Selection of consultees in school mental health consultation

To further understanding regarding the selection of teacher consultees, 15 mental health consultants completed a questionnaire. Consultants ranked teachers in their school consultation placements on ability to meet academic and socioemotional needs of children, receptivity to change, and likability. Next, after indicating which teachers they would most and least like to work with, consultants rated the teachers on nine 5-point rating scales. In general, results indicate that most preferred consultees, in comparison to least preferred consultees, are perceived as less needy of assistance around issues concerning children and lessons, more responsive to consultation, and more likable. It appears that teachers most in need of assistance are not selected for consultation.     

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.     

Implementation of a mental health consultation model and its impact on early childhood teachers' efficacy and competence

Early childhood mental health (MH) consultants work closely with childcare teachers onsite to serve as a resource for childcare providers as they foster and enhance children's early development. The increase in the quality of care that can be supported through an early childhood MH consultation program makes this type of consultation an optimal tool for enhancing the childcare environment and overall child development. This article details the initial launch of the MH consultation program to childcare centers in the state of Louisiana. Analyses support the assertions that (a) a model of MH consultation can be implemented successfully at a statewide level, (b) MH consultation is associated with an increase in teacher self‐efficacy, and (c) teachers' report that the MH consultation increased their competence in specific areas related to children's socioemotional development. Analyses indicate that there is a differential impact on teachers based on their age and level of experience. The clinical implications of these findings are discussed.     

ONGOING CONSULTATION AS A METHOD OF IMPROVING PERFORMANCE OF STAFF MEMBERS IN A GROUP HOME

A model of ongoing consultation was implemented in a community group home for 8 adults with severe and profound mental retardation. Two consultants, highly experienced in working with people with mental retardation and in the procedures used in group homes, taught staff members to use a token reinforcement system, to engage the adults in a variety of activities, and to improve the content and style of the staff members' interactions with the adults. The consultants taught skills to 9 staff members through brief mini-workshops, direct observation of the staff members' use of the skills during regular activities in the group home, and individual verbal feedback regarding a staff member's performance of the skills. Evaluation of the ongoing consultation process by the 2 consultants showed it to be effective in improving the performance of the staff members and in changing the behaviors of the adults who lived in the home. Continued implementation of the process, however, appeared to be necessary for the behavior changes of staff members to be maintained at high levels.     

Training currently practicing members of the ethics consultation service: one institution's experience

Most hospitals and nursing homes have individuals who engage in ethics consultation, and most do so with very little, if any, training. The goal of this article is not to advance the scholarly literature on training clinical ethics consultants, but instead to provide a road map for individuals doing ethics consultation who would like more training. In this way, I hope to advance the field in some small way, by educating, empowering, and encouraging small- to medium-sized hospitals to train the members of their ethics committee who engage in ethics consultation.     

Coding processes in the free recall of associated word lists

An experiment is reported on the free recall of lists of 18 words. The lists consisted of words that were strongly or weakly associated to the eliciting stimulus, were members of either a single category or more than one category and were arranged into sets of three associated words or six associated words. Each list was presented once only and free recall required after a filled interval of 18 s. One half of the subjects were provided with cues at recall: the remainder were given no assistance. Recall efficiency increased with association level and with restricted category membership of the words in a set. Clustering at recall (when adjusted for opportunity) was greater in the 6×3 lists than in the 3×6 lists. The provision of cues only led to a significant facilitation in recall with lists consisting of 6 sets of 3 words. A detailed analysis of the recall data suggested the importance of the category membership variable in the production of the later recall.     

Truly intensive clinical ethics immersion at the Washington Hospital Center

Opportunities for practical, hospital-based training in those skills demanded by clinical ethics consultation (CEC) have been limited. Given the number of individuals who provide part-time CEC, greater access to condensed, practical training such as the clinical ethics immersion course offered by the Washington Hospital Center, is necessary. Two participants in the initial cohort evaluate their CE training at a busy, urban referral center, exploring prior expectations, perceptions of its utility and suggestions for improvement. Such training will prove valuable not only for bioethicists who lack practical CEC experience "at the bedside" but also for ethics consultants whose ethics services have a low consult volume who wish to sharpen their skills.     

The politics of consulting for organizational change

This paper analyzes forms of political involvement among consultants engaged in planned organizational change. This analysis is intended to contribute to research and theorizing on organizational change and to help consultants and managers cope with the challenges posed by organizational politics. Four consulting styles are distinguished, those that vary in the sources of consultant power, the consultants’ degree of involvement in organizational politics, the processes on which consultants and their clients rely to implement organizational change, and the consultants’ definition of the main client. Factors accounting for variations in the use of the four consulting styles are noted, along with conditions that may influence the effectiveness of these styles. Implications for consulting practice also are discussed. He is also head of the department’s Graduate Program in the Sociology of Organizations. This article is a revised version of part of a paper presented at the World Congress of Sociology, International Sociological Association, Madrid, July, 1990. Thanks to Jean Bartunek, Jo Ann Harrison, Dafna Izraeli, Bruce Phillips, and Aryeh Shirom for their very helpful comments on earlier versions of this paper.     

The Nature and Predictors of Undercontrolled and Internalizing Problem Trajectories Across Early Childhood

Using growth curve modeling, trajectories of undercontrolled (oppositional, irritable, inattentive and overactive behaviors) and internalizing (worried, sad and fearful) problems from 18 months to 4.5 years were studied in a population based sample of 921 Norwegian children. At the population level, undercontrolled problems decreased and internalizing problems increased with increasing age. Child temperament and family factors present at 18 months predicted 43% of the stability and 20% of the linear changes in undercontrolled problems and 30% of the stability and 7% of the linear changes in internalizing problems. Persisting effects of child and family factors from 18 month were found on the two problem dimensions over and above the impact of changes in the same risk factors. Lower initial level of partner support and higher initial level of child emotionality predicted higher slope of undercontrolled problems and higher initial level of family stress predicted higher slope for internalizing problems. As expected, time to time change (t1 to t2 and t2 to t3) in risk factors predicted time to time change in problem scores as well. The study shows the significance of early emerging internalizing and undercontrolled problems, the need to consider their pathways separately from very young ages, lasting effects of early experiences, and the importance of a dynamic approach to the analysis of risk.     

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.     

Certifying clinical ethics consultants: who pays?

The movement advocating the formal certification of clinical ethics consultants may result in major changes to the field of clinical ethics consultation by creating a new standard of care. The actual certification process is still in the development phase, but unanswered questions include: What will certification cost, and, Who will pay? Currently there is little salary support for ethics consultants and no regulation requiring healthcare institutions to offer clinical ethics consultation. Without the support of healthcare administrators and accreditation bodies, this may remain unchanged. Healthcare administrators may be unwilling to pay for certification or professional services if accreditation bodies do not require healthcare institutions to provide certified ethics consultants' services. If consultants will not be reimbursed or paid, they may not seek certification. If certified consultants are required, healthcare administrators may look for ways to cover the costs for providing this service, including insurance or third-party reimbursement and direct billing of patients for consultations, which may affect who performs and who participates in ethics consultation. However, this is less than ideal, as bioethicists believe ethics consultation should be available to all as part of providing safe, quality ethical care and support and guidance for patients, families, and healthcare staff. Going forward, bioethicists should study quality improvement, patient safety, and cost-savings resulting from certification-eligible clinical ethics consultants' activities. Administrators and financial personnel can be surveyed regarding their support for the certification process. Bioethicists should enlist the help of patient rights and safety advocacy groups, professional medical associations, and healthcare administrators. Bioethicists should invite accreditation bodies, healthcare administrators, and financial personnel to collaborate in the development of the certification process. Without their support, certification may be of value only to the bioethics community, and may have little standing in actual clinical healthcare institution settings.     

Psychology and capital litigation: Research contributions to courtroom consultation

After briefly reviewing the history of capital punishment in the United States, we describe the activities most often performed by behavioral science litigation consultants, and we review five areas of psycholegal research that courtroom consultants can call on to guide their interventions. The research literatures of most frequent use to psycholegal researchers and litigation consultants are (a) assessment of public opinion about crime and punishment, (b) the effects of death qualification during voir dire, (c) the process and effects of sentencing-phase evidence, (d) the possibility of discriminatory application of the death penalty, and (e) the effects of litigation consultation itself. Practical implications for consultants from each of these literatures are considered.     

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.     

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.     

Improving sixth-grade students perceptions of high-effort assignments by assigning more work: Interaction of additive interspersal and assignment effort on assignment choice

Sixth-grade students were exposed to two pairs of mathematics assignments. Assignment Pair A included a high-effort and a moderate-effort assignment, each containing 18 three-digit by two-digit (3×2) problems. Assignment Pair B was similar except the high-effort assignment contained six additional one-digit by one-digit (1×1) problems interspersed following every third 3×2 problem. After exposure to each pair of assignments, students ranked assignments and chose a new assignment for homework. Analysis of Assignment Pair A data showed students preferred the moderate-effort assignment. Analysis of interactions showed that interspersing the additional brief problems to the high-effort assignment caused significantly more students to choose the high-effort assignment for homework and rank it as requiring less effort and time to complete and as being less difficult than the moderate-effort assignment. Results support the hypothesis that a discrete task is a reinforcer and suggest that educators can increase the probability of students engaging in more challenging assignments that require more effort to complete by interspersing additional brief tasks. Applied and theoretical implications are discussed along with future research.     

An “issue-focused” model for mental health consultation with groups of teachers

This paper presents and evaluates a model for group mental health consultation with teachers in which sessions are organized around mental health issues rather than cases. The rationale and advantages of the model are explicated and compared with other models of group consultation and group work with teachers. The model incorporates a heavy emphasis on educational preventive measures and is designed to simultaneously satisfy a wide range of consultee needs and to reduce anxiety and defensiveness. Consultant's preparations for the group sessions are highlighted so as to maximize their contribution to the participants' level of involvement, knowledge, skills, confidence, and objectivity. The different roles of the consultant during the session and the variety of techniques employed are described as they relate to group processes and consultation needs. Specific guidelines for the organization of consultation groups and training of group consultants are offered. Evaluation data based on feedback from participants in ten groups are included.     

Outcomes of systemic/strategic team consultation: I. Overview and one-month results

This is the first in a series of reports on an experimental, small-sample study of systemic/strategic team consultations. This report describes a "Milan-informed" method of team consultation for resolving therapy impasses. It then focuses on the initial one-month outcomes from the larger 3-year project. Eleven therapists were asked to select two ongoing cases matched for difficulty. While all cases continued in regular therapy, one of each therapist's cases was also selected at random to participate in a systemic/strategic, five-part team consultation. Analyses of one-month follow-up data showed that clients who participated in the team consultation were more likely to achieve their main and overall treatment goals than clients who received only regular therapy (p's less than .05, eta2 as a measure of effect size ranging from 32% to 41%). The strong findings of this initial study encourage more widespread use of team consultations as a context for treatment, training, and research.     

Young managers’ drive to thrive: A personal work goal approach to burnout and work engagement

This study approaches young managers’ occupational well-being through their work-related goal pursuit. The main aim was to identify content categories of personal work goals and investigate their associations with background factors, goal appraisals, burnout, and work engagement. The questionnaire data consisted of 747 young Finnish managers (23-35 years; M = 31 years) who were mostly men (85.5%). Seven work-related content categories were found on the basis of qualitative data analysis: (1) competence goals (30.5%), (2) progression goals (23.7%), (3) well-being goals (15.2%), (4) job change goals (13.7%), (5) job security goals (7.4%), (6) organizational goals (5.6%), and (7) financial goals (3.9%). ANCOVA analyses, where goal appraisals and significant background factors were controlled for, indicated that organizational goals were related to low burnout and the highest level of work engagement, whereas well-being and job change goals were related to higher burnout and lower work engagement. The study shows that the contents of young managers’ work-related goals can contribute to the understanding of individual differences in occupational well-being.