Opening the door to collaborative practice

Teacher Education Quarterly, Fall 1999 by Karasoff, Patricia

There is no doubt that this is the decade of collaboration. In an environment of rapidly changing public policies, integrated services are emerging at a time when state, county, and local education and human service agencies are struggling to serve their communities with scarce resources. Joining forces to establish integrated and collaborative services models is a viable approach for many communities and education, health, and human service providers in the 1990s. These newly-- configured service systems are designed to improve outcomes for children and youth, their families, and their communities.

These models strive to reduce fragmentation and duplication by delivering a broad range of education, health, social services, and mental health services in a coordinated system on or near school sites. These programs are characterized by a service system that strives to be flexible, prevention-oriented, family- and child-- centered, comprehensive, and holistic (Melaville & Blank, 1991; Schorr, 1989; Ad Hoc Working Group on Integrated Services, 1994).

In California, many counties are engaged in collaborative reform initiatives. These efforts focus on development of county-wide interagency councils and, ultimately, strategic plans for comprehensive integrated services for children and family services. Many of California's school-linked efforts are supported in part by the state Healthy Start Support Services Act of 1992, which provides funding to "school districts and county offices of education and consortia to create innovative, collaborative partnerships to meet the health, mental health, social service, and academic support needs of low-income children, youth, and their families." This initiative has provided funding to more than 800 schools in California, delivering services to more than 600,000 students and their families. Many other states have service integration initiatives, including: New Jersey, Kentucky, Connecticut, Kansas, North Carolina, Missouri, Georgia, Washington, Maryland, and Michigan. Within each of these states, hundreds of county and local collaboratives are being designed to meet their communities' needs. The service providers and policymakers within these states are attempting to craft new responses to increasingly complex problems with fewer resources. They must change the status quo and acknowledge the shortcomings of the past in order to design systems that are integrated and collaborative. The process of altering policies and practices to support change is challenging to all involved. Moving from a crisis orientation to a preventive one, from a specialist to a team approach, from a deficit orientation to a strength-based approach-all these approaches require a paradigm shift. This shift takes time and, like all change, can be a difficult process.

These interagency efforts require that educators, social workers, nurses, psychologists, and other human service providers work collaboratively, which for many professionals is antithetical to their training and experience. Collaboration is hard work, particularly in the bureaucracy of education and human services agencies. The work that occurs across agency and disciplinary lines is new and often difficult due to long-standing differences in agency culture, education, philosophy, and professional "turf." This situation creates a gap for most professionals between the training received and the skills necessary to work in these collaborative service systems.

This gap is precisely what the Integrated Services Specialist Program (ISSP) at San Francisco State University is designed to address. Almost all practitioners, administrators, and policymakers were prepared in highly specialized, isolated, and discipline-specific programs in postsecondary settings. Therefore, as these new service delivery systems are emerging, the provision of interprofessional education to human service professionals and educators is urgently needed at institutions of higher education (IHEs). In fact, in a report on integrated and collaborative services published by the Office of Education Research and Improvement and the American Educational Research Association (1995), interprofessional education was identified as one of the major components of this reform initiative. The report underscored the importance of leadership with the skills needed to implement integrated and collaborative services, as well as the urgent need for program development in this area.

A comprehensive review of the literature indicates that there is a growing movement emerging across the country to revise and develop university-based training programs to be more responsive to systems reform (Lawson & Hooper-- Briar, 1994; Jivanjee, Moore, Schultze & Friesen, 1995; Gardner et al, 1998). Results of a survey indicate that approximately 50 interprofessional/interdisciplinary training programs exist nationally. Most of these university-based programs are less than four years old (Jivanjee et al., 1995). Like the ISS program, these programs are interdisciplinary and generally focus on developing skills that enable professionals to provide services through collaborative partnerships by schools and public and private agencies. Generally, the curricula emphasize acquiring practice skills that are strength-based, prevention-oriented, child-centered, family-focused, and culturally responsive (Casto, 1994; Knapp, Barnard, Brandon, Gehrke, Smith & Teather, 1994; Lawson & Hooper-Briar, 1994; Wilson, Karasoff & Nolan, 1994; Tellez & Schick, 1994; Jivanjee et al., 1995; Brandon & Meuter, 1995 ; Gardner, George, Gil de Gibaja, Jorden-March, Lind, McCrosky, Taylor, Taylor-Dinwiddie, & Zlotnik, 1998; McCrosky, in press; Smith, Culbert, & Deiro, in press).