Matters for a School to Consider in Developing its Systems for
Problem Identification, Triage, Referral, and Case Management

Problem identification

(a) Problems may be identified by anyone (staff, parent, student).
(b) There should be an Identification Form that anyone can access and fill out.
(c) There must be an easily accessible place for people to turn in forms.
(d) All stakeholders must be informed regarding the availability of forms, where to turn them in, and what will happen after they do so.

Triage processing

(a) Each day the submitted forms must be reviewed, sorted, and directed to appropriate resources by a designated and trained triage processor. Several individuals can share this task; for example, different persons can do it on a specific day or for specified weeks.
(b) After the sorting is done, the triage processor should send a Status Information Form to the person who identified the problem (assuming it was not a self-referral).

Clients directed to resources or for further problem analysis and recommendations

(a) For basic necessities of daily living (e.g., food, clothing, etc.), the triage processor should provide information about resources either through the person who identified the problem or directly to the student/family in need.
(b) If the problem requires a few sessions of immediate counseling to help a student/ family through a crisis, the triage processor should send the form to the person who makes assignments to on-site counselors.
(c) The forms for all others are directed to a small triage "team" (1-3 trained professionals) for further analysis and recommendations. (If there is a large case load, several teams might be put into operation.) Members of such a team may not have to meet on all cases; some could be reviewed independently with recommendations made and passed on the next reviewer for validation. In complex cases, however, not only might a team meeting be indicated, it may be necessary to gather more information from involved parties (e.g., teacher, parent, student).

Interventions to ensure recommendations and referrals are pursued appropriately

(a) In many cases, prereferral interventions should be recommended. This means a site must be equipped to implement and monitor the impact of such recommendations.
(b) When students/families are referred for health and social services, procedures should be established to facilitate motivation and ability for follow-through. Case management should be designed to determine follow-through, coordination, impact, and possible need for additional referrals.
(c) Referrals to assess the need for special or compensatory education often are delayed because of a waiting list. Back logs should be monitored and arrangements made to catch-up (e.g., by organizing enough released time to do the assessments and case reviews).

Case monitoring/management

(a) Some situations require only a limited form of case monitoring (e.g., to ensure follow-through). A system must be developed for assigning case monitors as needed. Aides and paraprofessionals often can be trained to for this function.
(b) Other situations require intensive management by specially trained professionals to (a) ensure interventions are coordinated/integrated and appropriate, (b) continue problem analysis and determine whether appropriate progress is made, (c) determine whether additional assistance is needed, and so forth. There are many models for intensive case management. For example, one common approach is to assign the responsibility to the professional who has the greatest involvement (or best relationship) with the student/family.
(c) One key and often neglected function of the case monitor/manager is to provide appropriate status updates to all parties who should be kept informed.

Examples of the Type of Facts Sheets
that May be of Use in Your Work

A Few References on the Basics of Helping and Counseling

Basch, M. (1995). Doing brief psychotherapy. New York: Basic Books.

Brown, D.T. & Prout, H.T. (Eds.) (1989). Counseling and psychotherapy with children and adolescents: Theory and practice for school and clinic settings (2nd ed.). Brandon, VT: CPPC.

Gilliland, B.E., & James, R.K. (1993). Crisis intervention strategies. (2nd ed.). Pacific Grove, CA: Brooks/Cole.

Hames, C.C. & Joseph, D.H. (1986). Basic concepts of helping: A holistic approach. Norwalk, CT: Appleton-Century-Crofts.

Lauver, P. & Harvey, D.R. (1997). The practical counselor: Elements of effective helping. Pacific Grove, CA: Brooks/Cole.

Martin, D.G. & Moore, A.D. (1995). First steps in the art of intervention: A guidebook for trainee in the helping professions. Pacific Grove, CA: Brooks/Cole.

Meier, S.T. & Davis, S.R. (1997). The elements of counseling (3rd ed.) Pacific Grove, CA: Brooks/Cole.

Okun, B.F. (1997). Effective helping: Interviewing and counseling techniques (5th ed.). Pacific Grove, CA: Brooks/Cole.

Orton, G.L. (1997). Strategies for counseling with children and their parents. Pacific Grove, CA: Brooks/Cole.

Palamatier, L. Crisis counseling: Grades K-9. Bristol, PA: Taylor & Francis.

Test Questions -- Unit II: Section B

(1) The immediate objective of psychological first-aid is to

___(a) eliminate the fear individuals experience during and in the immediate aftermath of a crisis
___(b) help individuals deal with troubling psychological reactions during and in the immediate aftermath of a crisis
___(c) tell students counseling will be made available to them
___(d) all of the above

(2) Three phases of crisis intervention are (a) managing the situation, (b) mobilizing support, and (c) following-up.

___True ___False

(3) The following list mixes together general activities related to providing psychosocial guidance and support with specific things that can be done to facilitate student communication in a psychosocial counseling situation.

Put a + before the items that describe general activities related to providing psychosocial guidance and support.

___(a) advising
___(b) providing advocacy and protection
___(c) responding with empathy, warmth, nurturance, and positive regard
___(d) providing support for transitions
___(e) listening with interest
___(f) creating a private space and a climate where the student can feel it is safe to talk
___(g) clarifying the role and value of keeping things confidential
___(h) encouraging the student to take the lead
___(i) providing mediation and conflict resolution
___(j) promoting and fostering opportunities for social and emotional development
___(k) being a liaison between school and home
___(l) being a liaison between school and other professionals serving a student