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John G. MehmUniversity of Hartford
Models of Training in Supervision and Consultation: A Sampler
Friday, January 21, 2011
A Model of Doctoral Training in Consultation
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CPS 670: Consultation in Healthcare Delivery Systems: Case Perspectives
Two 1-credit courses in consultation
CPS 671: Consultation in Healthcare Delivery Systems: Systems Perspectives
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The Consultation Dilemma
Training in psychological consultation often places the doctoral student in a particularly challenging situation:
• A trainee is placed prematurely in the role of expert.
• Referral questions often range from the extremely difficult to the impossible.
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What to Do?
Is it possible to develop competencies in consultation before the student becomes a full-fledged expert?
Is there more to being a consultant than just being an expert?
What is the best sequence for development of competencies in consultation?
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APA (2007) Guidelines
Consulting is important to the effectiveness of many (if not all) practicing psychologists to greater or lesser degrees.
Completing a doctoral program in psychology does not [necessarily] prepare one to provide the best possible consulting services.
There is a body of knowledge and skills unique to this particular application of psychology.
American Psychological Association. (2007). Guidelines for education and training at the doctoral and postdoctoral levels in consulting psychology and organizational consulting psychology. American Psychologist, 62(9), 980-992.
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APA (2007) Guidelines
Three relevant areas of competency for consulting practice:
(I) Individual (G) Group (O) Organization / system / intersystem
American Psychological Association. (2007). Guidelines for education and training at the doctoral and postdoctoral levels in consulting psychology and organizational consulting psychology. American Psychologist, 62(9), 980-992.
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Consultation Competencies (Fouad et al., 2009)
The ability to provide expert guidance or professional assistance in response to a client’s needs or goals
Three major tasks Role of Consultant Addressing Referral Questions Communication of Findings
Three developmental milestones Readiness for Practicum Readiness for Internship Readiness for Entry to Practice
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Role of Consultant: Readiness for Internship
Essential Component:
Knowledge of the consultant’s role and its unique features as distinguished from other professional roles (such as therapist, supervisor, teacher)
Behavioral Anchors: Articulates common and distinctive roles of
consultant Compares and contrasts consultation,
clinical, and supervision roles
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Essential Component:Knowledge of and ability to select appropriate means of assessment to answer referral questions
Behavioral Anchors: Implements systematic approach to data
collection in a consultative role
Identifies sources and types of assessment tools
Addressing Referral Questions:Readiness for Internship
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Communication of Findings:Readiness for Internship
Essential Component:Identifies and acquires literature relevant to unique consultation methods (assessment and intervention) within systems, clients, or settings
Behavioral Anchor: Identifies appropriate interventions based on
consultation assessment findings
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Clinical Consultation CourseCourse Overview
What is consultation? What is a healthcare delivery system? What are the modes and processes of
consultation? What is the role of the psychologist as
a consultant in a healthcare delivery system?
Which consultation skills are essential?
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What Is Consultation?
A process whereby one individual (the consultee)
who has responsibility for providing a service to others (the clients)
voluntarily seeks assistance from another person (the consultant)
who is believed to possess some special expertise
which will help the consultee provide a better service to his/her clients.
(Orford, 1992)
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Key Characteristics of Consultation
It is a triadic relationship: consultant, consultee, and
client
It is voluntary It is focused on improving service The consultant utilizes his/her
expertise
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The Consultation Relationship (Caplan, 1970)
The consultation relationship differs from a supervisory or educational relationship:
While the consultant is an expert, the consultee is the customer in charge of the relationship
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The Consultation Relationship (Caplan, 1970)
Consultee has no obligation to follow the consultant’s advice
Consultant has no responsibility for the consultee’s work
The relationship between consultant and consultee tends to be collaborative
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Goals of Consultation
Main goal: to improve the consultee’s performance (rather than improve his/her insight or sense of well-being).
Secondary goal: to improve the consultee’s ability to function without the consultant when similar situations are encountered in the future.
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What Skills are Needed to be an Effective Consultant?
1. Have an organized and flexible approach to problem-solving.
2. Have solid clinical skills (esp. mood, substance abuse, and cognitive disorders).
3. Be a good communicator.4. Understand the consultation process.5. Understand cultural diversity.6. Be familiar with crisis intervention. 7. Think in terms of organizations & systems.
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Consultant provides organized approach to assist clinician work with client to:
Gain an intellectual understanding of the circumstances.
Express feelings. Explore coping resources. Reopen/expand social support network. Set reasonable goals (which can be
achieved and reinforced).
Consultation example: Crisis intervention
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Organizational Consultation CourseIssues from I-G-O model
1. How can an individual function more effectively within an existing organization or system of care?
2. How can a group (team, department, division) function more effectively within an existing organization or system of care?
3. How can the organization or system of care make positive changes to function more effectively overall?
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Management-administration Competencies
(Fouad et al., 2009)
Manage the direct delivery of services and/or the administration of organizations, programs, or agencies
Four major tasks Management Administration Leadership Evaluation of Management and Leadership
Benchmarks for three developmental milestones Readiness for Practicum Readiness for Internship Readiness for Entry to Practice
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Management: Readiness for Internship
Essential Component:Participates in management of direct delivery of services (DDS); responds appropriately in management hierarchy
Behavioral Anchors: Responds appropriately to managers and
subordinates Manages DDS under supervision, e.g., scheduling,
billing, maintenance of records Identifies responsibilities, challenges, and
processes of management
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Administration: Readiness for Internship
Essential Component:Knowledge of and ability to effectively function within professional settings and organizations, including compliance with policies and procedures
Behavioral Anchors: Articulates approved organizational polices and
procedures Completes reports and other assignments promptly Complies with record-keeping guidelines Demonstrates understanding of quality
improvement (QI) procedures in direct delivery of services, basic management of direct services, QI procedures
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Leadership: Readiness for Internship
Essential Component:Recognition of own role in creating policy, participation in system change, and management structure
Behavioral Anchors: Articulates agency mission and purpose and its
connection to goals and objectives Implements procedures to accomplish goals and
objectives
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Evaluation of Management and Leadership:
Readiness for Internship
Essential Component:
Able to develop and prepared to offer constructive criticism and suggestions regarding management and leadership of organization
Behavioral Anchor: Identifies strengths and weaknesses of
management and leadership of organization Provides input appropriately, participates in
organizational assessment
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Referral Questions:What are Common Organizational Issues?
1. Communication2. Decision-making 3. Conflict resolution4. Cultural diversity5. Transition of leadership6. Implementing change7. Responding to environmental events (external
threats)8. Workplace deviance (internal threats)9. Professional image10. Teamwork
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3 Core Issues for Teaching Organizational Consultation
Excellence Leadership Decision-making
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7 Good Questions for Understanding Organizations
What is viewed as excellence in the organization?
What values do the leaders reinforce?
How are decisions made?
How are individual differences (sex, ethnicity, status) treated?
How is underperformance handled?
How loyal are employees?
How is leadership developed?
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4 Important Functions of Leaders
1. Leaders are needed to provide strategic direction and vision to organizations.
2. They engage in motivation and coaching behaviors.
3. They enforce and interpret organizational policies.
4. They are important in obtaining resources for groups.
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Leadership Development and Career Growth:Where does discomfort arise?
ExecutiveLeadership
Skills
Technical Skills
Entry level
Supervisory
Managerial
growth
Discomfort Zone
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Three Procedures forMaking Decisions
1. Consensus (100% approval)
2. Simple majority (> 51% approval)
---------------------------------3. Everything else (?
% approval)
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So, do I need an MBA, too?
Datar, Garvin, & Cullen (2010)Rethinking the MBA: Business
Education at a Crossroads
According to business school deans and business leaders, even MBAs lack these essentials:
sufficient leadership development a "global mindset" skill in navigating organizational realities