A FOLLOW-UP STUDY OF FAMILIES REFERRED TO OUTSIDE AGENCIES

ANTHONY P. CONTI

Rutgers University

One aspect of the role of the school psychologist, as a consultant t o the schools, is the referral of children and their families to outside agencies (Ruzicka, 1967). Such referrals usually are undertaken when a child manifests certain behaviors that require additional evaluative procedures, such as a complete visual examina- tion, special educational experiences (e.g., residential placement), or long-term individual or family counseling. When he makes referrals the school psychologist usually follows a logical procedure: (1) evaluation of the child’s behavior and life situation; (2) decision, usually made in collaboration with other school staff, to refer the child and his family to an appropriate agency; (3) cmjerence(s) with the family of the child in question to discuss the decision and reasons for it and to establish a connection between the needs of the child and/or family and the services offered by the appropriate agency; and (4) recommendation of the appropriate agency to the family with a description of admission procedures.

Typically, school psychologists appear to be satisfied upon completion of the last step in the above procedure or its equivalent. It is reasoned (rationalized?) that the recommendation and the reasons for it have been conveyed to the family and that the job is done. It is now up to the family to make the suggested contact and derive benefit from the services that this contact provides. As weeks and months pass, with the work load ever increasing, the school psychologist loses sight or remains only peripherally aware of the consequences of the recommendation for any given family. Perhaps this ignorance is a form of selective perception that serves to avert threat from the already tenuous image held by school psychologists of themselves as valuable school personnel. It seems that so often, in this and other aspects of functioning, school psychologists “just go through the motions,” be- cause it was done before them in a prescribed manner. The process of selective perception and/or rationalization that operates prevents them from taking a hard look at the consequences of these ‘(motions” and how they benefit children, families, and school systems.

While the evaluation of recommendations of parents to outside services for a large number of school psychologists would be an interesting study, it would be a difficult undertaking complicated by a myriad of variables such as personality differences among psychologists, availability of services, etc. This type of evalua- tion is a process that is handled much more effectively by each individual school psychologist and should be something for which we all are accountable. This pilot study attempts to present such an evaluation.

METHOD This study considers the consequences of recommendations made to 37 families

(involving 40 children) that they utilize various outside agencies. All of the recom- mendations were made by the author, while employed as a school psychologist by a school system in central New York State, between February and August, 1970.

A FOLLOW-UP STUDY OF FAMILIES REFERRED TO OUTSIDE AGENCIES 339

Follow-up was done during the week of March 22-26, 1971. Information about each of the families was sought in three areas: (1) the type of service recommended; ( 2 ) whet,her the recommended contact was made; and (3) if the contact was made, was the service used in any way by the child and/or parents for more than two sessions? The information was obtained through school records and through direct contact with the family by the author or other school personnel.

RESULTS Initial inspection of the data reveals that the types of services to which the

37 families were referred may be divided roughly into two groups. Group I (N = 14) was composed of recommendations to clinics and/or schools for special evaluation and education for the severely mentally retarded (N = 2 ) , physically handicapped (N = 6 ) , children with multiple learning disabilities (N = 4), and severely emo- tionally disturbed children who required residential placement (W = 2). Group I1 (N = 23) was composed of families referred to public counseling services. The service recommended for each family, within both groups, was selected in con- sultation with a second psychologist. Factors such as availability of the service and financial costs were considered when each family was matched with an ap- propriate service.

Of the 14 families in Group I, all made initial contact with the recommended service on their own. In addition, as of the time of this study all families still were making some use of the recommended facility. Of the Group I1 families, informa- tion was unavailable on l family, 15 families had made no contact with the service recommended (or any other service) since the original recommendation had been made, and 7 families had initiated the recommended contact. Of these 7, 4 families had discontinued use of the service after one or two sessions, 2 families had continued beyond the second session and a t the time of the study still were making use of facilities offered by the service, and the remaining family had begun counseling the week prior to the evaluation, after great pressure from school staff.

Of those families referred in Group I, 100% made the recommended contact and continued to use the suggested service. Of those families referred in Group 11, 30% made the recommended contact, while 8% of those originally referred con- tinued beyond two sessions.

DISCUSSION While this evaluation represents a limited pilot study, its results raise some

important questions for school psychologists. Why is the model previously described effective in recommending outside services to families from Group I , but not to those from Group II? Are families in Group I easier to convince as to the need to utilize outside agencies, since problems manifested by their children are more noticeable than problems manifested by the children of families in Group II? Is information of this nature more readily acceptable when the problem can be seen more easily as lying within the child and external to the family (Group I) than it is when the family is perceived as a part of the problem (Group II)? Is contact harder to make when the treatment process threatens to involve the adult(s) in the family as well as the child (Group II)?

340 ANTHONY P. CONTI

What role does the school psychologist, and the family’s perception of him, play in determining whether the recommended contact will be initiated? Which of these factors, singularly or in combination with others, operates to make the families of Group I1 highly receptive to the recommendation when in the presence of the school psychologist? What factors operate to reduce this receptivity once they leave his presence? Is it easier for families to accept threatening information about their children and themselves in the context of the school than to accept the same information in the form of treatment, in another setting? Finally, if the recommended contact is made, is benefit derived for the child and family?

The answers to these and many other questions represent possible variables that may operate, a t any given time, to influence the consequences of the school psychologist’s recommendation that a family utilize outside services. Complex as the interaction of these factors may be, attempts must be made to control them when such recommendations are made. Two methods that might introduce some control in cases in which parents are reluctant might be: (1) the school psycholo- gist may arrange the initial contact for the family and accompany them to par- ticipate in the initial interview; and/or (2) the school psychologist might request the intake worker a t the appropriate agency to contact the family and suggest an interview.

If families such as the majority of those in Group I1 still refuse to initiate contact with and/or are unable to benefit from services provided by outside agen- cies, perhaps we should stop wasting our time on such recommendations and initiate treatment programs for them in the school.

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REFERENCE J ~ U Z I C K A , W. Working with parents and community agencies. In J. Magary (Ed.), School psycho-

2ogicaZ services in theory and practice, a handbook. Englewood Cliffs, N. J.: Prentice-Hall, 1967.