Issues in mental health quizlet

The central thesis behind Bordin's Working Alliance Model is the importance of:

"Collaboration for change" between the consultant and consultee.

what happened 1970

"Mental Health Consultation Model" created by Gerald Caplan

Sally has agreed to come to train staff on Motivational Interviewing to assist with client engagement

(doesn't say for how long, when, what client engagement, how much is sally charging, how many people can sally train

Tutor evaluates student and identifies the student needs tutoring from them one hour each week for 6 weeks

(doesn't say that what the tutoring is for, how much, who is going to do the tutoring, what content is going to be cover, what the goal is for 6 weeks or after the 6 weeks

Contracts

(occurs at the beginning of the relationship) ± Contract negotiation is the communication between a consultant and consultee ± Contracts can be Viewed as a Verbal and/or written process ± Discuss and agree on clear purpose and content relationship including: ° Fee schedule ° Resources needed ° Purpose of consultation ° Expectations and timeline

Contract Discuss and agree on clear purpose and content relationship including

- Fee schedule ° Resources needed ° Purpose of consultation ° Expectations and timeline

· Tear- Repair Process

- Predictable element of any alliance - Opportunity for growth and development - A conflict that you work through that leads to a stronger bond. Ex) like fights in a relationships - This will happen. Conflict will occur

· Advertising

- Recommended that you are precise or surgical approach - Joining various professional organizations related to your specific area may have access to a list of members of organizations - Going to workshops you have access to a list of other participants in the conference - You were able to sell your image or brand and highlight your accomplishments your experiences and your education - *make a separate account on social media one just for clients and one for personal

Developmental Case Consultation

- assumes longitudinal view of behavior change

Working Alliance Model, · model comprised of three elements

- mutual agreement and understanding of consulting goals - mutual agreement on the task associated with reaching consulting goals ex) goal for drug use during this phase as a task could be providing education to help with treatment), helping them explore different coping mechanism - Create the emotional bond between the consultant and consultee · an example can be a disagreement on a behavior change goal causes a consult data explicitly no concerns about the viability of consultation. Such a response could also impact any or other elements of the alliance.

Networking

- networking is the probably the most unrecognized or underrated skill of this successful external consultant - Ten gatherings people that might serve as potential consultees or referral sources. Conferences or workshops that you are attended to are excellent sources of contact, present sessions and workshops at the same conference mentioned above not only do you provide a dress rehearsal for what you might be able to do for organization but you can make direct contact with somebody and attend those sessions, you can also offer pro bono workshops with your community and make connections with civic and community leaders, join multiple professional associations, follow up with any leads that you encounter - Ex) talking to people in your graduate program

· Fee Structure

- the process is referred to a console team mining. - A consultee base must be developed, established relationships with those individuals who pay for your time next line in the beginning you may not be able to ask for as much money as or higher fees as you would like - Few external consultants start making out larger fees. The more experience you gain in consultation the higher fees can be for any contract - A consultant must consider preparation time, logistical planning, assessing the organizational needs developing learning objectives, researching the content to present, designing the presentation and preparing and editing the technology and materials. - During the actual delivery of the workshop a consultant must consider time setting up, ranging food and beverages and cleaning up this can include additional debriefing time which includes analysis feedback writing report and meeting with the consulting to review report - Exam: Getting started in consultation work may require doing initial work for little or no remuneration in order to gain additional consultation work over time. This process is referred to as: Consultee mining - Factors 1. Project the amount of time for the service to be completed-a consultant should always overestimate time 2. estimate an hourly rate-consider how much you make an hour in a regular full time job and then align your consultation fee per hour accordingly 3. multiply that amount of time projected to complete the service by your estimated hourly rate

Identify two of the four possible traps consultants could fall in to during the initial stage of consultation: ______________________ and ____________________________.

1 promising too much at the beginning of the process and 2) failing to realize that your expertise is not in the specified need area of the consultee

Beginning steps in the consultation process

1. issue or the consultation is an issue that needs to be addressed 2 the consultee decides that a professional with expertise in examining and assisting resolution of issues related to specific settings is needed. This is also known as I think we needed a consultant. I think we need a consultant 3. the consultee seeks out an individual to serve as a consultant also known as let's find a consultant 4. the consultee and consultant enter into professional working relationship in order to address an issue

Ch 5 Proposed by John Bergan

1977- grounded in behavioral psychology positivistic message ± Grounded in behavioral psychology ° Operant conditioning-the rats ° Classical conditioning- Pavlov's dogs. ± Emphasizes scientific research, exploring current behaviors and the principles of behavior change ± Early versions relied on behavioral modification interventions: reinforcement, punishment and shaping ± Bandura's Social Learning challenged operant learning's position that environment alone shapes behavior ± Progression of behavior therapy has directly influenced behavioral consultation ± Social learning theory: ° Behavior is shaped primarily by observing models Cognition can influence behavior

- It has been reported that as much as __________________ of consulting activities consist of referrals or repeat business from consultees.)

75 %

Which of the following is not true regarding organizational responsibilities?

A consultant is always responsible for the implementation of an intervention

When applying the process facilitator role, the goal is

A loss of objectivity and an identification within the clients story

4. the consultee and consultant enter into professional working relationship in order to address an issue.

Also known as let's get to work, Lets get to work -consultant and hire works together that works together to establish goals, out line and payments, ( kinda like a treatment plan) · issues such as length of consultation, payment of consultation services, termination services and limitations and boundaries of consultation will be discussed unconfirmed at this point. Also remembered that the consultee does not have to accept or incorporate the recommendations of the consultant. The consultant is only there to provide the consultee with recommendations and assist the consultee as request · as you can see first and foremost issues in the consultation relationship are consulting specific in focus. As in traditional counseling the focus has shifted to client driven services and away from old pathological views of services

° A licensed counselor with significant experience in clinical and administrative supervision was hired as a mental health consultant to work with a counselor who is struggling to get the clinicians and mental health paraprofessionals under his supervision to be punctual and competent with their documentation of cases. The counselor is seeking a consult prior to implementing a new course of disciplinary actions he has designed. Together, the consultant and consultee clarify what is meant by "punctual" and "competent" case documentation, complete an analysis of current undesirable and desirable counselor behaviors, and construct a plan that involves rewarding timely and competent documentation by using learning principles (e.g., positive reinforcement and shaping) to help attain the desired behavioral goals of punctual and competent documentation. Following these steps, the consultee executes the plan and, when completed, assesses its effectiveness.

Behavioral Case Consultation Example

Historical Perspectives

Brings together knowledge skills of counseling with the ability to reach consultees in various settings

This book focuses on the current related standards for consultation as developed by

CACRAEP

Caplan early defintion of consulation

Can be viewed differently by different people can be used to describe any acitivity

Amy a group addictions counseling facilitator is struggling to get her client Sam to speak in the group counseling sessions. Participation is required if Sam continues to be silent in the group his therapy will have to be terminated and he will be put back on parole. Amy seeks the help of a consultant who is knowledgeable about addictions counseling for advice on how to reach the client before he's banned from the group this is an example of

Client-centered case consultation

Gerald Caplan Describe four types of mental health consultations.

Client-centered case consultation consultee centered case consultation program centered administration consultation Consultee centered administrative consultation

__skills are helpful when addressing administrators about their own maladaptive behaviors that have contributed to the issues of the organization.

Confrontation

Dougherty 2009 defintion of consultation

Consultation is a type of service performed by counselors' psychologists and human resource workers in which they assist another person who has responsibility for a case or program

What is consultation

Consultation is an interpersonal relationship and it's problem solving in the context of the relationship. It's basic a communication process utilizing specialized knowledge

· another example could be a business has suffered a major loss in sales and the manager is trying to save money and hires a consultant to do an inspection of management to see what positive changes can be made to attract more people to come to the business · in other words this type of consultation focuses on the consultees and works with the employees or a business to help the Business or employees become more productive and more positive at their jobs

Consultee centered administrative consultation

Getting started in consultation work may require doing initial work for little or no remuneration in order to gain additional consultation work over time. This process is referred to as

Consultee mining

Program centered administrative consultation involves the consultant entering the work setting in the role of the

Content Expert

Krupis and Farqua

Definition by professionals are similar in nature and can be based on different settings, goals of consultation and theoretical orientation

Client centered consultation is characterized by the consultant taking a(n)

Expert stance

Caplan believe that consultation relationships should be hierarchical

False

Consultation follows a linear progression and therefore always flows in one direction

False

The consultee can basically just view the consultant as a co-worker.

False

Who wrote the theory and practice of mental health consultation 1970 that specified that beginning standards of mental health consultation:

Gerald Caplan

What happened in 1950

National Institute of Mental Health recognized

This type of evaluation attempts to measure the difference between what services currently exist and a desired target state

Needs assessment

Many researchers have agreed upon core skills used in consultation. Which of the following is not one of the core skill

Negotiation skills

Internal consultation is also referred to as

Nonprofit consultation

Role formation and structuring one aspect

One aspect is the Relational aspect- of creating effective role parameters including findings that link positive working relationships with stronger consulting outcomes and poor communication as an impediment to progress. · Establishing clear role parameters in consultation is a essential- process that requires among other things attention to the central elements and dynamics of the working alliance model. · Research supports the link between positive relationships and outcomes this focus on the relational aspect · Poor communication can create a barrier. · Includes - Healthy consultant and consultee communication patterns - Mutual goal setting - Establishment and maintenance of a strong bond

Evaluation of the implementation of an intervention occurs in what stage

Outcome stage

What are the five stages of consultation?

Preliminary Stage,Exploration & Goal Setting Stage,Intervention & Implementation Stage,Outcomes Stage and termination stage

Role formation and structuring second aspect

Procedural aspect-Role structuring also involves a working or action oriented, dimension consistent with the procedural portion of the alliance model and again · involves the shared effort and agreement between consultant and consultee goal and task setting - Consultant may opt to use expert role to prevent issues of role ambiguity - enter into good faith agreement to design and implement and maintain clear roles - facilitate positive alliance · Knowledgeable of their respective position roles and goals (Both parties must) · Need to have Self-awareness to recognize individual beliefs or biases that could help or hinder the establishment of solid consulting role parameters (both parties) · EX) focusing on your own style, knowing the same approach does not work in the same scenario. · Example, the direct role in scenario case 2.2 limited attention is given to setting mutually agreed upon goals whereas in 2.1 suggests that the consultant consistently seeks to establish a shared interest in working together from the beginning Expert goal takes away the any ambiguity.

Guiding Principles of Behavioral Consultation

Scientific Perspective, Present-Centered Orientation, Behavior-Change Principles

When utilizing a collaborator role, how is decision making power distributed?

The consultant and the consultee share the power of making decisions.

the consultee decides that a professional with expertise in examining and assisting resolution of issues related to specific settings is needed

This is also known as I think we needed a consultant. I think we need a consultant - identifying that you don't have the resources to do it on your own · the consultee decides that change needs to happen and that having a fresh and knowledgeable perspective may enable this change to occur. This fresh perspective will require the assistance of someone with specific training and consultation

Gallessich 1982 defintion of consultation

Tripartite interactions in human service agencies. The consultant a specialized professional assist consultees who are agency employees who are also professionals with work related concerns as a third component

Client centered consultation is a form of consultation

True

The development of consultation and mental health settings is largely attributed to the views and writings of Gearld Caplan

True

All of the following are important in the preliminary stage except

assessing for suicidal risk

When should confidentiality be addressed as an element of a consultation relationship

beginning

Consultants take reasonable steps to ensure that they have the appropriate _______________ when providing consultation services.

competencies

Ex) Cameron is a director of a marketing company. She has the opportunity to earn a significant bonus. If the company can increase their clientele numbers by 7% she is struggling to get her employees to work harder and finds them complaining about her calling her a tyrant. A few workers have threatened to quit. So Carmen contacts as consultants to help her learn how to install positive motivation in her workers. Together they created a plan that has appealing incentive for everyone involved if the goal is met, all while making it easier to encourage our one to join her in putting in the extra effort. This is an example of

consultee centered case consultation

External consultants are frequently contracted to serve in a _____________ role

counseling role

In terminating services with a client, the consultant must be aware of any ______ behaviors.

dependent

Bordin views the alliance as a ___ relationship

dynamic

Organizations include all of the following except

households

Request for Proposals (RFP

important to address every element, directive and question specified in the same order. Need to be able to sell yourself, why they should go with you.

Susan, a middle school counselor, consults with a 7th grade math teacher at the school where she works regarding a behavioral issue one of the teacher's students is having. This type of consultation would be best described as

internal consultation

which of the following is not a source of difficulty for consulting according to consultee centered case consultation

lack of power

An effective consultant considers ________________ as a lens through which one seeks to understand both the content and the process of consultation

multicultural considerations)

Responsive

need to be responsive to the inquiries and needs of consultees (an unsuccessful consultant is one who doesn't react, answer or reply in any effective or timely manner. A good consultant is responsive to the inquiry that needs of the consultees. Be empathetic and attempt to be helpful ex) responding to email and phone calls on time.

Collegial

need to interact with others in a spirit of collaboration regardless of type of relationship and who initiated it. Ex) need to be respectful in a team meeting as if you are just meeting them, wanting to get along with everyone

what is part of marketing

networking, advertising and fee structure

what was the Mental Health Consultation Model" created by Gerald Caplan

o Worked in Israel with emotionally disturbed immigrant children o Shifted focus from an individual child to the relationship between child and instructor o Changed how all instructors worked with children, not just the challenging ones o Impacted thousands of lives instead of a few

The _________ stage is when the consultee begins the discussion with a possible consultant to determine their needs and also selects a consultant with the expertise to help.

preliminary

Fiscal Responsibilities: From the consultant

t Need to provide: ° Accurate estimate of fees ° Projection of any costs that may be incurred to implement interventions as part of consultation process ± Contract should include information about consultant fees, what other fees will be reimbursed and how they will be reimbursed ± Ex) finding out if you need to travel etc. for the consultation, who is going to pay begins at the initial stage

What are the two steps in the termination stage

the final evaluation and termination of the services.

What happened in 1965

the mental retardation facilities and community mental health centers construction act amendments-added funding for consultation

Caplan 1970 defintion of consultation

the process of interaction between two professional persons, the consultant who is a specialist and the consultee who invokes the consultants help in regard to a current work problem. with which he is having some difficulty and which he has decided is within the other areas of specialized competence

the consultee seeks out an individual to serve as a consultant also known as let's find a consultant

there continues to be a discussion on whether the consultant should be internal or external of the setting. The recommendation is to get the best person for the job. A professional consultant will be able to maintain objectivity throughout the process or will rescue herself or himself if needed

The consultant must aim to remain objective and neutral

true

An important initial question of consultation within an organization is

who is the actual client?

For-profit Consultation

working as a consultant with the expectation of receiving payment or other compensation.

Interviews(exploration and goal setting)

° Ability to quickly develop rapport leads to higher likelihood of successful interview ° Individual or group focus ° Face to face or survey format ° Ex) the benefit of using surveys is that they can be administered to a large group of individuals without the time and expense of interviewing each person individually or in groups. The con took using surveys is that you will lose the personal touch that comes from face to face discussions

Basic counseling skills are at the core of the foundational skills needed

° Active listening, rapport building, reflection, modeling, reframing ° These are important in consultation because a consultant has to help the client solve the problem. if you cant identify the problem accurately it can be a problem. (problem solving) ° Reframing and modeling are important: Reframing is important because to have the clients consulting understand from their perspective. Modeling: being able to model to your client like showing up on time it sets a standard. Rapport building is important: being able to gain someone's trusts.

Crunching the Data(exploration and goal)

° After data collection ° Combine and analyze the data collected ° Look for common themes and significant data points ° Determine conclusions ° Present on all information, do not leave anything out ° Formal presentations can have its advantages

Intervention (Intervention & Implementation Stage)

° After updated goals are set ° Create potential interventions to reach the goals ° Evidence-based: gone through extensive research to examine effectiveness ° Not using evidence-based interventions can put the consultant at risk ° Consider cost of intervention, Some interventions cost money ° Review all intervention options with consultee for feedback

Goal Setting (Exploration & Goal Setting Stage)

° Ask the question, Is this the correct goal? ° What happens if this is not the correct goal? ° Can we change the goal? ° Consultants and consultants must be very clear during the discussion about setting goals ° Goal revision may be needed after exploring the data ° Obtain agreement on the established goals and the role of each party

Implementation (Intervention & Implementation Stage)

° Based on Re-evaluation, recycling and reformation of interventions ° Consultant may not be involved in the implementation of the intervention ° Role may be to facilitate growth of consultee to take these steps independently ° Consultant may remain connected to consultee for additional feedback as needed ° Traditional counseling, the role of the consultant will be to help facilitate growth in the consultees that they can make changes for themselves without having to depend on the consultant for constant help.

other basic skills that are required

° Communication ° Ability to define a problem and solutions ° Collaborate with others - groups or individuals ° Collect and analyze data

Things to review (outcome stage)

° Effectiveness of the intervention ° Overall cost ° Time efficiency ° Support from administrators and staff to continue intervention

Foundational Skills :Essential skills to be proficient in Core Skills: broken down into

° Interpersonal skills-maintaining rapport. ° Communication skills ° Problem-solving skills ° Relationship building skills ° Multicultural counseling skills ° Group work skills Core Skills (good at building and developing relationships and are able to clearly communicate and define a problem while consulting)

Ways to review (outcome stage)

° Interviews ° Surveys ° Pre and Post tests

Formal Contract:± Remley (1993) provides a clear definition of the requirements for a consultation contract, and believes there are three elements necessary to form a legal and formal contract:

° Needs to be an Offer - the terms of a consultation arrangement are proposed ° Acceptance - the person to whom the offer was proposed agrees to the terms ° Consideration - something of value (usually money) is proffered in exchange for doing what is specified in the offer (terms)

Present-Centered Orientation

° Oriented toward present concerns and problems and is well0suited for delineating current and future desired behaviors

± 5 stage model:

° Problem identification, problem analysis, intervention, treatment evaluation and post-implementation planning

Final Evaluation ( termination stage)

° Process of ending services ° Should be discussed in the beginning of the relationship ° Consultant reviews how well the process went ° Examines strengths and weaknesses of the process to be implement in next assignment ° Where the overall goals of consultation achieve ° Was the consultant successful in creating an atmosphere that was conductive and supporting and motivating the consultee to participate in the consultation process ° There's a consultant maintain cost during the process ° The final evaluation is beneficial in providing the consulting in the consultant with information about whether the goals of consultation were really actually achieved

Be aware not to fall into these traps during the preliminary stage

° Promising too much at the beginning ° Failing to realize that your expertise is not in the specified need area ° Not recognizing the real problem ° Not being clear on the specific roles of the consultant by creating boundaries

Observation (exploration and goal)

° Review group and individual systems and routines ° Collect information to be used throughout the process

Scientific Perspective(Guiding Principles of Behavioral Consultation)

° Rooted in a vision of an operationalized methodology and reliance on an empirically rigorous evaluation of chosen and applied interventions

Preliminary Stage

° The consultee begins a discussion with potential consultants ° determination of need is identified, actual goal may be unknown ° In this stage a critical piece is the that the consultee based on individual organization may contact a consultant without even having a specific goal in mind for consultation ° Consultant it's chosen ° Consultant to gather as much information ° Consultant is to assist in identifying the goal

Behavior-Change Principles:

° Use of agree upon learning principles such as shaping, reinforcement, extinction, and modeling promote desired behavioral changes

Saying Good Bye (termination stage)

° When to terminate may be tricky ° Termination Involves acknowledgement of termination, reducing support, formal ending ° Date may be agreed upon by both parties ° Ending a relationships has the potential to increase anxiety ° Let the consultee know there will be opportunities for follow-ups needed ° Set up groundwork for future consultation services if needed ° The consulting should be made aware of the termination of consulting services during the initial discussion and contract negotiations ° There are two steps in this process one is with if the goals were met or two the process failed to reach the goals

Getting to know you (exploration and goal setting)

° Work collaboratively to develop specific goals-spends time on the site. ° Develop meaningful relationship ° Work through resistance and reluctance ° Remaining neutral and objective among staff and conflict ° Knowing local and state resources - community & network ° Remain up to date on changing policies ° One important factor that can assist in transition to consultant is having the administrators and executives support the consultation role you have taken on. You will need the help and assistance of all employees ° One advantage of serving as an internal consultant is that you will already have first hand knowledge of the organization its resources and staff ° Once all the formalities are out of the way the consultant can begin the exploration of the consultees needs and establish some working goals. ° One clear challenge for the consultant will be to maintain objectivity during the process. This is not chance for the consultant to get back at other coworkers are making changes that personally I always wanted to make in the organization. Remaining neutral objective will be harder for the internal consultant but as a critical piece a successful consultation experience

Keep a file

° an important step in exploration process and we tell our students constantly to develop working relationships with as many resources as possible. Remember try not to burn bridges with community resources because you never know when you will need their assistance

Example of goal setting ((establish a group counseling program at the center)

° determine the biggest need of the youth being served at the center ° Examine resources to meet this need like group room time and day of group and who will facilitate the group ° Discuss with the administration what resources are needed to create group counseling program ° Design are using existing group counseling curriculum and implement the group counseling program ° Design or use already established assessment to evaluate program ° Make any necessary changes to program ° Implement program on a regular basis

what will be the philosophical model

° education and training ° Clinical ° Mental health ° Behavioral ° Organizational

what will be the actual dynamics of the consultation

° process consultation ° Third party intervention ° Team building ° Survey feedback

what is a type of organizing receiving consultation

° school setting new line mental health setting ° Organizational setting ° Higher educational setting

Margaret R. Rogers (2000) Developed core competencies

°Understand one's own culture,Develop cross-cultural communication/interpersonal skills,Understand cultural embeddedness of consultation,Use qualitative methodology to gather data,Acquire culture-specific context knowledge Understand one's own culture-a consultant needs to examine his or her own heritage and identity like race ethnicity or culture and possesses a self-awareness of personal beliefs, prejudice and assumptions. A consultant should make attempts to learn about the culture and background of consultees and clients in order to better understand and possibly adopt other perspectives and values ° Develop cross-cultural communication/interpersonal skills-a consultant should be able to bridge different perspectives from different groups. ° Understand cultural embeddedness of consultation-consultant should be able to view the consultation process through a cultural lens. It is important to consider though culturally embedded organizational forces that may have an impact on the client ° Use qualitative methodology to gather data-the validity of some instruments and procedures may not be able to be projected or generalized to diverse groups. Consultants should be skilled in using naturalistic data gathering techniques that would account for local cultural and contacts ° Acquire culture-specific context knowledge-in order to provide context relevant services, a consultant should seek to acquire culture specific information related to the context. This might also include culture specific issues in assessment, education and mental health. Understanding different cultures when working with others and how that can impact them. Ex) eye contact in south Asian muslim culture, handshaking, food, holidays, gender roles

Process of Behavioral Consultation

± Behavioral case consultation and behavioral system consultation ± Retain four common principles: ° use of indirect service interventions, integration of learning principles(like behavioral technology), problem-solving focus and empirically vetted interventions ± Consultant uses experience to identify the most effective strategy ± Consultant is in the expert role to ensure the process goes smoothly

Consultation Relationship (important aspects)

± Bolstered by use of empathy, genuineness, and basic listening/attending skills ± Involves relational and procedural aspects ± (Your impact)Each has the potential to impact the dynamic as well as outcomes- The consulted and consulted dynamic is similar to the counselor client and supervisor and supervisee dynamic because they both involve relational and procedural and elements · Key insights can also be gained regarding personal characteristics, skills and behaviors that may impact specific elements of the alliance or the alliance as the whole · For example relationship will be replaced with alliance and process and procedure will be used to illustrate the working element of a consultant and consultee dynamic. Consultation literature also described collaboration as specific professional service

Cognitive-Behavioral Model

± CBT posits that cognition guides affective and behavioral responses to situation ± Recognition of behavior, environment, and cognition influences behavioral change ± Key CBT dimensions: human behavior is influenced by a multitude of variables, cognition comes before behavior, behavior is purposeful ± Collaborative relationship ± A-B-C model ± Grounded in the social, operant, and classical learning traditions ± Behavioral principles are used to increase acceptable behavior

An experienced school counselor was hired as a consultant by a school to work with a teacher who was at "wit's end" with a particular student's inattentive and distracting classroom behaviors. The teacher is seeking a consult with the consultant because he has been ineffective in gaining control of a particularly inattentive and disruptive student. Together, the consultant and consultee first work to define inattentive and disruptive. Next, they analyze the student's current undesirable and desirable classroom behaviors using functional analysis and create a plan that combines positive and negative reinforcement principles in order to facilitate desired behavioral goals of increased attentiveness and less disruptive behaviors. The teacher (consultee) then implements the plan and evaluates its effect when finished

± Case example questions: -what additional information would you want to have at the problem identification stage What counseling skills could you call Ponce enhance your ability to clarify the main problems How might this additional or new information influence problem analysis, interventions and evaluation How would you deal with the console see who insist that you remain part of carrying out the plan? What could this suggest about the consultee About the consultation alliance and the consultants initial role in the process

Multicultural Considerations ( from consulatation stages)

± Each stage will require the consultant to be aware of the consultee's diversity and what it means to each person ± Progressing through the stages will require ongoing dialogue and how multicultural issues can play a role in aspects of the journey ± Need to increase awareness of how the changes will affect all of the employees

Behavioral Consultation

± Established on several common denominators: ° Indirect service delivery methods ° Grounding in behavior technology principles ° Blending of strength-based, problem-solving interventions ° Change involves multiple contexts and settings

Post-Implementation Planning

± Fifth/final stage ± Involves the consultant and consultee working together to design a plan that will present the reappearance of problem behaviors ± Continuing the current plan, using an alternate plan, ending the plan ± Prevent the reappearance of problem behaviors.

External consultation is ____

± Formal in nature ± Involves written contract, goals and report out ± Expectation of receiving payment ± Less frequent ± Focus on identifying aspects of a system's functioning that hinders goal accomplishment ± May not or maybe already employed in another capacity and expects to receive compensation for their consultation efforts ± Example might be a counselor who self-employed and in private practice ± Ex) trainer tik tok coaches, someone who goes to see a coach but doesn't change their diet.

Treatment Evaluation

± Fourth stage ± Intended to assess consulting outcomes and to determine what, if any, additional steps may be needed ± Evaluating goal attainment = assessing the degree to which changes in current behaviors are made.

Conjoint Behavioral Consultation

± Increasingly popular in school settings ± Unites parents and teachers in consultee role - beneficial for identifying and addressing barriers of home, school and community on the child ± Shared effort, mutual respect and cultural competence ± Aim to optimize outcomes for both parents and teachers ± Adoption of ecological systems paradigm ° Gather data from parents/teachers about a child's home, school, and community that could impact the classroom

Problem Identification

± Initial state ± Consultant-led interviews seek to highlight differences between present and desired client behavior ± Inaccurate problem identification could lead to ineffectual interventions

Multicultural Considerations

± Insensitivity to multicultural considerations can diminish consultation alliance ± CBC model is effective with client populations who tend to link thoughts, feelings and behaviors and value personal responsibility for their behaviors and groups that are oriented toward action, planning, and the future ± CBC model grounded in Eurocentric principles ± Identifying cultural value systems is done collaboratively

Formal Contract

± Not required to be in writing, but it is best practice ± Federal and state statutes may require certain contracts be in writing ± It is in your best interest to have a written contract and to review with a lawyer ± The more complete the communication and understanding between parties the better the chances for a successful relationship ± A consultation contract should attempt to match consultees perceptions and expectations with consultant interventions. This can include clarifying specific consultation work to be done, described in detail any work products expected from the consultant, specified time frame from the completion of the work, specify to whom the consultant should report and describe compensation or fees and method of payment. This can also include contract writers should number all pages count print the names of all people involved and each person sign and date the document, initial any changes could be written or typed to the original document initialed by everyone and provide at least two copies to be signed so that each person can retain an original

The most important feature to a consulation relationship is

± Relationship is a critical feature

Problem Analysis

± Second stage ± Involves collaboration between the consultant and consultee aimed at uncovering conditions that sustain problematic client behavior ± Understanding the problem (direct effort) ± Two tasks: problem analysis and devising a plan

Organizational Responsibilities

± Should be made clear at the beginning of the consultation relationship ± Consultant is responsible for assisting the consultee to clarify the problem and developing standards (goals) ± Standards serve as a guide for implementation of intervention ± Should be concrete, realistic and achievable by the people involved

Behavioral System Consultation

± Targets an entire social system ± Behavior ecology assumes the existence of an interrelated ecological environment ± Ecological systems theory explores the multiple layers of interconnected systems ± At the center is an individual surrounded by: ° Microsystems - immediate environment such as family or classroom ° Mesosystem - interrelation of multiple systems ° Exosystems - does not involve the individual as an active participant but does impact the individual Macrosystem - systems at the cultural level

Multicultural Considerations (necessary skills)

± The structure of Consultation should be nonhierarchical which is an open triad ± Culturally responsive and empowering (the process of consulting) ± Need to understand impact culture can have on consultation( can be gender, race, ethnicity, identity) ° Ineffective communication ° Misdiagnosis of problems- ° Inappropriate assessments being used- looking at what type of assessments are being given and how if it is effecting them or how it is not helping. ± Awareness and assessment of personal bias ± Consider culture as one lens to understand content and process of consultation ± Consultants need to have a basic understanding of racism, resistance, multicultural assessment, racial identity development, multicultural family counseling, social advocacy, development of partnerships and cross cultural interpersonal interactions ± Consultants should also understand their own culture and be able to attend to their own cultural biases

Intervention

± Third stage ± Designed to capitalize on consultee assets, involves discussions with the consultee on how best to implement the suggested techniques, educate clients on selected learning principles, or both

Behavioral System Consultation part 2

± Values collaboration but consultees have the final decision-making authority ± Consultant to identify the system's structure and process ± Assess gathered information and identify specific interventions needed within the system to address the barriers ± Evaluate outcome of the interventions to identify if the intervention had the desired impact

Problem-Centered Case Consultation -

± focuses on current behavior ± Essential feature = focus on direct provision of behaviorally-based services to consultees so they may effect positive behavioral change with clients

When would you develop a consultation/relationship,...If you are consultant going into a situation at what point would you develop the relationship

· As soon as you start to reach out (starts in the beginning)

trainer educator role

· Can be formal and informal · Content knowledge and skill set · the trainer educator role includes formal and informal dimensions, although divergent views remain as to whether the prearranged nature or formal training like seminars are legitimate consulting roles. · It is consistent that counselors will likely have considerable exposure to consultants using the train or educational role given the need to gain the continuing education credits necessary to retain professional licensure · An example of first is the formal setting of a seminar is a common mode of consultant interaction · Another example can be the seminar lines of both the trainer and educator role · Used when you are trying to get your continuing education credits. · Internal role- someone who works at an agency and is to help MHC.

Working alliance: creating clear roles

· Collaboration as a core element in the alliance · Acknowledgement of potential for conflict · Recognition of impact conflict has on role development · Recognition of the importance of shared goals and task setting (work together and have to be on the same page) · Mutual agreement on consultation tasks and goals of consultation and what that has on role development. Creating, Establishment and maintenance of a strong consultant and consultee bond based on the establishment of egalitarian and nonhierarchical relationship throughout the relationships

counseling and therapy similarities

· Collaborative and egalitatian orientation, from Bordin and caplan · non evaluative and non hierarchical · Generally optional · Quality alliances core consideration which includes relational and interpersonal and procedural working dimensions

consultation similarities

· Collaborative and egalitatian orientation, from Bordin and caplan · non evaluative and non hierarchical · Generally optional · core goal is to facilitate a more effective professional from Bernard and Goodyear -Quality alliances core consideration which includes relational and interpersonal and procedural example working dimensions

External Consultant

· Consultant is not part of the organization in which they are asked to consult · more be more objective · reduced influence by agency politics or staff and less prone to internalizing or being swayed by negative or organizational dynamics but may experience more constraints on their activities or access organization interpersonal and structural dynamics · less access to data information · Lack of understanding of nuances or culture of agency

other advantages of mental health consultation from the book

· Consultants can work with teachers, police officers nurses organization managers and other frontline individuals who then go and work was an even larger number of clients on daily basis · There's also the growing field of coaching and executive coaching · these could be in settings like businesses, government agencies schools, mental health agencies and hospitals · If you are using this text in your graduate training then your program is cognizant of the necessity for mental health professionals to have training in the consultation skills · consultation can be a buyable service and insurance companies desire for a speedy solution

Borden's 1979 Working Alliance Model

· Empirically supported (research and published) · Requires active consideration of both theories · grounded in psychodynamic tradition · holds wide support among counseling and allied mental health discrepancies · The importance of the working model is : "a collaboration for change must exist between consultant and consultee" The model operates from the stance that a collaborator should for change must exist between the consultant and the consultee · The collaborative aspect or shared effort is also essential feature of consultation relationships

Advocate role

· Facilitate individual, organizational and or system change (working individually or with an agency) · the role of advocate is well known to counselors and involves working individually or in tandem with clients to address their personal social needs through specialized services · Examples can be a broad range of community-based efforts geared toward policy change that would benefit the social or educational needs and development of clients · consultants may utilize this role by advocating for the acquisition of needed resources, increased or initiation of preventative health programs or by aiding others in their attempts to develop more effective decision making within a organization or community. · are known to use their influence and change within an organization or individual · ex) the opioid settlement from Purdue with in Nassau and Suffolk County , work competences roles that have been created. · Also allied with social justice (ofc) · eX) advocating for someone who needs someone for language needs.

process specialist role

· Goal: address how specific process influences or impacts present behavior · back seat kind of role. · Ex) if you are brought in as a consultation because the clinical team is not getting along, you watch the meeting and observe and then you would give feedback · Example, you are counseling intern at a school or mental health agency attending your first formal staff meeting period prior to the meeting the clinical supervisor or principal introduced JP as a consultant hired to help individual employees in the organization as a whole function more efficiently. To your surprise you note considerable discord among certain staff members on at least two occasions and staff members use humor and derogatory terms when describing certain clients or students · example a consultant using the process observer role may help facilitate the groups discussion on staff discord or the current use of humor at the workplace, provide feedback on the quality of staff communication patterns or when appropriate model or suggest effective problem resolution strategies for resolving staff discord and clarifying acceptable uses of humor with clients and in the workplace · the process facilitator what does SIM or active role in helping the administrator process the meeting agenda items such as asking the staff specific questions about their reactions to discord between their peers and the use of humor and their perceptions of how it impacted the meeting

Advantage of mental health consultation

· Growing need for mental health services · Dwindling resources · Option to reach higher number of clients while managing the costs. · Trained professionals in crisis management · provide resources and referrals to existing programs · Developing effective programs in the organization and community · Can be short term and flexible · Can assist PCP with mental health awareness to recognize and refer to mental health · Look at being a case manager from the administrative perspective · Working with the community 988 (mental health hotline)

Mulitcultural conisderations

· Important for counselors and consultants to be aware of · Culture of the staff, clients and overall community they serve to be considered · Always changing · Not one size fits all · continue to educate yourself about the recent cultural trends and impact on treatment, programming staffing and outcomes · EU S Census Bureau in 2012 reports that the next 50 years will be turning point in racial makeup with no one group holding an overall majority of other groups

Nonprofit Consultation

· Internal consultation · Most common type of consultation · Does not expect to receive compensation (do not receive revenues or profits, reinvested surplus revenues or profits back into the self-preservation of the organizations) · More informal · Counselors make seek internal consultation to deepen knowledge and skills to better serve clients · Nonprofit consultation is a more common occurrence between two people within the same organization for example two counselors are employed by the same organization. One council seeks consultation from the other regarding a particular client who's proving to be a difficult client Ex) Saltzman the DBT group that meets all the interns present updates about the clients and you all listen and give feedback and bounce ideas of each other.

working alliance task

· Is it a realistic connection between the tasks and overall consulting goals · Has to have a clear connection · Example if a consultees goal is to increase their documentation skills tasks must be dedicated primarily to improving the stated goal. · Ex) if I say the agency should go in one direction but the agency thinks something different there can be a tear. · In other words consulting outcomes hinge largely on the mutually set goals and tasks and degree to which the task and degree to which the tasks facilitate goal accomplishments

Working Alliance Model

· Model is dynamic and pan theoretical (spans of different theories)

Personal Skills

· Ongoing need to self-reflect, adapt and change · Professionalism · Being comfortable and uncomfortable situations · Able to handle oneself · Time management or task follow up · Identify when you need help and when to say no · Think outside the box

Effectiveness of consultation

· Only has been around for a short period of time. · Growing body of research into effectiveness of consultation is starting to grow · Providing promising results indicating strength and effectiveness of consultation · Reddy at al. (2000) conducted a meta-analysis of child and adolescent consultations from 1986 to 1997, showed positive effects on clients and consultees · Gibson and Chard (1994) reviewed 1,643 consultation outcomes, showed moderate overall effect · the effectiveness of consultation continues to provide promising results indicating the strength and usability of consultation · Executive coaching as an effective treatment modality that falls within the consultation framework

Commnalites are....

· Professional - need to treat all interactions with consultees in professional way, women coming into a private organization figuring why people are leaving · Responsive - need to be responsive to the inquiries and needs of consultees (an unsuccessful consultant is one who doesn't react, answer or reply in any effective or timely manner. A good consultant is responsive to the inquiry that needs of the consultees. Be empathetic and attempt to be helpful ex) responding to email and phone calls on time. · Collegial - need to interact with others in a spirit of collaboration regardless of type of relationship and who initiated it. Ex) need to be respectful in a team meeting as if you are just meeting them, wanting to get along with everyone.

Cook and Buccino 1979 Definitions of consultation

· Someone who gives professional advice or services regarding matters in the fields of personal special knowledge when asked do so by an agency or regarding matters in the field of a specific knowledge.

Technology

· Use of technology to remain in contact with consultee- identify what your best way to stay in contact. · Social media · Presentation of information · Document and information storage- how are you displaying the information · Sharing information · Data collection · Ethics-is it HIPPA compliant

1. issue or the consultation is an issue that needs to be addressed

· We don't like to use the term problem due to the inherent nature of the term and the issue may be one of the increasing the effectiveness or reach of an already successful program

Proposal

· Writing and communication are essential skills Request for Proposals (RFP) - important to address every element, directive and question specified in the same order. Need to be able to sell yourself, why they should go with you. Document should be in the specified format, no spelling errors, typos, grammatical errors. Upload to the right place, if it's a pdf with the proper lines or characters etc. Should be clear and concise Goal is to identify why you and your idea is the best one to choose/why it meets their needs The information describes and defines your ise: your compliments within your expertise area or subject, your education, previous experiences, length of time you've been a consultant, other groups you have worked for disclose only with their consent, your work on similar projects with similar organizations and the results of those activities, projected fees with as many details as you can provide only tentative until you have a contract in place, what you would offer that you believe would be particularly helpful to them

program centered administration consultation

· assist with program development ex) setting up a new grant with an agency. Making sure your program is effective · in program centered consultation the consultant helps a program administration in the program development · the consultant could also assist in making changes to an already existing program to enhance the effectiveness of the program · caplan Suggest that the consultant could provide long and short term options that the administration could use to address the needs of the program · example a program that is set up at a school that is already in effect but are seeing attendance numbers dwindle and if they don't get help the program could be cut · or anything that is already set up a program that's already set up and is struggling and needs help to keep it going · Program centered administrative consultation involves the consultant entering the work setting in the role of the content expert

counseling and therapy distinctions

· consider affective, cognitive behavioral dimensions that could hinder positive client outcomes · Generally framed as including more than one professional interaction · Involves an inheritance therapeutic component

supervision distinctions

· considered affective, cognitive behavioral dimensions that could hinder professional effectiveness and positive supervisee client outcomes · Can include a short term therapeutic focus directed at supervisors growth and development as a clinician · Requires longitudinal interactions with more experienced professionals · Inherently hierarchy and evaluated administrative authority often involved

Supervision similarities

· considered behavioral dimensions · Core goal is to facilitate a more effective professional · Quality alliance its core consideration, includes relational and interpersonal and procedural working dimensions

consultee centered case consultation

· facilitate growth in consultee ex) communication with employees. · The consultee actually facilitates growth in the consultee to learn and use new skills so the consultee can improve personal work with specific group of clients. · Caplan states the aim of this type of consultation is frankly to educate the consultee · Example can be a manager at a local company wants to learn to improve personal communication skills to be a more effective manager when dealing with employees need during the work day · A director of a company is given an opportunity to earn a major bonus if the company clientele hits a certain number. In other words this means a person individually has an opportunity to earn something but struggles with getting employees to work, this can include helping the consultant help them learn how to instill positive motivation and put in extra effort in order to achieve a goal · This type of consultation focuses on a specific individual within an organization that can help others. In other words the consultant focuses on the consultee · :

Fact-finder role

· goal is to gaining information and data collection and analysis · use the consulting knowledge information, analyze and get feedback · factfinding is a common role with the predictable goal of gaining information · Counselor consultants routinely draw from their counseling knowledge and skills given the need for gathering information analyzing information and then providing feedback to the consultee · Data collection methods include formal consultee organizational records, formal interviews, consultee observations and survey and questionnaires · Example is a consultant interested in understanding a consultees clinical caseload may seek current clinical records at the consultees agency while consultants interested in how the consulting experiences interactions with clients may choose to conduct interviews · Counseling role that would be similar is active listening

Consultee centered administrative consultation

· help agency leaders with issues of working together ex) communication, leadership, group dynamics · the consultant works directly with the consultees to help them with their issues of working together to make the organization successful. · Many organizations will have leaders that struggle to come together for the good of the organization resulting in lowered organization effectiveness like lower earnings, loss of positive public perception, inability to meet the demands of the consumer. · The consultant will work with the consultee on their communication with others and improving leadership characteristics and overall group dynamics · A consultant could be the consultation triage in selecting what type of consultation may be needed in working with the consultee person or group · Example employees at a jobs are struggling to meet the requirements of their daily job routines and consultants are contacted in order to change group production and can lead to the employees showing frustration and give them a chance to express it about what their new leadership and provide strategy to develop input for the workers and the manager that can change and lead to results of positive motivation, efficient self-monitoring cross checking and quicker results is there a request to work with a group on strengthening the group as a whole= consultee centered administrative consultation.

Client-centered case consultation

· identify how a client can be helped ex) outbursts in group home · the goal of consultation is to provide services to specific client · The primary goal of consultation is for the consultant to communicate to the consultee how this client can be helped · An example could be when a group home staff member request help from the agency counselor in dealing with the clients anger outburst at a group home or that participation is required and the specific member of a group is silent and they need to get the person back on track · Client centered consultation is characterized by the consultant taking an expert stance

Role Selection

· in the initial phase of consultation (part of the initial consultation) · Need to be Professional competent and flexible, this is crucial given the cultural environmental and ethical variables that influence outcomes · and is generally addressed as part of consultation contract · Consultant To consider - Their ability and frame of reference( want to know where your skill set is, boundaries) - The model being used - Nature of the problem - What are the Consultee characteristics (what are the expectations in working with you, what is their coping methods with dealing with deadlines, how they react) - If asked about variables these are all of the above · Example can be in a consultant who lacks cultural sensitivity and awareness could get lost in their expert role and not consider how different individuals or systems may interpret and respond to this or any other role · Engage in self-reflection and want to think about the ethical role and making sure you are working within what you practice.

Consultation triage

· is there a request for helping with one person dealing with a client= client centered consultation · if there is a request to help someone learn tools and techniques at work with a group of people on a common issue= consultee centered consultation · is there a request to work with a group on program development= program centered administrative consultation · is there a request to work with a group on strengthening the group as a whole= consultee centered administrative consultation

expert role

· knowledge and skill set to identify and solve problems · comes in as an expert on a certain topic · gives the power and authority · the expert role is the most frequently utilized consulting role · The only consultant that is given appropriate training and competency's given the authority explicit and implicit that often accompanies the expert roll · Example can be consultees who seek out experts are assuming that a consultant has the knowledge base and skill sets to accurately discern and address their problems or concerns · Ex) external role: consultant brought in to fix the data stream. They know how to solve the problem ( they are experts)

Professional

· need to treat all interactions with consultees in professional way, women coming into a private organization figuring why people are leaving

Internal consultant

· one who is a member of the organization in which they are asked to consult · Deeper understandings of agencies culture and nuances · Better access to data · Potential to be influenced by agencies dynamic, staff or hierarchy · less objective · someone who works for an agency but doesn't necessary work in the department that they are consulting for. · People are you know already so its less scary · But can be more complex but don't want to piss people off so its less objective

consultation distinctions

· primary focus is behavioral change · Can be one time event · Non evaluative · no administrative authority involved that is from Caplan

collaborator role

· share their expertise and work with consultee to codesign the solution(the out come that they want to hit) · distinguishing collaboration and the role of the collaborator in consultation remains elusive and can be confusing · Example the role of a collaborator for a consultant is distinct from the service of collaboration. · Consultation can involve persuasion, decision making with consultation is very often thought as a shared venture between participants · A collaborator role can parallel the expert role such as when a consultant relies on a consultee to affirm or adapt the experts suggestions when both have deemed to inappropriate in other words the collaborator role can fall on a directive or nondirective continuum · What needs to be consistent is that the collaborator role offers consultants and opportunity to share their expertise in a manner that delicious and then honors the consultees experiences knowledge and needs to cosign a mean for accomplishing a specific goal

Working alliance goals

· shared responsibility of key tasks such as task and goal creation presents opportunities to address the positive and negative aspects of the alliance in order to strengthen the relational and procedural dimensions of the consultant and consultee alliance and by extension and optimizing consulting outcomes · designing clear realistic tasks and goals that address the cognitive affective and behavioral domains of a client or organization should be a shared effort between the consultant and consultant. (depending on the type of consultation you are doing) · in doing that you will work through the positive and negative parts of the relationship and doing that will strengthen the relationships and the bond.

What is CACRAEP ?

· the council for accreditation of counseling related educational programs was founded in 1981 to serve as a national accrediting organization for counselors and related educational programs

working alliance bond

· the nucleus of the alliance, the bond is compromised of the mutual liking, caring and trust · occurs within the alliance over the course of their work together (from the beginning to the end of the relationships) · Stronger alliance can lead to reduced impact of conflict and facilitate more positive outcomes. · Ex) having a crappy car and needed to get a tire and new rotary vs having a new car and getting a bubble and being able to fix. The way you react is different and that can effect the consultation · With weaker bonds- is the opposite effect compared then a stronger alliance.

Early 13th Century

·consult" for medical patients

Caplan Erich lindermann

·to help survivors of 1942 the coconut grove- the fire in boston that lead to a lot of people to suffer from PTSD