Psychology in the Schools, Vol.

53(6), 2016 
C 2016 Wiley Periodicals, Inc.
View this article online at wileyonlinelibrary.com/journal/pits DOI: 10.1002/pits.21932

A QUALITATIVE STUDY OF FACILITATORS AND BARRIERS RELATED

TO COMPREHENSIVE AND INTEGRATED SCHOOL PSYCHOLOGICAL SERVICES
JOSE M. CASTILLO, JENNIFER R. WOLGEMUTH, CHRIS BARCLAY, AMIRA MATTISON, SIM YIN TAN,
SUJAY SABNIS, AMBER BRUNDAGE, AND LESLIE MARSHALL
University of South Florida

Recent studies indicate that the majority of school psychologists’ time continues to be dedicated to
SPED related activities. Despite ongoing calls for school psychologists to expand their roles, why
many practitioners do not deliver more comprehensive services is not well understood. This quali-
tative study investigated facilitators of and barriers to comprehensive and integrated services using
the National Association of School Psychologists Model for Comprehensive and Integrated School
Psychological Services as the guiding framework. Thirteen full-time, school-based practitioners
from across the US participated in semi-structured interviews. Constant-comparative analysis was
used to generate themes. Results indicated that practitioners experienced a number of systemic
barriers to (e.g., heavy caseload; inconsistent district policies, priorities, and role definitions; lack
of stakeholder involvement) and facilitators of (e.g., resources, graduate training and professional
development) comprehensive and integrated service delivery. Participants’ perspectives regarding
changes needed to expand their services focused on systemic issues as well. Implications for
research and practitioners’ efforts to advocate for systems change are discussed.  C 2016 Wiley

Periodicals, Inc.

Discussions of school psychological services delivered to address student needs traditionally

focused on individual practices (e.g., assessment, counseling, consultation). Armistead and Small-
wood (2014) more recently argued that it is the comprehensiveness (i.e., a range of services that
can be provided across different levels of the system) and integration (e.g., assessment informing
intervention through consultation) of services that uniquely position school psychologists to im-
pact outcomes for children and youth. Consistent with this argument, the National Association of
School Psychologists (NASP) recently developed the NASP Model for Comprehensive and Inte-
grated School Psychological Services (2010a) that represents the official position of the NASP on
the services school psychologists should provide.
The NASP Model (2010a) indicates that school psychologists should use data and collaborate
with educational stakeholders to provide both direct and indirect services for children and families
at the individual student and systems levels. At the student level, school psychologists should
engage in instructional support activities, interventions, and mental health services that develop
the academic, social, and life skills of students. At the systems-level, they should facilitate both
preventive and responsive services, promote school-wide practices that foster learning, and support
family-school collaboration. Finally, the model emphasizes school psychologists’ foundations for
service delivery including knowledge regarding legal, ethical, and professional practices, diversity
issues, and research and program evaluation.
Despite evidence that school psychologists deliver a range of services, national studies indicate
that practitioners consistently report a majority of their time is dedicated to special education
(SPED) related activities (Castillo, Curtis, & Gelley, 2012; Curtis et al., 2008; Curtis, Grier, Abshier,
Sutton, & Hunley, 2002). Previous national studies provide valuable information regarding current
services; however, the researchers have investigated discrete practices (e.g., initial SPED evaluations,
counseling) rather than comprehensive and integrated services consistent with the recently adopted
NASP Model (2010a).

Correspondence to: Jose M. Castillo, Department of Educational and Psychological Studies, University of South
Florida, 4202 E. Fowler Ave., EDU 105, Tampa, FL 33620. Phone: 813-974-5507. E-mail: jmcastil@usf.edu.

641
642 Castillo et al.

The emphasis on discrete practices has contributed to a lack of understanding regarding fac-
tors that contribute to school psychologists’ provision of comprehensive and integrated services.
Researchers have found that years of experience and graduate training were positively associated
with consultation services and inservices delivered (Curtis, Hunley, & Grier, 2002). Additionally,
employment conditions such as working in a rural setting and having a higher ratio of students to
school psychologists were related to higher levels of SPED activities (Curtis, Hunley et al., 2002).
Researchers who canvassed practitioners regarding variables that impact their specific services (e.g.,
mental health services) have found that factors such as time at and level of integration in a school,
level of training, administrator and school personnel support, and personal characteristics (e.g., be-
liefs about the services) were reported as facilitators and/or barriers (e.g., Forman, Fagley, Steiner,
& Schneider, 2009; Suldo, Friedrich, & Michalowski, 2010). However, these studies focused on
individual, discrete practices. The research literature to date has not canvased practicing school psy-
chologists about factors that facilitate or hinder a comprehensive and integrated range of services.
It is clear that a more systematic examination of factors that impact the delivery of a broad array of
interrelated services is needed.
Potential Factors that Impact Comprehensive and Integrated Service Delivery
Factors that may impact service delivery often are discussed in textbooks about the field
(e.g., Merrell, Ervin, & Peacock 2012) and its history (e.g., Fagan & Wise, 2007) as well as in
documents produced by professional associations (e.g., NASP, 2010a). However, the reasons for the
persistence of SPED related activities remain unclear (Fagan, 2014). Although often not based on
empirical investigations of factors impacting comprehensive and integrated services, the literature
offers potential explanations that should be considered.

Historical Origins, Legislation, & Paradigms. SPED policy that emphasized testing con-
tributed to a substantial increase in the number of school psychologists whose roles narrowly
emphasized assessment and other eligibility determination activities (Fagan & Wise, 2007). How-
ever, increased implementation of Response to Intervention (RtI) following the reauthorization of the
Individuals with Disabilities Education Act (IDEA; 2004) may involve school psychologists in more
curriculum-based assessment, direct intervention, and consultation activities (Merrell et al., 2012).
Questions remain, however, regarding whether school psychologists will embrace opportunities
for expanded roles. Researchers characterize school psychology as reflecting two paradigms, one
emphasizing psycho-educational assessment and the other emphasizing eco-behavioral problem-
solving (Fagan & Wise, 2007). School psychologists’ paradigm and personal preferences likely
impact their services (Fagan, 2014).

Graduate Training, Professional Development, and Supervision. Standards (NASP, 2010b)

and guidelines (Ysseldyke et al., 2006) exist for training; however, graduate programs likely incor-
porate those standards and guidelines differently. Ongoing professional development (PD) also has
been suggested as a factor because competencies erode quickly due to advancements in the field
(Armistead, Castillo, Curtis, Chappel, & Cunningham, 2013). In addition, supervision and mentor-
ing of school psychologists likely influence the services that they feel competent and supported to
provide (Fagan, 2014).

Personnel and Other Resources. Studies indicate that a critical shortage of school psycholo-
gists exists (Castillo, Curtis, & Tan, 2014; Curtis, Hunley, & Grier, 2004). Despite reductions, the ratio
remains well above the 1,000:1 ratio recommended by the NASP (Curtis, Castillo, & Gelley, 2012).
Higher ratios have been found to be positively associated with SPED related activities (Curtis,

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 Facilitators and Barriers 643

Hunley et al., 2002). Additionally, the literature discusses access to funding, physical resources, and
technology as factors that impact capacity for services (Merrell et al., 2012; NASP, 2010a).
Leadership and Key Stakeholder Collaboration. Leadership is a driving force for systems
change (Forman et al., 2013; Louis, Leithwood, Wahlstrom, & Anderson, 2010). Administrators
who expect school psychologists to engage in SPED eligibility activities versus those who expect
them to engage in intervention-focused services likely impact service delivery differently (NASP,
2010a). Collaboration with and ongoing communication and planning between school psychologists
and leadership, as well as other stakeholders (e.g., teachers) are discussed as important factors in
promoting comprehensive services (NASP, 2010a).
Diversity and Cultural Competence. School psychology as a field is greater than 90% White
and approximately 80% female (Castillo, Curtis, & Gelley, 2013). Increasing diversity in schools may
create a barrier to school psychologists working with culturally and linguistically diverse students
and their families. Furthermore, graduate training programs do not adequately promote and teach
cultural competence (Miranda, 2014).

Purpose of the Current Study

The literature highlights factors that may impact service delivery; however, limited empirical
research reveals the extent to which school psychologists feel enabled to or prevented from offering
comprehensive and integrated services. This qualitative interview study sought to generate informa-
tion from practitioners regarding factors that facilitate or hinder their delivery of comprehensive and
integrated services. The current study represented the first phase of a two-phase study. This phase
was intended to (a) provide an understanding and description of school psychologists’ experiences
with common facilitators and barriers as well as to (b) gather information to inform item develop-
ment for a survey to be administered to a larger, representative sample of practitioners during the
second phase. Interviews could provide information directly from practitioners who were experi-
encing factors that impacted their opportunities to provide comprehensive and integrated services
and provide contextual information to help interpret what occurred. Information obtained could be
compared to the literature to illustrate how practitioners perceive and experience factors that impact
their services. The specific research questions addressed during the first phase were:

1. What factors facilitated participants’ comprehensive and integrated services?

2. What factors hindered participants’ comprehensive and integrated services?
3. What changes would need to occur for participants to engage in more comprehensive and
integrated service delivery?

M ETHOD
Participants and Sampling Procedures
To be eligible, participants had to be full-time, school-based practitioners who were NASP
members. We used a combination of purposeful sampling strategies. First, we sought maximum
variation (Patton, 2002) on grade levels served, racial and socio-economic status of students, geo-
graphical location, and the ratio of students to school psychologists. Additionally, we identified type
of setting (e.g., urban) and school size as well as school psychologists’ race, gender, and experience
as variables for which to seek variability. The purpose was to establish a diverse sample of par-
ticipants with experiences delivering services in different school settings. Variation was important
because qualitative researchers do not strive to generalize their findings to a population. Instead,
they often endeavor to derive information that will resonate (i.e., be consistent with readers first

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644 Castillo et al.

or second hand experience with the phenomenon) with stakeholders from the population (Tracy,
2010). When information resonates with readers’ experiences, it can help clarify, expand on, or chal-
lenge their understanding of how a phenomenon operates; thereby, providing information that could
be used by researchers and practitioners to better understand, communicate, and/or further investigate
the phenomenon in question.
Second, we sent a recruitment email to school psychologists from around the nation who
members of the research team knew and who met the study’s inclusion criteria. School psychologists
who did not meet the criteria (e.g., university trainers), but who were in a position to contact eligible
practitioners also were contacted and asked to forward the recruitment email to potential participants.
The email included a letter describing the study and its purpose, how information would be used,
and that the study was approved by an Institutional Review Board. We asked recipients of the email
to contact a research team member should they be interested. We also asked participants to forward
the recruitment email to individuals they knew.
The recruitment procedures resulted in 13 participants, two of whom were contacted di-
rectly by research team members while the remaining 11 received an email forwarded from a
contact. There is no rule of thumb or even general consensus about how many interviews is enough
(Baker & Edwards, 2012). Instead qualitative researchers consider issues such as the heterogeneity
of the population (Bryman, 2012), the aim of the research (Becker, 2012), and the study design
(Adler & Adler, 2012; Bryman, 2012) when deciding on the number of interviews. Guest, Bunce,
and Johnson (2006) concluded twelve interviews is sufficient for projects that seek to discover
themes concerning general views and experiences among relatively similar people. We believed
a sample size of 13 practitioners who were purposefully selected to reflect the variations within
a homogenous population was adequate to capture the range of responses we might expect and to
provide descriptive enough accounts.
Consistent with the field, the sample was homogenous in terms of race (11 participants
self-identified as White) and gender (10 females). The sample was more diverse in terms of
age (M = 41.25, SD = 10.28), years of experience (M = 11.53, SD = 7.86) and degree earned
(see Table 1). The sample also was diverse in terms of employment conditions. At least one par-
ticipant was sampled from each of the nine geographic regions used by the US Census Bureau.
Participants’ settings also varied in terms of population density, types of schools, and school size as
well as numbers of students and the diversity of students served (see Table 1).
Research Design
We approached our interview study from a neo-positivist orientation in which researchers
seek to limit the influence of their subjective judgments, “through following a research protocol
and getting responses relevant to it, minimizing researcher influence and other sources of bias”
(Alvesson, 2003, p. 15). In other words, we sought to obtain valid and credible knowledge about our
participants’ experiences and perceptions that we could code and categorize while minimizing the
influence of our own perspectives (Roulston, 2010). As a result, our approach was largely deductive.
We reviewed the NASP Model (2010a) as well as the literature to identify the breadth and depth of
services that school psychologists provide, to define comprehensive and integrated services, and to
identify factors that impact services. Codes, themes, and sub-themes generated were informed by
the literature as was our interpretation.

Research Team
The research team consisted of one school psychology faculty member, one research fac-
ulty member with expertise in qualitative research methods, one post-doctoral fellow, and five
school psychology graduate students. The research faculty member provided ongoing training and

Psychology in the Schools DOI: 10.1002/pits

 Table 1
Individual Participant Demographic and Setting Characteristics

Participant Race Gender Years of Degree Grade Level Type Size Racial SES State Ratio <
Experience Diversity Diversity 1,000:1

1 Black Female 10 Masters Combinationb Suburban Medium Yes Yes CA Yes

2 White Female 1 Doctorate Combinationc Rural Combination Yes Yes NM Yes
3 Asian Female 2 Doctorate Combinationd Suburban Medium No No IL Yes
4 White Male 38 Doctorate Middle Suburban Medium No Yes NJ No
5 White Female 30 Mastersa High Suburban Large Yes Yes MN No
6 White Male 5 Specialist Elementary Combination Small No Yes MA Yes
7 White Female 5 Doctorate High Urban Medium Yes Yes AZ No
8 White Female 9 Specialist Combinationd Suburban Combination No Yes MI No
9 White Female 9 Specialist Combinationd Suburban Medium No No OH Yes
10 White Female 13 Specialist Combinatione Urban Combination Yes Yes TN No
Facilitators and Barriers

11 White Female 9 Specialist Combinationd Urban Combination Yes Yes LA No

12 White Male 14 Doctorate High Urban Large Yes Yes FL No
13 White Female 5 Specialist High Urban Large Yes Yes FL No

Note. SES = Socio-economic status.

a Degree not in School Psychology.b Pre-school, elementary, and middle school grades served. c Elementary and middle school grades served. d Pre-school and elementary grades
served. e All grade levels served.

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DOI: 10.1002/pits
646 Castillo et al.

support to the research team focused on conducting neo-positivist interviews (Roulston, 2010) to
maximize participant benefits (Opsal et al., 2015; Wolgemuth et al., 2015) and on coding and
thematic analysis. Training on conducting interviews included three steps. First, team members
participated in a training session in which general interview methods were discussed and a mock
interview was conducted. Next, all team members facilitated a practice interview using the study’s
interview protocol. Finally, team members met to debrief regarding the mock interviews and to
address any questions that arose.
Training on coding and thematic analysis involved three steps as well. First, the research faculty
team member provided information on identifying thought units, coding, and thematic analysis. The
team as a group then coded the first section of one of the actual interview transcripts. Following this
session, team members coded the remainder of the same transcript independently and then met to
discuss how they coded thought units.

Interview Protocol and Procedures

We conducted one semi-structured interview per participant. First, we asked participants to
describe (a) their practices as well as (b) facilitators of and barriers to those practices. Then,
we asked participants to review a diagram of the NASP Model (2010a) and to discuss (a) their
familiarity with the model, (b) how much they engage in the practices reflected, (c) their perspectives
regarding facilitators of and barriers to practices reflected, and (d) changes that would need to
occur for comprehensive and integrated services to be delivered. We asked participants about their
practices and perceived facilitators and barriers first to reduce social desirability response bias that
could be introduced by beginning with the NASP Model. Interviews ranged from 20 to 84 minutes
(M = 50, SD = 19). We conducted interviews by telephone and used conference call software to
record the conversations for transcription.

Data Analysis
First, an initial codebook was created based on codes derived from existing literature (i.e.,
a priori codes). Next, open-coding (identification of distinct concepts and categories based on
participants’ perceptions and experiences) was used to refine the initial codes and to delineate
additional concepts generated from the interviews. This stage was accomplished through constant-
comparative analysis of codes (CCAC) (Corbin & Strauss, 2008). In CCAC, thought units (coherent
and distinct meanings embedded within interview transcripts) were compared against each other
to examine similarities and differences. Each new thought unit that we determined to be similar
to previously coded units was assigned the same code. We assigned new codes to thought units
that were conceptually different. Finally, we aggregated related codes into axial codes (codes that
represent how a priori codes and/or codes developed through open coding meaningfully relate to
each other) to make connections within the data.
Establishing Inter-Coder Agreement. Two team members rated each transcript. Each dyad
member coded their assigned transcripts independently and then reviewed the codes with their
partner. Inter-coder agreement (ICA) was calculated by dividing the number of agreements by the
sum of the total number of agreements and disagreements. The ICA in this study averaged 62%.
Exploratory studies that use semi-structured interviews can produce wide-ranging responses that
can be difficult to code consistently when established codebooks do not exist and when numerous
codes are involved (Campbell, Quicy, Osserman, & Pedersen, 2013). With these limitations in mind,
each disagreement was discussed between dyad members until consensus was reached regarding
the appropriate code. The vast majority of disagreements were resolved during discussions between
the dyad members resulting in ICA estimates following discussions between dyads members that

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 Facilitators and Barriers 647

exceeded 95%. When dyad partners could not resolve a difference, the thought unit was discussed
during a research team meeting to decide how to code the event.
Thematic Analysis. We used axial (codes that represent how a priori codes and/or codes
developed through open coding meaningfully relate to each other) and open codes to generate
themes. We aggregated related codes into axial codes using ATLAS.ti to make connections within
the data. The number of times a code was mentioned, the number of participants who mentioned it,
and whether a code represented an issue from the literature were considered.
Validity. We designed our study with attention to the eight universal criteria of quality in
qualitative research (Tracy, 2010). The eight criteria for determining quality qualitative research are:
‘worthy topic,’ ‘rich rigor,’ ‘sincerity,’ ‘credibility,’ ‘resonance,’ ‘significant contribution,’ ‘ethical,’
and ‘meaningful coherence’ (Tracy, 2010). Of particular concern to us was ensuring the rigor of our
study and credibility of our findings. We sought to maximize rigor through a multi-step, independent
analysis process in which we attended to ICA and held multiple meetings to come to consensus.
Additionally, during analysis meetings we asked repeatedly, “How much data is enough?” (Tracy,
2010, p. 841). We determined we had collected enough data when the last two interviews yielded
no new information.
We also used member checking to enhance both the rigor and credibility of our findings. Partici-
pants were provided a document with the findings prior to a call with a research team member. During
the call, we asked participants whether the themes were sensible and represented their experiences.
We also asked what information they would add. Member checking with interviewees averaged
approximately 30 minutes. No substantive changes in themes resulted. Participants indicated that
the themes resonated with their experiences.

R ESULTS
Prior to asking participants about facilitators of and barriers to comprehensive and integrated
services, we asked them about the practices in which they engaged. All participants reported provid-
ing services related to SPED (e.g., testing). Services provided by most participants included direct
assessment and intervention (e.g., administering assessments, delivering interventions; 85% of par-
ticipants), student-focused consultation and collaboration (e.g., consulting with teachers; 77%),
and facilitating a multi-tiered system of supports and problem-solving (e.g., problem-solving team
participation; 77%). Some participants also reported PD and supervision (46%) and family and com-
munity engagement activities (46%). These reports are consistent with recent findings that school
psychologists spend substantial amounts of time engaged in SPED related services, but that more
opportunities for providing direct and indirect services are occurring (Castillo et al., 2012).

Facilitators of Comprehensive and Integrated School Psychological Services

Six themes emerged related to facilitators. Themes included access to resources, training
and PD, key stakeholder involvement, personal variables, policies and procedures, and sufficient
time/small caseload. Three to eight subthemes were included within each theme (see Table 2).
Access to Resources. Most (92%) participants mentioned resources that enabled compre-
hensive services. Eight subthemes included professional association materials (54%); district and
community personnel (54%); campus infrastructure (e.g., availability of programs to address spe-
cific needs; 38%); access to technology (31%), to research (31%), and to other resources (31%);
availability of materials (31%), and funding (15%). For example, Participant 9 explained that “we
have to have the resources and means to do it. You know it doesn’t do any good to come up with
great intervention programs when you can’t afford to buy them.”

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648 Castillo et al.

Table 2
Facilitators of Comprehensive and Integrated School Psychological Services

Facilitators Mentions Participants

Access to resources 109 92%

Professional association materials and resources 42 54%
District and community personnel supports 21 54%
Sufficient campus infrastructure (e.g. program availability) 8 38%
Access to technology (e.g., computers, software) 17 31%
Access to other resources (e.g., textbooks, readings) 7 31%
Availability of assessment and intervention materials 6 31%
Access to research 5 31%
Funding 3 15%
Training and professional development 95 92%
Graduate training received 66 62%
School psychologist learning community 10 62%
Self-study 13 38%
District provided professional development 6 23%
Involvement with key stakeholders 83 92%
Administrative buy-in and support 20 77%
Availability of and collaboration with support staff 20 69%
Relationship building and networking 20 54%
Teacher buy-in and support 8 54%
District staff buy-in and support 6 31%
Parent buy-in and support 4 23%
Building educators’ capacity to implement practices 3 23%
Positive climate among stakeholders 2 15%
Personal variables 60 69%
Possess the knowledge and skills necessary 13 46%
Personal preference for engaging in the practices 16 38%
Positive attitudes and beliefs about the practices 8 38%
Level of experience in school psychology and related fields 5 38%
Personal use of problem-solving to reduce barriers 8 31%
Personal work habits (i.e. adaptability, record keeping) 10 15%
Policy/priority issues 10 46%
District policies and procedures 6 31%
School policies and procedures 3 23%
State policies and procedures 1 8%
Sufficient time/small caseload 12 38%
Sufficient time to deliver services 8 31%
Being at one school 2 15%
Lower ratio of students to psychologists 2 8%

Note. N = 13.

Training and PD. Training and PD (92% of participants) referred to the school psychologists’
involvement in activities to develop knowledge and skills. Various sources of PD included graduate
training (62%), peer learning communities (62%), self-study (38%), and district provided PD (23%).
Participant 9 valued her, “broad range of training [that included] everything from mental health to
psychological assessment and neurological understanding of . . . disorders like ADHD.” Participant

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 Facilitators and Barriers 649

3 appreciated “a licensed clinical psychologist who’s also supervising me for post-doc hours. So I
get supervision from her. So that’s been really helpful.”

Involvement with Key Stakeholders. Involvement with key stakeholders (92% of participants)
referred to relationships with administrators, teachers, and other stakeholders and the importance of
their buy-in and support. Subthemes mentioned by the majority of participants included administra-
tive buy-in and support (77%), availability of and collaboration with support staff (69%), relationship
building and networking (54%), and teacher buy-in and support (54%). When discussing adminis-
trators, Participant 6 stated, “Administrative support is definitely huge. At the smaller school I have
a principal who not only lets me do these things, but also encourages me to do these things. She is
completely on board with the school-wide initiatives that we have done with positive behavior sup-
port. She’s supportive of everything that I have done with the school-based problem-solving team, so
she’s very supportive and encouraging. Conversely at the larger school, there is a very authoritarian
style of administration, which is not conducive to those things. So I think that contributes to that
role of just testing, testing and [it is] very clearly defined that that’s all you’re supposed to do. That
kind of hinders some of the better work I think and it becomes a reactive position.” Participant
11 asserted that “having a good relationship with the school staff, the teachers, the secretary, you
know . . . the principal and I think that’s probably the most important thing with facilitating what I
do in the schools is developing a relationship with the school staff.”

Personal Variables. Personal variables (69%) referred to participants’ knowledge, skills,

beliefs, and attitudes. Six subthemes included possessing necessary knowledge and skills (46%),
a preference for delivering a range of services (38%), having a positive belief about the practices’
effectiveness (38%), having experience (38%), personal problem-solving to reduce barriers (31%),
and efficient work habits (15%). For example, Participant 1 stated, “If I become overwhelmed with
the number of assessments I have to do, then I have to look at what is driving the number of referrals
[and] what I can do within my collaborative group to reduce that.”

Policies and Procedures. Policies and procedures (46% of participants) referred to mandates
and guidance that enable comprehensive services. Three subthemes involved (a) school (23%), (b)
district (31%), and (c) state (8%) policies and procedures. For instance, Participant 10 noted, “Our
state is changing the way we’re identifying some disabilities, which I think are lending more towards
using more of the [NASP] practice model in what we do.” When discussing how these changes
related to district policies, she stated, “we are having to figure out how we’re going to implement
those rule changes. So as a district, we are trying to decide what kind of interventions we’re going
to be offering and what that’s going to look like . . . ”

Sufficient Time/Small Caseload. Sufficient time/small caseload (38% of participants) referred

to time available. One subtheme referred to having sufficient time to deliver services (31%). Par-
ticipant 3 noted, “I get a chance to spend a lot of time working on problem solving before SPED
[eligibility consideration] . . . to get into classrooms . . . to really get to see kids . . . to do interven-
tions . . . ” The two other subthemes referred to conditions that increase time available (see Table 2).
For example, Participant 6 noted that “At the smaller school because the ratio is so small . . . I get
the opportunity to spend more time doing more of the prevention-based work.”

Barriers to Comprehensive and Integrated School Psychological Services

Six themes related to barriers emerged. Specific themes included a lack of time/heavy caseload;
policy, priority, and role issues; a lack of stakeholder involvement; obstacles to problem-solving

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650 Castillo et al.

Table 3
Barriers to Comprehensive and Integrated School Psychological Services

Barriers Mentions Participants

Lack of time/heavy caseload 68 100%

Lack of time in school psychologist’s schedule 33 77%
Heavy caseload of SPED evaluations 11 46%
Lack of time in teacher and student schedules 11 38%
High ratio and high number of schools 8 38%
SPED administrative duties and timeline 5 23%
Policy/priority/role issues 43 85%
District policies, procedures, and initiatives not aligned 14 62%
Others’ defining school psychologists’ role narrowly 20 46%
Role assigned to other personnel 9 38%
Lack of key stakeholder involvement 31 77%
Staff knowledge, skills, beliefs, and attitudes not aligned 18 46%
Lack of teacher buy-in and support 7 31%
Lack of administrator buy-in and support 3 23%
Lack of inclusion in decision-making 3 23%
Obstacles to problem-solving implementation 10 62%
Lack of problem-solving components being implemented 5 38%
Limited student and family access 5 31%
Lack of access to resources 19 54%
Lack of funding and human resources 10 46%
Lack of access to assessment and intervention materials 9 15%
Insufficient training and professional development 9 38%
Lack of knowledge and skills 6 31%
Lack of engaging in professional development 3 15%

Note. N = 13.

implementation; a lack of access to resources; and insufficient training and PD. Two to five subthemes
were identified for each theme (see Table 3).
Lack of Time/Heavy Caseload. A lack of time/heavy caseload (100% of participants) referred
to participants’ limited time, particularly considering SPED activities. Five subthemes included
limited time in their schedules (77%), a heavy caseload of SPED evaluations (46%), a lack of time
in teacher and student schedules (38%), high numbers of students or schools (38%), and SPED
administrative duties and timelines (23%). Participant 8 stated, “being pulled in so many directions
and needing to be [at] more than one place at the same time can be challenging.” Participants
often noted how some practices are barriers to others. For example, Participant 3 stated, “if your
time is just spent doing evaluations, it’s going to be really hard to help support a system . . . do
direct intervention . . . do consultation,” and “[administering] the reading screener . . . takes a lot
away from . . . counseling, the consultation, the behavior intervention.”
Policy/Priority/Role issues. Policy/priority/role issues (85% of participants) referred to ex-
pectations that limited the range of services provided. Three subthemes indicated that misalignment
between district policies and priorities with services (62%), limited expectations for services school
psychologists provide (46%), and the assignment of services to other personnel (38%) acted as
barriers. Participant 6 declared, “If you have someone who’s clearly defining your role in a way
that doesn’t encompass all of these services, then that’s definitely going to make a difference. For

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 Facilitators and Barriers 651

example, at the larger school I’m at, I think a lot of it is focused on student level services and
even more focused on just instructional services . . . I mean it’s just not an option to do the more
systems level work or focus on consultation and collaboration just because they don’t let us.” When
discussing the Child Study Team process in her district, Participant 3 stated, “And the focus of all
of that is SPED. The gatekeeping of SPED - who goes in, who goes out. Re-evaluations, IEPs, and
that’s a major factor in us not being able to provide the services that we’ve been trained to provide. I
think the structure that’s in place, the Child Study Team, serves no other purpose, legally, than to be
the gatekeeper of SPED. There’s no other definition, no other role for a school psychologist by law
than to do that.”

Lack of Key Stakeholder Involvement. Lack of key stakeholder involvement (77% of partic-
ipants) referred to limited administrator and staff relationships, buy-in, and support. A lack of
(a) staff capacity (46%), (b) teacher (31%) and (c) administrator (23%) buy-in and support, and (d)
school psychologists’ inclusion in decision-making (23%) were issues encountered. Participant 6
stated that staff “are overwhelmed and they’re not willing to take on new things and new roles and
invest their time on things. I’d say it comes down to burnouts and it’s hard sometimes when you
don’t see immediate results . . . People who have been in the district for a while are kind of jaded
and disillusioned . . . They don’t believe that whatever they do is going to make a difference.” When
discussing school psychologists’ lack of involvement in decision-making, Participant 5 noted, “if
there’s a committee that doesn’t have a school psychologist involved, they’re planning things and
not paying attention to some of the things that are critical.”

Obstacles to Problem-Solving Implementation. Obstacles to problem-solving implementation

(62% of participants) referred to the various issues that inhibit problem solving services. Problem-
solving was hindered by a lack of critical components being implemented (i.e. data collection,
teaming; 38%) as well as limited access to students and families (31%). Participant 7 stated, “There
had been no student study team process . . . It was not organized. There was not anyone leading and
saying this is what we need in order to go to the next step. It was just kind of like ok, well here’s
a file and we took this information from the teachers and it was very disorganized.” Participants’
comments regarding student and family access addressed issues such as school factors. Participant
13 noted, “administrators suspend students that we are trying to do FBA with . . . 10 days for cursing”
and “it’s hard to implement the intervention too if they are out so much and then they come back
and they are suspended immediately . . . ”

Lack of Access to Resources. A lack of access to resources (54% of participants) referred

to limited financial, human, and technical capacity. Two subthemes emerged, limited funding and
human resources (46%) and limited assessment and intervention materials (15%). “I would say
the number one barrier to my work would be budget cuts and the state cutting funds,” declared
Participant 9. Participant 10 noted, “The amount we have to spend on these educational and mental
health interventions for our children seems to decrease every year.”

Insufficient Training and PD. Insufficient training and PD (38% of participants) referred to a
lack of competencies. Some practitioners discussed limited knowledge and skills (31%) and others
discussed limited PD opportunities (15%). Participant 1 stated, “If you’re a school psychologist
that does not remain informed about instructional strategies in curriculum and academics . . . it’s
hard to collaborate and consult with teachers with a child who they think has a learning disability.”
Participant 5, when discussing NASP Conventions, stated that her district does not “pay for out of
state travel” and that despite her willingness to pay herself, she was denied “because it doesn’t align
with our district and building and your individual goals.”

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652 Castillo et al.

Table 4
Changes Needed to Enable Comprehensive and Integrated Service Delivery

Changes Mentions Participants

Expectations and guidance 19 77%

Changes in state and district policies and procedures 14 69%
Changes in focus of service delivery model 5 31%
More time 10 46%
Assignment to one school 5 31%
Reduced caseload 5 23%
Others’ perceptions of roles and responsibilities 14 31%
General stakeholder perceptions 10 31%
Administrator perceptions 4 23%
More professional development 5 31%
More personnel resources 5 31%

Note. N = 13.

Changes Needed to Facilitate Comprehensive and Integrated Service Delivery

Five themes emerged regarding changes that would facilitate comprehensive and integrated
service delivery. Themes found were related to expectations and guidance, more time, changing
others’ perspectives of school psychologists, additional PD, and additional resources. Zero to two
subthemes were identified within each theme (see Table 4).
Expectations and Guidance. Changes in expectations and guidance (85% of participants)
referred to state and district policies and procedures (69%), as well as the focus of service delivery
models (38%). Participant 6 noted, “you have things like policy, which drives then what schools
focus on. So . . . if we are heavy on the culture of high stakes testing then that drives, I guess policy
drives that practice and then that practice kind of limits, or determines how you focus on things
like student level services or systems level services. So I think what needs to change in my opinion
would be to focus more on . . . policy that’s more conducive to actually focusing on what students
need rather than things like accountability.” Participant 6 also stated a desire for “more focus on the
systems level services and preventative services rather than the individual reactive services. So in
order for that to happen I guess what needs to change is the perception of people involved that . . . the
problem is not within the kids themselves. The problem is with the systems and the structure that
we have. If we can improve those then we can improve how the children function rather than focus
on what’s wrong with kids.”
More Time. More time (46% of participants) referred to participants’ need for more availability
in their schedules. Two subthemes reflected (a) assignment to one school (31%) and (b) a reduced
caseload (23%) as needed changes. “Either lower ratios to work with . . . [or] actually [having] a
blocked out time for things like systems level services or consultation and collaboration . . . .or even
research and program evaluation,” were noted as ideas from Participant 6. Participant 9 stated “I’m
fortunate this year to be in one school . . . a lot of [psychologists] barely have time to get their actual
compliance pieces done with reevaluations and things.”
Others’ Perceptions of Roles and Responsibilities. Others’ perceptions of roles and respon-
sibilities (31% of participants) referred to the need for stakeholders to support school psychologists
engaging in comprehensive and integrated services. The two subthemes emphasized general stake-
holders’ (31%) and administrators’ perceptions (23%). Participant 4 voiced her desire to be “seen as

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 Facilitators and Barriers 653

someone who serves all children,”, “seen as more than just a SPED person,”, and “seen as the school
psychologist for everyone.” Participant 4 also wanted administrators to “be involved in positive
behavior supports for the school . . . be involved in implementing RTI in your school,” and to “not
just allow it - but actually promote it.”
More PD. More PD (31% of participants) referred to participants’ need for additional knowl-
edge and skills. A range of PD needs arose in the participants’ comments, including more training
in program evaluation, academic curriculum, and interventions. Participant 4 stated, “If you asked
school psychologists what they know about research and program evaluation, they would probably
not have a lot to tell you; though, that could be one of the most valuable services that school psy-
chologists could provide.” Participant 3 noted that “how often you’re able to get PD to help continue
to learn ways to intervene with students” is an important factor.
More Personnel Resources. More personnel resources (23%) referred to a need for more
personnel capacity and the financial resources to hire more staff. Regarding financial resources,
Participant 8 noted, “change . . . which bucket you’re getting your funding to pay for your school
psychologists . . . in my district . . . we are not able to be funded through some of our at-risk fund-
ing . . . I’m sure there’s more creative ways to do that.” Participant 1 noted “it would be great if I had
someone to take on the data and help me with the data.”

D ISCUSSION
Themes regarding facilitators and barriers and changes that need to occur often focused on
systemic issues. Participants’ experiencing the number of students served and SPED responsibilities
as barriers is consistent with the literature (Castillo et al., 2012; Curtis, Hunley et al., 2002). Other
systemic barriers frequently reported involved role definition, policies, and priorities. School psy-
chologists’ history as gatekeepers (Fagan & Wise, 2007) appeared to be manifested in participants’
reports of expectations that they engage in SPED related activities. It also appeared, at least for
some participants, that these expectations were codified in how the responsibility for other services
was assigned to different personnel, thereby limiting opportunities for expanding their practices. A
majority of participants also described a mismatch between desired services and policies, priorities,
and procedures. When administrators did not value other services nor create the mandate to deliver
them through policies and procedures, participants reported difficulty delivering comprehensive and
integrated services.
Participants’ reports of policy and expectations as barriers may have been related to another
barrier they described, lack of key stakeholder involvement. Participants in this sample described
situations in which they did not have buy-in from teachers and administrators nor did they have
opportunities to influence decision-makers. Participants may not have attended to key stakeholders’
understanding of the need for specific services, which could have resulted in stakeholders rejecting
those practices (Castillo & Curtis, 2014). Furthermore, administrators who neglected to include par-
ticipants in district and building planning may have resulted in a mismatch between what participants
had the capacity to do to support the system’s goals and the responsibilities with which they actually
were tasked.
Insufficient graduate training or PD and a lack of available resources are themes that were noted
as barriers, but that were less frequently mentioned. However, these same themes also were the
most frequently mentioned facilitators. Participants’ perceptions of these factors as both facilitators
and barriers appears to be consistent with literature that indicates they are critical elements for
building capacity to implement effective services (Armistead et al., 2013; Forman et al., 2013). Key
stakeholder involvement and personal variables also were reported as facilitators. The attributes

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654 Castillo et al.

and actions relative to stakeholder involvement and personal variables discussed by participants
(e.g., building relationships, problem-solving barriers) are consistent with many of the elements of
leadership reflected in the literature (Louis et al., 2010). Participants also mentioned the importance
of policies that reinforce comprehensive services and that provide more time for additional services,
but they were the least frequently mentioned facilitators.
Of note is that none of the participants discussed issues related to cultural and linguistic
diversity as facilitators or barriers. It is unclear why participants did not discuss diversity issues
as factors; however, that they were not mentioned indicates diversity issues may not have been a
factor considered. Perhaps participants ascribed to notions of color-blindness or found it difficult to
discuss diversity and cultural issues consistent with barriers to cultural competence discussed in the
literature (Milner, 2015). Finally, graduate training may not have adequately prepared participants
to consider cultural issues (Miranda, 2014).
When asked about changes that need to occur to expand their services, participants discussed
the need for expectations and guidance to better align with comprehensive and integrated models.
Participants also described the importance of reduced numbers of students and caseloads. Addi-
tionally, some participants recommended broadening others’ perceptions of school psychologists’
roles beyond gatekeepers to SPED. These reports are consistent with suggestions that organizational
support is needed to facilitate many services (NASP, 2010a).

Implications for Research and Practice

Research is needed to further investigate factors that impact comprehensive and integrated
services. Findings from the current study provide information regarding the perceptions and experi-
ences of practitioners that can be used to describe issues encountered and the context in which they
occurred; however, by themselves, these results should not be generalized to the broader population
of school psychologists. Future research should examine the extent to which the facilitators and
barriers highlighted in this study are present for a large, representative sample of practitioners. The
dataset could be used to examine both the presence of facilitators and barriers and the relationship
between specific facilitators and barriers and services provided. Additionally, qualitative studies
that further examine how school psychologists experience particular high frequency facilitators and
barriers could provide valuable information to better understand the situations being encountered.
Studies that gather more in-depth information could be used by school psychology training programs,
professional associations, and district-level supervisors to facilitate training and support, collabora-
tions, dialogues, or other actions to address common issues. Additionally, the information may be
used to work with policy makers to address systemic issues through legislation, rule, mandate, or
other mechanisms that provide guidance to stakeholders regarding school psychological services.
Although future research certainly is needed, findings from the current study illustrate the
need for school psychologists themselves to advocate for changes that would reduce systemic
barriers to comprehensive and integrated service delivery. Although participants in the current
study focused on systemic changes that need to occur, no themes emerged regarding how they
personally could advocate for and facilitate change as individual school psychologists despite calls
for school psychologists to become more active leaders and advocates for effective policy and
systems change (e.g., Adelman & Taylor, 2012; Conoley, 2012; Lochman, 2012). Assertions that
school psychologists should actively advocate for systems change, however, may not have matched
the reality of participants’ capacity to serve in such a role.
Participants, for example, may not have viewed advocacy and systems change as essential
services they could provide nor possessed the knowledge and skills to engage in those activities.
Participants discussed graduate training and PD as factors that impacted practice; however, only the

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 Facilitators and Barriers 655

most recent version of the NASP blueprint for training and practice includes an explicit emphasis on
systems change (Ysseldyke et al., 2006). Another potential explanation relates to relational trust and
psychological safety in the participants’ schools. Researchers have articulated that negative school
climates that result in unsafe environments to bring up new ideas or needed changes act as barriers
to change (Edmundson, 1999). Some participants discussed the negative impact that principals with
authoritarian styles or a lack of involvement with decision-makers had on their ability to provide
comprehensive and integrated services. Additional research is needed to understand how school
psychologists view their roles and abilities to serve as advocates for and leaders of change.
National level associations (e.g., NASP) that engage in and support advocacy efforts
(see http://www.nasponline.org/advocacy/index.aspx) can be a resource to school psychologists.
Information is available regarding relevant policies, professional development on advocacy, and ad-
vocacy tools designed to facilitate opportunities to expand service delivery. Federal and state policy
makers play a significant role in defining the parameters for service delivery. School psychologists
need to facilitate opportunities to share data about what school psychologists do, the impact of their
services, and the current state of the field.
Intentional, focused efforts to get involved with other key stakeholders as well as to communicate
regarding the services that school psychologists can provide and how those services relate to the
needs of the stakeholders likely are needed as well. Participants discussed the role that administrators
and teachers played as gatekeepers to expanding their roles beyond SPED activities. Participants
described how relationships with these stakeholders and buy-in and support from them helped
facilitate service delivery. Specific guidance regarding how school psychologists can advocate for
the types of services they can provide is available (e.g., Adelman & Taylor, 2012; Conoley, 2012;
Lochman, 2012).
The need to further investigate these types of advocacy efforts is evident when one considers
a couple of issues raised by participants. Participants viewed low ratios of students to school
psychologists as a facilitator and high ratios as a barrier. Curtis et al. (2012) reported that the
mean student to school psychologist ratio across the country was 1,383:1 in 2010, which was
substantially higher than the 500–700:1 ratio recommended when providing comprehensive and
preventive services (NASP, 2010a). Researchers suggest, however, that efforts to increase the number
of school psychologists may be hindered by personnel shortages across the US (Castillo et al., 2014;
Curtis, et al., 2004). By strategically targeting decision-makers, advocates can share information
about the relationship between school psychological services and outcomes, the relationship between
effective services and the number of students served, and the personnel shortages likely to contribute
to higher ratios.

Limitations
A few limitations should be considered when interpreting findings from the current study.
First, although purposeful sampling is common in qualitative research, it limited the available pool
of potential participants. Second, participants who self-selected could introduce sampling bias.
Third, the study was limited to NASP members. In a qualitative study the concern is not that
these participants fail to generalize to the population, but that their experiences may differentially
generalize to theory. It is possible that NASP members who self-select may be more familiar with
the NASP model and therefore, express barriers and facilitators unique to their familiarity.
Additional limitations involved data collection and analysis procedures. Interviews were con-
ducted by telephone. Establishing rapport is important when interviewing and participants may have
provided additional information in face-to-face interviews during which rapport may have been
more easily established. However, it is unclear whether conducting interviews via telephone actually

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656 Castillo et al.

results in a loss of rapport or distorts the quality of information provided (Novick, 2008). Another
limitation involved the 62% ICA estimate. However, high ICA estimates are difficult to achieve
in qualitative studies that use procedures such as semi-structured interviews with open-coding
(Campbell et al., 2013), which influenced our decision to continue to have two Research Team
members code each transcript and discuss differences until consensus could be reached. Thus, all
differences in coding decisions were discussed to facilitate consistent application of codebook def-
initions. Finally, the results may not fully exhaust the range of facilitators and barriers experienced
by school psychologists.

Conclusion
The current study provided qualitative data on factors that facilitate and hinder comprehensive
and integrated service delivery from a sample of school-based practicing school psychologists. A
number of themes emerged that inform future research and that reinforce the need for individual
school psychologists to advocate for systems change. Although calls for and models of compre-
hensive and integrated service delivery are critical for establishing the need for and defining the
practices in which school psychologists engage, additional efforts are needed to ensure that school-
based practitioners have every opportunity to provide an array of services that positively impact
children, youth, and their families.

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