You are on page 1of 235

The Foundations of Consultation

and Collaboration

The Promise of Consultation and


Collaboration
A cornerstone activity for members of the
helping professions
Attempt to alleviate current problems while
preventing the their future occurrence
Attempts to promote the psychological well
being of society though indirect methods
Often viewed as an alternative to direct
methods such as one-on-one and group
counseling/psychotherapy

Consultation Defined
A process in which a human services professional

assists a consultee with a work-related (or


caretaking-related) problem with a client system,
with the goal of helping both the consultee and
the client system in some specific way

Consultation Defined contd


Consultation deals

exclusively with
consultees workrelated or
caregiving-related
problems

Consultant and

consultee work
together in solving
the problems
defined by
consultation

Role of human service

Voluntary for all

professional
Problem-solving
process
Triadic in nature
Helping relationship
Internal or external

parties
Relationship of peers
Collaborative
Temporary
Remedial or
developmental

Consultative Relationship
Relationship between the consultee and

consultant is one of peers, of two equals


Though the two roles are equal in terms

of power, it is the consultee who has the


greatest need within the consultative
relationship

Consultation and Consultants


Who are consultants?
Who are consultees?
Who is the client system?

Consultants and Consultees


Priority can be

given to either
consultee or client
system depending
on the approach
used by the
consultant

Consultant

provides indirect
service to the
client system by
providing direct
service to the
consultee

Rights of Consultation
Participants
Participation in consultation is voluntary

for all parties involved


Consultees free to do whatever they
wish with consultants suggestions and
recommendations

Length of Consultation
Though consultation relationship is

temporary, the length of


consultation may range from a
single session to weekly sessions for
more than a year

Triad of Consultation
Consultee

Consultant

Client System

Figure 1.2 The triadic relationship in consultation

Collaboration Defined
Collaboration is very similar to consultation in

that it follows the same problem-solving process


Collaboration involves the interactive exchange of
resources, interdependence, and a focus on
decision making

Collaboration contd
Collaboration is a service in which the helper

accepts responsibility for the mental health


aspects of a case.

The Relationships of the Parties in


Collaboration
Collaborator
#1

Collaborator
#2

Client System
Figure 1.3 The Relationships of the Parties in Collaboration

A Distinguishing Difference Between


Consultation and Collaboration
In consultation, the consultee retains

responsibility for the outcome, is considered to


be the determiner of the suitability of possible
interventions, and is responsible for adequate
implementation of the intervention (i.e.,
ensuring treatment integrity)

(Zins & Erchul, 1995)

Multicultural Limitations of
Consultation and Collaboration
Developed from Eurocentric models
Limitations make person-in-environment

perspective important
Cultural competence in service delivery essential
Some multicultural models available (e. g.,
Ingraham)

Multicultural Consultation
Consultant, in a culturally sensitive manner,
adjusts services to accommodate and value
cultural differences
Through employing multicultural framework,
consultants are in better position to provide
services with multicultural competence

Multicultural Framework
a) consultant knowledge, skills and dispositions related
b)

c)
d)

e)

to cultural competence in consultation


understanding consultee needs for development in
knowledge, skill, confidence and objectivity
cultural variations in the parties involved in
consultation (e. g., consultant-consultee similarity)
contextual influence (e. g., organizational culture)
and power influences (difference in power among
parties in the consultation relationship)
methods for supporting consultee success in
multicultural situations

Levels of Prevention
Preventive vs. remedial perspectives
Primary prevention
Secondary prevention
Tertiary prevention
Universal
Selected
Indicated

Historical Overview
Prototypic roles: healer and technological adviser
Started in modern times as a clinical expert role
Currently, focus is on facilitation of consultees

professional development in current and future


situations

Compared to Other
Human Service Activities
Counseling and psychotherapy
Supervision
Mediation

Consultants, Consultees,
and Collaborators

Skill Areas for Consultants


and Collaborators
Interpersonal skills
Communication skills

Problem-solving skills
Skills in working with organizations

Skill Areas for Consultants


and Collaborators contd
Skills in dealing with cultural diversity
Group skills
Ethical and professional behavior skills

Roles of the Consultant


The consultant can take on a variety of
roles depending on several factors:
Nature of the
problem

Skills of the
consultant

Purpose and
desired outcomes

Skills of the
consultee

of consultation

Directive
*
Advocacy
Expert
Trainer/Educator
Collaborator
Fact Finder
Process Specialist
*

Non-directive

Emergence of Advocacy
The use of advocacy has received

increasing attention
There has also been an increase in the
use of the advocacy role in consultation

Roles contd
Expert role is NOT opposite of collaborative role
The collaborative role in consultation is not the

same as the service of collaboration


It is useful to think of the collaborative role being
implemented on a continuum from nondirective
to directive

Internal/External
Consultants
Consultant can either be separate from (external)

or part of (internal) system in which consultation is


to occur
There are both advantages and disadvantages to

being internal or external

Orientation to Models of
Consultation
Mental health
Behavioral
Organizational

Consultee as a Variable
Consultee variables include:
knowledge
skills

attitudes
personal characteristics

Research in Consultation
and Collaboration
Consultation research suggests that

consultation has efficacy even though


consultation practice has outpaced its
body of research.

Research contd
The research on collaboration is very limited
Increase in the use of qualitative and mixed

methods
Behavioral research most heavily researched
School-based also heavily researched

The Generic Model of


Consultation and Collaboration

Stage I: Entry

Phase One: Exploring organizational needs


Phase Two: Contracting
Phase Three: Physically entering the system
Phase Four: Psychologically entering the system

Stage II: Diagnosis


Phase One: Gathering information

Phase Two: Defining the problem


Phase Three: Setting goals
Phase Four: Generating possible interventions

Stage III: Implementation


Phase One: Choosing an intervention
Phase Two: Formulating a plan
Phase Three: Implementing the plan
Phase Four: Evaluating the plan

Stage IV: Disengagement


Phase One: Evaluating the process of

consultation
Phase Two: Planning post-consultation matters
Phase Three: Reducing involvement and
following-up
Phase Four:Terminating

Putting the Generic


Model into Practice
Equal attention should be paid to what you are
doing and to how you are doing those things
Very important to get supervised practice in

consultation
Implement in a collaborative manner
whenever possible

Multicultural Competence
Using the Generic Model
It is key to effective implementation that the
generic model be adapted with cultural
competence in order to be relevant to the
needs of consultees and their clients systems
Designed to take consultees where they are
and can be adapted to their style of problem
management and cultural context

Consultee Readiness for


Change
Stages can assist consultants to assess
consultees stage of change and increase
likelihood of a successful consultation
experience
Success of generic model is tied to consultee
readiness for change

Resistance to Consultation
Resistance: The failure of a consultee or
organization to participate constructively in the
consultation process

Reluctance: The hesitancy of the consultee to


engage in consultation

Types of Resistance
Systems-level
When unhealthy is due to lack of insight regarding the
need to change
Consultee
There are a variety of sources of resistance (e. g., a
consultees misconception concerning the nature of
consultation)

Dealing Effectively
with Resistance
There are several things consultants can

do to minimize resistance:
Create strong relationship to build trust and alleviate

fear
Demonstrate cultural competence and sensitivity
Collaborate whenever possible
Create conditions so that a consultation has a
satisfying outcome and is worth the effort

Personalizing the
Generic Model
As consultant or collaborator, you are

your best intervention


Who you are as a person can affect the

outcome of consultation or collaboration as


much as what you do when you engage in
these services

Entry Stage

Stage I: Entry

Phase One: Exploring organizational needs


Phase Two: Contracting
Phase Three: Physically entering the system
Phase Four: Psychologically entering the system

Phase One: Exploring


Organizational Needs
To consult or not to consult:
Why am I here?
Who are you?
What is likely to happen?
What will be the result?
What can go wrong?

Phase Two: Contracting


Reason for
contracting:
To clearly define

expectations of
both consultant
and consultee

Elements of a
contract:
Goals
Time frame
Responsibility of

consultant and
agency
Boundaries
Review and
evaluation

Phase Three: Physically


Entering the System
Moving into work space
Getting to know employees of organization
Adapt to organizations schedule
Have those affected by consultation informed

about the consultants role

Phase Four: Psychologically


Entering the System
The gradual acceptance of consultant by

members of the organization in which


consultation is being performed
Consider the process level (how organization
functions) and personal interaction (how people
within an organization function)

During Phase Four a


Consultant Should. . .
Create trustworthiness by:
Demonstrating understanding
Using power appropriately
Respecting confidentiality
Exhibiting credibility

Interpersonal Influence
in Consultation
Consultation can be seen as process of socially
influencing consultees
Trick is for consultants to impact consultee in

terms of gaining cooperation while maintaining a


relationship among equals

Consultants need to use some social influence


strategies but avoid more ethicallyquestionable coercive types

Multicultural Implications:
Entry Stage
Be aware of others value systems
Use effective communication and interpersonal

skill
Determine comfort level in dealing with any
cultural or ethnic issues related to problem
Be aware of how cultural differences may
impact outcome of consultation

Application of Multicultural
Implications for Entry
Certain minority cultural groups may be

concerned about interpersonal orientation of


consultant who is from a majority culture
Consultee from a majority culture may be more

interested in the assistance-value of a consultant

Diagnosis Stage

Stage II: Diagnosis


Phase One: Gathering information

Phase Two: Defining the problem


Phase Three: Setting goals
Phase Four: Generating possible interventions

Phase One:
Gathering Information
Deciding to proceed
Selecting dimension
Deciding who will be involved in data collection
Selecting the data collection methods

Types of Data
Genetic data
Current descriptive data
Process data
Interpretive data
Consultee-client system relationship data
Client system behavior data

Means of Collecting Data


Interviews
Surveys
Questionnaires
Observation
Documents/Records

Phase Two:
Defining the Problem
How many factors affect the problem?
How has the problem developed over time?

What past events are causing the current


problem?
How are future expectations related?

Phase Three:
Setting Goals
The process of shaping a movement toward
concreteness and specificity from a broader,
more general perspective

Goal Setting Steps


Specify objective

Prioritize goals

How will objective be


measured?

Rate goals

Specify target
Specify time span

Determine

coordination
requirements

Phase Four: Generating


Possible Interventions
Intervention: A force that attempts to modify
some outcome
Actions or activities that, when put together in a

systematic manner, make up a plan to achieve a


goal

Multicultural Implications:
Diagnosis Stage
Be aware of differences in gathering data
Be aware of perceptions of what needs to be
accomplished held by consultee
Cultural differences can play a role in
interventions proposed

Application of Multicultural
Implications for Diagnosis
Consultee from a high context culture may prefer

interviewing and observation


Those from a low context culture may prefer

surveys or document research

Some cultural groups may see the focus of

diagnosis as being the group, and some may see


focus as being the individual

Implementation Stage

Stage III: Implementation


Phase One: Choosing an intervention
Phase Two: Formulating a plan
Phase Three: Implementing the plan
Phase Four: Evaluating the plan

Phase One:
Choosing an Intervention
Select one or two interventions that have high

probability of being successful


Take advantage of decision consultation

Increasing Focus on
Evidenced-Based Interventions
Evidenced-based interventions are validated
by research and/or data-based decision making

Types of Interventions
Individual interventions
Dyadic and triadic interventions
Interventions for use between groups

Interventions for the entire organization

Phase Two:
Formulating the Plan
Plan: A detailed step-by-step method, formulated

before hand, for doing something


Considerations:
What (objective)
Where (locale of implementation)
When (time frame)

How (methods, procedures, sequence)


Who (who is responsible for what)

Phase Three:
Implementing the Plan
Help consultee be flexible
Reassure and prepare consultee
Offer technical assistance during this time
Exercise caution toward dependency

Treatment Integrity
Treatment integrity has typically been
presumed but not assessed
Important in drawing conclusions about
interventions success
Sometimes referred to as treatment fidelity
In its simplest form refers to the degree to
which the intervention is implemented as
intended

Treatment Integrity contd


Treatment integrity has two dimensions
First dimension focuses on how effectively the

consultee carries out the intervention

The traditional focus on treatment integrity in


consultation

Second dimension is consultation procedural

integrity (CPI)

Refers to how well the consultant carries out consultation


process in which the intervention is embedded

Treatment Integrity contd


Recently, methods for assessing treatment

integrity have received attention


Interviews, observation and monitoring of
implementation, training in the intervention, and
use of scripted intervention plans can assess
treatment integrity

Phase Four:
Evaluating the Plan
Evaluation: The collection of data/information
about implementation to determine
effectiveness in meeting specified goal
Implementation evaluation
Outcome evaluation

Techniques Used in
Outcome Evaluation
Individualized goal attainment measures
Standardized outcome assessment devices
Consumer satisfaction survey

Multicultural Implications:
Implementation Stage
Cultural differences can impact perception of

the type of intervention selected


These differences should be taken into account

when selecting and implementing an intervention

The question of responsibility during


implementation may be based on cultural
differences
During evaluation, it is important to have
multicultural input

Application for Multicultural


Implications during Implementation
Some cultural groups choose to focus on using

groups rather than focusing on time factors


Some cultural groups may see efficiency of the
plan as most beneficial during evaluation
Other groups may evaluate social impact of plan

Disengagement Stage

Stage IV: Disengagement


Phase One: Evaluating the process of

consultation
Phase Two: Planning post-consultation matters
Phase Three: Reducing involvement and
following-up
Phase Four:Terminating

Phase One:
Evaluating Process
Determine process and effects of consultation

Assess accountability and improvements in


service
Add knowledge to the field of consultation

Types of Evaluation
Summative
the evaluation of outcomes or products

Formative
evaluation of the process of consultation
perform evaluations at the end of each

phase of consultation

Summative Evaluation
Summative evaluation refers to the evaluation
of outcomes or products
Often referred to as product evaluation

Assesses how well consultation worked

Types of
Summative Evaluation
Pre-post method

Group comparison method


Single case method

The Use of Qualitative


Methods in Consultation
Quantitative approach can get at cause and
effect
Qualitative approach can help explain why
the cause and effect relationship exists, for
whom it exists, and how to sustain any effects
that were observed

Types of
Qualitative Methods
Triangulation

Member checks
Recursive data collection
Case study method

Focus groups
Ethnographic interviews

Phase Two: Planning PostConsultation Matters


Review planning process:
Determine objectives
Establish procedures
Define steps
Assign responsibility
Test for feasibility, cost effectiveness and capabilities

Phase Three: Reducing


Involvement and Following-up
Reducing Involvement:

Gradual reduction in
consultants contact
with consultee and
organization, which
prevents abrupt
termination

Follow-up: Process of

periodically checking
how well results of
consultation are being
maintained over time
and how the
organization is
performing postconsultation efforts

Phase Four: Terminating


Terminating provides closure in a formal yet

personal manner
Leave consultee satisfied in process and

accomplishments
Tie up unresolved issues before leaving
Beware of the issues of dependence and depression

Multicultural Implications:
Disengagement Stage
Be aware of the cultural social needs of consultee

involving time factor involved with disengagement


Dependency during follow-up phase may be
influenced by cultural factors

Application of Multicultural
Implications for Disengagement
Some consultees may require longer
follow-up period before termination as a
result of degree of dependency or

importance of relationships

Pragmatic Issues
Recent changes in society and organizations
The influence of organizational theory
Bureaucratic model
Systems theory

The ecological perspective


Organizational change

Pragmatic Issues contd


Dealing with organizational culture

Issues in assessment in organizations


Culturally sensitive organization
Time constraints

Basic Societal Change


Affecting New Workers
Diminishing percentage of young people
entering workforce
New workers less skilled than previous
generations
A significant proportion of new workers
are from minority groups
Women make up at least 60% of new
workers

Organizational Changes
Affecting the Workplace
Increased complexity and diversification
Managers of agencies/organizations more
familiar with organizational change concepts
Organizations/agencies more concerned with
ethics
Greater competition among all types of
organizations

Organizational
Theory Defined
The study of the structures and processes
of organizations and the behavior of
groups and individuals within them.

The Bureaucratic Model


Designed by Max Weber as the ideal of
organizational effectiveness
Means to ends in nature
Each unit under direct control of higher unit
Organizations meant to be efficient, effective,
and equitable

Open Systems
Organizational Theory
Two types of systems: closed and open
Closed systems:
Not affected by their environments
Have a finite amount of energy
When energy is used up, system runs down

Open systems:
Have permeable boundaries
Can obtain energy from and send energy back to the
environment

Organizations can be viewed as open systems

Four Components to
Systems Theory
A framework (pattern of activities)
Goals
Methods and operations
People

Basic Assumptions of
Systems Theory

Organizations are open systems


Subject to internal and external influences
Considers organizations a totality
Interdependence among its parts
Assumes that an organization is more than a sum
of its parts
Organizational behavior is seen as dynamic and
cyclical

Nine Characteristics
of Systems
Importation of energy
The throughput
The output
Systems are cycles and events
Negative entropy
Information input, negative feedback, and the coding
process
The steady state and dynamic homeostasis
Differentiation
Equifinality

Five Subsystems
within an Organization
The technological or production subsystem
The support subsystem
The maintenance subsystem
The adaptive subsystem
The managerial subsystem

The Ecological Perspective


Emphasizes behavior as function of interaction
of characteristics of the environment and the
characteristics of the individual
Behavior needs to be examined in its given

context
Interventions therefore need to focus on realigning

fit between environment and individual by changing


one or both

Ecological Perspective
contd
Often contrasted with medical model, which examines

problems as residing in the individual


Promotes environmental wellness factors that lead
to individual self-esteem and competence as well as
the effort to lower incidence of environmental
stressors on individuals that may lead to negative
outcomes

Approaches to
Organizational Change
Empirical-rational approach
Normative-reeducative approach
Power-coercive approach

Top-down approach
Bottom-up approach
Shared approach

Cultural Attributes of a
Successful Organization
Uniqueness in their philosophy
A focus by management on maintaining the philosophy
Deliberate attempts to integrate the philosophy
throughout the organization
Involvement by all staff in communicating and
reinforcing an organization-wide view of events and
decisions

Culturally Competent
Organization
Views diversity as a value-added opportunity
Proactive in responding to the constant diversity-

related, economic, political and social conditions


Effectively provides services cross-culturally
Goal for consultants is to help to develop and maintain
an organization that is culturally competent in its
functioning through a variety of interventions at
different levels within the organization

Social Justice
Goal for consultants is to help to develop and maintain

an organization that is culturally competent in its


functioning through a variety of interventions at different
levels within the organization
Mental health professionals realize they must move
beyond one-on-one helping and assist with ecological and
systems interventions that promote positive human
development and remove barriers such as equal
opportunity for all organizational members

Time Constraints
Organization members increasingly asked to do more

with less
Time a precious commodity in organizations

Methods to create time for effective consultation

include:
Scheduling meetings in advance as much as possible
Doing as much data gathering as possible early on in the

consultation process
Training prospective consultees in the problem-solving
process prior to consultation

Models of Consultation
and Collaboration

Mental Health Consultation


and Collaboration

Basic Characteristics of
Mental Health Consultation
Method used by professionals in respect to a lay client

or program for clients


Problem is mental health related
Consultant had no professional responsibility for the
outcome of the case
Consultee can accept or decline the suggestions of the
consultant
The relationship between consultant and consultee is
to coordinate

Basic Characteristics of Mental


Health Consultation (cont.)
The consultant is external
Consultation often takes place in short set of interviews
Consultants use problem/response method during

consultation, not predetermined answers


Goals of consultation are to help consultee improve
handling or understanding of the current work difficulty
and to increase capacity to deal with future problems

Basic Characteristics of Mental


Health Consultation (cont.)
Consultation continues indefinitely
Aim of consultation is to improve job performance
Consultation does not focus on personal problems or

feelings of consultee
Consultation is a professional function of specialist
MHC is a method of communication between mental
health specialist and other professionals

Psychodynamic Approach
Fosters concept that behavior is a product of

unconscious motivation and that most personal


issues result from early childhood experiences,
resulting in conflicts that affect behavior and cause
use problems
MHC has become eclectic since this original
psychodynamic approach

Transfer Effect
The concept that what is learned in one situation

should be useable in similar, future situations

One-Downsmanship
A valuable relationship building technique that
a consultant can use to ensure relationship
remains on equal footing

Types of Mental
Health Consultation
Client-centered case
Consultee-centered case
Program-centered administrative
Consultee-centered administrative

The Client-Centered
Case Process
Focus is clients case giving the consultee difficulty
Consultant functions as expert
The consultee acts as link between client and

consultant as well as professional collaborator

Application for
Client-Centered Process
Create list of questions about both client and

consultees situations and options


Answer questions by gathering information from
consultee
Write report for consultee outlining observations
and recommendations

Consultee-Centered
Case Process
Goal is improvement of consultees ability to work

on particular case and cases in the future


Consultant plays roles of detective, expert, and
educator

Application for ConsulteeCentered Process


Determine what reason the consultee is having a

problem:

Lack of knowledge
Lack of skill
Lack of self-confidence
Lack of professional objectivity

Lack of Objectivity
Simple identification: Identifies with client
Transference: Transfers onto client feeling and attitudes

from key relationships in past


Characterological distortions: Personality problem that
interferes with effective delivery of human services
Theme interference: Special type of transference in
which consultee experiences an unexplainable block
in progressing on case

Process of Program-Centered
Administrative Consultation
Assessment of mental health aspects of some

program or internal functioning of organization


Consultant should be knowledgeable and
experienced in:
Organizational theory and practice
Program development
Fiscal policy

Administrative procedures
Personal management

Administrator acts as principle consultee

Program-Centered
Administrative Process
Application:
Scanning: General overview of organization and its
functions
Gather and interpret additional data
Consultant makes interim recommendations
Formal report of recommendations for both
short-term and long-term goals and methods of
implementation

Consultee-Centered
Administrative Consultation
Process:

Consultant works with organizations administrative-

level personnel to help solve problems in personal


management or implementation of organizational policy
Administrator has job of helping consultant decide
whether additional forms of consultation are required,
whether there are to be other consultees and how
involved they are to be in the consultation process

Consultee-Centered
Administrative Consultation
Application:
Beginnings follow same methods as other

consultation processes
Determine who consultees will be
Study organizations social system and identify
problems and issues

Trends in Mental
Health Consultation
Move toward eclecticism

Emergence of mental health collaboration


Major implication of Caplan and Caplans recent
ideas for practicing consultants seems to be
necessity for members of helping professions to
determine at outset of helping relationship whether
consultation or collaboration is in order

Trends contd
Consultee-centered consultation has evolved beyond

Caplans original conceptualization


Factors such as constructivist theory impact it

Process employs a constructivist approach that

emphasizes cognition and constructing conceptual


change
How consultee and consultant understand and view the

problem

Multicultural Aspects
Client-centered allows for minimal disclosure on

part of consultee
Consultee-case suitable for consultees wanting
assistance from a knowledgeable authority figure
Increased breadth and flexibility allow for
sensitivity to cultural variables

Behavioral Consultation and


Collaboration

Behavioral
Consultation Defined
Relationship whereby services consistent with

behavioral orientation are provided either


indirectly to a client or system or directly by
training consultees to enhance skills with clients
and/or systems

Characteristics of
Behavioral Consultation
Use of indirect service delivery models
Reliance on behavioral technology principles

Diversity of intervention goals


Changes aimed at various targets in different

settings

Key Concepts in
Behavioral Consultation
Scientific View of behavior
Emphasis on current influences on behavior

Principles of behavior change


Focus on problem solving

The Consultation Process


Behavioral case consultation
Behavioral technology training
Behavioral systems consultation

Behavioral Case
Consultation
Consultant provides direct, behavior-based service

to consultee concerning management of client or


group of clients assigned to consultee
Consultants use system problem-solving process
to assist consultee with clients

Verbalization Technology
Control of consultants and consultees
verbalizations by consultant for full benefit and
effectiveness for consultation process to occur
Four aspects:
Message source
Message content
Message process
Message control

4 Stages of Problem
Identification for BCC
Problem identification stage
Problem analysis

Plan (treatment) implementation stage


Problem (treatment) evaluation stage

Behavioral
Technology Training
Used when consultees seek to increase general

usage of behavioral technology principles when


working with clients
Often used in schools

The Training
Consultant trains consultees in general behavior

principles or specific behavioral technology skills


Can be formal or informal
Individual or group
Education/training model (chap. 11) is similar to
this training

Behavioral Systems
Consultation
Behavioral technology principles applied to a

social system
Consultant uses principles to analyze and change
interactions among various sub-systems of larger
social system or between two or more interactive
systems

The Consultants
Function and Roles
Expert in behavioral systems consultation,

systems theory, and behavioral ecology


Guides consultee through systematic problemsolving process
Consultation relationship is collaborative

Implications for
Consultation
Behavioral systems consultation assumes that all

or part of a system is experiencing functional


difficulty
Consultation consists of the following:
System definition
System assessment
System intervention
System evaluation

Conjoint Behavioral
Consultation
Uses parents and teachers as conjoint consultees
Designed to bridge gap between school and home

and maximize spread of effects from one setting


to another
Process parallels that of behavioral case
consultation while taking into consideration
ecological factors

CBC contd
Concepts of CBC are compatible with culturally-

competent practice
Sheridan and Kratochwill (2008) recommend the
following practices to maximize CBCs
effectiveness with diverse families:
Practice cultural sensitivity
Build trusting relationships
Address diversity issues directly

Enhance communication
Implement a family-centered approach

Collaboration from a
Behavioral Perspective
Use of behavioral collaboration can be increased

by organizations making effective use of


behavioral technology training

Multicultural Aspects Related


to Behavioral Consultation
Appealing to cultural groups that do not freely

express feelings
Valuable to cultural groups that want concrete
and predictable outcomes

Organizational Consultation
and Collaboration

Organizational
Consultation Defined
Process in which professional provides assistance

of a technical, diagnostic/prescriptive, or
facilitative nature to individual or group from
organization to enhance organizations ability to
deal with change and maintain or enhance
effectiveness in some designated way

Key Concepts in
Organizational Consultation
Organization as client
Process is as important as content

Edgar Scheins
Model of Consultation
Purchase of expertise
Education/training consultation
Program consultation
The doctor/patient model
The process model

The Purchase of
Expertise Model
Consultee knows what problem is, what needs to

be done and who can help solve it


Consultant comes in as expert to simply solve
problem

Education/Training
Consultation
Most frequently used purchase of expertise

consultation
Consultant provides education/training services in
any number of areas and settings

Critical Skills for Education/


Training Consultation
Assessing training needs
Developing and stating measurable objectives
Understanding learning and change process

Designing learning experience


Planning and designing educational events

Critical Skills for Educational/


Training Consultation
Using heuristic laboratory methods
Using multiple learning stimuli
Functioning as group teacher or trainer

Helping others learn how to learn

4 Steps of Educational/
Training Consultation
Needs assessment
Planning education/training activities

Performing education/training
Evaluation

Program Consultation
Form of purchase expertise consultation in which

organization in some way uses consultant to help


plan new program or revise or deal with factors
that affect existing program
Goal is to provide an organization technical
assistance so a given program can be successful

The Doctor/Patient Model


Consultee knows something is wrong, but does

not know what is wrong


Consultant is given power to make diagnosis and
prescribe solution
Goal is to define problem and recommend
realistic interventions

Critical Skills for the


Doctor/Patient Model
Diagnostic skills
Prescriptive skills
In-depth knowledge of organizational theory
Ability to read organizations
Data collection skills
Date interpretation skills
Human relations skills

The Process Model


Consultants expertise should include skills to

involve consultee in defining the problem, to form


team with consultee and to ensure that
consultation process focuses on consultees needs
Consultant makes consultee more effective
problem solver

Seven Steps to
Process Consultation
Making initial contact
Defining relationship
Selecting a setting and method of work
Gathering data/making diagnosis
Intervening
Reducing involvement
Terminating

Process Consultation contd


Prevention is key goal
Process consultation considers how persons, settings

and events become resources for positive


developments within an organization
Consultant uses humble and critical inquiry, by
which consultant makes no assumptions in order to
get to the notions about what consultee really wants

Collaboration from an
Organizational Perspective
Aim is same as organizational consultation
Enhanced functioning of the organization
Emergence of internal consultant role has created

many opportunities for collaboration in organizations

Multicultural Aspects Related


to Organizational Consultation
Cultural groups that prefer structured, expert-

based consultation will find purchase of expertise


model attractive
Cultural groups preferring assistance in problem
definition will find doctor/patient model attractive
Cultural groups for which relationship is essential
will prefer process model

Trends in Organizational
Consultation
Major trends are linked to several societal factors:
Impact of living and working in an information society
Ever-increasing pace of change in all aspects of life
Growing awareness that quality change requires
systemic thinking
Realization that change can be successfully
accomplished only through social influence
Increasing internationalization and diversity within
organizations

School Based Consultation


and Collaboration

School-Based Consultation
and Collaboration
Consultation and collaboration are effective in

providing psychological services in schools


As mental health and instructional needs of
students have become of increasing concern,
interest in consultation and collaboration has
increased

School-Based Consultation
and Collaboration contd
Increased importance due to:
Revisions to the Individuals with Disabilities Act
School violence
No Child Left Behind Act
Emphasis on school reform and restructuring
Increased school accountability and high stakes
testing
School-based consultation can be focused on

primary prevention, secondary prevention or


tertiary prevention

School-Based Consultation
and Collaboration contd
Consultants have ability to significantly impact

mental health and development of children by


improving skills and knowledge of parents and
those professionals who work with children at
school
Manner in which consultation and collaboration
take place in schools varies according to the
model being employed

Consulting and Collaborating


with School Administrators
Schools leadership is powerful force in

determining extent to which consultation and


collaboration are considered acceptable services
Consultants will want to remember that
administrator support and acceptance of
programs is essential for change to occur
Administrators have priorities and pressures for
which they may actively seek consultation

Organizational
Development Consultation
Series of planned and sustained efforts to apply

principles of behavioral science to improve


functioning of the school
Not an event of itself, but a process of changing the

system

Way of making carefully planned, predictable

change in school
Goal is to enhance schools effectiveness by helping
school personnel understand and effectively act on
problems

Consulting and
Collaborating with Teachers
School-based consultants assist teachers with both

academically and behavioral challenged children


as well as those with lesser concerns
School consultation and collaboration can be
effective and efficient ways to help teachers
enhance professional skills
Consultants work strategically to address both
student presenting issues and consultee behavior
and cognition

Teachers contd
Consultants have engaged in collaboration with

teachers as method of providing service to


students and families
Consultation has benefited teachers in variety of
areas
Conducting effective parent conferences
Managing student behavior
Choosing instructional methodologies
Meeting unique needs of children of military

children

Adlerian Consultation:
Consultation with Teachers
Four basic assumptions:
Teachers cannot take responsibility for student
behavior
Teachers should be more involved with
encouragement than with praise
Teachers cannot always prevent failure on part of
student
Teachers need to try to meet affective and cognitive
needs of students

C-Group
Forces of the group:
Consultation

Cohesion

Collaboration

Commitment

Clarification

Change

Caring

Concern

Confrontation

Confidentiality

Communication

C-Group contd
Group consists of four to six teachers and

consultant
Meets once a week
Six to eight sessions
Teacher presents problems with individual
student and group discusses them

Instructional Consultation
Collaborative process in which problem is

identified and interventions are selected and


made
Instructional consultation (IC) is important model
for helping teachers modify instructional behavior
and more effectively create learning environment
for students
Goal of IC is to increase student and staff
performance regarding student academic and
behavioral issues

Steps of Instructional
Consultation
Establishing collaborative relationship
Identifying problem

Observing classroom
Assessing curriculum-based learning
Planning instructional intervention

Terminating

Instructional
Consultation contd
Three ecological components make up

instructional triangle and are assessed:


a) Current competencies and skill sets of student
b) Tasks expected to be accomplished by student
c) Teachers management and instructional behavior

Instructional
Consultation contd
Most common roles of instructional consultant

appear to be those of collaborator and


educational trainer
May also include being advocate for particular

instructional technique or service for student

Recent developments in this model include

concept of instructional consultation teams and


ecological perspectives

Consulting and
Collaborating with Families
Schools are consciously attempting to assist children

and increase parental/guardian involvement


Families influence students academic, social, and
behavioral competencies
Consultation and collaboration with families are

essential and has been on the rise

Research has shown that parent consultation can be

effective in assisting with school-based behavioral and


emotional problems of students

Parent Case Consultation


Parents may seek out consultation for a variety of

reasons
Their childs moving into or out of the school
Their childs academic, emotional, or social behavior

Can be Adlerian, behavior, or mental health


Goal is to promote increased positive involvement

by parents in school life of their child and improve


family relationships

Home School Collaboration


Goal is to create effective partnerships between

school-based professionals and parents to enhance


student learning
In collaborating with parents, school-based
professionals ensure parents are true partners, are
viewed as experts on their children, and have
some responsibility for the outcomes

Home-School
Collaboration contd
Parent involvement typically one-way flow of

information from school to parent


Home-collaboration: a two-way communication effort

based on joint efforts to assist the child


Sometimes referred to as home-school partnerships
or school-family partnerships

From an ecological perspective, often helpful to

think of school and parents together rather than


only separately

Home-School
Collaboration contd
Allows parent to exercise their roles, rights and

responsibilities related to childs welfare


School personnel can learn detailed information
about child and family and engage parents in
jointly defined goals
Reciprocal influences of home and school on
student learning is maximized

Home-School
Collaboration contd
Basic considerations in home-school collaboration
include:
A preventive, problem-solving approach

Both educators and families are critical in

socializing learners
Broad opportunities for parent participation are
essential
Building relationships with parents can take time
and effort

Cross-Cultural
Considerations
When working with parents:
Culture directly influences family in significant
manner
Consultants can ensure schools remove barriers
for non-mainstream parents
Consultants will want to exercise caution in
making any generalizations regarding
characteristics of a given culture

Cross-Cultural
Considerations contd
Difference can impact the way consultant works

with parents about the school-related issues child is


facing
Diversity within culturally diverse groups (i.e.,
individual differences) needs to be taken into
account

Cross-Cultural
Considerations contd
Consultants will want to involve parents by taking

on collaborative role to tap knowledge base and


expertise on their children as method of
consulting with cultural competence

Cross-Cultural
Considerations contd
Holcomb-McCoy (2009) and Holcomb-McCoy &

Bryan (2010)
Discuss emerging framework for parent

consultation involving advocacy and empowerment


that leads to a more supportive, culturallyresponsive climate at school
Consultation in this form considers and deals with
existing cultural differences and acknowledges
interdependence of parents and their
environmental contexts

Interagency Collaboration
Rationale:
Problems of children effect all aspects of childs
life
Shared responsibility for case shifts focus from
what the school can do to what the community
should do to provide services

Interagency contd
Agencies collaborate to help children and their

families, promote community mental health


reform, or develop systems-level programs to
promote student success and well-being
School, health services, social services, the child

evaluation center, family services organizations, and


often the family itself

Interagency collaboration and school-community

partnerships can be effective in improving access


to services for citizens as well as to meet their
complex needs

Interagency contd
Collaboration requires cultural competence
Shared responsibility necessitates solid agreement

on roles and responsibilities of individual


collaborators
Collaborating professionals will want to recognize
that their team will have distinct personality
that will impact how the team will function

Interagency contd
Five elements of interdisciplinary collaboration:
1. Interdependence
2. Progress in collaboration involves building
interventions with the contributions of each
collaborator
3. Flexibility in collaborative process to
accommodate power sharing and role adaptation
4. Collective ownership of goals
5. Discussion of progress and feedback to fellow
collaborators

Multicultural
School Consultation
Approach to consultation that takes into account how

cultural issues affect consultation process and how


related adaptations can be implemented at individual,
group or system-wide levels
Ethnic and linguistic minority children constitute the
most rapidly growing segment of the youth population
in the U.S.
Consultants take into account individual differences
and cultural issues

Multicultural School
Consultation contd
Ingraham (2000) points out several components of
multicultural school consultation:
Domains for consultant learning and development

(e.g., understanding cultural context for


consultation)
Domains of consultee learning and development
(e.g., avoiding overemphasis on culture)
Cultural variations in consultation constellation
(e.g., taking into account cultural differences
among consultant, consultee, and client system)

Multicultural School
Consultation contd
Ingraham (continued):
Contextual and power influences (e.g., minimizing
power differentials between consultant and
consultee)
Hypothesized methods for supporting consultee
and client success (e.g., using consultation
methods matched with consultees style)

Multicultural contd
Lopez and Truesdales six underlying principles that

facilitate framing multicultural consultation:


1.
2.

3.
4.

5.
6.

Consultants are sensitive to cultural differences


Consultants and consultees acquire knowledge about
their clients cultural backgrounds
Consultants are mindful of cultural differences in
communication
Cultural differences influence interpersonal
relationships between consultants and consultees.
Multicultural issues are addressed throughout every
stage of the consultation process
Consultants acknowledge how systemic issues impact
the cultural context of consultation

Multicultural contd
Multicultural consultation has increasing empirical

support for its effectiveness but more is needed

Practical Matters
Consultation/collaboration and special education

Response to intervention (RTI)


Systems view of the school
Developing a framework for prevention and

intervention
Time constraints

Practical Matters:
Special Education
Contributors to increased opportunities for

consultation and collaboration in areas related to


special education:
Federal legislation
Advances in the field of special education
National organizations related to school-based

professionals

Dictates an awareness of special education literature

including classifications as well as assessment methods


and related ethical, professional and legal issues

Practical Matters:
RTI
RTI is a systemic intervention and change
Consultants often needed in its implementation

Practical Matters:
RTI vs. Consultation
RTI and consultation are both problem-solving

activities but not one in the same


Consultation focuses on teacher-consultee while RTI

focuses on student client


Consultants can be internal or external to school whereas
professionals implementing RTI are school-based
Consultation is less likely to be team-based like RTI
Consultation focuses on more areas and can be more
general than RTI
Participation in consultation is voluntary while
participation in RTI may not be

Practical Matters:
Systems View of Schools
Individual interventions often not adequate in dealing

with issues related to educational and psychological


well-being of students
Systems view allows for capacity building within
schools that includes development of supportive
environments for all stakeholders
Allows for the use of ecological and preventive
perspectives and their related interventions
Can reflect a postmodernism point-of-view

Practical Matters:
Systems View of Schools
Consultants take on broad framework for consultation

because of complexity of organizational factors and


how they can be changed
Consultants and consultees can intervene at several
ecological levels including individual client level
Takes focus of a reactive approach for dealing with
issues of individual students to broader approach that
promotes prevention and well-being of all students

Practical Matters:
Systems View of Schools
System-level change demands that all aspects of

education be examined in terms of multiple levels and


be based multiple partnerships among stakeholders
All students receive services that match their needs

Idea is that consultant will use existing structures and

processes within school to target, initiate and maintain


system level changes including evaluating and
sustaining change initiatives

Practical Matters:
Systems View of Schools
One concern is that not all teachers are comfortable

with systems approaches


Some want more concrete ways of approaching

perceived problems

Many school consultants have not been trained in

systems methods
View typically dictates that consultants examine child
in interaction with a variety of levels of the ecosystem
such as home, school, and community
Complicates nature of consultation relationship

Practical Matters:
Developing Framework for
Prevention and Intervention
Prevention programs seeing resurgence in schools
Many have been designated as evidenced-based
Focus of prevention is to build capacities in

systems (e.g., a school or other organization) so


overall development of members of that system in
things such as mental health, social skills, and
health is optimized relative to the mission of the
system

Practical Matters:
Developing a Framework
Interventions include:
Tier 1: Universal

Target the entire population

Tier 2: Selective

Target segment of the population at risk

Tier 3: Indicated

Target students who need individualized and intense


intervention

Each of the three tiers provides great

opportunities for consultation

Practical Matters:
Time Constraints
Time constraints are large and real issue for

conducting effective consultation and


collaboration
Limitation of school consultation and
collaboration is that both take time to do well
Effective time management on the part of school
professionals is one obvious help in creating time
for consultation and collaboration

Practical Matters:
Time Constraints
Consultants can have more positive impact on

consultation process by using their limited time to


observe and assess the problem, model and coach
Other strategies:
Early release/late arrival of students
Use of substitutes
Teaching strategies that free up personnel

Use of telephone and/or other technologies such as VoIP

and e-mail for task accomplishment


Engaging in peer consultation
Use of group methods.

School Consultation
st
in the 21 Century
Consultation and collaboration will:
Focus more on positively impacting all students
Develop culturally sensitive interventions
Engage in system-level initiatives
Use data-driven decision making
Use the ecological approach more often

School Consultation in
st
the 21 Century contd
Use of telephone, texting, the web and e-mail to

accomplish tasks (such as follow-up) increasing


Use of consultation and collaboration teams will
continue to increase
Role of consultants and collaborators in gifted
education receiving increased attention
School-based consultants will help their schools create
positive climate with regard to school reform
movements continuing impact on public education

School Consultation in
st
the 21 Century contd
Infusion of positive psychology to increase well-being

of individuals in school through mental health and


behavioral consultation also receiving more attention
Positive behavior support (PBS) movement will
provide an approach that allows consultant to help
develop support and interventions at individual,
classroom or school-levels
Multiple issues brought about by high-stakes testing,
such as teacher burnout, will be fertile areas for
consultation

School Consultation in
st
the 21 Century contd
School-based consultants may well be called upon to

serve as cultural mediators between school and


community
School-based consultants will be increasingly called
upon to promote childrens health and collaborate
with medical/health professionals to meet childrens
health needs
School-based consultants are increasingly called on to
act as organizational consultants during a disaster or a
national or local crisis

Case Study Illustrations

Case Study Illustrations


Purpose of this chapter is to assist in applying

theory to practice and obtaining a more realistic


picture of what transpires in consultation
ACME Human Services Center
Typescript of consultation and collaboration
sessions

Ethical and Legal Issues

Ethics Defined
Standards of moral and professional conduct
Code of ethics: Written ethical guideline followed

by professionals
Discourages inappropriate practice

Protects recipient of services


Promotes exemplary behavior

Making Ethical Judgments


Identify problem

Consider courses of

Identify potential

action
Consider
consequences for
various decisions
Determine best course
of action

issues
Review ethical
guidelines
Consult colleagues

Values
Beliefs and principles held by a person that have

been formed by his or her life experiences


Consultant should know what his or her values are
Consultant should not expect others to hold the
same values
Consultant should be aware of specific values held
by cultural and ethnic groups

Competence
Providing services and accepting jobs for which

one is qualified
Maintain high levels of professionalism
Know ones professional limitations
Know when to decline and refer
Avoid situations in which personal concerns could

affect professional performance

Multicultural Issues
Ethical practice dictates that consultants take

cultural context of consultees and client systems


into account
To practice ethically, consultants need to
demonstrate sensitivity to and respect for cultural
differences when they provide services whether to
families, in schools, or in any other organization

Consultant-ConsulteeClient Relationship
Work-related focus
Dual relationships

Freedom of choice

Rights of Consultees
Confidentiality: Protecting the identities of parties

involved in consultation
Informed consent:To inform consultees about the
nature and goals of consultation, their right to
privacy, the voluntary nature of participation and
the complete freedom they have in following
suggestions made by the consultant

The Consultant
and the Group
Consulting with groups with caseloads

Intervention Areas
Involving Ethical Issues
Individual vs. systems-level
Use of assessment data

Empirical validity of interventions

Issues in Disaster/Crisis
Consultation
Consultants bear in mind acute vulnerability of

client system in crisis and disaster situations


Resulting chaotic environment will heighten
ethical considerations
Consultants assure that cultural competence is
exhibited when engaging in crisis consultation in
that responses to a crisis vary to a given culture

Ethical Issues in
Organizational Consultation
Typical ethical issues exacerbated by complexity

or organization
Aspirational ethics
Virtue ethics

Consulting
Over the Internet
Relationship development
Confidentiality
Location-specific factors

Collaboration
and Ethical Issues
Not all collaborators may have freedom to participate

in team effort
Confidentiality is assumed in consultation
In collaboration, pertinent material may have to be

distributed among team members

In consultation, consultee can accept or refuse

consultants recommendations
In collaboration, such freedom is not presumed due to

each team members unique knowledge and skills to


which other team members typically defer

Legal Issues: Malpractice


Behaviors often leading to legal entanglements:
Misrepresenting ones training
Failing to respect integrity and privacy
Using improper diagnosis and assessment
Collecting fees improperly
Libel and slander
Breech of contract
Failing to keep adequate records

Failing to provide informed consent


Providing poor advice