The results of a large-scale randomized controlled trial of Conjoint Behavioral Consultation (CBC) on student outcomes and teacher-parent relationships in rural schools are presented. CBC is an indirect service delivery model that addresses concerns shared by teachers and parents about students. In the present study, the intervention was aimed at promoting positive school-related social-behavioral skills and strengthening teacher-parent relationships in rural schools. Participants were 267 students in grades K-3, their parents, and 152 teachers in 45 Midwest rural schools. Results revealed that, on average, improvement among students whose parents and teachers experienced CBC significantly outpaced that of control students in their teacher-reported school problems and observational measures of their inappropriate (off-task and motor activity) and appropriate (on-task and social interactions) classroom behavior. In addition, teacher responses indicated significantly different rates of improvement in their relationship with parents in favor of the CBC group. Finally, the teacher-parent relationship was found to partially mediate effects of CBC on several student outcomes. Unique contributions of this study, implications of findings for rural students, study limitations and suggestions for future research are discussed.

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ChaoRong, "The efficacy of conjoint behavioral consultation in the home setting: Outcomes and mechanisms in rural communities" (2017 AbstractThis study reports the results of a randomized controlled trial examining the effect of Conjoint Behavioral Consultation (CBC), a family-school partnership intervention, on children's behaviors, parents' skills, and parent-teacher relationships in rural community and town settings. Participants were 267 children, 267 parents, and 152 teachers in 45 Midwestern schools. Using an Intent to Treat approach and data analyzed within a multilevel modeling framework, CBC yielded promising results for some but not all outcomes. Specifically, children participating in CBC experienced decreases in daily reports of aggressiveness, noncompliance, and temper tantrums; and increases in parent-reported adaptive skills and social skills at a significantly greater pace than those in a control group. Other outcomes (e.g., parent reports of internalizing and externalizing behaviors) suggested a nonsignificant effect at post-test. CBC parents reported using more effective parenting strategies, gaining more competence in their problem-solving practices, and feeling more efficacious for helping their child succeed in school than parents in the control group. Parents participating in CBC also reported significant improvements in the parent-teacher relationship, and the parent-teacher relationship mediated the effect of CBC on children's adaptive skills. Implications for practice in rural communities, study limitations, and directions for future research are discussed.

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School-based interventions are often implemented by natural treatment agents (e.g., teachers) through indirect service delivery (e.g., consultation). Behavioral or problem-solving consultation is a service delivery model whereby a consultant with expertise in data-based problem solving and intervention development works with a consultee (e.g., teacher, parent) to identify and analyze specific targets for intervention and develop, implement, and evaluate strategies to address identified concerns (Sheridan & Kratochwill, 1992). unique to consultation is its indirect nature, whereby treatments are implemented by individuals who are part of children's natural environments (e.g., teachers, parents) and not trained behavioral therapists in a "pull-out" (e.g., small group therapy, individual therapy) fashion. Contextual factors inherent in consultation-based intervention implementation in schools (e.g., lack of specialized intervention training, environmental disruptions, resistance from students) pose threats to treatment integrity that, if undetected, may lead to erroneous conclusions regarding intervention effectiveness (Elliott, witt, Kratochwill, & Stoiber, 2002). In this chapter, we introduce conjoint behavioral consultation (CBC) as a coordinated, cross-system approach to consultation; identify and describe active ingredients of CBC (including those representing both collaborative problem solving and behavioral intervention plan implementation); explore the various dimensions of treatment integrity for CBC research; articulate integrity variables in need of investigation; and offer specific research directions.CBC (Sheridan & Kratochwill, 2008) is a variant of behavioral consultation involving a similar structured problem-solving procedure and implementation of behavioral interventions by parents and teachers in a coordinated and collaborative (i.e., conjoint) fashion. CBC is predicated on ecological-behavioral theory (Bronfenbrenner, 1977) and a belief that positive connections between individuals from the primary ecological systems in a child's life maximize developmental progress. CBC seeks to improve child concerns that disrupt learning, enhance the capacity of families and schools to foster child functioning, and bolster family-school relationships. To this end, embedded throughout CBC is the development of collaborative partnerships between families and schools to facilitate joint problem-solving interactions that maximize change in child behaviors across the home and school contexts. It aims to develop a sense of shared responsibility between parents and teachers, such that current and future needs are addressed through a cooperative problem-solving process (Sheridan, Eagle, Cowan, & Mickelson, 2001). within this larger aim is the goal to increase communication between parents and teachers by fostering open and equal participation in the consultative process. Likewise, CBC focuses on improving relationships between parents and teachers such that all parties establish a sense of respect for the expertise an...