Faith Johnson CNS 786: Assignment 2.

Consultation Case Study

The QC outpatient treatment center is interested in engaging consulting services for the

purpose of improving client behaviors and treatment compliance within a particular group. In

clients who have both substance abuse and mental health diagnoses, treatment recommendations

can be quite the blur, especially in clients who are ordered by a parole officer to complete

treatment. For instance, clients required to attend services due to probation are habitually

uncooperative, unwilling to participate, and want the quickest way out. Likewise, they are rude,

disrespectful, and disruptive. Often times, they do not see any harm or wrongdoing in their

actions. They do not always respect other group members or clinical staff and see no problem in

how they respond to others. These clients perceive their clinicians to be contributing factors in

their being in treatment. They view clinicians as an enemy and someone that is out to get them.

They do not see their clinician as a helping hand, but rather someone who negatively collaborates

with their parole officers. In order to develop an accurate definition of the clients’ difficulties,

the following cultural factors must be considered: social class, religion/spirituality, ethnicity,

age, gender, and how they were raised.

The QC staff suspect that socioeconomic status, and a lack of knowledge and confidence

play a large part in the behavioral patterns of these clients. The center director, Brenda Green,

views the problem as an inconvenience to the reputation of the center as well as a disturbance to

the overall clinical well-being of all clients. Mrs. Green is concerned that if an intervention does

not occur soon that the clinicians will begin over-exerting themselves and become clinically

drained. She is also concerned that other clients will become hesitant to continue services. Mrs.

Green feels that educating clients on the importance of therapy and the effectiveness of group

therapy will help the behaviors of these clients as well as the center as a whole. She wants to be
Faith Johnson CNS 786: Assignment 2.1

fully involved in bringing change to the center but understands that she must take steps back to

allow the consultant to be successful. Mrs. Green expects that the clients develop appropriate

coping techniques from the help of the clinicians. I, the consultant, will use my problem-solving

and communication skills to develop a deeper understanding of the center’s needs along with the

needs of the client’s. Forms of treatment will include, but are not limited to: designing,

implementing, and assessing appropriate interventions, educating clinicians on alternative ways

to communicate with uncooperative clients, developing clinical approaches to increase

attendance and openness to groups, working to minimize negative behaviors, and teaching clients

techniques to modify outside environmental actions.

The reinforcing behaviors of the clients are suspected to correlate with living

arrangements, level of peer support, and the relationship between the client and the parole

officer. Reviewing patient charts with Mrs. Green could provide a clearer understanding into the

lives of the clients outside of the center. To reinforce positive behavior change, time constraints

must be considered. At what point can these behaviors no longer be changed? Other constraints

to be considered include transportation availability and any potential constraints set forth by the

parole officer(s). Also, reviewing the values and expectations of the center is important in

creating an intervention that aligns with the problem at hand but also centers around the beliefs

of the center. To be most effective, I must also consider the views of the clinicians as well. Mrs.

Green has asked me to evaluate what interventions would bring about the most timely and

efficient improvements to the center, clinical staff, and clients. She has also asked me to provide

suggestions for the continuation of maintenance to prevent similar problems in the future.