Hand held, manual focus, bounced flash.

Other info:

Exposure: f/6.3 1/25s, ISO 3200
Exposure Mode: Auto
Focal Length: 80.0 mm
Lens: EF-S17-85mm f/4-5.6 IS USM
Flash: Fired, compulsory mode
Metering Mode: Spot
Subject Distance: 0.3 m
Custom Rendered: Normal process
White Balance: Manual
Scene Capture Type: Standard
Model: Canon EOS50D
Camera Raw
White Balance: Custom
Temperature: 3975° K
Tint: +10
Recovery: 16
Blacks: 19
Brightness: +16
Contrast: +30