Treatment integrity in conjoint behavioral consultation: Conceptualizing active ingredients and potential pathways of influence.

Abstract

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...

A randomized trial examining the effects of Conjoint Behavioral Consultation in rural schools: Student outcomes and the mediating role of the teacher–parent relationship

“…A second methodological advancement of this study concerns the depth of fidelity measurement. The fidelity assessment included a dual focus on both collaborative problem-solving and behavioral intervention plans (Sheridan, Rispoli, & Holmes, 2014) that tapped both adherence and quality (Dane & Schneider, 1998). The CBC Fidelity Matrix (Kunz et al, 2011) examined both adherence to CBC objectives and the quality with which CBC was delivered by consultants, with both found to be high.…”

An empirical study of multidimensional fidelity of COMPASS consultation.

“…; and (4) Do measures of intervention-level fidelity mediate the relationship between implementation-level fidelity and student outcomes? The idea of intervention-level variables as mediators is commonly accepted and found in other conceptual models (see Noell, 2008; Sheridan, Rispoli, & Holmes, 2013). Based on previous empirical work (Odom et al, 2010; Reinke et al, 2013) and the general assumption that measures of similar constructs are likely to be positively related (Campbell & Fiske, 1959), we expected that the four fidelity components would be positively correlated with each other at both the implementation and intervention levels, with correlations strongest within, as opposed to, across levels.…”

The efficacy of conjoint behavioral consultation in the home setting: Outcomes and mechanisms in rural communities

“…Independent, trained coders listened to approximately 25% (n = 82) of all interviews, selected randomly to represent each type of CBC session. A CBC fidelity matrix containing definitions of core problem-solving objectives for each CBC interview was used (Kunz, Bieber, Witte, Chapla, & Sheridan, 2011;Sheridan, Rispoli, & Holmes, 2014c). Consultants' adherence to each interview objective was coded dichotomously (1 = met, 0 = not met).…”