In this Health Pilots x In the Arena with NOW crossover episode, members of the BLOOM Clinic team at UCSF Benioff Children’s Hospital Oakland share how reflective supervision is helping them show up stronger for themselves, for each other, and for the families they serve. Hear as they discuss the emotional weight of pediatric primary care, the healing potential of reflective spaces, and how this trauma-informed, team-based model is helping to restore trust in healthcare, especially for Black families. Their story is one of mutual care, vulnerability, and collective strength.
In this Health Pilots x In the Arena with NOW crossover episode, members of the BLOOM Clinic team at UCSF Benioff Children’s Hospital Oakland share how reflective supervision is helping them show up stronger for themselves, for each other, and for the families they serve. Hear as they discuss the emotional weight of pediatric primary care, the healing potential of reflective spaces, and how this trauma-informed, team-based model is helping to restore trust in healthcare, especially for Black families. Their story is one of mutual care, vulnerability, and collective strength.
Some key themes discussed in this episode:
✔ Reflective supervision as a relational, strength-based practice
✔ Addressing vicarious trauma and emotional burden among healthcare providers
✔ Creating space for healing, not just for families but care teams
✔ Restoring trust in medical settings for Black families and historically excluded communities
✔ Team dynamics and shared accountability in a trauma-informed model
✔ Challenges in integrating reflective supervision: time, resources, and cultural norms
✔ The parallel process: “being held to hold”
✔ Vision for BLOOM and the potential for replication across the country
Resources & links:
Listen + subscribe to In the Arena with NOW and Health Pilots for more community-centered conversations whether on Apple Podcasts, Spotify, or wherever you listen!
___
🎙Podcast production services by Wayfare Recording Company
© 2025 Center for Care Innovations. All Rights Reserved.
Episode 58 teaser // Dayna Long (guest):
Primary care is – we are the frontline medical providers for our community. We care so much about our families, and we also recognize that our families' health is related to their social and environmental context. In order to be the most efficient, the most compassionate, the most available providers that we can, it is important for us to be able to step back and reflect and acknowledge – “How are we doing in the moment? How available are we? How are we processing what we just heard so that we can best and most efficiently help our families?”
It is a mutual relationship that we as providers have with our families, and oftentimes our families go through hard times, and it is really important that our families know that we are capable of being in the journey with them.
Reflective supervision with this team-based model makes me realize that I am not alone in carrying this burden. We are all doing it together. We are all on one team and understanding that there's some trustworthiness, there's relationships, there is expertise on this team so that I can feel more confident that I can step out of this room and go into another patient room. And that patient that I just stepped out of? That room – they are still being held and their needs are being met, and that makes me a better provider.
Health Pilots podcast intro:
Welcome to the Health Pilots podcast presented by the Center for Care Innovations. This podcast is about strengthening the health and well-being of historically underinvested communities. Every episode offers new ideas and practical advice that you can apply today!
Intro // special crossover episode with Vital Village Networks:
We’re bringing to you a special crossover and collaboration with Center for Care Innovations’ “Health Pilots” podcast and “In the Arena,” a podcast hosted by the Networks of Opportunity for Child Wellbeing, powered by Vital Village. Stay tuned at the end of the episode for info on where to subscribe and get connected!
Ronda Alexander (host), Vital Village Networks:
I'm Ronda Alexander, director of national partnerships with Boston Medical Center's Vital Village Networks. I am so excited about today's conversation about reflective supervision with members of University of California, San Francisco's Black Love Opportunity and Outcomes Improvement in Medicine Clinic, otherwise known as BLOOM, based out of Oakland, California. BLOOM’s mission is to deliver excellent family centered care that honors the experiences of self-identified black caregivers and their babies. This clinic is open to any family who wants their services with a particular focus on black families. BLOOM's vision of the world is that every child deserves to grow up valued, celebrated, healthy, and exceptional.
Today, we're going to be diving deeper into BLOOM's participation and experience in the Center for Care Innovations’ Resilient Beginnings Network, a learning program dedicated to advancing pediatric care delivery models that are trauma- and resilience- informed. Vital Village Networks was engaged in the learning program as both thought partners and faculty.
Please welcome for our conversation today: Dr. Dayna Long, Dr. Justin Williams, Toby Eastman, Fran Merriwether, and Lisette Mazon. Welcome! So excited to have this conversation with you all.
So just to hear a little bit from each of you, can you share a little bit more about who you are, your work at BLOOM, and maybe a bit on your connection to reflective supervision?
Fran Merriweather:
Well, I'll start. My name is Fran Merriweather, and I'm a clinical social worker.
And, I've been at UCSF for over 30 years, and I am the BLOOM Clinic social worker. And a lot of what I do is listening to families who sometimes have a hard time being heard in other medical settings. A lot of our families have experienced trauma and challenge. They struggle to work to bring up their kids in the healthiest way possible, and part of what I do is to support families in whatever way they need to make that happen.
And I work collaboratively with other team members to make that happen, and I am a person who has received reflective supervision most of my professional life, know the value of it, and appreciate how it enables me to continue to do the work and to continue to think outside of myself. Even after 30 years, there's still things to be learned, and having a safe place to think about it is a gift. And so, I'm especially grateful for having the opportunity to do that in this position and in this clinic.
Ronda:
Well, thank you so much, Fran.
We welcome Dr. Dayna Long.
Dayna Long:
Thank you, Ronda, for hosting us today. My name is Dayna. I am a primary care pediatrician based out of our federally-qualified health center in Oakland.
I've been a pediatrician now for 25 years working in safety nets [health settings]. The work on BLOOM has been so nourishing, for me personally and professionally. We founded Bloom in July of 2023, and my connection to reflective supervision is that the work that we are doing to really be with families in practice – it can be a lot. We hear a lot about vicarious trauma – a lot of our families don't have the resources that they need on a daily basis in terms of having enough food, or stable housing, or caring for their mental health.
A lot of our babies have a lot of medical and social complexity. So, we started reflective supervision about six months into BLOOM with the realization that we needed to make sure that as providers, our cups were full so that we really could be present and serve families. And for me, as a medical provider, reflective supervision was a new practice. It's not something that is integrated into our medical education, and I've come to realize that it is so very necessary to sustain us to really love and enjoy the work and to be our best self in it.
Ronda:
Thank you, Dayna.
I'd love to invite Dr. Justin Williams to share a little bit more.
Justin Williams:
I'm Dr. Justin Williams. I am another primary care pediatrician who's based out of Children's Hospital Oakland. I completed residency in 2023, so I'm fairly new to the practice.
Throughout my training, I've had bits and pieces of reflective supervision. I think they're trying to incorporate it more into medical training, excuse me. However, I can see having it in a clinic dedicated, as we're dealing with some of the most vulnerable families in the Bay Area – it's so impactful.
I think just in terms of growing as a provider, from my end, learning the medical knowledge, knowing the medical scheme and how to think about disease and that sort of thing, and then having these reflective supervision incorporated into our day, it expands on that. So, instead of walking into a room, just thinking about this particular thing, I'm able to recognize, what am I bringing into the room.
I am from Oakland. I'd love to say I am serving my community. I'm serving the people that raised me. But knowing that I'm from Oakland, knowing that I can hear the stories and the reflections and the things that people are telling me, and I'm like, “yeah, this all sounds familiar. This sounds like childhood, sounds like growing up with some of my friends.” Also recognizing carrying some of that in ways in which I need to be aware when I'm talking to families.
And so, I think the reflective supervision has been a great way of stepping into moments in times with families who are dealing with a multitude of things, recognizing everything that I'm bringing into it from my medical training, from my personal background, from currently what's happening in the world, and just say, “Hey, this is where I'm at. This is where you are. Here we go.”
Ronda:
Lovely. Thank you, Justin.
Lisette?
Lisette Mazon:
Yes, hi. I'm Lisette. I am a resource navigator through the family information navigation desk program. I primarily work in primary care at our clinic here at Children's Hospital, but I am the main navigator for our BLOOM clinic. And in my work, I get to screen families for basic needs and social determinants of health (SDOH), and then I connect them to local community resources. So like Fran, I'm hearing everyone's stories. I'm hearing a lot of what their current needs are – sometimes big, sometimes small.
And I am actually very new to reflective supervision. I previously worked as a community health worker for, I think, almost seven years, before coming into Children's Hospital, and I was doing very similar work. And at this point, I don't even know how I did that work without reflective supervision because it has really transformed the way I am able to address caregivers and families, and just the treatment that I am able to provide to them and the relationships that I've developed since then, it just has been amazing. And I feel like everyone should have reflective supervision when providing care.
Ronda:
Great, thank you, Lisette. Toby.
Toby Eastman:
Hello. I'm Toby Eastman. I am a licensed clinical social worker.
I've been with Children's [Hospital] for about 12 years and in the field for over 30 years, with the last about 15 years or so of my career being primarily focused on early childhood mental health. And within the field of early childhood mental health, reflective supervision has been sort of a foundational aspect and focus of the way we think about the work. These opportunities to sort of, step back and look at what we're doing and how we're feeling and, yeah, the ways, all the ways that we are interacting and relating to the folks that we're working with.
So, I've had the good fortune to be trained in reflective supervision and be the beneficiary of that kind of supervision, and I feel so greatly, greatly honored to have brought this model to BLOOM Clinic.
I am actually a program manager in the behavioral health services division of the hospital. So, I run an early childhood mental health program within the hospital, and I was asked by Dr. Long to come to the BLOOM Clinic to provide this reflective space for the team. And again, it's just such a great honor to do that.
Ronda:
Thank you all so much for just showing up and telling us a little bit more about who you are and just bringing your full selves. So, let's get into it.
Toby, you started to talk about this a little bit, but what is reflective supervision?
Toby:
So, again, this opportunity to have a space where you can sort of pause for a moment. In the BLOOM Clinic, the days are very busy and very full.
And not only are they sort of back-to-back working, they're ingesting trauma. People have, unfortunately, have horrific experiences of violence, of oppression – and they're hearing those stories, and trying to take them in and process them. When you have an opportunity to sort of pause, and step back and say, “Wow, how is this impacting me? What does this mean for me? And how is it impacting the way that I'm relating to a family?” It just supports and enriches the work.
And I use the term work as supervision loosely. I'm not supervising anyone in the sense of telling anyone what to do. These are folks that are highly skilled in what they do. And what I'm doing is offering really more of a collaborative space, a consultive space, a space for them to share what's coming up with them, what they need to think about, what's going on. Reflective supervision – one of the primary tenets of it is also that it's relationship-based.
So, we started this process together with me building a relationship with this team and thinking about what were the components of the relationship that was needed in order for us to build trust, and build rapport, and really work together.
Another component of reflective supervision is that it is strength-based. Sometimes we spend time sort of venting about what is wrong, you know? The things that are wrong in a larger world and the community. But we also spend a lot of time on thinking about what is right – What are the things in the clinic that are going right? What's going right in the work? What's going right for families?
And then, the last component that I wanted to frame what reflective supervision is, that it is an active and present process. So, I'm highly present with the team. I'm allowing them to drop into their presence and focus and selves, a sense of mindfulness, so that they can be in that space of reflection.
Ronda:
That's a really helpful, overview and sort of definition and — the fact that it's strength-based and we're talking about what's going right, and what's really working for families, but also that it's asking and inviting folks to be actively present. I really appreciate that word.
So, I know that your work is in primary pediatric care. Why is reflective supervision particularly important in that setting?
Dayna:
Primary care is – we are the frontline medical providers for our community. And as primary care physicians, we care so much about our families, and we also recognize that our families' health is related to their social and environmental context. In order to be the most efficient, the most compassionate, the most available providers that we can, it is important for us to be able to step back and reflect and acknowledge – “How are we doing in the moment? How available are we? How are we processing what we just heard so that we can best and most efficiently help our families?”
It is a mutual relationship that we as providers have with our families, and oftentimes our families go through hard times, and it is really important that our families know that we are capable of being in the journey with them. And so, we have to buttress up our capabilities in order to be present, so that we are not shielding away from the pain that our families experience, or the joy, but we are fully able to celebrate, to mourn, to grieve, and to be a helpful person to our families.
Justin:
I think I'll really just echo everything Dr. Long said in that being a frontline provider, being the first person of all of the people who practice medicine, the medical context in which families are engaging with the health care systems – we are the ones who they come to when there's housing issues, when there's issues around school, when there's issues around just social things and that are getting in the way of their children's health.
And so I think for me, it's really very much that centering, very much that: “I came in this room with an agenda, and you are telling me x, y, and z. I have to meet you here. I have to meet you in the space where this is the thing that's happening to you in your life.” And maybe we can get to something on my agenda, but I have to be able to - not only, as Dr. Long said - be someone who you find helpful - and have my things that I need to talk about - but build that relationship. Make sure that not only am I addressing the concerns that you're dealing with, but also in some ways rectifying a fractured relationship that a lot of families have with medicine by being a provider who can go beyond the height and weight, and vital signs, and physical exam, but can also meet you at the thing externally that are affecting the health care, the medical things - and show up in a space where you feel comfortable telling me anything. Because I think that's also been a very important part of this.
Reflective supervision is being the person who can learn to hear people, be present with people, and allow them to communicate what it is and be like, “Wow. I'm glad you feel super comfortable just talking to me about this thing.”
Dayna:
Yeah, Justin, I agree with you completely. And to give the audience some context – as pediatricians, we do see joyful families often.
And we also have babies that are born prematurely that are not always compatible with having completely healthy lives secondary to their medical complexities or to that prematurity. We have families that experience significant amounts of domestic violence and substance abuse, and those things are hard to witness, and they're often hard to help families navigate. So, the reflective supervision process enables us as a team to lean in and trust each other. There are times when I have walked out of the room and I want be in tears because I just found out that the toddler that I've seen has been in a situation where they had positive screens for cocaine or fentanyl, or that a caregiver of a family that we're seeing had been shot.
That is hard, and we do grieve as primary care physicians. And so reflective supervision allows us to have this sense of reciprocity and trust within each other so that I can walk out the room and I can say, “Fran, this mother was recently shot, and I am so sad now for these babies.” And Fran is able to not only hold me in that space, but also to hold the family in that space.
Fran:
I think Toby pointed out to us last week that what we are engaged in oftentimes is a parallel process: we are being held by our reflective supervision as we are holding families. And one of the things that I— no matter what the situation is – I always want to reflect with the family because I really do see caring, attuned, attached relationships when I walk into the room.
And I want families to be able to hold on to that. And despite what other issues may be happening in their lives, and I feel that being able to hold that for them and to recognize and acknowledge that is the same way that, in reflective supervision, how I'm feeling is acknowledged and recognized because we know that parents' emotional, and mental health, and their well-being their emotional well-being is so connected to how well their children can— how resilient they can be. And I feel like reflective supervision is a resiliency building connection for us just as we hope and want support resilience in families, despite some of the most unimaginable circumstances that exist for some of our families, or just families who are in the day-to-day grind just trying to make it.
So, it allows for us to hold them because reflective supervision holds us.
Ronda:
Yeah. I mean, what I heard is that it's space to be seen and heard not only for the families, but for you all as a team as well.
So, I'd love to hear from maybe Toby and Lisette around why is providing this kind of care and experience important for families in general across the board, and for black families in particular, during these early years?
Toby:
I can start. I was thinking as folks were talking about, this one saying that one of our early childhood, great mentors, often shares, and it's this concept that “history is not destiny.” So, you know, the adversities, the traumas, even the oppression that people have experienced and that very young children often experience and are witness to – that that doesn't necessarily form who they will be in the future. And that what mitigates those adverse experiences is a healing, trusting, caring, secure relationship.
And so, if I'm able to provide that in the clinic, and I think Justin said this a bit ago, that these providers are then able to provide that kind of relationship to a family. And then that parent or caregiver is able to provide that relationship to the child. And it changes — we're changing a trajectory for people with these young relationships.
Ronda:
Thank you for that.
Lisette, what have you seen? What might you want add to that about why this sort of care and support is so important during these early years?
Lisette:
On the one hand, I think we know about the importance of just having all these basic needs being met for a child under [age] five.
But personally, for me, I feel that at least with my BLOOM families, a lot of them have a history of not being heard, of not having a say in the care of their children, of even, for mothers during their prenatal care, or labor and delivery, where things were just happening to them. And that can create trauma and a lack of trust in health care. So, I think also for me and for all of our team, it's how do we build that trust, when they've already had maybe negative experiences, either themselves or with previous children. And I think for me, it's building on to that and giving them that opportunity where, “It's okay. It's okay if you don't trust me in this moment, but I want you to know that, you know, that I am here. I want to be here, and these are the resources that are available to you.” And giving them that space to make that decision of what help do they want, what help or what resources do they want at this time. So just giving them that space, allowing them to have a choice in the trajectory of their care and the trajectory of their healing, I feel is so important with black families in particular that may not have been heard in the past.
Ronda:
Thank you so much.
Toby, can you tell me I mean, we've talked about the importance of reflective supervision, but how is it actually done? What exactly does it look like in practice?
Toby:
I'll kind of take you a little bit through the trajectory of my time of this building of this relationship. So, again, when I initially started with the clinic, Dr. Long and I met, and we talked about what a framework or structure would be.
So even that, I'm sort of coming into this space not with, like, my own agenda, or my own structure, or “this is how it's going to be,” but let's think collaboratively about what's needed here and what could work. And so, I came into the space initially just building relationship. And part of the building relationship was building trust, sharing who I am, why I'm here, and what kind of things folks want to think about. And then also talking about just sort of resilience and what resilience means for family, what BLOOM Clinic's definition of resilience is, and what they need to be resilient.
And in that sense, sort of like, resourcing the team, both in the building of the relationship and talking about, sort of resourcing, so that then we can talk about trauma.
We need to have some grounding and some space. And I did some education and some sort of didactic spaces around trauma and vicarious trauma. That was, for some of the providers, really eye-opening in terms of really thinking about the impact of hearing other folks' experiences on their own well-being, on their work, perhaps their own past experiences of trauma.
And we've evolved - we've spent a lot of time talking about that, and now we've sort of evolved into this space where we're doing a lot around self-care and grounding. We've been doing that throughout, but now because we've deepened our relationships, we can just really — and the team, I can't say enough times, I just need to say over and over again — just the brilliance, and the dedication, and the passion, and compassion that they bring to their work.
They bring that to these reflective spaces where we're just able to drop into our emotions, drop into impacts, and how they want to take what they're learning here back out into their relationships with families.
Ronda:
Thank you for that.
I would love to shift gears just a tiny bit sort of back to you all as a team and your work as a team and providers. Lisette, I'm wondering from you, what are some differences that you noticed between reflective supervision and perhaps other types of trainings that are offered to care teams?
Lisette:
So as health care workers, I think a lot of us are familiar with trainings around trauma informed care and cultural humility – and those are all great. It's a great way to learn how to speak to people that are different from us and how to not further traumatize them.
But for me personally, reflective supervision has allowed me to be able to process some emotions and be able to decompress after maybe some really stressful cases. And something really interesting is, because I grew up in San Francisco, with a very similar, diverse population of people, and similar hardships that we see in Oakland, and that our families are also experiencing – I noticed that some cases were triggering some personal maybe not trauma, but personal wounds that I didn't even know that I had. So, it was reflective supervision that allowed me to be able to process those emotions, to be able to better support the families that we're seeing because at the end of the day, I don't want to be distant from the situation. I want to be able to be an active listener. I want to be able to really understand, what the caregivers need to be able to actually connect them to the help that they need, to the resources that they need.
And, by just being emotionally absent from it, that was not going to be helpful to anyone - not to me, not to our families, and especially not to the rest of the team. So I do think that reflective supervision has allowed me to heal and to help all of our families heal in this process.
Ronda:
Lovely. Thank you, Lisette.
I'd love to just open up the space for maybe a minute or two to hear from others about the impact on your work professionally, but as well as the personal impact that reflective supervision has had for you.
Fran:
I would say that having been the beneficiary of reflective supervision in another position, that that supervisor, Cielo Rios Munoz, who was wonderful, really allowed me to begin to think about the triggers. And I think, so often we subvert our triggers to do the work, but it doesn't have to be bad. If we can acknowledge what's triggering us, why, and how do we work through that, we can come out, I think, healthier on the other end, but you need a supportive environment to be able to do that and a safe environment to be able to do that. And I think, we get that, we are offered that with Toby, so that we can put it on the table and be able to work through that as best we can.
Because I do think so much of this is conscious and unconscious triggering that happens. And it's really important to have someone who can explore that, and a place to explore that. And sometimes be able to say, maybe someone else - if it ever comes up - that part of it I may not be able to do until I'm working through this, that which triggers me, and so somebody else can hold that or deal with this piece of what needs to happen as I work through work through that – which is probably not putting me in a place that I'm doing the best work that I can for a family. So, I really appreciate the personal reflection.
And I can tell you - I used to hydroplane. One of the things that would happen is when I was in a program that worked with kids from 0 to 3. And then after our program ended, when they were really challenged, I would start having heaviness about what's happening after [age] 3: “What is school gonna be like? What is the world gonna be like?” for this family.
And that's where reflective supervision helped me a lot because I was carrying a lot and feeling overwhelmed.
Ronda:
Yeah, what I'm hearing you say is that one of the impacts reflective supervision has had on you is that is allowing you to understand yourself so that you can better understand and support these babies and their families. And that sounds like a powerful way to not only hold a family, but also community.
[Mhmm.]
Yeah, go ahead, Dayna.
Dayna:
Wanna add to this question before we move on.
And so, when we think about the impact of reflective supervision, both professionally and personally, oftentimes as a provider, we have to see patients every 15 minutes, and oftentimes the needs and desires of our families takes more than 15 minutes to get through. And BLOOM is a clinical situation where we do have this team, this trauma-informed team that includes not only the providers, but the doula and the lactation consultant and our social worker, our resource navigator – really all working together.
The reflective supervision that we've implemented - it really helps me to better be aware of the entire team dynamics. I have to say that as the provider, I was not always aware that sometimes after clinic, some of the team members would be so sad, or so burdened, or so overwhelmed by what they were carrying that it was causing difficulties in their personal life, or they after work they would have to sit in their car and cry for a minute because it was so overwhelming. And I and I have to say as a provider, I wasn't always aware of what was happening within the team.
And so reflective supervision has made me listen better, be much more understanding, and understand those team dynamics so that we all can work and flow with each other to best serve our families because we understand each other. It just makes us so much more efficient clinically.
But the second concept that I want to mention is better processing my own overwhelm. It is a lot. In one particular morning, you have four hours. You have fifteen minutes. You will have 15 to 20 patients that you see within one morning. And it can become pretty overwhelming running in and out of rooms, and you're hearing so much. There's so much – there's so many referrals, there's so many conversations that need to happen that it can become impossible to do it all in fifteen minutes.
Reflective supervision with this team-based model makes me realize that I am not alone in carrying this burden. We are all doing it together. We are all on one team and understanding that there's some trustworthiness, there's relationships, there is expertise on this team so that I can feel more confident that I can step out of this room and go into another patient room. And that patient that I just stepped out of? That room – they are still being held and their needs are being met, and that makes me a better provider.
Ronda:
That is just – it's such a beautiful way to think about practice and to see the other side of it. I mean, as a parent, I'm often thinking about, “Okay, I'm here at this appointment, and I want see my child's doctor, and I only have a few minutes.” But to also understand the side of it from providers is I think that's such an important piece.
Toby:
Can I just piggyback on all of that, Ronda?
Ronda:
Yes.
Toby:
I just so appreciate what's being said here, both about just the flow of relationships and how, this team is sort of, in advance, as they're in these clinic spaces and with families and knowing, “Oh, wow. I need to step away, right at this moment, but someone else that I know and trust, knowing that they're gonna hold this family is gonna step right in.” How beautiful is that? And what a what a strong model for families.
And it also just makes me think about the way I love the fact that love is in the acronym. I hear the folks here talking about the way that they hold families is with love. Your experience – you – your very particular experience matters to me. You are important. You deserve this high level of care and support. And yeah, it's just exemplified. And I think, oftentimes, in a busy setting like this, in a hospital setting in particular, we can all just sort of go to this sort of outcomes-based thinking and structure: “Oh, well, did, you know, did we get all the vital signs?”
And there's so much more complexity happening in terms of what's happening relationally. So, them being able to see that with each other and see what's happening in terms of that with their families is, as they're all saying, critical to them providing optimal care.
Ronda:
Yeah. Thank you so much for adding that.
Fran:
I also think it's part of what helps with reflective supervision too is that living with the situations we can't impact in the ways that we hope. And sometimes change or the things that we want and hope for families are not happening. And it can be sad and disappointing.
And, in that moment with a family, we're trying to— and we are supporting them. And I think it's very hard sometimes to admit that things aren't working the way we hope, and the outcomes we hope for families aren't happening. And here is a place to talk about that, and to live with that, and to continue to do the work, and meet the family where they are, and to do what they need us to do for them. So, there is that part of it where we do hold the sadness sometimes and the disappointment, when the difficulties continue and the struggle continues for families.
Ronda:
Thank you for that, Fran. I know we've been talking about the benefits and how helpful and useful reflective supervision can be for babies, for families, for care teams, those providing care.
But I’m also a little interested in what are some of the barriers and some challenges to reflective supervision. Toby, might you start us off there?
Toby:
I appreciate, one of the things that I've heard today, is just meeting folks where they are.
That you don't know how people are going to show up to clinic on any given day or what they're experiencing or what they need. And that's how I tried to come to the reflective supervision space as well.
We come together, we have we do just have a short period of time together, and sometimes people have to come in –people are still in clinic, they're still at the tail end of supporting a family, and we just roll with it.
I just roll with flexibility. And roll with, when people are able to get there, I'm happy to see them. When they've gotten there is the right time. They've gotten there right when they needed to get there.
So that kind of flexibility and just holding people where they are and sometimes people land there, and it's like, “I gotta talk about what just happened right now, right here and now.” So whatever agenda I've had set or whatever, that might have to go out the window so that we can just be with what is right here and right now. So, again, working with that kind of flexibility, we did some work around what time works best, right? How do we sort of fit this into their busy day? Does it make sense to do it at the beginning of the day, or the end of the day, middle of the day?
And, yeah, and we continue again — I run this other program, and I come to this space because I want to. But it is also, it's a constant dance, and thinking about, where is the time, where is the capacity, where is the money to keep this kind of structure and process going? But the commitment is there on all ends. So, yeah, those are some of the challenges and barriers that I think about.
Ronda:
Thank you, Toby.
I just want to leave space for just a second for anybody else who wanted to uplift a barrier or a challenge that you faced around reflective supervision, before we begin to wrap up.
Justin:
I think, when you first asked the question, the first thing that came to my mind was time. And I want to echo that and honor that, but I think a real big thing for me is also meaningful implication of reflective supervision into the workday.
Because one thing about what I believe Toby and Dayna have really strived for was making sure that this is incorporated in our clinic. And as Toby's saying, sometimes we're wrapped up.
We're doing our best to — we're wherever we are in our process, in our day with everything we have going on, and we land here with whatever it is that we've got. And we go forth, and we get what we need out of this reflective supervision practice that we're doing.
But I think knowing that this is a space that was created for this, and we're all going to show up, and we're all going to meet each other where we're at, and we're going to do that. I think that if other clinics, other hospital systems, other places, spaces decided that this is going to be an hour out of your day, this is, this is going to be incorporated into how we move through our practice, it would be something that I could see existing in other spaces.
Dayna:
Justin, thank you for saying that.
For me, when I think of BLOOM, it is an amazing innovation that is cross disciplinary. It is cross departments. It is community engaged and informed. It is this weaving together of primary care in a safety net of these concepts of early relational health, of bringing into the same space infant and early childhood mental health specialists, bringing in the doula, and the birth workers, and the community health workers, the mental health clinicians, and their providers.
It truly is exceptional and a model that has nourished and sustained us. My biggest hope and dream for BLOOM is not only that we can continue to do the work, but that we can “bloom” really across the country. And I feel as if reflective supervision has created these seeds for us to be able to be so efficient and to meet the community where they're at and hearing from the community that BLOOM is exactly what they need. It's exactly what they're looking for and that our babies are growing and loved. That is the greatest gift, I think, that any of us could hope to give.
Ronda:
Thank you so much, Dayna. I'm also thinking about the work that Vital Village Networks does around bringing communities together to build and drive solutions together. And I heard you all talk about trust, not only within your team, but building trust, with your patients. And I think trust leads to the space of vulnerability and being able to show up and be vulnerable. And if we want our work, our families, our communities, our neighborhoods to be different, we have to show up differently and be willing to trust.
And so, a lot of our work at Vital Village Network sort of focuses on upholding, and centering the dignity of children and families, as a broader community. And I feel like reflective supervision is absolutely - seems to be a key strategy for what that looks like in practice from all sides, Dayna, as you mentioned, it's interdisciplinary. It's not just for physicians or folks who are on the front lines, but it's for all of us. I just really appreciate that.
As we begin to wrap up, I'd love to hear maybe a one to two sentence takeaway about the value that you found in reflective supervision.
Fran:
Reflective supervision also helps me to know that, as I've talked before with about families, that healing is possible. Healing for families, it can look a lot of different ways. We know it can take time, but that we can move, we can deal with the trauma and the challenges and look forward to healing.
And I think, reflective supervision also allows for that because it's the sort of vicarious trauma that we carry sometimes as people who work in health care, it's cumulative. And we do need healing ourselves. And so for me, I'm really interested in trying and working on healing not only for myself in working in these spaces, but allowing families and letting families know that it is possible. We may not forget, and we can heal, and we can start on that road to healing. So for me, that's what it it provides.
I want to live in a space of healing for myself and for families.
Ronda:
Yeah. Thank you so much, Fran.
Dayna, I have a question for you. What's the call to action? You started to speak about what you wanted to see, but what's your call to action around reflective supervision?
Dayna:
So, my first call to action is that we all give praises and thanks to Toby, and what she brought to the team, and what she taught us about reflective supervision, and that the work is sustained, and that we have a lot of other BLOOMs popping up, because we know that our community needs them. They provide value and health.
Ronda:
I just want to thank you all for this lovely conversation, for a chance to learn and hear more about reflective supervision and what it looks like, in your work and what it means for children, for families, and for communities.
I want to just send some special thanks to the Center for Care Innovations and the Resilient Beginnings Network for the work that they've been so engrossed in and supporting over the last several years. Of course, thank you to our listeners and to the team, the entire team at BLOOM, because I know it's not just the five of you. There are many, many more. And for folks who want to learn more about the BLOOM Clinic, I'm sure you can find out contact information and all the details, in our show notes.
Before we step away, I would just really love to invite Toby to lead us in just a quick meditative moment. So, Toby, I'm going to turn it over to you, and you'll be the last voice we hear.
Toby:
I want to just end today with just a moment to be able to drop into ourselves— with a little breathing. So just notice where your body is in space and time. And I'll lead you through a little bit of measured breathing, but please feel welcome to go at your own pace. So, breathing in for one, two, three, four... and out for one, two, three, four, five. And just noting how that feels in your body.
Health Pilots podcast intro:
Thank you for listening to this special crossover episode, a collaboration of the Center for Care Innovations and Vital Village Networks.
Special thanks to Wayfare Recording Company for editing and production services.
For more information about the Health Pilots podcast and the Center for Care Innovations, to see what’s in store for programming, upcoming events, and funding opportunities – visit careinnovations.org
To learn more about Vital Village Networks, check out vitalvillage.org, and be sure to listen in on more of the In the Arena podcast featuring community leaders who are centering healing, power sharing, and narrative change in their advocacy efforts to create thriving, healthy communities.
Subscribe to both podcasts on Apple, Spotify, or wherever you listen to podcasts – and connect with us on our socials!
We appreciate you tuning in — catch you in the next one!