| Dentist - Psychologist Collaboration: The Case of the Anxious Patient/Bruce Peltier and Paul Glassman | |
| Dentist - Psychologist Collaboration: A Big Kid in a Candy Store/Bruce Peltier | |
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Establishing Collaborative Multidisciplinary Teams in the Treatment of Children and Adolescents/David B.Goldstein |
| David B. Goldstein, Ph.D. | Establishing Collaborative Multidisciplinary Teams in the Treatment of Children and Adolescents
My practice has highlighted the treatment of children, adolescents, and their families and many of the children I have intervened with have behavior disorders and co-occurring difficulties in the school setting. Working with these children and adolescents over the years has regularly led me to the doorsteps of non-psychology professionals also interested in the behavior of children and adolescents, i.e., teachers, speech and language pathologists, occupational therapists, physical therapists, audiologists, and pediatric optometrists. These professionals were often more integrally involved with the child’s experiences in school than the psychiatrist, neurologist, or pediatrician treating a particular child. In addition, these non-psychologist professionals generally supported the work I was doing with the child and it was not unusual for their intervention strategies to have a positive impact on behaviors I targeted in individual, group, or family therapy. Multidisciplinary approaches have become an accepted strategy in efforts to understand and manage learning disabilities in children and adolescents. Cratty and Goldman (1996) and Duane and KanLeong (1985) considered an interdisciplinary approach as an effective method of addressing children and adolescents with learning disabilities. The Learning Disabilities Association (LDA), a national organization dedicated to defining and finding solutions for a broad spectrum of learning difficulties, has also endorsed interdisciplinary assessment and treatment approaches. In fact, the LDA publishes a journal that disseminates contemporary perspectives on learning difficulties entitled, Learning Disabilities: A Multidisciplinary Journal. In short, both my professional experiences and support from the research literature informed my decision to organize a multidisciplinary team as part of my independent practice. At present, our multidisciplinary assessment and treatment team includes the following professionals: psychologists, a neuropsychologist, a professional with expertise in behavior analysis, a psychiatrist, an occupational therapist, a physical therapist, an audiologist, a speech and language pathologist, educators, tutors, a reading specialist, and a pediatric optometrist. My aims in assembling this multidisciplinary team were as follows: (1) I wanted to be able to provide the most effective, integrated, and comprehensive services to children, adolescents, and their families struggling with behavior problems, learning disabilities and developmental disorders; and (2) I was interested in creating a climate that would promote collaborations among professionals of distinct disciplines and hopefully produce some unique and useful assessment tools, treatment strategies, and research opportunities. Collaborating with professionals from distinctly different disciplines toward common or interrelated goals has had some noteworthy advantages. First, relative to working with other psychologists, establishing relationships with professionals in complementary disciplines reduces concerns around competition for limited resources. These concerns seem especially salient during the era of managed care and it’s attendant pressures to reduce or eliminate psychological services to our clients (Goldstein, 1999). Second, the opportunities to cross-refer appear greater amongst a network of dissimilar professionals who provide distinct and complementary services to a common population. Although we are in the early stages of our collaborative endeavors, we have already created some interesting assessment materials and treatment programs. For example, we have developed an extensive questionnaire, called the Developmental Screening and Referral Inventory (DSRI), that we give to the parent(s) of every child referred to our treatment team. The DSRI provides extensive information on the social, educational, physical, behavioral, and family background of every child seen in our clinic. Not only does the DSRI furnish the team with information that proves helpful in assessment and treatment planning. Additionally, the content of the DSRI is organized in such a fashion as to help us make decisions as to whether a child should be referred to an audiologist, speech and language pathologist, occupational or physical therapist, pediatric optometrist, psychologist, neuropsychologist, and/or psychiatrist for more in-depth evaluation. Our multi-disciplinary approach has also led to the development of a comprehensive reading clinic and an early intervention program for pre-school and kindergarten age children who are having difficulties adjusting to the many new and challenging routines demanded of them as they first enter the classroom environment. Along with working in concert to provide office-based services, we are also creating a web site that we hope provides additional benefits to our clients. In addition, the web site offers another medium for lively communication and inventive collaboration amongst the various professionals comprising our multidisciplinary team. Ultimately, I found that developing a multidisciplinary team to treat children and adolescents with behavior disorders, learning disabilities, and developmental disturbances has been a sound clinical approach while strengthening and invigorating my private practice. References Cratty, B.J., & Goldman, R. (1996). Learning disabilities: Contemporary Viewpoints. Newark: Harwood Academic. Duane, D. & Kan Leong, C. (Eds.) (1985). Understanding learning disabilities: International and multidisciplinary views. New York: Plenum. Goldstein, D. (1999) The starvation of our mental healthcare system. Unpublished Manuscript.
David B. Goldstein, Ph.D., Mind-Steps, 6401 Poplar Avenue, Suite 306, Memphis, TN 38119. E-mail: DavidGoldstein@mind-steps.com |
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