SYSTEMS CONSULTATION AND HEAD START: AN ALTERNATIVE TO TRADITIONAL FAMILY THERAPY

Journal of Marital and Family Therapy April 1999,Vol. 25, No. 2,155-168

SYSTEMS CONSULTATION AND HEAD START: AN AL'I'ERNAW TO TRADITIONAL FAMILY THERAPY

Teresa McDowell Pacific Lutheran University

As Marriage and Family I;berapists (MFTs) enter Head Start programs, systems consultation emerges as a viable alternative to providing therapy to enrolled children and families. As systems consultants, family therapists can offer organizational consultation, training, and support to Head Start stafi classroom interventions, and direct work with families. nis article describes a multidimensional model for providing comprehensive mental health consultation to Head Start programs. It Wlores the skills necessa y for MFTs to work effectively as systems consultants. Finally, recommendations are made for applying the model in both university and private settings.

Offering therapy to Head Start children and families may be the most readily identified option, if not the only one considered by marriage and family therapists (MFTs) who are interested in working with Head Start programs. Head Start can serve as an effective placement site for interns in MFT training programs who need experience doing therapy. In fact, Head Start programs often solicit clinicians to work directly with enrolled families. The fit between MFTs and Head Start programs can, however, be expanded far beyond the limits of traditional family therapy. This paper presents a model of multidimensional systems consultation that can be used by MFTs to offer comprehensive services to Head Start. It also explores several areas of skill development necessary if MFTs are to work as systems consultants. The model has the potential to enhance MFT training programs, broaden MFTs' experience working with diverse systems, and improve the overall functioning of Head Start programs.

MFT training programs must meet the challenge of preparing trainees to enter a changing field competitively. Health care reform has moved training programs to better prepare MFTs to work in managed care settings (Patterson, McIntosh-Koontz, Baron, & Bischoff, 1997) and to expand employment opportunities beyond traditional agency placements and private practice. Widening the definition of family therapy by incorporating systems consultation into MFT programs offers trainees an additional area of competency that improves their overall skill and increases their employability.

Teresa McDowell, MA, is a part-time faculty member and the Head Start Project Coordinator at Pacific Lutheran University, Tacoma, Washington 98447. She is also in private practice.

MFT trainees who have worked as consultants in the project include Christine Adams, Karrie Ferguson, Erin Fischer, Todd Hanson, Scott Hess, Stephanie Owens, Jan Rice, Mike Shoemaker, Elizabeth Sullivan, and Michele Yoder.

The author wishes to thank Cheryl Storm, PhD, for her contribution to this article.

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Experience in systems consultation helps MFTs to increase their overall competence in working with families and to creatively expand their professional identity. Expertise in working with agency systems enhances a family therapist’s ability to intervene in the multiple organizations that are often involved with families (Imber-Black, 1988). In order to do family therapy, or to offer training in family therapy, MFTs are frequently forced to navigate through mental health and social service agencies. To be successful in these settings, it is important to conceptualize them as systems that must be entered planfully (Elizur, 1993). There is also growing opportunity for MFTs to provide systems consultation to a variety of organizations, including businesses, schools, hospitals, and family firms (Hanson, Himes, & Meier, 1990; Imber-Black, 1988; Keoughan & Joanning, 1996; Wynne, Weber, & McDaniel, 1986). MFTs with experience providing systems consultation to Head Start are better prepared to expand their scope of practice to include work with other organizational systems.

Head Start programs also benefit from a multidimensional systems consultation approach. When MFTs limit their work to providing therapy, the impact tends to be specific to individual Head Start families who eventually move on and leave the program. If the MFTs train and consult with staff, a more lasting change occurs between staff and all of the families they work with over time. There may be a ripple effect as improved relationships among staff affect the relationships between staff and families. Broadening the unit of treatment to include the agency as well as participant families also helps to challenge the assumption that low-income Head Start families, by definition, are in need of therapy.

The model and project design described in this paper are part of a partnership project between Pacific Lutheran University’s MFT master’s level program and a rural Head Start program located in the western region of Washington state. The project is currently in its third year of operation.

PROJECT DESIGN

The Pacific Lutheran University PLU-Head Start project trains beginning MFTs to work as systems consultants by supplementing their knowledge of family systems with the specific skills and experience they need to consult with social service agencies. As beginning consultants are learning how to conceptualize and intervene in Head Start systems, Head Start staff are improving their skills in working with families and in their working relationships with each other.

The staff of this project includes a project coordinator who maintains a strong bridge between consultant trainees and the Head Start program and works extensively with the consultation team. This team is made up of three to four second-year MFT students who are in their first few months of practicing therapy. These beginning consultants participate in a two-day workshop in systems consultation, which includes relevant readings. This initial training is followed by two half-day meetings with the project coordinator, who provides further training in working specifically with Head Start. Ongoing consultation- of-consultation is provided to trainees for two hours every other week. These meetings also allow the consultation team to share their views of the overall system and to coordinate services. Supervision of therapy cases is provided during weekly supervision meetings and as needed.

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Each consultant is assigned three Head Start teams. These include two center teams and one support or administrative team. There are 10 centers in the Head Start program dispersed between two rural counties. Each center has a staff team that includes classroom teachers, assistant teachers, a team leader, a cook, and a bus driver. In this particular Head Start program, a family advocate is also assigned to each center to make home visits with homeless families and parents whose goals include literacy, employment, or substance abuse recovery. Centers support from two to 10 staff members. Consultants meet with center staff every other week for two hours to do team building, training, and case consultation. Three additional hours are spent seeing families, going on home visits with Head Start staff, meeting with staff individually, or offering training to parents. The consultation team offers training and team building to the entire staff several times a year. Classroom observations are scheduled outside of regular meeting times when children and parents are present. The PLU-Head Start project coordinator works with the Head Start administrative team to provide overall direction and continuity over time.

THE HEAD START CONSULTATION MODEL

The Head Start consultation model serves as a way to organize services and helps guide the process of consultation. Regardless of the model used, the consultation process typically includes preentry, entry, assessment, intervention, and follow-up (Hanson, et al., 1990; Imber-Black 1988; Weber, McDaniel, & Wynne, 1986). Preentry includes the initial contact, determining who in the organization should be involved in consultation, information sharing between the consultant and the prospective consultee, and a decision to consider a relationship. Entering the consultee system is a process of joining and assessing that results in an agreement by means of a written or spoken consultation contract. The consultant assesses the consultee organization from the initial contact on, formally and/or informally. Interventions may be part of the initial contract or be designed as the assessment unfolds. Finally, the consultation process includes a closing activity, such as an ending report or follow-up, which helps ensure lasting change in the system.

Within the PLU-Head Start project, the consultation process occurs on two levels. The ongoing process primarily involves the project coordinator and Head Start administrators. The project coordinator maintains joining with the Head Start program, contracts for services, makes ongoing assessments, plans consultation activities, and provides follow- ups through discussions of the project’s progress. On another level, individual consultants are entering center teams each year, assessing team training needs and dynamics, contracting for specific services, actively making interventions, and following up by tracking and discussing team progress over time.

The consultation model is used to organize the many needs of the Head Start program and to negotiate services. The model is reviewed and revised at the beginning of each contract year. The consultation model is divided into four parts to provide Head Start with organizational consultation, staff support and training, classroom intervention, and direct work with families. The model shown in Figure 1 is shared and negotiated with the Head Start administrators, parents, and center staff at the time of contracting for services. Center teams work with consultants to tailor consultation activities within each part of the model to meet their specific needs.

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FIGURE 1 The Four Part PLWHead Start Consultation Model

I. Organizational Consultation 1. Administrative consultation 2. Mental Health Performance Standard review 3. Staff team building

II. Staff Support and Training 1. Staff training and workshops 2. Staff consultation in their work with families 3. Individual staff support 4 . Critical incident debriefing

ID. Direct Work with Families 1. Parent discussion groups 2. Parent workshops 3. Consultation with families 4. Brief therapy intervention and referral

IV. Classroom Involvement 1. Classroom observations 2. Classroom interventions 3. Input on plans for children with special needs

Based on a n earlier model developed by Teresa McDowell and Linda Smith, former Twin Harbors Head Start Director

Organizational Consultation Organizational consultation focuses on the interactions between staff members and

on administrative planning. Consultants work collaboratively with the Head Start administrative team to meet program goals, including offering support and training to staff, making mental health services available to families, maintaining high quality classrooms, developing positive working relationships with other community agencies, and building efficient and effective staff teams.

Center teams typically set goals for their own team performance such as increasing communication or resolving conflict more effectively. Consultants redirect interactions, share observations, and keep discussions focused and productive so that teams are able to develop their own solutions. Consultants encourage team building within center teams by facilitating the process of interaction between team members.

Staff Training and Support Consultants share basic information about family systems and the family life cycle

with Head Start staff to help establish a common language. Family therapy model concepts and techniques are shared that are applicable to paraprofessionals working with families. In our project this usually includes training on strength-based approaches and

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solution-focused interviewing skills as well as structural mapping. Staff also identlfy training needs that are relevant to their work with participant families. Once a base of knowledge about family systems is in place, Head Start centers are encouraged to have regular team case consultations. The consultant facilitates a discussion about the staff member’s interaction with a family. The goal is to have the family presented in a way that offers new information while encouraging all team members to offer input and find solutions. This is also an opportune time to discuss interactions between Head Start staff, participant families, and other helping agencies such as Child Protection Services, housing authorities, or literacy programs. The consultant helps Head Start staff determine how to involve other helpers positively and interrupt negative interactions between Head Start staff and other agency representatives should they arise.

Consultants also go on home visits with staff members. The consultant reviews the situation with the home visitor and solidifies a goal that targets change in the interaction between the staff member and the participant family prior to the visit. The consultant may take an active or relatively inactive role during the visit. Afterwards, the consultant and the home visitor process observations and develop further solutions. Individual staff can request time with the consultant to discuss work and skill-related issues. Teams also debrief with a consultant when difficult situations arise in their work with children and families, such as the suicide of a participant parent, or a report of child abuse in a family that the staff feels particularly close to.

Classroom Involvement Head Start standards require that classroom observations be completed at least twice

a year. The project uses the Pacific Lutheran University-Head Start Systemic Classroom Observation Tool and process (McDowell, Fergusson, & Sullivan, 1997). This is more of a collaborative than an evaluative approach and includes staff and parent input prior to the observation. Staff are offered training in patterns of interaction to help them self-assess both negative and positive patterns within the classroom. This awareness better prepares teams to develop their own interventions to shift problem patterns. A follow-up with center teams allows staff to review input and set team goals. Consultants may be asked to give input regarding children with special needs. This input usually includes discussions of parent-staff-child interactions as well as necessary referrals to community resources. Teams may also ask consultants to enter classrooms to offer activities with children that target topics such as control of anger or acceptance of diversity.

Direct Work with Families Consultants go to parent meetings to introduce themselves and to discuss mental

health. They give workshops on topics identified by parents as of interest. Parent discussion groups may also be offered that are either topic specific or designed for general support. Family consultations are available to address mental health concerns that are beyond the scope of the Head Start family advocate or classroom teacher. Family consultation may lead to families’ identifying the need for therapy. Consultants then offer brief family therapy as one of the referral options. Head Start staff as well as other involved community helpers may be included in family consultation or family therapy when appropriate.


APPLYING THE CONSULTATION MODEL

As beginning consultants struggle to gain competence in the project, several areas of development repeatedly emerge as necessary for MFTs to add to their existing skills and knowledge in order to effectively apply the Head Start consultation model. MFTs must learn how to think about the consultation process and be able to develop consultation plans (Hanson, et al., 1990). They need to understand what consultation is and how it differs from supervision, therapy, administration, and education (Hanson, et al., 1990; Keoughan & Joanning, 1996; McDaniel, Wynne & Weber, 1986; Storm & Todd, 1998; Wynne, et al., 1986 1. Consultants must develop an awareness of how to apply MFT knowledge to organizational systems, including the limitations of various therapy models within an organizational context (Imber-Black, 1988; Keoughan & Joanning, 1996; McDaniel, Weber, & Wynne, 1986). It is necessary for MFTs to develop a “third roving eye” which allows them to take a metaview by keeping in mind the multiple levels of complex systems when intervening (Imber-Black, 1988; Wynne, et al., 1986). Finally, consultants need to develop the ability to ascertain an organization’s culture and work to promote change within that cultural epistemology (Elizur, 1996; Hanson, et al., 1990; Imber-Black, 1988).

Understanding the Consultation Process When the consultation model is applied, it is evident that both consultants and

consultees need to understand the process of consultation. Consultants are responsible for joining with staff, structuring consultation meetings, presenting and negotiating services within the model, determining interventions, and keeping track of progress. They must also become familiar with the process necessary to complete each activity within the four-part model. The process for completing a classroom observation is different from the process of team building or consulting with a family. Head Start staff must also learn the process and procedures for completing these specific activities. Staff need to become familiar with how team building sessions are structured and how the classroom observation process is completed. The structure for case consultation is typically foreign to Head Start staff and must be learned over time. The process of completing an in-home visit with a consultant needs to be clarified for staff. There is a learning process for both consultant and consultees for each consultation activity.

why am I here? Negotiating the consultation process. Stephanie began working with a center team that was relatively unfamiliar with the consultation process. During regularly scheduled consultation meetings, the team followed their typical work agenda, allowing Stephanie only minimal time to address the group. She quickly became an “observer” of team meetings. In order to address the necessary team development issues, the process of consultation had to be overtly renegotiated. Stephanie met with the team leader to discuss the process of consultation. This allowed her to shift her position and structure sessions in such a way that team building could occur.

Systems Consultant or Family %erapist?

Consultants are like hikers in uncharted woods. The terrain of consultation can be confusing and its boundaries ambiguous, and there is no map to guide the

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consultant’s behavior . . . maps automatically transposed from therapy, teaching, supervision, or administration simply will not suffice. (Weber, et al., 1986, p. 29)

It is no simple task for MFTs to clearly define their role as systems consultants. There are no well-established models or clear guidelines to follow, no videotapes of master systems consultants to emulate, no shelves of books on consultation to choose from. It appears that for the most part, MFTs have trained themselves at some point in their careers when opportunities arise to work in settings such as hospitals, social service agencies, schools, or businesses. The PLU project has adopted the model suggested by McDaniel, Wynne, & Weber (1986) that describes systems consultation as lying somewhere on the continuum between supervision, education, therapy, and administration. The beginning consultant must learn to shift positions flexibly on this continuum without going too far into any one of the alternative roles. Consultation may move closer on the continuum to any of these roles at any given time depending on the specific activity within the four parts of the consultation model.

Organizational consultation may require the consultant to assume an administrative point of view. Reviewing the mental health standards to help administrators plan how to best meet the mental health requirements may lead to discussions about training needs, staff placements, and changes in operating procedures. Working on the organization itself through team building requires the consultant to be aware of the interactional process and structure it. Staff training and consultation is closer to education or supervision than critical incident debriefing, which leans toward therapy. When consultants work directly with families, they may alternate between being workshop educator, group facilitator, or therapist. Classroom involvement again requires shifts in roles. At one moment consultants are evaluating the classroom against administrative expectations, the next they are helping the staff team set goals, and the next they are working directly with a child.

Developing a ‘2 Third Roving Eye” Working as a systems consultant requires taking a metaview of agencies and the

families they serve in relationship to each other and within the broader context (Elizur, 1996; Imber-Black, 1988). In fact, consultants need a roving lens that can simulta- neously focus on agencies as multilevel systems in relation to each other and family systems. This perspective must be maintained at all times for consultants to predict how intervening with staff in one part of the system will affect staff interactions throughout the organization.

As consultants engage in the activities in any of the four parts of the consultation model, they also consider how to best support the overall consultation goals. For example, the classroom observation process allows consultants to help staff meet goals identified in several parts of the consultation model. The observation assesses and provides an avenue for input into practices in the classroom. It is also a time when children with special needs can be assessed. The team’s self-assessment and goal setting sessions with the consultant before and after the observation are opportune times for team building. The report is written collaboratively by the consultant and the team and provides a formal avenue for communication between center and administrative staff. Parents are asked to be involved in giving input about the classroom, and discussions about the observations can reveal staff training needs.

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Not only is it important for consultants to maintain a meta perspective in their work with Head Start, but it is also often beneficial to encourage this perspective among staff. Encouraging administrators to consider the broader system helps them identify possible ramifications of program decisions. Teachers are better able to change behavior when trained to assess patterns of interaction that include all members of the classroom. Center staff are better able to help Head Start parents meet their goals when they are able to conceptualize families within a broader context.

Help me help her: Using a metaperspective in consulting with stafj Amy, a Head Start family advocate, sought out Karrie, the consultant working with her team, for an in-home visit with a participant family. Amy was frustrated by what she perceived as not having good-enough solutions for the participant she was working with. She wanted Karrie to use her expert knowledge of family therapy to come up with better ideas for her to offer the participant, Karrie resisted the temptation to assume the expert role and instead stepped back to take a meta view of the situation. Karrie knew that Amy’s job required that she help families to change. In order to be successful in her role, Amy felt she needed to provide the correct answers. Karrie also identified a repetitive pattern in which the participant complained of a problem, and Amy offered solutions that were accepted politely by the participant, who then failed to follow through. Amy’s request that Karrie find the correct answers was more of the same. Karrie helped Amy explore her own ideas for alternative ways of working with the participant, which led Amy to encourage the participant to explore her own solutions. These participant-driven solutions were documented as areas of change to fulfill the requirements of Amy’s work setting.

Too many cook: Helping consultees take a meta view. During a team case consultation, Tom, a family advocate, reported that he was working with a multiproblem participant family who he felt desperately needed additional social service resources. Betsy, the consultant, asked Tom to draw a structural map of the family that included the extended system and all existing helpers. Tom was surprised to see that although the family had almost no kin or community support, he could list eight different agency helpers already involved. Betsy asked eight staff members who were present for the consultation to each be the voice of one of the involved agencies. Tom assumed the role of the participant family and patiently listened to advice from all eight helpers. The often conflicting and confusing overload of input helped Tom reconsider his idea of adding more voices. By encouraging the consultees to step back and take a broader perspective Betsy was able to facilitate a discussion centering on coordinating and collapsing services, and encouraging the family to build support within their kinship and social networks, and to address Tom’s feelings of being overwhelmed that led him to want more support in the first place.

Becoming Aware of Organizational Culture It is generally agreed that consultants entering an agency need to be aware of and

have ways of assessing the organizational culture (Elizur, 1996; Imber-Black, 1988; Schein, 1984). The culture of a local Head Start program is influenced by multiple factors, including the assumptions of the broader culture about low-income families that lead to continued federal funding, the philosophy of the Regional Head Start organization, the policies of the local grantee who administers the program, the assumptions and practices of the local Head Start staff, and the beliefs of the

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community in which the program operates. No two Head Start cultures are exactly alike, but there are cultural values and assumptions that most Head Start programs share. These become familiar to consultants working across programs. Consultants entering Head Start programs might ask questions such as:

What is your mission statement? How would you describe “the Head Start way”? What is important for me to know so I can support the way you work? What are your policies and practices about child discipline? How would you like to see parents be involved? What are the most significant problems you face with participants? What are your agency’s strengths and weaknesses as a work group? How will I know if I misunderstand where you are coming from? What are the common mistakes that employees make who don’t fit in?

It is important for consultants to recognize when they have broken cultural norms in ways that will impede their work and when cultural norms need to be challenged because they prevent necessary change. To successfully consult with Head Start and apply any part of the consultation model, consultants must be aware of the cultures of the Head Start organization, the enrolled families, and the community. When working with administrators, consultants need to know the history, mission, and goals of the program. Every consultation activity must support the program’s goals and philosophy. For example, empowering parents is part of the Head Start mission. It is expected that parents and staff will work collaboratively. In fact, many staff members have been Head Start parents themselves. When consultants offer staff training and case consultation, this mission can be supported by the use of respectful language that focuses on family strength rather than pathology.

HEAD START CONSULTATION AND UNIVERSITY MFT TRAINING PROGRAMS

Systems consultation with Head Start is an approach that MFT training programs can readily adopt by building relationships with Head Start partners, incorporating consultation training into the course curriculum, and providing consultation-of-consultation.

Deueloping a Relationship with a Head Start Program Forming an ongoing relationship with a local Head Start provides MFT training

programs with a placement site for consultant trainees, an arena to help meet MFT training goals, and financial support for incorporating systems consultation curriculum and field experience. A strong relationship between the MFT program faculty and Head Start administrators acts as an umbrella under which beginning MFTs can practice consultation skills and be protected from the impact of learning errors that might otherwise cause them to be fired by consultee agencies.

In addition to providing a field site for practicing systems consultation, a Head Start Program can help meet numerous MFT training goals. For example, low-cost classroom observations can be offered to Head Start that students who are studying human development can complete. Students can meet some M€T course requirements by

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providing training to Head Start staff and parents on course-related topics. This approach not only meets learning objectives but gives students experience in public speaking, observing diverse systems, and tailoring information to varied audiences.

Working with Head Start provides an avenue for MFT programs to offer additional paid positions to graduate students. Finances are often of concern to adult students and jobs that are relevant to the field are highly valued. Training programs can negotiate with Head Start programs for mental health dollars that would otherwise be spent on private contracts. Student trainee salaries are substantially lower than fees charged by private practitioners or community mental health agencies, which frees funds for faculty to coordinate the project and make additions to the curriculum.

Course Readings and karning Activities Additions to the curriculum can be made by incorporating consultation readings and

activities into courses already in place or by offering additional training. In the PLU-Head Start project, we give a two-day workshop in systems consultation. The workshop offers interested graduate students and MFTs from the community an opportunity to familiarize themselves with systems consultation, while providing the initial training for beginning consultants who will be working in the Head Start project.

Required readings target applying MFT knowledge to systems consultation (Keoughan & Joanning, 1996; McDaniel, Weber, & Wynne, 1986; McDaniel, Wynne, & Weber, 1986; Wynne, et al., 1986; Wynne, et al., 1987), maintaining an awareness of the multiple levels of complex systems (Held, 1982; Shook, 1985; Woodruff & Engle, 1985), recognizing organizational culture (Schein, 1984), and understanding the consultation process (Elizur, 1996; Hanson, Himes, & Meier, 1990; Imber-Black, 1988; Weber, McDdniel, 8 Wynne, 19861. Following are examples of learning activities that are designed to give course participants experience in applying concepts from these readings and related lectures.

Think of this as you would of a family. Trainees view video clips of organizational interactions from movies such as Disclosure and think about these work systems as if they were families. Trainees also work in dyads to apply a family therapy model to their own employment setting. This develops a beginning awareness of the similarities and differences between diverse human systems and provides a starting place for the application of MFT knowledge to organizations. The limits of applying MFT models also begin to emerge. Videos are presented a second time to give course participants an opportunity to watch for and discuss organizational culture.

Consultation, therupy, or supemision: What’s the difference? This activity is designed to help course participants define consultation and differentiate consultation from what they experience in therapy or supervision. Participants are divided into three groups. Each group is assigned the role of therapist, supervisor, or consultant. They discuss their assigned roles among themselves before viewing videotapes of actual systems consultation or a scripted mock consultation. The consultation is stopped at various decision points, and the groups give input from their prospective roles.

Living proof that MITs can be systems consultants. Interviews with MFTs who are successfully incorporating systems consultation into their professional identity help participants to see how the course material can be applied. The instructor guides these interviews to ensure that relevant points are covered. The visiting consultants then field

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questions from course participants. Three’s company: Intemiewing members of the same work system. Three members

from different organizational levels of the same work system are asked to visit the classroom to be interviewed. In preparation, the course participants are divided into three groups and develop questions that will help them to understand the organization from a systemic perspective, to define aspects of the organization’s culture, and to identify an area of interaction the interviewee would like to change. Once interviews are completed, members of the three interview groups are mixed to talk about their perceptions. This initial discussion gives participants experience in applying systems concepts to a real organization and helps them to consider organizational culture. The difference in information gathered by interviewing numerous members of the same system helps participants recognize the need to keep multiple levels of complex systems in mind at all times. After the groups have had time to discuss the organization as a system, consider its multiple levels, and hypothesize about its culture, they begin to develop a consultation plan that would help meet at least one goal identified by the interviewees.

How it’s done: Case examples. The instructor gives start-to-finish examples of consultation projects involving various types of organizations, such as large businesses, family firms, and social service agencies. Contracts, reports, and actual interventions are shared without revealing the names or iden*ing details of the organizations involved. Team- building techniques are used in class to demonstrate interventions and give participants an idea of what it is like to be on the receiving end of consultation.

Consultation-of-Consultation Consultation-of-consultation is a vital part of the training model. In our project, the

coordinator acts as an administrative supervisor for program needs, as an Approved Supervisor for therapy cases with Head Start families and as a consultant to the consultation team. Trainees report that a respectful, open, collaborative approach that in many ways mirrors their work as consultants is most helpful in consultation-of-consultation. Group consultation-of-consultation serves as a place to clarfy roles, decide on consultation plans, ward off disasters, and debrief from the stress of taking on a new role. Trainees observe each other by working as teams whenever possible. They also share videotapes of their work during consultation-of-consultation. Consultants have used journaling as a way to process the learning experience and share struggles with each other and the project coordinator.

HEAD START CONSULTATION AND PRIVATE OR AGENCY SETTINGS

Providing systems consultation can broaden the scope of practice for MFTs eager to meet the demands of a growing and changing field. The readings from the systems consultation workshop offered in the PLU project can act as a starting place for MFTs who are interested in pursuing training and experience in consulting. It is very useful in the project for beginning consultants to work in teams. MFTs in private practices or agencies might also find it helpful to form teams to offer consultation to Head Start. Being part of a team can help allay the anxiety associated with taking on a new role, and working together can help beginners think through more carefully the process of consultation. A consultation team may also be more marketable because of the variety


of services it can offer. MFTs working in agency or private settings can use the systems consultation model

to initiate or enhance relationships with Head Start. The fact that consultation services have been successfully provided to other Head Start programs can help increase the confidence of Head Start administrators and consultants. The model provides structure for MFTs and Head Start programs as they work together to negotiate services. Initial contracts to provide mental health services to Head Start are often limited to classroom observations, input for children with special needs, and staff and parent training. Services may be added as trust and interest grow. Activities within each of the four parts of the model can be creatively changed or added according to the needs of the Head Start program. For example, a Head Start program might contract on a per capita basis with a mental health agency to provide assessment and referral services to enrolled families, or use a consultant to facilitate a staff retreat.

To get started, agency representatives or private practitioners can ask to meet with Head Start program directors to discuss the mental health needs of the program. Information about who currently provides mental health services, the program’s satisfaction with those services, and the needs of the program that are not being met can be very beneficial in planning an approach to offering services. This can be a good time to offer free staff training so that members of the program can get to know your work.

MFTs can draw from the systems consultation model and existing literature to planfully approach Head Start as an organizational system. Initial contacts need to include administrative staff as soon as possible. Without the blessing of the Head Start program director and executive team, it is unlikely that consultation will be successful, or even begin. It can also be important in the planning stages to include staff members with varying roles, including teachers and family advocates. Prospective consultants may be asked to go with staff to discuss the mental health consultation plan with the parent policy council and/or grantee organization. The more staff members, board members, and parents who understand and support the consultation plan, the better. Once the initial joining and contracting for services is complete, it remains necessary to continually assess the organizational structure of the Head Start system and to intervene accordingly.

SUMMARY

Although systems consultation is still relatively new and unexplored territory for most MFTs, the PLU-Head Start project has shown that MFTs can expand their roles to work with social service agencies. The project’s success has been demonstrated by positive changes in Head Start staff and families, MFT trainees, and the MFT program.

The comprehensive services offered in the consultation model give Head Start a way to maximize mental health dollars. Head Start administrators report that having a team of systems consultants improves the consistency and quality of mental health services. Systems knowledge has permeated the Head Start system. It is no longer uncommon to hear staff talk about “patterns of interaction” or not “triangulating” a fellow staff member. Staff relationships improved among and between teams. Staff have acquired specific skills in areas such as solution-focused interviewing, group facilitation, and engaging multiple members of participant families. Staff also report an increase in successful referrals to family therapy. Head Start parents have increased access to mental health services and

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training. They have appreciated having support groups, having informal talks with consultants, and not having to go to mental health centers for help.

MFTs who train as systems consultants show improvements in their skills as therapists in numerous ways, including heightened ability to differentiate process from content, increased skills in facilitating group interaction, enhanced awareness of the relationship between multiple systems, and keener joining skills when collaborating with agencies. MFT trainees who have consultation experience are well prepared to compete for jobs. Several have secured positions in schools or in working with multiple community systems. Others have pursued jobs within Head Start or in mental health agencies that contract with Head Start. The ability to view organizations systemically has helped consultants successfully adjust to agency settings.

Incorporating systems consultation curriculum and field experience into the MFT program not only expands the learning experience for students but opens an entire area of study for faculty. Maintaining a relationship with Head Start gives the M l T program a living organizational laboratory for trying out creative ideas while providing a valuable service to community.

The MFT field needs to continue to explore systems consultation. We have only scratched the surface in identlfying and measuring the specific skills and training necessary for MFTs to work effectively as systems consultants. The project has been limited to working with one type of social service agency. We need to add to our understanding of how to prepare MFTs to work in diverse systems, such as schools, churches, hospitals, and businesses. The activity of consultation-of-consultation has proven helpful but is virtually uncharted.

The Head Start systems consultation model itself needs to be applied in other Head Start programs to identify weaknesses and to expand its applicability. Additional consultation activities need to be explored creatively. The model’s application to other social service agencies might also be considered. PLUS partnership with Head Start has proven to be a natural and successful starting place to explore new systems territory and to experiment with expanding the limits of traditional marriage and family therapy.

REFERENCES

Elizur, Y. (1993). Ecosystemic training: Conjoint supervision and organizational development. Fa m i l y Process, 32, 185-201.

Elizur, Y. (1996). Involvement, collaboration and empowerment A model for consultation with human- service agencies and the development of family-oriented care. Family Process, 35, 191-201.

Hanson, J., Himes, B., & Meier, S . Consultation concepts andpractices. Englewood Cliffs, NJ: Prentice Hall. .

Weld, R. (1982). Entering a mental health system: A strategic-systemic approach. Journal of Strategic and Systemic Therapies, I , 4G50.

Imber-Black, E. (1988). Families and larger systems: A family therapist’s guide through the labrinth. New York: Guilford Press.

Keoughan, P., & Joanning, H. (1996). Getting down to business: From therapist to consultant. Family Therapy ~Veus, 16-28

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McDowell, T., Fergusson, K., & Sullivan, E. (1997). The Pacific Lutheran University Head Start systemic observation tool. Education Resources Information Center, ED 402 062.

Patterson, J., McIntosh-Koontz, L., Baron, M., & Bischoff, R. (1997). Curriculum changes to meet challenges: Preparing MFT students for managed care settings. Journal of Mam'uge and Family nerapy, 23 (41, 445459.

Schein, E. (1984). Coming to a new awareness of organizational culture. Sloan Managemmt Reuiew, 25 (21, 3-16.

Shook, L. (1985). Family therapy consultation and organizational change. Journal of Strategic and Systemic nerapies, 4, 8-14.

Storm, C., & Todd, T. (1997). Thoughts on the evolution of MFT supervision. In T. Todd & C. Storm (Eds.), 7%e systemic supervisor: Context, philosophy, andpragmatics (pp. 1-16). Needham Heights, MA: Allyn & Bacon.

S. McDaniel, & T. Weber (Eds.), Systems consultation: A newperspective forfamily therapy (pp. 29-34). New York: Guilford Press.

Woodruff, A., & Engle, T. (1985). Strategic therapy and agency development: Using circular thinking to turn the corner. Journal of Strategic and Systemic nerapies, 4, 25-29.

Wynne, L., McDaniel, S., & Weber, T. (1987). Professional politics and the concepts of family therapy, family consultation, and systems consultation. Family Process, 26, 153-166.

Wynne, L., Weber, T., & McDaniel, S. (1986). The road from family therapy to systems consultation. In L. Wynne, S. McDaniel, & T. Weber, (Eds.), Systems consultaion: A newperspectiw,for family therapy (pp. 3-1 5). New York: Guilford Press.

Weber, T., McDaniel, S., & Wynne, L. (1986). Signposts for a systems consultation. In L.Wynne,

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168 JOURNAL OF MARITAL AND F M I L Y THERAPY April 1999

SYSTEMS CONSULTATION AND HEAD START: AN ALTERNATIVE TO TRADITIONAL FAMILY THERAPY

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