Consultation Case Study

Yu Chu Chang

Background Information: (8pts) In this section, include relevant background information of

your case such as records, interviews, biophysical, ecological, and health and social
development. Use the ecological model to guide you and the information you provide.

This section should include:

1. Student or class context (age, grade, demographics, cultural, and environmental

considerations.)
● Name: Student G
● Age: 11 years old
● Grade: 5th grade
● Demographic: Latino
● Cultural/Environmental Considerations: Teachers and the counseling team had been
working with him since kindergarten, but nothing seemed to work out. Parents were
not very involved.
2. Adult consultee(s) information: (who, years of experience, demographics, cultural and
environmental considerations)
● Name: Karma Magana (5th grade teacher)
● Years of Experience: 20 years of experiences as a teacher (11 years at Orange Grove
Elementary School)
● Demographics: Caucasian
● Power Dynamics: Had a lot of experiences and had good relationships with admins,
students, and parents.
● Cultural/Environmental Considerations: Coming from a social class/cultural
background that was different from the majority of her students, Mrs. Magana was able
to bring different perspectives, resources, and opportunities to the classroom.
3. Consultant information (you): (who, years of experience, demographics, power
dynamics, cultural and environmental considerations)
● Name: Yu Chu Chang
● Years of Experience: Second-year school counseling student
● Demographics: Asian, international student from Taiwan
● Power Dynamics: Second semester at Orange Grove Elementary School. Had
worked/met with most teachers and staff during classroom presentations or meetings.
● Cultural/Environmental Considerations: Mandarin as first language, sixth year
living in the USA, had experiences in teaching students with disabilities, had a master
degree in Television and Film production.
3. Context of student and problem (Initial understanding of environmental info and other
relevant information)
● Student G had been having behavioral problems in Mrs. Magana’s class.
● He had difficulty following directions, concentrating in class, and respecting others.
● He had been on check-in and check-out for a while but it did not seem to work.
● His best friend, Student J, also displayed problematic behaviors.
Stage 1: Relationship Building and Problem Identification- How can we develop a
positive working relationship and collaboratively define the problem?

This stage is where a collaborative relationship is built, the problem is clarified, and baseline
data collection starts. Several sessions may be necessary to meet all the objectives of this
stage.

1. Before beginning interviews and the formal problem-solving process, it is necessary to

take steps to build collaborative relationships with your consultees. Describe the
process of building a relationship with your consultees.
● I had been to Mrs. Magana’s classroom for a few tier 1 lessons before. I greeted her but
did not get a chance to engage in longer conversation with her.
● During our first consultation meeting, I greeted Mrs. Magana and introduced myself to
her. I started the conversation by praising some of her students and sharing my
experiences working with them.
● I explained the purpose of the consultation meeting and ensured that she felt
comfortable working with me as a team.

2. Using the Conjoint Problem Identification Interview (CPII), or a similar process,

provide a summary of the following information gathered from the initial meeting(s).
make sure to identify how you gathered the data and who you interviewed:

a. Goal specification e.g., ABCs of the behavior (Antecedent, Behavior, and

Consequence), identify the severity of the problem, identify broad goals for
consultation-AKA-expected outcomes
● According to Mrs. Magana, Student G got distracted or used
disrespectful language every 5 to 10 minutes.
● The target behavior often happened when student G was not engaged in
class or did not understand the task.
● When getting redirected, student G would become frustrated and use
more disrespectful languages.
● Mrs. Magana had tried several different strategies in response to the
target behaviors. Some of them successfully de-escalated the situation.
● Expected outcomes: Student G follows directions, participates in class
regularly, and engages in group activities.

b. Performance Assessment (Collaboratively select measures to assess progress.

What data will be gathered? Who will collect it? How will it be recorded? On
what schedule? How will you support this process?)
● The frequency and severity of Student G’s disrespectful behaviors will
be documented (How often? Who is affected? What are the
consequences?). We will also pay attention to the times and
circumstances when he gets distracted in the classroom.
 ● Since most of the target behaviors happened in the classroom, data will
be collected by me and Mrs. Magana collaboratively through classroom
observation.
● Mrs. Magana will document the times when Student G gets distracted or
uses disrespectful language. She will also keep track of Students G’s
response to her redirections/instructions
● I will spend 1-2 hours observing in the classroom every week,
documenting Mrs. Magana and student G’s interactions and paying
attention to classroom dynamics.
● I will also have a few one-on-one meetings with Student G to
understand his perspectives and intentions.

c. Procedural objectives (Schedule a day and time for the next interview (PAI)
within approximately 1-2 weeks; Arrange to contact the consultee to monitor
the integrity of baseline data collection; Ensure that the definitions of the
problem behavior are written in objective, operational terms; Summarize the
important points of the meeting and check for a consensus and shared
understanding of the problem)
● Meeting Summary: Mrs. Magana and I decided to focus on Student G
and his problematic behaviors. Student G had difficulty concentrating in
class and used disrespectful language to others, which resulted in
incomplete tasks and conflicts with peers. Mrs. Magana and I will be
monitoring the frequency and intensity of Student G’s behaviors and
collecting data before our next meeting.
● Next interview with Mrs. Magana is scheduled on 10/14/22. However, I
will continue to go into her classroom, observe Student G, and follow
up with the data collection process.

3. Steps to take before Stage 2:

● Using an agreed upon system, collect baseline data on the target behaviors (i.e.,
problem behavior, academic concern, and goal behavior.
o I will be using Student G’s score on his check-in/check-out sheet as his
baseline data. This week, Student G got an average of 22 out of 30. A
weekly average of 28 out of 30 is expected after 2 months of intervention.

<Insert baseline data/ graph with baseline and expected level of performance here>

● Look for the discrepancy between baseline performance and expected level of
performance based on developed goals).

● Use CPII to gather some information from the parent. Integrate this information
into this section by clearly labeling it as parent input. Discuss any differences in
problem conceptualizations between school and home.
-
Stage 2: Problem Solving and Analysis - What conditions (ecological or personal) led to
the problem and currently support it? What should we do about it? (8pts)

An intervention developed through problem-solving consultation will focus on changing the

conditions surrounding the target behavior, teaching the consultee the skills required to
produce the target behavior or both. In the analysis phase, the consultant and consultee must
decide what ecological conditions and skills should be targeted for change.

1. Using the Conjoint Problem Analysis Interview (CPAI), collect relevant data, and
summarize the following information:

a. Problem validation (Is baseline data sufficient and informative? Is there a

meaningful discrepancy between the student’s present performance and the
desired performance? Is there agreement between the consultant and consultee
that the problem is a problem?)
● The baseline data is sufficient and reflects that Student G has difficulty
following directions in multiple classes.
● There is a meaningful discrepancy between Student G’s present and
desired performance. A weekly average of 28 out of 30 on student G’s
check-in/check-out sheet is expected, which indicates a 20% increase
from the baseline data.
● Both the consultant and the consultee agreed that Student G’s disruptive
behaviors had become a severe problem in the classroom. Student G
would constantly get distracted and use disrespectful language to peers
and adults, resulting in a toxic learning environment.
b. Analysis Determine conditions or skills needed for goal attainment, search for
information regarding evidence-based interventions used for these specific
skills and deficits
● Student G displays more intense and frequent disruptive behaviors when
he is not interested in the subject, does not understand the tasks, or
when other students are being disruptive.
● Student G lacks skills such as impulse control, anger management, and
following directions.
● Constant redirection, explicit instruction, and incentives would be
helpful for Student G to achieve his goal.
● Some evidence-based treatments for children with disruptive behaviors
include mindfulness practices, multisystemic therapy, parent-child
interaction therapy, and social-emotional learning curriculums focusing
on anger control, impulse control, and problem-solving.

c. Plan design (Establish plan strategies that will be used to address the problem;
Establish plan tactics that will serve as the procedures, materials, personnel,
and conditions of the intervention; Establish performance assessment
procedures to monitor progress towards goals and skill development throughout
implementation.
 Support with an artifact of the intervention plan.
● Seating arrangement: remove Student G from all possible distractions
(i.e., Student J, who also has behavior concerns) and place him closer to
the teacher and the whiteboard.
● Redirection and accommodation from Mrs. Magana: constantly remind
Student G and stand next to him during class. Provide praises,
high-fives, nods, or tiger tickets (PBIS store) as positive reinforcements
when Student G follows directions, uses kind language, or stays on task.
● Individual counseling: Student G has started receiving individual
counseling weekly. We will be working on topics such as impulse
control, anger management, and making good choices. Student G will
also get to express his point of view, report progress, and share how the
behavioral problems have impacted him. Tiger tickets will be provided
at the end of each session.

d. Procedures and process of implementing the plan.

Set a date for the Treatment Evaluation Interview, allowing no more than a few
weeks to elapse between the start of implementation and evaluation; Establish
procedures for communicating the initial implementation to address questions
or concerns from those implementing the intervention
● Treatment evaluation interview date: 11/09/22
● I will check in with Mrs. Magana at least once a week to address her
concerns and questions, exchange information regarding student
progress, and ensure the intervention plan is appropriately implemented.
If necessary, we will also make adjustments to the intervention plan
based on student outcomes and the consultees’ feedback.
e. Establish procedures for professional development for the consultee, if general
training is required for successful implementation
● Student data is organized and shared with the consultee to ensure that
she has a complete understanding of the problem.
● No general training is needed at the moment.
Stage 3: Treatment Implementation- How well is the treatment plan working? What
adjustments need to be made for the plan to be effective? (8pts)

This stage focuses on formative evaluation and adjustments that need to be made to the plan
for it to work better

A formal interview is not conducted in the treatment implementation stage, yet there should be
ongoing communication regarding (a) skill development, (b) implementation monitoring, and
(c) plan revisions. In this section, you will describe your activities and progress across these
objective areas.

Note: Because there is no formal interview associated with the treatment implementation
stage, the consultant guides the consultation process in ways other than formal meetings.

● Brief Contacts – Brief contact with the consultee should take only a few minutes, and
allow the consultant to monitor implementation and discuss plan revisions, client
progress, and future meetings with the consultee.
● Observation – Direct observation can also be a way to monitor intervention
implementation.
● Training Session(s) – Training sessions outside of the intervention setting serve to
develop the consultee’s skills
-

1. Consultee Skill Development- Determine the consultee’s implementation skills and

whether or not they need training or resources. If the consultees have sufficient
skills, describe how you determined this and if they do not, describe how you will
provide training and support.

Examples of artifacts may include teacher tip sheets,

intervention summary pages or other resources.
● The consultee, Mrs. Magana, has sufficient implementation skills. She has
rearranged the seats several times, but instead of placing Student G in the same
spot and making him feel isolated, she also changes his seats and encourages
him to participate in class discussions. She often stands next to him during
instruction time to monitor his behaviors.
● Mrs. Magana also works closely with the school counselors. She communicates
her concerns in a timely manner and is open to suggestions and adjustments.
● Mrs. Magana keeps track of Student G’s behaviors and records her observation
on the check-in/check-out sheet, which is really helpful for
teacher-parent/consultee-consultant communication and monitoring student
progress.
● The Antecedent-Behavior-Consequence (ABC) behavior handout and tracking
sheet were provided to Mrs. Magana to help her and the counseling team
examine Student G’s behaviors from a different perspective.
2. Implementation Monitoring -Determine if data collection and implementation is
occurring according to plan and with integrity. Describe how the plan is
progressing at this point.

Artifact of data collection tools needed.

● I continue to meet with Student G once a week for individual counseling. Some
topics we have covered include making good choices, actions and their
consequences, impulse control methods, etc. Student G participated in the
conversation and fully comprehended the content.
● I have been able to collect data through Student G’s check-in/check-out sheet.
Student G’s scores fluctuate but show slight improvement compared to the
baseline data.
● Student G’s check-in/check-out sheets are signed by his parents and brought
back the following day. The comments and redirection records provided by
Mrs. Magana help me keep track of Student G’s performance on the days when
I am not on site. I also check in with Mrs. Magana once a week to briefly
discuss Student G’s progress.

3. Plan Revision -Identify if and when there is a need to change the plan, which would
occur in two situations, when there is: (a) a lack of agreement between
implementation and the implementation plan, or (b) a lack of behavior change in
the client. Make a revision plan, if necessary. Describe here.

● The check-in/check-out scores and comments reflected that Student G’s

performance had been unstable, especially during the subjects/tasks he did not
like. After discussing with Mrs. Magana and consulting with my supervisor, we
decided to increase the frequency of positive reinforcements and provide
rewards (e.g., game time, candies, popcorn, slime) at the end of each week if he
got 80% of the score.
● We also noticed that Student G had difficulty handling the tangible rewards he
received (e.g., he would play with the rewarded toys/food during the class or
sell his PBIS tickets to his classmates). Therefore, we decided to have him pick
up the rewards at the end of the day/week.
Stage 4: Treatment Evaluation- Did the intervention work, and what should happen
next? (8pts)

This stage focuses on the summative evaluation of the plan. In the end, how well did this
intervention work?

Following a suitable period of intervention implementation in Stage 3, the treatment

evaluation stage of consultation concerns the evaluation of goal attainment, effectiveness, and
treatment acceptability of the intervention. Consideration of post-implementation planning is
the last step in Stage 4.

Use the Conjoint Treatment Evaluation Interview (CTEI) This interview will help determine
whether the goals of consultation have been achieved if it is necessary to return to problem
identification or analysis, and what type of post-implementation plan should be established.

Using the CTEI, describe the following objectives:

1. Goal Attainment- Establish the extent to which all goals are met by (a) comparing the
goals defined during the CPII to the summarized data from the treatment
implementation stage and (b) asking the consultee for their judgment on the extent of
goal attainment

Insert progress monitoring graph with baseline, progress data checkpoints,

and the expected level of performance here
● Student G has yet to attain his goal of having a weekly average of 28 out of 30.
He got an average of 27.2 once, but his overall score fluctuated (he got low
scores on some days because he came to school late and did not get rated by the
teacher/supervisor).
● The consultee, Mrs. Magana, found the chart/data helpful and thought we
should continue with current interventions for a more extended period before
we make any major adjustments.
2. Consultation Guidance -Using the information provided in the goal attainment
evaluation section (describe above), determine the next steps (i.e., a continuation of the
intervention, modification of the intervention or measurement system, or Tier 2 or 3
supports) and describe.

● Even though the goal had yet to be attained, Student G displayed improvements
in following directions and making good choices. A continuation of the
intervention might help establish good habits and monitor Student G’s progress
over time.
● Previous interventions such as seating arrangement, redirections and positive
feedback from the teacher, and individual counseling will continue to be
implemented. However, the reward system established during stage 3 requires
modification. Mrs. Magana and I noticed that with the reward system we
developed together, Student G was able to get small prizes even on the weeks
he did not do well. We plan to raise the points he needs for each prize and
communicate our expectations with Student G.
● During one of the follow-up meetings, Mrs. Magana also pointed out that
Student G played with the prizes he got (e.g., food, toys, and color pencils) in
class. To address this problem, we decided to have him pick up his prizes at
dismissal.

3. Post-implementation Planning - Select a post-implementation plan alternative (i.e.,

How will the intervention be maintained and eventually faded?). Make provisions for
post-implementation data recording. Establish procedures that specify what to do in
the event of problem recurrence. How will you make sure the student/class continues to
receive support post consultation? Describe your mutual plan here.

● To maintain the intervention, we will make sure that Student G’s situation is
communicated and monitored by various stakeholders since each of them could
 be part of the support team and reinforce positive behaviors in different
settings. Informal check-ins and follow-up meetings will also be held with Mrs.
Magana to examine the implementation and outcomes of the intervention plans.
● Check-in/check-out sheets will continue being used to collect Student G’s
behavioral data. The reward system will also be examined constantly to ensure
that the reinforcements are fair and effective.
● In the event of problem recurrence, we could consider placing Student G in
groups on impulse control or self-awareness. We could also ask him to be the
“helper” in the classroom/counseling office to increase his self-worth and build
a stronger rapport.
● To ensure that Student G and Mrs. Magana receive support post-consultation, I
will connect them with my supervisor and other mental health professionals in
school so they can continue receiving help even when I am not on site.

4. Procedural Objectives - Schedule additional consultation meetings if one or more goals

of consultation have not been achieved. End consultation if all goals have been
achieved

● I will continue to check in with Mrs. Magana, exchange information with her,
and monitor Student G’s performance. The interventions we implemented
seemed to work and self-sustain; thus formal meetings will not be needed
unless any significant behavioral problem reoccurs.
Stage 5: Reflections on the consultation process (8pts)
How effective do you feel your consultation was, and why?
● I feel that my consultation was pretty effective. I was able to build a strong working
relationship with Mrs. Magana through the collaboration process. Although some
interventions did not turn out as expected (i.e., the reward system), we were able to
identify the problems immediately and make adjustments to the plans in a timely
manner. Mrs. Magana and I also established a great system of communication. I
constantly updated her on the progress Student G made in the individual counseling
sessions while she shared her observation in the classroom with me. Exchanging
experiences and information helped me look at things from a different perspective and
address any new problem Student G encountered.

Do you feel that you adequately considered cultural and environmental contexts within your
consultation process? How do you think you were able to do this, and how might you have
improved in this area?
● I feel that I somewhat considered the cultural and environmental contexts during the
process. Knowing that there are more than 90% Latino students at our school, I
constantly reexamine my implicit bias, ensuring that I am not making
judgments/guiding the student based on my own experiences and stereotypes. I also
improve my cultural competence by asking questions. Since it is difficult to familiarize
ourselves with every culture, it is helpful to remain open-minded and learn from the
people we work with. Meanwhile, avoiding assumptions and showing respect and
empathy are essential in establishing trusting relationships.
● In the future, I will utilize the ecological model and stay aware of the impacts each
cultural/environmental factor brings to the consultation process.

What challenges did you face in this consultation process? How did you deal with these?
● Since I am not on site every day, my biggest challenges were catching up with what
happened when I was gone and keeping track of the interventions other school
personnel had implemented. Student G was referred to the principal a few times when I
was absent. Due to a lack of communication, the principal established a different
reward system for Student G, which overlapped with the one that already existed.
● When I recognized the inconsistency of implementation, I spoke to Mrs. Magana and
the principal to gain further clarification. Luckily, we were able to reach a consensus of
continuing with one of the reward systems and working on improving future
communication.
If you observed a significant positive change, discuss what factors you believe led to a
successful outcome. Even if you did not observe a positive change, or saw a regression,
explain what you think led to this outcome.
● There are several factors that I believe led to the current successful outcome:
○ Collecting student data and using charts to demonstrate student progress-The
visuals helped me and Mrs. Magana identify the occurring time and frequency
of the challenging behaviors. The charts also made it easier for us to compare
the outcome with the baseline data.
○ Ongoing communication-Information exchange helped me and Mrs. Magana
stay on the same page and identify implementation barriers timely.
○ Using different interventions in different settings-Mrs. Magana focused on
immediate positive reinforcement (i.e., nodding, smiling, verbal affirmation)
and seating arrangement in the classroom while I provided skill-building
counseling sessions and delayed reinforcement (i.e., the reward system).

What did this case teach you about:

● Consultation on this type of concern

o For behavioral concerns, consultation is beneficial especially during the
implementation stage. Since behavioral problems are relatively easy to observe
and document, consultants and consultees working collaboratively as a team
can provide thorough services to the students and collect data across various
activities and incidents.

● Consultation in general
o Solving problems alone can be exhausting sometimes. It is powerful to use a
strength-based approach when working with the consultees. This case taught
me that the consultees are experts in their fields and that they bring valuable
resources to the consultation relationship. Making good use of these resources
and experiences can potentially bring benefits to everyone.

● Yourself as a consultant. How will you continue to develop your consultation skills
after this class?
o I will build rapport with school staff by attending staff meetings, participating
in school events, and offering support to those with additional needs. I will also
shadow other professionals to get a better idea of how to consult people in
different roles and positions under various circumstances.

● What would you do differently in the future (e.g., alternative models, different
decisions, more attention to one stage, etc.)?
o Besides working with school staff, I will communicate with the student’s
parents more in the future. Understanding the student’s cultural background and
family relationship can help me examine his behaviors from an ecological
perspective. It is also vital to monitor the challenging behaviors in different
settings/by different people as there might be unidentified triggers or factors
contributing to the problem.