Supporting Integrity of Discrete Trial Teaching via Tiered Consultation: A Pilot Study

Empirically supported consultation procedures for supporting implementation of evidence-based interventions for Autism Spectrum Disorder (ASD), such as performance feedback, may be challenging to implement in public schools. Educators may find performance feedback aversive, and support personnel may find its directiveness incompatible with their professional roles. This pilot study extends recent advances in implementation science, by investigating the influence of tiered consultation on intervention integrity of Discrete Trial Teaching (DTT). A less intensive form of implementation support was examined for its feasibility and effectiveness. Collaborative Student Data Review (CSDR) includes discussion, general feedback, and modeling. Preliminary findings indicate that CSDR is a feasible and acceptable form of implementation support, and that it shows potential as a form of implementation support for DTT.     

Reflective Capacity: An Antidote to Structural Racism Cultivated Through Mental Health Consultation

Effecting a paradigm shift from “reproductive health” to “reproductive justice” within the perinatal field requires changes simultaneously at the levels of the individual healthcare provider and the system of care. The Infant-Parent Program at the University of California, San Francisco (UCSF) has extended its pioneering infant and early childhood mental health consultation to perinatal service systems applying an infant mental health approach to programs caring for expecting and new parents. In partnership with two nursing programs, UCSF consultants direct their efforts at supporting reflective practice capacities and use-of-self in patient–provider relationships. Both nursing programs serve vulnerable groups of expectant and new parents who grapple with challenges to health and well-being stemming from structural racism. As reflective capacities are supported within the consultation case conferences, providers spontaneously identify the need for tools to effectively address issues of race, class, and culture and to combat structural racism throughout the healthcare system. Policies and procedures that uphold structural racism cease to be tolerable to providers who bring their full selves to the work that they are trained to do. Using these nurse consultation partnerships as organizational case studies, this article describes a range of challenges that arise for providers and delineates steps to effective engagement toward reproductive justice.     

Consultant Problem Understanding as a Function of Training in Interviewing to Promote Accessible Reasoning

The focus of this article is on how consultants develop a “high-quality” understanding of a teacher's presenting problem situation from interviewing them. A longitudinal quasi-experimental study was conducted with 10 graduate students enrolled on an accredited training program in school psychology in which interviewing and problem-solving skills were taught and practiced. Eight individuals who had been selected for the same training program but who had not enrolled acted as a comparison group to measure possible practice effects. The results indicated that following training consultant use of statements designed to reveal their reasoning to the teacher significantly increased, and was highly correlated with the quality of their subsequent written analyses of the teacher's problem situation.     

Consultant or Comrade: Comments About Analysts' Working Relationships in Schools

The articles in this issue of the Journal of Applied Psychoanalytic Studies pose a dilemma for educators. On the one hand, each article describes an important psychosocial intervention implemented in schools. On the other hand, these interventions, at least as described in the articles, are either imposed on the work of teachers and students or isolated from that work. Either circumstance ultimately limits the impact of the intervention. I claim that analysts and teachers are natural allies despite lack of evidence for alliance in these articles. To extend that alliance beyond conversations about individual children, analysts must understand that teachers' views of learning and development are different from those that influence the organization and management of schools.     

An Anthropologist at Ground Zero, or How I Applied My Group Perspective to the 9/11 Organizational Relief Effort

This paper, originally presented November, 2001 at the Plenary Session of the Annual Conference of the Eastern Group Psychotherapy Society in New York, describes the application of group psychodynamics to organizations under stress. The presentation illustrates the system sensitivity required of consultants assisting organizations traumatized by the 9/11 terror attacks. The author's comments and recommendations were shaped by his experience overseeing the consulting work provided by EGPS Members to Wall Street in the aftermath of the attacks.     

关于结直肠患者的PCQ风险评分系统的运用进展

摘要：回顾关于结直肠患者的PCQ（patient consultation questionnaire,问卷量表一加权评分系统）风险评估体系自1999年产生以来的运用进展情况。查阅了1999年至今的相关文献,分析总结PCQ系统的评估原理、评估流程、评估效果,并作一综述。结果显示：PCQ系统对各种疾病的分辨能力较高,随着WNS（weighed numerical score,加权分数）分数的增加,各种疾病分数表现为阶梯状上升的层级分布图。癌症患者与非癌症患者的平均WNS分剐是70-80、40-55之间,有统计学意义。当以WNS分数60为界时,WNS系统的敏感度、特异度可分别达到86.5％、84.5％。以WNS50为转诊标准,仅40％的患者需紧急转诊,发现91％的癌症患者。提示PCQ系统的准确性高、特异性强,是一个很有发展前景的评估体系,可以进一步的开展多中心研究进行验证,进而推广使用并引进到中国。     

Ethical and methodological aspects of medical computer data bases and knowledge bases

Ethical problems are related to computer data bases, containing data on individuals and groups of persons, as well as to computer knowledge bases, containing general rules and elements of expert systems.In the present essay the following conclusions are made regarding computer data bases: privacy, security, and confidentiality of medical computer data bases should be ensured. This duty should rest with physicians in hospitals. The principle of informed consent should be applied to gathering information which is to be stored and processed by computers. Information stored in computer data bases should not be used for purposes for which the subjects (patients as well as personnel) have not given their consent. In order to decrease the possibility of misuses of medical data bases containing information on individuals, these registers should not be linked to other central data bases.     

A Teacher-Consultation Approach to Social Skills Training for Pre-Kindergarten Children: Treatment Model and Short-Term Outcome Effects

This study evaluated the post-treatment outcome effects of a classroom-based social skills program for pre-kindergarten children, using a teacher-consultation model. The pre-K RECAP (Reaching Educators, Children, and Parents) program is a semi-structured, cognitive-behavioral skills training program that provides teachers with in-classroom consultation on program implementation and classroom-wide behavior management. Data on children's social skills and behavior problems were collected from parents and teachers at pre- and post-treatment, for 149 children aged 4–5 years (of whom 56% were girls). Significant treatment effects were found for teacher but not parent reports, with treatment group children improving significantly more than comparison group children in their teacher-rated social skills and internalizing and externalizing problems. These results provide some preliminary support for the efficacy of the program on children's social skills and behavior problems, and for a teacher-consultation model for training teachers to implement school-based mental health programs.     

Enhancing CBT Consultation With Multicultural Counseling Principles

The use of multicultural principles to enhance cognitive behavioral therapy (CBT) for individuals of marginalized backgrounds has received increased attention in light of the heightened national awareness of systemic oppression and racialized violence directed towards Black, Indigenous, and People of Color. However, there has been less of a focus on applying such principles to consultation for skill development. If ethical guidelines are expected to influence the behavior of clinicians in session, guidance is needed to indicate how and where and when clinicians should receive training in implementing culturally responsive CBT. Individual reading and reflection are necessary but are not sufficient in acquiring new clinical skills. Consultation is recommended and strongly suggested when clinicians are working with new populations or delivering a new treatment, or even using a new modality. Consultation can also be useful when adopting a new approach or stance to therapy. For practicing clinicians who have not developed these skills, additional consultation can and should be used to address this gap. Moving forward, integration of cultural responsiveness into standard consultation will ensure that these skills are seen as a core competency, rather than an optional additional skill that may be (or not be) elected. This paper presents core experiences that may be integral to a CBT consultation model that aims to enhance providers’ ability to provide CBT in a way that is culturally responsive to their clients. These recommendations attend to both content and process within CBT consultation and reflect guiding assumptions for helping clinicians to develop the ability to practice CBT in a culturally responsive manner, including (a) normalizing discussions of cultural identity and oppression, (b) an emphasis on cultural self-awareness, (c) emphasizing culturally informed CBT case conceptualization, and (d) skill development in applying cultural elements to CBT interventions.