World*Go*Round, Vol. 31, No. 2, March, 2004

Letter from the President 

    In my last Letter from the President (January 2004) I posed an uncomfortable question: do school psychologists (SPs) do more harm than good? In summary, I argued that the tendency for SPs to adopt a medical model in their professional practice resulted in them focusing their attention on what was "wrong" with the child, to place too much reliance on individually administered psychometric tests and to overlook factors within the child’s environment which could be of far more relevance to understanding the problem and to planning intervention. This way of working can have the unfortunate consequence of placing the "blame" on the child and to exonerate others who live and work with him or her. As a result recommendations for intervention can place attention on the child and not on approaches that might help the school or family change the ways in which they function.
     In my experience SPs who work in this way are privately quite uncomfortable about their practice. During informal conversations they may often acknowledge that a child’s problem lies outside his/her particular cognitive profile or self esteem and that the key issue is the poor quality of teaching and management in the school and the chaotic relationships in the family. However they apologetically acknowledge that their report has only focused on the within child problems highlighted by the results of the psychometric assessment; school and family problems do not feature.
Why is it that we sometimes work in this way? Whatever happened to scientific objectivity and to openly expressed independent professional judgement? One way to address this question is to ask: – Who employs the school psychologist? For, above all else, there are extremely good reasons why psychologists do not want to upset their employer and these reasons may not always be in the best interest of the child. I can illustrate this with the following two examples that I have encountered in my professional experience.
     The first of these relates to an SP working for a local educational authority (LEA) in the UK – by far the most common employer of SPs. He had assessed a child and felt strongly that her needs could best be met if she remained in her local mainstream school with additional resources – speech and language therapy, support teacher and teaching assistant (para-professional). The mainstream school fully agreed with this recommendation. The local authority, however, took the view that the child should be placed in a local special school that had vacancies and which, in their view, could meet the child’s need. The SP’s report, recommending the mainstream placement, was rejected by the LEA and the SP was instructed to rewrite the report recommending the special school. After some uncomfortable discussions with the family and with his professional colleagues, the SP reluctantly agreed to accede to the LEA’s request. After all there was a vacancy in the special school, the LEA had no money to fund the mainstream place and a long and protracted argument would result in no services being provided to help the child. Hence in this case the SP was working to meet the needs of the LEA to keep within its budget and not the necessarily the needs of the child for a good education. 
     In the second example the SP undertook a private assessment, paid for by the parents, who believed that their child was dyslexic. They wanted the diagnosis of dyslexia so that they could lobby their child’s private school for additional resources and the examination board for special arrangements to be made for their son in his forthcoming public examinations. In this context the SP felt under considerable pressure to arrive at the diagnosis of dyslexia and to write the appropriate report when, on private reflection, she did not consider that the child’s problems were all that "dyslexic" in nature.
     These two examples paint a pretty bleak picture of SP practice and raise a number of uncomfortable ethical issues. After all we all enter the profession because we would like to help children and families and we believe that our academic knowledge, professional training and experience provides us with a set of skills and abilities that gives us a unique insight into understanding children and the contexts in which they live and work. However we end up being extremely cautious; we shy away from challenging our employers and are prepared to compromise our independent professional judgement so as to maintain their trust in us. It is certainly not uncommon for LEAs in the UK to request that the SP changes a report so as to meet their requirements. Faced with this request it is hard for SPs to maintain their stance as, apart from anything else, keeping good relationships with employers may have an impact on promotion prospects. In addition it is also extremely difficult to disappoint a parent, who has requested a private assessment, and to come up with an alternative opinion to the one that was sought. It is also ironic that employers, whether LEAs or parents, often champion the independent expertise of the SPs that they employ. However when faced with an opinion from the SP with which they disagree, rather than accept the opinion, they may question the competence of the SP and request an alternative opinion and go on doing so until they find a professional who agrees with them!
     So can we ever arrive at a scenario in which SPs can work truly independently and not feel under pressure to come up with a "diagnosis" that meets the needs of the employer rather than the child?
Consider, for a moment, how the work of an SP might change if it were the child who was the employer. Would we still uses phrases in our report emphasising the child’s "serious emotional disturbance" or his/her "unstable personality." Perhaps, instead, we would comment on the incompetence of the teacher, or his/her problems in teaching literacy, and to the totally inadequate LEA services and resources. Quite a thought! However this would just be substituting one problem for another and I am not suggesting that, even if it were possible, the child should become the employer.
     There are no easy solutions to the uncomfortable issues raised in this letter. Indeed they are central to the theme of this year’s colloquium in Exeter "School Psychologists: Whose Needs Whose Benefits?" This theme forces us to consider these and other difficult questions that are central to EP practice. In this letter I am suggesting that our work may serve to benefit our employers rather that children. If this is the case we, as school psychologists, must strive to challenge our existing ways of working so that we can find alternatives that maintain our independence as psychologists and which bring demonstrable benefits to children and young people in this uncertain world. I am confident that the keynote speakers, the symposia, workshops, papers and posters at the Exeter Colloquium will provide the necessarily stimulus to take the profession forward.

Peter Farrell