Alternative school psychological services: Development of a model linking theory, research and service delivery
Chryse Hatzichristou, Ph.D.
University of Athens, Greece
In N.M.Lambert, I.Hylander and J.Sandoval (Editors), Consultee-Centered
Consultation: Improving the Quality of Professional Services in Schools and
Community Organizations (in press). Mahwah, NJ: Lawrence Erlbaum.
Address all correspondence concerning this article to Chryse Hatzichristou, Ph.D, Professor of School Psychology. Department of Psychology, School of Philosophy, University of Athens, Panepistimiopolis, 15784 Ilissia, Athens, Greece.
Alternative school psychological services: Development of a model linking theory, research and service delivery
Chryse Hatzichristou, Ph.D.
Background
A number of studies during the last two decades, examining the status of children’s mental health in various countries, have yielded similar findings and correspondingly similar recommendations (Costello, 1989; Hatzichristou, 2000; Koyanagi, 1995; Pfeiffer & Reddy, 1998; Rog, 1995; Wardle, 1991) that only a low percentage (20 – 3 %) of those children identified to be in need of mental health services actually receive any care, while the great majority of students in need remain untreated. Moreover, the services provided are often inappropriate, inadequate and lack coordination across multiple providers and systems (eg. health care, educational, juvenile justice and child welfare systems).
There has been growing concern in many countries regarding the limitations of traditional direct psychoeducational services provided to children. This has reflected a growing emphasis on the importance of broadening the array of services delivered in school psychology (Lambert, 1993) and a growing interest in consultation theory, practice and research, mainly in the U.S.A. Several models of consultation have been developed reflecting the theoretical preference of the consultant, such as the “mental health”, “behavioral” and the “Adlerian” model, in an effort to cover the different needs and requests of a wide range of children (Brown, Pryzwansky, & Schulte, 2001). Findings from several studies have shown that all professionals in a school setting value consultation as one of the major and preferable job functions of school psychologists and the research evidence has further supported the efficacy of consultation interventions (Hughes, 1979; Kratochwill, Elliott, & Busse, 1995; Lambert, Sandoval, & Corder, 1975; Medway & Updyke, 1985; Reschly & Wilson, 1995).
There is considerable variability among different countries regarding the role, function and training of school psychologists, the types of school psychological services offered (Oakland & Saigh, 1989), and the utilization of consultation services. Even in countries with a history of public support for psychological services, consultation in schools has been developed only in the last few years in England and Wales (Lambram, 1993) or there is no clear differentiation between consultation and counseling services like in the Federal Republic of Germany (Mason, Mietzel, & Höfler, 1989). Despite the variability in professional practice, a conceptual framework has been proposed with specific components for examining and comparing the evolution of school psychology in different countries (Hatzichristou, 2002). Common phases and considerable similarities in the most important areas that define the specialty of school psychology show that a similar dynamic process of change that differs in pace is followed in different countries.
It is noteworthy that cross-cultural issues may affect not only the attitudes, the expectations and the needs of teachers and other school professionals when acting as consultees, but even the successful outcome of the consultation process (Brown, Pryzwansky, & Schulte, 2001). Nastasi et al (2000) point out that “effective consultation is dependent upon our understanding of the diverse population we serve, our ability to work with individuals from varied cultures, and our capacity for conducting assessments and developing interventions that can fulfill the diverse needs of clients (e.g., students), consultees (e.g., parents, teachers) and systems (e.g., schools, communities)” (p. 401). Ingraham (2000) emphasizes the need for a comprehensive framework that considers diversity issues in the structures, processes, context, and their interaction for practice especially within schools.
Cultural differences can become a barrier to effective consultation and as Henning-Stout et al (2000) report, research and practice in consultation will be well served by looking first to culturally based assumptions that limit the effectiveness of the proposed theories and models of application. Cross cultural perspectives can frame and guide consultation practice and consultation efforts must address the role of culture in promoting and sustaining the behavior of individuals (Nastasi et al, 2000). It is vital to take into account the cultural context from which theory and interpretation arise. All researchers who aim to achieve cultural understanding can contribute to developing a knowledge base that can support relevant and responsive service delivery across cultures (Henning-Stout & Meyers, 2000).
Based on the concerns described in the relevant literature, a conceptual framework was presented incorporating relevant science, and professional practice competences influencing school psychological services (Hatzichristou, 1998). The proposed integrative framework synthesizes and expands the following conceptual domains: (a) the scientist-practitioner specialty in school psychology; (b) the systemic (social, cultural/ethnic/national, ecological) approach in assessment and intervention practices; (c) the evolving roles and functions of school psychologists in research, practice, and training; and (d) the systemic approach of personal and professional development and identity of school psychologists. This chapter describes how this integrative conceptual framework led to the development of a data-based model of alternative school psychological services addressing developmental competencies and needs of culturally diverse populations within one country. The application of the model in a specific educational and cultural context – the Greek context –is presented. The model attempts to provide guidelines for understanding the culture of individual students, the country, and the school system to determine the service delivery model and the specific school psychology services, including consultee-centered consultation, that are likely to be most useful.
Greece is a country with limited provision of school psychological services. The educational system is centralized, and the curriculum is fully prescribed for every grade and every school in the country. Since 1989, the first fifty psychologists were employed and have worked in special education public schools. Recently, the foundation of “Centers of Diagnosis, Assessment and Intervention” in various school districts has been announced. School psychological services operate in many private schools in the big cities. For the most part, psychological services involve a focus on individual cases following a “clinical” direct service model. The lack of school psychological services in the Greek public schools, presented a unique opportunity and a great challenge for the development of alternative service delivery models with the goal of filling the system’s vacuum.
A model for the development of a school psychological service delivery system
Based on the integration of the domains of the proposed framework the data-based model of alternative school psychological services was developed (Hatzichristou, 1998.) There are four evolving and interrelated phases (Figure 1) each of which contributed to widening the “presentation” of the needs of Greek children, and understanding the current “representations” of the professionals in the system: 1) examination of the patterns of psychosocial and academic functioning of the average students; 2) examination of the profiles of at risk groups of students with unmet needs; 3) school and community based needs assessment and 4) development of a service delivery model and provision of specific services. The four phases of the model emphasize the necessity of a systematic examination of needs at multiple levels (individual, school, culture, community, country) with multiple measures for the development of prevention and intervention programs taking into consideration the ways the social, ethnic, and ecological validity constructs are represented in problem identification and intervention procedures.
The application of the model in the Greek school system was developed over many years when the author had different positions at Max-Planck Institute for Human Development and Education in Berlin, Germany and later at the University of Thessaly.
The development of the model continued over the last years at the Department of Psychology, University of Athens during which the development of the model was extended by examining, determining, and understanding basic educational and cultural factors in order to promote all students' psychological well-being and academic competence in the regular Greek schools.
The project explored the patterns of school-based competence of primary and secondary school students using a multifaceted, multicomponent assessment. Available evidence suggests the importance of using a multimethod assessment approach of children's behavioral patterns and competence across various domains (Coie & Dodge, 1988; Hatzichristou, 1987). The use of the term school-based competence implies and includes several domains of adaptive behavior of children in a specific cultural context -the Greek context- as determined by the standards of significant others (teachers, peers, and self) in a specific situational context - the school setting.
The development and application of the model constituted a dynamic process of adaptation, change, and evolution being enriched by several new research domains and service components. The evolution of the model included organizational and resource development and a strategic planning perspectives and resulted in the foundation of the Center for Research and Practice of School Psychology at the Department of Psychology, University of Athens.
The lack of traditional direct school psychological services in Greek public educational system provided a unique opportunity for the introduction of indirect services, like consultee-centered consultation. Indirect service delivery constitutes the core concept of almost all consultation models. In consultee-centered consultation in schools, the consultation triad can be defined flexibly to include different constellations of consultant, consultee(s), and the contexts in which they work. Both consultees and clients may consist of multiple parties or systems, i.e. consultees may be teachers, administrators, parents and clients may be an individual student, group, classroom, or system. Furthermore, it has been increasingly recognized that a successful consultation leads to a different conceptualization of the problem on behalf of the teacher consultee. Although teachers expect the child to change, the real success for the consultation process is to help the teacher change his/her presentation and representation (understanding of the problem as Hylander and Sandoval, have proposed).
The origin and evolution of the model in the Greek schools included a synthetic consultation approach consisting of several basic components designed to support a broad understanding of the theory and practice of consultee-centered consultation. Key factors that support the consultation process taking into account cultural, educational and systemic aspects and promote conceptual change between consultant(s) and consultee(s) will be addressed in the following brief description of the development and evolution periods of the model.
Phase I: Profiles of "average" Greek students
Development period. The lack of systematic research data on children's functioning in the Greek schools led to the need for a systematic examination of the adaptive behavior and school-based competence of "average" Greek students. Therefore, the aims of the first phase of the model included the following: a) examination of the profiles and normative patterns of competence across several domains of the "average" Greek students in childhood and adolescence based on the perceptions of teachers, peers and self, b) examination of the types, prevalence and developmental trends of psychosocial and academic problems in the general school population, c) examination of the association between psychosocial problems and academic performance, and d) examination of the effects of several independent variables on children's functioning in school.
The sample consisted of two age groups: a) elementary school pupils (10 to 12- year-old, N=1041) and b) secondary school students ( 13 to 16-year-old, N=862). The students attended public schools in various towns and cities in Greece. The instruments of the study included a teacher rating, a peer nomination assessment, and a self-rating. Achievement data were also obtained. Detailed descriptions and discussion of the findings and comparisons with published results from relevant studies in different countries are included in various papers (Hatzichristou & Hopf 1991, 1992a,1992c,1996; Hopf & Hatzichristou, 1997, 1999) and are beyond the scope of this article. The types, prevalence and developmental trends of psychosocial and academic problems in the student population were identified. A high percentage of Greek students experience problems in various domains of competence in school underlining the urgent need to develop prevention and intervention programs to address the academic and mental health needs of Greek youth.
The importance of distinctive educational and cultural factors affecting students' adjustment in the Greek schools, based on empirically derived data, identified specific needs in the general school population and constituted a solid knowledge base for school-based consultative services in the Greek educational setting. For example, strong gender-related differences were found in every aspect of children's functioning in school reflecting the greater gender-role differentiation of the Greek society as compared to other countries.
School achievement also was clearly related to almost every domain of children's competence, reflecting the strong emphasis of the Greek parents on the education of their children and the intense pressure for academic success in the Greek society. The most "maladaptive" children based on the combination of the perceptions of all raters had substantially lower achievement in all subjects underscoring the importance of prevention and early intervention, and of finding ways to promote social and emotional growth of children as well.
Evolution period. The developing course of the model led to the enrichment of phase I including new research domains with additional goals. The first research domain aimed at exploring the perceptions and causal attributions regarding academic achievement and students’ psychosocial adjustment based on teacher, parent and student questionnaires. The other research domain aimed at exploring; aspects of interpersonal relationships and communication between teachers and students; classroom environment / school climate aspects; support systems in the school context and the family; and, school-family partnership and collaboration. Furthermore, the examination of various dimensions of students’ school-based competence was extended.
These data resulted in the identification of teachers’, parents’, and students’ personal theories of several aspects of children’s school and psychosocial adjustment. Further, the data facilitated a better understanding of the presentations and representations of various problems during the consultation process, which are key factors in promoting conceptual change of both the consultant and the consultee.