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.     

Antecedents and Consequences of Victimization of Lesbian, Gay, and Bisexual Young People: A Structural Model Comparing Rural University and Urban Samples

Research indicates that antigay victimization is widespread and that lesbian, gay, and bisexual young people may be very vulnerable to such victimization. The current study builds upon previous work by Hershberger and D'Augelli (1995), who studied the consequences of sexual orientation-based victimization in 194 urban lesbian, gay, and bisexual youths. Using structural equation modeling, the present study models both antecedents and consequences (including psychological distress, self-esteem, and suicidality) of victimization via a secondary analysis of their data set. In addition, a second sample of 54 lesbian, gay, and bisexual youths from a rural university setting was examined to cross-validate and generalize the relationships found in urban settings. Results indicated that a revised model of victimization exhibited sufficient fit to the urban sample data and provided preliminary support for the generalizability of the model beyond the initial sample. Additional similarities were found between the urban and rural university community samples, including a high prevalence of reported suicide attempts: 42% of the urban sample and 32% of the rural university sample had attempted suicide at least once. Results indicated that victimization based on sexual orientation has similar correlates for young people in different community settings.     

TRAINING PARENTS IN BEHAVIORAL SELF-MANAGEMENT: AN ANALYSIS OF GENERALIZATION AND MAINTENANCE

This study examined the generalization and maintenance effects of three phases of parent training (Instructions plus Feedback and two Self-management Training phases) on levels of disruptive child behavior and the accuracy with which parents implemented programs. Data were collected from five families in three main settings: the initial training setting (the home), a variety of generalization settings in the community, and the family breakfast. A multiple baseline across subjects design was used. Instructions plus Feedback comprised instructing parents to use a range of behavior management procedures and provided home-based differential feedback concerning accuracy of program implementation. Self-management Training phases involved training parents in goal setting, self-monitoring, and planning skills, specific to their performance of appropriate parenting skills in generalization settings. Results indicated that the Instructions plus Feedback phase was sufficient to produce reduced levels of problem behavior at home and high levels of accurate implementation, but generalization effects out of home were equivocal. Self-management maintained reduced levels of problem behavior at home but, in addition, resulted in generalization effects in community settings for both children and parents. Maintenance probes 3 months following the program revealed the effects had been maintained.     

PROCEDURAL VARIATIONS IN GROUP CONTINGENCIES: EFFECTS ON CHILDREN'S ACADEMIC AND SOCIAL BEHAVIORS

There has been little research on the effects of the many procedural variables in applied group contingencies. In the present study, an individualized contingency and three group contingencies with different “responder” criteria (e.g., reward based on the group average, reward based on the work of a designated, low-achieving student, or reward based on the work of a randomly selected student) were applied to the academic work of primary grade children in a learning disabilities classroom. Group social interaction during each contingency was measured systematically. Although there were large individual differences in students' academic and social responses to the different contingencies, some consistent effects were observed. Two of the four low-achieving target students did their best academic work during the group contingency which focused on their performance as a designated responder. This type of contingency also produced high levels of positive social interaction in three of four groups of children observed.     

Emotional Empathy in a Courtroom Simulation: A Person-Situation Interaction1

A pair of experiments were conducted using a simulated courtroom trial of a criminal case. In Experiment I subject-jurors were asked by defense counsel either to imagine themselves as the defendant (empathy-inducing appeal) or to pay close attention to evidence (nonempathy appeal). Later the judge delivered only general instructions or, in addition, charged jurors to give consideration only to the facts presented. When there was no Fact-focused judge's charge, juror-subjects who heard the empathy-inducing appeal rated the defendant's actions as more lawful and attributed less of the cause for the incident to his personality than did their counterparts in the nonempathy condition. Experiment II included individual differences in the tendency to empathize as an additional mediating variable. The original pattern of effects found for the manipulated variables in Experiment I appeared again, but were overshadowed by the stronger effects of the individual difference variable and of subject sex. Subject-jurors who scored high on the empathy individual difference measure rated the defendant less guilty, assigned less cause to him, and showed corresponding mood shifts when they heard the empathy-inducing appeal. In addition, male subjects empathized more strongly with the male defendant and viewed him more favorably.     

USE OF A SELF-RECORDING AND SUPERVISION PROGRAM TO CHANGE INSTITUTIONAL STAFF BEHAVIOR

The use of a self-recording and supervision program to increase interactions between direct care staff and profoundly retarded persons in a state residential facility was investigated. Following baseline, staff were provided with instructions regarding what to self-record, criteria for how many interactions to record, and a prepared card on which to make the recordings. Throughout the study, the staff supervisor monitored intermittently staff-client interactions. Observations indicated that when the staff recorded their interactions with clients in a loosely structured dayroom setting, the rate of interactions increased noticeably for each staff person. Behavioral ecology measures indicated that other staff responsibilities, such as maintaining the cleanliness of residents and the physical area, were not affected detrimentally when social interactions increased and actually showed small improvements. Additionally, small decreases in resident self-stimulatory and disruptive/aggressive behaviors occurred when the rate of social interactions from staff persons increased. Follow-up measures indicated that the rate of staff self-recording was variable, but when staff did self-record, the increased rate of staff-client interactions maintained.     

Visual timing in hitting an accelerating ball

To investigate the timing of actions relative to events in the environment, we observed subjects leaping to punch a falling ball. We analysed their knee and elbow angles as functions of time for three ball-drop heights, finding that the differences in the functions for the different heights could be explained on the basis that the subjects were gearing their actions to a particular optic variable. This variable specifies the time remaining before contact with an object if the closing velocity is constant; for the falling ball it gives an increasingly accurate estimate of the time-to-contact. Our visuo-moto control model incorporates a delay parameter, the value of which was estimated from the data. In addition, correlations indicated that the knee and elbow were generally quite tightly coupled. The relationship of this task to laboratory tracking tasks and to the timing of actions in everyday life is described.