local charter school due to the extensive clinical counseling program
that MFT candidates were required to participate in throughout their traineeship process.
This research studied the reflective practices of MFT candidates and the impact the use of
reflection had on their ability to provide consistent clinical support for students with social-
emotional needs on their clinical caseload. The data indicated that while the participants did not
partake in specific training in regards to reflection, they utilized these practices throughout their
traineeship. Based on the overall findings of this study, the following four recommendations are
for future research on the topic of reflective practices amongst MFT candidates.
The first recommendation is to study an implementation of a structured training on
reflection, the specific tools that can be utilized, and the impact reflective practice has on
professional development to the MFT candidates. After partaking in the training, applications of
reflective practice in the field would be studied. This study should be replicated to determine if
the training had an effect on the MFT candidate’s understanding of reflection and their
perception on the impact these practices had on their ability to provide clinical counseling
services. The second recommendation is to use a sample of MFT candidates who completed
their traineeship at different locations to have a better understanding of the training they received
REFLECTIVE PRACTICES AND MFT CANDIDATES 112
in regards to reflective practices. This study would identify any potential disparities in the
training on reflection that MFT candidates received based on the traineeship program they were
enrolled in. The third recommendation is to conduct a longitudinal study of MFTs throughout
their degree completion and post licensure. By doing so, researchers can identify the impact
training on reflection has on the services they are providing to students during their traineeship
and whether or not the candidates continue to utilize the reflective tools post graduation when
they have become licensed Marriage and Family Therapists.
The last recommendation is to recreate an assessment tool that MFT candidates could
utilize to monitor their use of reflection. Reflective practice was demonstrated and identified as
a beneficial tool for MFT candidates in this study. The various benefits of reflective practice
assisted in the recommendation to create an assessment tool. This assessment tool would assist in
the monitoring and identification of reflective practices displayed by MFT candidates. An
assessment tool was previously created to assist teachers in monitoring their use of reflective
practices (Larrivee, 2008). While components of this tool could apply to the use of reflective
practices by MFT candidates, there were other areas that are not relatable to the clinical
counseling field. The creation of an assessment tool for MFT candidates would assist in the
development of trainings on reflective practice. Additionally, this tool would facilitate and assist
in the monitoring of the reflective practices used by MFT candidates during their traineeship.
Consequently, this could facilitate professional development and therefore would positively
affect on student services.
Conclusion
This study focused on the reflective practices of Marriage and Family Therapy
candidates and the impact on the services they provided to students with mental health needs.
REFLECTIVE PRACTICES AND MFT CANDIDATES 113
The results for this study indicated that specific trainings on reflection were not provided via
their clinical counseling traineeship program. However, the candidates and clinical supervisors
innately utilized reflective practices throughout the traineeship program. This study suggested
that even without the training, reflection played a role in the clinical services MFT candidates
provided to students on their caseload. Although candidates did not receive training, they were
provided tools, such as the Individual Supervision Write Up and Case Presentation Write Up,
which integrated reflective components. In the end, there is much to learn with regard to the
training that MFT candidates receive on reflection. With the growing need for students who
require social and emotional support in our schools nationwide, there is a demand for clinical
professionals with the knowledge and expertise to help meet students’ idiosyncratic needs. The
effectiveness of the treatment clinicians provide to these students directly impacts the student’s
ability to develop the social and emotional skills necessary to become functioning members of
our society.

REFLECTIVE PRACTICES AND MFT CANDIDATES 114
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REFLECTIVE PRACTICES AND MFT CANDIDATES 126
Appendix A: Participant Handout

Dear MFT candidate,

Thank you for your interest in participating in a research study conducted by the USC Rossier
School of Education. You have been selected based on your participation in the
ValleyridgeClinical Counseling Program. Your participation is completely voluntary. Review of
the following data will not be evaluative in any way.

The purpose of the study is to identify the reflective practices of graduate students obtaining a
degree in Marriage and Family Therapy. I will also interview you to seek information about the
existing knowledge you have regarding reflective practices. This information will help us acquire
information of how reflective practices may or may not influence your clinical work with
students.

Data collection for the study will include the following:

1. Three observations of group clinical supervision - for the entire duration of supervision
2. Focus Group - Consisting of Clinical Supervisors - Approximately 30 minutes in duration
3. One individual interview per participant - Approximately 1 hour in duration
4. Clinical Group Supervision Agendas for the 2015-2016 academic year

You will not benefit directly from participation in the research study, but you will be
contributing to the body of literature related to reflective practices of Marriage and Family
Therapy candidates. The results will be reported without names or any identifying information:
all information that is obtained in connection with this study will remain confidential. All data
will be stored in a password protected electronic file.

Your participation will be considered your consent for inclusion in the study.

For further information or questions please feel free to contact:

Michelle Tehrani, MS, PPS
Ed.D. Candidate 2017
Rossier School of Education
mytehran@usc.edu
(818) 333-6653

Thank you very much!

REFLECTIVE PRACTICES AND MFT CANDIDATES 127
Appendix B: Interview Participant Information Form

Name: ____________________________________________

Phone: ____________________________________________

Email: ____________________________________________

Please mark an “X” in the grid to indicate when you are available to participant in the interview.

Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8:00-9:00
9:00-10:00
10:00-11:00
11:00-12:00
12:00-1:00
1:00-2:00
2:00-3:00
3:00-4:00
4:00-5:00

With your permission, the interview will be recorded for more accurate data collection. Please
mark either “Yes” or “No” to indicate whether or not you grant the researcher permission to
record.

____ Yes ____ No

Thank you,

Michelle Tehrani

REFLECTIVE PRACTICES AND MFT CANDIDATES 128
Appendix C: Interview Protocol

I. Introduction – MFT Candidate
Thank you for taking the time to participate in my study. The interview should take about an
hour, does that work for you?

Before we get started, I want to provide you with an overview of my study and answer any
questions you might have about participating. This interview and the observations I have
conducted are for my doctoral dissertation. I am currently a candidate in the Doctor of
Education program at USC. The primary purpose of this study is to inquire and learn more about
masters level Marriage and Family Therapist (MFT) candidates during their training process. I
am particularly interested in understanding the ways in which MFT candidates engage in
reflective practices. The research is on reflective practice, which is sometimes used in clinical
settings as self-supervision, mindfulness, strategic thinking, self-awareness, or clinical analysis.
Please let me know which terminology you prefer as we begin the interview.

I want to assure you that I am strictly wearing the hat of researcher today. What this means is
that the nature of my questions and observations are not evaluative. I will not be making any
judgments on how you are performing as a Marriage and Family Therapy candidate. None of the
data I collect will be shared with other MFT candidates or the clinical supervisor. Please note
that participating in this interview is voluntary, and you can stop at any time you want to.

I have brought a recorder with me today so that I can accurately capture what you share with
me. May I also have your permission to record our conversation? Do you have any questions
before we get started? Do I have your permission to begin the interview?

II. Setting the Stage – MFT Candidate
A. I was wondering if we could start with you telling me about what your role and job duties
are as a MFT candidate at your traineeship site.
B. What type of support have you encountered from peers through your traineeship process?
C. What type of support have you encountered from clinical supervisors?
D. In your opinion, what is the purpose and benefits of individual clinical supervision?
E. In your opinion, what is the purpose and benefit of group clinical supervision?
F. I know you engage in reflective practice (or other preferred term), I am wondering if you
can just tell me about your immediate thoughts on reflective practice (or other preferred
term) before I ask more specific questions?

III. Heart of the Interview
1. How would you define reflective practices (or other preferred term) as a MFT candidate
in a traineeship setting?
2. In your experience so far, what training have you received regarding reflective practices
(or other preferred term), if any?
3. I was wondering if you could tell me your experiences with reflective practice (or other
preferred term).
a. If Yes:
REFLECTIVE PRACTICES AND MFT CANDIDATES 129
i. Please describe a situation when you have utilized reflective practices (or
other preferred term) in a clinical setting.
ii. Can you also please identify what you did as a reflective practice (or other
preferred term)? And how was it helpful?
1. How is your use of reflective practice (or other preferred term)
shared with your clinical supervisor?
iii. How did your use of reflective practice (or other preferred term) influence
your overall clinical practice, if at all?
What is your perception of the relationship between reflective practice (or other preferred
term) and the counseling service provided to students with social and/or emotional needs at your
traineeship site?
-Probing: In what ways might it help you to cope with difficult students/clients to
better meet their needs?
What do you think is the relationship between reflective practice (or other preferred term)
and professional growth?
What do you perceive is the nature of the relationship between reflective practice (or
other preferred term) and student/client outcomes?
-Probing: How might reflective practice (or other preferred term) allow you to
change your practice? Examples?
What would you say are some factors that can act as a barrier to using reflective practice
(or other preferred term) in a traineeship setting, if any?
What would you say are some benefits to using reflective practice (or other preferred
term) in a traineeship setting, if any?
I was wondering if you could tell me some of the ways in which you have seen other
peers utilize reflective practice (or other preferred term) in your traineeship setting.
What are some of the reflective practices (or other preferred term) that have been used
during the group clinical supervision setting?

IV. Closing Question
I am wondering if there is anything that you would add to our conversation today that I might not
have covered?

V. Closing
Thank you so much for you sharing your thoughts with me today! I really appreciate your time
and willingness to share. Everything that you have shared is really helpful for my study. If I
find myself with a follow-up question, I am wondering if I might be able to contact you, and if
so, is email is ok? (verify email address) Again, thank you for participating in my study. As a
thank you, please enjoy a coffee on me! (Starbucks gift card)

REFLECTIVE PRACTICES AND MFT CANDIDATES 130
Research and Interview Question Table

Research
Questions
Interview Question Literature
#1: How are
Marriage and
Family Therapy
candidates
describing the
reflective practices
they use in a
traineeship
program within a
K-12 educational
setting?
IQ 1: How would you define reflective
practices (or other preferred term) as a
MFT candidate in a traineeship setting?
IQ 2: In your experience so far, what
training have you received regarding
reflective practices (or other preferred
term), if any?
IQ 3: I was wondering if you could tell
me your experiences with reflective
practice (or other preferred term), if any.
IQ 7: What would you say are some
factors that can act as a barrier to using
reflective practice (or other preferred
term) in a traineeship setting, if any?
IQ 9: I was wondering if you could tell
me some of the ways in which you have
seen other peers utilize reflective practice
(or other preferred term) in your
traineeship setting.
IQ 10: What are some of the reflective prac
(or other preferred term) that have been use
during the group clinical supervision setting
IQ 1: Dewey (1938), Schön
(1992), Valli (1997), Farrell
(2012), & Valli (1997)

IQ 2: Rizq et al. (2010), Leung
(2007)

IQ 3: Pack (2011)

IQ 7: Jaeger (2013)

IQ 9: Valli (1997), Williams &
Grudnoff (2011)

IQ 10: Larrieu & Dickson
(2009)
#2: How are MFT
candidates’
perceptions of
reflective practice
impacting their
ability to
consistently
support students
with social and
emotional needs
within the school
setting?
IQ 4: What is your perception of the
relationship between reflective practice
(or other preferred term) and the
counseling service provided to students
with social and/or emotional needs at
your traineeship site?
IQ 5: What do you think is the
relationship between reflective practice
(or other preferred term) and professional
growth?
IQ 6: What do you perceive is the nature
of the relationship between reflective
practice (or other preferred term) and
student/client outcomes?
IQ 8: What would you say are some
benefits to using reflective practice (or
other preferred term) in a traineeship
setting, if any?
IQ 4: Raney (2014), Larrieu &
Dickson (2009)

IQ 5: Fife & Whiting (2007),
Leung (2007)

IQ 6: Raney (2014), Larrieu &
Dickson

IQ 8: Williams & Grudnoff
(2011), Larrieu & Dickson
(2009), Raney (2014)
REFLECTIVE PRACTICES AND MFT CANDIDATES 131
Appendix D: Focus Group Protocol

I. Introduction – Clinical Supervisors
Thank you for taking the time to participate in our study. The focus group should take no more
than 30 minutes, does that work for everyone?

Before we get started, I want to provide you with an overview of our study and answer any
questions you might have about participating. This focus group and the observations we have
conducted are for our doctoral dissertation. We are currently candidates in the Doctor of
Education program at USC. The primary purpose of this study is to inquire and learn more about
master’s level Marriage and Family Therapist (MFT) candidates during their training
process. We are particularly interested in understanding the ways in which MFT candidates
engage in reflective practices. The research is on reflective practice, which is sometimes used in
clinical settings as self-supervision, mindfulness, strategic thinking, self-awareness, or clinical
analysis. Please let us know which terminology you prefer as we begin our interview.

We want to assure you that we are strictly wearing the hat of researchers today. What this means
is that the nature of our questions and observations are not evaluative. We will not be making
any judgments on your job performance, or the training Marriage and Family Therapy candidates
receive at their traineeship site. None of the data we collect will be shared with other
professionals in this setting. Please note that participating in this focus group is voluntary, and
you can stop at any time you want to.

We have brought a recorder with us today so that we can accurately capture what you share with
us. May we also have your permission to record our conversation? Do you have any questions
before we get started? Do we have your permission to begin the interview?

II. Setting the Stage – Clinical Supervisor
A. I was wondering if we could start with you telling me about what your role and job duties
are as a Clinical Supervisor at ValleyridgeCharter School.
B. In your opinion, what is the purpose and benefits of clinical supervision (both individual
and group)?
C. I was wondering what your thoughts are of reflective practice in a traineeship setting.

III. Heart of the Interview
1. How would you define reflective practices (or other preferred term) as a clinical
supervisor?
2. What is your perception of the relationship between reflective practice (or other preferred
term) and the counseling service provided to students with social and/or emotional needs
at your school site?
3. What do you think is the relationship between reflective practice (or other preferred term)
and professional growth?
4. In your experience so far, what ways have reflective practices (or other preferred term)
been discussed in supervision?
5. I was wondering if you could tell me some of the ways in which you have seen MFT
candidates utilize reflective practice (or other preferred term) in your traineeship setting.
REFLECTIVE PRACTICES AND MFT CANDIDATES 132
6. What methods, if any, have you used to foster reflective practices (or other preferred
term) in MFT candidates at your traineeship site?
1. Are there any materials you use to support reflective practices?

IV. Closing Question
I am wondering if there is anything that you would add to our conversation today that I might not
have covered?

V. Closing
Thank you so much for you sharing your thoughts with us today! We really appreciate your time
and willingness to share. Everything that you have shared is really helpful for our study. If we
find ourselves with a follow-up question, we are wondering if we might be able to contact you,
and if so, is email is ok? (verify email address) Again, thank you for participating in our
study. As a thank you, please enjoy a coffee on us! (Starbucks gift card)

Research and Interview Question Table
Research Questions Interview Question Literature
#1: How are Marriage
and Family Therapy
candidates describing
the reflective practices
they use in a
traineeship program
within a K-12
educational setting?
IQ 1: How would you define reflective practices (or
other preferred term) as a clinical counselor?
IQ 4: In your experience so far, what ways have
reflective practices (or other preferred term) been
discussed in supervision?
IQ 5: I was wondering if you could tell me some of
the ways in which you have seen MFT candidates
utilize reflective practice (or other preferred term) in
your traineeship setting.
IQ 6: What methods, if any, have you used to foster
reflective practices (or other preferred term) in MFT
candidates at your traineeship site?

IQ 1: Dewey
(1938), Schön
(1992), Valli (1997),
Farrell (2012), &
Valli (1997)

IQ 4: Raney (2014)

IQ 5: Rizq et al.
(2010), Leung
(2007)

IQ 6: Edwards &
Thomas (2010)

#2: How are MFT
candidates’
perceptions of
reflective practice
impacting their ability
to consistently support
students with social
and emotional needs
within the school
setting?
IQ 2: What is your perception of the relationship
between reflective practice (or other preferred term)
and the counseling service provided to students with
social and/or emotional needs at your school site?
IQ 3: What do you think is the relationship between
reflective practice (or other preferred term) and
professional growth?
IQ 2: Raney (2014),
Larrieu & Dickson
(2009)

IQ 3: Fife &
Whiting (2007),
Leung (2007)
REFLECTIVE PRACTICES AND MFT CANDIDATES 133

Appendix E: Observation Protocol

Observer Observation Date Start Time End Time

Observation Location Clinical Supervisor Number of MFT Candidates in
Attendance
Agenda Provided

▢ Provided
▢ Attached

Research Question #1:
How are Marriage and Family Therapy candidates
describing the reflective practices they use in a
traineeship program within a K-12 educational
setting?
Research Question #2:
How are MFT candidates’ perceptions of reflective
practice impacting their ability to consistently
support students with social and emotional needs
within the school setting?
REFLECTIVE PRACTICES AND MFT CANDIDATES 134

Observation Environment Diagram

Identify: Location of Participants, Gender of Participants, Location of Supervisor, Materials (laptops, notepads, etc.)

REFLECTIVE PRACTICES AND MFT CANDIDATES 135

Time Activity Observation Reflective Practices Observer Comment:
9:00-9:30

REFLECTIVE PRACTICES AND MFT CANDIDATES 136
Time Activity Observation Reflective Practices Observer Comment:
9:30-
10:00

REFLECTIVE PRACTICES AND MFT CANDIDATES 137
Time Activity Observation Reflective Practices Observer Comment:
10:00-
10:30

REFLECTIVE PRACTICES AND MFT CANDIDATES 138
Time Activity Observation Reflective Practices Observer Comment:
10:30-
11:00

REFLECTIVE PRACTICES AND MFT CANDIDATES 139
Time Activity Observation Reflective Practices Observer Comment:
11:00-
11:30

REFLECTIVE PRACTICES AND MFT CANDIDATES 140

Time Activity Observation Reflective Practices Observer Comment:
11:30-
12:00

REFLECTIVE PRACTICES AND MFT CANDIDATES 141
Observer Role

- What am I doing?
- What is my role throughout the observation?

- What are some of the interactions I have with
other participants throughout the observation?

- How did my interaction or presence during the
observation influence the participants?

- Other Notes:

Abstract (if available)

Abstract This qualitative study examined the reflective practices of Marriage and Family Therapy (MFT) candidates during their clinical traineeship. Since the implementation of the Individuals with Disabilities Education Act (IDEA) (2010), the number of professionals providing mental health services in educational settings has increased, resulting in shortages of trained professionals such as MFTs (Mellin, 2009). As part of professional development, reflective practices were useful in allowing mental health practitioners to identify, process, and interpret clinical experiences. Participants in this study were second year masters level MFT candidates who were completing their clinical traineeship hours for graduation in a K-12 educational setting. Three observations of group clinical supervision, a focus group interview, three individual interviews with MFT candidates, and collection of artifacts were conducted to gather data. A reflective framework based upon Schön (1992), Valli (1997), Rodgers (2002), and Farrell (2012) was utilized to analyze the data. Four overall themes emerged from the data: the reflective terminology and definitions used by MFT candidates and clinical supervisors varied, there was an overall expectation for MFT candidate reflection in the traineeship process, perceptions regarding effects of reflection, and the MFT traineeship process was highly collaborative in nature. The implications for practice based on the findings included creating a clear definition of reflection within the MFT traineeship program, developing trainings on reflective practices, and monitoring candidate progress towards the utilization of reflection. Areas for further research were also identified.

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University of Southern California Dissertations and Theses

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Asset Metadata

Creator Tehrani, Michelle Y. (author)

Core Title An exploration of reflective practice amongst marriage and family therapy candidates

School Rossier School of Education

Degree Doctor of Education

Degree Program Education (Leadership)

Publication Date 04/18/2017

Defense Date 03/21/2017

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag clinical traineeship,marriage and family therapy candidates,MFT candidate,MFT traineeship,OAI-PMH Harvest,reflection,reflective practice,school-based mental health

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Carbone, Paula (committee chair), Andres, Mary (committee member), Crawford, Jenifer (committee member)

Creator Email mtehrani07@gmail.com,mytehran@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c40-356587

Unique identifier UC11257896

Identifier etd-TehraniMic-5202.pdf (filename),usctheses-c40-356587 (legacy record id)

Legacy Identifier etd-TehraniMic-5202.pdf

Dmrecord 356587

Document Type Dissertation

Rights Tehrani, Michelle Y.

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the a...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA