Vignette

Vignette #1

You are a school psychologist currently working for a district with one elementary school, one middle school, and one high school. Recently, you received a phone call from a teacher with concerns about a student in class (Henry). Below is a description of information you gathered from teachers, parents, cumulative records, and direct observations.

Henry is a 7-year-old first grade student in your school district. His classroom teacher reported that he is having difficulty controlling his behavior and shows poor sustained attention. Specifically, his teacher reports attention-seeking behaviors from peers, loud outbursts, and argumentative behaviors when redirected back on task.

Henry’s mother reported that he talks about how much he enjoys school at home, but she is worried that he’s being treated unfairly. She believes “school is a place of punishment” and “everyone is looking to bother me at home when there is nothing wrong.” Henry’s mother described a typical weekday afternoon consisting of homework at the kitchen table with his older sister (freshman in high school) followed by free time (playing outside, video games).

A review of his records showed that Henry’s mother required emergency surgery to deliver him at 37 weeks gestation. Henry was born underweight weighing approximately 4 lbs 7 oz and required brief hospitalization (1 week) before discharge. All developmental milestones were reported within typical parameters. Henry was described as a hyperactive child, always “driven by a motor.” When Henry was 4, his pediatrician prescribed a low dose of Adderall to address hyperactivity before beginning Kindergarten the following year. However, Henry’s mother no longer gives him the medication because it reportedly increased his hyperactivity, making it worse.

At school, Henry receives general education supports for academics with no history of learning problems. In Kindergarten, Henry’s classroom teacher developed a behavior management plan to help improve his off-task behaviors. His teachers reported that “he enjoys positive feedback” and “needs so much attention” but did really well with the behavior plan. Henry’s current classroom teacher does not implement a behavior management plan. When asked to elaborate, his current teacher described Henry as “hyper”, “socially immature”, and “very demanding.” Henry has difficulty sharing and cooperating with others and tends to be persistent with demands, showing difficulty discontinuing a preferred behavior to transition back to work.

Reflection Questions:

1. Describe a client-centered consultative approach in this scenario. Who is the client? How about consultee-centered consultation? Who is the consultee, and why might this need to be considered as well?

2. Discuss at least two of the four types of consultee-related issues according to Caplan. Why did you identify them as issues?

3. Consider “control” from behavioral consultation. What the strengths/limitations of incorporating control in this scenario? In other words, when might having more “control” help you be effective? Ineffective?

4. Compare/contrast the appraisals and expectations for consultation of the teacher and the parent. Where do you note discrepancies? How would a consultant facilitate the consultative relationship moving forward?