Comprehensive school-linked services: Implications for school psychologists

Psychology in /he Schools Volume 32. Ocrohcr 1995

COMPREHENSIVE SCHOOL-LINKED SERVICES: IMPLICATIONS FOR SCHOOL PSYCHOLOGISTS

VICTOR ROMUALDI AND JONATHAN SANDOVAL

Division of Education University of California, Davis

This article reviews the primary concepts underlying the current movement toward the provision of comprehensive school-linked services for children and families in low-income communities and the implications of this movement for school psychologists. The development of collaborative partnerships involving schools, public, and community-based agencies is an attempt to increase the availability and accessibility of needed services to children and families. The adoption of collaborative governance and a case management system is intended to offer an alternative to the proliferation of separate categorical programs and the associated lack of coordination among programs. The hope is to emphasize prevention and efficient early intervention. Colla- borative efforts can provide an opportunity for role expansion among school psychologists. This possibility is discussed within a consultation model of service delivery that is consistent with the collaborative nature of school-linked services and with the preventive stance that orginated them. School psychologists are in a position to contribute to team consultation, case management, and needs assessment. Implications for training are drawn.

There is a growing consensus that schools cannot address all of the needs of the children they serve and that they cannot function on their own and in isolation. An alternative to “going it alone” is the development of collaborative partnerships among schools, community agencies, and families (Chavkin, 1993; Dryfoos, 1991, 1994). In- itiatives have been taken in a variety of cities and states to investigate how these alliances may be formed and operated in the best interests of children and families (Dryfoos, 1994; Levy & Shepardson, 1992). The initiatives have been called integrated education and human services, services integration, interprofessional collaboration, coordinated services for children, family support services, and school-linked services; we have chosen to use the term comprehensive school-linked services as a generic descriptor.

The purpose of this paper is twofold. Our first goal is to discuss the relevance of growing efforts toward comprehensive school-linked services for the field of school psychology. Most of the literature on comprehensive services to date has had a policy- making orientation or a predominantly local focus, and has not appeared in mainstream school psychology publications. In particular, we wish to argue that collaborative partnerships extending beyond the school can provide a valuable opportunity for school psychologists to expand their professional role. Our second goal is to examine the potential contribution that school psychologists may make in collaborative partnerships.

THE POLITICAL AND SOCIAL CONTEXT

Historically, individual families have been responsible for the care of school-aged children, with the assistance of churches, community organizations, and a few trained professionals such as physicians and teachers. However, several trends in society have more recently emerged to weaken the capacity of the family. Changes in family structure,

Requests for reprints should be sent to Jonathan Sandoval, Division of Education, University of California, Davis, Davis, CA 956164579,

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Comprehensive Services and School Psychology 307

including an increasing number of working women and single-parent households, have resulted in a greater need for outside assistance (APA, 1994; Coleman, 1987). At the same time, an increasing professionalization and specialized in-service provision have added considerable complexity to the family’s task of managing human services for children (Morrill, 1992). Moreover, widespread poverty and economic instability, although creating an even greater demand for external help, substantially limit a family’s ability to secure appropriate assistance (APA, 1994; Schorr, 1988). As a result of these trends, a growing number of children come to school with social, emotional, and health problems that are not adequately addressed and which dramatically interfere with learning (Hampson, Stephens, & Sullivan, 1992; Lein, Raddle, & Raddle, 1992).

At a time when many indicators (such as rates describing lack of immunization and child abuse and neglect) show disturbing evidence of unmet needs, human-service agencies have become overwhelmed and less able to provide assistance beyond crisis intervention (APA, 1994). Traditionally, the rise in social problems among children and their families has been accompanied by a proliferation of programs designed to address them (Holtzman, 1992). The resulting service delivery system has been characterized by a lack of coordination that reflects more categorical funding sources than a comprehensive focus on child and family needs (Gardner, 1990). The literature has documented a growing awareness among professionals that the human support service delivery is not only strained but also ineffective, due to duplication of efforts and lack of flexibility, and that systemic changes are necessary to meet present challenges (APA, 1994; Soler & Shauffer, 1990). Financial issues also support the need for a change in approach to service delivery. As national economic growth is slowing, competition for public funds has increased, making the issues of cost-effectiveness and cost containment crucial ones to address (Kirst, 1986).

It has been pointed out, however, that “reformers must resist the temptation to view coordination as a panacea” (Kahne & Kelley, 1993, p. 198). Although coordination can improve the existing service delivery system by responding to children’s needs in a holistic fashion and by increasing families’ ability to access services, it cannot in itself be considered a guarantee of improved service quality. The growing demand for accountability in human services underlines the need to move from a system based on compliance with rules and regulations (Kirst, 1990) to one emphasizing the assessment of program outcomes (Guthrie & Guthrie, 1991; Kahne & Kelley, 1993).

An essential element emphasized in the collaboration literature has been a focus on increased prevention (California Child Welfare Strategic Planning Commission, 1991). Critics have pointed out that the current human service delivery system is crisis oriented and designed to address problems that have already occurred (Melaville, Blank, & Asayesh, 1993). It is accepted that prevention, when successful, is more cost-effective in the long run than reactive interventions (Cowen & Hightower, 1990; Upshur, 1990). Proponents of comprehensive services argue that increased service integration will promote prevention by addressing the multiple implications of presenting problems rather than considering them in isolation (Schorr, 1988).

FEATURES OF COMPREHENSIVE SCHOOL-LINKED SERVICES

Comprehensive Services The rationale for comprehensiveness in a service delivery system is the belief that

responses to children’s needs that are complex and interrelated require a wide range of

308 Romualdi and Sandoval

interventions across different domains (Bronfenbrenner, 1979). Children’s health, mental health, educational, and welfare needs must all be addressed by working with the child, the family, and the community.

“Comprehensive” refers both to the range of services offered and the diversity of resources mobilized and to the ability to respond to overlapping risk factors (Melaville & Blank, 1991). However, rather than focusing on the replication of established programs, recent initiatives have emphasized a flexible menu based on the specific needs of a given community. In fact, in discussing the School of the Future initiative, recently promoted by the Hogg Foundation for Mental Health in four Texas cities, Finn- Stevenson (1992) observed that although the term “program” is used to describe this and similar efforts, it does not fairly represent the breadth and flexibility of initiatives involving the delivery of a continuum of services.

The theoretical foundations for this approach are rooted in historical trends such as behavior ecology and systems theory that have been part of the school psychology literature (e.g., Davis & Sandoval, 1991), although, because of specialization of in- dividuals and institutions, they have remained somewhat marginal to predominant research focus and practices. Instead, school personnel have been forced to limit themselves to certain services that they are mandated to provide. For example, they may focus on special education functions and disregard, albeit reluctantly, other services that they know would be helpful, such as substance abuse counseling for a parent.

Collaboratively or Cooperatively Delivered Services The spectrum of collaborative approaches to service delivery stretches broadly. At

one end, cooperation can be interpreted as an improvement to existing practices that involves agencies helping each other to reach their individual goals. At the opposite end, collaboration may be conceptualized as the process of establishing common goals and pooling resources (Dryfoos, 1994; Himmelman, 1991; Melaville & Blank, 1991). In the past, schools may have established working relationships with other community agencies to provide services to children, but the schools have kept their boundaries clear. What is currently being attempted is collaboration of the second sort, where boundaries between agencies and the schools are dissolved. Indicators of such new approaches to increased collaboration are agency personnel stationed at the school site, a governance structure comprised of school and agency personnel, free information sharing among institutions and all agency personnel, and a sense of identity as part of a team larger than a single agency.

When heterogeneous agency “cultures” meet and try to work together, difficulties related to turf and control issues are likely to arise (Altman, 1991; Lopez, Dalal, & Yoshida, 1993; McKinney, 1992; Soler & Shauffer, 1990). The collaboration between schools and other institutional agencies (such as County Offices), and between institutional agencies and community-based organizations (often created around culturally appropriate community needs), will present new and complex organizational issues.

Of particular interest in documenting the development of school-linked services is the ability of schools and school districts to adjust to the changes that seem necessary for such institutional collaboration. Such an issue is deeply connected to the role o f staff and the adjustments in professional identity, which may involve retraining and loss and/or shift of status (Semmel, Abernathy, Butera, & Lesar, 1991). Professionals, for example, may be asked to perform coordinating functions that, unlike direct service delivery, transcend their specialized knowledge and propose more “generic” roles. Because


the separation of professional cultures is likely to create barriers to collaboration in the absence of a common language and paradigmatic assumptions (Lopez et al., 1993; Mor- rill, 1992), a critical understanding of competing professional paradigms and their potential overlap is a necessary step in the development of a shared framework both for practice and research (Knapp, 1995).

The fields of education in general and of school psychology in particular have discussed extensively the organizational tasks and issues shaping the functioning of schools and districts (Fullan, 1991; Illback & Zins, 1992; Sarason, 1982; Schmuck, 1990). Resistance to change has been documented in the schools, when innovations are perceived as threatening to established assumptions, beliefs, and behaviors (Fullan, 1991; Nevin, Thousand, & Villa, 1993). Such resistance, which has been addressed in the consultation literature (Zins, Curtis, Graden, & Ponti, 1988), will likely be an issue among school practitioners accustomed to functioning within categorical domains (Dryfoos, 1991). The response of school psychologists coming in close contact with other professionals who bring partially overlapping areas of expertise may provide a new perspective in the study of change and potential resistance. It may also present the opportunity for critical self-reflection beyond a discussion of resistance narrowly defined as a typical consultee response.

Culturally Appropriate Services Those communities most in need of services often include a high concentration of

ethnically and culturally diverse students and families. Service provision, as a result, must be culturally appropriate and reflect growing population trends (Correa & Tulbert, 1993). In addition to overcoming language barriers, a critical issue for school professionals is how to become acquainted with families’ values, beliefs, and practices that may shape their interactions with institutions and their perceptions of needed support.

In developing culturally appropriate school-linked services, a polarity has been identified between collaborative processes focused on empowerment, often associated with community-based efforts, and institution-driven initiatives, often associated with betterment (Himmelman, 1991). Betterment programs tend to identify specific needs and issues and address them through specific interventions. When systemic issues, such as a lack of coordination between service delivery sources, are identified, the guiding prin- ciple is to work toward greater efficiency. The expansion of a service umbrella and the streamlining of institutional mechanisms designed to promote coordination and cost- effectiveness seems to fall within a betterment perspective. On the other hand, empowerment-oriented initiatives tend to be more congruent with trends in critical an- thropology (e.g., Delgado-Gaitan, 1990) that have identified the need to increase the participation of low-income families in institutional decision making as a cmdition for realigning social services with the growing cultural and linguistic diversity in American communities. Empowerment theory is generally concerned with the redefinition and redistribution of power differences traditionally associated with expert-based models of intervention and has presented itself as an alternative to programs shaped by a deficit perspective on service needs (e.g., Cochran & Woolever, 1983). A key issue in defining the nature of a program is the extent to which parents are involved in governance functions and are able to shape the collaborative process and service design. Parent involvement is conceptualized in collaborative literature not only as a way of grounding interventions into a range of recognized needs, but also as a way to increase self-efficacy among families in shaping policy and attaining services (Smrekar, 1993).


Case-managed Services Although a variety of sources agree that case management is an essential feature

of collaborative efforts, there is disagreement on what case management should be (Schwartz, Goldman, & Churgin, 1982). Originally born out of mental health and social work practices, this approach is increasingly applied in the field of education. Case management can be defined at the system level in terms of coordination of services and at the client level in terms of need assessment and advocacy (Kingsley, 1989).

As a process, case management involves several phases, including identification of clients, intake and assessment, development of a service plan, community intervention (linking, brokering, and advocating), and monitoring and evaluation of progress. However, to the extent that effectiveness is dependent on the approach guiding these activities, case management is not an easily describable and replicable model. Sources advocating such renewed focus on case management often emphasize the manager-client partnership or the sharing of responsibility and working with the client rather than on the client (Weil, Thomas, Callahan, De Carolis, & Ooms, 1992). In other words, effectiveness depends not only on structural changes but also on process variables that require more subtlety to document, study, and implement.

The appropriateness of case management models for school settings is an open issue. Not only is little research available on which to build standards, but also doubts exist about the suitability of mandating uniform standards across diverse situations (Weil et al., 1992). Surveys of California projects show a variety of approaches to assigning case managment functions, ranging from the development of a new professional niche, often filled by social workers, to a sharing of the function among all service providers. Another polarity was detectable between models adopting an expert approach to case management, relying mostly on agency professional personnel, and models employing community members with valuable linguistic and cultural backgrounds as family ad- vocate case managers.

School-linked Services Another feature of the current emphasis on collaboration is the delivery of services

at or near the school site. Of all community agencies, schools are situated throughout the community and are often within walking distance of families. When asked why he robbed banks, Depression-era outlaw Willie Sutton explained “because that’s where the money is”; comprehensive services are delivered in schools because that is where the children and families are. Also, school buildings are used for a limited time during the day and are not commonly used at night or on weekends, and, although the number of year-round districts is increasing, many schools sit idle during the summer. This strategic space can be used effectively for other purposes.

Schools also have an advantage in that they can be more welcoming than other institutions. Although schools may be intimidating places for many parents and may have been the locus of unpleasant experiences for some of them, their connection to the neighborhood and the community is more evident than for other agencies.

NEW AND CONTINUING ROLES FOR SCHOOL PSYCHOLOGISTS

The development of comprehensive and coordinated services for children has been the focus of a Task Force established in 1991 by the American Psychological Associa- tion (APA). A preliminary document (APA, 1994) addressed the relevance of this new


trend to psychology and concluded that “since decisions about service delivery are more likely to be outcome-oriented, consumer-driven, and cost-conscious, the particular strengths of our profession (including its conceptual underpinnings, empirical base, and concern for assessing outcomes) are likely to flourish in such an environment” (p. 15).

The redefinition of professional roles necessitated by a shift to collaborative service delivery provides an opportunity for school psychologists to expand their functions and reshape their professional identity. The remainder of this paper will discuss the issue of role expansion in light of the recent federal and state comprehensive initiatives.

Relevance of Consultation and Collaboration Since the implementation of PL 94-142, multidisciplinary teams (often called stu-

dent study, or child study, teams) including teachers, parents, and support personnel have become the decision-making structure for the identification of children in need and the development of an intervention plan. Multidisciplinary teams provide a problem- solving arena in which school psychologists can function as consultants with teachers and other practitioners (Conely & Conely, 1990). However, these teams have performed primarily a referral function (Elliott & Sheridan, 1992). In fact, much evidence exists to suggest that multidisciplinary team procedures tend to reflect a psychoeducational model centered on individual deficits rather than a systemic perspective (Christenson & Cleary, 1990; Rosenfield, 1992; Ysseldyke, Thurlow, Graden, Wesson, Algozzine, & Deno, 1983), thus limiting the opportunities for meaningful consultation. Problems pointed out in the literature include minimal involvement of parents and regular educators (Pfeiffer, 198 l), uneven involvement across disciplines (Ysseldyke, 1983), and unsystematic collection and use of assessment data (Pfeiffer, 1981). The increasing number of referrals and the procedural guidelines regulating the identification of exceptional children have undoubtedly played a role in stifling the problem-solving process as well as the expansion of school psychologists’ roles (Bush et al., 1989). Current practices often reinforce rigid professional boundaries and support a “gate-keeping” function for school psychologists (Mehan, Hertweck, & Meihls, 1986; Meyers, 1988; Skrtic, 1991). On the other hand, the development of a commitment to problem solving, professional flexibility, and collegiality has been considered an essential step in the reform of service delivery systems and the group structures and processes associated with them (Rosenfield, 1992).

The importance and value of individual assessment should not be underestimated or dismissed. Nevertheless, an excessive focus on individual variables may obscure systemic issues, organizational variables, and community characteristics connected to student success and failure (Davis & Sandoval, 1991; Meyers, 1988; Rosenfield & Reynolds, 1990; Slavin, Madden, & Karweit, 1990).

Reinventing Case Management School psychologists have a long tradition of functioning as case managers within

school settings. However, such functions developed largely within the constraints of categorical bureaucracies (e.g., Special Education) and cannot be automatically and un- critically transplanted to interagency collaboration. A similar issue applies to other professional traditions such as, for example, the tendency in social work literature to ad- vocate the professionalization and specialization of case management duties (Brown, 1992). The consultation tradition developed in the field of school psychology emphasizing collaborative and egalitarian relationships (Caplan, 1970; Henning-Stout, 1994) may


provide a critical perspective in such a debate and help in advocating a case management model that is conceived as a group responsibility and a team process involving different professionals according to expertise and level of involvement. The literature on team problem solving may be a relevant contribution within these lines (e.g., Rosenfield, 1992). Furthermore, the use of a consultant-consultee model as a prototype for case management may help in developing such functions beyond the supervisory or fiscal role that is often evident in agency-based practices.

The case manager as resource broker. It is essential that a child or family have access to appropriate services. Not only do case managers need to know what possible agencies or personnel can be of assistance to their clients, but they must also know how to access the assistance and arrange for the services to be delivered. Familiarity with community resources has long been recognized as an essential area of competency for school psychologists (Sandoval, 1985; Tharinger & Stark, 1992). As a result, they are likely to have the skills, through training and experience, to help collaborative teams make effective referrals.

The case manager as evaluator. As team members, school psychologists will be able to share the brokering, advocacy, and coordination features of case management with other collaborative members. However, the evaluation component may identify an area of expertise unique to school psychologists and may provide a clear opportunity for role expansion.

An understanding of assessment and outcome definition will be very valuable in evaluating individual interventions as well as program effectiveness. The increased focus on coordination and collaboration may sometimes overshadow the concern for the quality of the services to be provided. Someone must determine that the services have been delivered effectively. Such a role will not establish school psychologists as the only evaluators, but will bring to bear an aspect of their tradition and training that is directly relevant to the goals of the collaborative team. Additional contributions to team building and functioning that psychologists may offer, particularly with regard to systemwide facilitation and assessment, are discussed in the organizational development (e.g., Schmuck, 1990) and program evaluation literature (e.g., Illback, Zins, Maher, & Greenberg, 1990).

The explicit goal in creating school-linked collaborative and case management structures has been to avoid the categorical constraints that both educational and social programs have encountered (Koppich & Kirst, 1993). While collaborative literature has extensively commented on the inefficiency, overlap, and duplication typical of categorical interventions (Morrill, 1992), educational critics have highlighted the limitations to creative adaptations and truly individualized planning that remedial and special education programs involve (Skrtic, 1991).

The constraints to personal choice that categorical funding and institutional ex- pectations present have been acknowledged in the school psychology literature (Sandoval, 1986). Although these obstacles are still relevant, comprehensive services and other restructuring efforts are introducing alternatives and providing opportunities that should not be missed. As Sandoval pointed out, the conscious adoption of a model helps in organizing and prescribing what is otherwise perceived as a random array of activities. In the present context, the adoption of a school psychology service delivery model consistent with the role expansion and redefinition available through restructuring efforts is strongly recommended to maintain focus and preserve professional identity through


change. Rather than promoting a specific model among those traditionally identified in the literature (Sandoval, 1986), we suggest an eclectic approach emphasizing broad prevention and organizational issues in tune with the explicit goals of the school-linked comprehensive services movement. Space and scope limitations do not allow for an extensive discussion of the relative merits of traditional models with respect to such goals. However, we agree with recent contributions to the consultation literature proposing the relevance of a constructivist perspective in consultation and the importance of process variables in developing and maintaining an egalitarian relationship between consultant and consultee (Cobern, 1993, Henning-Stout, 1994; Sandoval, in press). The concern for egalitarian interactions appears to be particularly relevant in light of at- tempts to increase parent participation and cultural diversity within an empowerment framework.

Continuing as Direct Service Provider When appropriate, of course, the school psychologist will remain a direct services

provider. Should needs be identified, the school psychologist may provide crisis intervention, group or individual counseling or brief therapy, or educational programs for parents, teachers, or students. School psychologists are in the unique position to bridge mental health and education domains and could make such expertise available for the collaborative service menu.

Em bracing Needs Assessment Needs assessment is a key component of coordinated services. Clearly it is necessary

to determine the needs present before they can be addressed by available services. At least three levels of needs assessment may be differentiated: community, family, and child. At the community level, one needs to assay problems common to all members of a community and the resources available to help. The only professionals in the school or in most community agencies with measurement expertise are psychologists, whose training includes extensive work in research methods, statistics, evaluation, testing, and assessment. These skills can be used to collect and analyze archival data, questionnaire and interview data, and other information providing insight into the community’s functioning. On the other hand, other competencies, including needs assessment methodology, may require more explicit attention within school psychology training programs.

At the family level, too, strengths and weaknesses must be determined to construct a service plan. The understanding of family dynamics, familiarity with parent contacts, sharing and obtaining information, and eliciting wishes and preferences for academic decisions will complement expertise from other mental health professionals in the team. The collection of family information has been addressed specifically in the literature on minority children and families (Correa & Tulbert, 1993). It has also been mandated as part of the implementation of PL 99-457 and its required development of individual family service plans for targeted preschool children.

At the child level, even though other needs may have been determined at the other two levels, there must be a special focus on academic progress. School psychologists are prepared to function beyond the level of eligibility determination, although additional training may be required for school psychologists to demonstrate more commitment to an ecological perspective than what is traditionally allowed within categorical constraints.


TRAINING FOR A NEW PROFESSIONAL IDENTITY

Of interest to this discussion is the role that training plays in the choice of a model of service delivery among school psychologists (Sandoval, 1986). The need to improve training to make it more consistent with role diversification and to define a broad set of domains of competence has been suggested by many researchers (Meyers, 1988; Rosenfield, 1992). Furthermore, some of the skills associated with a new role, which may involve familiarity with program evaluation, organizational problem solving, and a systems approach applied to school settings, are not always part of targeted core competencies. Although a discussion of specific competencies goes beyond the scope of this paper, the recent debate on entry level and training requirements addresses some op- tions (Stone, 1989). It should be pointed out that although the organizational development literature addresses problem solving internal to school systems, it does not address the potential difficulties or challenges involved in collaborations with out-of-school organizations. However, the abundant research on group processes and organizational facilitation that is a component of a school psychology tradition can be a valuable springboard to develop updated models.

Role expansion should not be viewed as a clarification internal to our profession but should venture on to the more general issues of school reform and restructuring. Although the issue of community involvement and parent empowerment and participation has been central to collaborative and comprehensive services literature, current efforts have not been successful in linking service delivery reform to school change and restructuring (Wehlage, Smith, & Lipman, 1992). Limited success in this area may be associated, at least in part, with lack of clarity on the specific ways through which school-linked services and a redefinition of professional roles may provide an opportunity to address more general reform issues. We suggest, however, that the evaluation of current initiatives may set the stage for a critical reflection on the local and systemic obstacles preventing progress. We also feel that this is an excellent opportunity for school psychologists to increase their connectedness to other disciplines and to the community at large, in an attempt to promote and support a renewed call for collegiality in education (Bardon, 1992).

Finally, as part of rebuilding or consolidating a professional identity, an active involvement in the services integration movement may address the important issue of correcting narrow, and often stereotypical, perceptions of school psychologists among other professionals involved in educational research and practice, associating them with routine individual assessment practices.

Although most of these issues indicate long-term goals, collaborative and restructuring efforts provide immediate opportunities for experimentation, cross-training, and model building, which should not be missed to preserve school psychologist credibility and to expand school psychological services to children.

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Comprehensive school-linked services: Implications for school psychologists

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