Reflections on Consultation: Applying a DisCrit and Equitable Implementation Lens to Help School Psychologists Disrupt Disparities

ABSTRACT

School psychologists can engage in consultation to address inequities in educational opportunities to support multiply marginalized students. This critical work is codified in the NASP 2020 Practice Model, which outlines professional and organizational principles to facilitate school psychologists’ engagement in equitable, effective supports to students, schools, and families. However, the legacy of historical beliefs about race and ability, based on white supremacy, have become intertwined in complex ways that are evident within and across multiple school ecologies, including consultation. In this paper, we apply DisCrit, a theoretical framework that incorporates a dual analysis of race and ability through an integration of critical race theory and disability studies, to provide a conceptual review of problem-solving consultation structure, roles, and purpose. Next, we highlight the potential of embedding equitable implementation, an emerging perspective from implementation science, into consultation. Equitable implementation occurs when strong equity components (e.g., trusting relationships, community-defined evidence) are integrated into the implementation process to facilitate quality delivery of programs. With this perspective and an illustrated case study, we hope to provide actionable steps for researchers and practitioners to center disrupting problematic ecologies and advancing equity as foundational in their consultation. We also reflect on opportunities, challenges, and implications for training and practice that are aligned with the NASP 2020 Practice Model.

Schools throughout the United States actively perpetuate disparities through inequitable access to high-quality instruction and disproportionate exclusionary discipline practices for students of color, which can intersect to result in special education referrals (Sullivan et al., 2021; Sullivan & Proctor, 2016). The seminal National Research Council report on students of color in special education concluded there was bias in special education referral processes and highlighted the lack of reliability in decision-making regarding special education identification (Donovan & Cross, 2002). More recent empirical work supports these findings, highlighting inaccurate referrals for special education services and arbitrary special education decisions (Kincaid & Sullivan, 2017; Sullivan et al., 2020). As a result, students of color are identified with a disability where none may exist, and the resulting placement may undermine their access to high-quality education and opportunities to make significant academic gains (Fenning & Rose, 2007; Sullivan & Proctor, 2016). Further marginalization occurs within some areas of special education (Fisher et al., 2020; Losen et al., 2015; Skiba et al., 2002). When special education data are disaggregated by race, Black students receive out-of-school suspensions at four times the rate of than White students (Fisher et al., 2020). Further, Black students with a disability label are three times more likely than White students with a disability label to be transferred to an alternative school or to receive a school-related arrest (Fisher et al., 2020). These patterns persist across disciplinary practices, behavior intensity, socioeconomic status, age, and grade (Fisher et al., 2020). These educational disparities exemplify the deeply embedded structural racism within our K-12 schools.

As school psychologists often consult with teachers when academic, behavioral, social, or emotional issues first arise, they have a unique opportunity to address and disrupt these disparities through their consultation practices (Ingraham, 2000; Sander & Bibbs, 2020; Shriberg & Fenning, 2009). Per the NASP 2020 Practice Model, consultation is “a systematic and comprehensive process of effective decision-making and problem solving that permeates all aspects of service delivery” (p. 28; Domain 2). Based on work emerging in the 1970s, there are a range of school-based consultation models, most having roots in and strong commonalities with problem-solving consultation (Kratochwill et al., 2014). Problem-solving consultation is focused at two levels – addressing a targeted issue (e.g., student concern, systems problem) and, secondarily, building the skills and capacity of educators to independently manage similar issues in the future (Kratochwill & Bergan, 1990). Practice guides articulate the process for engaging in consultative activities from identifying the current issue to putting an intervention in place to evaluating outcomes (Kratochwill & Bergan, 1990; Sheridan & Kratochwill, 2008). School-based problem-solving consultation research has consistently documented positive student outcomes (e.g., Hurwitz et al., 2015; Sheridan et al., 2012, 2017).

However, in light of persistent inequitable practice and intervention outcomes in education and in the evidence-based practice movement generally, it is important to be reflective of whether and how our work as school psychologists is structured in a manner that truly prioritizes and advances equity and social justice (Ingraham, 2000; Sander & Bibbs, 2020; Sullivan et al., 2021). Across domains, school psychologists are expected to engage in equitable practices for diverse student populations across their professional work to “promote effective functioning for individuals, families, and schools with diverse characteristics, cultures, and backgrounds through an ecological lens across multiple contexts” (National Association of School Psychologists, 2020, p. 8). Per the practice model, all of school psychologists’ efforts should be founded on “equitable practices … respect for diversity … and advocacy for social justice” (p. 8). The legacy of historical beliefs about race and ability, largely based on white supremacy, have become intertwined in complex ways that are evident within and across multiple school ecologies, including consultation (Newell et al., 2020; Newell & Kratochwill, 2007; Ramirez et al., 1998).

As such, centering dis/ability critical race studies (DisCrit), a theoretical framework that incorporates a dual analysis of race and ability through an integration of critical race theory and disability studies, is essential to begin identifying, disrupting, and dismantling interlocking systems of oppression in education (NASP Domain 8: Equitable Practices for Diverse Student Populations; Annamma et al., 2013; Ladson-Billings, 1995; Ladson-Billings, 2006; Sabnis & Proctor, 2021). DisCrit recognizes that race and ability are socially constructed identities that structural racism and discrimination impose on individuals. DisCrit acknowledges the interdependent ways in which race and ability shape, and policies and practices reinforce, perceptions of normativity (i.e., White, middle-class, able-bodied citizens). Finally, DisCrit posits that white supremacy embedded within the school system allows educators to perceive certain students and their families as inferior, which has lifelong consequences for students and families. As neither institutional racism nor ableism on its own explains why students of color are more likely to be labeled with disabilities and segregated than their White peers with and without disabilities, DisCrit can facilitate naming these dynamics and understanding how they are present in consultation. In this way, we can re-align the expectations and behaviors of school psychologists to provide equitable educational services for multiply marginalized students (Annamma et al., 2013; Sabnis & Proctor, 2021).

To center and advance equity in consultation (NASP Domain 2: Consultation and Collaboration), researchers and practitioners can reflect on and apply DisCrit to consider how practices in education, consultation included, have historically and are currently used to address student concerns through a white supremacy lens (Newell & Kratochwill, 2007). In doing so, we recognize and cite prior consultation researchers who have focused on culturally responsive practice (e.g., Castro-Villarreal & Rodriguez, 2017; Clare, 2009; Goforth, 2020; McKenney et al., 2017; Newman & Ingraham, 2017; Ramirez & Alghorani, 2004; Ramirez et al., 1998), and supporting clients from diverse backgrounds (e.g., Ingraham, 2000; La Roche & Shriberg, 2004; Newell, 2010; Newell et al., 2020; Newell & Kratochwill, 2007; Ramirez & Smith, 2007; Sheridan et al., 2006). We also rely upon the work of prior researchers who have focused on systems change and equity (e.g., Conoley et al., 2020; Gutkin & Conoley, 1990; Sander & Bibbs, 2020; Schumacher-Martinez & Proctor, 2020; Shriberg & Fenning, 2009; Sullivan et al., 2015). Such work is vital to a comprehensive and transformative understanding of equity in school psychology, and we would emphasize that such work has not to date been sufficiently incorporated into general problem-solving consultation research and guides, particularly those focused on student (rather than systems) issues.

Along with these contributions, we highlight equitable implementation, which is an emerging perspective from implementation science that has the potential to contribute actionable steps for school-based practitioners and researchers to center disrupting problematic ecologies and advance equity as foundational in their consultation (DuMont et al., 2019). Equitable implementation occurs when strong equity components are integrated into an implementation process. At its heart, consultation is a process of facilitating the selection and delivery of an intervention or practice to support students. At best, this approach reflects an implementation process wherein the needs and potential practices are explored, efforts are made to adapt the intervention and prepare the implementer, the intervention is implemented alongside support, and then continued implementation is sustained (Aarons et al., 2011). As such, consultation researchers may be guided by implementation science about how to center equity and “attend to what is being delivered, for whom, under what conditions, and how delivery should be tailored to best meet the needs of the focus population” (Loper et al., 2021, p. 4). Power has historically been present and unquestioned in implementation to the harm of minoritized people who are excluded from representation and participation in intervention and implementation activities (Clare, 2009; Stanton et al., 2022).

Positionality

The second author has been an advocate for problem-solving consultation for decades and the remaining authors were trained in problem-solving consultation at scientist-practitioner school psychology graduate training programs and, like so many others, have used this framework as the bedrock of our intervention activities in school-based research and practice. We represent a range of professional roles with university programs (e.g., assistant professor, graduate student, full professor). We come from varied backgrounds, including dominant (White, cis, heterosexual, native speaking) and marginalized identities (e.g., multi-lingual, immigrant). By the nature of our training, research interests, and positionality, it is likely that our critique of problem-solving consultation will be limited; we hope to dialogue with scholars and practitioners around how to improve equity in the practice of consultation in schools.

Purpose

To center equity, researchers and practitioners must consider the presence of white supremacy and ableism in educational systems that continues to perpetuate differential outcomes for students of color and particularly multiply marginalized students (NASP Domain 8: Equitable Practices for Diverse Student Populations; Domain 10: Legal, Ethical, and Professional Practice; Ladson-Billings, 2006; Sabnis & Proctor, 2021). These painful but accurate realities are evidenced in theory, as articulated through DisCrit (Annamma et al., 2013), continued research findings (Girvan et al., 2017; Kincaid & Sullivan, 2017) and practice outcomes (De Brey et al., 2019). In this paper, we utilize a DisCrit lens to reflect on elements of problem-solving consultation structure (i.e., how it is organized), roles (i.e., who participates and how roles are articulated), and purpose (i.e., what consultation purports to address). For each of these elements, we introduce aligned elements of equitable implementation and highlight how they could be integrated by problem-solving consultation researchers and practitioners to address patterns of persistent power and disrupt inequities and advance equity in their work (Loper et al., 2021). Table 1 highlights the key elements in equitable implementation (i.e., trusting relationships, dismantling power structure, investments and decision-making to advance equity, context defined evidence, adaptation, and critical perspectives), corresponding NASP domains, and examples in an illustrated case study.

Table 1. Equitable implementation elements applied to consultation.

Elements	Considerations for Consultation	Example
Trusting relationships	Consultants make frequent and consistent communication with the student and family. Consultants use the word “we” instead of I/they, throughout consultation process to develop meaningful partnerships. Consultants demonstrate commitment to cultural humility and transparency, by sharing information pertaining to consultation with all members, prioritizing student and family needs, showing genuine interest, and resolving barriers to engagement. Consultant is flexible with the meeting and take as much time needed to build connection with student and family. Consultants actively seek feedback from all members regarding consultation role and structures.	Ms. Calli, a school psychologist (consultant), conducts weekly meeting with Ms. Fox, a fourth grade English Learners teacher (consultee), Lana, an English Learners fourth-grade student (client) and her family (client), to develop a trusting relationship during consultation partnership^2,7. Taking into consideration Lana’s family’s availability, the meeting occurs after school on a Friday night over Zoom. Recognizing that Lana’s family prefers to speak in Thai, their home language, Ms. Calli invites her school psychologist colleagues who also speaks Thai to translate during these meetings. As a sign of respect, Ms. Calli also learned a few greetings in Thai such as Sawasdi for hello and Khob Khun Ka for thank you. Acknowledging the power differentials and language differences that may prevent Lana and her family from speaking up, the first few meetings focused on understanding Lana’s family, schooling experiences, and strength, instead of her challenges. During these meetings, the group identified some commonalities (e.g., favorite food and holiday) that they all share. Ms. Calli recognized that building trust is an ongoing process and requires more than one meeting^2,7. To ensure that all members have various opportunities to share their thoughts and ideas, Ms. Calli also conducted a quick 10 minutes check in with each member individually throughout the week. Since Lana and Ms. Fox prefer to share their thoughts in writing, they also use a shared Google Doc to document meetings notes, progress, and questions.
Dismantling power structure	Consultants reflect and acknowledge their own knowledge, biases, & understanding of student’s presenting issue and important identities. Consultants identifies broader context that may contribute to presenting student challenges. Consultants find ways to minimize power differentials by garnering consultee and client’s expertise.	Reflecting on her limited knowledge regarding ELs reading instruction, Ms. Calli decided to do research and consult with EL experts around her (e.g., Ms. Fox the ELs teacher, the district ELs program director)^10,8. In addition to gathering Lana’s reading assessment data (e.g., DIBELS, summative/formative test), Ms. Calli also works with Ms. Fox to identify (1) system-level data such as the school’s report on ELs academic achievement, curriculum, attendance, and disciplinary referral and (2) classroom factors such as class- wide data, classroom management, climate, teacher behavior, and discipline practices in the classroom^1. Understanding the importance of valuing and prioritizing student’s voices, Ms. Calli conducted an interview with Lana and her family to better understand their concerns, goals, and expectations as part of the data collection process^7. When Ms. Calli finally synthesized and shared all of the data with the team^1,8, she provided time all team members to process the findings and have multiple opportunities for questions and discussion^2.
Investments and decision-making to advance equity	Consultants work collaboratively to review the data and determine shared goal and intervention. Consultants name advancing equity and anti-racism as an explicit consultation goal. Consultants make efforts to ensure that the intervention not only target individual student but also the systemic ecologies that fostered the issue. Consultants provide sufficient support and resources to facilitate equitable impacts.	Through reviewing the individual- and system-level data, the group decided their shared goal is to increase Lana’s English comprehension by (1) targeting explicit vocabulary instruction in the classroom, (2) assigning vocabulary homework and providing reading strategies at home (e.g., scheduled reading time), and (3) encouraging Lana to continue her love of reading in her first language^1,3,8. Acknowledging the research evidence on the importance of explicit vocabulary instruction for student’s comprehension, Ms. Fox also takes the initiative to encourage other teachers in her grade level to incorporate the practice during their grade level meeting, describing the purpose as addressing inequity within reading outcomes.
Context-defined evidence	Consultants incorporate additional data collection methods to understand school- and home-related ecologies. Consultants collect and review data with a sense of value and curiosity that demonstrates active cultural humility and a willingness to follow the data and value different perspectives.	The group recognized that to be able to provide fair assessment, Lana’s performance in standardized assessment must be compared to her true peer (i.e., those with the same amount of language and schooling experiences)^1,8. Since a true peer comparison is not currently available, an informal assessment to assess Lana’s reading ability in her first language (i.e., Thai) was also conducted. Similar to the DIBELS oral reading fluency test, a teacher who is fluent in Thai asked Lana to read a passage taken from a Thai fourth grade textbook for one minute. To assess her phonological skills, Lana was asked to identify the beginning and end syllable sounds in Thai words. Qualitative interviews with her parents were also conducted to examine Lana’s ability in the Thai language, particularly regarding her reading skills^8.
Adaptation and cultural adaption	Consultants work to consider how the intervention fits with the current context (e.g., student, family, classroom, school), and what adaptations would improve fit with the context as well as the client’s experiences and worldview.	As most reading intervention programs have not been validated with ELs, Ms. Calli decided to refer to research institutions such as the Meadow Center and IRIS Center and consult with the district ELs program director to find information regarding reading strategies and adaptations for ELs to support Ms. Fox implementation of the vocabulary intervention^1,8,9. Ms. Calli and Ms. Fox also takes into consideration Lana’s strength in phonological awareness (both in English and Thai), as well as her interest in learning about world history when planning the reading intervention for Lana. Additionally, Ms. Calli recommends using Lana’s progress monitoring scores to show her growth instead of comparing it with native English-speaking norms^8,9. Once an intervention plan was created, the group checks in with Lana and her parents to ensure that the plan aligns with their expectations. To increase fit, Ms. Calli utilizes Implementation Planning and Direct Training to adjust the intervention and prepare Ms. Fox.
Critical perspectives and cultural humility	Consultants provides time during the meeting for the team to reflect and discuss concerns to build trust and engagement. Consultants should consider this reflective process as part of cultural humility.	Instead of using meetings to share large amounts of information, Ms. Calli makes a conscious effort to include time for reflection and discussion^2. Initially, it took a while for the group to use this time and share their ideas; however, as they continued to meet, they became more engaged in the discussion^7. Ms. Calli also perceives silence as processing and reflection time, instead of disengagement. As a result, the meeting space becomes a positive and welcoming experience for all members to learn from each other.

Note. ¹ NASP Domain 1: Data-Based Decision Making, ² NASP Domain 2: Consultation and Collaboration, ³ NASP Domain 3: Academic Interventions and Instructional Supports, ⁴ NASP Domain 4: Mental and Behavioral Health Services and Interventions, ⁵ NASP Domain 5: School-Wide Practices to Promote Learning, ⁶ NASP Domain 6: Services to Promote Safe and Supportive Schools, ⁷ NASP Domain 7: Family, School, and Community Collaboration, ⁸ NASP Domain 8: Equitable Practices for Diverse Student Populations, ⁹ NASP Domain 9: Research and Evidence-Based Practice, ¹⁰ NASP Domain 10: Legal, Ethical, and Professional Practice.

Structure of consultation

Problem-solving consultation is based on a public health model of providing targeted, efficient, and strategic support to intermediaries (i.e., consultees) who could then work directly with clients and thereby expand their impact (Caplan, 1963; Erchul & Martens, 2010). Utilizing a DisCrit perspective, we comment on both individual-focused structure and the three-meeting structure of problem-solving consultation. Further, we highlight how the equitable implementation elements of (a) investments and decision-making to advance equity and (b) recruiting and reflecting on critical perspectives could further enhance structure of consultation.

Individual-focused structure

As typically enacted, the structure of problem-solving consultation is focused around a specific, operationalized student issue (Bergan & Kratochwill, 1990; Kratochwill et al., 2014; Sheridan & Kratochwill, 2008). Although this focus can lead to improvements, the presenting issue is often narrowly defined and broad contextual variables that may be contributing to this challenge are not considered (Kazdin, 1985). For example, the focus on attending to a student’s disruptive behavior may be akin to focusing on an individual’s healthy eating habits that, while important, are viewed as intra-individual, rather than impacted by broader context (e.g., expense and time associated with healthier food, differential accessibility of different types of food by zip code; Wedick et al., 2015). Although focusing on a person’s healthy eating can provide individual relief, doing so for individuals time and time again does not address broad health disparities and systemic reasons for these individuals’ challenges (Neff et al., 2009), thus negatively impacting the expected public health benefit. It may be appropriate to question the value of efficiently supporting individuals by developing and implementing many separate interventions. Rather than focusing on individuals’ challenges that are the inherent products of unhealthy ecologies (e.g., policies rooted in white supremacy, teachers with biased expectations), consultants could focus on addressing the dysfunctional educational ecologies themselves (Annamma & Morrison, 2018; Mash, 1985). Problem-solving consultation guides could encourage consultants to think systemically (e.g., improve classroom management, shift school-wide expectations) and include reminders about the limitation of individually focused work (Gutkin & Conoley, 1990; Sullivan et al., 2021). Although student-specific consultation is appropriate in many cases, the number of students who could benefit from further support highlights the necessity for school psychologists to focus on systemic need; indeed, inequities in who accesses consultation should push consultants to act.

Three-meeting structure

The traditional structure of problem-solving consultation, especially in research, is typically predicated on at least three separate meetings. Most research on problem-solving consultation and conjoint behavioral consultation has retained this three-meeting structure (e.g., Sheridan et al., 2006, 2017), although practice guides suggest flexibility is possible (e.g., Kratochwill et al., 2014; Sheridan & Kratochwill, 2008).

This efficient, structured process is typified by the last meeting focused on evaluating the effectiveness of consultation (i.e., treatment evaluation interview [TEI]; Bergan & Kratochwill, 1990). This meeting can be a time to address the next student or systems challenge to engage with during continued collaboration (e.g., Kratochwill et al., 2014), but traditionally TEI meeting task list suggests that this meeting is primarily focused on evaluating the student outcomes associated with consultation activities in a binary manner (Kratochwill & Bergan, 1990). If student improvements are observed, and given consideration of maintenance and generalization, consultation is typically ended without further follow-up, which some research suggests is necessary to consider in a more planful, ongoing manner to maintain gains (Nelson et al., 2021).

If student improvements are not observed, the expectation in practice is typically that interventions need to be reevaluated with consideration of the functions of behavior as possible areas for modification. The discussion about why an intervention designed through consultation may not have made a positive impact could be broadened to explicitly consider fidelity data collection, treatment intensity, and cultural alignment, among other factors. Further, given the complexity of student responsiveness, classroom ecologies, and school policies, particularly as they intersect to impact multiply marginalized students, the scope of the TEI may be broadened to prompt consideration of these complexities and encourage ongoing consultation that address systemic, not only student, issues.

Equitable implementation to improve consultation structure

The current structure of problem-solving consultation prioritizes efficiency and reflects a focus on individual-focused intervention. Although this structure can be highly effective for certain issues (Hurwitz et al., 2015), it might be enhanced by two important directions aligned with equitable implementation literature. First, consultation could incorporate explicit investments and decision-making to advance equity to ensure that efficiency or the individual-focus does not take priority over engaging in important, reflective conversations and changing broader outcomes. Second, we highlight the need to recruit critical perspectives and engage with cultural humility.

Investments and decision-making to advance equity

Efforts to advance equity require ongoing investments to reflecting and acting at every decision point (NASP Domain 8: Equitable Practices for Diverse Student Populations; NASP Domain 7: Family, School, and Community Collaboration; NASP Domain 10: Legal, Ethical, and Professional Practice; Sabnis & Proctor, 2021). Decision points can be identified throughout consultation related to actions such as identifying all vested partners, involving the student, meeting to develop a shared purpose, or planning data collection. To facilitate this process, equity should be explicitly described and pursued as a foundational goal of consultation, regardless of the specific student referral concern (Clare, 2009). By naming the goal of advancing equity and being explicitly anti-racist, consultants can clearly communicate their goals and values to consultees and clients (Fallon et al., 2022; Galloway et al., 2019).

Consultation goals should focus on an individual student while also attending to systemic ecologies that fostered the current issue (e.g., lack of sufficient Tier 1 instruction; cultural misalignment of SEL curricula, lack of community resources; Sullivan et al., 2021). As noted by Sullivan et al. (2021, p. 24) “systems advocacy does not ignore client needs but emphasizes systems as essential targets for our efforts.” For example, a teacher referral for a Black male fourth-grade student centered on his reading skills may account for the fact that Black male fourth graders are less likely than their White male peers to be at grade level (National Center for Education Statistics, 2021b). Therefore, one consultation goal may be to improve this individual student’s reading gains, but another critically important goal should be evaluate and correct grade-level inequities in reading proficiency through system-wide assessment and prevention and intervention (e.g., adjust Tier 1 curriculum, increase time spent with reading, ensure cultural match between reading curriculum and student body, improve teachers’ reading instruction training; Sullivan et al., 2020). Expanding the scope of consultation to actively invest in systemic advancements in equity is an example of pushing back on individualistic patterns of discursive power, in which problems are narrowly defined and intra-individual interventions are reflexively targeted (Stanton et al., 2022).

Importantly, the ultimate impact of articulating goals and regular conversations about equity is dependent on the investment in dedication, time, expertise, and resources to these efforts. This shift in scope opens available material power (or how resources are distributed and who has access; Stanton et al., 2022) to be more equitably distributed. That is, when we define consultation goals narrowly our efforts as consultants and the associated resources (e.g., consultee time for training, interventions purchased) are spent to only benefit an individual student. Such a pattern is in opposition to the original public health aims of consultation (Erchul & Martens, 2010). Instead, consultation resources (e.g., time, interventions, training) could be targeted systemically to maximize their impact. In doing so, consultants must make sure that systemic consultative aims receive sufficient support to be reasonably expected to improve. For example, a goal of supporting classroom teachers to generalize proactive behavior support beyond an individual student requires more than problem solving for a particular student. Rather, efforts to support teachers’ class-wide implementation may require training, implementation planning, and other support that should be embedded within consultation (Sanetti & Collier-Meek, 2019). Although this recommendation for evaluating power and centering equity within systems broaden the scope and are more time-intensive than traditional problem-solving consultation, these efforts are more likely to attend to the systems-level roots of the student-focused issue, rather than perpetuating a focus on individual students (Sullivan et al., 2021). They also can impact system issues and become the prevention focus so necessary in the consultation process. Future research could document the impact of this consultation approach on both individual and systemic outcomes.

Critical perspectives and cultural humility

Throughout the consultation process, consultants should actively encourage their own and others’ critical perspectives to reflect on the extent to which process and outcomes are inclusive and equitable (NASP Domain 2: Consultation and Collaboration, Domain 7: Family, School, and Community Collaboration; Newell et al., 2020). Sabnis and Proctor (2021, p. 9) wrote that “ … critical race studies has discussed the ‘culture of niceness’ that prevents people from openly talking about thorning issues to avoid tensions or conflicts.” This reflection must not be viewed as a nuisance or imposition, but rather as an expected, requested, and welcomed part of typical consultation. The voices of the client, their families, and others who have historically not had a voice in consultation or schools should be centered in this effort (Clare, 2009; Goforth, 2020; McKenney, 2021; Sabnis & Proctor, 2021). Further, this process may also leverage and connect with community partners who can contextualize and assist with school-based consultation efforts (Arora et al., 2019).

To do so, a consultant can practice cultural humility (i.e., having a perspective that is focused on others as opposed to the self) through engaging openly, giving perspectives respectful consideration, showing a genuine interest in learning, viewing situations from different perspectives, and asking questions when unsure (Hook et al., 2013; Newell et al., 2020). This is a lifelong process that can be highlighted in graduate school consultation courses, but also through ongoing learning and self-reflection, affinity groups, and professional development (see Ingraham, 2017, for a review of preparing consultants for multicultural practice). Through demonstrating this humility and incorporating critical perspectives, the course of consultation can change and improve (Goforth, 2020; Newell, 2010). For example, consultation goals might evolve over time as new structural issues are uncovered, the individuals present at consultative meetings may change, a student may share a goal that requires intervention adjustment, or an implementer may ask for additional support. Being able to know and incorporate critical perspectives to advance equity will ensure that consultation is not static but rather responsive to oppressive dynamics and new opportunities (Sabnis & Proctor, 2021). Research could document the impact of encouraging critical perspectives on variables such as consultee trust and vulnerability, student participation, selected measurement and intervention approach, and ultimate student and system outcomes.

Roles in consultation

Problem-solving consultation typically includes three roles: the consultant, consultee, and client. Although the type and number of people who may occupy these roles can vary, much of the school-based consultation literature has evaluated the impact of the consultant as school psychologist, special education teacher, or researcher; the consultee as teacher; and client as an individual student (e.g., Hurwitz et al., 2015). There is also a substantial body of research on conjoint behavioral consultation, which includes the teacher and parent together as consultees (e.g., Sheridan et al., 2012, 2017) and there is emerging research on the consultant being a problem-solving team or working within the context of a team (e.g., Dowd-Eagle & Eagle, 2014; Newton et al., 2012; T.R. Kratochwill et al., 2021). The ways in which these roles are operationalized in research and typically enacted in practice may center those with privilege and may inadvertently do a disservice to students who need support, particularly those who are multiply marginalized. Following this critique, we highlight how equitable implementation elements, such as (a) trusting relationships and (b) dismantling power structures, could enhance how roles in consultation are operationalized and practiced.

Consultant

As described in numerous problem-solving consultation texts, the consultant is responsible for directing the consultation process, often collecting, and analyzing the data (NASP Domain1: Data-Based Decision-Making), developing the intervention plan (Domain 3: Academic Interventions and Instructional Supports, Domain 4: Mental and Behavioral Health Services and Interventions), and evaluating outcomes (Domain 9 Research and Evidence-Based Practice; Bergan & Kratochwill, 1990; Sheridan & Kratochwill, 2007; Kratochwill et al., 2014). Notably, consultants are likely to hold multiple privileged identities (e.g., White, cisgender, abled; see, for example, characteristics of school psychologists described by Goforth et al., 2021) as they begin consultation. There is little doubt that this privilege is reinforced by delineation of roles in consultation as the consultant holds a substantial amount of responsibility and power in influencing the course of consultation.

Verbal analysis highlights how positive consultation outcomes are associated with consultants eliciting questions from the consultee in the initial meeting and speaking and directing the conversation more often in subsequent meetings (e.g., Bergan & Tombari, 1975, 1976; Martens et al., 1989; see Erchul et al., 2014 for a review). Further, social power bases (i.e., coercive, reward, legitimate, expert, referent, and informational power; French & Raven, 1959; Raven, 1965) have been proposed as a way for consultants to change the consultees’ attitudes or behaviors (Erchul & Raven, 1997). The impact of the structured, directive, and expert role of the consultant, reflected in the structure of consultation and recommended verbal behavior, could be empirically evaluated to better understand how it influences meaningful collaboration (e.g., time to clarify misunderstandings, ensure contextual fit of the intervention, truly evaluate acceptability). For example, during the Problem Analysis Interview the consultant shares baseline data and their analysis of the student issue, introduces an intervention, and provides direct training (Kratochwill & Bergan, 1990). All of these activities occurring within one meeting may not leave the consultee with time to reflect on the data or fit of the plan before being trained on it and being expected to begin plan implementation. The expert power and directiveness of the consultant combined with the focus on efficiency of these time-limited meetings may inadvertently detract from a genuinely collaborative relationship and therefore hamper subsequent collaboration and implementation.

Notably, consultants’ perceptions of the effectiveness of social power bases differs by gender, with male school psychologists most likely to use expert power and female school psychologists eschewing the use of more coercive or overt strategies (Erchul et al., 2004; Getty & Erchul, 2009). This difference seems particularly notable given the fact that most of the foundational consultation texts were written by males (e.g., Bergan & Kratochwill, 1990; Erchul & Martens, 2010; with notable exceptions: Rosenfield, 1987; Rosenfield & Gravois, 1996; Sheridan & Kratochwill, 2008), but practicing school psychologists are primarily female (Goforth et al., 2021). Notably, White women (the largest demographic of educators; National Center for Education Statistics, 2021a) continually prioritize “niceness” within their interpersonal and collegial relations, which likely limits the effectiveness of their consultation efforts (e.g., advocate on behalf of a student or family; having difficult conversations about a colleague’s classroom management; Biddanda, 2019; McKenney, 2021). At present, problem-solving texts generally do not address how to engage in consultation in consideration of these differences in gendered socialization that are present within consultation, which poses additional challenges to addressing issues systemically.

Consultee

The consultee has a pivotal and critical role that changes over the course of consultation. Consultees are often responsible for seeking out consultation (Bergan & Kratochwill, 1990; Sheridan & Kratochwill, 2008), suggesting they can be gatekeepers for which students receive additional support. The request for consultation could be viewed as reflection of the consultee’s expectations that a student has the potential to do better with additional or different support (Gershenson et al., 2016). However, biases in teacher expectations are pervasive. For example, teachers who are not Black tend to have lower expectations of Black students (Gershenson et al., 2016) and teachers tend to underestimate the academic achievement of students of color (Cherng, 2017). It is likely that bias in teacher expectations could shape who has access to consultation, leaving students of color to receive fewer proactive supports.

Once consultation begins, the consultee is primarily responsible for sharing their concerns about the client or student. Based on the consultee’s description (e.g., operational definition of student concern, impacting variables, previous interventions), the consultant develops a sense of the student issue and plans for baseline data collection (Kratochwill et al., 2014). This structure reflects an assumption that the consultee (typically a teacher) can accurately and neutrally describe the student issue. However, the information that teachers or other consultees report may not be reflected in the data that are gathered (Cherng, 2017; Gilliam et al., 2016; Girvan et al., 2017). Consider for example that educators, who are majority White female (National Center for Education Statistics, 2021a), are subject to interpreting events through implicit and, in some cases, explicit bias (see Annamma & Morrison, 2018). Research has found that educators are more likely to surveil students of color closely (Nance, 2017); view these students as physically larger or older (Waytz et al., 2015); interpret their behavior more intensely (Girvan et al., 2017); view their pain with less empathy (Forgiarini et al., 2011); and believe that an escalated adult response is warranted (Smolkowski et al., 2016). These educator biases result in demonstrable outcomes that impact students across their lives including more frequent office discipline referrals (particular for ambiguous problem behaviors; Smolkowski et al., 2016), suspensions/expulsions (beginning in preschool; Gilliam et al., 2016; Girvan et al., 2017), referrals for special education (Kincaid & Sullivan, 2017; Sullivan et al., 2020), and dropout (National Center for Education Statistics, 2020). Further, some educators may hold explicit biases around the inherent worth, value, and strengths of students of color (Annamma & Morrison, 2018). A teacher may be motivated to inflate student concerns to sabotage consultation that is focused on within-classroom intervention to instead have the student removed from their classroom (Gershenson et al., 2016; Gilliam et al., 2016). Although a consultee’s bias or motivation for engaging in consultation is not always an issue, given that it is regularly present, the appropriateness of having a teacher often being the sole communicator about the student issue and the sole source of student data might be worthy of reconsideration

Later in consultation, the consultee role changes significantly from initially strongly contributing with their perceptions of the student issue to being responsible for delivering the consultant-identified intervention plan. As noted above, analyzing student baseline data, learning about the intervention, and being trained to deliver it typically occurs during just one approximately 30-min meeting (Sheridan et al., 2012, 2017). Early conceptualizations of the plan implementation stage in consultation (e.g., Kratochwill & Bergan, 1990) did not provide clear direction for the consultant and expected that consultees would be able to independently implement the intervention. As new research developed, we learned that consultees need much more guidance and support to effectively implement interventions (Sanetti & Collier-Meek, 2019). Research findings suggest that initial training is insufficient for most teachers to independently implement student interventions (e.g., Sanetti et al., 2015) and teachers report that they would appreciate more support (Long et al., 2016). In particular, teachers who serve marginalized students are more likely to describe their schools as having limited support and chaotic organizational climates (Johnson et al., 2012). Such schools tend to have greater teacher turnover and new teachers as well (Fallon et al., 2019; Johnson et al., 2012), and as a result, these teacher consultees may particularly benefit from implementation support embedded in consultation. We have learned so much about how to involve and support the consultee during intervention implementation, and how inequity in school conditions may impact teacher and student outcomes. This knowledge base must be actively incorporated into consultation best practices.

Client

The typical problem-solving consultation structure is focused on understanding and supporting a client (i.e., individual student, classroom). The early basis for consultation was to move from direct services to the child (i.e., child psychotherapy) to a mediator-based model in which the consultee was the treatment agent rather than the psychologist. This early approach (1970s to the late 1980s) was dominant in the early conceptual work in behavioral consultation focused on educational settings (e.g., Bergan & Kratochwill, 1990) and family-focused models in community psychology (Tharp & Wetzel, 1969). Both of these approaches were grounded in the broader movement to engage a wide range of nonprofessional “therapeutic agents” in mental health services, in large measure, as even 50 years ago, professionals recognized that there would never be enough mental health providers to address the growing needs of children and families in the U.S. and around the world (Guerney, 1969; Gutkin & Conoley, 1990). Of course, over time we have seen a broader model of consultation services in which nonprofessional mental health agents such teachers and parents come together as consultees (e.g., conjoint behavioral consultation; Sheridan & Kratochwill, 2008). Nevertheless, the mediator-based mental health movement, and consultation as a service model in particular, has a downside and has been minimizing the role of the client/child in their role in services. Although engaging the client/child directly in services (e.g., self-control program, self-monitoring) was considered a desirable feature of traditional behavioral consultation (Bergan & Kratochwill, 1990), direct contact with the child is still not a prominent feature of problem solving and needs to be reexamined (see Kratochwill & Pittman, 2002).

The complete absence of the student in the consultation process may be one example of epistemic power, or whose knowledge or involvement is seen as critical to decision-making and knowledge production (Geuskens, 2018). In much of school-based consultation, teachers’ perspectives are deemed critical, while students’ and parents’ voices may be seen as optional, unnecessary, or even outright undesired by some consultants. As such, consultants and consultees may work on behalf of students to define expectations, identify and implement interventions, and analyze data to inform future actions, without substantive efforts to engage the students or their families in intervention services (Weist et al., 1991). Disability right activists have highlighted the harm of this approach in adopting the phrase “nothing about us without us” (Carmel, 2020). The direct involvement of students in the consultation process may also be considered within the broader framework of human rights of children. For example, there is growing emphasis on the internationally recognized rights for all children (United Nations, 1989), which include children’s rights of participation. Children have the right to communicate their perspectives and have them respected, particularly when the decisions are about them (Nastasi & Naser, 2014). We obtain a brief glimpse of this issue in research on intervention acceptability where this variable is measured in only 40% of studies and of those studies, student (60%) and family (22%) assessment fall behind teachers (75%; Silva et al., 2020).

DisCrit highlights the importance of elevating and centering the voices of marginalized populations to shift the nature of their experience in schools. Without such effort, it is unlikely (if not impossible) for consultation to (a) reflect shared expectations and values and (b) incorporate culturally responsive intervention and support (Goforth, 2020). Therefore, our message is that student and family involvement is fundamental not only to improving the quality and effectiveness of interventions but also to ensuring consultation advances equity and does not act as a structure of further marginalization. Conjoint behavioral consultation is a step in the right direction for extending services in this manner. However, one critical challenge for future consultation researchers will be finding ways to extend involvement of children, families, and even other significant intervention agents (peers, extended family members, and significant community agents) that are feasible given the extraordinary level of need.

Equitable implementation to improve consultation roles

Consultation practitioners and researchers can reflect on how roles (i.e., consultant, consultee, and client) are operationalized to understand how power is reinforced within consultation. Further, they can consider changing these patterns as they prioritize trusting relationships and make efforts to dismantle power structures.

Trusting relationships

Trusting relationships are the foundation of effective collaboration and can be developed through the course of consultation (NASP Domain 2: Consultation and Collaboration, NASP Domain 7: Family, School, and Community Collaboration; Ingraham, 2000; Sheridan et al., 2012). The importance of collaborative relationships is highlighted in the rapport-building stage (before problem/needs identification) in recent best practices for problem-solving consultation (Kratochwill et al., 2014). However, exactly how consultants can facilitate the emergence and sustainment of trust, and how this might intersect or contradict with the consultant-as-expert role, within the structure of problem-solving consultation has not been clearly articulated. Trust is critical not only to the openness and sharing necessary to start the consultation process, but also to all steps throughout the process. Trust is an important prerequisite to (a) facilitate honest impressions of the proposed intervention; (b) encourage potentially vulnerable disclosures about an implementer’s feelings of preparedness and self-efficacy; and (c) engage in meaningful discussions about the sufficiency of implementation support, the contextual fit of the intervention, student and systemic outcomes, and shared next steps (Adams & Christenson, 2000; Edmondson, 2018; Santiago et al., 2016).

The expectation of trust, openness, and vulnerability without actionable effort by the consultant is unrealistic. Caregivers’ level of trust in schools varies by demographic variables (e.g., student eligibility for free/reduced lunch, number of caregivers in a home; e.g., Santiago et al., 2016), with results suggesting that families who do not fit into the oft-narrow expectations of schools (e.g., White, middle class, dual parent) may (reasonably) feel less welcomed and trusting. Further, many student behavior and academic outcomes are negatively related to family-school trust, suggesting that when referrals for consultation arise, they likely do in the context of limited trust (Adams & Christenson, 2000; Froiland & Davison, 2014; Santiago et al., 2016).

Ingraham (2000) describes how trust can be developed through the consultant’s own cultural reflections as well as by demonstrating valuing multiple perspectives, creating emotional safety, and providing affective support. As consultants are likely to hold privileged identities, which are then reinforced through their role in consultation, they have a critical responsibility to interrogate their own privilege, reflect on how it may intersect with development of trust, and act to prioritize and build trust (e.g., engage flexibility, prioritize student and family needs, show genuine interest, actively seek feedback). Swanger-Gagne et al. (2009) provide suggestions for how consultants can build trust in relationships with teachers and families in the context of CBC including utilizing a partnership model founded on the family’s values, investing in truly knowing the family, utilizing culturally sensitive procedures, engaging in supportive communication, being responsive to needs, and making frequent contacts. Further, recent textual analysis research in consultation found positive consultation outcomes associated with congruent (teacher and caregiver) consultees’ communication (Garbacz et al., 2015) and with consultants’ and consultees’ use of the word “we” (rather than pronouns such as “I” or “they”; Newman et al., 2015), suggesting that working alliance or trust could be documented within spoken language during consultation meetings. Other examples for consultant to build trusting relationships are also described in Table 1, such as being flexible with meetings and actively seeking feedback from consultee and client. Research that (a) operationalizes trust between consultants, consultees, and clients; (b) evaluates how it changes over time during consultation; and (c) validates strategies for building and maintaining trust, is necessary for advancing the practice of consultation. Consultant training should prepare future school psychologists to not expect trust to simply be present but rather earned through their deliberate engagement with consultees and clients.

Dismantling power structures

In the current operationalization of roles, consultation is typically a triadic process, wherein (a) the consultant wields the most power; (b) consultees’ power shifts over time as they articulate the concern (i.e., high power) and then engage in implementation (i.e., low power); and (c) the client, who is the target of support, has the least power and active involvement. As noted above, this limited student role may reinforce an ableist, paternalistic perspective that fails to prioritize students as authorities in defining how educational systems can better support their development (Sabnis & Proctor, 2021). Student voice and involvement in consultation has rarely been studied to our knowledge. To flip the unquestioned epistemic power structure often present in consultation, students could be meaningfully engaged in consultation to (a) share their perspectives on the current challenges, expectations, and ecologies; (b) co-construct goals that reflects shared values; (c) ensure comprehensive data collection and analysis that incorporates different ways of knowing across contexts; (d) ensure the proposed interventions address the system, support the student, and are culturally responsive and acceptable; and (e) engage in ongoing communication about implementation, outcomes, and next steps. This process should be focused on developing meaningful partnerships that values and prioritizes the voices of students (NASP Domain 2: Consultation and Collaboration; NASP Domain 7: Family, School, and Community Collaboration; NASP Domain 10: Legal, Ethical, and Professional Practice). This type of collaboration between families and teachers is characteristic of CBC (Sheridan & Kratochwill, 2008) and multicultural consultation (Ingraham, 2000), which could provide a foundation for how to engage families to promote equity. This work could also extend to better understand how to meaningfully involve student(s) themselves as well. Research on varied ways to include students in substantive ways and the associated outcomes with these approaches would advance the consultation literature.

To make inroads in this area, a recalibration of the consultant and consultee roles may be helpful. Rather than only a dynamic of expert and recipient, consultant and consultee can add in an active partnership to share knowledge and experience to the service of advancing equity and outcomes for the student and system (Ingraham, 2000). To do so, consultants must engage in ongoing reflections to acknowledge their own biases, the role of power in consultation, the narrow scope of standards for success in education (i.e., White, able-bodied, middle class), and how context contributes to the presenting concern (Schumacher-Martinez & Proctor, 2020). Consultant training should continue to include student-level data collection and intervention, but also prioritize and systematically prepare new school psychologists to identify currently hidden critical components of their role as consultants (Ingraham, 2017; Newell et al., 2020). That is, consultants should learn to evaluate and build trust with diverse consultees and clients (Santiago et al., 2016). To do so, consultants need to utilize structural awareness to reflect on systemic barriers (Metzl & Hansen, 2014); continually practice cultural humility (Ingraham, 2017; Sander et al., 2016) and practice-building consensus across multiple perspectives (e.g., nominal group technique; Ingraham, 2017; Potter et al., 2004). They should also be prepared to provide ongoing implementation support (Sanetti & Collier-Meek, 2019). Further, this reframing of consultation requires a different orientation to the role of consultee, including clarifying the goals, scope, and timeline for consultation (e.g., to advance equity in the school, looking beyond individual student) as well as expectations for their involvement (e.g., reflect on their biases, be vulnerable, be engaged and committed; Ingraham, 2000). In doing so, the consultant will continually be reflecting on ways to minimize power differentials and invite and center client and consultee expertise. Such a process may help address unquestioned patterns of discursive and epistemic power when present in consultation (Stanton et al., 2022). As this process is operationalized into problem-solving guidelines, research can be conducted to understand the multi-layered outcomes associated with this approach.

Purpose of consultation

In reflecting on the purpose of consultation, we comment on how problem-solving consultation addresses (a) the student concern and intervention, and (b) building consultee skills. Further, we highlight how equitable implementation elements exemplified by (a) context-based evidence and (b) adaptation and cultural adaptation could enhance how the purpose of consultation is operationalized and practiced.

Student concern and intervention

The primary focus of problem-solving consultation (teacher-focused and conjoint) is addressing a consultee-reported client concern (Kratochwill & Bergan, 1990; Kratochwill et al., 2014; Sheridan & Kratochwill, 2008). That is, the goal of consultation is often to correct a mismatch between the expectation of the consultees and the students’ behavior or academic performance. Most often in prior research this discrepancy is a behavioral concern, though academic concerns or a combination of both have also been addressed. Although there is a focus on “needs assessment” (Sheridan & Kratochwill, 2008), a deficit focus of problem-solving consultation may still be evident. After all, school psychologists are often contacted to solve problems whether it is for addressing a classroom issue, systemic concern, or treating a developing psychological disorder (Conoley et al., 2020; Sander & Bibbs, 2020). The DisCrit literature highlights significant issues with the broad use of the deficit perspective for supporting multiply marginalized students throughout education (Annamma et al., 2013; Annamma & Morrison, 2018). The current performance of students who are the target of consultation may be compared, in the deficit perspective, to a narrow norm: an able-bodied, middle or upper class, cisgender White student (Annamma & Morrison, 2018; Goforth, 2020). Consultants should be advised to question the appropriateness of this expectation or norm, likely due to its pervasiveness in education (Sabnis & Proctor, 2021) and consultants’ socialization in this culture. This is an example of discursive power, wherein dominant perspectives are allowed to articulate and define reality and shape how others are viewed (Foucault, 1972). By defining students’ current performance and needs as well as teachers’ expectation from this lens, consultation may contribute to unchallenged narratives about students’ abilities and a narrow definition of educational success.

The process of consultation also involves selecting student interventions that have a high probability of being effective. Most scholars of consultation will likely endorse the evidence-based practice movement and recommended that research-supported interventions be adopted for children and families (American Psychological Association Task Force on Evidence-Based Practice for Children and Adolescents, 2008; Kratochwill, 2006, 2007; Kratochwill & Hoagwood, 2006). Indeed, the APA Task Force specifically recommended a systems approach in providing evidence-based care for children. However, there is pervasive inequity within the academy as certain interventions are prioritized (e.g., focused on discrete problems at the individual level; Conoley et al., 2020); privileged groups are more likely to be funded and published (e.g., White men, WEIRD nations; Kozlowski et al., 2022); and client outcomes are evaluated in a narrow context (e.g., White, suburban students; Grant et al., 2022). Consultants must remember this inequity as they review and select evidence-based interventions and reflect on what interventions might be most effective in consideration of the client’s identity characteristics and school system context. To this end, recent systematic reviews that summarize effective school-based interventions evaluated with racially and ethnically minoritized students can be particularly useful for consultants to review (see Fallon et al., 2022; Long et al., 2019). The evidence-based practice movement, while critically important and a bedrock of school psychology practice (National Association of School Psychologists, 2020), is certainly not beyond reflection and critique.

Traditionally, a rather narrow range of interventions has been included in problem-solving consultation with a major emphasis on function-based procedures. More interventions are likely to effectively improve student outcomes within the context of consultation (Kazdin, 2018). At present, function-based questions are the focus of the Problem Identification Intervention, which may lead consultants to suggest these types of interventions (Kratochwill & Bergan, 1990). Function-based interventions can be highly effective in shifting student behavior (Hurl et al., 2016), though applied behavior analysis has been critiqued for being race-neutral (Fong et al., 2017) and insufficiently prioritizing the rights and preferences of clients with disabilities (Kapp et al., 2019). At present, there are limited questions about the client’s individual identity or the broader contextual setting. In the future, items related to the client and family identity, such as the Cultural Formulation Interview (APA, 2013) or the ADDRESSING model (Hays, 2008; Jones, 2014) could be more generally incorporated into the initial interview. In short, our menu of intervention options needs to be expanded beyond the delivery model used in traditional problem solving (see Kazdin, 2018 for numerous examples of innovation).

Consultee skills

Consultation texts highlight two simultaneous aims – addressing an area of concern for the client, while also building the skills of the consultee (Kratochwill & Bergan, 1990; Sheridan & Kratochwill, 2008). Through these dual aims, it is expected that consultation can facilitate support for more students by sharing consultant (expert) knowledge with the consultee to use in future practice (Caplan, 1963). In consultation, the meeting structure and components highlight the primary focus of client-centered activities, while consultee-level outcomes have traditionally been addressed in the TEI when maintenance and generalization are discussed (Kratochwill & Bergan, 1990). Nevertheless, decades of research suggests that this discussion is unlikely to be sufficient, as most teachers need ongoing support to fully implement interventions (Sanetti et al., 2015).

Research on students’ ability to generalize suggests that training, practice, and support are needed to effectively master this skill (Skinner & Daly, 2010). There is limited research, both in consultation and more broadly in education, on teachers’ maintenance and generalization as well as strategies to support these behaviors (Riley-Tillman & Eckert, 2001; Sheridan et al., 2019). Similar to the limited attention paid to implementation support, the lack of explicit direction for how consultation can build consultee capacity may disproportionately harm both teachers who could most benefit from this support (e.g., new teachers, teachers in unsupportive work climates) and their students, who are more likely to be multiply marginalized (Fallon et al., 2019; Johnson et al., 2012). If supporting the consultee to build and use new skills and practices is indeed a critical component, it must be better articulated and integrated into the consultation process.

Equitable implementation to improve consultation purpose

To more equitably and comprehensively address the dual purpose of consultation, consultants can consider incorporating context-based evidence and embedding adaptation and cultural adaptation.

Context-based evidence

Consultants can reflect on the impact of their role in determining what evidence is incorporated into consultation (i.e., epistemic power; NASP Domain 7: Family, School, and Community Collaboration, Domain 9: Research and Evidence-Based Practice). The ways in which target behaviors are conceptualized and interventions are designed are impacted by the area of concern as well as the consultant’s clinical judgment and theoretical orientation (Kanfer, 1985). In the tradition of behavioral psychology, and most recently, the evidence-based practice research movement, much of the consultation research has relied upon targeted interviews and then systematic direct observation or curriculum-based measures to evaluate the student issue and progress across time. These methods are useful for understanding discrete student challenges; however, additional data collection could facilitate broader understanding of the current issue that attends to systemic (e.g., school, home, community) causes. These methods should include an elevation of the student’s experience (e.g., interviews with student, student collection of data, student perspective informing data collection), which has been historically minimized in problem-solving consultation.

As a way to expand understanding of context and systems, consultants can contextualize current measures used for data collection (e.g., limitations of measures, data collection procedures) while also valuing and prioritizing other ways of knowing (Ramirez & Smith, 2007). For example, consultants seeking to understand school-related ecologies or family and community needs and perspectives can incorporate additional data collection methods, such as qualitative interviews, permanent product review, surveys, or extent data. They can also utilize systematic direct observation or curriculum-based measures to understand the context beyond the individual student (e.g., teachers’ frequency of praise, corrections, opportunities to respond; average reading level of grade). Other evidence, such as assessing the client’s reading ability in their first language when a true peer comparison may not be available, can also be considered as described in Table 1. These data sources could be collected and reviewed with a sense of value and curiosity that demonstrates active cultural humility and a willingness to follow the data and value different perspectives (Newman & Ingraham, 2017; Sander & Bibbs, 2020). The potential utility of multi-method (e.g., observation, self-report) and multi-target (e.g., academic, behavioral, classroom) data collection within consultation, needs to be considered alongside the likely practical challenges (Kratochwill, 1985).

When non-evidence-based interventions are adopted, the consultant should evaluate the intervention to determine its efficacy within a scientific-practitioner model of practice (Barlow et al., 1984). These efforts may pay dividends for better understanding the student and context; facilitating collaborative engagement; and selecting and adapting an appropriate intervention (McKenney et al., 2017; Newell et al., 2020). Consultation researchers might evaluate the impact of adjusting the meeting prompts related to identifying the area of focus and data collection on both consultation and student outcomes.

Adaptation and cultural adaptation

School psychologists engaged in consultation must consider critical questions at the basis of student-level intervention efforts: for whom do interventions work, under what conditions, and serving which outcomes (Clare, 2009; Ingraham, 2000). Although most school-based research is conducted with a narrow student sample (i.e., White, middle class; Grant et al., 2022), recent systematic reviews have highlighted school interventions evaluated with minoritized student samples to inform and improve targeted intervention selection (Fallon et al., 2022; Long et al., 2019). Further, there is burgeoning evidence that local intervention adaptations to increase cultural fit (Dusenbury et al., 2003; Leviton, 2013; Thier et al., 2020) or to better match the implementer or classroom context (Sanetti et al., 2015) can improve intervention fidelity and bolster student outcomes. Unfortunately, few school-based intervention developers have systematically culturally adapted an intervention prior to broad-scale implementation to increase reach to specific populations and focus on cultural fit (Barrera et al., 2017) and there is limited research to identify the core components of educational interventions (Forman et al., 2013). As such, consultants and consultees are responsible for embedding planful adaptation (which retains theorized core intervention components while matching the student population and implementation context) into the consultation process. Future researchers might directly embed implementation planning within typical consultation alongside direct training to help consultees modify the intervention to fit their setting and implementers are prepared to deliver the intervention (Sanetti & Collier-Meek, 2019).

Cultural adaptation is “the systematic modification of an evidence-based treatment or intervention protocol to consider the language, culture, and context in a way that is compatible with the client’s cultural patterns, meanings, and values,” (Bernal et al., 2009, p. 362) and is distinct from cultural attunements, which involves relatively surface-level changes without adjustments to the intervention itself (e.g., modifying language). Studies have documented stronger outcomes for culturally adapted interventions, in comparison to the original intervention (Degnan et al., 2018; Rathod et al., 2018). Working collaboratively with consultees and clients, consultants can critically consider the current context (e.g., student, family, classroom, school), how the potential practice aligns with it, and what adaptations would improve fit with the context as well as the client’s experiences and worldview (Bernal & Adames, 2017; Ingraham, 2000). There are different frameworks for how to engage in cultural adaptation that could be integrated into consultation (Bernal et al., 1995). For example, Barrera et al. (2013) suggest a five-part iterative process for cultural adaptation including information gathering, preliminary adaptation design, preliminary adaptation tests, adaptation refinement, and cultural adaptation trial. Consultation could more directly involve a process for adaptation within intervention development (Ramirez & Smith, 2007). Together, with an understanding of the theoretical underpinnings of an intervention and centering the client’s worldview, school psychologists can make local adaptations to increase cultural fit, which has been repeatedly shown to increase engagement, improve outcomes, and facilitate sustainability (Barrera et al., 2017).

Challenges, opportunities, and conclusions

There is no doubt that consultation is a critical avenue for school psychologists to effectively improve outcomes for students (National Association of School Psychologists, 2020). However, the pervasiveness of inequitable school-based experiences for multiply marginalized students (Skiba et al., 2002; Smolkowski et al., 2016) and resulting student outcomes (National Center for Education Statistics, 2021b) must challenge school psychologists to critically review their practices, including consultation (Conoley et al., 2020). In this paper, we commented on assumptions embedded in consultation utilizing DisCrit and highlighted how perspectives from both culturally responsive and systems change consultation work and suggestions from an equitable implementation lens could contribute to shape the practice of school-based consultation and research.

We are not naïve about the challenges of bringing change to school-based consultation. At present, school psychologists report that they are not able to engage in as much consultation as they would like given their other responsibilities (Bahr et al., 2017). There is no doubt that many of the suggestions we raise (e.g., building trust, adapting interventions) require a greater initial time commitment than is currently operationalized and practiced in school-based consultation. Further, school psychologists report being uncomfortable commenting on their colleagues’ practices, making it more preferred to focus on intra-individual student issues (Cochrane et al., 2019; McDougal et al., 2000). School psychology trainers already report challenges associated with sufficiently covering consultation content in their courses and wanting more resources to meaningfully and authentically embed issues of cultural and linguistic diversity in their courses (Sander et al., 2016). However, consistent data (e.g., inaccurate reports of the behavior of students of color; Skiba et al., 2002; Smolkowski et al., 2016) and our ethical responsibilities (e.g., U.N. Rights for Children, 1989; National Association of School Psychologists, 2020) must move us to seriously work to reflect and change inequitable patterns in consultation (Sander & Bibbs, 2020).

Further, even our best efforts at culturally competent, problem-solving consultation for individual students will not make sufficient difference in addressing the pervasive systems-level issues of inequity in education (Conoley et al., 2020; Sullivan et al., 2021). School psychologists can work to embed lessons from culturally responsive and systems change consultation work and an equitable implementation lens in their consultation to consider how the broader system contributes to an individual student referral and address that systemically in addition to supporting outcomes for the client. School psychology trainers have a responsibility to teach about consultation in a way that acknowledges the reality of schools (e.g., most teacher consultees are White females, National Center for Education Statistics, 2021a; inconsistent behavior reporting, Skiba et al., 2002). School psychology students in training need to be prepared for the responsibilities, challenges, and opportunities ahead through discussion, modeling, and practice in consultation courses (Ingraham, 2017; Newman & Ingraham, 2017). This education will involve directly facilitating conversations about equity and bias and planning to actively support teachers’ implementation and generalization. With this preparation, school psychologists can center disrupting problematic school-based ecologies and advance equity as foundational to their consultation practice.

Disclosure statement

Drs. Collier-Meek, Kratochwill, and Sanetti have financial interests in some of the consultation books cited in this article..

Additional information

Notes on contributors

Melissa A. Collier-Meek

Melissa A. Collier-Meek is an Associate Professor of School Psychology at Teachers College, Columbia University.

Thomas R. Kratochwill

Thomas R. Kratochwill is Professor of School Psychology at the Wisconsin Center for Educational Research at the University of Wisconsin-Madison.

Hao-Jan Luh

Hao-Jan Luh is an Assistant Professor of School Psychology at Eastern Illinois University.

Lisa M. H. Sanetti

Lisa M. H. Sanetti is Professor of School Psychology at the Neag School of Education at the University of Connecticut.

Annisha Susilo

Annisha Susilio is a doctoral candidate of School Psychology at the University of Massachusetts Boston and presently on internship at the Santa Barbara Internship Consortium.