Wake Forest University

CNS 786: Consultation and Program Development in Counseling

Assignment 3.1: Consultation Case Study

Literature Review

Leah I. Johnson, M.A.

Baker, J. A., Grant, S., & Morlock, L. (2008). The teacher‐ student relationship as a
developmental context for children with internalizing or externalizing behavior problems. School
Psychology Quarterly, 23: 3–15.

General Summary

This literature was produced to discuss the prevalence of internal symptoms (depression

and anxiety) versus external symptoms (aggression and impulsive) in children demonstrating

social-emotional and behavioral problems both of which are associated with impaired academic

and social development. The study was conducted on approximately 430 school aged children

considered to be at-risk based on their academic performance and socioeconomic status. This

longitudinal study was designed to monitor academic achievement, positive work habits, and

classroom adjustment with a focus on teacher-student relationships. It yielded outcomes

supporting the theory that when developmental disadvantages compound over long periods of

time, children are more likely to drop out of school, engage in criminal acts, and have overall

poor adult adaptation.

Synthesis
The text addresses the dynamics and diversity of the school setting in addition to the

multicultural considerations when engaging in school-based consultation. School-based mental

health consultants must work directly with school staff and parents to address a wide range of

behavioral and academic concerns, therefore it is pertinent they retain a systemic perspective of

their work in the schools (Scott, Royal, & Kissinger p.208). Finally, a consultant who is

culturally competent, knowledgable about how to support the teacher-student relationship, and

understanding of the needs of the client to achieve academic goals will be able to maintain an

effective working relationship between themselves and their consultee.

Limitations

Although this article initially set out to study all the children in the school settings, the

study sample was limited to low income African-American and Hispanic students based on the

outcomes of the standardized behavioral tests administered; with African-American males being

overrepresented in the externalizing behavior group. Despite being disproportionate, the authors

did not want to set a control for race, for fear that it may misrepresent effects that could be a

result of other factors, such as poverty. The teachers participating in this study were

predominantly Caucasian which may or may not have impacted the outcome of the teacher-

student relationship quality due to cultural differences.

Implications for Counselors

Counselor’s should be aware of the need to identify the normative contexts in schools

that may influence positive developmental outcomes for at-risk children. The article emphasized

the importance of a warm, trusting, emotionally secure and nurturing relationship between the

teacher and the student. Thus, having a positive impact of the student’s self-esteem, reducing

negative behaviors and creating an environment that becomes motivational and conducive to

learning. This will also present a need to address the topic of setting boundaries for the consultee

to implement when building relationships with the client. Counselor’s will need to align with the

administration and teaching staff to ensure there is absolute compliance regarding appropriate

boundaries with students/families and working under the premise of unconditional positive

regard. Finally, as consultants, counselor’s should be willing to facilitate in-service trainings to

address present or perceived barriers.

Implications for Consultee and/or Clients

 It is important for school staff to understand the correlation between the teacher-student

relationship and positive academic performance. To better understand this relationship, the

teachers and parents must be willing to participate in training programs offered to address

nurturing teacher-student relationships, firm and consistent boundaries, familial support, and

gauging academic outcomes based on those areas and goal setting.

Marcus, S. C., Ph.D, & Durkin, M., M.Sc. (2011). Stimulant adherence and academic
performance in urban youth with attention-Deficit/Hyperactivity disorder. Journal of the
American Academy of Child & Adolescent Psychiatry, 50(5), 480-489.
10.1016/j.jaac.2011.02.007.

General Summary
The study presented in this article was conducted to determine if there was a correlation

between medication compliance in urban youth diagnosed with attention-deficit/hyperactivity

disorder (ADHD) and improvement in their grade point average (GPA). The author’s gathered

information from approximately 3,500 students attending Philadelphia public schools. They

found that although adherence among students was low, when taken properly there was a

marginal improvement in their GPA.

Limitations
This article does not address other medications or diagnoses that possibly contribute to

urban youth’s academic performance. They only studied students assessed to be sufficiently

severe enough to warrant a pharmacological intervention. Consideration was not taken when

differences among student were not controlled such as wrap around services or their home

environments.

Synthesis
 This study, as with the other, yielded results that shown a majority of the sample being

African-American boys from low income communities. Again emphasizing the fact that cultural

awareness with these populations is critical when addressing how to effectively communicate

with the clients and their families. A consultant that is able to relay information regarding

common co-morbid clinical diagnoses of disruptive behavior disorders, mood or anxiety

disorders, and specific learning disabilities is also an asset to the consultee.

Implications for Counselors

Medication compliance is an issue that will always need to be addressed by counselors.

As consultants, it is essential to provide the consultee with accurate information regarding the

impact of noncompliance with stimulant medications on their client’s academic performance as

well as being a contributing factor in disruptive or inattentive classroom behaviors. Knowing

which core subjects are affected the most based on the client’s ADHD diagnosis can help the

consultant suggest which areas the consultee may need to focus on.

Implications for Consultee and/or Clients

Willingness of administrators, teachers, families, and communities to participate in in-

services that address medication compliance as well as recognizing symptoms associated with

ADHD (mild, moderate, and severe) could help target larger student populations that could

benefit from consistent medication management or identifying individuals that may qualify for

additional services.

Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008). Evidence-based psychosocial treatments
for children and adolescents with disruptive behavior. Journal of Clinical Child & Adolescent
Psychology, 37(1), 215-237. 10.1080/15374410701820117.
General Summary
This journal article was developed to identify and discuss evidence-based treatment

outcome studies of disruptive behaviors in children and adolescents. They broadly defined

disruptive behaviors based on the symptoms outlined for diagnoses in the DSM-IV such as

oppositional defiant disorder (ODD) and conduct disorder (CD). These behaviors included

aggression, noncompliance, delinquent behaviors, and disruptive classroom behaviors. They

researched and evaluated differing methods such as anger control training, assertive training,

problem-solving training, and positive parenting in addition to medication management for ODD

and CD diagnoses.

Synthesis
This article focused on evidence-based research conducted on adolescent populations

addressing behavioral issue while at school. The text refers to this as school-based consultation

and emphasizes the importance of being knowledgable about the unique systemic dimensions

within the school setting (Scott, Royal, & Kissinger p.197). Both the article and the text discuss

ethical interventions in response to cultural variances. As the consultant, being mindful to use

evidenced-based research to support interventions will help to stay abreast on the most current

studies and implement most useful tactics to help support their consultee when developing goals

for the client.

Limitations

This article targeted child or adolescent disruptive behaviors as the primary disorder,

limiting their research to exclude those with attention-deficit/hyperactivity disorder (ADHD).

Additionally, they did not include truancy or alcohol/substance abuse as contributing factors.
Implications for counselors
This article admits that despite the extensive research on disruptive behaviors in children

and adolescents, there is still no single intervention that could be considered best practice.

However, the article emphasized the importance of parent-training programs on the forefront of

addressing the disruptive behaviors. The article also strongly recommended multi-faceted

treatment modalities that include the participation of teachers, behavior specialists, psychiatrists,

peers or other outside agencies that work with the troubled youth. The article mentioned how

current treatment planning relied heavily on clinical assessment as the main fact finding source

for information such as what the individual and the family would hope to gain from treatment

within the school setting. Finally, to keep in mind cultural differences/preferences, academic

functioning, and level of comprehension for both parent and child.

Implications for Consultee and/or Clients

Similar to the previous article reviewed, the outcomes of this type of study is influenced

by the participation of school staff in addition to parents/legal guardians of the youth being

studied. The authors strongly suggest positive parenting programs and problem-solving training;

which would require additional time and efforts on behalf of the teachers and parents. These

efforts could greatly impact the outcomes for the client if either party is unwilling or unable to

dedicate time to the necessary training. The text warns that interventions often challenge

consultees to revamp their teaching in style and substance, heavy emphasis is placed on the

relationship components of trust and sharing (Scott, Royal, & Kissinger p.210).
 References

Baker, J. A., Grant, S., & Morlock, L. (2008). The teacher‐ student relationship as a
developmental context for children with internalizing or externalizing behavior problems. School
Psychology Quarterly, 23: 3–15.

Marcus, S. C., Ph.D, & Durkin, M., M.Sc. (2011). Stimulant adherence and academic
performance in urban youth with attention-Deficit/Hyperactivity disorder. Journal of the
American Academy of Child & Adolescent Psychiatry, 50(5), 480-489.
10.1016/j.jaac.2011.02.007.

Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008). Evidence-based psychosocial treatments
for children and adolescents with disruptive behavior. Journal of Clinical Child & Adolescent
Psychology, 37(1), 215-237. 10.1080/15374410701820117.

Scott, D. A. (2015). Counselor As Consultant, 1st Edition. [Textbooks.com]. Retrieved from

https://bookshelf.textbooks.com/#/books/9781483322612/