The protocols for referral for psychological services need to be clearly identified and related to expected outcomes. Too often referents are unclear as to what constitutes a problems that should be addressed psychologically and psychological counselors are unclear about expected outcomes.
Definitions:
Psychology
Oxford : The science of the nature, functions and phenomena of human mind and conduct.
Funk & Wagnall : The science of the human mind in any of its aspects, operations, powers or functions.
Psychiatry
Oxford : The study and treatment of mental disease.
Funk & Wagnall : The branch of medicine that treats disorders of the mind…
Therefore, the psychological intervention is an action to step into a situation which has to do with the human mind and conduct. It has no medical aspects. This is further enhanced by the federal regulations promulgated under IDEA which “define medical services as services provided by a licensed physician…” – this ‘bright line’ criterion has been endorsed in two Supreme court decisions addressing related services. It is therefore suggested that psychological interventions in the school conform to the following criterion.
1. The child must demonstrate the need of such intervention
The child manifests a clearly identified social [interpersonal], emotional [fear, anger, sadness, doting, etc.] and/or behavioral [withdrawal, aggression, hyperactivity, etc.] trait [assumed to be part of the child’s personality] which interferes in defined [documented] ways with the child ability to perform competently [up to normal expectations] in a specific domain [in this case academic].
2. The person(s) intervening must demonstrate the capacity and intentionality of the intervention
The person who is designing or implementing the intervention manifests 1) a clearly defined fundamental assumption about why the atypical performance occurs, 2) a clearly defined theory of change and 3) a clearly defined set of protocols, techniques and procedures which are expected to address and alter the trait which is interfering with performance. This plan should 4) demonstrate a clearly defined time schedule and 5) an agreement [by the child/family & those responsible for the delivery of the service] set of outcome expectations
3. The intervention must relate to the future goals and desires of the client
If over 13 years of age, the adolescent should complete, with the help of the community of interest [peers, family members and child managers who interact with the child in or in conjunction with the domain over time] a vision statement that addresses the child’s specific goals and desires in the specified domain and in adult living. This step is specifically oriented in helping the members of the domain and the persons intervening to do so on behalf of the child – supporting his/her goals.
4. The child must be understood as a component in a network of systems [neighborhood, school, family, etc.] and within that network a community of interest [those people who interact with the child with concern] should be defined.
Each of these people are potential secondary and tertiary clients with the need to design and implement interventions to correct traits of child managers that may initiate and maintain the child’s attitudes and behaviors that have led to problems in living. This community of interest may also be thought of as a ‘circle of friends’ who by their participation have an intimate interest in the achievement of the child. This interest may be maximized through a formal method of participation.
5. The intervention process and expectations must be authorized by the client(s) and the client(s) must agree to participate effectively
A contract for the intervention should be developed which specifically spells out all the issues in #2 and the child/family’s specific expectation of appropriate participation. A defined process for review should be included identifying specifically, when progress will be reviewed, what constitutes progress, how that progress will be measured and how a plan of correction will occur. A ‘change order’ agreement that ensures that the client authorizes any change in the ‘plan’ should be included in this contract.
In all other aspects, the district should refer to the article Psychotherapy Services for Students with Emotional or Behavioral Disorders: A Legal Analysis of Issues by Etscheidt which appeared in the August 2002 issue of Behavioral disorders, 27(4), 386-399.