Consultation and mental health interventions in school settings: A scientist–practitioner’s guide

Child and youth mental health is an area of increased focus over the last number of years and is even more pertinent in the time of the COVID-19 pandemic. An oft-referenced statistic is that 20 to 25% of school-age children and youth have diagnosable mental health disorders, but up to 80% do not receive adequate mental health intervention or receive no intervention at all. As well, many researchers in school mental health contend that schools are the ideal setting for mental health services and good mental health in students is positively associated with academic achievement. Cole and Kokai’s Consultation and Mental Health Interventions in School Settings: A Scientist–Practitioner’s Guide arrives in a very timely manner, with documented increases in mental health issues and disorders in children and youth, coupled with an even greater paucity of mental health care intensified by the current pandemic. The editors and contributing authors offer a solution – a simple yet elegant practice model, the Model for Psychological Services in Schools. The Model was developed for school-based psychologists and their multidisciplinary team colleagues for diagnoses, conditions and issues that most often affect school-age children and youth. The authors’ description of school psychologists as scientist–practitioners is most welcome. Through their scientist–practitioner training, these professionals are the best prepared school employees to choose school interventions. They understand evidence-based practice and consider school context through their knowledge of each school’s climate and culture. This description is indeed the essence of school-based psychological service.

Both editors have a stellar professional background with impeccable relevant experience. Cole and Kokai have each played a substantial role in psychology leadership in local, provincial, national and international psychology associations. Ester Cole, with Jane Siegel, first developed the Model of Consultation in School Psychology in their first book, Effective Consultation in School Psychology, in 1990. The book was updated and expanded in 2003. Along with numerous other publications in the field, Cole worked as a school psychologist in a large urban school board, followed by many years as a supervising psychologist, then solely in private practice. Cole was also an adjunct professor in graduate psychology programs. Kokai was the Chief Psychologist of a large urban school board and beforehand spent many years providing psychological services to the general student population as well as deaf and hard of hearing students. She has instituted many innovative projects to support school psychology. Since her recent retirement, Kokai has concentrated on school psychology leadership and advocacy initiatives.

Cole and Kokai have done a masterful job in selecting contributing authors, as well as organizing the chapters. They also ensure that the authors keep to their task, that is, explaining how the Model can be utilized for specific student diagnoses, conditions and issues commonly seen in schools. With the Model, the contributing authors also provide a most practical organizational tool for school psychological services. The Model is a 3 by 4 matrix: primary, secondary and tertiary prevention and intervention across the top as columns, and four groups of recipients of service on the side as rows: direct support to students and parents and mediated support to students and parents, school staff and the organization (district or school).

Cole and Kokai have appropriately extended the flexibility of the Model to many areas that are pertinent to school psychology practice today. The Multidisciplinary Team approach extends to other mental and allied health professionals working within or connected to schools, as well as education personnel. However, each chapter stays true to the Model, offering a roadmap for school psychologists to provide services within the Model’s expanded offerings. School-based support services can move from reactive to proactive services, changing Multidisciplinary Team Meetings from pre-referrals to a more systemic method of solving student problems.

The book is divided into three sections. The first section introduces the Model, followed by a practical appendix consisting of a PowerPoint presentation that school psychologists can use to explain and promote their role in school districts. Potential audiences include graduate school psychology training programs, school district leaders and decision makers (for advocacy to broaden the school psychology role past the ubiquitous ‘test and place’ assessment), district psychology departments and multidisciplinary school teams, and knowledge transfer and public education to the general public regarding school psychology’s broader role.

The second section, titled ‘Addressing Student Needs’, provides eight chapters on specific diagnoses or conditions commonly seen in school-aged students, including Autism Spectrum Disorder, Attention Deficit-Hyperactivity Disorder, Anxiety, Depression, Anger and Self-Regulation, Non-Suicidal Self-Injury, Dyslexia as a Learning Disability and Gifted and Talented Students.

The third section, titled ‘School Level Interventions’, addresses school level issues that require collaborative services from school psychologists. The chapters include Immigrant and Refugee Students (by the Editors), Promoting Resilience in Culturally Diverse Youth, Fostering Student Engagement and Psychosocial Development, Responding to Mass Shootings, Bullying Prevention and Social-Emotional Learning.

Most chapters include valuable appendices that often include case studies and annotated readings, evidence-based intervention programs and strategy lists with web addresses. Included in each chapter are clear explanations of the topic with diagnostic criteria when applicable, summaries of current research and, as applicable, completion of the Model for the specific diagnosis, condition or issue. A typical reader would not necessarily think that all cells in the Model’s matrix could be completed, but the contributing authors do. For example, most school psychologists would not think of primary prevention intervention for students with attention-deficit hyperactivity disorder, but Wiener and Bedard include them as we know which classroom structures work best for these students. These interventions would be protective factors and essential for these students, while being helpful for the whole classroom. Other unique and helpful contributions are seen throughout the book. Examples are (1) samples of a school non-suicidal self-injury protocol with tips for developing the process in Heath et al.’s chapter, (2) the work on intervention-oriented assessment in Geva and Kilpatrick’s chapter on dyslexia and (3) Worrell et al.’s non-traditional means of identifying gifted and talented students.

This book has very few weaknesses. I would have liked to see case studies for all diagnoses, and applicable conditions and issues indicating the potential roles for school psychologists. Some of the case studies describe selective parts of the comprehensive Model which involve direct assessment services and mediated consultation. As well, some case studies appeared to have a peripheral role for the school psychologist while the student was being treated at a community agency. To me, this kept the school psychologist in a minor role of school-community agency liaison role where they could have been providing more direct intervention. However, given that some school districts may not have the capacity for their school psychologists to get engaged in the direct treatment of some conditions, these case studies can serve as good examples for their collaborative consultation with community agencies.

In conclusion, this book delivers on what is promised. It is an extremely useful resource for school psychology training purposes. In my opinion, it should be read by every practicing school psychologist. The book provides a novel way to showcase school psychological practice roles, capitalizing on the profession’s strengths and competencies, such as differential diagnoses and data-based decision making. In addition, school psychologists’ collaboration with school Multidisciplinary Teams within the context of school climate and culture provides the best support for students in the current world context.