consultation class 04

8/10/2019 Consultation Class 04

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CPY 560 Consultation / Dr. Burt Bertram

MENTAL HEALTH

CONSULTATION

Caplan ModelClinical Supervision

Behavioral Consultation

Coaching

Class #4


Community Counseling & Consultation

Consultation:

What Is It?

Community

Service Delivery

Organizations

Personal / Professional

Mission Statement

Process

Consultation &

Organization

Change

Community

ChangeConsultation & Advocacy

Conflict Resolution

Mediation

Mental Health

ConsultationOrganizations

SocialJusticeChangeAgent


Consultation Generic Model

Target of the Consulting(Individual, Group, Family, Organization, Community)

Consultant Consultee/Client

Consultanta person in a position to have some influence over an

individual, a group, or an organization, but who has no direct power to

make changes or implement programs.Peter Block, Flawless Consulting (2nd Ed.), 2000


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Consultation Assumptions

1. ConsultationisaProblemSolving&Educationalprocess

2. ConsultationisTriadic ( Consultant,Consultee,Client)

3. ConsultationisVoluntary theConsulteeasksforhelp

4. ConsultationisCollaborative Consultant/Consultee=Peers

5. ConsultationisTemporary

6. ConsultationisfocusedonWorkRelatedProblems(broadlydefined)

7. ConsultationseekstohelpbothConsultee andClient

8. Th eConsultanthasnopowerover theConsulteesactions

9. Th eConsultantmay ormaynot have directcontact withtheClient

10. TheConsultantworkswiththeentireperson oftheConsulteeprimarilyintermsofincreasingeffectivenesswiththetargetClient.


GenericModelofConsultation

StageOne Entry

InitialMeeting

DefineDesiredOutcome

Contracting

Physical/PsychologicalEntryintotheSystem

StageTwo Diagnosis

GatheringInformation

DefiningtheProblem

SettingGoals

GeneratingPossibleInterventions

StageThree:Intervention ChoosingtheRightIntervention

FormulateaPlan

ImplementthePlan

EvaluatethePlan

StageFour Disengagement

EvaluatingtheConsultationProcess

PlanningforPostConsultation

ReducingInvolvement/FollowingUp

Termination


Caplan

Consultation Model

Client-Centered Case Consultation

Expert / 2nd Opinion Model

Program-Centered

Admi nis trat ive

Consultation

Classic

Expert Model

Consultee-Centered Case Consultation

Supervision/Coaching Model

(Mental Health Consultation)

Consultee-Centered

Admi nist rati ve

Consultation

Process/OD

Consultant Model


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Client-Centered Case Consultation(Expert / Specialist Consultation)

Consultant functions as a specialist who assesses the client,

arrives at a diagnosis, and makes recommendations concerning

how the consultee might modify his or her dealing with the

client.

Consultee: Mental Health Professional, Teacher, Medical,

Clergy, Parent, Adult Child

Target: Efforts are directed to the Case (client,

student, child, parent, employee, etc.)

Caplan Model - CONSULTATION

2ndOpinion Model



Consultee-Centered Case Consultation(Supervision/Coaching Mental Health Consultation)

Consultation is concerned with difficulties a consultee

encounters with a particular client for whom he or she has

responsibility the difficulties spring from shortcomings in

the consultees professional functioning.

Consultee: Mental Health Professional, Teacher, Medical,

Clergy, Parent, Adult Child

Target: Efforts are directed to the consultee

to address

o Lack of Knowledge

o Lack of Skill

o Lack of Confidence

o Lack of Objectivity

Theme Interference

Supervision or Coaching Model



Program-Centered Administrative

Consultation(Expert/Specialists)

Consultant is called in to study a problem and provide a set

of recommendations for dealing with the problem.

Consultee: CEO, Administrator, Manager, Supervisor,

Team Leader, Etc.

Target: Efforts are directed to the administrative

functioning of the organization or to a larger

systemic context (community consultation)

Classic Expert Model


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Consultee-Centered Administrative

Consultation(Process/OD Consultant)

Goal is to improve the professional functioning of one or

more members of an administrative, executive, or managerial

staff/team. Consultant moves freely throughout the

organization takes active role in identifying organizational

problems and recommending an d/or initiating activities to

address the problems.

Consultee: Senior Leadership and/or Organization

Target: Efforts are directed at improved

organizational functioning through

leadership competence improvements

Process/OD Consultant Model


Caplan

Consultation Model

Client-Centered Case Consultation(Expert 2nd Opinion)

Consultant functions as a specialist who assessesthe client, arrives at a diagnosis, and makes

recommendations concerning how the consulteemight modify his or her dealing with the client.

Consultee: Mental Health Professional,

Teacher, Medical, Clergy, Parent, Adult Child

Target: Efforts are directed to the Case

(client, student, child, parent, employee, etc.)

Program-Centered

Admi nis trat ive

Consultation(Expert/Specialists)

Consultant is called in to

study a problem and providea set of recommendations for

dealing with the problem.

Consultee: CEO,Administrator, Manager,

Supervisor, Team Leader,Etc.

Target: Efforts are directed

to the Admin functioning or

to a larger system context(community consultation)

Consultee-Centered Case Consultation(Mental Health / Human Service Consultation)

Consultation is concerned with difficulties a

consultee encounters with a particular client forwhom he or she has responsibility the difficulties

spring from shortcomings in the consulteesprofessional functioning.



Target: Efforts are directed to the consulteeto address

o Lack of Knowledge

o Lack of Skill

o Lack of Confidenceo Lack of Objectivity

Theme Interference

Consultee-Centered

Admi nist rati ve

Consultation(Process/OD Consultant)

Goal is to improve the

professional functioning of oneor more members of an

administrative or leadership

staff/team. Consultant movesfreely throughout the

organization takes active rolein identifying organiz-ational

problems and recommending

and/or initiating activities to

address the problems. Consultee: Senior

Leadership / Organization Target: Efforts are directed

at improved organizational

functioning throughleadership competence

improvements


Mental Health / Psychological Consultation

CaplanConsultee-Centered Case Consultation

(Supervision & Coaching Model)


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What is Mental Health Consultation?

Mental

Health

Consultation Aprocessofinteractionbetweentwoprofessionalpersonstheconsultant,whoisaspecialist,andtheconsultee,whoinvokestheconsultantshelpinregardtoacurrentworkproblemwithwhichhe[orshe]ishavingdifficultyandwhichhe[orshe]hasdecidediswithintheothersareaofspecializedcompetence.

GeraldCaplan (1970). TheTheoryandPracticeofMentalHealthConsultation,p.19.

Client(Individual, Groups/Families, Organizations, Communities)

Consultant Consultee

Mental Health Professional

Teacher

Child Care Worker

Human Service Professional

Mental Health Consultant

Human Services Consultant


MentalHealth/PsychologicalConsultation

Psychological consultation involves a broad helping approach

in which qualified psychological consultants help consultees (1)

resolve work-related issues pertaining to individuals, clients, or

programs that they are responsible for, (2) become active agents

in achieving solutions to problems, or (3) strengthen consultees

work-related competencies to address similar issues in the the

future.

Wallace, W.A., & Hall, D.L. (1996). Psychological consultation:

Perspectives and applications. Pacific Grove, CA: Brooks/Cole.


MentalHealthConsultation

Brown, Pryzwansky and Schulte (2001, p.4)

Updated Caplans definition of mental health consultation. Theirdefinition is a reasonable attempt to be inclusive of the diversity ofopinions within the field. Definition includes:

Consultation is initiated by either the consultee or the consultant.

Relationship characterized by authentic communication.

Consultees may be professionals or non-professionals.

Provides direct services to consultees; it assists them to developcoping skills that ultimately make them independent of the consultant.

Is triadic in that it provides indirect services to third parties (clients).

Types of problems considered are work related when the concept ofwork is broadly conceived.

Consultants role varies with consultees needs.

Locus of consultant may be internal or external.

All communication between consultant and consultee is confidential.


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Clinical Supervision

Florida Statute Chapter 491

Rules 64B4-2.002 Definition of Supervision

Supervision is the relationship between the qualified supervisor

and intern that promotes the development of responsibility,skills, knowledge, attitudes and adherence to ethical, legal

and regulatory standards in the practice of clinical social

work, marriage and family therapy and mental healthy

counseling. Supervision is face-to-face contact between an

intern and a supervisor during which the intern apprises the

supervisor of the diagnosis and treatment of each client,

client cases are discussed, the supervisor provides the intern

with oversight and guidance in diagnosing, treating and

dealing with clients, and the supervisor evaluates the interns

performance.


AdaptedfromHaworthPressArticlePrest,L.,Schindeler Zimmerman,T.,&Sporakowski,M.(1992).

Theinitialsupervisionchecklist(ISSC):AguideforMFTsupervisionprocess.TheClinicalSupervisor,10,117133.

(TobeusedbybothSupervisorandSupervisee duringinitialsupervisionsession)

1. Education,TrainingandClinicalExperience

Inquireaboutthefollowingcharacteristicsofthesupervisee/supervisor

Educationalbackground

Trainingexperiences

Setting(s)numberofyears

Theoreticalorientation(s)

Clinicalcompetencewithvariousissues(e.g.,ethnicity,gender,substanceabuse,alternativelifestyles,abortion,populations,problems,andfamilyforms)

Senseofmission/purposeinthefieldofcounseling

Educationalplansandprofessionalgoalsofthesupervisee

Clinical Supervision Initial Session Checklist


PhilosophyofSupervisionExploresupervisees/supervisorsphilosophyofthesupervisionprocess,including

Philosophyoftherapy&change Purposeofsupervision

PreviousSupervisionExperiencesInordertoassesstherangeofthesuperviseescompetence,discussthe

followingpoints: Previoussupervisionexperiences(e.g.format,setting) Strengthsandweaknessesastherapist/supervisee(asindicatorsof

developmentallevel) Superviseescompetencewithstagesoftherapyprocess:initialcall,intake,

joining,middlephase,termination,referral) Levelofdevelopmentintermsofcaseplanning,notes,collateralsupportand

networking Supervisorycompetencewithvariousissues(e.g.ethnicity,gender,substance

abuse,alternativelifestyles,abortion,populations,problems,andfamilyforms) Methodsformanagingsupervisorsuperviseedifferences

Clinical Supervision Initial Session Checklist


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2. SupervisionGoalsInordertoestablishandevaluategoalsofsupervision,address thefollowing

Goals(personalandprofessional

Processofgoalevaluationandtimeframe(e.g.weekly)

Requirementsforwhichsuperviseeisseekingsupervision(e.g.,licensureorcertification)

Requirementsmet

by

supervisors

supervision

3. SupervisionStyle&TechniquesAnoptimumfitintermsofsupervisorystylemaybefacilitatedbyaddressing

Specificexpectationregardingroles,hierarchy,etc

Typesofsupervisionwhichwouldfacilitateclinicalgrowthofthesupervisee

Preferredsyle (e.g.,didactic,therapeutic,experiential,collegial)

Similarities/Differencesbetweentherapyandsupervisionmodels

Focus(e.g.,therapistsdevelopment,cases,orboth)

Ifcasefocused,inwhatmanner(e.g.,fewcasesexploredindepth,crisismgt)

Modality,(e.g.,audio,video,verbal,cotherapywithsupervisor,livesupervision)


4. TheoreticalOrientationRecognizingthatagoodtheoreticalfitsisimportanttothesupervisoryprocess,address:

Modelsorspecificschoolstrainedinfortherapyand/orsupervision Extenttowhichthesemodelshavebeenusedclinically Populations,problems,orfamilyformswithwhichmodelshavebeenmost

effective Interestinlearningnewapproaches Integrationoftheoreticalmodels

5. Legal/EthicalConsiderationsDefinethelegalandethicalparametersofsupervision:

Responsibilityforclientsdiscussedinsupervisionindifferent contexts(e.g.,licensedvs.unlicensedtherapist,privatepracticevs.academic setting)

Numberofcasesforwhichthesupervisorwillberesponsible Emergencyandbackupproceduresavailable(e.g.,supervisoraccessibility) Awarenessofandadherencetoprofessionalethicalcodes Confidentialityregardingsupervisiondiscussions Confidentialityissueswhenmorethanonesuperviseeisinvolved Specificissuesrelatedtodualroles(e.g.,professorstudentorcolleaguecolleague

supervisoryrelationships Processfordealingwithissuessuchasburnoutandtransference/counter

transference


6. UseofSelf/PersonalIssuesSupervisionmayincludeafocusonuseofself orotherpersonalissues

Utilityofuseofself insupervision

Superviseescurrentfamilyandotherrelationships

Issuesrelatedtosupervisorsandsuperviseesrace,gender,andethnicity

Discussionoftechniques(e.g.,genograms,superviseesdifferentiationprocess)

Conflictsbetweenpersonalvaluesandbeliefsandgoalsforsupervision

Significantlifeeventsorcontextsshapingsuperviseesclinicalwork

7. SuperviseesWorkplace

Theseorganizationalconsiderationsareimportant Superviseesplaceofemployment/practice

Agency dynamics(administrativecontrol,theoreticalconflicts)

Agency structure(othersupervisorsinvolvedincases,responsibility/liability

Referralsystem(e.g.,courtordered,selfreferred,etc.)

Superviseessupportsystem


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8. PracticalIssuesThesupervisionprocessisacontractualoneinwhichthesupervisor providesaservicetothesupervisee/consumer. Thefollowingpracticalconsiderationshouldbeaddressed:

Feeandarrangementsforpayment

Location,schedule,anddurationofmeetings

Durationof

supervision

(e.g.,

semester,

months,

years,

etc.) H owwilltimeandfeesbesplitamongsupervisees

Format(video,audio,orcasepresentation:Individualvs.Group Supervision)

Modality(e.g.,experimentaltechniques,liveobservation,etc.)

Theroleofothersupervisee(e.g.,spectator,cosupervisor,cosupervisee)

Supervisionsessionguidelines(e.g.,smoking,punctuality,cueingoftapesahead)

Processforhandingconflictsbetweenmembersofthesupervision group

Processandresponsibilityfordocumentingsupervision(e.g.,forms,verification)

Exchangeofregularandemergencyphonenumbers


BEHAVIORAL CONSULTATION

Mental Health Professionals

Teachers

Parents

Medical Professionals

Clergy

Adult Children

Other Care Givers

Client-Centered

Case Consultation

Consultee-Centered

Case Consultation


Target ClientClient, Student, Patient, Child, Aging Parent, Other

Consultant ConsulteeMental Health Professional

Teacher

Medical Professional

Parent

Adult Child

Clergy

Other Care-Givers

CONSULTATION -A process of interaction betweentwo professional persons the consultant, who is a

specialist, and the consultee, who invokes theconsultants help in regard to a current work problem withwhich he [or she] is having difficulty and which he [or she]

has decided is within the others area of specializedcompetence.Caplan, G. (1970) p.19


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Consultee-Centered

Case Consultation

2nd Opinion Model

Consultant functions as a specialist whoassesses the client, arrives at a diagnosis,

and makes recommendations concerning how

the consultee might modify his or her dealingwith the client.


Teacher, Parent, Medical, Clergy, Adult Child,Other Care-Giver

Target: Efforts are directed to the TargetClient (Client, Student, Child, Patient, Parent,

Other)


Consultation is concerned with difficulties aconsultee encounters with a particular

client for whom he or she has responsibility

the difficulties spring from shortcomings inthe consultees professional functioning.




to address Lack of Knowledge

Lack of Skill

Lack of Confidence

Lack of Objectivity(Theme Interference)

Client-Centered

Case Consultation


2nd Opinion Model

Consultant functions as a specialist who

assesses the client, arrives at a diagnosis,

and makes recommendations concerning how

the consultee might modify his or her dealingwith the client.

Consultee: Mental Health Professional,Teacher, Parent, Medical, Clergy, Adult Child,

Other Care-Giver

Target: Efforts are directed to the TargetClient (Client, Student, Child, Patient, Parent,

Other)

Client-Centered

Case Consultation

2nd Opinion Expert

Assessment of Target Client

Review of clinical data

Clinical Observation

Opinion given to primary care

professional and/or

Care given to Target Client


Consultee-Centered

Case Consultation


Consultation is concerned with difficulties aconsultee encounters with a particular

client for whom he or she has responsibility

the difficulties spring from shortcomings in

the consultees professional functioning.




to address

Lack of Knowledge Lack of Skill

Lack of Confidence

Lack of Objectivity(Theme Interference)

Supervision, Consultation or

Coaching

Focus on the efforts of the

primary care giver

Sometimes access to clinical

information (data, records, orobservation)

Opinion given to primary care

professional rarely is care

provided to the Target Client by

the consultant

Behavioral Consultation is

approach often utilized


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BehavioralConsultation

1. Accept the Consultee

Determine consultees state of mind deal with emotion

2. Define Collaborative Relationship

Describe collaborative approach that is basis of consultation

3. Invite Consultee to Describe the Issue / ProblemSolicit description of target client (physically, temperamentally, socially, intellectually, etc.)

Solicit specific description of troubling behavior

4. Invite Consultee to Describe Background / History of the ProblemWhen did the problem begin?How were things before the problem?

What was occurring in the system (family, classroom, workgroup, community) when theproblem began?

5. Past Attempts to Solve ProblemExactly, what did the Consultee do/say?Specifically, how did the Client react/respond?Exactly, what did the Consultee do/say in response?

6. Desired Solution/OutcomeWhat will things look like if this problem is fixed?

(This will help identify Target Outcome Behaviors)


7. Feedback Loop Check Communication

All along the way, summarize/feedback to ensure accuracy

8. Collaborative Definition of Problem & Target Behaviors

Together with the Consultee, agree on the definition of the problem and the target behaviors

9. Identify Possible Intervention

Identify additional data needed

Brainstorm possible strategies

Evaluate strategies

Decide on Intervention

10. Set Responsibi lities, Time Tables, Resources, Check Points

11. Support / Coach Consult ee During Implementation of InterventionIdentify external resources: books, tapes, videos, etc.

12. Evaluate Effectiveness of Intervention

Adjust as necessary

13. Terminate or Identify Additio nal Interventions


ClientCenteredCaseBehavioralConsultationMentalHealthProfessionals, Teachers,MedicalProfessionals,

Parents,AdultChildren,Clergy,OtherCareGivers

Identify the Problem

Collaboratively: Specify objectives to

be achieved

Describe: Problems in observableterms

Identify: Environmental factors thatmay influence student behavior

Establish: Procedure for data-collection

Treatment Evaluation

Determine: Were treatment goals weremet

Evaluate: Treatment plan effectiveness

Assess: Consultant effectiveness andconsultee satisfaction

Discuss: Continuation, modification ortermination

Discuss: Strategies for maintainingand/or generalizing progress

Schedule: Additional meetings orterminate

Problem Analysis

Obtain: Baseline data

Collaboratively: Define behaviorchange goals

Identify: Sequential reinforcing pattern

of behaviors

Design: Treatment strategies to

change sequential behaviors

Treatment Plan

Implement: Treatment plan/strategies

Continue: Data collection / observation

Monitor: Treatment integrity


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COACHING

Life Coach

Business CoachLeadership Coach

Management CoachParent CoachXXXXX Coach


Coaching isaprocessovertimeinwhichtheCoach,utilizingasetofhelpingvalues,knowledge and skills assiststheCoachee toidentifyand achievedesiredgoals.

Coachingisbasedonthebeliefthatgiventherightcircumstances,everypersoncan learn,grow,changeandexpandhis/her personaland/or performancecapabilities.

Broadlyconsidered,Coachingfocuseson:

Knowledge/SkillTransfer

PerformanceImprovementorPerformanceCorrection

CareerAdvancement

Personaland/orProfessionalGrowthandDevelopment

Personaland/orProfessionalTransformation


Professional Coaching is an ongoing professional relationship that

helps people produce extraordinary results in their lives, careers,

businesses or organizations. Through the process of coaching,

clients deepen their learning, improve their performance, and

enhance their quality of life. In each meeting, the client chooses the

focus of conversation, while the coach listens and contributes

observations and questions. This interaction creates clarity and

moves the client into action. Coaching accelerates the client's

progress by providing greater focus and awareness of choice.

Coaching concentrates on where clients are now and what they are

willing to do to get where they want to be in the future. ICF member

coaches recognize that results are a matter of the client's intentions,

choices and actions, supported by the coach's efforts and

application of the coaching process.

http://www.coachfederation.org/


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TheInternationalCoachFederationistheprofessionalassociationofpersonalandbusiness coachesthatseekstopreservetheintegrityofcoachingaroundtheglobe.

ICFhelpspeoplefindthecoachmostsuitablefortheirneeds.Itsupportsandfostersdevelopment ofthecoaching profession; hasprograms tomaintainandupgradethestandardsoftheprofession;conductsacertification programthatisthegoldstandardforcoachesworldwide; andconductstheworldspremier

conferenceandothereducational eventsforcoaches.

ICFisthelargestnonprofitprofessionalassociation worldwide ofpersonal andbusinesscoacheswithmorethan6000membersandover145chaptersin30countries. Weexistto...

Build,Support, andPreserve theIntegrityoftheCoachingProfession .

WehelptoBuildbyeducating andpromotingthecoaching profession.OurCoachReferralServiceandthePRplanareintegralpartsofthisprocess.

WeSupportbyfosteringthecommunityaspectamongmembers. Ourannualconferenceplusregularcommunications aswellasthelocalchapters areourprimarytoolsinthisregard.

ToPreservetheintegrityofthecoachingprofession,weareactivelyinvolvedinresearchinganddeveloping programs inthelegal,regulatory,andcredentialing areasthatwillservecoachesandtheirclients.

ItistheimmediategoaloftheICFtotakeourorganizationtothenextlevelandbecomeastrong(andunified)voiceforthecoachingprofessionandprovideeverincreasingvalueforitsmembers.

http://www.coachfederation.org/


Coaching Process & Competencies

SET A THE FOUNDATION Meeting Ethical Guidelines and Professional Standards

Establishing the Coaching Agreement

CO-CREATE THE RELATIONSHIP Establishing Trust and Intimacy with the Client

Coaching Presence

COMMUNICATE EFFECTIVELY Active Listening

Ask Powerful Questions

Direct Communication

FACILITATE LEARNING & BEHAVIORAL RESULTS Creating Awareness

Designing Actions

Planning and Goal Setting

Managing Progress and Accountability


ThePowerofCoaching

Coaching vs. Training vs. EducationAll forms of transmitting learning are important Coaching brings itall together.

EDUCATION focuses on acquiring information and concepts it is themost theoretical.

TRAINING builds on Education by providing simulated application of theinformation and concepts.

COACHING puts it all togetherinformation, concepts, and simulationare applied and supported in the real world, one-on-one with thelearner.

Results of Research: Thirty-one managers from a public sector municipal agency

underwent a conventional managerial training program. The training was thenfollowed by 8 weeks of one-on-one executive coaching.

Training Alone Productivity

22.4%

T ra in in g + Fo ll ow -u p C oa ch in g P ro du ct iv it y 8 8. 0%

Public

Personnel

Management,Winter,1997


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COACHING PSYCHOTHERAPY

Attain specific goals Relieve pain or symptoms

Create higher functioning Restore functioning and/or adjustment

Vision: How can I History: Why did I

Clients wants to move toward goals Patient wants to move away from pain

FOCUS

CONTEXTLearning Model Medical Model

ORIENTATION

RESPONSIBILITY

RELATIONSHIP

Outcome & Action Process and Feelings

Inner and Outer worlds Inner World

Coach responsible for Process Therapist responsible for Process

Client responsible for Outcome Therapist responsible for Outcome

Coach & Client Co-creators/Partners Therapist is Expert / Client is Patient

consultation class 04

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