Reflective Time Record
Please fill this in to record that Reflective Time has taken place, at least 6-weekly. It is both the responsibility of the line manager and the staff member to ensure that Reflective Time is completed regularly and will be addressed as a performance issue if this is not the case. All staff in the service should receive Reflective Time. Reflective Time is an evidence-based model (Treisman, 2020) and should be followed through the 6 key phases related to trauma-informed supervision. This form will be stored electronically and accessed at future points if required.
Line Manager Name
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First Name
Last Name
Staff Name
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First Name
Last Name
Reflective Time Date
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Venue of Reflective Time
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Highlight key issues discussed but keep it brief. Do not disclose any health or private issues in this form.
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Re-Connect
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Relationships
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Reflection
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Realise
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Respond
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Reward
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Highlight any issues (performance / conduct etc) that are to be continued into further sessions.
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Date of next Reflective Time. This should be booked at the end of the current session and put into the Outlook Calendar of both times.
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Please document any comments from the staff member relating to this Reflective Time that need to be recorded.
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Submit
Should be Empty: