Conjoint Behavioral Consultation

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Conjoint BehavioralConsultation

• Practicum in School Psychology Consultation
• August 26, 1999
• S. Sheridan, Ph.D.

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Consultation An Overview
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What Is Consultation??

• First, what do you think?!?

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What Is Consultation??

• An indirect form of service-delivery that
  involves the cooperative, problem-solving efforts
  of two or more persons to clarify a clients
  needs, and to develop, implement, and evaluate
  appropriate strategies for intervention
• (Brown et al., 1991 Sheridan Kratochwill,
  1990 Zins et al., 1988).

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Why Do Consultation??

• Attempts to provide comprehensive mental health
  services without support and follow-through by
  significant others leads to
• disjointed and fragmented services,
• lack of follow-through (generalization),
• unreasonable case loads, and
• significant job stress.

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Conjoint BehavioralConsultation (CBC)
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Conjoint Behavioral Consultation A Definition

• A structured, indirect form of service delivery
  in which teachers and parents are brought
  together to collaboratively identify and address
  students needs (Sheridan Kratochwill, 1992).
• Emphasizes meaningful parental/family
  participation in their childs education
• A consultation model that goes beyond the school
  setting, promoting and supporting home-school
  partnerships in the context of cooperative and
  collegial problem-solving

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Conjoint Behavioral ConsultationA Definition

• The bi-directional, reciprocal interconnections
  between home and school are central, especially
  as they contribute to the academic, behavioral,
  and social-emotional development of children.
• All stages of consultation (from problem
  identification to evaluation) are conducted in a
  simultaneous (rather than parallel) manner.

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The class was quietly doing its lesson when
Russell, suffering from problems at home,
prepared to employ an attention-getting device.
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Key Characteristics of Consultation/CBC

• Indirect service delivery (triadic model)
  carried out via a joint, problem-solving process.
• Work-related focus (not therapeutic)
  consultation is NOT counseling!
• Participants Consultant, consultee, client.

• Voluntary, collegial relationship that involves
  parity interdependence
• Roles of participants are both defined and
  varied each participant brings his or her own
  expertise to the process.

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Direct Service (Dyadic) Model
Therapist
Client
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Indirect Service (Triadic) Model
Consultant
Consultee
Client
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Conceptual BasesEcological Theory

• Concerned with the interaction between an
  individual and the environment.
• Ecosystems (the interactions among systems) are
  examined, rather than focusing on an individual
  within a narrow context.
• Emphasizes the mutual accommodation between an
  individual and the environment.
• Problems are seen as a function of a mismatch
  between the person and environment.

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Conceptual BasesEcological-Systems Theory

• An individual is an inseparable part of a small
  social system comprised of 4 interrelated
  systems
• Microsystem Relation of the client with the
  immediate setting.
• Mesosystem Interrelations among the major
  systems in ones life.
• Exosystem Events in systems in which one does
  not directly participate, but that impinge upon
  the immediate system.
• Macrosystem Overall cultural or subcultural
  patterns of which the other systems are a
  concrete manifestation (economic, political, etc.)

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Macrosystem
Exosystem
Mesosystem
Micro- system
Mesosystem
Exosystem
Macrosystem
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Conceptual BasesEcological-Behavioral Theory

• Combines the empirical technology of behavioral
  theory/analysis with the conceptual advances of
  ecological theory
• Allows for a comprehensive and functional
  understanding of a clients needs
• Recognizes the importance of broad-based data
  collection and cross-setting intervention.
• Stresses the importance of looking at the entire
  system surrounding clients, as well as
  coordinating these systems.

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Conjoint Behavioral Consultation

• Based on the assumptions that
• Consistency and congruence in approaches,
  attitudes, and actions across home and school
  systems are important
• Structured, joint problem solving facilitates
  clear communication, shared goals, and congruent
  practices
• CBC is one vehicle by which to foster
  constructive, goal directed, solution-oriented
  home-school partnerships

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CBC Outcome Goals

• Obtain comprehensive and functional data over
  extended temporal and contextual bases
• Identify potential setting events that are
  temporally or contextually distal to target
• Improve skills and knowledge of all parties
• Establish consistent programming across settings

• Monitor behavioral contrast and side effects
  systematically via cross-setting treatment agents
• Develop skills and competencies for future
  conjoint problem solving
• Enhance generalization and maintenance of
  treatment effects

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CBC Process Goals

• Improve communication and knowledge about child
  and family
• Increase commitments to educational goals
• Address problems across, rather than within,
  settings
• Promote shared ownership for problem
  identification and solution

• Promote greater conceptualization of a problem
• Increase the diversity of expertise and resources
  available
• Establish and strengthen home-school
  partnerships enhance the home-school relationship

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Stages in Behavioral Consultation/CBC

• Conjoint Problem Identification
• Conjoint Problem Analysis
• Conjoint Treatment Implementation
• Conjoint Treatment Evaluation

Stages are procedurally operationalized through a
series of behavioral interviews requiring both
process and content expertise.
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Process Expertise

• Procedural knowledge about stages and objectives
• Discrete verbal skills that guide consultant and
  consultee through consultation stages
• Serve as a script for problem solving
• Allow a standardized approach for eliciting and
  organizing relevant information
• Essential foundation and structure for
  consultative interactions

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Content Expertise

• General, working knowledge about assessment
  methods, intervention strategies, evaluation
  techniques.
• Understanding of important case information, and
  the manner in which it influences consultation
  procedures and outcomes.
• Requires consultant to incorporate professional
  knowledge base as it relates to client and case
  characteristics (e.g., population considerations)
  as they are presented in consultation.

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CBC Procedural Considerations
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Pre-consultation

• A preconsultation meeting is recommended to
  begin building the home-school consultation
  relationship, and to establish roles,
  responsibilities, shared expectations, etc.
• To the greatest extent possible, this should
  include all individuals who will be a part of
  consultation