Mental health articles

As a consultant, you will frequently be called on to solve problems. Some may argue that consultation can be defined as problem solving. In many instances, your clients
will have repeatedly attempted and failed to solve the problems they are currently facing.
Bringing in an outside, objective perspective can be helpful in re-conceptualizing
the situation. A simple device, the classical problem-solving sequence, can assist clients in systematically dealing with the problems at hand, and will give them the tools to more effectively work with future challenges.
How thoroughly the problem-solving sequence is conducted depends on the complexity of the problem, the seriousness of the issues involved, the amount of time available,
and the potential consequences of any decisions made. However, the same six problem-solving steps are useful whether the consultant is assisting in the development of a treatment plan for a consultee’s deaf client or helping to manage the merger of two giant corporations.
The first step is to define the problem. Although at first this appears to be the easiest step, in practice, the presenting problems often are fuzzy and ill-defined. Consultees
may know that something is not right, but may not know precisely what is going on within the organization or client system. In addition, even if they know they are dissatisfied with the current state of affairs, they may not have identified what the
end goal should be. Just as in individual psychotherapy, a thorough assessment of current
functioning and clarification of how things would be different if the consultee
could “wave a magic wand” can often be a major intervention in and of itself. The formulation of a succinct goal statement will guide the rest of the problem-solving process.
The second step is to identify alternative solutions. The consultee and the consultant can brainstorm various possible solutions to the identified problem; they also can conduct
research and discuss the situation with others to develop a list of possibilities. At this stage, it is important not to prematurely filter out ideas, but to generate as many
ideas as possible. Even if an idea initially sounds untenable, it may spark other, more plausible ideas.
The third step is to weigh the consequences of alternative solutions. The implications
of each solution should now be examined. What are the short-term and longterm costs? Who else will this affect? How feasible is each solution? What time factors are involved?
The fourth step is to implement the decision. As clinicians know, this step can be difficult. Making a choice involves many factors, and there is often a great deal of ambiguity.
The most difficult decisions are those that preclude other possibilities. People
sometimes procrastinate in making choices so that they will not have to face the consequences
of the decision, even if they know it is the best decision in the long run. The
consultant should be supportive during this stage, but must always allow the consulteeto make the final decision, since the consultee must feel invested in the decision and is
the one who bears the burden of the consequences.
The fifth step is to evaluate the consequences of the decision. Once the decision has
been implemented, the results should be monitored and evaluated. Are the desired results
being achieved? Quantitative results are best if possible. Instead of asking if
morale has improved, the consultant could determine if employee absences have decreased.
Instead of asking if the mental health client has improved, the consultant
could determine if the client has had fewer return visits to the emergency room. Subjective
measures are also important, but results that can be measured (e.g., by using a standardized or individualized survey instrument) provide justification for charging a fee for services.
The final step is to redefine the problem and restart the problem-solving sequence.
Complex problems are seldom fully resolved with a single perfect solution. Even if you were to arrive at a perfect solution, environments that are internal and external to the
organization or client may change with time. You must monitor the situation to see if new problems have arisen, or if the old problem still exists in other forms. Then you
can move once again through the entire problem-solving sequence. This general sequence,
which is used frequently in consulting, is shown in Box 1.5.
Consulting can be thought of as helping people solve their own problems, and psychological consulting can be thought of as solving people problems. Eventually, this
process becomes internalized, just as experienced clinicians no longer need to meticulously
follow a rigid list of assessment steps for every diagnosis. Although this sequence serves as a guide, many influences affect a person’s problem-solving ability (DuBrin, 2000), and mental health professionals should be well suited to deal with the
effects of psychological and contextual factors.

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