Robert Moran!

EDCEP 871!
Consultation Field Experience!
Spring 2014!

!
!

Consultation Field Experience!

The two main consultees that I worked with on this were the special education teacher
and the school nurse. We also had a larger group meeting that included the two
previously mentioned, the mom of the client, a classroom teacher, our assistant
principal, and myself. This consultation was put together to address the fact that the
client was missing a lot of school because of health related issues, and as a result was
suffering in the classroom. The special education teacher, the school nurse and myself
met a number of times outside of this larger meeting to discuss strategies that might be
useful for the client. I also met a number of times with the classroom teachers and the
assistant principal to discuss policies and classroom modifications that would be
beneficial to the client. I was also in contact with mom a number of times to discuss her
concerns with her sons physical and mental health.!

!
Josh (client) is a seventeen year old male student in our high school. He is caucasian
and lives at home with both of his parents, and two other siblings. Josh receives special
education services, and is able to attend his core classes with para support. I actually
taught him his freshman and sophomore years when he was in my algebra and
geometry classes. Josh is a very likable kid, but he is also very quiet and reserved. I
notice that he seems to keep to himself and does not seem to have a regular group of
friends. Josh is also very obese, and this definitely contributes to the health issues that

Page 1

will be addressed later, and most likely has an impact on his self-image and social
connections.!

!
The problems that were addressed in our meeting and other consultations were his
attendance, his grades, his physical health, and his mental health. Josh suffers from
severe asthma and has to be administered breathing treatments on an almost daily
basis. He also has a number of other allergies that require him to carry an epi-pen with
him at all times. As previously mentioned, Josh is very obese and some of the
medications he is taking make his face appear to be puffy and swollen. This year, and
especially after Christmas break, Josh has had a high absentee rate. He has missed
264 class hours this school year, and most of those have come second semester.
Obviously with the number of days missed, Joshs grades have suffered. His mother is
also concerned with Joshs mental health. She suspects that he is depressed, and
given his circumstances, her concerns are certainly justified.!

!
My goal was to use a mental health client-centered case consultation model for my
guiding framework. From my initial conversations with Joshs mom, I suspected that
there may be some depression and/or anxiety that accompanied his health problems. I
chose to use a couple of instruments to see if Josh was at-risk for depression and/or
anxiety. I will discuss in detail the results of these assessments later on in this paper.!

!
I have been aware of Joshs health issues for a couple of years now because I did work
with him as a classroom teacher his freshman and sophomore years. It was late first

Page 2

semester of this year that I was informed of his attendance issues. Initially, our principal
was handling the situation and conversing with Joshs parents about the need for him to
be in school. There was some miscommunication and some butting-of-heads that went
on between them before I was made aware that I should probably step in to help out the
situation. I had some initial conversations with mom that were mainly an opportunity for
her to vent her frustrations with the way our principal was handling the situation. During
those conversations, she also voiced her concerns about Joshs health concerns and
the need for breathing treatments, his struggles to keep up in the classroom, and the
possibility that he suffers from anxiety and may be depressed. !

!
Shortly after those conversations, I met with the school nurse to find out more about
Joshs health issues as she understood them. I also met with Joshs special education
teacher to get her input on his academic progress. I knew that we needed to get a
meeting some key people so that we could discuss the best way to help Josh physically,
mentally, and academically. Because of the conflict that had already occurred with our
principal, I felt it was best to include our assistant principal as our administrative
representative at this meeting, and he agreed. I also invited a classroom teacher to
give input about his progress in her class. The make-up of our meeting consisted of
Joshs mom, assistant principal, school nurse, special education teacher, classroom
teacher, and myself.!

!
I think our initial meeting went very well. I opened the meeting by stating that we were
all there with Joshs well being as our primary concern. I wanted everyone to have the

Page 3

opportunity to give any input that would be relevant to helping Josh succeed. Mom
started by expressing her frustration with her initial attempts to work through our school
principal, but quickly moved on to say that she was optimistic that the group assembled
would be willing to put Joshs needs first. She went into some detail about Joshs health
issues and why it was causing him to miss so much school. He is obese, and does
have a severe case of asthma which requires breathing treatments on a daily basis.
She admitted that if Josh said he wasnt feeling good, there were days that she would
not press him to go to school. They have a breathing treatment machine at home, and
there were many days that he would go home to get a treatment and not come back.
We have a machine at school, but mom did not think that it was adequate. She also
talked about some allergies that he has that require him to carry an epi-pen, and
medications that he is taking that have some other side effects. Our school nurse
spoke up at this time and said that we would be getting a new breathing treatment
machine that could be used in the nurses office if need be. She also said that staff is
informed of Joshs allergies, and that she does have an emergency epi-pen in the office
in case it is needed.!

!
Joshs special education teacher and classroom teacher also made comments about his
progress in his classes, and how his absences were making it hard for him to keep up.
The assistant principal commented on his absences as well, and said that he would like
to see us come up with a solution to getting him here on a more regular basis. I
suggested that maybe we could come up with some type of a modified schedule that
would allow him to be here for his core classes. I asked if there was a particular time of

Page 4

day that seemed to be rough for Josh with his breathing. Everyone seemed to agree
that the afternoons were the hardest time. This is when we came up with the idea to
change his schedule to get his core classes in the morning so that if he needed to go
home for a breathing treatment around noon, he could. His mom said that sometimes
after his treatments he feels jittery and cant focus, and that is why in the past he
wouldnt come back to school. Our assistant principal agreed to allow his day to be
shortened because of this, but we did leave open the option for him to come back in the
afternoon on the days he was feeling up to it.!

!
Mom also brought up her concerns about his mental state. She told the group what she
had said to me in our earlier conversations about her suspicions of him having some
depression or anxiety. We agreed that I would start meeting with him on a weekly basis,
and that I would do a couple of assessments to see if he was showing signs of
depression or anxiety.!

!
The first inventory I chose to administer was the Multidimensional Students Life
Satisfaction Scale (MSLSS). The purpose of the scale is to measure the students
satisfaction with different areas of his/her life. The sub scales are: family, friends,
school, living environment, and self. On all sub scales except for living environment,
Josh scored rated himself very satisfied with his life. Even the living environment scale
showed that he was moderately satisfied. The results did surprise me. Not only did he
express satisfaction in his life, but for the most part, he was very strongly satisfied. This

Page 5

was especially surprising considering his mother had expressed concerns about him
being depressed.!
The second inventory I used was the Revised Childrens Manifest Anxiety Scale
(RCMAS-2). The purpose of this scale is to measure the students level of anxiety. The
sub scales are: physiological anxiety, worry, and social anxiety. Again, I was a little
surprised at the results. Josh scored at or below the 50th percentile on all scales and
the total. After hearing his moms comments about anxiety and depression, I expected
one or both of these inventories to show some signs of concern. Knowing Josh as well
as I do, I dont believe he was being dishonest in his answers. I am beginning to
believe that he is truly happy with his life despite his health concerns. I know he would
like to get to the point where he feels better and can attend school all day. He enjoys
being around his friends, and does like school.!

!
Josh and I completed the Working Alliance inventory, and I think we both agree that this
counseling relationship has been good for him. He even feels more strongly about it
than I did. His goals are to improve his physical health in order to improve his quality of
life. He has good friends and a great family who support him. This undoubtedly
contributes to his positive outlook on life.!

!
In reflection on this consultation process, I believe that my relationship skills were
definitely an asset for me. My relationships with Josh and his mom, as well as with my
coworkers that were involved allowed me to put this group together in a way that looked
out for the well-being of Josh. My communication skills also worked well for me as I

Page 6

was able to coordinate with everyone and talk with them multiple times to set up the
initial meeting and to check on the progress of our interventions and modifications. I
feel that my professionalism was acceptable as well. I have definitely benefited from
having 20 years of experience in education. I have an understanding of how to talk with
an unhappy parent in a way that keeps the situation calm and still allows them to voice
their concerns. Even though I was working within the school (one organization), I
believe I was able to organize multiple areas within the school: regular education,
special education, nursing, and administration. I am most pleased that we were able to
come up with a solution that was best for Josh and one that everyone agreed on. The
modifications to his schedule are definitely helping him, and I believe everyone is
satisfied with his progress. In the future, we hope that his health will improve, and he
will be able to attend school for a full day.!

!
In conclusion, I feel that most of Joshs issues are related to his health. I believe the
modifications to his schedule were the best thing we could do at this point. His
attendance is better, and his grades are improving. Base on the results of the
inventories I administered, I do not believe that Josh is depressed or struggling with
anxiety. He seems genuinely happy and satisfied with his life. Having said all that, it
has recently come to my attention that Josh and his family will be moving to Texas this
summer and he will be completing his senior year down there. My understanding is that
they are hoping that the move to a drier climate will help with his asthma and allergies.
When I talked to Josh about this, he does not seem excited about the move. He has
grown up here in Clay Center, and likes the friends he has here. I understand the move

Page 7

from a health standpoint, but I am concerned about this move for Josh with regards to
his social well-being. They do have family where they are moving, so I have no doubt
that he will have great support from them. I just hope that his health continues to
improve and that he keeps his positive outlook on life.!

Page 8