Resistance,reactance, and consultation

A review of techniques for dealing with consultee resistance is presented, with the limitations of these techniques. The social psychological theory of reactance is offered as a useful conceptual framework for considering resistance in consultation. Examples of the application of reactance theory to both minimizing consultee resistance and to utilizing consultee resistance for beneficial change are provided. Variables that predict the likely effectiveness of a reactance utilization intervention are described. Finally, ethical issues involved in the application of reactance techniques are discussed.     

Relative frequency of consultee lack of knowledge,skills, confidence,and objectivity in school settings

Caplan (1963, 1970) specifies consultee lack of knowledge, skills, confidence, and objectivity as the “four common reasons for the work difficulties that underlie the need for consultation” (p. 127). Although Caplan hypothesizes that the majority of consultation cases result from consultee lack of objectivity, there has been no empirical examination of the relative frequency with which consulting school psychologists encounter each type of consultee difficulty. To assess this, ten school psychology consultants rated the primary consultee problem for each consulation case they had. Contrary to Caplan's assumption, data analyses indicated that significantly more consultation cases resulted from colsultee lack of knowledge, skills, and confidence than from consultee lack of objectivity, which accounted for only 7% of the cases. These findings call into question the practical utility of psychodynamically oriented Caplanian techniques for consulting school psychologists. Because the preponderance of consultation cases develop from consultee lack of knowledge, skills, and confidence, school psychologists would be best advised to focus primarily upon the development and utilization of problem solving, behavior analysis, and sophisticated communication skills as their principal consultative strategies.     

The identification of resources and constraints influencing plan design in consultation

The present study investigated the effects of consultant verbalizations on consultee verbalizations reflecting consultee resources that might be used in plan implementation and constraints potentially limiting the nature of plans implemented in consultation. Interviews of 50 consultants trained in behavioral consultation and participating in a field experience with public school teachers were analyzed. Plan-tactic-elicitors verbalized by consultants were shown to have a positive effect on the incidence of resources as opposed to responses not reflecting resources or constraints. Other types of consultant elicitors all had a negative impact on resource incidence when compared to the incidence of other types of consultee responses.     

The impact of consultant,consultee, and organizational variables on teacher attitudes toward consultation services

The current study investigated relationships between consultant, consultee, and organizational characteristics and teacher preferences for school-based consultation versus traditional referral services. Stepwise regression analysis revealed that principal initiating structure, number of years of teaching experience, and number of years teaching at the current school each made statistically significant, although weak, contributions to predicting teacher attitudes toward consultation. Initiating structure and number of years of teaching experience were negatively related to consultee preference for consultation, while years of teaching at the current school correlated positively.     

Training teachers in behavioral consultation and therapy: An analysis of verbal behaviors

This study evaluated the relative effectiveness of two teacher-training packages under two analogue consultation conditions in a 2 × 2 completely randomized factorial design. The subjects were 56 elementary school teachers in an urban school district in Arizona. The conditions included a training package of classroom behavior modification and consultation, a training package of consultative service procedures, and general multidisciplinary team processes (a nonspecific control). The consultation conditions included one variant in which very specific consultant questions were presented, and a second in which much more general, somewhat vague, consultant elicitors were presented to subjects in problem-identification, problem-analysis, and problem-evaluation behavioral consultation analogue interviews. The effectiveness of these training packages was evaluated in respect to knowledge of behavior modification principles and concepts, and the frequency of specific categories of consultee verbal behaviors. The results indicated that the experimental training package was effective in increasing teachers' knowledge of behavioral procedures and in increasing the frequency of teacher verbalization regarding overt child behaviors and behavioral intervention plans during the problem identification and problem analysis phases of consultation. It was also found that even after training, specific consultant questions were important in eliciting consultee statements related to environmental conditions surrounding behavior. The use of more general consultant verbal behaviors resulted in significantly more vague, unspecified, and irrelevant types of consultee verbalizations. Implications for future research are discussed.     

The analysis of verbal interactions occurring during consultation

This article describes a consultation analysis technique for coding conversion between a consultant (e.g., psychologist) and a consultee (e.g., teacher) serving a client (e.g., student). Consultation analysis classifies the topics discussed in consultation, the verbal processes exhibited during consultation, and the extent to which one participant in consultation controls the kinds of things which another participant says. Uses of consultation analysis in training and research are discussed.     

Consultation from the consultee''s perspective

School-based and other mental health consultants are confronted with consultees who must adjust to the process of consultation by learning the parameters of the interaction. Consultees must learn how to act in this unique setting, must learn to use the consultant and the process for their own ends, and must learn about ways that they, themselves, contribute to problems which assail them. Consultation is successful to the extent that consultees come to a quick understanding of how to proceed. By being aware of what it is that the consultee must learn, the consultant may expedite the necessary insight.     

A conceptual overview of selected consultation models

Because of their current popularity and utility 4 consultation models have been selected for analysis: consultee centered, group process, social action, and ecological (exemplified by Gerald Caplan, Ronald Lippitt, Saul Alinsky, and James Kelly, respectively). The process of consultation as outlined by these models is described along the following dimensions: definitions of consultation, self-perceptions of the consultant, target populations, motivation of the client system, entry, goals, diagnosis, techniques, termination, and evaluation. The discussion focuses on criteria for selecting an appropriate consultation model.     

Refraining Resistance and Noncompliance in Cognitive Therapy

Despite its general success, not everyone responds to cognitive therapy. Some clients have difficulty complying with assignments and others appear to be frankly resistant. This article considers strategies for dealing with passive noncompliance and active resistance within cognitive therapy. In general, it is argued that the process of therapy is usually facilitated by staying within the cognitive model—that is, by exploring and working through those beliefs and attitudes that underlie noncompliance and resistance in the same manner that other problematic beliefs and attitudes are approached. Also considered are strategies for dealing with unrealistic expectations regarding the pace of change, therapists' errors leading to noncompliance and resistance, and instances in which the therapeutic model is simply insufficient.     

Multicultural Issues in School-Based Consultation Conceptual and Research Considerations

In this article, we review literature relevant to multicultural issues in school-based consultation. Specifically, multicultural literature in the counseling and psychotherapy fields is presented as it relates to consultation. Ways in which culture may affect the consultant, consultee, and client are suggested. Because of the paucity of multicultural research in consultation and lack of major break-throughs in multicultural research as related to consultation, a conceptual framework related to the utility of multicultural issues is presented as a new paradigm for future investigations.     

Meta-analysis of consultation outcome studies

The results of 54 controlled studies of psychological consultation using mental health, behavioral, and organization development models were synthesized using meta-analysis. The results supported the continued use of consultation as an effective practice in modifying consultee and, to a lesser extent, client behavior and attitudes. On the average, consultees showed improvements greater than 71% and clients showed improvements greater than 66% of untreated comparable groups. No differences were found in terms of effectiveness among the three models.     

Counseling in the República Bolivariana de Venezuela (Bolivarian Republic of Venezuela)

Counseling is an emerging profession in Latin America that offers people an opportunity to voice pain, exercise power, authentically connect with others, and experience healing within the community. Counseling reflects collaborative efforts between consultant and consultee who come together to reach mutual healing and growth through the use of indigenous and integrated approaches. Counseling in Venezuela includes using holistic assessment models and emancipating healing modalities centered on people's resilience, sense of hope, and community resources.     

Characteristics of consultants and consultees and success in mental health consultation

Selected attitudinal and value characteristics of high and low successful consultants were considered. Twelve consultants and 15 consultees completed six measures. Consultants were categorized as high or low success consultants based on the coding of consultants' logs. Results indicate high and low success consultants do not differ on the selected characteristics. Also, the results indicate that more successful consultants have consultees who are more authoritarian and dogmatic and are more dissimilar to their consultees in level of dogmatism and reported need for assistance. Future investigations will indicate whether the results can be replicated on a more representative consultee sample.     

Barriers to treatment success in behavioral consultation: Current limitations and future directions

Behavioral consultation is a prominent indirect service model in the practice of psychology in the schools. Despite some empirical support for the use of behavioral consultation strategies, consultants frequently face a number of barriers to implementation of treatment in practice. This article outlines a number of these barriers in behavioral consultation, including the lack of standardization of consultation, lack of specific training of consultants, little or no consultee (teacher) training, problems surrounding target behavior identification, and external constraints to consultation. Each of these areas is described along several dimensions that need to be addressed in future research.     

The Use of Consultation in Psychological Practice: Ethical,Legal, and Clinical Considerations

The importance of consulting with other professionals to maintain acceptable standards of care is well documented in many health care professions. However, evidence indicates that many psychologists fail to utilize consultation when needed, and that consultation use varies along dimensions such as the education and training of the consultee, the type of setting, number of years in practice, and proximity to available consultants. In this article, we review the research on the use of consultation by psychologists as well as other health care professionals. We discuss the clinical, ethical, and legal implications of seeking consultation as a professional psychologist. Finally, a detailed and practical model for the regular use of consultation is given to improve the routine use of consultation in clinical practice.     

The use of consultation in psychological practice: ethical, legal, and clinical considerations

The importance of consulting with other professionals to maintain acceptable standards of care is well documented in many health care professions. However, evidence indicates that many psychologists fail to utilize consultation when needed, and that consultation use varies along dimensions such as the education and training of the consultee, the type of setting, number of years in practice, and proximity to available consultants. In this article, we review the research on the use of consultation by psychologists as well as other health care professionals. We discuss the clinical, ethical, and legal implications of seeking consultation as a professional psychologist. Finally, a detailed and practical model for the regular use of consultation is given to improve the routine use of consultation in clinical practice.     

Consultant skill and efficiency and the implementation and outcomes of consultation

This article describes an investigation of consultant services rendered by school psychologists to teachers. Success in achieving stated problem-solving goals was analyzed using predictor variables measuring consultant efficiency, interviewing skills, and flexibility in applying psychological principles. Results indicated that the predictor variables exerted maximum impact on the initial problem-identification phase of the problem-solving process. Consultants lacking in skills failed to identify consultee problems and, as a results never reached the stage of plan development and implementation. Consultants successful in identifying problems were almost invariably able to solve those problems. Implications for training school psychologists were drawn and suggestions made for research in an area improverished by lack of empirical data.     

Consultation Contracts

Consultants enter into legal contracts each time they agree to a consultation arrangement outside of their regular work setting. They need to understand the legal context of contracts within which they perform their services and recognize the benefits a written agreement provides. Counselors often provide consultation services as a regular part of their job responsibilities. In such situations, a separate legal contract is not formed when a consultation relationship is created. A written understanding of the consultation arrangement, however, can be beneficial to the consultant and consultee even though a legal contract does not exist.