Best Practices in School-Based Problem-Solving ...

1 Review Copy Not for Distribution30 Best Practices in School-BasedProblem- solving Consultation:Applications in Prevention andIntervention SystemsThomas R. KratochwillMargaret R. AltschaeflBrittany Bice-UrbachUniversity of Wisconsin MadisonOVERVIEWC onsultation continues to be a major approach forproviding mental health and educational services tochildren and adolescents, and behavioral consultationhas been identified as a practice guideline for problemsolving and the delivery of evidence-based interventions(Frank & Kratochwill, in press; White & Kratochwill,2008). Traditionally, consultation was recognized as themost preferred and satisfying function of schoolpsychologists (Gutkin & Curtis, 1999; Sheridan &Walker, 1999; Sheridan, Welch, & Orme, 1996), andit has become a major part of response to intervention(RTI; Kratochwill, Clements, & Kalymon, 2007).Consultation s linkage to RTI is particularly importantin that consultation can play a major role in theproblem- solving process needed for the provision ofprevention services.

2 The purpose of this chapter is toreview some of the fundamental features of schoolpsychologists Problem-Solving consultation and itsrelationship to prevention and intervention and tomultitiered services in content and practice recommendations in thischapter fall under the Consultation and Collaborationdomain in the National Association of SchoolPsychologists (NASP)Model for Comprehensive andIntegrated School Psychological Services(NASP, 2010). Theconsultation and collaboration Practices related to themodel that are addressed in the chapter includeengaging in a consultative Problem-Solving process;addressing needs at the individual, family, and systemslevels; and applying psychological and CONSIDERATIONST hree major models of consultation have been featuredin the professional literature and include mental healthconsultation, organizational development consultation,and behavioral consultation (labeledproblem-solvingconsultationin this chapter), but many more have beenidentified over the years.

3 It is beyond the scope of thischapter to review these and other models of consul-tation, and the reader is referred to other sources for thisinformation (see Brown, Pryzwansky, & Schulte, 2011).Although differences exist among these models, allemphasize Problem-Solving expertise of the consultantwithin a triadic relationship (consultant consultee client). The behavioral model of consultation emergedas an alternative to traditional service deliveryapproaches in applied settings (Reschly, 1988) andhistorically has strong ties to applied behavior analysisand behavior therapy ( , Bergan & Kratochwill,1990). Nevertheless, the model has expanded, primarilyin the theoretical foundations that underlie the inter-ventions, and, consequently, new names have beeninvoked to describe the evolution in research andpractice (see Gutkin & Curtis, 1999). The term461 Review Copy Not for Distributionproblem- solving consultationis adapted here to replace thetermbehavioral, but other terms could be used as well( , solution oriented, ecobehavioral).

4 Many of theproblem- solving models presented in this edition ofBestPracticescan be traced to the Problem-Solving features ofbehavioral consultation (Bergan, 1977; Bergan &Kratochwill, 1990).Consultation can be distinguished from the assess-ments and interventions that are used as part of theproblem- solving process (Frank & Kratochwill, in press;White & Kratochwill, 2005). Consultation is the processthat defines the interactions that constitute the iden-tification, analysis, intervention implementation, andevaluation that occur between a consultant and amediator/consultee. Although Problem-Solving consul-tation traditionally has been affiliated with behaviormodification and intervention techniques derived fromthis theoretical school, a more current focus is to use awide range of assessment and intervention technologiesfrom diverse theoretical origins embedded within anevidence-based practice framework (see Gutkin &Curtis, 1999; Sheridan & Kratochwill, 2008). Forexample, school psychologists may apply more tra-ditional behavioral principles and techniques ( ,functional assessment andanalysis) in developingintervention programs and use behavioral assessmentmethodologies to evaluate the effectiveness of theseservices.

5 Likewise, school psychologists also may applyevidence-based instructional principles such as pausetime, pacing, teacher feedback, and homework instruc-tion when developing an intervention plan to enhancethe academic performance of students who are under-achieving (Gettinger & Stoiber, 2009). Whereas specificintervention strategies may vary across presentingproblems, two identifiable features are most frequentlyassociated with Problem-Solving consultation: (a) indirectservice delivery and (b) a Problem-Solving of these features extends into its use withinprevention and intervention services and, in particular,with multitiered most widely recognized feature of consultation isits indirect service delivery approach. Services can bedelivered by a consultant ( , school psychologist) to aconsultee ( , teacher and/or parent), who, in turn,provides services to a child in the school and/orcommunity setting. Services can also be rendered to agroup of teachers, administrators, or a problem -solvingteam, although the research base on teams is far lessdeveloped than on single-mediator approaches.

6 Theindirect approach to service delivery generally isregarded as a distinct advantage of consultation, sinceit allows the school psychologist to have an impact onmany more mediators, and especially children, thancould be served by a direct service approach. In fact, thecentrality of consultation in linking assessment andintervention Practices is making consultative modelsincreasingly prominent as a component of solution-focused, multitiered prevention service delivery systemssuch as RTI (see National Association of State Directorsof Special Education [NASDSE], 2005).Consultation involves a collaborative relationship inwhich the consultant is viewed as a facilitator. Emphasisis placed on the collaborative Problem-Solving processthat occurs during a series of interviews and relatedassessment and intervention activities. Throughout thisprocess, the school psychologist s role is to elicit adescription of the problem , assist in analyzing theproblem, construct a plan for intervention, and establisha monitoring system once the program is consultee s role is to clearly describe the problem ,work with the consultant to implement the interventionprogram with integrity, observe progress, periodicallyevaluate the plan s effectiveness, and monitor theintervention outcomes.

7 For the consultation process tobe effective, both consultant and consultee should bringthe following dispositions to the consultation process: (a)a sense of preparedness and clear expectations, (b) awillingness to participate actively and openly in acollaborative work environment, and (c) a capacity toassume a proactive role, especially with preventionprograms and of ConsultationProblem- solving consultation has two important goals:(a) to provide methods (prevention and intervention) forchanging a system, classroom, or child s behavioral,academic, or social problem ; and (b) to improve thesystem and/or a consultee s skills so it, he, or she canprevent or respond effectively to future problems orsimilar problems in other children. Given these goals,consultation can be both a proactive (prevention) and areactive (intervention) service. Although consultation-based interventions often have changed children sproblem behaviors successfully (Sheridan et al., 1996;White & Kratochwill, 2008), the proactive goal ofinfluencing a consultee s ability to handle futureproblems has not been observed consistently in research(Coffee & Kratochwill, 2013).

8 Plus, the role ofconsultation in prevention systems is really in its infancycompared to work in developing interventions forexisting problems. The accomplishment of these goalsBest Practices in School Psychology462 National Association of School PsychologistsReview Copy Not for Distributionrequires consultees to participate in a general process foranalyzing conditions that result in an effective plan toprevent and resolve the problems. Successful schoolpsychology consultants must demonstrate expertise incoordinating and facilitating the Problem-Solving pro-cess, demonstrating a strong knowledge of preventionand intervention Practices , and implementing methodsfor monitoring whether the intervention is the remainder of this chapter, the basic compo-nents of Problem-Solving consultation, relationshipvariables that may influence the consultation process,and school psychologists use of consultation withsystems, groups, and/or teachers and parents of Structure and Process ofConsultation: Applications for the Individual,Group, and SystemConsultation has been conceptualized as a series ofstages that structure and focus the problem -solvinginteractions between consultant and consultees (Bergan& Kratochwill, 1990; Sheridan & Kratochwill, 2008).

9 This series of stages and their corresponding interviewsdefine consultation as separate from more genericproblem- solving approaches as recently presented inthe literature ( , Brown-Chidsey & Andren, 2013). Aheuristic five-stage framework for consultation can beapplied to a system, group, or individual Problem-Solving With Special Education TeachersTraditionally, school psychologists have implementedconsultation with classroom teachers in an effort toestablish intervention programs in the regular class-room. This emphasis on interventions with teachers alsoadvanced the development of a knowledge base toprevent more serious behavioral problems in childrenand is one reason why the approach is recommended inRTI models (Gresham, 2006; NASDSE, 2005). School-Based consultation services have expanded to includework with special education teachers, particularlyteachers of students with emotional disturbance andteachers from early intervention programs for pre-school-age children. In addition, consultation also hasbeen used for many years to successfully remediateacademic and socialization difficulties in school such as these have presented uniqueopportunities for school psychologists to increase contactwith special education teachers while generally address-ing more severe presenting problems in special needschildren who often experience multiple , school psychologists roles as consultants havebecome increasingly complex, with unique timedemands and prevention and intervention foci thatmay vary according to the child s presenting problemsand the teacher s level of expertise in areas such asbehavior management and individualized Focus on Promoting CompetenciesProblem- solving consultation can focus on preventionby linking the process to a multitiered system such asRTI.

10 However, prevention can move beyond the deficitRTI model and include promoting social competencyskills in clients. In this regard, case-based problemsolving can extend to a focus that also includes buildingsocial competencies to prevent more serious problemsfrom developing (Stoiber & Kratochwill, 2000). Forexample, during the problem analysis phase, the schoolpsychologist can ask teachers and parents to completemeasures on the academic functioning of students,such as the Academic Competence Evaluation Scales(DiPerna & Elliott, 2000), to target academic enablersor skills development. Figure provides an illustra-tion of the subscales of the Academic CompetenceEvaluation Scales. This assessment tool can help theschool psychologist identify skills for development andpromotion at a primary or secondary level of Teacher Pairs/Conjoint ConsultationAnother method of expanding consultation servicesentails involvement of parent teacher pairs in problemsolving. Although consultation with teachers (regularand special education) to deal with problem reduction isan effective method of remediating School-Based prob-lems, this traditional focus often fails to address thebroader context and focus within which the child sproblems may occur (Kratochwill & Pittman, 2002).