The Role Of Behavioral Or Mental Health Consultation In Schools

A common misconception is that the role of a school psychologist solely entails administering assessments. Although this is a major responsibility school psychologists have, there are numerous other areas that this type of practitioner may play a role in, such as consultation. Brown, Pryzwansky, & Schulte (2011) define consultation as “a voluntary problem-solving process that can be initiated and terminated by either the consultant or consultee”. A typical school consultation problem-solving process involves: recognizing the issue, examining the problem, choosing an intervention, clarifying application actions and tasks, executing the intervention, and evaluating intervention efficiency. There are a variety of consultation models, which include: instructional, Adlerian, process, rational-emotive, and many others. However, two models that are utilized the most frequently by school psychologists are mental health consultation and behavioral consultation.

There are several similarities and differences between these two models. The mental health consultation model formed after World War II. Caplan, a mental health professional, played a major role in the formation of this type of consultation. The role he played is why mental health consultation is also known as Caplanian consultation. There are different kinds of mental health consultation, which include: client-centered case consultation, consultee-centered case consultation, program-centered administrative consultation, and consultee-centered administrative consultation. The model continued to grow by eventually incorporating: group-based consultation, mental health consultation in the schools, and collaboration as an alternative. One cause of a shift in this model was due to the fact that it became more common for consultants to be working in the same area as consultees. For example, psychologists began working in schools. The model continues to be modified in order to adjust to a continuously changing world. In terms of research, there is a gap in knowledge in regard to this model.

Compared to the mental health consultation model, there is a large amount of research that has focused on the behavioral consultation model. Research on this model has specifically been attentive to outcomes, process, practitioner, and training. Plotts & Lasser (2013) state, “behavioral consultation refers to the application of specific problem-solving steps to increase or decrease a specific, well-defined behavior”. The model is composed of different components of learning and behavior psychology. Eventually, ecological and social learning also began to contribute to this model. Two behavioral consultation models are Conjoint Behavioral Consultation and Cognitive-Based Consultation. In a school setting, there a variety of different tools that a consultant using a behavioral model may advocate for, such as positive behavior supports and completing functional behavioral assessments. Typically, once a behavior has been defined, baseline data will be collected, a realistic goal will be determined, an appropriate intervention will be selected, and progress will be monitored. There are many similarities when utilizing either model of consultation.

There are countless pros to using these models, such as being preventive. When prevention is successful, it eliminates the need for rigorous services an individual would have most likely received in the future. Furthermore, the models provide opportunities to assist multiple students at once versus automatically having to separately work with each one independently. A system that is commonly applied in schools today is a multi-tiered system of support, which is composed of three different tiers. The behavioral and mental health consultation models can both be applied to other roles of the school psychologist, such as a counselor. It is imperative that when one serves as a consultant, he or she follows certain ethical guidelines and have mastered a certain set of skills.

When using either the behavioral or mental health consultation model, one must follow similar ethical guidelines. When one serves as a consultant, he or she must keep the dialogue of the consultation session confidential. However, the consultee(s) should be informed that limitations of confidentiality do exist. The most appropriate time to advise these individuals of this is prior to consultation. Furthermore, consultants have to possess the ability to recognize their own limitations. Although a consultant may have the competency to consult a general education teacher one day, he or she may not have the competency to do so on another day. For example, a consultant’s father may have recently passed away. As a result, their ability to consult could easily be impaired, but the consultant would need to be able to make that determination. There are additional ways consultants must understand self-awareness and competency when following the behavioral or mental health model. There is a higher probability that a consultant will be successful when he or she has knowledge of their own feelings, views, judgments, and their possible influence on another individual. Furthermore, consultants need to keep existing biases and different cultures into consideration. As a result, the consult will more likely be able to establish rapport with the consultee(s). Additional skills that consultants need to master are interpersonal communication and active listening. Strong communication and listening methods will more likely lead to gathering the relevant information that is needed to explore existing issues. Once this is determined, the consultant can decide what the most appropriate intervention(s) would be to implement in an attempt to resolve these problems. However, the consult would need to ensure that the interventions that he or she recommends are evidence-based. It is not uncommon for assumptions to develop in terms of specific consultation models, which have been explored by the psychology department of the University of Nebraska-Lincoln. In the 90s, assumptions developed that specifically addressed behavioral consultation. Five of these assumptions were: consultation is a superior use of resources when compared to direct intervention/therapy, consultation is conducted collaboratively, talking to teachers is sufficient to cause them to change their behavior, teachers will generalize problem-solving skills developed in consultation to new problem situations with other clients, and direct contact between the consultant and client is unnecessary.

Articles, such as the one by Kratochwill et al., (1998), addressed the issues associated with these assumptions. The main issue was that these assumptions were based on minimal research. Brown et al., (2011) discuss the assumptions of mental health consultation. There are assumptions that formed in regard to mental health consultation. The function of a behavior is a combination of both intrapsychic and environmental characteristics. This is one reason that it is imperative that a positive environment is created for the client. Typically, the consultee is responsible for the implementation of intervention(s). As a result, it will become more likely that the consultee will have the ability to solve problems on their own. However, the consultee’s attitude has a significant impact on generalization. For example, a consultee may have completed CPI (crisis prevention) training but may still have the belief that children should not be restrained under any circumstances. A student in the classroom begins throwing various objects, but the consultee does not use their CPI training in this situation. In this case, the consultee has the skills to handle this situation independently but does not utilize those skills because of their beliefs. However, it has been concluded that their attitudes cannot be approached directly. Depending on the problem at hand, consultation is not always the best choice, but should be utilized when appropriate.

Consultants are a beneficial resource. However, consultation is only beneficial if the consultant has the appropriate training and knowledge, which he or she needs to be able to determine. Unfortunately, this is difficult for some professionals to accurately determine, especially individuals that are newer to the field. Thankfully, it is not uncommon for school psychology programs today to incorporate ethics and consultation into students’ course schedule. Furthermore, any professional needs to be self-aware of their own competency. For example, after working with a consultant, a teacher may decide that she is going to collect data on a certain student but may not completely understand how to do this.

However, if the teacher does not accurately collect data it is not only ineffective but could potentially have negative consequences for the student(s). Consultants can help consultee discover what could be hindering their ability to complete certain tasks or implement an intervention. Terminology can get in the way of teachers fully understanding what he or she is implementing in their classroom. Recently, a school psychologist in Illinois was consulting with a middle school in the area. She quickly learned that several teachers in the district do not know what interventions that he or she is implementing. After further examination, she concluded that the reason for this is because there are teachers that do not understand the difference between interventions and accommodations, so these terms are being used interchangeably. As a result, she plans on preparing a presentation to explain the differentiation of these terms.

In conclusion, following the behavioral or mental health consultation model can help resolve a wide range of problems, or prevent them. Hopefully, research will continue to be conducted on these models. It is vital that the consultant utilizing these models maintain up-to-date on the current research. The models can be applied in an assortment of settings. Fortunately, numerous school psychologists have the competency to serve as consultants in the school setting. The main focus of schools has been on academics, but today there has been a push to broaden this focus on behavior as well. Consultation can make drastic differences.