Medical Model Vs Eco Behavioral Model

The purpose of this study was to explore the ways in which school psychologists conceptualize culturally responsive consultation based on their description of using an ecological approach or an intrapsychic approach to consultation. Additionally, this study aimed to address barriers school psychologists may face when providing culturally responsive consultation based on the consultation method they describe using. I conducted a secondary analysis of 1 to 2-hour, semi-structured interviews of 15 school psychologists throughout the United States. I used a constructivist paradigm to understand participants’ approaches to consultation and how these approaches related to their descriptions of culturally responsive consultation. I used constant comparison analysis and analytic memos to derive themes. Through data analysis three major consultation themes emerged: 1) structured problem-solving with a medical model lens to guide their case conceptualization, 2) structured problem-solving with an ecological lens to guide their case conceptualization and, 3) “On-the-fly” consultation and limited use of a problem-solving framework to guide their case conceptualization. The participants who described a medical model approach described their conceptualization of cultural variables (e.g., race/ethnicity) in a broad and vague manner and did not incorporate cultural variables in their consultation or intervention selection. The participants who described an ecological approach to consultation actively incorporated culturally related variables (e.g., speaking in the family’s native language, addressing issues related to acculturation, etc.) throughout their consultation process and intervention selection. The participants who described an on-the-fly varied in their consideration of cultural variables. With respect to barriers to consultation, the participants who described an ecological approach to consultation described lack of stakeholder involvement as the most salient barrier to delivering comprehensive consultation services. Those who described the use of a medical model approach and those who described an on the fly approach noted similar barriers to comprehensive services (e.g., lack of cultural knowledge).