Barriers to evidence-based treatment: developmental psychopathology and the interdisciplinary disconnect in school mental health practice

Reframing the role of school psychologists and related school professionals in a public health and primary prevention model represents a proactive antidote to their more traditional reactive stance to mental health problems. Two additional concepts, developmental psychopathology and complex comorbidity, are suggested as critical to complete this transition, and illustrations of these concepts for more effective school mental health services are provided.     

School Psychology: Training Individuals for One of the Best Kept Secrets in Professional Psychology

Abstract

School psychology training at the doctoral level is discussed. Given the increasing diversity in the schools as well as the varied education and mental health needs of the population, school psychology training is necessarily broad, involving traditional skills such as assessment, intervention, consultation, and counseling, all of which are taught within a context of a changing school population with changing needs. Because there is compulsory education, school psychologists’ interface with a broad cross-section of individual children, their parents, and their teachers. Moreover, school psychological practice is not limited to schools, as doctoral school psychologists are health service providers; many of these individuals work in other settings for which they are trained to provide services. The complexities and challenges of training school psychologists within this broad agenda effectively across domains are discussed.     

The 2003 Survey of Academic Medical Center Psychologists: Implications and Outlook

This paper offers commentaries on Pate and Kohout’s (2005) report of data from the 1997 and 2003 surveys of psychologists in medical school settings. The commentaries reflect upon the significance of the survey findings and implications for psychology’s role in medical school and academic health science settings. Though the response rate to the survey was disappointing, the data indicate that psychologists are moving up in academic rank, and have made substantial gains in salary. The data also indicate that among psychologists who are medical staff members, who constitute half the 2003 sample, an increasing proportion are functioning autonomously as reflected in gains in the percentage having admitting privileges, staff voting privileges, and authority to write orders. Research continues to be a major focus for psychologists in academic medical centers. Overall, the findings indicate that psychologists can have productive, satisfying careers in medical school/academic health center settings—though there is one troubling sign, a sizeable drop in the number of positions being created for younger, more recently trained psychologists. Methodological enhancements are described that could improve the quality, scope, and usefulness of data from future studies, both for understanding long-term trends and for conducting salary negotiations. High quality data provide a solid foundation for advocating for psychologists’ full participation in the life of medical schools and academic health centers.     

Preparation of school psychologists for school-based consultation: A training activity and a service to community schools

Presents a set of training experiences to develop school-based consultation skills in preservice school psychologists and discusses problems in implementing this model of service. Based on their experience in training school psychologists at the University of California, Berkeley, the authors report on preparing students to deal with teacher and principal expectations. Also discussed are methods for mobilizing teachers to plan more precisely to meet the needs of individual pupils in the classroom. A distinction is made in the paper between school-based and community-based mental health consultation.     

Psychologists'' and teachers'' reactions to mental health and behavioral school consultation

School psychologists and elementary school teachers were shown videotapes of a psychologist consulting with a teacher, with the psychologist using either behavioral or mental health consultation techniques. Problem situations and teacher-consultee verbalizations did not differ across the two sets of videotapes. Afterwards, subjects judged the effectiveness of of the consultation and the personal attributes of the consulting parties. In general, teachers preferred behavioral consultation, while psychologists rated the mental health consultation as more effective. Implications of these findings for consultation reaearch and practice are discussed.     

The school psychologist in evaluating educational programs

A discussion of school psychology practice is presented, with emphasis on school programs rather than on individuals. While pressures exist to continue emphasizing the individual as the unit of study, current literature in evaluation theory and community psychology suggest a more viable model for the practice of school psychology. The learning process as it occurs in school programming is discussed, illustrating potential sources of involvement for school psychologists in effecting change in education. It is suggested that school psychologists, operating from a framework of evaluation theory, are well suited to be evaluators of school programs.     

Creating Safer and More Nurturing Schools: Expanding the Capacity of Schools in the Era of Future National Reform

ABSTRACT

Positive academic performance is a strong indicator of subsequent positive life course outcomes (e.g., employment) as well as underrepresentation in psychiatric populations, drug use, school dropout, and subsequent legal trouble (A. Farn & J. Adams, 2016). As such, helping all children to be successful in school is a top priority for parents, educators, and politicians alike. However, schools are challenged by an increasing demand to meet children's health and metal health needs in order for them to benefit from, and progress in, their educational experience. Public concerns regarding violent acts on school property have highlighted the need to address student and teacher safety. The authors provide recommendations for school psychologists regarding promising practices that respond to national initiatives to prevent school violence, increase access to health and mental health care, and enhance equity among students.     

Partnerships with Psychiatry and Other Clinical Disciplines: A Key to Psychology's Success in U.S. Medical Schools

This paper describes the growth of psychology in medical schools and the distribution of psychologists across medical school departments. The Association of American Medical Colleges (AAMC) and American Psychological Association (APA) use different data collection approaches that reflect their different missions. AAMC focuses solely on medical school faculty, whereas APA tries to reach all psychologists working in academic health centers (AHCs). The number of psychologists in medical school settings has increased, largely due to their research expertise; but psychologists also contribute through teaching and clinical service. Psychologists hold appointments in wide variety of medical school departments, which has been a key factor in their success. Through partnership and interdisciplinary collaboration with a wide range of academic physicians, psychologists have gained increased support, become valued members of the AHC and medical school communities, and can rise to leadership positions in medical schools.     

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.     

Implementing school psychological service programs: Description and application of the durable approach

Implementing school psychological service programs is a challenging and complex endeavor facing school psychologists. In order to assure that their programs occur as planned, practitioners may benefit from organizational management strategies. This paper presents the DURABLE approach as a strategy that can be employed by school psychologists to facilitate implementation of counseling and other intervention programs. In the paper, the seven phases of DURABLE are described. Then results are reported of an investigation in which the approach was applied by school psychologists to facilitate implementation of group counseling programs in urban high schools. Discussion occurs within a context of the need for school psychologists to incorporate organizational management strategies into their practice.     

A survey of referral problems in 59 Ohio school districts

Feedback for the school psychologist is vital to construct and maintain remedial or preventative programs in the public schools. This study was undertaken to see if referral data would be useful as a source of such information.

Referral forms were solicited from school psychologists in 59 Ohio school districts and an analysis was made of their contents. The data obtained indicates that referral information can be used to provide school psychologists clues pertaining to referral procedures and the types of children and problems referred.

Specifically, this study indicates a greater need in the area of communication among pupil personnel workers. Further, it indicates that the psychologist in the school deals largely with problems of an academic nature thus offering a direction for in-service programming. Finally, the data reveals an interesting trend in the area of mental health which could possibly be an area of fruitful research.     

Enhancing the Behavioral and Mental Health Services Within School-Based Contexts

ABSTRACT

Recent health care reform provides many new opportunities to expand mental health and behavioral support to students in schools and school–community partnerships. Through newly available funding sources, as well as expanded legislative initiatives, school psychologists can advocate for and become leaders in delivering universal programming, tiered mental health supports, and formalized collaborative efforts with community agencies. The authors highlight the application of tiered levels of services, with current practice samples, designed to address students' mental and behavioral health. Implications for practice are discussed.     

Survey of School Psychologists' Attitudes,Feelings, and Exposure to Gay and Lesbian Parents and Their Children

Abstract

School psychologists' attitudes and feelings toward gay and lesbian parents were surveyed in relation to their training and exposure, and professional services offered to gay and lesbian parents and their children. The relationship between attitudes, feelings, training, exposure, and demographic characteristics was explored as well. A stratified random sample of 500 school psychologists who were members of NASP was surveyed using a 30-item questionnaire. Out of the 500 surveys sent, 267 school psychologists (53.4%) returned them. Overall, school psychologists have positive attitudes and feelings toward gay and/or lesbian parents. More specifically, school psychologists who were female, homosexual/bisexual, or living in the Western region of the United States had significantly more positive attitudes and feelings toward gay and/or lesbian parents. Although few school psychologists (30%) received any formalized training, those who had some training indicated more positive attitudes. The majority of school psychologists (89.4%) reported having personal associations with homosexual individuals. More exposure to homosexual individuals by a school psychologist indicated more positive attitudes as well as feelings. Implications of the findings and future research directions are discussed.     

The actual and preferred roles of the school psychologist according to secondary school administrators

This paper examines the perception of the role of school psychologists as viewed by secondary school administrators. Particular attention is focused on differences of priority in terms of rank-ordering of functions between actual and ideal. Data were drawn from questionnaires returned by 361 principals representing every tenth school of the 3,683 listed as members by the North Central Association of Secondary Schools in 1983. Several results emerge from the study. There is little difference in rank order between actual and ideal roles. Significant rank order differences were in the areas of “Counseling with students” and “Staffing for special education.” Administrators in this sample clearly desire more involvement of psychologists with counseling and less with staffing. Results raise questions with regard to prevalent training programs if psychologists are to assume a greater counseling role.     

Role function and job satisfaction of school psychologists practicing in an expanded role model

School psychologists are typically itinerant among multiple schools and often spend up to two-thirds of their time on assessment activities related to students with disabilities and special education programs. School psychologists in delivery of an expanded role service model are assigned to a single school and provide more consultation and intervention services. 97 school psychologists assigned to an expanded role in a single southeastern urban school district were surveyed on their job roles and job satisfaction. The majority were satisfied or very satisfied with their jobs, particularly with engaging in activities that were of service to others and staying involved in a variety of job activities. School psychologists wanted to spend less time in assessment, multidisciplinary team meetings, and administrative duties. The discrepancy between the desired and actual amount of time spent in multidisciplinary meetings was negatively related to job satisfaction. Psychologists wanted to spend more time in direct and indirect intervention, professional development, and networking.     

Health psychology in international perspective: A summary and some thoughts for the future

This article reviews the progress made by the field in its short history and attempts to look at developments which seem likely to occur as the field matures.

Recommendations are made for training of health psychologists in the future and a plea is made for international standardisation of health psychology training programmes at the Ph.D. level which incorporate research and clinical training. Health psychologists are further encouraged to take a more active public and political role in order to provide needed visibility for their work.     

Conceptualization and Treatment of Social Withdrawal in the Schools

Social withdrawal represents a class of behavior problems that are not as frequently referred by teachers in school settings as are disruptive, acting-out behaviors. Approximately 15% of all children referred to school psychologists and other mental health professionals in the schools are socially withdrawn. This paper provides several definitions of social withdrawal from a social skills perspective and presents a four-fold classification system of children's social skills deficits. Assessment procedures for identifying socially withdrawn children are briefly reviewed. Four social skills training strategies (i.e., modeling, coaching, peer-mediated interventions, and group contingencies) are reviewd and the relative efficacy of each are evaluated. Several commercially-available social skills training curricula designed for school settings are described at the conclusion of this paper.     

Results from a National Survey of Psychologists in Medical School Settings—2003

Preliminary results are presented from a 2003 collaborative survey of psychologists employed in medical schools and academic health centers. The findings are reported along with comparable data from a similar survey conducted in 1997. There were several noteworthy changes in results from 1997 to 2003. Salaries increased substantially at all ranks, though women’s earnings remain lower than men’s. There were increases in the percentage of respondents who completed their doctorates 20 or more years ago, and in the percentages holding higher academic ranks and having tenure. However, there was a decrease in the absolute number and percentage of psychologists at lower ranks who received their doctorates recently. Overall, the findings indicate that psychologists have established a secure home in medical school settings. Future reports will present more detailed analyses of the 2003 dataset as well as additional comparisons with the 1997 survey data.     

The role of Canadian school psychologists: Perceptions of a sample from the general public

A sample of 77 subjects responded to a questionnaire designed to collect information about their perceptions of the role of school psychologists. The results indicate that overall the respondents had a fairly accurate sense of what a school psychologist does, although they overestimated the importance of psychotherapy as one of the school psychologist's functions. It is recommended that school psychologists more clearly specify their function when dealing with members of the general public.     

Psychotropic Medication Consultation in Schools

Abstract

Assessing, consulting, and intervening with students being treated with psychotropic medications is an increasingly common activity for school psychologists. This article reviews some of the literature providing evidence for the greater need for training in school psychopharmacology. A legal and ethical case study is presented that highlights the complexity of medication issues for school psychologists. Training programs are encouraged to examine current curricular requirements to insure that graduates are exposed to evidenced-based treatments including pharmacological approaches. It is vital that school psychologists examine their own competencies as they work to ethically and legally consult with families and physicians to improve adaptive functioning in school-aged populations.