BAHAR BAŞTUĞ Assist. Prof. Dr.

Consultative, Teaching and Administrative Roles

Lecture Preview Consultation Teaching Administration

In addition to research, assessment, and psychotherapy, consultation, teaching, and administration are three common professional services offered by clinical psychologists. These activities are not necessarily separate or distinct.

Psychologists may both teach and consult in addition to conducting psychotherapy, psychological testing or research. Therefore, an overlap may exist among these activities.

Consultation Clinical psychologists study, research, and treat a wide range of problems and people who are distressed by problematic feelings, thoughts, and behaviors. Psychologists are experts about theories and principles of human behavior. This expertise can be used to help many individuals, families, groups, and institutions.

Consultation Clinical psychologists are asked to consult with others to assist in solving problems in diverse settings.

Consultation Psychologists provide cons to others. They regularly receive cons from others. Consultation may be provided to other mental health professionals; to organizations, groups, and individuals; and to the general public.

Consultation the application of knowledge and theories of human behavior to specific questions and problems in various community settings such as hospitals, clinics, schools, businesses, and government agencies. Cons involves offering professional advice to others concerning problems that exist in their setting.

Consultation Cons usually involves the participation of a consultant with specialized knowledge and skill and a consultee or client who benefits from the expertise of the consultant. Unlike one-to-one psychotherapy, a consultant has the opportunity to assist large groups of people and entire organizations through his or her work with a consultee.

«Two (or more) heads are better than one» Clayton and Bongar (1994) reported that cons activities improve quality of care, client satisfaction, and treatment outcome.

Consultation roles for clinical psychologists Consultants may take many different roles based on a continuum between being directive and being nondirective. Directive consultant is viewed as offering expert and technical consultation. They help consultees solve problems through their knowledge about issues.

Nondirective consultants use their skills and expertise to facilitate the consultee’s skills. Directive cons generally is task-oriented, whereas the nondirective approach is process-oriented. The directive approach focuses more on results, while the nondirective approach focuses on process or growth.

Dougherty defined the following six common cons roles:  expert,  trainer/educator,  advocate,  collaborator,  fact finder, and  process specialist.

The expert consultant is the most common one. The expert consultant is a technological advisor. He/she has the specialized skills, knowledge, or experience that the consultee needs to help solve a problem. An expert consultant may have special skills in conducting intelligence testing for children applying to a school system’s gifted and talented program. The school hires the consultant to help them understand what the test scores mean.

The trainer/educator consultant has specialized information that is useful to the client and can be acquired through education. A consultant may be asked to train employees of a company to manage stress better through the use of relaxation techniques. A consultant who has knowledge about domestic violence may train police officers to recognize the signs and symptoms of domestic violence.

The advocate consultant seeks to convince a consultee to do something that the consultant believes. A consultant may advocate for the rights of severely disabled patients who have difficulty advocating for themselves.

The collaborator consultant is an equal partner working with a consultee to achieve a common goal. If a researcher is interested in learning more about the effect of physical exercise in the treatment of depr and knows a great deal about exercise but little about depr, the researcher may decide to work with a collaborating consultant who is an expert on depr. An individual psychotherapist and a group psychotherapist treating the same patient might collaborate.

The fact finder consultation role involves seeking information and relaying the results to consultees who lack the expertise, time, energy, or psychological sensitivities to do the task themselves. A psychologist may be interested in buying a new computer for his laboratory. He may hire a fact finding consultant who has knowledge about the use of computers. Or a company concerned about poor morale might hire an outside fact-finding consultant to investigate the causes of the problem.

The role of the process-specialist consultant is to help the consultee better understand the process of events that might cause problems. A clinic manager dissatisfied with running the staff meetings might hire a process-specialist consultant to observe the meetings and suggest ways to improve communication and staff participation.

Types of Consultation In mental health settings, there are several types of cons conducted by clinical psychologists: (1) informal peer group cons, (2) client-centered case cons, (3) program-centered administrative cons, (4) consultee-centered case cons, and (5) consultee-centered administrative cons.

Types of Consultation informal peer group cons is the most used. It involves asking coworkers to consult on a challenging case informally during lunch or time breaks. A psychologist may struggle with the treatment of a difficult patient. The psychologist may believe that process has stopped and wonders how he or she might best alter the treatment plan to best assist the patient. The psychologist might asked a colleague to discuss the case to develop insight into better treatment strategies.

Types of Consultation client-centered case cons involves cons with a fellow professional such as another psychologist who is responsible for the treatment of a particular patient. Both consultee and consultant have some responsibility for the care of the patient.

Types of Consultation program-centered administrative cons focuses on a program or system rather than on an individual case. The cons involve an important aspect of the functioning of a clinic, practice or research program. A psychologist might seek consultation about the curriculum, structure, and advertising strategy of group psychotherapy programs for patients. The consultation might concern how best to conduct intake interviews and assign patients to therapists in a large mental health clinic.

Types of Consultation consultee-centered case cons focuses on challenges experienced by the consultee rather than on problems concerning a client. Inexperience, lack of information, and mistakes made by the consultee are often the topic of discussion. A graduate student may seek consultation from an experienced supervisor about discomfort and anxiety experienced when conducting psychotherapy with patients who are older than the student.

Types of Consultation consultee-centered administrative cons involves working on administrative and personnel issues within an agency. An outpatient clinic board of directors may wish to consult with a psychologist about problems in the leadership performance of their executive director.

Organizational Consultation Clinical psychologists provide consultation to nonmental health agencies and organizations such as businesses, nonprofit agencies, and government organizations dealing with the interpersonal and organizational problems and conflicts. Organizational consultation uses systems theory.

For systems theory, all aspects of a system interact and react to changes and behavior in each element of the system. Each element or subsystem within the large organizational structure is dependent on other elements or subsystems,changes that occur at one level will usually influence changes at other levels. Consultants to organizations must use systems theory to diagnose organizational problems and provide interventions.

Executive Coaching It has become popular in business and industry. Clinical psychologists, social workers, marriage and family therapists, human resources specialists have developed services as an executive coach. They focus on ways to help executives become better leaders and managers as well as develop strategies to improve interpersonal relationships, productivity, and efficiency in companies. Executive coaches may consult with business leaders about stress management and goal setting.

Stages of Consultation The stages that have been used for the therapy process apply to cons: (1) understanding the question, (2) assessment, (3) intervention, (4) termination, and (5) follow up.

Stages of Consultation (1) Understanding the Question: In order to understand the nature of the referral question,the consultant must evaluate the situation and the goals of the cons. The consultant must determine if his or her training, experience, and expertise is enough to provide a cons.

Stages of Consultation The initial question changes during the course of the cons. Sometimes before agreeing to be hired, a consultant must determine whether the organization is ready for the experience. An organization initiates contact with a consultant, but it may be resistant to change, to feedback, or to the results of the cons.

Stages of Consultation (2)Assessment: This phase includes interviews and psychological testing and/or review of records or other data. The consultant should enter the organizational system. The consultant must assess the customs, beliefs, rules, and general climate of the organization. He/She must attempt to develop a trusting relationship with the consultees before offering any advice.

Stages of Consultation Interviewing is the most common method of a cons assessment. The consultant may choose to use either structured and standardized interviews or unstructured, and nonstandardized interviews. Surveys, questionnaires and direct observation are methods of assessment in cons. A consultant may observe an organization, sit in on meetings, and/or watch people while working and interacting.

Once an assessment is complete, the consultant develops a diagnosis and outlines goals for intervention. The goals should be specific, realistic, measurable, and based on collaboration between consultant and consultees.

Stages of Consultation (3) Intervention: The consultant can develop an intervention strategy. The consultant provides the advice or suggestions for change. In this stage, applying occurs. Applying the intervention is the responsibility of the consultee, with guidance from the consultant. Once an intervention is applied, an evaluation is conducted to determine whether the intervention has been useful.

Stages of Consultation (4) Termination: After the goals of the cons have been met, or not, the termination phase occurs. Researchers recommend conducting a terminate interview to discuss the consultation process, share feedback, plan for follow-up at termination.

Stages of Consultation (5) Follow-Up: Interventions and advice may or may not be used. The advice may be what the consultee doesn’t wanted to hear, the intervention plans may not be realistic, or they may be too difficult to apply. Follow-up maximizes the consultee’s benefit from the consultation.

To Whom Do Clinical Psychologists Offer Consultation? Clinical psychologists provide advice and cons to their peers. They may have a high degree of expertise in a certain area less familiar to other people. Psychologists may consult with a colleague about a patient they treat in psychotherapy when they are unsure how best to handle a particular therapeutic situation. Discussing a case with an objective and unbiased colleague is very useful.

Psychologists may seek cons when conducting psychological evaluations or testing. Some of the data from an evaluation may be difficult to interpret or may conflict with data from other sources. The psychologist conducting the evaluation may seek a second opinion by asking a colleague to cons on the case and review the testing materials.

Psychologists conducting research consult with colleagues. A psychologist may seek the cons of another to assist in interpreting research data, designing appropriate experiments, and determining equipment to use.

Consultation with Nonmental Health Professionals Many psychologists consult with teachers and administrators, physicians and nurses, attorneys and judges, clergy, the military, and people working in business and industry. Psychologists consult with medical personnel concerning patient care. Many medical patients need assistance in coping with anx or depr associated with their illness.

Many hospitals have a consultation-liaison (C&L) service so that psychological consultation can be made available to every medical department at all times. Patients recovering from a heart attack, obtaining dialysis for kidney failure, or receiving radiation/chemotherapy for cancer are fearful and depressed. Consultation with a psychologist may assist these patients in coping more effectively with their treatment, diagnosis, feelings, and posthospital adjustment.

Psychologists consult with teachers and school personnel in every kind of schools. Many psychologists consult with attorneys and judges on various cases such as child custody and criminal cases. They may be asked to consult on the selection and training of new police and fire recruits.

What are needed to be an effective consultant? Excellent group and problem-solving skills, the ability to work with organizations, and professional and ethical behavior are important. Skills necessary for effective consultation are empathy, genuineness, social skills, ease in working with others and effective listening.

Teaching Teaching activities are a part of the professional duties of many psychologists. Clinical psychologists teach in a wide variety of settings and to a wide variety of audiences. Teaching may involve formal college classroom instruction, individual supervision of a psychologist-in-training, or lecturing on stress-management techniques to firms or schools.

Teaching may be incorporated into psychotherapy and psychological testing activities. For instance, a psychologist may teach a patient how to use relaxation techniques to cope with stress or teach a couple how to communicate better. Psychoeducational approaches involve teaching patients to cope with a wide range of medical and psychiatric problems.

Teaching in Academic Settings Many clinical psychologists teach in psychology departments in colleges and universities. They teach courses: Introduction to Psychology, Abnormal Psychology, Clinical Psychology, Psychological Testing, Statistics, and Research Methods. Academic psychologists may teach undergraduates, graduates, and postgraduates.

Clinical psychology professors provide individual and/or group supervision of clinical cases treated by graduate or postgraduate students. They review the assessment, treatment, and cons activities of students working with clinical patients and offer guidance, support, advice, and ensure quality care regarding clinical methods and interventions.

They supervise the dissertation projects of several doctoral students. Full-time professors are classified as assistant, associate, or professors. Universities hire part-time instructors who are not suitable for full-time position. These part-time teachers are often called lecturers, and instructors.

In colleges and universities, clinical psychologists teach in other departments such as education, counseling, women’s studies, business, law, and medicine. Clinical psychologists teach in medical schools and hospitals as well. They may teach seminars to medical students, nurses, psychology interns, and postdoctoral psychology fellows.

Clinical psychologists may teach medical school classes on the topics such as health psychology, abnormal psychology, and pediatric psychology. Clinical psychologists provide individual supervision. Students meet regularly with a supervisor to closely examine their clinical work. They may audio or videotape sessions in order to review them in detail with the supervising psychologist. Videotaping is the most popular method of supervision.

Teaching in Nonacademic Settings Clinical psychologists may teach seminars, provide guest lectures, or give presentations in outpatient mental health clinics, group private practice clinics, nonprofit institutes and day care centers. Topics may include how to assess and treat patients with certain disorders or how to work more effectively with certain patient populations. Many clinical psychologists conduct workshops for other psychologists or professionals (e.g., nurses, social workers, physicians). Workshops may last for a single day or for several days.

Teaching Clinical psychologists may teach in business and industry environments, focusing on stress management techniques, ways to improve employee morale, and strategies to improve interviewing and communication skills. Clinical psychologists provide lectures to the general public at schools, businesses, volunteer organizations, bookstores and coffee houses. An elementary school may wish to have a psychologist present a lecture on the effects of television violence on children.

Administration

Effective administration involves excellent leadership, decision-making, negotiating, and organizational skills. Psychologists may work as unit chiefs of hospital psychiatric units, mental health services, chair psychology departments in colleges or universities, work as deans in universities, or manage staff and other clinicians in large group private practices.

Administration Psychologists have the responsibility of hiring and firing employees,designing and applying programs and services, managing budgets, and supervising the activities of many other professionals. There is no administration course in formal training. The qualities that make a psychologist a successful clinician, consultant, or researcher are not likely to be the same qualities that make a successful administrator.

Administration Managing a budget, negotiating contracts, and dealing with employee conflicts and office politics are different skills from the ability of psychotherapy and research. These skills are generally not a specific part of the clinical psychology training process.