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 cont’d Consultation deals exclusively with consultee’s 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 consultant’s 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 cont’d 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 consultee’s 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 cont’d 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 cont’d 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 cont’d 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 consultee’s 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 consultee’s 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 organization’s schedule Have those affected by consultation informed about the consultant’s 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 other’s 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 intervention’s 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 cont’d 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 cont’d 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 cont’d 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 cont’d 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 client’s 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 consultee’s 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 consultee’s 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 organization’s 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 organization’s 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 Caplan’s 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 cont’d Consultee-centered consultation has evolved beyond Caplan’s 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 consultant’s and consultee’s 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 Consultant’s 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 cont’d Concepts of CBC are compatible with culturally- competent practice Sheridan and Kratochwill (2008) recommend the following practices to maximize CBC’s 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 organization’s 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 Schein’s 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 Consultant’s expertise should include skills to involve consultee in defining the problem, to form team with consultee and to ensure that consultation process focuses on consultee’s 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 cont’d 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 cont’d 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 cont’d 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 School’s 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 school’s 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 cont’d 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 cont’d 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 cont’d 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) Teacher’s management and instructional behavior Instructional Consultation cont’d 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 student’s 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 child’s moving into or out of the school Their child’s 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 cont’d 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 cont’d Allows parent to exercise their roles, rights and responsibilities related to child’s 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 cont’d 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 cont’d 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 cont’d 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 cont’d 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 child’s life Shared responsibility for case shifts focus from what the school can do to what the community should do to provide services Interagency cont’d 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 cont’d 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 cont’d 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 cont’d 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 cont’d 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 consultee’s style) Multicultural cont’d Lopez and Truesdale’s 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 client’s 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 cont’d 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 cont’d 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 movement’s continuing impact on public education School Consultation in st the 21 Century cont’d 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 cont’d 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 children’s health and collaborate with medical/health professionals to meet children’s 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 one’s 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 consultant’s recommendations In collaboration, such freedom is not presumed due to each team member’s unique knowledge and skills to which other team members typically defer Legal Issues: Malpractice Behaviors often leading to legal entanglements: Misrepresenting one’s 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