Conceptualizing the Problems and Possibilities of Interprofessional Collaboration in Schools

Conceptualizing the Problems and Possibilities of Interprofessional Collaboration in Schools Abstract Recent educational programs and initiatives hinge on effective collaboration between education professionals, such as school social workers, school psychologists, teachers, and principals. The authors seek to build on prior conceptual work to explore the range of collaborative practices school social workers engage in with other school professionals. Drawing on conceptual frameworks related to interprofessional and other collaborative work in schools, the authors examined how school social workers (N = 39) report collaborating with other professionals based on a hypothetical case designed to elicit collaborative practices. To triangulate the findings, the authors also draw on responses by 14 teachers, five school psychologists, and four principals. The authors identified five modes of collaboration: initiator/coordinator, assessor, intervener, whistleblower, and collaborator. The article concludes with a discussion of the implications for theory and practice. Interprofessional collaborations (that is, collaborations between social workers and professionals from other disciplines) draw on core social work skills (Graham & Barter, 1999) and are seen as central to school social work practice (D’Agostino, 2013; Sabatino, 2009). Indeed, enactment of key processes to bridge traditional professional boundaries is crucial to recent educational programs and initiatives (for example, schoolwide positive behavior supports, community school initiatives, expanded school mental health) (Anderson-Butcher et al., 2010; Fusarelli & Lindle, 2011; Markle, Splett, Maras, & Weston, 2014; Mellin, Anderson-Butcher, & Bronstein, 2011). A growing body of research describes various forms of collaborative activities that may take place in schools, including collaborations between teachers (Moolenaar, 2012), between social workers employed in school and other agency settings (Bronstein, Ball, Mellin, Wade-Mdivanian, & Anderson-Butcher, 2011), between school staff and other community actors (for example, teachers, parents, community service providers; Anderson-Butcher et al., 2010; Horwath & Morrison, 2007), and between school social workers, teachers, and other school support professionals (that is, interprofessional collaboration) (Bronstein, 2003). A sophisticated line of research investigates interprofessional collaboration specifically through the conceptualization and measurement of optimal school-based interprofessional collaborative processes (Bronstein, 2003; Mellin, Taylor, & Weist, 2014). Optimal interprofessional practice blends disciplinary-specific knowledge and skills (versus parallel practices) toward common goals. Potential benefits of these practices include improved service integration (Sabatino, 2009) and student academic, health, and mental health functioning (see, for example, Markle et al., 2014; Mellin et al., 2011; Whiteley, Gillespie, Robinson, Watts, & Carter, 2014). Given these potential benefits, scholars consistently find variability in the quantity and quality of interprofessional collaboration between social workers, educators, and other student support professionals in school settings (Markle et al., 2014; Mellin et al., 2011; Weist et al., 2012) and argue that optimal interprofessional collaborative efforts are difficult to routinely achieve in schools (Bronstein, 2003; Moolenaar, 2012; Weist et al., 2012). Yet the range of interprofessional interactions and the specific factors that shape such collaborative activities are not well understood. The present study, thus, draws on a sample of school social workers to explore the types of collaborative work they report in response to a hypothetical case study. It includes triangulated data from teachers, school psychologists, and school principals. Because evidence suggests variability in the quantity and quality of collaboration between social workers, educators, and other student support professionals in school settings (Markle et al., 2014; Mellin et al., 2011; Weist et al., 2012), we primarily aim to describe this variability and to shed light on factors that may shape it. Understanding this variability has potential to (a) shed light on the range of collaborative practices social workers may engage in and (b) build knowledge about factors that may support or hinder these practices. Background and Conceptual Frame Motivated by the goal of enhancing school capacities to promote student mental health and address the complex needs of student school populations, prior research focuses on defining and measuring interprofessional collaboration in schools (Bronstein, 2003; Mellin, 2009), specifically defined as collaboration across two or more professionals with disparate disciplinary training. It highlights attributes of optimal interprofessional collaborative processes (Bronstein, 2003; Mellin, 2009) and posits that shared problem solving, decision making, power, and responsibilities operate as key mechanisms linking interprofessional collaboration to desired outcomes (Mellin, 2009). Such processes are also seen as necessary for optimal response to complex student health and mental health needs (for example, Markle et al., 2014; Mellin et al., 2011; Whiteley et al., 2014). Bronstein’s (2003) synthesis of theory and research on interdisciplinary collaboration, as well as elaboration of this work (Mellin, 2009), conceptually guides our inquiry. This work outlines the defining characteristics of the interprofessional collaborative practice process as (a) interdependence (that is, professionals are in interaction with and dependent on one another), (b) emergence (that is, new professional tasks emerge as a result of collaboration), (c) professional role flexibility, (d) mutual goal setting, and (e) reflexivity. Bronstein (2003) also posited that interprofessional collaboration is shaped by personal characteristics of professionals, professional role constraints, and organizational characteristics (for example, school organizational arrangements, policies). Evidence, however, about the specific factors that enhance or inhibit interprofessional collaboration is thin (Suldo, Gormley, DuPaul, & Anderson-Butcher, 2014). Extant research focuses on dispositions of professionals that inhibit optimal collaborative processes (for example, poor communication skills, variation in teachers’ beliefs about meeting student psychosocial needs in school settings) or role-related power differentials. Less hierarchical organizational structures and wider organizational support for collaboration may also play roles. Thus, although the key elements that define optimal interprofessional collaboration appear well understood, less is known about the range of collaborative activities in schools or the factors that shape them. Research on intraprofessional collaboration among teachers offers an additional set of conceptual categories to expand investigation of the range of interprofessional collaboration in schools. Although there are clearly differences between working collaboratively within a profession and working across professions, collaborative work in schools, whether intra- or interprofessional, is nested within the same set of organizational conditions. We, thus, draw on research on teacher collaboration as complement to literature on interprofessional collaboration (Little, 1990). Little (1990) explicitly articulated a range of desirable collaborative activities, spanning from transactional interactions to “joint work.” Examples of transactional interactions include collegial interactions, such as “storytelling and scanning for ideas,” “offering and/or accepting aid and assistance” (p. 519), and “sharing” practices and opinions in more or less public venues. As they move from more transactional interactions to more collaborative, joint work, teachers report that they act collectively rather than autonomously. Thus, inquiry on intraprofessional collaboration offers nuance to the literature on interprofessional collaboration in that it suggests that there are different forms of collaborative work that may be invoked to achieve variable goals under different conditions. Analytic Frame and Research Questions Our inquiry integrates insights from literature on inter- and intraprofessional collaboration through its attention to (a) the array (that is, from transactional to collective forms) of collaborative activities described by school social workers (Little, 1990) and (b) factors that may affect interprofessional interactions (Bronstein, 2003; Mellin, 2009). It centers on two exploratory research questions: (1) What types of collaborative activities do school social workers describe doing with others in schools? And (2) What factors appear to shape collaboration? Method Data Collection and sampling Strategy All study procedures were approved by the University of California at Berkeley Committee for the Protection of Human Subjects. Data were generated from responses to an open-ended, online survey that was administered during the fall of 2015 and winter of 2016. Participants were asked to provide simple demographic and employment information. In addition, they were presented with a case (see  Appendix A) and asked to respond to two open-ended written prompts. The case was constructed to orient participants toward interprofessional interactions by raising multiple issues (for example, classroom, family) that could include multiple professional roles and that cut across both student-level academic and psychosocial outcome domains. The case was informed by real-world problems of practice relevant to the local region (Goss, 2006) and deliberately included a potentially problematic teaching practice to elicit complex school-related dynamics. In their written responses, participants were asked to (a) explain how the student in the case should be supported and (b) identify the members of staff (including themselves or not) who would be involved in responding to the student featured in the case study. We obtained permission to recruit participants indirectly via the local professional association of school social workers and via university-maintained databases related to preprofessional school credential programs offered in school social work, psychology, teaching, and administration. Because school social work credential holders must hold MSW degrees in this state, this strategy maximized access to them. University databases hold contact information for credentialed professionals with ties to the university credentialing programs and, thus, capture master professionals practicing in the area. We sought experienced professionals because they would be most poised to describe the range of possible work with other professionals in schools. Given that recruitment was indirect, we conservatively estimate that approximately 300 professionals appeared across these lists. We received 70 total responses, and 66 provided written responses to the case. Of those 66, 39 (60 percent) were school social workers, 14 (21 percent) were teachers, five (8 percent) were school psychologists, and four (6 percent) were principals. All of the sample were credentialed by the state in their subject area (for example, school social work, teaching, administration), and 87 percent of the sample had been employed in their current school setting for over a year. Except for teachers, who primarily taught at the elementary level, a majority of the respondents had served students across elementary, middle, and high school levels. Sixty-five percent of respondents served as preservice field or teaching supervisors. Analytic Strategy We used Little’s (1990) framework to identify forms of collaboration that were described by the school social workers, particularly attending to the range of professional interactions and those that suggested joint work. We began by distinguishing joint work from other types of interactions described by school social work respondents early in our coding process, and then we used an open coding scheme to identify categories of collaboration that emerged from the data. We refined the categories of collaboration that emerged in school social workers’ responses by comparing them with responses from other school professionals, looking for disconfirming evidence and previously undetected themes. We conducted a saturation analysis of the open-ended comments in the survey to make sure all major themes of collaboration were represented in our presentation of findings. Once collaboration types were ascertained, we assessed the degree of interrater agreement about the types, finding that 93 percent of codes corresponded across two raters (conflicting codes were resolved by consensus). We mapped the frequency of codes to the respondent’s professional role, as well as co-occurring codes that represented different aspects of collaboration. We tabulated both the frequency of school professionals named as potential collaborators and analyzed the relationship between the types of collaboration described and the school professionals who were named as potential collaborators. Findings School Professionals Are Collaborating on Differentially Constructed Problems All but one respondent (a social worker) described collaborating with other professionals. Respondents named at a minimum three professionals and a maximum of nine adults who were needed to address the student’s needs. The teacher was most commonly named as a professional who should be involved with the student in the case (29 times), followed by principal (24 times), and then social worker (20 times). Whereas social workers, school psychologists, and principals were likely to name teachers, social workers, and principals as professionals with whom to collaborate, teachers were less likely to name school social workers and more likely to name the school counselor as someone who needed to be involved. This is perhaps not surprising in that prior research suggests that school social workers and counselors report overlapping roles (Agresta, 2004). We did observe differences in how the “problem” of the case was constructed (for example, language proficiency, classroom management, family issues) across all school professionals, but did not find consistent patterns in problem definition by professional role. School-based support teams and other collaborative organizational arrangements were also mentioned as a source of support, uniquely named 12 times over all respondents. In addition, many other professionals were listed as potential resources, including school counselors, English language specialists, speech and occupational therapists, vice principals, and special educators. Collaboration Takes Many Forms Our coding strategy yielded several overarching modes of collaboration described by respondents. Although responses varied in their particulars, and respondents often expressed taking on multiple modes in response to the scenario, we grouped them, for analytic purposes, into five representative categories: (1) initiator/coordinator, (2) assessor, (3) intervener, (4) whistleblower, and (5) collaborator. Initiator/Coordinator The initiator/coordinator mode of collaboration, most common overall (82 percent of all respondents, 82 percent of social workers), focuses on connecting the student, family, and teacher with resources within and outside of the school, and/or beginning a dialogue between adults in the school to address the student’s needs. The initiator/coordinator does not necessarily provide direct support to the student, or even follow-up on the student’s progress beyond the first set of interactions. School social workers wrote that they might “set the student up for linguistically and culturally appropriate counseling,” “link [the family] to community resources,” “bring the [the student] up at our case management meeting,” or initiate a student support meeting. This mode hinges on school social worker’s connections to outside organizations and other adults in the school. The school social worker acts as a knowledgeable liaison, with the power to convene adults on behalf of the student. Assessor The assessor mode of collaboration (61 percent overall, 88 percent of social workers) was characterized by gathering information about the student, ranging from parent and family information to formal language and academic assessments. One social worker wrote that she would “determine which services were being provided and the gap in those services.” Another wrote, “[I would] ensure we had up-to-date [English language development] testing for him,” and another indicated, “I would interview the student and the family to get more information.” The assessor role was often a prelude to taking up an initiator role. Once information was gathered, it was used to inform other adults within the school, make a plan for a direct intervention, or refer the student to an outside agency or expert. The degree to which school social workers who primarily described their roles as assessors were actively engaged in collaboration with adults as they planned next steps toward intervention was unclear. Intervener The intervener mode of collaboration (54 percent overall; 41 percent of social workers) implemented a specific initiative with the student, teacher, or family. Some school social workers indicated that they would provide direct interventions to the student, such as “getting the student engaged in extracurricular [activities]” or “involv[ing] him in a psychoeducational group with similar peers so he can feel connected.” Others identified interventions they would provide to the teacher directly. For example, one school social worker indicated she would “provide teacher with appropriate academic interventions for the student,” and another social worker stated that she would “make recommendations to the teacher regarding classroom management.” Others explained that they would intervene directly with the student’s family, by “inviting the family to school...and providing parent education.” The intervener mode enables the school social worker to coordinate with individuals implicated by the case and usually positions the school social worker as the one with expertise. Whistleblower The whistleblower mode (32 percent overall, 41 percent of social workers) focused on alerting school administrative personnel to case particulars. This was not only so the principal or vice principal could be informed of the student’s needs, but for the explicit purpose of counseling the teacher about inappropriate teaching practices and providing the teacher with professional supports. As one school social worker wrote, “I would address the teacher incompetence by working with the VP [vice principal].” Although it clearly makes sense for school social workers to connect with school principals about classroom practice they see as detrimental, it also raises questions about the limits of collaboration when teachers are seen as a potential obstacle to student success, rather than partners in creating the conditions for it. Collaborator In the modes of collaboration we have discussed so far, it was unclear to what extent these convenings functioned as spaces through which adults engaged in “joint” (Little, 1990) or “shared” (Bronstein, 2003; Mellin, 2009) work to address the student’s needs. Yet, we did see evidence of this form of interchange. The collaborator mode (15 percent overall, 6 percent of social workers) included co-assessment of the student’s needs in venues like a student support team; it also included cocreating possible interventions and monitoring the student over time with other adults. A school social worker explained that she would contact the literacy specialist and “collaborate on deciding, implementing, and assessing Tier 2 interventions,” and that she would be in “ongoing consultation with the teacher.” This mode came closest to Little’s (1990) definition of joint work, in that multiple adults are engaged in “shared responsibility” for work that is “truly collective action,” and echoes attributes of optimal interprofessional collaboration (Bronstein, 2003; Mellin, 2009). It is interesting that principals, who accounted for only 6 percent of our sample, were responsible for approximately 93 percent of the references to collaboration in this mode. Collaborating with a Weak Teacher The case that we presented to our study participants elicited a concern about potentially weak teaching practice. School social workers’ responses particularly stood out to us as a potential obstacle for collaboration because many diagnosed the teacher as a significant problem in the scenario, based on the limited information available in the case. These sentiments characterized the whistleblower role, but the comments were frequent even among social workers who cited teachers as needed partners in a collaboration to serve the student. Social workers wrote, “[The] teacher needs to stand up for the student when he is ridiculed by his peers.” Another indicated that a needed intervention was “psychoeducation of teacher on the cultural [sic] of the student.” Several social workers indicated that they would directly offer advice, craft interventions, and secure professional supports for the teacher. As an example, one social worker, who described her efforts as “collaboration,” said she would “develop a professional development program so that teachers have the necessary skills”; another stated that part of her role would be “helping the teacher increase his or her management skills.” Other comments included social workers seeing it as their role to ask mentor teachers to provide support to the teacher, and some social workers indicated that they might even model better teaching practices in the classroom that centered on community building and social–emotional learning for students. Similar responses were noted by school psychologists, but not among teachers or principals. Discussion Drawing on conceptual work on inter- (Bronstein, 2003; Mellin, 2009) and intraprofessional collaboration (Little, 1990), we provide a description of the range of collaborative modes school social workers might invoke with a variety of school professionals. To the extent that responses to the case reflect real-world practice in schools, our findings suggest the utility of pursuing a more fine-grained understanding of what constitutes collaboration in school settings. Although we recognize the importance of clearly conceptualizing and measuring optimal forms of interprofessional collaboration (Bronstein, 2003; Mellin, 2009), our findings suggest that definitions or measures of interprofessional collaboration that privilege the shared aspects of the practice may underestimate the potential range of interprofessional interactions, especially in cases where this form of practice may not be desirable, possible, or practical. For example, predominant school social work collaborative modes included those of initiator and assessor. Although such modes may not contribute to optimal interprofessional processes, it is very plausible that joining with other professionals to initiate work on student issues or to conduct thorough situational assessments likely contributes to optimal service delivery. Given the concerns, moreover, that many of the social workers expressed about teaching practice described in the case, it appeared difficult for them to juggle competing goals of student advocacy and active collaboration alongside the teacher. Our findings show that social workers coordinate with many adults inside and outside of the school, but that collaboration does not always entail engaging in work that is “truly collective action.” Given that prior work identifies barriers to optimal interprofessional collaboration in schools (see, for example, Weist et al., 2012), our findings suggest both role-related and organizational factors that may shape collaborative efforts. It is not surprising that social workers were highly represented in initiator and assessor modes relative to other respondents, given that tasks and roles associated with consultation, assessment, referral making, and community outreach appear central to their work in schools (Agresta, 2004). Such modes also appear consistent with national estimates of activities in which school social workers typically engage (for example, individual counseling) (see Kelly et al., 2010). Our findings suggest further consideration of whether such tasks may or may not be enhanced by greater interprofessional interchange and teaming. Again, processes of shared responsibility may not always provide the optimal pathway for school social workers to support other adults or students in the building. In some cases, it may behoove social workers to refrain from engaging in joint work with teachers and others, because of their multiple role responsibilities (Agresta, 2004). National estimates, indeed, document the wide range of activities in which school social workers engage (Kelly et al., 2010, 2016). Our findings also point to organizational factors that may shape collaborative activities. First, Little (1990) conceptualized teachers’ willingness to expose their practice to their fellow teachers as a result of a meaningful, shared enterprise. This happened within an intraprofessional atmosphere, in which exposing one’s practice could be valuable for the teachers’ work with students and their own professional development. Although Little’s conception is useful because it helps us expand the range of interactions we might consider to be collaboration, the intraprofessional interactions of the teachers she studied are distinct from the purpose, content, and form of the interprofessional interactions we studied. Although the characteristics and potential benefits of interprofessional collaboration are well documented, the collaborative modes observed in our analysis leave teachers’ practices far more exposed than those of other school professionals. The professional risk, then, is far higher to the teacher than to a social worker or principal in collaborating for the benefit of the student, reflecting long-standing organizational dynamics characteristic of schools that may complicate authentic collaborative work (Little, 1990). In addition, school support teams were commonly referenced in response to the case, and we saw them as potentially highly collaborative environments. At times, social workers seemed to describe them as triage centers, where adults quickly evaluated the presenting “symptoms” and then dispersed responsibility among a team of experts. At other times, the team appeared to be a place of mutual problem solving, and one that could potentially follow the student and his or her needs over the course of a significant period of time. Such teams offer opportunities to probe ideal forms (that is, focused on shared activities) of school-based interprofessional collaboration (Mellin et al., 2011). Our findings also suggest that principals may play key roles in defining the possibilities of collaborative practices in schools. It may be that principals, who have a larger view of the organization, also have a broader understanding of what collaboration could look like in their schools. Or this could reflect hierarchical organizational arrangements in schools and the underlying power inherent in the position of principal. National estimates suggest that school social workers are more likely to consult often or always with administrators (53.4 percent) relative to other school staff (2.5 percent) (Kelly et al., 2016). At minimum, our work suggests additional scrutiny of the roles principals may play in facilitating interprofessional exchange in schools. Although preliminary, our findings also have implications for preprofessional and professional education. Extant work suggests that conditions that facilitate exposure to other professional worldviews, relationship building, and teamwork are crucial (Mellin et al., 2011). Emerging preprofessional and professional education interventions appear promising in promoting these processes, but, to date, focus on health professionals and settings (Gould, Lee, Berkowitz, & Bronstein, 2015). Future work should consider to what extent and how such interventions dovetail with school professionals and settings. It is important to ground our findings within key limitations of our study. First, our sampling strategy limits our ability to generalize the findings beyond the particulars of our respondents. Future work would benefit from strategies that systematically sample a wider, representative range of school professionals (for example, school counselors) within and across schools. Second, we acknowledge that case-based responses may not directly reflect actual practice and, thus, represent a distinct view of collaborative practice. Future research would benefit from alternative methods of generating data on interprofessional practices, including surveys and observations of professionals. Extant national surveys of school social workers might include items tapping the nature and extent of collaborative activities in future iterations. Given these study limitations, our findings suggest the potential of integrating well-developed frameworks on interprofessional (Bronstein, 2003; Mellin, 2009) and intraprofessional collaboration in schools. Specifically, the findings indicate that integrating these frameworks is generative in providing analytic breadth to the range of collaborative practices that may or may not be suitably deployed in schools. References Agresta, J. ( 2004). Professional role perceptions of school social workers, psychologists, and counselors. Children & Schools,  26, 151– 163. Google Scholar CrossRef Search ADS   Anderson-Butcher, D., Lawson, H. A., Iachini, A., Bean, G., Flaspohler, P. D., & Zullig, K. ( 2010). Capacity-related innovations resulting from the implementation of a community collaboration model for school improvement. Journal of Educational and Psychological Consultation,  20, 257– 287. Google Scholar CrossRef Search ADS   Bronstein, L. R. ( 2003). A model for interdisciplinary collaboration. Social Work,  48, 297– 306. Google Scholar CrossRef Search ADS   Bronstein, L. R., Ball, A., Mellin, E. A., Wade-Mdivanian, R., & Anderson-Butcher, D. ( 2011). Advancing collaboration between school- and agency-employed school-based social workers: A mixed-methods comparison of competencies and preparedness. Children & Schools,  33, 83– 95. Google Scholar CrossRef Search ADS   D’Agostino, C. ( 2013). Collaboration as an essential school social work skill. Children & Schools,  35, 248– 251. Google Scholar CrossRef Search ADS   Fusarelli, B. C., & Lindle, J. C. ( 2011). The politics, problems, and potential promise of school-linked social services. Peabody Journal of Education,  86, 402– 415. Google Scholar CrossRef Search ADS   Goss, M. M. ( 2006). An alignment of good intentions: Mandating basal curriculum (Doctoral dissertation). Retrieved from ProQuest. Gould, P. R., Lee, Y., Berkowitz, S., & Bronstein, L. ( 2015). Impact of a collaborative interprofessional learning experience upon medical and social work students in geriatric health care. Journal of Interprofessional Care,  29, 372– 373. 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The persistence of privacy: Autonomy and initiative in teachers’ professional relations. Teachers College Record,  91, 509– 536. Markle, R. S., Splett, J. W., Maras, M. A., & Weston, K. J. ( 2014). Effective school teams: Benefits, barriers, and best practices. In Handbook of school mental health  (pp. 59– 73). New York: Springer. Google Scholar CrossRef Search ADS   Mellin, E. A. ( 2009). Unpacking interdisciplinary collaboration in expanded school mental health: A conceptual model for developing the evidence base. Advances in School Mental Health Promotion,  2, 4– 14. Google Scholar CrossRef Search ADS   Mellin, E. A., Anderson-Butcher, D., & Bronstein, L. ( 2011). Strengthening interprofessional team collaboration: Potential roles for school mental health professionals. Advances in School Mental Health Promotion,  4, 51– 60. Google Scholar CrossRef Search ADS   Mellin, E. A., Taylor, L., & Weist, M. D. ( 2014). The Expanded School Mental Health Collaboration Instrument [School Version]: Development and Initial Psychometrics. School Mental Health,  6, 151– 162. Google Scholar CrossRef Search ADS   Moolenaar, N. M. ( 2012). A social network perspective on teacher collaboration in schools: Theory, methodology, and applications. American Journal of Education,  119, 7– 39. Google Scholar CrossRef Search ADS   Sabatino, C. A. ( 2009). Collaboration and consultation: Professional partnerships for serving children, youth, families, and schools. In C. Massat, R. Constable, S. McDonald, & J. Flynn (Eds.), School social work: Practice, policy, and research perspectives  ( 7th ed., pp. 376– 402). Chicago: Lyceum Books. Suldo, S. M., Gormley, M. J., DuPaul, G. J., & Anderson-Butcher, D. ( 2014). The impact of school mental health on student and school-level academic outcomes: Current status of the research and future directions. School Mental Health,  6, 84– 98. Google Scholar CrossRef Search ADS   Weist, M. D., Mellin, E. A., Chambers, K. L., Lever, N. A., Haber, D., & Blaber, C. ( 2012). Challenges to collaboration in school mental health and strategies for overcoming them. Journal of School Health,  82, 97– 105. Google Scholar CrossRef Search ADS   Whiteley, R. F., Gillespie, J., Robinson, C., Watts, W., & Carter, D. ( 2014). Effective teaching and learning in interprofessional education in child welfare. Journal of Education and Training Studies,  2, 148– 158. Google Scholar CrossRef Search ADS   Appendix A: Case Study Prompt Born in Mexico, Javier (age nine) arrived in California in February of 2015. Javier was classified as an English language learner and assigned to a fourth-grade class in a school that was composed equally of Latino and African American students. Javier’s fourth- and fifth-grade teachers had similar assessments of him. Both described Javier as being a shy student who didn’t try very hard in school. Javier’s grades were poor and he participated very little in classroom activities. His fifth-grade achievement test scores barely registered as having been taken—he scored below the 10th percentile for all subtests. His fifth-grade teacher expressed surprise by how little English Javier was picking up. Javier didn’t seem to be making much progress in socializing with his peers; according to Javier, his only friend was Jeffrey, a Spanish-speaking, bilingual student in his class who was more competent than Javier both academically and socially. Javier often seemed withdrawn and unengaged, as observed by his tendency to put his head down on his desk and hum to himself while the classroom activities went on around him. When Javier was in a group with just Jeffrey and another adult to speak with, and was allowed to speak some Spanish, he would likely be described as a boy full of spunk and humor. He was lively and talkative in this setting. Javier was walked to and from school every morning by his mother. According to Javier, his mother didn’t allow him or his sisters to play outdoors in their neighborhood. He revealed that his family was very afraid of their African American neighbors and that his mother demanded that he stay away from them. She told Javier that they would be a bad influence on him. Two classroom observations: Seated in a horseshoe of desks in a sunny, second-story classroom, the 29 fifth-grade students seem unable to sit still. Their teacher repeatedly and distractedly calls for order just as often as she requests an answer from last night’s math homework. Even those students who are not engaged in the ritual of offering answers to their harassed teacher are engaged in some form of communication with a nearby peer—laughing, tickling, whispering, writing notes. Javier has his head on his desk and is humming to himself. He is seated near several especially rambunctious boys. The teacher, apparently tired of telling this particular group to be quiet, suddenly walks over to this section of the class and says, “I want someone from this side of the room to answer!” Javier looks up at her quickly, then down again. The boy next to him says, “Well, don’t ask JAVIER!” He pronounces the name as an English-speaker would. As his friends start to snicker at the mispronunciation of Javier’s name, the boy continues: “He doesn’t know ANYTHING!” The entire class now erupts in laughter. Javier’s teacher chuckles with them for a few moments then continues on with the homework exercise. Javier gives a small smile and looks around the room at his peers. It is unclear if he understands that they are laughing at him. The teacher was returning papers to the students, who were sitting in their desks, waiting for their papers to arrive. Javier was given a series of three papers, and each seemed to be identical. They were all book reports written on the same form. Javier had written the same book report over, word for word, three times, turning them in on successive weeks. Across the bottom, the teacher had written the same comment on each report: “This needs to be longer.” The book reports were all concerning a picture book about Pokemon. Source: Goss, M. M. (2006). An alignment of good intentions: Mandating basal curriculum (Doctoral dissertation). Retrieved from ProQuest. Adapted with permission. © 2018 National Association of Social Workers This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Children & Schools Oxford University Press

Conceptualizing the Problems and Possibilities of Interprofessional Collaboration in Schools

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© 2018 National Association of Social Workers
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Abstract

Abstract Recent educational programs and initiatives hinge on effective collaboration between education professionals, such as school social workers, school psychologists, teachers, and principals. The authors seek to build on prior conceptual work to explore the range of collaborative practices school social workers engage in with other school professionals. Drawing on conceptual frameworks related to interprofessional and other collaborative work in schools, the authors examined how school social workers (N = 39) report collaborating with other professionals based on a hypothetical case designed to elicit collaborative practices. To triangulate the findings, the authors also draw on responses by 14 teachers, five school psychologists, and four principals. The authors identified five modes of collaboration: initiator/coordinator, assessor, intervener, whistleblower, and collaborator. The article concludes with a discussion of the implications for theory and practice. Interprofessional collaborations (that is, collaborations between social workers and professionals from other disciplines) draw on core social work skills (Graham & Barter, 1999) and are seen as central to school social work practice (D’Agostino, 2013; Sabatino, 2009). Indeed, enactment of key processes to bridge traditional professional boundaries is crucial to recent educational programs and initiatives (for example, schoolwide positive behavior supports, community school initiatives, expanded school mental health) (Anderson-Butcher et al., 2010; Fusarelli & Lindle, 2011; Markle, Splett, Maras, & Weston, 2014; Mellin, Anderson-Butcher, & Bronstein, 2011). A growing body of research describes various forms of collaborative activities that may take place in schools, including collaborations between teachers (Moolenaar, 2012), between social workers employed in school and other agency settings (Bronstein, Ball, Mellin, Wade-Mdivanian, & Anderson-Butcher, 2011), between school staff and other community actors (for example, teachers, parents, community service providers; Anderson-Butcher et al., 2010; Horwath & Morrison, 2007), and between school social workers, teachers, and other school support professionals (that is, interprofessional collaboration) (Bronstein, 2003). A sophisticated line of research investigates interprofessional collaboration specifically through the conceptualization and measurement of optimal school-based interprofessional collaborative processes (Bronstein, 2003; Mellin, Taylor, & Weist, 2014). Optimal interprofessional practice blends disciplinary-specific knowledge and skills (versus parallel practices) toward common goals. Potential benefits of these practices include improved service integration (Sabatino, 2009) and student academic, health, and mental health functioning (see, for example, Markle et al., 2014; Mellin et al., 2011; Whiteley, Gillespie, Robinson, Watts, & Carter, 2014). Given these potential benefits, scholars consistently find variability in the quantity and quality of interprofessional collaboration between social workers, educators, and other student support professionals in school settings (Markle et al., 2014; Mellin et al., 2011; Weist et al., 2012) and argue that optimal interprofessional collaborative efforts are difficult to routinely achieve in schools (Bronstein, 2003; Moolenaar, 2012; Weist et al., 2012). Yet the range of interprofessional interactions and the specific factors that shape such collaborative activities are not well understood. The present study, thus, draws on a sample of school social workers to explore the types of collaborative work they report in response to a hypothetical case study. It includes triangulated data from teachers, school psychologists, and school principals. Because evidence suggests variability in the quantity and quality of collaboration between social workers, educators, and other student support professionals in school settings (Markle et al., 2014; Mellin et al., 2011; Weist et al., 2012), we primarily aim to describe this variability and to shed light on factors that may shape it. Understanding this variability has potential to (a) shed light on the range of collaborative practices social workers may engage in and (b) build knowledge about factors that may support or hinder these practices. Background and Conceptual Frame Motivated by the goal of enhancing school capacities to promote student mental health and address the complex needs of student school populations, prior research focuses on defining and measuring interprofessional collaboration in schools (Bronstein, 2003; Mellin, 2009), specifically defined as collaboration across two or more professionals with disparate disciplinary training. It highlights attributes of optimal interprofessional collaborative processes (Bronstein, 2003; Mellin, 2009) and posits that shared problem solving, decision making, power, and responsibilities operate as key mechanisms linking interprofessional collaboration to desired outcomes (Mellin, 2009). Such processes are also seen as necessary for optimal response to complex student health and mental health needs (for example, Markle et al., 2014; Mellin et al., 2011; Whiteley et al., 2014). Bronstein’s (2003) synthesis of theory and research on interdisciplinary collaboration, as well as elaboration of this work (Mellin, 2009), conceptually guides our inquiry. This work outlines the defining characteristics of the interprofessional collaborative practice process as (a) interdependence (that is, professionals are in interaction with and dependent on one another), (b) emergence (that is, new professional tasks emerge as a result of collaboration), (c) professional role flexibility, (d) mutual goal setting, and (e) reflexivity. Bronstein (2003) also posited that interprofessional collaboration is shaped by personal characteristics of professionals, professional role constraints, and organizational characteristics (for example, school organizational arrangements, policies). Evidence, however, about the specific factors that enhance or inhibit interprofessional collaboration is thin (Suldo, Gormley, DuPaul, & Anderson-Butcher, 2014). Extant research focuses on dispositions of professionals that inhibit optimal collaborative processes (for example, poor communication skills, variation in teachers’ beliefs about meeting student psychosocial needs in school settings) or role-related power differentials. Less hierarchical organizational structures and wider organizational support for collaboration may also play roles. Thus, although the key elements that define optimal interprofessional collaboration appear well understood, less is known about the range of collaborative activities in schools or the factors that shape them. Research on intraprofessional collaboration among teachers offers an additional set of conceptual categories to expand investigation of the range of interprofessional collaboration in schools. Although there are clearly differences between working collaboratively within a profession and working across professions, collaborative work in schools, whether intra- or interprofessional, is nested within the same set of organizational conditions. We, thus, draw on research on teacher collaboration as complement to literature on interprofessional collaboration (Little, 1990). Little (1990) explicitly articulated a range of desirable collaborative activities, spanning from transactional interactions to “joint work.” Examples of transactional interactions include collegial interactions, such as “storytelling and scanning for ideas,” “offering and/or accepting aid and assistance” (p. 519), and “sharing” practices and opinions in more or less public venues. As they move from more transactional interactions to more collaborative, joint work, teachers report that they act collectively rather than autonomously. Thus, inquiry on intraprofessional collaboration offers nuance to the literature on interprofessional collaboration in that it suggests that there are different forms of collaborative work that may be invoked to achieve variable goals under different conditions. Analytic Frame and Research Questions Our inquiry integrates insights from literature on inter- and intraprofessional collaboration through its attention to (a) the array (that is, from transactional to collective forms) of collaborative activities described by school social workers (Little, 1990) and (b) factors that may affect interprofessional interactions (Bronstein, 2003; Mellin, 2009). It centers on two exploratory research questions: (1) What types of collaborative activities do school social workers describe doing with others in schools? And (2) What factors appear to shape collaboration? Method Data Collection and sampling Strategy All study procedures were approved by the University of California at Berkeley Committee for the Protection of Human Subjects. Data were generated from responses to an open-ended, online survey that was administered during the fall of 2015 and winter of 2016. Participants were asked to provide simple demographic and employment information. In addition, they were presented with a case (see  Appendix A) and asked to respond to two open-ended written prompts. The case was constructed to orient participants toward interprofessional interactions by raising multiple issues (for example, classroom, family) that could include multiple professional roles and that cut across both student-level academic and psychosocial outcome domains. The case was informed by real-world problems of practice relevant to the local region (Goss, 2006) and deliberately included a potentially problematic teaching practice to elicit complex school-related dynamics. In their written responses, participants were asked to (a) explain how the student in the case should be supported and (b) identify the members of staff (including themselves or not) who would be involved in responding to the student featured in the case study. We obtained permission to recruit participants indirectly via the local professional association of school social workers and via university-maintained databases related to preprofessional school credential programs offered in school social work, psychology, teaching, and administration. Because school social work credential holders must hold MSW degrees in this state, this strategy maximized access to them. University databases hold contact information for credentialed professionals with ties to the university credentialing programs and, thus, capture master professionals practicing in the area. We sought experienced professionals because they would be most poised to describe the range of possible work with other professionals in schools. Given that recruitment was indirect, we conservatively estimate that approximately 300 professionals appeared across these lists. We received 70 total responses, and 66 provided written responses to the case. Of those 66, 39 (60 percent) were school social workers, 14 (21 percent) were teachers, five (8 percent) were school psychologists, and four (6 percent) were principals. All of the sample were credentialed by the state in their subject area (for example, school social work, teaching, administration), and 87 percent of the sample had been employed in their current school setting for over a year. Except for teachers, who primarily taught at the elementary level, a majority of the respondents had served students across elementary, middle, and high school levels. Sixty-five percent of respondents served as preservice field or teaching supervisors. Analytic Strategy We used Little’s (1990) framework to identify forms of collaboration that were described by the school social workers, particularly attending to the range of professional interactions and those that suggested joint work. We began by distinguishing joint work from other types of interactions described by school social work respondents early in our coding process, and then we used an open coding scheme to identify categories of collaboration that emerged from the data. We refined the categories of collaboration that emerged in school social workers’ responses by comparing them with responses from other school professionals, looking for disconfirming evidence and previously undetected themes. We conducted a saturation analysis of the open-ended comments in the survey to make sure all major themes of collaboration were represented in our presentation of findings. Once collaboration types were ascertained, we assessed the degree of interrater agreement about the types, finding that 93 percent of codes corresponded across two raters (conflicting codes were resolved by consensus). We mapped the frequency of codes to the respondent’s professional role, as well as co-occurring codes that represented different aspects of collaboration. We tabulated both the frequency of school professionals named as potential collaborators and analyzed the relationship between the types of collaboration described and the school professionals who were named as potential collaborators. Findings School Professionals Are Collaborating on Differentially Constructed Problems All but one respondent (a social worker) described collaborating with other professionals. Respondents named at a minimum three professionals and a maximum of nine adults who were needed to address the student’s needs. The teacher was most commonly named as a professional who should be involved with the student in the case (29 times), followed by principal (24 times), and then social worker (20 times). Whereas social workers, school psychologists, and principals were likely to name teachers, social workers, and principals as professionals with whom to collaborate, teachers were less likely to name school social workers and more likely to name the school counselor as someone who needed to be involved. This is perhaps not surprising in that prior research suggests that school social workers and counselors report overlapping roles (Agresta, 2004). We did observe differences in how the “problem” of the case was constructed (for example, language proficiency, classroom management, family issues) across all school professionals, but did not find consistent patterns in problem definition by professional role. School-based support teams and other collaborative organizational arrangements were also mentioned as a source of support, uniquely named 12 times over all respondents. In addition, many other professionals were listed as potential resources, including school counselors, English language specialists, speech and occupational therapists, vice principals, and special educators. Collaboration Takes Many Forms Our coding strategy yielded several overarching modes of collaboration described by respondents. Although responses varied in their particulars, and respondents often expressed taking on multiple modes in response to the scenario, we grouped them, for analytic purposes, into five representative categories: (1) initiator/coordinator, (2) assessor, (3) intervener, (4) whistleblower, and (5) collaborator. Initiator/Coordinator The initiator/coordinator mode of collaboration, most common overall (82 percent of all respondents, 82 percent of social workers), focuses on connecting the student, family, and teacher with resources within and outside of the school, and/or beginning a dialogue between adults in the school to address the student’s needs. The initiator/coordinator does not necessarily provide direct support to the student, or even follow-up on the student’s progress beyond the first set of interactions. School social workers wrote that they might “set the student up for linguistically and culturally appropriate counseling,” “link [the family] to community resources,” “bring the [the student] up at our case management meeting,” or initiate a student support meeting. This mode hinges on school social worker’s connections to outside organizations and other adults in the school. The school social worker acts as a knowledgeable liaison, with the power to convene adults on behalf of the student. Assessor The assessor mode of collaboration (61 percent overall, 88 percent of social workers) was characterized by gathering information about the student, ranging from parent and family information to formal language and academic assessments. One social worker wrote that she would “determine which services were being provided and the gap in those services.” Another wrote, “[I would] ensure we had up-to-date [English language development] testing for him,” and another indicated, “I would interview the student and the family to get more information.” The assessor role was often a prelude to taking up an initiator role. Once information was gathered, it was used to inform other adults within the school, make a plan for a direct intervention, or refer the student to an outside agency or expert. The degree to which school social workers who primarily described their roles as assessors were actively engaged in collaboration with adults as they planned next steps toward intervention was unclear. Intervener The intervener mode of collaboration (54 percent overall; 41 percent of social workers) implemented a specific initiative with the student, teacher, or family. Some school social workers indicated that they would provide direct interventions to the student, such as “getting the student engaged in extracurricular [activities]” or “involv[ing] him in a psychoeducational group with similar peers so he can feel connected.” Others identified interventions they would provide to the teacher directly. For example, one school social worker indicated she would “provide teacher with appropriate academic interventions for the student,” and another social worker stated that she would “make recommendations to the teacher regarding classroom management.” Others explained that they would intervene directly with the student’s family, by “inviting the family to school...and providing parent education.” The intervener mode enables the school social worker to coordinate with individuals implicated by the case and usually positions the school social worker as the one with expertise. Whistleblower The whistleblower mode (32 percent overall, 41 percent of social workers) focused on alerting school administrative personnel to case particulars. This was not only so the principal or vice principal could be informed of the student’s needs, but for the explicit purpose of counseling the teacher about inappropriate teaching practices and providing the teacher with professional supports. As one school social worker wrote, “I would address the teacher incompetence by working with the VP [vice principal].” Although it clearly makes sense for school social workers to connect with school principals about classroom practice they see as detrimental, it also raises questions about the limits of collaboration when teachers are seen as a potential obstacle to student success, rather than partners in creating the conditions for it. Collaborator In the modes of collaboration we have discussed so far, it was unclear to what extent these convenings functioned as spaces through which adults engaged in “joint” (Little, 1990) or “shared” (Bronstein, 2003; Mellin, 2009) work to address the student’s needs. Yet, we did see evidence of this form of interchange. The collaborator mode (15 percent overall, 6 percent of social workers) included co-assessment of the student’s needs in venues like a student support team; it also included cocreating possible interventions and monitoring the student over time with other adults. A school social worker explained that she would contact the literacy specialist and “collaborate on deciding, implementing, and assessing Tier 2 interventions,” and that she would be in “ongoing consultation with the teacher.” This mode came closest to Little’s (1990) definition of joint work, in that multiple adults are engaged in “shared responsibility” for work that is “truly collective action,” and echoes attributes of optimal interprofessional collaboration (Bronstein, 2003; Mellin, 2009). It is interesting that principals, who accounted for only 6 percent of our sample, were responsible for approximately 93 percent of the references to collaboration in this mode. Collaborating with a Weak Teacher The case that we presented to our study participants elicited a concern about potentially weak teaching practice. School social workers’ responses particularly stood out to us as a potential obstacle for collaboration because many diagnosed the teacher as a significant problem in the scenario, based on the limited information available in the case. These sentiments characterized the whistleblower role, but the comments were frequent even among social workers who cited teachers as needed partners in a collaboration to serve the student. Social workers wrote, “[The] teacher needs to stand up for the student when he is ridiculed by his peers.” Another indicated that a needed intervention was “psychoeducation of teacher on the cultural [sic] of the student.” Several social workers indicated that they would directly offer advice, craft interventions, and secure professional supports for the teacher. As an example, one social worker, who described her efforts as “collaboration,” said she would “develop a professional development program so that teachers have the necessary skills”; another stated that part of her role would be “helping the teacher increase his or her management skills.” Other comments included social workers seeing it as their role to ask mentor teachers to provide support to the teacher, and some social workers indicated that they might even model better teaching practices in the classroom that centered on community building and social–emotional learning for students. Similar responses were noted by school psychologists, but not among teachers or principals. Discussion Drawing on conceptual work on inter- (Bronstein, 2003; Mellin, 2009) and intraprofessional collaboration (Little, 1990), we provide a description of the range of collaborative modes school social workers might invoke with a variety of school professionals. To the extent that responses to the case reflect real-world practice in schools, our findings suggest the utility of pursuing a more fine-grained understanding of what constitutes collaboration in school settings. Although we recognize the importance of clearly conceptualizing and measuring optimal forms of interprofessional collaboration (Bronstein, 2003; Mellin, 2009), our findings suggest that definitions or measures of interprofessional collaboration that privilege the shared aspects of the practice may underestimate the potential range of interprofessional interactions, especially in cases where this form of practice may not be desirable, possible, or practical. For example, predominant school social work collaborative modes included those of initiator and assessor. Although such modes may not contribute to optimal interprofessional processes, it is very plausible that joining with other professionals to initiate work on student issues or to conduct thorough situational assessments likely contributes to optimal service delivery. Given the concerns, moreover, that many of the social workers expressed about teaching practice described in the case, it appeared difficult for them to juggle competing goals of student advocacy and active collaboration alongside the teacher. Our findings show that social workers coordinate with many adults inside and outside of the school, but that collaboration does not always entail engaging in work that is “truly collective action.” Given that prior work identifies barriers to optimal interprofessional collaboration in schools (see, for example, Weist et al., 2012), our findings suggest both role-related and organizational factors that may shape collaborative efforts. It is not surprising that social workers were highly represented in initiator and assessor modes relative to other respondents, given that tasks and roles associated with consultation, assessment, referral making, and community outreach appear central to their work in schools (Agresta, 2004). Such modes also appear consistent with national estimates of activities in which school social workers typically engage (for example, individual counseling) (see Kelly et al., 2010). Our findings suggest further consideration of whether such tasks may or may not be enhanced by greater interprofessional interchange and teaming. Again, processes of shared responsibility may not always provide the optimal pathway for school social workers to support other adults or students in the building. In some cases, it may behoove social workers to refrain from engaging in joint work with teachers and others, because of their multiple role responsibilities (Agresta, 2004). National estimates, indeed, document the wide range of activities in which school social workers engage (Kelly et al., 2010, 2016). Our findings also point to organizational factors that may shape collaborative activities. First, Little (1990) conceptualized teachers’ willingness to expose their practice to their fellow teachers as a result of a meaningful, shared enterprise. This happened within an intraprofessional atmosphere, in which exposing one’s practice could be valuable for the teachers’ work with students and their own professional development. Although Little’s conception is useful because it helps us expand the range of interactions we might consider to be collaboration, the intraprofessional interactions of the teachers she studied are distinct from the purpose, content, and form of the interprofessional interactions we studied. Although the characteristics and potential benefits of interprofessional collaboration are well documented, the collaborative modes observed in our analysis leave teachers’ practices far more exposed than those of other school professionals. The professional risk, then, is far higher to the teacher than to a social worker or principal in collaborating for the benefit of the student, reflecting long-standing organizational dynamics characteristic of schools that may complicate authentic collaborative work (Little, 1990). In addition, school support teams were commonly referenced in response to the case, and we saw them as potentially highly collaborative environments. At times, social workers seemed to describe them as triage centers, where adults quickly evaluated the presenting “symptoms” and then dispersed responsibility among a team of experts. At other times, the team appeared to be a place of mutual problem solving, and one that could potentially follow the student and his or her needs over the course of a significant period of time. Such teams offer opportunities to probe ideal forms (that is, focused on shared activities) of school-based interprofessional collaboration (Mellin et al., 2011). Our findings also suggest that principals may play key roles in defining the possibilities of collaborative practices in schools. It may be that principals, who have a larger view of the organization, also have a broader understanding of what collaboration could look like in their schools. Or this could reflect hierarchical organizational arrangements in schools and the underlying power inherent in the position of principal. National estimates suggest that school social workers are more likely to consult often or always with administrators (53.4 percent) relative to other school staff (2.5 percent) (Kelly et al., 2016). At minimum, our work suggests additional scrutiny of the roles principals may play in facilitating interprofessional exchange in schools. Although preliminary, our findings also have implications for preprofessional and professional education. Extant work suggests that conditions that facilitate exposure to other professional worldviews, relationship building, and teamwork are crucial (Mellin et al., 2011). Emerging preprofessional and professional education interventions appear promising in promoting these processes, but, to date, focus on health professionals and settings (Gould, Lee, Berkowitz, & Bronstein, 2015). Future work should consider to what extent and how such interventions dovetail with school professionals and settings. It is important to ground our findings within key limitations of our study. First, our sampling strategy limits our ability to generalize the findings beyond the particulars of our respondents. Future work would benefit from strategies that systematically sample a wider, representative range of school professionals (for example, school counselors) within and across schools. Second, we acknowledge that case-based responses may not directly reflect actual practice and, thus, represent a distinct view of collaborative practice. Future research would benefit from alternative methods of generating data on interprofessional practices, including surveys and observations of professionals. Extant national surveys of school social workers might include items tapping the nature and extent of collaborative activities in future iterations. Given these study limitations, our findings suggest the potential of integrating well-developed frameworks on interprofessional (Bronstein, 2003; Mellin, 2009) and intraprofessional collaboration in schools. Specifically, the findings indicate that integrating these frameworks is generative in providing analytic breadth to the range of collaborative practices that may or may not be suitably deployed in schools. References Agresta, J. ( 2004). Professional role perceptions of school social workers, psychologists, and counselors. Children & Schools,  26, 151– 163. Google Scholar CrossRef Search ADS   Anderson-Butcher, D., Lawson, H. A., Iachini, A., Bean, G., Flaspohler, P. D., & Zullig, K. ( 2010). Capacity-related innovations resulting from the implementation of a community collaboration model for school improvement. Journal of Educational and Psychological Consultation,  20, 257– 287. Google Scholar CrossRef Search ADS   Bronstein, L. R. ( 2003). A model for interdisciplinary collaboration. Social Work,  48, 297– 306. Google Scholar CrossRef Search ADS   Bronstein, L. R., Ball, A., Mellin, E. A., Wade-Mdivanian, R., & Anderson-Butcher, D. ( 2011). 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The persistence of privacy: Autonomy and initiative in teachers’ professional relations. Teachers College Record,  91, 509– 536. Markle, R. S., Splett, J. W., Maras, M. A., & Weston, K. J. ( 2014). Effective school teams: Benefits, barriers, and best practices. In Handbook of school mental health  (pp. 59– 73). New York: Springer. Google Scholar CrossRef Search ADS   Mellin, E. A. ( 2009). Unpacking interdisciplinary collaboration in expanded school mental health: A conceptual model for developing the evidence base. Advances in School Mental Health Promotion,  2, 4– 14. Google Scholar CrossRef Search ADS   Mellin, E. A., Anderson-Butcher, D., & Bronstein, L. ( 2011). Strengthening interprofessional team collaboration: Potential roles for school mental health professionals. Advances in School Mental Health Promotion,  4, 51– 60. Google Scholar CrossRef Search ADS   Mellin, E. A., Taylor, L., & Weist, M. D. ( 2014). 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Google Scholar CrossRef Search ADS   Weist, M. D., Mellin, E. A., Chambers, K. L., Lever, N. A., Haber, D., & Blaber, C. ( 2012). Challenges to collaboration in school mental health and strategies for overcoming them. Journal of School Health,  82, 97– 105. Google Scholar CrossRef Search ADS   Whiteley, R. F., Gillespie, J., Robinson, C., Watts, W., & Carter, D. ( 2014). Effective teaching and learning in interprofessional education in child welfare. Journal of Education and Training Studies,  2, 148– 158. Google Scholar CrossRef Search ADS   Appendix A: Case Study Prompt Born in Mexico, Javier (age nine) arrived in California in February of 2015. Javier was classified as an English language learner and assigned to a fourth-grade class in a school that was composed equally of Latino and African American students. Javier’s fourth- and fifth-grade teachers had similar assessments of him. Both described Javier as being a shy student who didn’t try very hard in school. Javier’s grades were poor and he participated very little in classroom activities. His fifth-grade achievement test scores barely registered as having been taken—he scored below the 10th percentile for all subtests. His fifth-grade teacher expressed surprise by how little English Javier was picking up. Javier didn’t seem to be making much progress in socializing with his peers; according to Javier, his only friend was Jeffrey, a Spanish-speaking, bilingual student in his class who was more competent than Javier both academically and socially. Javier often seemed withdrawn and unengaged, as observed by his tendency to put his head down on his desk and hum to himself while the classroom activities went on around him. When Javier was in a group with just Jeffrey and another adult to speak with, and was allowed to speak some Spanish, he would likely be described as a boy full of spunk and humor. He was lively and talkative in this setting. Javier was walked to and from school every morning by his mother. According to Javier, his mother didn’t allow him or his sisters to play outdoors in their neighborhood. He revealed that his family was very afraid of their African American neighbors and that his mother demanded that he stay away from them. She told Javier that they would be a bad influence on him. Two classroom observations: Seated in a horseshoe of desks in a sunny, second-story classroom, the 29 fifth-grade students seem unable to sit still. Their teacher repeatedly and distractedly calls for order just as often as she requests an answer from last night’s math homework. Even those students who are not engaged in the ritual of offering answers to their harassed teacher are engaged in some form of communication with a nearby peer—laughing, tickling, whispering, writing notes. Javier has his head on his desk and is humming to himself. He is seated near several especially rambunctious boys. The teacher, apparently tired of telling this particular group to be quiet, suddenly walks over to this section of the class and says, “I want someone from this side of the room to answer!” Javier looks up at her quickly, then down again. The boy next to him says, “Well, don’t ask JAVIER!” He pronounces the name as an English-speaker would. As his friends start to snicker at the mispronunciation of Javier’s name, the boy continues: “He doesn’t know ANYTHING!” The entire class now erupts in laughter. Javier’s teacher chuckles with them for a few moments then continues on with the homework exercise. Javier gives a small smile and looks around the room at his peers. It is unclear if he understands that they are laughing at him. The teacher was returning papers to the students, who were sitting in their desks, waiting for their papers to arrive. Javier was given a series of three papers, and each seemed to be identical. They were all book reports written on the same form. Javier had written the same book report over, word for word, three times, turning them in on successive weeks. Across the bottom, the teacher had written the same comment on each report: “This needs to be longer.” The book reports were all concerning a picture book about Pokemon. Source: Goss, M. M. (2006). An alignment of good intentions: Mandating basal curriculum (Doctoral dissertation). Retrieved from ProQuest. Adapted with permission. © 2018 National Association of Social Workers This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices)

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Children & SchoolsOxford University Press

Published: May 10, 2018

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