Treatment integrity and child outcomes: Conjoint behavioral consultation in an urban setting with clients of ethnic minority status

Abstract

Scope and Method of Study: Home and school represent two of the most powerful influences in children's lives. Research indicates that students benefit when there is a collaborative relationship between families and educators (Clark & Fiedler, 2003). Conjoint Behavioral Consultation (CBC) is one model that attempts to develop effective partnerships and collaborative relationships between parents and educators (Christenson & Sheridan, 2001). Thus, the purpose of this study was to investigate the effectiveness of CBC in an urban setting with clients of ethnic minority status when addressing externalizing behavior concerns that are present at home and school. In addition, procedural and treatment integrity of the consultation and intervention processes were assessed. Lastly, the acceptability of the CBC model and the interventions derived from the model were investigated. Participants in this study consisted of three sets of caregivers and teachers within an urban school district in southern Louisiana. Participants were asked to complete rating scales related to their behavior concerns, participate in CBC meetings, collect behavior data on an ongoing basis, implement the intervention that was created within the CBC process, and finally to complete rating scales related to the acceptability of the intervention and consultation process.

Findings and Conclusions: Based on the data collected in this study, there is evidence that the application of consultation is an effective model of service delivery in an urban school setting with clients of ethnic minority status. The effectiveness, integrity, and acceptability of the behavioral interventions implemented within the context of CBC in the home setting were inconsistent in most cases and nonexistent in three of the cases that were dropped due to lack of initial participation and response to the consultant. Thus, indicating CBC, in its original form, may be more difficult to effectively implement when working with caregivers and families living in situations of high stress due to environmental factors, i.e. setting, SES, family composition. Although acceptability ratings of the teachers and caregivers included in this study were relatively high, treatment integrity, which according to previous research, may be a more direct measure of treatment acceptability were only in the moderate range with some specific areas in the low range.