TPC Journal-Vol 9 Issue 3-FULL

The Professional Counselor | Volume 9, Issue 3 227 In supervision, the relationship rests on a de facto hierarchy in which supervisors take on ultimate responsibility for ensuring the standard of care is being met and utilize consultation as one of their supervisory roles (Bernard & Goodyear, 2018). In interprofessional collaboration, the duty of care is co-equal across the specific roles and functions of the collaborating care providers. In consultation, on the other hand, the duty of care rests with the primary provider, though consultants are obligated to act ethically within the consultation relationship. These general comparisons between consultation, supervision, and collaboration, however, are not rigid and the skill sets, responsibilities, and best practice guidelines governing a specific relationship between two professionals may share elements of each depending on context. Developing competency in each area appears to share a common theme, though counselors and other helping professionals should be intentional about practicing through the lens of a coherent, guiding framework when engaging in supervision, consultation, or interprofessional collaboration with other professionals and on behalf of the clients and students being served. Although recent scholarship on supervision and collaboration can be found supporting the efficacy of each intervention, recent scholarship on consultation in the professional counseling literature is largely conceptual and continues to lack robust empirical grounding. In our study, we addressed these gaps by obtaining further validation of a consultation skills instrument, the Consultation Skills Scale (CSS; Moe, Perera-Diltz, & Sparkman-Key, 2018). The Need for Counseling-Specific Consultation Research Given the commonality of peer consultation and collaboration across the various health care and allied fields (Newman & Ingraham, 2017), it is imperative to consider the research base on the apparent efficacy of consultation as an adjunctive practice. Research on consultation is similar to research on clinical supervision in counseling, with outcome-based research focusing on the effect consultation has on the consultee as opposed to clients or organizational contexts. The main evidence-based outcome of consultation appears to be improvement in treatment integrity or fidelity, with this effect being documented with consultees working with both youth (Brennan, Bradley, Allen, & Perry, 2008) and adults (Collier-Meek & Sanetti, 2014). The improvement of practitioners’ treatment fidelity attributable to the effect of consultation has been documented in manualized, experimental research (Ruble et al., 2018), and with single-subject design research (Smith, Eichler, Norman, & Smith, 2015). As supervision is only mandated for counselors during distinct periods early in their training, Ruble et al. (2018) suggested that consultation as a mode of intervention is ideal for diffusing innovation and evidence-based practice throughout counselors’ career development. For example, promising results have been generated in the critical area of child and adolescent behavioral and mental health consultation, in which consultants are viewed as enhancing the standard of care being provided by another primary therapist (Vuyk, Sprague- Jones, & Reed, 2016). The ability to diffuse affirmation of lesbian, gay, bisexual, transgender, and other gender- and sexuality-diverse people as the standard of care in mental health work also appears to be supported through consultation practice (Moe et al., 2018). In a comprehensive meta-synthesis of qualitative studies sharing a focus on consultation processes, five cross-cutting themes were identified related to best practice in consultation implementation (Newman et al., 2017). The five themes were: (a) taking system-level factors into consideration; (b) providing consultation in a coherent and consistent manner; (c) creating space for consultee voice, social-emotional support, and learning; (d) striving for ecologically valid and culturally competent consultation practice; and (e) obtaining sufficient training to apply relational process skills before engaging in consultation (Newman et al., 2017). These themes are echoed within both classic and recent scholarship on consultation and underscore the need for training in consultation as a distinct intervention. What training is needed specifically, and how to assess training in consultation, is an overlooked area in the professional counseling and counselor education literature base. As an under-