consultation

METHODS OF COMMUNITY INTERVENTIONS CONSULTATION

1. Counselling in community settings METHODS OF COMMUNITY INTERVENTIONS CONSULTATION .

2. CONSULTATION Consultation is the process whereby an individual (the consultee ) who has responsibility for providing a service to others (the clients) voluntarily consults another person (the consultant) who is believed to possess some special expertise which will help the consultee provide a better service to his or her clients. Consultation is the process in which the consultant (counselor) works with the consultee (parent, teacher, administrator) with the goal of bringing about a positive change in the client (child). Consultation is generally considered a process of helping someone understand problems as part of larger systems

3. Consultation is voluntarily provided by the counselor to assist another professional or an organization with a problem. Thus, counseling consultation is said to be triadic which means that there are three parties (sometimes groups) involved: a consultant, a consultee , and a client . Thus,Consulting is the service you seek to answer a specific problem using the expert knowledge of a professional. A consultant has specialized knowledge and expertise on the process or the problem that is of interest to you. Often a consultation will be a short term engagement on one specific topic. Consultants work with individuals, families, groups and organizations. Occasionally teaching or training will be part of the engagement.

4. TRIADIC - CONCEPT

5. IMPORTANT CONCEPT OF CONSULTATION One common meaning of consultation refers to the arrangement in which a problem is turned over to a consultant who then takes responsibility for its solution . A consultant aids the consultee who, however, retains responsibility for subsequent actions , whether in the care of particular clients or in the management of a program or organization. For this reason, the consultant is said to provide an indirect service to the person or organization in need, for he works through someone who continues to provide direct services.

6. Consultation can be viewed from several orientations, each springing from a somewhat different historical perspective . First, there is mental health consultation . This grew out of the psychoanalytic and psychodynamic tradition . It was often practiced in rural or underdeveloped areas where there was a shortage of mental health personnel. Consultation became a way of using existing community personnel (such as teachers or ministers) to help solve the mental health problems of such areas. A second orientation developed out of the behavioral tradition . In order to implement the technology of behavior modification that had been so successful in laboratory settings, it was necessary to move into real-life situations. To do that, people in the patient's environment (such as home or school) had to be trained to properly dispense reinforcements for the desired behavior. Consultation became a way of providing such training.

7. The third orientation is an organizational one that emphasizes consultation to industry . Specialists work with management or work group leaders to improve morale, job satisfaction , and productivity or to reduce inefficiency, absenteeism, alcoholism, or other problems

8. TYPES OF MENTAL HEALTH CONSULTATIONS Approaches to mental health consultation can be classified in many ways. The most widely accepted classification is Caplan's (1970). It includes the following categories : Client-centered case consultation . This is the case of referral to a specialist who provides direct services to the client . A clinician with particular expertise may be asked , by the consultee or the client himself , to examine the patient, make recommendations for further treatment, or himself take over responsibility for the subsequent clinical care. The important relation is between the consultant and the patient ; the interaction between consultant and the referring clinician, although important, is secondary. For example, a clinician might be asked to consult with a colleague on a diagnostic problem involving a specific patient.

9. 2 . Consul tee-centered case consultation . In this instance, the aim is to help the consultee enhance the skills that he or she needs in order to deal with future cases . Here the focus is on the consultee’s difficulties in working with a particular patient or patients. The focus may be as narrow as the treatment of a particular case, or as broad as the consultee’s understanding or management of many patients of a similar kind. For example, a teacher might be advised on how to selectively reinforce behavior in order to reduce classroom disturbances. Although he may see the patient on a particular occasion, the consultant remains essentially outside of the clinical relation.

10. 3 . Program-centered administrative consultation . The notion here is to assist in the administration or management of a specific program . The focus of concern is with the program itself , rather than the consultee’s problem i n it. A consultant may be called into provide specific technical help , such as advising on the construction of a new building, suggesting alternate designs or analyses in research , reviewing staff organization, providing information on community resources or giving any specific help to the program. His role is instrumental to the work of the consultee and his organization .

11. . 4. Consultee -centered administrative consultation . Here the aim is to improve the skills of an administrator in the hope that this will enable her or him to function better in the future. The focus is on the work of the consultee in regard to his program. The consultee’s understanding of the situation, previous efforts, knowledge, and attitudes that would facilitate or block the solution of problems, are the center of concern.

12. G eneral Characteristics The relationship is voluntary . The consultee invites the consultant’s help with a particulars problem. The consultant accepts the arrangement, if he feels he can be of any help . Either party is free to terminate the relations. Since the consultee remains responsible for subsequent work with the patient (or program or organization) he retains the freedom to accept or ignore the counsel of the consultant.

13. 2 . The consultant is an outsider He is not subject to the authority structure of the consultee’s organization . He is not concerned, with continuing relations with others in the organization, superiors or subordinates. His concern while there is only with the problem and the consultee’s work and the effort to solve and improve the other. Not being in or of the organization, he has a degree of detachment which allows him to see and interpret things which may not be noted by those working within the organization.

14. THE RELATIONSHIP IS TIME-LIMITED Consultation has a clear onset and termination . There maybe recurrent consultations over a period of time which involve the same consultee and consultant, but each unit has its own focus and duration. There is not continuous involvement in the on-going work of the consultee .

15. CONSULTATION IS PROBLEM-FOCUSED The consultant is concerned with the work of the consultee and not his character , personal problems or personal life. The consultant must scrupulously avoid therapeutic involvement in the personal life of his consultees . The principle of problems-focus and the avoidance of personal involvement is an important guideline The boundary between personal and work problems is a slim one and consultants must necessarily draw on their clinical skills and in some degree, address the emotional problems of the consultee in order to help him in his work with his clients.

16. THE CONSULTANT’S FUNCTIONS Teaching and training of consultees He brings to the attention of consultees result of appropriate research, the literature of the field, experience with comparable problems in other settings, knowledge about the functioning and other material of relevance to the work of the consultee . A communication facilitator H e serves as a facilitator either among consultees within an agency or between agencies or between the consultee , the agency, and the larger community. By virtue of his more extended view of work in the field and of other resources, a consultant is often in a position to bring together previously isolated workers or agencies.

17. HUMAN-RELATIONS MEDIATOR As an outsider, the consultant can often see and help resolve internal conflicts and frustrations in the organization which limit the work of the consultee . EX: a psychologist may be asked by a teacher to discuss his work with a particular difficult student. In short order, it becomes clear that his effectiveness as a teacher with any of his children is greatly limited by his resentment of administrative policies, feelings of lack of support from relevant administrators , conflicts with fellow teachers or similar matters. The consultant may have to focus on these issues and act as a mediator, and help to resolve them..

18. Phases in the Consultation Process Entry Initial stage involves the establishment of the relation between consultant and consultee . I n this phase, a clearly understood contract is evolved and with it trust is established . The consultant makes clear the terms under which he works. Assurance is given that the consultee’s privacy will be respected and information will be kept confidential. The limits of the consultant’s competence and authority is made clear

19. ENTRY ……. Entry is facilitated if the consultee has had the principal responsibility for initiating the arrangement. If it resulted mainly from the consultant’s efforts or derived from administrative decision, then entry phase becomes more difficult. there needs to be clear sanction for consultation from those with authority in the consultee’s system. Acceptance of the humanness of the consultee , respect for his professional and organizational position and appropriate warmth and support facilitate the development of a relationship in this first phase.

20. DEFINING THE PROBLEM Defining and analyzing the problem in hand . The consultee’s phrasing of the problem and his diagnosis of the issues involved must remain central and be respected by the consultant, though he remains alert to related and perhaps more pervasive issues which lurk behind the problem as presented. Although as a general rule, the consultant should not engage himself with the clearly personal problems of the consultee’s life, the boundary is difficult to maintain, particularly where the personal problem interacts with the work difficulty. This particular situation Caplan has called “theme interference ”

21. ANALYZING ALTERNATE ACTIONS.. Following diagnosis of the problem, the task moves to a search for alternate solutions. This phase encompasses the development of specific, alternative solutions and strategies of problem solving jointly with the consultee . Their feasibility, possible impact and side effects, likely costs and benefits and other considerations are discussed. The consultee may lack specific knowledge, which the consultant can supply or help him discover. He may lack appropriate skill or experience, and the consultant can help in their development ; or, there may be barriers within the person or in his work situation which must be altered before appropriate action can be taken in accordance with consultee’s motives, abilities and status.

22. DEALING WITH BARRIERS TO UNDERSTANDING OR ACTION The consultee’s understanding of a problem and decision making may be limited by factors deriving from psychological problems within the consultee or in the consultee organization. The consultee may not lack appropriate knowledge or skills, but he is unable to use these in working with a particular client or problem. Professional objectivity may be limited and appropriate empathy replaced by over identification and personal involvement, and so perception and judgment may be distorted. Often the consultee is not conscious of the relation between his personal problems and his difficulty with the client and the consultant should not attempt to make this link conscious.

23. DEALING WITH BARRIERS TO UNDERSTANDING OR ACTION…. He should remain focused in the problem of the client under discussion. Still, he must be attuned to the symptoms by which theme interference manifests itself, such as excessive emotional response, distortion and particularly stereotyping etc. Organizations have collective beliefs and values, biases and routine procedures, which may limit objectivity and professional effectiveness. So as the consultant has to tread softly with regard to the consultee’s personal neurosis, so must he deal with the “institutional neurosis ” too.

24. TERMINATION When it is mutually agreed that further consultation is unnecessary, termination follows . Inevitably however…. Negative feelings can intrude, including disappointment, incompleteness or desertion Some degree of dependence may have evolved . Interplay with the consultant may have been intellectually stimulating , socially pleasant or status-producing and he is reluctant to give it up . Working with the consultee may have engaged the vanity as well as professional interest of the consultant and he might wish to continue the relation. Increased effectiveness not mutual satisfaction is the goal

25. Consultation with Groups Groups might include workers in the same agency or different agencies or even unrelated caretakers, parents or others who share concern with common problems. ADVANTAGES.. A major advantage lies in the utilization of the group process itself for educative and social-change purposes. In the group, commonly held views and shared problems emerge more readily. Communication and human-relations skills are sharpened. There is an obvious economy in working with several people simultaneously.

26. DISADVANTAGES. coordination and scheduling problems arise Personal problems do enter and there is the danger that the group of fellow consultees may mishandle them. Insecure people are likely to hold back, and dominant ones may take over. Therefore, In the period of entry itself, greater attention need to be given, to developing group cohesiveness and other qualities of effective group functioning.

27. CONCLUSION Consultation is the process in which the consultant (counselor) works with the consultee , with the goal of bringing about a positive change in the client . Consultant roles may include that of advocate, expert, trainer/educator, collaborator, fact finder, process specialist etc. Consultation focuses on primary prevention, with the consultant (considered to be an expert) diagnosing a problem and providing a solution while having no responsibility for carrying out the recommended changes.