7 Chapter 7: Counselling and Consultation Skills

Krista Cameron; Madeline Fisher; and Conor Barker

As discussed in previous chapters, many responsibilities contribute to an effective school psychologist. However, their role in consultation and counselling has yet to be discussed in depth. In this chapter, consultation and counselling within the discipline of school psychology in Canada is defined. We discuss the different types of talk that have emerged throughout history, as well as the process in which many school psychologists engage when consulting. The role of a school counsellor is also addressed, including essential practices such as collaboration and confidentiality. These practices are further demonstrated as we examine the relationships between school psychologists and teachers, principals, parents, and students. These personnel help provide the most effective care for students and play a role in the implementation of treatments 

School psychologists use counselling therapies to help support students’ mental health. Therapies such as Cognitive Behaviour Therapy, Solution Focused Brief Therapy, Motivational Interviewing, Family Systems, and Reality Therapy/Choice Theory are defined in this chapter with direct connections to their use in school psychology. The last section of this chapter includes an overview of the barriers that occur when engaging in multicultural consultation and counselling. The strategies school psychologists use to overcome these challenges are also addressed.  

This chapter provides readers with an understanding of consultation and counselling as it pertains to school psychologists using literature, case examples, and an interactive activity.  

Learning Objectives

  • Understand the definition of consultation and significant consultation milestones over time.
  • Understand the steps of the consultation process and the roles of the personnel involved.
  • Understand the strategies of an effective school counsellor.
  • Understand five different types of counselling therapies and how school psychologists utilize them.
  • Understand the barriers and opportunities for multicultural consultation and counselling within school psychology. 

Counselling and Consultation Skills

What Is Consultation?

Tommy is an 8-year-old boy with behavioural problems at home and school. He quickly becomes frustrated and angry when an authority figure reprimands him. He bullies other children in his class and has difficulty making friends. Aside from his inappropriate behaviour, Tommy struggles to focus in class and is therefore doing poorly in several academic subjects. Tommy is raised in a single-parent home with low socioeconomic status (SES). Tommy’s mother and teacher have expressed concern and requested a consultation with the school psychologist. Let us consider what consultation is and how it may improve Tommy’s behaviours at home and school. 

Consultation is viewed as an indirect method of delivery, wherein school psychologists focus on the importance of enhancing the consultees’ (e.g., teacher, parent) problem-solving skills (Sladeczek et al., 1997). This is often done within triadic relationships (consultant-consultee-child) to produce positive changes in a third party. Sladeczek et al. (1997) explain that consultation as an indirect service includes consulting with multiple parties, in-service and parent training, and curriculum advisement. This delivery method is cost-effective, time efficient, preventive, and more available to children and teachers; this is in comparison to direct service methods that focus on providing one-on-one services, such as crisis intervention or academic tutoring. Consultation as an indirect service has shown to be effective in strengthening social initiation behaviours, improving school performance, treating irrational fears and childhood phobias, decreasing children’s noncompliance and increasing parent’s child management skills, decreasing disruptive behaviour, and managing behavioural excesses of children diagnosed with attentiondeficit/hyperactivity disorder (ADHD; Sladeczek et al., 1997). Now that we know a little about consultation, how may a consult from a school psychologist help Tommy? 

In Tommy’s case, a school psychologist would meet with the consultees (e.g., Tommy’s mother and teacher) to discuss ways to enhance their problem-solving skills when faced with Tommy’s inappropriate behaviour and academic struggles. By providing parent training, Tommy’s mother can gain child management skills that help decrease his disruptive and noncompliant behaviours. Additionally, curriculum advisement for Tommy’s teacher would help them manage behavioural excesses he is displaying with symptoms of ADHD and help improve his school performance.  

The case example of Tommy helps signify the importance of consultation and the positive outcomes effective consulting can have. However, it is essential to explore the evolution of consultation further to understand the practice precisely. We will examine, in-depth, the development of consultation in Canada over the past four decades.  

History of Consultation in Canada: The 1960s 

Consultation has been a role of school psychologists since the early 1900s; however, an increase in the field of consultation emerged in the 1960s. During the sixties, mental health consultation was proposed as an alternative method for indirect delivery services in Canadian schools. Mental health consultation was initially described by Gerald Caplan (1963) as the interaction between a consultant (a specialist or expert in the field) and a consultee (a professional) who was seeking assistance with a client. Caplan (1995) proposes four central types of mental health consultation: (1) client-centered case consultation; (2) program-centered administrative consultation; (3) consultee-centered case consultation; and (4) consultee-centered administrative consultation.  

Client-Centered Case Consultation  

The primary goal of client-centered case consultation is to increase the knowledge of the consultee (Sladeczek et al., 1997). It is explained by Caplan (1995) that the consultant must first determine whether the consultee is requesting a consultation or simply a screening so that they can decide which specialized agency to refer the patient to. If a consultation is requested, after assessment, the consultant can provide treatment recommendations that the consultee will pursue. The consultant must also communicate with the consultee in ways they can best understand, avoiding terms that may be confusing to those without training in school psychology (Caplan, 1995). A mutually respected relationship between the consultant and consultee is key to success for the client (Sladeczek et al., 1997). 

Program-Centered Administrative Consultation 

In contrast, Caplan (1995) explains that program-centered administrative consultation occurs at the group level, with the consultant working with a group of consultees to assist with administering programs dealing with the prevention, treatment, or rehabilitation of individuals with mental health problems. Instead of performing assessments on individual clients, consultants in this type of mental health consultation assess and recommend plans of action for programs or policies. This may include the planning and administration of services involving the recruitment, training, and effective utilization of personnel within these programs. Overall, the consultant’s goal is to help administrators maintain or increase the productivity of their program or institution while improving their clients’ mental health (Caplan, 1995).  

Consultee-Centered Case Consultation 

In consultee-centered case consultation, Caplan (1995) reports that the primary focus of the consultant is on the consultee rather than a specific client of a consultee. Yes, the consultee has requested a consult because of their client; however, it is the consultee’s difficulties in helping the client in which the consultant is interested. Little to no time in the consultation is spent assessing the client, but instead evaluating the consultee’s understanding of their client’s problems (Sladeczek et al., 1997). The consultant may provide support by assisting the consultee with themes that interfere with their ability to work with a specific client or situation and building the consultee’s confidence and self-esteem for when future difficulties with clients occur (Sladeczek et al., 1997).  

Consultee-Centered Administrative Consultation 

As stated by Caplan (1995), the focus of consultee-centered administrative consultation is at the administrative level, with the consultant assisting the consultee in improving their ability to address problems that occur within programs that deal with the prevention and control of mental health problems and the interpersonal aspects of the agency. This consultation is often applied in group situations with its goal of helping a group of administrators improve their functioning. The consultant aids by clarifying the complexities of the issue and proceeding with caution when proposing recommended plans of action, as common problems in group administrative settings are incompatibilities and role clashes amongst personnel (Caplan, 1995).  

The 1960s were a significant decade for advances in consultation for school psychologists. The four mental health consultation types emerged and became effective methods in assessing and treating children’s mental health over the years. School psychologists as the consultants and teachers or parents as the consultees, together, can make a difference in children’s lives through mental health consultation.  

History of Consultation in Canada: The 1970s  

Consultation became increasingly popular in the 1970s in elementary, secondary, college, and universities (Sladeczek et al., 1997; Jordan et al., 2009). Consultation was viewed to convey skills to teachers and parents so that they could effectively deal with a particular child’s behaviour and apply these skills to similar problems as they occur in the future. In doing so, this allowed school counsellors and psychologists time to attend to more severe issues, such as violent behaviour among children (Simons & Davies, 1973, as cited in Sladeczek et al., 1997). 

In the mid-to-late 1970s, a new framework of consultation emerged. Developmental consultation involves a child’s entire system or environment (Sladeczek et al., 1997). This approach requires the engagement of pivotal individuals (e.g., parent, sibling, teacher) in the child’s life throughout the consultative process. The influence of the child’s family was considered crucial to the client’s assessment, diagnosis, and treatment (Axford, 1977, as cited in Sladeczek et al., 1997). To this day, this is still relevant. 

History of Consultation in Canada: The 1980s 

In the 1980s, theory, research, and the practice of consultation decelerated. Explanations for this include minimal research activity in the field, lack of available training in consultation and, in turn, limited numbers of professional consultants. In the eighties, medical models of education were the preferred service methods for assessing and treating children’s abnormal behaviours. Within the perspectives of the medical model, children’s behaviour and mental health stemmed from “within” the child and therefore, treatment was to “do” something to the child (Farrell, 2010). The medical model is not as widely used in mental health services today, as it does not consider the impact of environmental factors on clients, such as in consultation.  

History of Consultation in Canada: The 1990s 

The theory, research, and practice of consultation made a comeback in the nineties, marking considerable advances that continue to be used today. One of these advances was the publication of the book Effective Consultation in School Psychology, which provided school psychologists with a blueprint for conducting consultations (Cole & Siegel, 1990, as cited in Sladeczek et al., 1997). Some critical discussions included expanding future roles of school psychologists, the process of school consultation, responding to teachers’ needs, parent-teacher mediated intervention, assessment and intervention with underachieving adolescents, dynamic assessment in the classroom, and integration of consultation in the delivery of school psychological services (Sladeczek et al., 1997).  

Collaborative Consultation  

The importance of collaborative consultation also emerged in the nineties. Collaborative consultation is a model that encourages the school psychologist to renounce their position as an “expert,” creating a space for a mutually respected relationship between school psychologists and educators (Siegel & Cole, 1990, as cited in Sladeczek et al., 1997). This attitude is key in effectively matching a method of delivery services to an educator’s needs. This form of consultation follows a three-step model of prevention in which tertiary prevention refers to treatment; secondary refers to early identification and intervention of problems before they become more severe; and primary prevention is a proactive approach in eliminating problems before they develop (Akin-Little et al., 2003). 

School Team Consultation 

As consultation within schools became increasingly in demand in the 1990s, school team consultation emerged as another type of service delivery in Canada (Cole & Brown, 1996, as cited in Sladeczek et al., 1997). The goal of school team consultation is to understand individual student needs to plan necessary interventions in home and school settings. This can be done through consultation with school personnel and educators. Once a mutual understanding of the student’s needs occurs, the school psychologist can refer to special education (Sladeczek et al., 1997).  

History of Consultation in Canada: The Present  
So where does consultation stand for school psychologists today? While not specific to Canada, school psychologists rated their knowledge of different domains involved in their job. School psychologists believed they held the most knowledge on collaborative consultation compared to other skills (Bahr et al., 2017). This was followed by significant knowledge in data-based decision-making, school-wide practices to promote learning and interventions for mental health (Bahr et al., 2017). Therefore, many practices dating back to the 1960s are still relevant in consultation today. We expand on the role of school psychologists and the consultation process next 

What is the Consultation Process?

Now that we learned about the history of consultation in Canada and the significant advances that have occurred since the 1960s, we can examine the consultation process and the roles of the personnel involved.  

Roles in Consultation 

The role of a school psychologist in consultation is the expert. However, in some cases, such as in collaborative consultation, it is encouraged psychologists relinquish their role of the expert to create a mutually respected relationship between the consultant and consultee. Although, as the consultant, a school psychologist is the one who holds the responsibility of planning and recommending treatments which are regulated by ethical and confidentiality standards (Barker and Berg, 2022).  

The role of a teacher in the consultation process is as the consultee, the individual requesting the consult. When a teacher requests a consult, there is usually variance in terms of what they know and do not know about how to approach a student’s situation. Therefore, the school psychologist helps them identify the issue and frame plans of action. It is noted that although not considered the expert, teachers still have a professional designation in the consultant-consultee relationship.  

Lastly is the role of a student as the client. The role of a student differs based on their individual needs and reasons for consultation. The teacher may have a different reason for consultation than what the student expects. However, in all cases, consent must be provided by the student’s parents or guardians, and the client must be informed of the recommended plans of action. We further expand on these roles as we discuss the consultation process. 

The Consultation Process 

We briefly learned about the consultation process as we considered how it evolved over time. However, it is important to specify the step-by-step process in which consultation occurs for many school psychologists in Canada. Refer to the steps outlined below:   

Identifying the Client  

As the consultant, the school psychologist must identify who the client is. Are they a student, teacher, administrator, or school system?  

Identifying the Question  

They then must clearly understand what the client’s question is. This is done by communicating with both the client and the consultee.  

Conducting an Assessment 

Next is to conduct an assessment based on the information they gathered from clarifying the question in context. School psychologists may conduct interviews, observations or refer to informal measures of data like school report cards when doing so.  

Reviewing the Literature  

Reviewing relevant, empirical literature is an important step in ensuring they, as the expert, know as much information as possible about the client’s problem before making any conclusions. 

Stating the Issue  

As the consultant, they must answer the question asked by the client and provide the necessary background information to support their conclusion. This should be done in layperson terms (i.e., in language that understandable to a student or non-expert). 

Providing Recommendations  

The last step in the consultation process is to provide evidence-based recommendations that will answer the client’s question and also benefit the consultee in helping this client in the future. These recommendations are usually presented in both verbal and written formats.

Consider this scenario of the consultation process:  

Sally, a 10-year-old, has trouble focusing on school. She cannot sit still during class and is often fidgeting with the supplies on her desk. This has negatively affected her grades in most subjects, including math, English, and science. However, Sally does well in art and physical education. Sally’s teacher is concerned and therefore contacts her parents to discuss Sally’s behaviours at home. Her parents note the same concerns, as well as Sally’s difficulties remembering to complete her homework and chores. Both Sally and her parents want her to do better in school, so Sally’s parents give her teacher consent to request a consultation from the school psychologist.  

The first step the school psychologist must do is to identify who the client is. In this case, the client is Sally, whereas the consultee is Sally’s teacher. The school psychologist must then identify what the question of concern is. Sally wants to do better in school but there is more to it than that. As the consultee, the teacher will help the school psychologist understand that Sally has trouble focusing and remembering to complete her homework which in turn is affecting her grades. After clarifying the question, the school psychologist will conduct an assessment. In Sally’s case, this will involve an interview with her, an observation of the classroom setting in which Sally is struggling, and a review of her report cards containing her grades and general comments from her other teachers. Once sufficient data is gathered, the school psychologist will conduct a literature review on evidence-based research that has examined similar problems to Sally’s. By combining the information collected from the assessment and literature review, the school psychologist can then answer the client’s initial question and state the issue. Although they must explain what information has led them to this conclusion and do so in language that is clear to students and non-professionals (e.g., Sally, her teacher, and her parents). The school psychologist believes Sally is displaying symptoms of ADHD. The last step of the consultation process is to provide evidence-based recommendations to improve Sally’s behaviour at home and at school. The school psychologist may suggest Sally and her parents set a routine, so it is easier for her to remember when to complete her homework and chores. As the consultant, the school psychologist may also meet to discuss recommendations for the teacher as the consultee. This would include curriculum advisement, that would not only help Sally succeed but also benefit her teacher, as they can use these skills in future problems they encounter.  

The case scenario of Sally helps outline the most common steps of the consultation process for school psychologists and further emphasizes the roles the consultant, consultee, and client have in consultation. However, it is important to note that there can also be barriers to the consultation process.  

Barriers to Consultation 

Barriers to consulting can arise when there are contradictions between consultant, consultee, and client. It is indicated above that teachers play a significant role as the consultee in the consultation process. Though Wilczynski et al. (2000) demonstrated that teachers’ interest and support for consultation can vary. For example, some teachers may not believe consultation is necessary for certain behaviours, such as inattentiveness or disruptive behaviour, whereas a school psychologist may wish to examine the underlying predictors of these actions. Some teachers may seek alternative approaches to dealing with problems in the class, such as discussing with other teachers or the principal (Wilczynski et al., 2000). However, some teachers request a consultation from the school psychologist and, in turn, play the role of the consultee throughout this process. When this is the case, Caplan (1995) outlines four major difficulties that can impact the consultee’s ability to deal with clients’ problems and seek consultation help.  

The first difficulty is the lack of understanding of psychological factors in the case. This occurs when the consultee has not learned enough about psychopathology in their preprofessional training to realize what factors are operating in a specific case or cannot apply what they have learned to the idiosyncratic complexities of their client. Second, is a lack of skill or resources to deal with the problems involved. This difficulty involves the consultee’s lack of professional use of the self when dealing with the psychological complications of their client or a lack of knowledge of appropriate community resources that may be of benefit to the client. The third difficulty identified by Caplan (1995) is a lack of objectivity in handling the case. There may be personal interferences that affect the consultee’s judgment of the client leading to partisanship that can lower the consultee’s effectiveness in utilizing their professionalism. Lastly, consultees may experience periods of lack of confidence and self-esteem in their abilities to help a client due to fatigue, illness, inexperience, youth, or old age (Caplan, 1995).  

Consultants can aid in these difficulties and improve barriers to consultation by providing the consultee with knowledge about the client and assisting them in formulating action plans. Consultants can help consultees with their interferences by urging the consultee to adopt more reality-based expectations of the client and provide ego support for those experiencing a lack of confidence and self-esteem (Caplan, 1995).  

What is School Counselling?

Effective School Counselling in Canada  

At the heart of many Canadian schools are school counsellors who strive to make a positive difference in students’ lives. The Prince Edward Island (PEI) Department of Education’s (2005) handbook for school counsellors outlines that the goal of school counselling is to promote student learning and address the personal, social, emotional, and career needs of students (as cited in Walker, 2015). In other words, an effective school counselling program (SCP) helps students make positive changes in one or more domains of their lives. This belief is shared by the following Canadian provinces: Alberta, British Columbia, Manitoba, and Nova Scotia (Walker, 2015). School counsellors have several responsibilities, including counselling services, implementing classroom curriculum guidance, addressing mental health issues, intervening during crises, and providing support to students regarding course and career choices (Walker, 2015). While engaging in these duties, school counsellors expect to consult with teachers, parents, health professionals, and community agencies. There are an intense array of role demands for school counsellors. Therefore, it is essential to discuss further the traits that make an effective school counsellor and SCP.  

Collaborative Working Practices  

Collaboration (i.e., bringing people together to address a certain situation) is important in all institutions, as it allows multiple people to share their knowledge and wisdom in generating a solution (Walker, 2015). For school counsellors specifically, collaboration with principals, teachers, parents, and students is essential in meeting the needs of students (Salina et al., 2013). But how can school counsellors effectively engage in collaborative working practices? Trice-Black et al. (2013) suggest that trusting relationships impact a school counsellor’s willingness to collaborate with colleagues. The more trust a school counsellor had in a colleague, the more likely the counsellor was to work collaboratively with this individual. This is reciprocal, as school staff must also trust the school counsellor’s ability to adequately address their concerns (Trice-Black et al., 2013). We now further discuss the necessary relationships for effective collaborative working practices for school counsellors.  

School Counsellor – Principal  

Both school counsellors and principals hold significant power in school settings; therefore, mutual respect between these individuals is important in achieving positive outcomes for students. Salina et al. (2013) explain that principals and counsellors often lack knowledge of how to work together due to their distinct roles. Thus, principals must recognize the expertise school counsellors contribute to the school setting by listening to and engaging them in the systematic changes to educational practice. When a positive relationship exists between school counsellors and principals, student achievement and improved graduation rates occur (Salina et al., 2013).  

School Counsellor – Teacher  

Salina et al. (2013) also note the importance of school counsellor and teacher relationships. Teachers often identify students’ issues and need for support, in turn requesting consultation. In addition, many school counsellors conduct assessments (e.g., observations and conversations) in classrooms with the teacher present and participating. This shows teachers and students that the school counsellor is there to advocate for them both. Therefore, school counsellors support teachers, and teachers support counsellors (Salina et al., 2013).  

School Counsellor – Parents  

An effective SCP involves the collaboration between school counsellors and a student’s family. A child’s parents or guardians are the primary providers of support in child development and therefore play a significant role in their child’s benefit from school counselling (Walker, 2015). School counsellors and parents must be able to effectively communicate about the child’s difficulties and the parent’s abilities to pursue the counsellor’s recommendations for treatment.  

School Counsellor – Students 

A trusting relationship between school counsellors and students is crucial in an effective SCP. Fox and Butler (2007) found that there was a common desire amongst students to get to know their school counsellors, as they are discussing personal and sensitive issues that are often difficult to share with someone unfamiliar. School counsellors must organize their workload to ensure time to meet students and present themselves as approachable and accessible. This opens the field for connections and trust between counsellors and students (Fox & Butler, 2007).  

Collaborating with principals, teachers, parents, and students contributes to the role of an effective school counsellor. However, there are regulations and responsibilities that school counsellors must uphold when communicating and sharing information with other colleagues. This is where confidentiality and ethics come into consideration.  

Challenges to Confidentiality  

There are several benefits to collaborative working practices, although school counsellors must consider the limits to confidentiality when communicating with other parties. Confidentiality is a critical component in all forms of therapy and, in this case, is necessary for an effective SCP. Confidentiality is sometimes difficult for school counsellors as many individuals are involved in students’ lives (Walker, 2015). This can lead to ethical dilemmas and transgressions. Ethical dilemmas occur when there are conflicting ethical reasons to take incompatible courses of action (Knauss, 2001; Beauchamp & Childress, 2001, as cited in Dailor, 2011). In contrast, ethical transgressions violate professional expectations for ethical codes of conduct (Dailor, 2011). Let us further examine the challenges to confidentiality by referring to the previously discussed relationship between school counsellors and principals, teachers, parents, and students.  

As school counsellors and principals are trained independently of one another, they lack knowledge regarding each other’s roles in education settings. Principals may have different perceptions of confidentiality than what is standard for practicing counsellors, in turn negatively affecting school counselling services (Salina et al., 2013). Teachers, more often than principals, observe first-hand students’ difficulties in the classroom and thus are frequently involved in the counselling process. However, school counsellors must withhold private information discussed in one-on-one sessions with students from teachers.

When considering confidentiality between the school counsellor and parents, it can be difficult. Many students do not want to engage in counselling sessions if they know their parents are going to find out. Although in some provinces in Canada, it is an ethical obligation for parents to consent to counselling services if their child is under the age of 18 (Walker, 2015). In addition to this, parents may also be granted the right to access the information disclosed in their child’s session. In contrast, other provinces, including Alberta, now do not require parental consent for students to see the school counsellor and respect the student’s wishes. This leads to the school counsellor and student relationship, in which students flourish when they know what is discussed is confidential (Walker, 2015).  

Ethical Dilemmas  

Now that we know some of the challenges regarding confidentiality and collaboration for school counselling programs, let us consider the ethical dilemmas that may occur as a result. Dailor (2011) found four ethical dilemmas most reported by school counsellors: whether to contact child protective services; whether to disclose a student’s risky behaviour to their parents; how to address unethical conduct by a colleague; and how to balance a parents request to view their child tests protocols with the ethical responsibility to maintain test security. These dilemmas demonstrate the challenges school counsellors experience when trying to maintain confidentiality while working collaboratively (Dailor, 2011). So, what can school counsellors do to provide effective services while upholding their ethical obligations? Firstly, Dailor (2011) notes that school counsellors with multilevel post-secondary training felt more prepared in addressing ethical dilemmas compared to those without extensive ethics training.  Additionally, problem-solving and decision-making skills help professionals handle difficult situations and make well-reasoned choices (Dailor, 2011). 

Clinical Compared to Administrative Supervision  

Based on the challenges of confidentiality and ethical dilemmas discussed above, it is important to examine different kinds of supervision for school counsellors. School counsellors are likely to receive administrative supervision from principals. Dollarhide and Miller (2006) describe administrative supervision as of a broad range of organizational issues, such as managing the matters of a school. However, school counsellors express a desire for clinical supervision, which focuses on the development of the supervisee, as well as the quality and safety of the counselling services being delivered. Clinical supervision is hard to access for school counsellors as they work in schools rather than clinical settings. The benefits of clinical supervision should be noted, as it is often an effective tool in effective SCPs. By receiving clinical supervision, school counsellors’ skills in counselling and ethics are improved, better preparing them for ethical dilemmas. Moreover, clinical rather than administrative supervision helps school counsellors manage the limits to confidentiality when collaborating with others. Administrative supervisors (e.g., principals) lack knowledge on the theory and practice of counselling; therefore, those with clinical training offer better guidance to school counsellors (Dollarhide & Miller, 2006). 

Implications for School Counsellors  

From what we have learned about SCPs, it is evident that working in collaboration with educational stakeholders and forming trusting and positive relationships with colleagues is the most successful way in which school counsellors can provide effective services for students. Specifically, collaboration between school counsellors and principals is of importance. Frequently discussing each other’s roles and responsibilities, such as a school counsellors’ obligation to maintain students’ confidentiality, can prevent the aforementioned ethical dilemmas from occurring. School counsellors have high role demand, which is continuing to increase, and therefore their role as mental health providers must be further recognized. Acknowledging this, as well as school counsellors’ need for clinical supervision, can contribute to the overall success of an effective school counsellor and SCP. 

Counselling Therapies

There are many forms of counselling therapies used by school psychologists or school counsellors. In this section we discuss cognitive behavioural therapy, solution-focused brief therapy, motivational interviewing, family systems, and reality therapy/choice therapy.

Cognitive Behavioural Therapy (CBT)

Cognitive behavioural therapy (CBT) is considered the ‘gold standard’ in counselling interventions. It was originally developed by Aaron Beck in the 1960s as a psychotherapy to treat depression (Beck, 1964). Since then, CBT has become an extremely popular and well-studied therapy. Many scholars, including Beck, have continued to develop CBT and it has now been adapted for use with many populations and in many settings, including schools (Beck, 2021; Simpson & Atkinson, 2019). There are far too many contributions to the development of CBT to list here, but it is worth noting there are also many other forms of therapy derived from Beck’s work that share characteristics of CBT but vary, including exposure therapy, acceptance and commitment therapy, and cognitive processing therapy (Beck, 2021).

While there are variations of CBT, the key theoretical elements remain the same. In all forms, CBT is a structured, short-term, and goal-oriented therapy where clients learn to question and change their thoughts and beliefs to reduce emotional problems. CBT is effective and significantly improves individuals’ quality of life (Beck, 2021; Simpson & Atkinson, 2019; Oud et al., 2019). The three main elements of CBT include a person’s maladaptive beliefs, behavioural strategies, and maintaining factors (Alford et al., 1997). At the center of CBT is the notion that all psychological disturbances involve maladaptive thinking, and the goal of therapy is to teach clients to evaluate their thinking in an adaptive way that will decrease emotional problems (Alford et al., 1997).

Beck (1964) proposed three levels of cognitions: automatic thoughts, intermediate beliefs, and core beliefs. These are our thoughts (both conscious and unconscious), and they influence behaviours and emotions. Cognitive dissonance occurs when individuals have thoughts that differ from their behaviour, and their thoughts then change to ‘excuse’ their behaviour and close the gap between thoughts and behaviour. CBT states that to make change, behaviour must change, so thoughts and feelings follow. CBT emphasizes that unhelpful patterns of thinking and behaviour often cause psychological problems, and that changing behaviour will change the thinking patterns and therefore lead to a better quality of life (Beck, 2021). By working with the therapist or counsellor, clients learn to change their thinking, behaviours, and emotions through self-monitoring and other activities. CBT mainly focuses on current behaviours, and a positive relationship between the client and counsellor is extremely important for success (Simpson & Atkinson, 2019).

Within the context of school psychology, CBT was adapted for clients with differing educational backgrounds, cultures and ethnicities and used on children (Beck, 2021). It can also be used in a group setting, which in a school environment could mean involving parents and teachers to best support the child’s needs. There is some evidence that CBT may be more effective for adolescents when a parent or guardian is actively involved (Oud et al., 2019). CBT can also be adapted for shorter sessions, which is often ideal in a school setting as the school psychologist only has so much time with each child. In children, CBT is often used to treat anxiety disorders, phobias, appetite disorders, and other behavioural problems (Rait et al., 2010). It is also effective in treating depression in adolescents (Out et al., 2019).

There are limitations to consider when using CBT with young children. There is evidence for effective use of CBT on children over the age of eight, but there is less evidence on the effective use of CBT for younger children as the developmental level required to understand thoughts, behaviours, and emotions in the context of a specific problem has not yet been reached (Simpson & Atkinson, 2019; Rait et al., 2010). It is important for school psychologists to consider the needs of each child to choose appropriate therapies. While CBT is one of the most used treatments and has a large body of research supporting its effectiveness in clinical settings, there are other options available to school psychologists (Rait et al., 2020).

SolutionFocused Brief Therapy (SFBT)

Solution-focused brief therapy (SFBT) is sometimes referred to as the opposite of CBT. SFBT is a form of therapy focused on solution-building instead of problem-solving, where instead of focusing on problematic behaviours, the client focuses on the positives in their lives and solutions to problems (Iveson, 2002). SFBT was first developed by Steve de Shazer in the 1980s to analyze inconsistencies in problem behaviour (Shazer et al., 1986). Since the 1980s, SFBT has been extensively studied and applied in the literature, proving to be an effective intervention for many psychological problems and disorders (Iveson, 2002). Lethem (1994) discusses SFBT’s use on children, and Rhodes and Ajmal (1995) have discussed its use in schools. Since the 1990s, SFBT has become a common form of therapy used by school psychologists.

SFBT is rooted in positive psychology and is a time-limited, future-oriented approach that helps clients achieve and sustain behavioural change. The therapy is rooted in the idea that the client has the knowledge to solve their own problems, which can be achieved with the help of guidance from a clinician (Kim, 2008). There is evidence that creating clear goals makes it easier to achieve them (Iveson, 2002). A key element in SFBT is determining the goals of therapy and recognizing when these goals are met, and treatment can be stopped (Iveson, 2002).

There are eight key aspects of SFBT. The first is the idea of problem free talk, where the client and the counsellor do not talk about negatives and instead focus on positives, such as times in the past when the client successfully solved problems and coped with difficulties. For example, if the goal is to quit smoking, the counsellor would not talk about smoking; they would focus on positive behaviours incompatible with smoking. During this talk, the clinician must determine what the client hopes to achieve from therapy (2002). The second aspect of SFBT is the miracle question, where the client is asked to think about how their world would change if their problem went away. They are then asked to identify small behavioural steps that can lead to a solution (Kim, 2008). The third is exception questions, where the client is asked to describe scenarios when the problem behaviour is not an issue for them (Kim, 2008). Fourth, coping questions involve asking the client how they manage to keep going despite the adversity they are facing (Kim, 2008; Iveson, 2002). Scaling questions involve rating the problems clients are having and identifying what it would take to reduce the rating. Time outs are also a key aspect and involve taking a step back and looking at the progress made in the session so far (Iveson, 2002). Accolades, or providing encouragement, are crucial to creating a positive environment. Moreover, assigning tasks so the client can work on their behaviours between sessions is a critical component of SFBT (Kim, 2008).

Because of its flexible approach, SFBT is well-suited for children in school settings. Daki and Savage (2010) found that SFBT is effective for students with reading difficulties and helps build confidence and learning skills. Student engagement improved in the classroom when students felt they had the proper tools to succeed. Teaching students solution-focused techniques such as emphasizing strengths, pursuing meaningful goals, and monitoring academic success are applicable to the classroom and can be incorporated into the curriculum (Daki & Savage, 2010). SFBT can also be used in conjunction with other therapies, which can be helpful for students with more complex cases or multiple diagnoses (Kim, 2008). Finally, SFBT usually requires only a few sessions, making it practical in school settings where time is a barrier. Overall, SFBT’s flexible and solution-based approach is ideal for school psychologists and is an important tool to consider when planning interventions (Kim, 2008; Daki & Savage, 2010; Rhodes & Ajmal, 1995).

Motivational Interviewing

Motivational interviewing is a type of psychotherapy based on a cycle of change. It was initially developed to help individuals commit to change and work through ambivalence in a series of directed steps (Miller, 1983). Motivational interviewing combines a supportive environment with a directed method to facilitate change and involves ‘change talk’ where the client explores their motivation for making a change supported by the clinician (Miller, 1983; Hettema et al., 2005). The therapy is brief (one or two sessions) and can be combined with other therapies (Burke et al., 2003). Research indicates that motivational interviewing is especially useful for angry or oppositional clients who are resistant to change (Hettema et al., 2005). As it has been validated in school settings, school psychologists often use motivational interviewing.

Motivational interviewing involves five steps that the clinician guides the client through. The first stage (stage 0) is precontemplation. In this stage, the individual does not acknowledge they have a problem and does not think about changing. The counsellor’s task here is to increase the individual’s perception of the risks associated with their behaviours (Hall et al., 2012). The next stage is contemplation, where the client recognizes a problem but does not necessarily want to make changes. The counsellor must help the individual weigh the pros and cons of continuing the behaviour (Hall et al., 2012). The next stage is preparation, where the individual is now actively thinking about changing their behaviour. The counsellor helps the individual create a realistic plan and goals for changing their behaviour. Next is the action stage, where change is implemented. The maintenance stage involves following through on goals and keeping up with change (Hall et al., 2012). The counsellor’s job is to help prevent relapse. Finally, the last stage in the cycle is relapse, where the counsellor must help the individual get back to the contemplation stage and not lose motivation (Hall et al., 2012).

Although motivational interviewing is typically used in counselling for addiction, it can also be applied in school settings. There is evidence that motivational interviewing improves grades in adolescents and reduces risky behaviour (Hall et al., 2012). Motivational interviews can also be used with parents of younger students to encourage positive behavioural support. Motivational interviews are typically brief and can be used with other therapies, making them a valuable intervention for school psychologists (Hettema et al., 2005; Hall et al., 2012).

Family Systems Therapy

Dr. Murray Bowen developed family systems therapy in the 1950s. It first focused only on mother-daughter relationships, but further development by Bowen resulted in consideration of all components of the family unit. Family systems therapy seeks to improve the outcome of patients by considering family interactions when treating psychological problems. The family systems approach involves the interaction between different systems in the child’s life. Specifically, the systems refer to the patterns of predictable behaviour among individuals in the family (Bowen, 1977; Papero, 1983). Bowen (1971) emphasized how one member of the family unit can influence another. For example, he discussed how anxiety is quickly transferred between family members and described this phenomenon as emotional reactiveness (Bowen, 1971).

Family systems approaches are highly effective when working with children. Other counselling therapies focus on teaching skills and doing individual ‘homework,’ but this can only go so far until we need to consider the family systems involved. In school psychology, the family systems approach involves the interaction between different systems in the child’s life (Papero, 1983). The child’s microsystem is the immediate surroundings, including parents, peers, teachers, and family. The exosystem involves broader environments such as the schoolboard, media, and the parent’s work environment. Finally, the macrosystem involves broader laws and culture, which also impact the child. This theory assumes that family systems are always trying to work towards equilibrium and that interactions within these systems allow problem behaviours to continue (Papero, 1983). To change behaviour, the school psychologist or counsellor must see which systems are affecting this behaviour and suggest changes. This approach is unique compared to the therapies described above because it focuses on external factors influencing the child’s behaviour instead of internal factors within the child.

Reality Therapy/Choice Theory (RT/CT)

Reality Therapy/Choice Theory (RT/CT) was developed by Dr. William Glasser and is rooted in the idea that individuals control their thoughts and actions based on what is happening in their environment. RT/CT states that other individuals or events cannot make people feel or act in specific ways; only the individual can control their feelings and actions (Glasser, 1998). The theory also states that the root cause of unhappiness is unsatisfying relationships, and an individual chooses maladaptive behaviours to deal with unfulfillment (Howatt, 2001). RT/CT provides a framework for overall wellbeing and mental health and acknowledges that behaviour is predicated on choices, and choices ensure basic needs are met.

Originally, Glasser proposed only two basic needs (i.e., love and acceptance) but later expanded it to include five basic needs: survival, love and belonging, power, freedom, and fun (Litwack, 2007; Glasser, 1998). The concepts of a ‘perceived world’ and a ‘quality world’ are also central to RT/CT. The perceived world includes everything a person has experienced or knows. The individual’s basic needs inform the quality world and include everything we know or believe makes us happy and fulfilled (Corey, 2013). People constantly compare their reality to this quality world; when reality is incongruent with an individual’s quality world, they become frustrated, leading to maladaptive behaviour.

RT/CT facilitates developing satisfying relationships while emphasizing individuals’ behaviour and not assigning blame to others (Corey, 2013). It is also important to focus current behavioural problems. While Glasser’s work (1998) is typically thought of as a therapy technique, the basic principles can be applied to many situations. RT/CT can be used in various settings, including schools (Corey, 2018).

In the context of school psychology, RT/CT teaches children about the choices they make and their needs and values. If problem behaviour occurs, the child’s needs are not being met. There is evidence that RT/CT methods decrease disruptive behaviour in students, as it helps students make behavioural choices that satisfy their needs (Byron, 2005). Considering basic needs leads to more appropriate and effective interventions for the child.

Multicultural Considerations in Consultation and Counselling

Multiculturalism involves actively recognizing and valuing cultural diversity and aiming to offer equal opportunities to all individuals (Parker et al., 2019). Multicultural consultations involve changing the services to address clients’ or students’ culturally diverse needs (Ingraham, 2000). Counsellors are also responsible for fostering positive and inclusive school environments using culturally responsive methods. This ensures that all children, regardless of their cultural background, are treated equally (Fox et al., 2020). Multiple authors discuss the importance of multicultural consideration in consultation and counselling and propose theories or frameworks outlining best practices, opportunities, and barriers school psychologists may face. In the following section, we discuss barriers faced by school psychologists providing multicultural consultation and counselling, as well as opportunities for school psychologists to address these barriers.

Barriers and Opportunities

There are many barriers to multicultural consultation and counselling at the individual and administrative levels. School psychologists must be willing to challenge and overcome these barriers to provide the most effective counselling and consultation to their students.

A barrier commonly faced by school psychologists is the lack of administrative support for implementing multicultural approaches (Ingraham, 2000). When administration is not supportive, the psychologist is unable to make changes that will benefit culturally diverse students. School administration also rarely asks school psychologists for input when making changes, even though school psychologists are uniquely equipped to help develop systemic interventions due to their wide area of expertise (Parker et al., 2019).

School psychologists are often responsible for developing systems-level interventions, yet they are not always possible in practice. School district policies, time constraints, and levels of training impact how involved a school psychologist is in interventions (Parker et al., 2019). Taking the time to plan system-level interventions may also be outside the scope of their practice (Parker et al., 2019). According to Ingraham’s (2000) Multicultural School Consultation (MSC) framework, the school psychologist must have the knowledge, skills, objectivity, and confidence to advocate for students and implement interventions. Learning to advocate for students and teachers and to make systemic changes is an opportunity for school psychologists to create a more inclusive environment (Fox et al., 2020).

Another common barrier to multiculturalism in consultation and counselling is teacher resistance to change. Some teachers are not willing to change their classroom routines or emphasize students’ cultural differences (Parker et al., 2019). Often, teachers’ mindset and pre-existing beliefs hold them back from implementing interventions outlined by the school psychologist. Sometimes if the teacher is willing to change, they are unable to because of school policies (Parker et al., 2019). In Canada, school psychologists often have multiple schools to attend, and it would be impossible to provide support to every teacher directly. Fox and colleagues (2020) highlight that school psychologists learn more about students’ cultural background than other school personnel. Thus, they can act as advocates for students to help them connect to their school.

School counsellors offer support services to teachers. Counsellors who are highly involved in teaching methods ensure that all students are being treated equally and that diverse cultural backgrounds are being considered in the classroom (Fox et al., 2020). This relates back to Ingraham’s (2000) MSC framework which states that working with teachers is a skill school psychologists must develop to promote inclusivity in schools.

Another barrier to multicultural consultation is parental involvement. School psychologists are busy, and so are parents. Involving parents can be difficult because of time, including work schedules that conflict with school hours (Parker et al., 2019). Parents also make decisions about how accepted they are at the school based on if they see themselves and their families represented there (Fox et al., 2020). School counsellors should use visual aids that include culturally diverse people. This is especially important for children attending a new school, as seeing themselves represented there will lead to more positive experiences (Fox et al., 2020). It will also facilitate a better relationship between the school psychologist and the parents, which is often critical to the student’s success.

Implications for Practice

Despite the barriers encountered when providing multicultural consultation and counselling, there are also many opportunities for school psychologists to overcome them. Multiple authors discuss the importance of incorporating multicultural frameworks into daily practice (Ingraham, 2000; Fox et al., 2020). Ingraham (2000) developed the Multicultural School Consultation (MSC) framework as a guide to understanding cultural differences in school-based consultations. Consultants who work in multicultural settings must be able to attend to the perspectives of their consultee, client, and themselves; they must be able to link the perspectives of all parties (Ingraham, 2000). This means school psychologists must understand their culture and the impact of their culture on others. Self-reflection is critical to understanding how others perceive them during consultation, and is especially important when cross cultural consultation is occurring. School counsellors should also educate themselves about different cultures within their school. This knowledge is essential to inform their counselling practices, but also an important ethical consideration when using tests and assessments that may be biased against certain students (Fox et al., 2020).

Overall, it is essential school psychologists develop the knowledge, skills, objectivity, and confidence to provide multicultural consultation and counselling in schools (Ingraham, 2000). They must be aware of the power dynamics present between school administration, teachers, and students; school psychologists are responsible for understanding the perspectives of all three parties involved in the consultation triad. Each case will be different, and school psychologists must exercise judgement based off their expertise to choose intervention methods that are most effective for the child, while considering the impact of culture.

Conclusion

In this chapter, we learned about consultation and counselling within the discipline of school psychology in Canada. We discussed the history of consultation including different types of consultation developed throughout history. We also talked about the consultation process that school psychologists follow. The role of the school counsellor was explained, including important practices such as collaboration and confidentiality. We also examined the role of other individuals who provide effective care for students and their relationship with the school psychologist (including parents, teachers, and principals). Five counselling therapies—cognitive behavioural therapy, solutionfocused brief therapy, motivational interviewing, family systems, and reality therapy/choice therapy were defined in this chapter and examined in the context of school psychology. Finally, we discussed the barriers and opportunities for multicultural consultation and counselling within school psychology.

After finishing this chapter, readers should have a thorough understanding of consultation and counselling as it pertains to school psychology using literature, case examples, and an interactive activity.

 

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Foundations in School Psychology Copyright © 2023 by Krista Cameron; Madeline Fisher; and Conor Barker is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License, except where otherwise noted.

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