Primary process and peer consultation: an experiential model to work through countertransference

Various models exist for peer supervision and consultation of group therapy. This article documents the authors' experience using an experiential group consultation of group therapy model that relies on primary process to overcome countertransference dilemmas. A review of group therapy supervision and consultation models is followed by vignettes from the authors' experience. Discussion of the vignettes highlight critical issues in group consultation and expound upon the strengths and challenges of using an experiential model.     

Models of consultation: Preferences of educational professionals at five stages of service

Three professional education groups (elementary school principals, special education teachers, and second-grade teachers from two school systems) were asked to rate their preference for four models of consultation as offered by school psychologists at each of five stages of the consultation process. Results indicate that there were no differences among the three professional education groups in their ratings of the models. However, there was a significant difference in the ratings given to each model, with the collaboration model receiving the highest rating. A model by stage interaction also was noted, a finding which suggests that consultation preference should not be considered a unidimensional concept. The implications of these results for the training and practice of school psychologists in the consultation role are discussed.     

Edgar Schein's Process Versus Content Consultation Models

Edgar Schein (1969, 1978, 1989, 1990) has proposed three models of consultation based on assumptions inherent in different helping styles. The first two models, purchase-of-expertise and doctor-patient, focus on the content of organizational problems. The client gives the problem to the consultant to find and implement solutions. The process consultation model focuses on how organizational problems are solved. The client and consultant collaborate throughout the problem-solving effort to find workable solutions. Because of the nature of organizations' cultures and the underlying assumptions that determine how they operate, Schein has suggested that it is most efficacious for consultants to begin in the process consultation mode and involve the client in the investigation of the problem.     

Strangers at the benchside: research ethics consultation

Institutional ethics consultation services for biomedical scientists have begun to proliferate, especially for clinical researchers. We discuss several models of ethics consultation and describe a team-based approach used at Stanford University in the context of these models. As research ethics consultation services expand, there are many unresolved questions that need to be addressed, including what the scope, composition, and purpose of such services should be, whether core competencies for consultants can and should be defined, and how conflicts of interest should be mitigated. We make preliminary recommendations for the structure and process of research ethics consultation, based on our initial experiences in a pilot program.     

Collaborative Consultant: A New Role for Counselors Serving At-Risk Youths

School and community counselors have important roles in developing and implementing mental health programs for youths and families. Counselors who are working with the more complex issues of at-risk youths can enhance implementation of prevention programs by altering their roles to function within a collaborative consultation model. This model represents a new paradigm in that counselors interdependently and collaboratively partner with people previously considered their “consultees.” Such collaboration can result in more comprehensive and integrated programs, and it can prevent fragmentation and duplication of efforts. Collaborative consultation is described and contrasted with more traditional consultation models, and a 5-stage implementation process is presented. Personal and systemic factors that support the collaborative process are examined.     

Directions in Consultation Research: Bridging the Gap Between Science and Practice

The authors promote the application of research findings to consultation and suggest directions for practice-relevant consultation research. The authors suggest that consultation research is in an early evolutionary stage and that further development depends on resolving several fundamental issues. Three approaches to consultation research are discussed: naturalistic studies, single-case designs, and alternative means of determining significance. Representative research in three areas of interest (consultant practice, consulting process, and consultation interventions) is reviewed, and criteria for evaluating research are discussed. The authors conclude with comments on operationalizing the scientist-practitioner ideal in consultation research and practice.     

Consulting With Teachers in Two Areas: Grief and Mourning: Relaxation Techniques

Consultation with teachers remains untried by many counselors despite mandates, role definitions, and models for consultation. Barriers include the preference for the status quo and the lack of information and preparation. Involvement and training can help overcome these barriers. Two possible consultation areas are grief management and relaxation training. Grief is the normal reaction to any kind of loss. Being aware of the various stages is the first step in helping someone through the grief process. Relaxation techniques can be learned with proper guidance. Before tying any new ideas, however, counselors and teachers must have sufficient information and training.     

Multicultural Issues in Consultation

In this article the authors examine the historical development of consultation and superimpose multicultural theories and models onto several traditional consultation models. Included in this article is a selective review of literature from consultation, communication, and education as they relate to multicultural issues. An ethical imperative for the consultant is made to acknowledge, validate, and implement multicultural sensitivity.     

A school-based mental health consultation curriculum

Many articles have been written about mental health consultation and school-based consultation, but little has been written about how consultants are to be prepared for their role. Other authors focus on the theory or process aspects of the approach but do not take the next step in specifying what neophite consultants need to learn. The following paper presents one position on consultation that integrates a theoretical model, a process model, and a curriculum for training school-based mental health consultants. Elements of the proposed curriculum include: ethics, relationship building, maintaining rapport, defining problems, gathering data on what has already transpired, gathering data on the client, sharing information, generating interventions, supporting interventions, and following up and disengaging.     

Generic Models of Counseling Supervision: Counseling/Instruction Dichotomy and Consultation Metamodel

Major conceptual models for counseling supervision are described and compared: supervision as a counseling analog, as an instruction or teaching analog, and as a role that includes counseling and teaching aspects. Although each of these approaches avails supervisors of familiar roles, none adequately provides the scope and utility required of a model for such a complex function. Thus, a higher order metamodal, supervision as consultation, is presented, and this consultation metamodel is related to the psychoeducational model for counseling psychology.     

Fundamental Issues in Defining Consultation

Understanding and articulating one's definition of consultation is essential for successful consultation to occur. Early definitions presented the consultant primarily as a one-an-one content expert. Today there are many definitions ranging from the original one-on-one content expert to system-wide operations. Several different definitions are reviewed and presented for consideration, The main issues that surround the operational definitions of consultation are also included. The final conclusion is that consultants define consultation depending on their work setting, educational backgrounds, goals, and conceptual models.     

Integrating consultation and program evaluation in school psychology

Consultation approaches to providing psychological services are widely used by school psychologists. Recently, the need for school psychologists to be proficient in educational program evaluation has been recognized. The present paper discusses how school psychologists can use their existing consultation skills as an approach to program evaluation. The integration of consultation skills with evaluation results in an approach to program evaluation that is particularly useful where program goals and objectives are broad and nonspecific (as in many educational innovations). Also, the consultation approach to evaluation is easier for school psychologists to blend with their other roles in schools than the assessment-oriented evaluator role of some evaluation models. The consultation approach to evaluation is illustrated using a federally sponsored training program for school teachers and administrators.     

Evaluating ecological,behavioral, and process consultation interventions

The present study evaluated the differential effectiveness of conceptually distinct consultation programs (ecological, behavioral, and process) in inner-city elementary schools. Program children, evidencing acting-out problems, were monitored through baseline, treatment, and follow-up phases, using an observational format incorporating behavioral, process, and ecological dimensions. Significant reductions in observed and rated behavioral problems occurred only in classes provided behavioral consultation. Significant increases in achievement scores were noted for children provided process consultation. Few consistent changes were noted for those in the ecological and control classes. The teachers rated the behavioral and process consultation approaches as most beneficial and helpful.     

School psychology consultation: “Frenzied,faddish, or fundamental?”

A review of the current school psychology literature reveals that the term consultation is increasingly used to describe a variety of intervention goals and processes. The history of the consultation role in school psychology and the background and assumptions of three currently popular consultation models are discussed. Finally, suggestions are offered for more precise usage of the term consultation in order to accurately describe, implement, and research the school psychologist's roles.     

A Review of Gerald Caplan's Theory and Practice of Mental Health Consultation

Gerald Caplan's Theory and Practice of Mental Health Consultation (1970), considered to be a classic seminal work in the field of consultation, is reviewed. First, the author presents Caplan's general definition of consultation along with what may be considered the general principles or procedures of consultation. Then the author presents Caplan's procedures and principles as relevant to each type of consultation. Next, each of Caplan's four models of consultation is described. Last, these four models are compared in terms of the professional role of the consultee, the primary goal of consultation, and the target of consultation intervention.     

A Balancing Act—Telehealth Cancer Genetics and Practitioners’ Experiences of a Triadic Consultation

Telehealth is increasingly used for outreach service in cancer genetic counseling; however what occurs during the consultation and the roles practitioners adopt is largely unknown. Fifteen practitioners participated in semi-structured interviews that explored their roles within telehealth, compared to face-to-face consultations, and the relationship between practitioners during telehealth. As they were not physically present with the patient, most participants felt that telehealth altered the genetic clinician’s role to one of a ‘visiting specialist’. Genetic counselors described undertaking multiple roles during the telehealth process. Two models of interaction were observed. The medical model reduced the interaction to a dyadic consultation by having the genetic counselor off-screen and included minimal clinician meetings and supervision. The triadic co-facilitation model incorporated a high level of information exchange, counselor autonomy and included the counselor onscreen. The co-facilitation model offers a useful framework for telehealth genetic counselling, offering complementary roles between practitioners and efficient service delivery.     

心理咨询的价值悖论与责任伦理

从责任伦理角度审视心理咨询中的价值问题,价值是一个不可悬置也不可逃避的问题。一方面,人的生存悖论与人的社会化过程失衡是人的心理失衡或心理疾病产生的主要原因;另一方面,心理咨询的宗旨是促进来访者的改变,这种改变往往意味着价值观的改变。因而改变过程中必然会出现文化及规范、咨询者价值取向及来访者已有的价值观三者间的冲突和矛盾。心理咨询中的价值之争实为价值冲突所致。对心理咨询中的价值问题的处理应该遵循普遍性原则,采取多种形式的价值介入。     

A model for the behavioral assessment of behavior disorders in children: Measurement considerations and practical application

School psychologists have traditionally experienced difficulty in assessing children referred to them for behavior disorders. Given this reported difficulty, a behavioral assessment model is proposed which specifies three types of assessment information: direct observations, rating scale data, and interview data. Characteristics of these three types of assessment information are discussed, along with recommendations for their use. Two psychological models are suggested to guide school psychologists through the assessment process. Bergan's behavioral consultation model is recommended for securing valid and reliable interview and observational data, and Campbell and Fiske's multitrait-multimethod model is proposed as a means of logically integrating behavioral assessment information. The notion of convergence or agreement between dissimilar assessment methods is discussed.     

A conceptual review of discipline in the schools: A consultation service model

Although discipline has been identified consistently as the major problem in U.S. education, few conceptual models are available to guide the analysis of discipline problems and to integrate the consultation and preventive mental health perspectives. A model is presented that integrates a consultation problem-solving process (involving problem identification, problem analysis, intervention, and evaluation) with the preventive mental health levels (i.e., primary, secondary, and tertiary preventions). These perspective interface because discipline-related problems can occur and be resolved at all three prevention levels, although most are addressed only at the tertiary level. A review of the relevant literature is presented with each component of the model, and pragmatic applications are suggested to facilitate both problem-solving and consultation. Although the tertiary prevention level is emphasized, consultants are reminded that secondary and primary prevention programs are potentially more cost-effective and efficacious.