Mental health articles

BRIEF HISTORY OF CONSULTATION The impetus for mental health services to move beyond the clinic setting to improve treatment outcomes fueled movements to develop methods of consultation. These early efforts at consulting began as a means of offering an alternate response to meeting the community’s mental health needs when scarce professional resources meant that many individuals would not have had access to care. In the late 1940s and 1950s, Gerald Caplan was a psychiatrist faced with this dilemma. He developed a process in which available professional resources could be used more efficiently, refining and assessing these efforts into what would become the first formalized model of consultation. Caplan went into the community where thousands of adolescent immigrants were living in residential facilities. He focused the efforts of his staff on working with the caregivers there to initiate changes that would benefit a larger group of individuals more quickly (Caplan, 1970). Caplan conceptualized this process of mental health consultation as “ the process of interaction between two professional persons- the consultant, who is a specialist, and the consultee, who invokes his help in regard to a current work problem with which the latter is having some difficulty, and which he has decided is within the former’s area of specialized competence” (Caplan, 1963, p. 470). His approach acknowledged the importance of community-based care and demonstrated valuing the input and expertise of the professionals within the system requesting assistance. Caplan and subsequent providers recognized the importance of taking the expertise out of the clinic setting and translating it into functional guidance for direct caregivers who had more frequent contact with the clients. This movement acknowledged the greater likelihood of generalizability and prevention when presenting concerns could be evaluated and addressed within the community. Caplan’s continued work on this method of mental health services resulted in a wealth of insight into the basic features of effective consultative relationships. His intent was not only to indicate what elements were critical for establishing the consultation relationship but also to differentiate the consultative role from that of supervision,therapy, and teaching. In defining the underlying premises of consultation, Caplan’s
basic assertions established the guidelines for the development of multiple consultative approaches.

Tags: consultation