SCHOOL PSYCHOLOGISTS AS MENTAL HEALTH PROVIDERS: THE IMPACT OF STAFFING RATIOS AND MEDICAID ON SERVICE PROVISIONS

As one out of five children in the United States demonstrate some type of mental or behavioral health concern warranting additional intervention, federal policies have emphasized the need for school‐based mental health (SBMH) services and an expansion of Medicaid reimbursement for eligible children and families. Most youth access mental health services at school; therefore, it is important to evaluate how staffing ratios, credentialing, and state Medicaid policies may influence school psychologists’ involvement in the delivery of SBMH services. A survey of 192 school psychologists found that as practitioner to student ratios increased, the availability and provision of SBMH services decreased. As state Medicaid policies have been found to influence the provision of mental health services at school, current study results demonstrate an association between state level Medicaid policies and the number of school psychologists qualified to bill for Medicaid‐reimbursable services. Implications for service delivery and policy development are discussed.     

Correlates of vocational practice among school psychologists

This study surveyed 362 school psychologists to: (a) identify the percentages of school psychologists who have had some involvement in the practices of vocational assessment, vocational counseling, consultation with vocational education teachers, and vocational program or curriculum development, and (b) identify factors that are associated with such vocational involvement. Results indicated that 30–40% of those school psychologists surveyed reported some involvement in vocational assessment, vocational counseling, and consultation with vocational education teachers, while only 12% indicated involvement with vocational program or curriculum development. Sex, experience, salary, perceived control over role functioning, and involvement in practices other than traditional assessment were found to be associated with increased involvement in vocational activities. Results also indicated that school psychologists who were certified guidance counselors, and who were members of the American Association of Counseling and Development, were more likely to be involved in vocational practices than were school psychologists who were not so certified or affiliated. Results are discussed in terms of their implication for involving greater numbers of school psychologists in vocational practices.     

Reports of child sexual abuse in the schools

Few studies have examined the problem of child sexual abuse (CSA) as it relates to the role of the school psychologist. The purpose of this study was to examine the incidence of CSA reports to school psychologists, to examine the perceived quality of service to child victims, and to survey the usage of CSA prevention and screening programs as adjunct services in managing this problem. Of the 171 respondents, 498 child sexual abuse cases were reported. Respondents with prior CSA training rated their performance significantly higher than those without training in handling these cases. Those respondents reporting use of CSA prevention and screening programs generally rated their effectiveness as average or above. The results of this study suggested a need for training of school psychologists in the assessment of child sexual abuse. The results also implicated the use of prevention and screening programs as part of a service delivery program to all students in the public schools.     

School-linked and school-based health services: A renewed call for collaboration between school psychologists and medical professionals

Health care and education reform provide opportunities to build systems that promote rather than retard collaboration between school psychologists and medical professionals. School-linked and school-based health services (SLSBHS) are a family of approaches that provide medical, social, and mental health services to students through school settings. These services have potential to provide more than acute care or first-aid services. SLSBHS provide medical care to uninsured children, students with chronic medical needs, at-risk children, and the overall school population. However, there are usually not enough funds to hire new staff members in most school districts. Expanding the roles of current school staff, promoting interdisciplinary collaboration, and implementing creative fiscal strategies are necessary to develop SLSBHS. Interdisciplinary collaboration may be the largest hurdle to developing SLSBHS. As such, school psychologists and medical professionals may need to rethink their professional roles and develop new techniques of interdisciplinary consultation to fulfill the potential of SLSBHS.     

Recognising and managing pupils with mental health difficulties: teachers' views and experiences on working with educational psychologists in schools

The role and future directions of the educational psychology services are being re‐examined and there is a drive to build a more integrated system of services for children and young people that incorporates education, health and social care. This qualitative study examines teacher’s perspectives on their professional involvement with educational psychology services. The results indicate that while it was clear that educational psychologists are highly valued by teachers, there are a number of issues that teachers believe constrain service provision. We suggest that greater cross‐system consultation is needed in order to more closely examine how the roles of professionals working in education, health and social care services impact on each other.     

Traditional Assessment,Consultation, and Intervention Practices: Urban School Psychologists' Use,Importance, and Competence Ratings

This article examines the practices of school psychologists who work within an urban school district. Participants (N = 86) rated 20 specific practices on their current use, their importance, and their level of competence. Overall the school psychologists rated their involvement in traditional assessment activities as significantly more common than consultation/collaboration and prevention/intervention; however, they indicated consultation and prevention/intervention activities as significantly more valued than traditional assessment practices. Participants also noted prevention, intervention, and functional assessment as their top priorities for professional development. Thus, a practice gap was noted with regard to what this group of school psychologists' value and what they do. Results are discussed within the context of current educational reform initiatives.     

Transition services for students with intellectual disabilities: School psychologists’ perceptions

For individuals with intellectual disabilities (ID), transition services increase access to postschool opportunities. School psychologists should contribute to transition services but have reportedly limited involvement in this area. This study distributed a national survey (N = 176) assessing school psychologists’ current knowledge, attitudes, and behaviors regarding transition services for students with ID. Results indicated that attitudes toward and knowledge of the ID population were significant predictors of transition task performance, and knowledge was a significant predictor of transition‐related attitudes and behaviors. The results provided preliminary evidence that increasing school psychologists’ specific knowledge of transition services and encouraging positive attitudes toward the transition needs of students with ID may increase school psychologists’ performance in transition practice. Specific recommendations are provided.     

An examination of ethnic incongruence in school‐based psychological services and diversity‐training experiences among school psychologists

The current study examined the prevalence of ethnic incongruence in three school psychological services: assessment, consultation, and counseling; the prevalence of diversity training among school psychologists; and practitioners' attitudes about their training experiences. A mail survey was sent to a random sample of 500 school psychologists drawn from the 1999 membership roster of the National Association of School Psychologists (NASP). Ethnic incongruence, defined as ethnic differences between a professional and a client, was commonly reported for assessment, consultation, and counseling cases. Diversity training was reported by 90.7% of participating school psychologists in the form of graduate coursework, internship experiences, or continuing education. Though most respondents rated their training experiences positively, improvements were suggested. © 2005 Wiley Periodicals, Inc. Psychol Schs 42: 419–432, 2005.     

Personal and systems‐level factors that limit and facilitate school psychologists' involvement in school‐based mental health services

The common path through which youth with mental health problems actually receive treatment is the education system. The current study used qualitative methodology to explore why school psychologists are not providing the level of mental health services that children need, leaders in the field call for, and practitioners desire. Thirty‐nine school psychologists participated in 11 focus groups; they responded to structured questions regarding the range of mental health services they currently provide, as well as the personal and systemic factors that facilitate and limit their provision of these mental health services. Analysis of themes that emerged across focus groups indicated that school psychologists provide a broad variety of mental health services with an emphasis on group and individual counseling as well as crisis intervention. The factors most often mentioned as prohibiting the delivery of such services included problems inherent to using schools as the site for service delivery, insufficient training, and a lack of support from department/district administration and school personnel. The enabling conditions that emerged most involved perceptions of ample support from administration and school personnel, sufficient integration into the school site, and particular personal characteristics, such as the desire to provide counseling and the ability to maintain personal boundaries. Implications for practitioners, administrators, and trainers are discussed. © 2010 Wiley Periodicals, Inc.     

Examining the role of school psychologists as providers of mental and behavioral health services

The school setting represents the most common setting by which youth receive mental and behavioral health (MBH) services (Farmer et al., 2003, Psychiatr Serv, 54, 60–66). Nevertheless, many school psychologists are not providing MBH services despite the high prevalence of need. Additional research is needed to understand factors leading to these deficits, as well as potential solutions to ameliorate these concerns. The current study surveyed 341 school psychologists across seven states and found current ratios are one school psychologist for every 1,500–2,000 students. Study results suggest school psychologists are providing a half to full day of universal, prevention-oriented MBH services each week whereas more targeted, direct services (e.g., individual or small group counseling) are offered 1–4 hr each week. The school psychologist-to-student ratios also demonstrated a statistically significant and inverse association with the provision of targeted MBH services, with higher ratios resulting in fewer MBH services. Respondents provided potential solutions for how to expand the delivery of MBH services within schools, including increased awareness and support among school and district administrators, as well as access to training and professional development related to MBH services.     

Implementing a school‐based health center: The Winston‐Salem/Forsyth County experience

This article traces the inception and implementation of school‐based health centers in the Winston‐Salem/Forsyth County (NC) school system. The challenges that arose during implementation are discussed, along with the opportunities that SBHCs provide to enhance the provision of comprehensive services for children. The involvement of the several school psychologists in the initial planning, organization and implementation of these centers is delineated as an example for other school psychologists who are interested in working with school‐based health centers. School‐based health centers represent an opportunity for school psychologists to assume a leadership role in the delivery of enhanced health and mental health services for children and families. © 2003 Wiley Periodicals, Inc. Psychol Schs 40: 289–296, 2003.     

School consultation: The training needs of teachers and school psychologists

This paper describes the roles of teachers and school psychologists and presents an overview of current and prospective methods of providing services to special needs children. On the basis of the literature and professional experience, it is suggested that changes are needed in the provision of special education services. The consultative relationship between teachers and school psychologists is viewed as the key to successful classroom intervention for special needs children. Although each profession brings expertise into the consultative relationship, better training is needed for teachers and school psychologists to ensure that effective intervention strategies are developed.     

An Evaluation of the Effectiveness and Acceptability of Teleconsultation

School-based psychological services are typically provided through a triadic model of consultation in which a school psychologist works directly with a teacher or school staff member to address the academic, behavioral, or mental health concerns of a student. With advances in current technology, school psychologists have the capacity to use videoconferencing to engage in their consultative responsibilities. Teleconsultation has the potential to improve the provision of consultative services by increasing school psychologists’ efficiency and providing individuals, especially those in rural areas, access to greater service. The current study evaluated the effectiveness and acceptability of teleconsultation as a means to deliver behavioral consultation services to three teachers and their students. A nonconcurrent multiple baseline across subjects was used. Results showed that consultants could develop a behavioral intervention with a teacher and effectively implement the intervention to improve student outcomes. Teachers also rated teleconsultation as an acceptable means for service delivery.     

Continuing education and school psychology: A review of state requirements

Continuing professional education has become increasingly important over the past several years. Recognizing that school psychologists need to update skills on a regular basis, professional organizations in school psychology have developed programs for continuing education. While the interest to participate in such programs seems high, possible conflicts with the requirements of state departments of education may prevent such programs from achieving their potential for success. A survey was conducted to determine present standards for continuing education of school psychologists among state departments of education. The results of this survey are discussed and recommendations are offered to local and state school psychology organizations.     

THE PROVISION OF COUNSELING SERVICES AMONG SCHOOL PSYCHOLOGISTS: AN EXPLORATION OF TRAINING,CURRENT PRACTICES,AND PERCEPTIONS

Although school psychologists have been called on in recent literature to assume a leadership role in a collective and comprehensive effort to address students’ mental health needs, many practitioners find that their professional roles continue to be narrowly focused on special education‐related activities, such as individualized assessment and eligibility determination. Meanwhile, students’ mental health needs have never been greater. The current study focused specifically on school psychologists’ provision of school‐based counseling, an activity that has been shown to be effective in addressing students’ mental health needs, as well as a professional role that many practitioners have expressed a desire to expand. A national sample of school psychologists responded to an Internet survey related to various aspects of counseling service delivery, including their training to provide services, current practices, and perceptions of the importance for school psychologists to assume the responsibility of providing school‐based counseling services.     

SUPPORTING STUDENTS IN FOSTER CARE

Students living in foster care are at risk for experiencing many challenges in school, spanning domains of social–emotional, behavioral, and academic functioning. They are twice as likely to be absent from school and to have received and out‐of‐school suspension and up to three and a half times more likely to receive special education services. Therefore, it is important for schools to recognize and respond to the unique needs of students in foster care to provide the necessary resources for school success. When working with students in foster care, school psychologists should be equipped to support the success of these students by determining what the needs of students in foster care are, and how to meet identified needs. The current paper will discuss the education‐related vulnerabilities and presenting problems for children in foster care and outline social–emotional, behavioral, and academic supports that school psychologists can offer.     

The Transition to Kindergarten for Typically Developing Children: A Survey of School Psychologists’ Involvement

Research suggests that a large percentage of kindergarten children do not successfully transition to school (Rimm-Kaufman et al. 2000). As a result, a number of school transition initiatives have been developed by educators and policy makers to address the difficulties young children may experience upon kindergarten entry. Despite this attention, our review found no studies examining the involvement of school psychologists in kindergarten transition practices. The present study reports the outcomes of a national survey of the membership directory of the National Association of School Psychologists examining school-based involvement in kindergarten transition activities; school psychologists’ perceived involvement with and training in kindergarten transition activities; and school psychologists’ perceived barriers to engage in kindergarten transition activities. Results showed that most schools engaged in at least one kindergarten transition activity per year, with half of the responding sample reporting involvement. School psychologists were more likely to be involved in kindergarten transition activities if they were employed in an urban locale or a large to moderate-sized school setting. School psychologists most frequently reported involvement with kindergarten screenings and collaborating with kindergarten and preschool teachers. Implications and recommendations for practice among early childhood and other educational professionals are delineated.     

Suggestions for the delivery of psychological services in secondary schools

The present paper describes the past, current, and suggested future practices in the delivery of school psychological services at the high school level. Because high schools differ from elementary and middle schools (i.e., organizational structure, student characteristics and needs, etc.), school psychologists need to use different approaches in the delivery of services at the secondary level. It is proposed that school psychologists must become integrated into the total social system of the high school to be most effective. Methods for accomplishing this objective, including collaboration with other school personnel and utilization of community resources, are discussed.     

A comparison of teachers' and school psychologists' perceptions of the importance of CHC abilities in the classroom

The broad cognitive abilities defined by the Cattell–Horn–Carroll (CHC) theory have been shown to predict school achievement. However, the ecological validity of these constructs has not been studied in classroom settings. This study compares ratings by a sample of teachers (n = 53) and school psychologists (n = 86) of the importance of the CHC cognitive abilities in the classroom. The scale demonstrated adequate reliability (total scale α = .93, median α = .74), although evidence of construct validity varied between teachers and school psychologists. Both teachers and school psychologists rated quantitative ability, crystallized knowledge, and fluid reasoning as most important to school success. However, school psychologists rated short‐term memory and quantitative ability as more important than did the teachers. Importance of these differences for consultation is discussed. © 2009 Wiley Periodicals, Inc.     

The school psychologist's role as an assessment consultant

Consumers of school psychological services are interested in receiving a broader range of services from school psychologists than the traditional diagnostic one. One strategy that school psychologists might employ, in order to free up more time for providing alternative services, is to minimize their diagnostic function on the Child Study Team and become assessment consultants. This article discusses the types of services that an assessment consultant could provide to a Child Study Team.