Consultation Exercise
Jaia3926
Consultation1.pptxConsultation
CHD 6513 Mental Health Administration, Supervision and Consultation
Consultation Defined
What is Consultation? What is not?
What are the various ways consultation can be used in the field of Mental Health?
Consultation Defined
Consultation is a process of interaction between two professionals in which one professional (the consultee) seeks the help of a specialist in a particular area (the consultant) with regards to a current work problem which the consultee has decided is within the consultant’s area of specialized competence (Caplan, 1970).
A movement from a didactic model (client and clinician) to a triadic model relationship, focused on a helping relationship that is developed based on the needs of the client.
Primary Levels of Consultation
Primary Is the Proactive Interventions aimed an enhancing mental health
Ex. Individuals-coping skills, Family education, Community tasks force
Secondary –Identifying and treating problems for at risk populations before they can develop into more serious issues for an individual (remediation programs), group (Mentoring or tutoring), or community (programs for housing or safety.
Tertiary- Treatment and Rehabilitation efforts to reduce
the impact of debilitating mental health problems.
Individuals (Counseling, rehab), Family/Groups (Counseling, Mediation),
Community (Child abuse,
Substance abuse,
HIV/AIDS awareness)
Mental health consultation is complex and has many levels
Models and Levels
Consultation
Gerald Caplan’s Consultation Model
Caplan’s Model is well known due to its ability to be utilized in a variety of settings Mental health, medical facilities, community organizations, and psychology in school settings. His ability to provide a flexible outline for consultation was also influenced by his models main 4 points.
1. Focus on preventing mental illness and promoting mental health
2. Coordinate, nonhierarchical relationship orientation between consultant and consultee
3. Clear delineation of four major types of consultation (Client-centered, consultee-centered, program-centered administration, and consultee-centered administration).
4. Placed focus on individual and environment to promote change
Caplan’s Model of Consultation
Client-Centered Case Consultation
Goal: To provide services to a specific client.
“the primary goal of the consultation is for the consultant to communicate to the consultee how the client can be helped” Caplan.
Consultant considered an Expert
Functions as a specialist who may diagnose or assess a client to provide recommendations for improving concerns or treatment
Consultee: Mental health professional, teacher, medical professional, parent, adult child
Target: Efforts are directed to the “Case”
client, student, child, parent, employee, etc.
Consultee-Centered Case Consultation
Goal: To educate the consultee
May need to work on improving skills, confidence, objectivity, and/or knowledge
The consultation focus is on the consultee’s need to be more effective with a client or group of clients.
Consultee: Mental health professional, teacher, medical professional, parent, adult child
Target: Efforts directed to the consultee
Lack of knowledge, skill, confidence, objectivity
Program-Centered Administrative Consultation
Goal: To study an area of improvement and provide recommendations.
Examples could be assisting in making changes to already existing programs, enhancing effectiveness of programs, providing long or short-term options that administration could use to address needs of a program.
Consultee: Administrator, supervisor, team leader, mental health professional, etc.
Target: Efforts are directed to the administrative functioning of an organization in program development.
Community, mental health facility, treatment program
Consultee-Centered Administrative Consultation
Goal: To improve one or more administrative members of a professional team/staff
The consultant works directly with the consultee to help them with their issues of working together to make the organization successful.
Improve skills such as leadership, competency, and administrative skills.
Take an active role in identifying organizational problems and recommending ways to address problems
Consultee: Senior leadership/organization
Target: Efforts are directed at improving organizational functioning through leadership and competence improvements
Organizational Culture Model
Consultation in an organizational setting
Provides organizations of deficits and needs in areas of training, efficiency, employee needs and issues, and diversity
Principles are complex and intertwined in that the first goal is to help humans grow and develop in their work setting, while also providing assessments on ideas to increase efficiency
Theories of Consultation
Developing a map of consultation
Learning Theory
Defines consultation as a triadic helping relationship involving a consultant, consultee, and client.
Role is not only to identify the behavior and discrepancies of the client, but also to identify the discrepancies that exist in the consultee’s skills level, knowledge, and resources needed to address the problem
Covers behavioral, cognitive-behavioral and social learning theories
Learning Theories
Learning Oriented – Focuses on helping the client indirectly through building problem solving skills.
Behavioral approach- Focuses on operationalizing the problem through observation, charting, and reviewing records in order to implement a strategy that will decrease the action.
CBT approach- Focuses on the thoughts, opinions, and interpretations of the lived experiences of the consultee and consultant
Adlerian- Focuses on the meaning we give to the events rather than the events themselves.
RET and Alderian both believe that the more ingrained erroneous beliefs are the more demanding we are of others
Social Learning theorist- Focuses on viewing the problems as a combination of behavioral, interpersonal, and environmental factors.
Gestalt Theory
Recognizes that every interaction overlaps with others and that the first step is to identify this impact within the fact that consultation was received
This will then need to be processed with the consultee
As a consultant, the focus is on the ability to bring up ideas, individual, or themes not yet identified.
This will allow more awareness of the cycles of experience and increased awareness for the consultee
Process the fear of change to embrace and work with consultee works with client to decrease resistance and develop a strategy for change
Psychoanalytic Theory
As a consultant, focus is on searching for hidden underlying meanings and experiences and human behavior
Identifies way in which a client on consultee will deflect the need for change
This is often due to the clients fear that change will be catastrophic
This type of consultation is direct and works directly with the client and consultee
Chaos Theory
Nature is highly complex, and the only prediction you can make is that she is unpredictable.
The amazing unpredictability of nature is what Chaos Theory looks at. Why? Because instead of being boring and translucent, nature is marvelous and mysterious.
As a consultant, the focus is on making sure even a seemingly minute factor are explored, which can actually have a major impact, for example the butterfly effect
Therefore, we must first understand the chaos, then explore the patterns, with the ideal that a small action can cause much positive or negative change
Systems Theory
Identifies that there are problems in more that one system
Explore the problem as the best solution
Believes that resistance is actually a maladaptive way to change
As a consultant, the focus is on identifying other alternative adaptive solutions
Ethics, Issues, and Guidelines
ACA codes, barries, and helpful questions
Ethical Codes
D.2. Provision of Consultation Services
D.2.a. Consultant Competency Counselors take reasonable steps to ensure that they have the appropriate resources and competencies when providing consultation services. Counselors provide appropriate referral resources when requested or needed.
D.2.b. Informed Consent in Formal Consultation When providing formal consultation services, counselors have an obligation to review, in writing and verbally, the rights and responsibilities of both counselors and consultees. Counselors use clear and understandable language to inform all parties involved about the purpose of the services to be provided, relevant costs, potential risks and benefits, and the limits of confidentiality
Issues and Barriers
The nature of consultation itself it causes a triadic relationship
In most consultation relationships the primary relationship is between the consultant and the consultee
If there is a need the consultant may directly interact with the client. This could be done in observation, evaluation, defining an issue, obtaining more information about the case, or may directly provide interventions to the client.
Guide: Preparing for the Consult
Client/guardian has signed a release
You have processed the reason for the consult, what you need, and the amount of information needed to release
Develop a list of information or questions that you need to discuss
Explore the guide on the next slide to process the many ways in which you may seek consultation and how it can be different.
Guide: Helpful Questions
What are the needs of the client?-You have a client that you are wanting to discuss, be seen, or be assessed?
Who is the client? - What information can you provide about the client to provide the consultant a factual, holistic view. (this is only the clients story, not your issues with working with the client)
History- How long has this been going on? What is most recent events? Are there any traumatic or critical events in the clients story?
NOW- How is current behavior? Is there times during the day, or at places it is better or worse? Are there identifiable triggers? What happens when an event or something triggers distress?
Analysis- What are you perceptions and theory of the concerns? What do you see? Describe the picture of what this looks like? How does the client interact and respond to you?
Why are you seeking consultation now? What fears do you have if nothing changes?
What are your expectations or needs from the consult?
References
Brack, G,. Jones, E.S., Smith, R.M., White, J., & Brack C. J. (1993). A primer on consultation theory: building a flexible worldview. Journal of Counseling & Development, 71,619-628.
Caplan, G., Caplan, R. B., & Erchul, W. P. (1994). Caplanian mental health consultation: historical background and current status. Consulting Psychology Journal, 26(4), 1-10.
Werner, J.l., & Tyler, J.M. (1993). Community Mental Health Centers’ Origins. Journal of Counseling & Development, 71, 689- 692.
