An Examination of the Efficacy of Conjoint Behavioral Consultation with Diverse Clients

This study explored the efficacy of conjoint behavioral consultation (CBC) by assessing objective outcomes and social validity with a sample of students with and without di versity. Diversity characteristics that were investigated included ethnicity, socioeco nomic status, family composition, maternal education level, and language spoken in the home. Behavioral change, goal attainment, acceptability, satisfaction, and percep tions of efficacy of the CBC model were measured with 125 students representing vary ing levels of diversity, and 192 target behaviors. Data were collected across 8 years of a federally funded training program across two states. Findings indicated that CBC–me diated interventions yielded generally high effect sizes regardless of the presence of di versity or the number of diverse characteristics exhibited. Social validity measures also yielded very favorable results, suggesting that participants (teachers and family mem bers, including those who experienced some form of diversity) found the procedures positive. Implications for research and practice are presented. The demographic composition of the United States is becoming increasingly diverse. Currently, 38% of elementary school children are The research described herein was supported by federal grants awarded to the first author by the U.S. Department of Education, Office of Special Education and Rehabilitative Ser vices. The statements and opinions contained herein belong to the authors and are not re flective of the granting agency. The authors would like to acknowledge the several parents, teachers, graduate stu dents, and children who all contributed greatly to the completion of this study. Address correspondence to the first author at University of Nebraska–Lincoln, Ne braska Center for Research on Children, Youth, Families, and Schools, 216 Mabel Lee Hall, Lincoln, NE 68588–0234; E-mail: [email protected]. Efficacy of Joint Behavioral Consultation with Diverse Clients 397 ethnic minorities, and it is likely that White Americans will cease to be the numerical majority between the years 2030 and 2050 (Sue, 1997). At the same time, one in six children in the United States is living in poverty and 28% are living with a single parent (Annie E. Casey Foundation, 2004). The proportion of American school children who were English Language Learners was 10.2% in 2003 (National Clearing house for English Language Acquisition, 2004). Most importantly, the number of children who are diverse with respect to their socioeco nomic status, language, or other characteristics is increasing rapidly (Lynch & Hanson, 2004). Thus, it is more important than ever to exam ine the effi cacy of services provided to diverse children in American schools. Diversity is defi ned as demonstrating characteristics that are unique or diff erent from the mainstream society, including those of ethnicity, socioeconomic status, parental educational level, language, and family stability, among others (Sue, Bingham, Porch-Burke, & Vasquez, 1999). In the present study, diversity factors that were investigated included socioeconomic status (household income of less than $15,000), family composition (fewer than two adults in the home), ethnicity (nonCaucasian), maternal education level (less than a high school edu cation), and language spoken in the home (nonEnglish.) All of these di versity factors have been identifi ed as predicting lower rates of school completion (Doll & Hess, 2004; Rumberger & Larson, 1998). Moreover, all fi ve of the diversity factors investigated in this study have been identifi ed as social diff erences that challenge att empts to build collaborative relationships across educators, parents, and communities (Giles, 2002). When values, life experiences, and expectations of diverse families diff er in important ways from those of the educators who teach their children, communication and cooperation become more diffi cult to achieve (Sue et al., 1999). A premise underlying this study is that the challenges posed by diversity do not represent defi cits in the child, the school, or the family, but are evidence of a lack of synchrony within the child/family/school system (Pianta & Walsh, 1996). Eff ective learning transitions will be bett er sup ported when students experience continuity across home and school (Christenson & Sheridan, 2001). This premise is supported by a comprehensive ethnographic study of ethnically diverse adolescents in which students who experienced discontinuity across their home, school, and peer worlds had the most diffi culty in making transitions among these diff erent contexts and were at greatest risk for poor school performance and mental health concerns (Phelan, Davidson, & Yu, 1998). Low-achieving students in the study reported extreme diffi culty when the values, beliefs, knowledge, skills, and actions of their group were undervalued. In contrast, students moved easily and smoothly between 398 Sheridan, Eagle, & Doll in School Psychology Quarterly 21 (2006) and among home and school environments when they experienced congruent worlds, where similar values, expectations, and ways of behaving were evident among their family, school, and peers. In this exploratory study, the cumulative eff ect of diversity was the variable of interest, and it was operationalized by the number of respects in which a child diff ered from the mainstream population. There is ample justifi cation for this operationalization within the developmental risk research, where overwhelming evidence from multiple, independent longitudinal studies shows that the cumulative eff ect, and not simply the presence of isolated risk or diversity factors, makes students vulnerable to adverse outcomes (Bureau of the Census, 1996; Coie et al., 1993; Rutt er & Sroufe, 2000; Werner, 1989). As a recent example, the U. S. Bureau of the Census’s 1996 population survey found a strong relationship between number of risk factors experienced by adolescent participants and outcomes such as school dropout, teenage pregnancy, and parenting (U. S. Department of Commerce, 1997). Given this precedent, we have used a similar strategy to represent the cumulative eff ects of diversity (i.e., the number of diversity characteristics). Cross–system consultation provides multiple opportunities to minimize confl icting demands experienced by diverse students and build congruence between diverse families and schools. Incongruencies may be minimized and continuities enhanced when families and schools (a) communicate frequently; (b) discuss perspectives; (c) clarify roles, re sponsibilities and resources; and (d) make shared decisions (Christenson & Sheridan, 2001; Comer, Haynes, Joyner, & Ben–Avie, 1996). These actions allow educators to develop awareness of students’ differences, allow more time to develop relationships and trust building with parents, and aid parents in their understanding of diff erences be tween the home and school and in their feelings of acceptance at school (Tarver Behring, Cabello, Kushida, & Marguia, 2000). However, struc tured and systematic procedures for enhancing continuities and decreasing discrepancies among diverse contexts are not well researched. Conjoint behavioral consultation (CBC; Sheridan, Kratochwill, & Bergan, 1996) is uniquely suited to intervening with children whose in dividual/family diversity threatens their educational success, requiring enhanced continuity between home and school. CBC is an indirect model of service delivery in which parents, teachers, and a consultant work together to address the academic, social, or behavioral needs of a child. As an extension of within–system (i.e., parent–only or teacher– only) consultation, CBC combines perspectives and resources across multiple systems (home, school, and other support systems) to eff ect Efficacy of Joint Behavioral Consultation with Diverse Clients 399 positive change in a child. Parents and teachers serve as joint consultees, and consultation is conducted with parents and teachers working together in a cooperative, constructive manner (Sheridan et al., 1996). CBC was designed to promote a partnership model that creates oppor tunities for families and schools to work together around a common in terest. In doing so, it builds upon and promotes the capabilities and strengths of both family members and school personnel. It emerged as a unique and distinct service delivery model as proponents of behavioral consultation became concerned with the lack of att ention given to the ecological realities of children. From an ecological–behavioral perspec tive, the coordination and interconnectedness among primary systems (e.g., home and school) in a child’s life promotes continuity (Bronfenbrenner, 1977) and provides a “safety net” conducive for children’s healthy development (Christenson & Sheridan, 2001). In a 4–year investigation of the outcomes of CBC, Sheridan, Eagle, Cowan, and Mickelson (2001) reported average eff ect sizes of 1.08 and 1.11 when addressing a range of academic, social, and behavioral diffi culties in home and school sett ings, respectively. Additional studies have documented positive outcomes (both objective and subjective) as sociated with CBC service delivery (Colton & Sheridan, 1998; Sheridan, Kratochwill, & Elliott , 1990; Weiner, Sheridan, & Jenson, 1998). Recent reviews of evidence–based family intervention and parent consultation models identifi ed CBC as one of the few models demonstrating ade quate methodological rigor and positive outcomes to be considered “effi cacious” (Guli, 2005). Although CBC outcome, process, and acceptability research is in creasing (e.g., Sheridan, 1997; Sheridan et al., 2001), the potential for un derstanding the eff ectiveness of CBC with diverse clients has not re ceived att ention. Indeed, empirical investigation of the eff ectiveness of all forms of consultation with diverse clients and families lags far behind other areas of consultation research (Ingraham, 2000). Similarly, devel opments in the area of evidence–based interventions (EBIs) have sorely neglected samples of diverse participants (Doyle, 1998; Kratochwill & Stoiber, 2002). Att ention to the eff ects of consultation and interventions for specifi c diverse groups of children has been encouraged by leaders in the EBI movement (e.g., APA Division 16/Society for the Study of School Psychology Task Force on EBIs), who recommend evaluation of treatments and computation of separate eff ect sizes for individuals dem onstrating diversity (Evidence Based Intervention Task Force, 2003; Kratochwill & Stoiber, 2002). Conceptual discussions of CBC’s use with diverse clients have begun to appear. Specifi cally, Sheridan (2000) defi ned multicultural CBC 400 Sheridan, Eagle, & Doll in School Psychology Quarterly 21 (2006) as “a home–school consultation relationship wherein important individual diff erences are present among two or more participants (i.e., parent, teacher, student, school psychologist–consultant) with respect to associ ation with distinct cultural group(s) . . . includ[ing] sociodemographic (e.g., race, gender, national origin, class, language) as well as less tangi ble features of individuals (e.g., beliefs, att itudes, values) and schools (e.g., norms, customs)” (p. 345). Features of CBC such as interactive and collaborative problem solving; distributed decision making; apprecia tion for cultural values, perspectives, and norms; and relationship build ing are consonant with the principles of multicultural sensitivity. This is consistent with the conceptualization of “multicultural” as being “multivisional” in perspective, or extending one’s ability to understand other people (Soriano, Soriano, & Jimenez, 1994) and the belief that multiculturalism not only refers to the coexistence of diverse groups but also the ability to work eff ectively with diverse groups (Sue, 1998). Rela tional processes inherent within the CBC model may allow for the recognition and appreciation of individual cultural diff erences among consultants, consultees, and clients. Virtually no research has been conducted that identifi es the effi cacy of home–school consultation services with a diverse sample. The present study begins to address this need by examining case studies conducted in applied sett ings over the course of 8 years. EXPLORATORY QUESTIONS Several exploratory questions were posed in this study. Specifi cally: 1. What are the eff ects of CBC across home and school sett ings when working with clients and families who represent varying levels of diversity? 2. To what degree do parents and teachers of clients representing vary ing levels of diversity fi nd the CBC model acceptable? 3. To what degree do parents and teachers of clients representing vary ing levels of diversity report the outcomes to be eff ective? 4. To what degree do parents and teachers of clients representing vary ing levels of diversity report satisfaction with the consultant and services?