ABSTRACT
In the field of intellectual disability in Ireland, the UK and some other countries, clinical psychology services are offered to clients within the context of a chronic care model. That is to say, psychologists as part of multidisciplinary disability teams or agencies offer services to clients over the course of the lifespan. At critical points in the lifecycle intensive episodes of contact occur, for example at initial diagnosis; at transitional points in the lifecycle such as school entry or leaving home; and during crises, for example when challenging behaviour or mental health problems occur. Between these episodes of intensive contact, clients are attached to the service but have a low level of input from psychologists, perhaps in the form of annual reassessments or contributing to individual programme planning meetings. The framework in Figure 5.1 outlines the stages of consultation during an episode of intensive contact, from initially receiving a referral to the point where the episode of intensive contact with the case is ended. Many such episodes of contact occur over the course of a client’s lifespan. In the first stage a plan for conducting an initial assessment is made. The second stage is concerned with the processes of engagement, alliance building, assessment and formulation. In the third stage, the focus is on case management, the therapeutic contract, and the management of resistance. In the final stage, disengagement or recontracting for further intervention occurs. After a period of disengagement, the process may recur at a later time in the client’s life when further input from a clinical psychology service may be required. Interviews with clients, carers and other members of the client’s network occur during all contacts, and it is vital that all contacts are appropriately recorded and documented. In this chapter a more detailed consideration of the stages of the consultation process will be given along with guidelines for interviewing and report writing.
STAGES OF THE CONSULTATION PROCESS
