Author: Jaqui Richard
Last saved by: Sue Sheridan-Statz
Company: TC - University of Nebraska

Conjoint Problem Identification Interview (CPII)
		
Child's Name:_____________________________		Date:  ___________

Parent's Name:____________________________		Age:  ____________

Teacher's Name: ___________________________		Grade: ___________

School: __________________________________ 

Consultant's Name: _________________________

Consultant Note:  The goals of the CPII are to:

Behavioral goals:						

•	Identify and define child's needs in behavioral terms.

•	Identify initial needs of behavior in terms of antecedent, situation, and consequent conditions across settings.	

•	Establish a procedure to collect baseline data across settings.

Relationship building goals:
 
•	Establish/improve a working relationship between parents and teacher, and between the consultant and consultees.

•	Validate shared goals of supporting the child.

•	Identify the strengths of the child, family and school.

•	Increase communication and knowledge regarding the child, goals, concerns, and culture of family and school.

Conjoint Problem Identification Interview (CPII)
			
The consultant should question and/or comment on all of the following:

GREETING: 

GENERAL STATEMENT TO OPEN CONSULTATION MEETING

There are several goals for today’s meeting.  One of the goals is to begin identifying some initial concerns. We will identify some of ( child’s name )’s strengths and areas of need.  We will discuss some events that might relate to his/her success, and develop a plan to collect more information.  Another important goal for this meeting will be to develop working relationships with each other and try to understand everyone’s point of view.  These will be very important as we work together, so please let us know your thoughts and ideas, and whether you agree or disagree with what is being discussed.  Also feel free to stop and ask questions at any time.

STRENGTHS IDENTIFICATION

Let's start by identifying some of his/her strengths.  This is important for us to know because we can use the information to address concerns.  What are some of  ( child's name )'s strengths?  What is he/she good at?  What does he/she like to do?

Home:

School:

BEHAVIOR PERSPECTIVES

We might all have different points of view about what success looks like for ( child’s name ), so it will be helpful to talk about your expectations for your child/ student within your family and in the classroom.  Tell us what your expectations are for ( child’s name ).  Where would you like to see ( child's name ) in a year?  It may be helpful to ask what the parents and teachers find important to teach their child/ student within the environment of the home/ school community.

Home:

School:

NEEDS IDENTIFICATION

What are some of your concerns for ____________?  What is important to you and your 
family?  What is important in the classroom for ___________ to be successful?

Home:

School:

* Parents’ and teachers’ concerns can be summarized by organizing them into some general areas, such as social, academic, or behavioral. 

BEHAVIOR PRIORITIZATION

It will be very important to focus on one specific area to make the process more manageable and maximize opportunities for ( child's name ) to be more successful.  We discussed several areas of need, including ( list concerns ).  Where would be a good place to start?  

Home:

School:

* This is a good opportunity to both assess and validate unique perspectives across home and school, and also to begin building a bridge for shared goals and cross-setting similarities.

BEHAVIOR SPECIFICATION

We need to get an understanding of specifically what happens when ( child's name ) is (consultee's concern).  Tell us what you mean by…  Think of the last time ( child's name ) engaged in the behavior, what did it look like?  If I were in the classroom or home, what would I see?  

Home:

School:	
	
TARGET BEHAVIOR DEFINITION

In order to be clear and certain that we’re all talking about the same thing, it will be helpful to define exactly what we mean by ( target behavior ).  What would be a good definition of (target behavior )? (i.e., identify key components that the consultees shared). 

** Summarize child’s strengths.  Also summarize concerns in precise, observable terms.  Write down definition on a piece of paper and place in a position for all to see.  Refer to the written definition often, especially when blank lines occur on forms [e.g., __(______)_____].

BEHAVIOR SETTING 

a.	Now that we have determined the most important concern, let's take a look at when it is most likely to happen. Where does the child display ( target behavior )?  Please provide some specific examples of where ( target behavior ) occurs-- If the consultee responds with a general setting, such as “ in the classroom” or “at home,” ask for a more specific location. If academic, in which areas does the child seem to experience the most difficulty?

Home:

School:

b.  It will be very helpful for us to focus on one setting in which to start. Which is the most important setting to focus on initially?  Which of the settings at school is most important?  Which of the settings at home is most important? -- Establish one setting priority at home and one at school

Home:

School:

 

 EXISTING PROCEDURES 

As we have been talking, it is clear that you have all been investing a lot of time and energy to help ________ be more successful.  Let’s talk about what you have already tried. (e.g., if academic need, this may include the curriculum or instruction; if behavioral, it may include discipline procedures or rules in place).   

Home:	

School:

It is helpful to share these strategies because we can learn from each other, and we may be able to use them later when we begin discussing a consistent plan to use across home and school.  

RATIONALE AND SPECIFICATION OF DATA COLLECTION PROCEDURES 

a.  It will be very helpful to watch ( child’s behavior ) for a while to get a clear sense of what is occurring. This will help us key in on some important facts that we may have missed, and also help us keep track of the progress that ( child’s name ) makes. 
										
b. We should select a specific time, place, and procedure for keeping track of 
( target behavior )  now and throughout this whole process.  It will also be helpful to write down things that happen before, during, or after, or that might be related to the problem. Monitoring should occur in the same place where we would like to make some changes once we develop our plan.  That way, we’ll be able to measure if our plan is actually working. We’ve been discussing ( target setting ). What would be a simple way for you to keep track of ( target behavior ) in that setting?  Provide consultees with charts on which data can be recorded.

| Home | School

What will be recorded?  
( target behavior )

Where will recording occur? | |
How will it be recorded? | |
When will recording begin? | |
	
Summarize/Validate Data Collection Procedures
NEXT APPOINTMENT

When can we all get together again to discuss what you found and determine where to go from here?

CLOSING 

Remind consultees that you will call them to see how things are going with data collection.  It may be helpful to establish a time to do this.  Also, let them know that they are free to call you with questions, concerns, or problems.  Be sure that phone numbers and e-mail addresses are exchanged.

Revised 7/24/03

Conjoint Problem Analysis Interview (CPAI)

Child's Name:	_______________________________		Date: __________ 

Parent's Name: _______________________________		Age:  __________

Teacher's Name:  _____________________________		Grade: _________

School: ____________________________________						

Consultant's Name: ___________________________

Consultant's Note: The goals of the CPAI are to:

Behavioral goals:

•	Evaluate baseline data across settings.

•	Discuss and reach agreement on a goal for behavior change across settings.

•	Re-examine the needs of behavior in terms of antecedent, consequent, and sequential conditions across settings (including events that are functionally related, but are separated by time and context to the target behavior).

•	Collaboratively develop an intervention plan to address the target need across home and school settings.

•	Reaffirm data collection procedures.

Relationship building goals:

•	Build partnerships between across settings through inclusive language (i.e. we, our, etc.)

•	Elicit and validate parents' and teachers' perspectives of the target concern.

•	Foster an environment that facilitates "give-and-take" communication across settings. 

•	Promote joint decision-making and shared responsibility for plan development.

Conjoint Problem Analysis Interview (CPAI)

GREETING 

GENERAL STATEMENT TO OPEN CONSULTATION MEETING  

There are several goals for today's meeting.  First, we want to discuss additional information about our concerns for (child's name).  We also want to work together to develop a consistent plan to help (child's name) be more successful at home and school.  It will be very important to develop the plan together so it will work in your home or classroom, so please share your thoughts and ideas.  Also, feel free to stop and ask questions at any time.  

GENERAL STATEMENT REGARDING BEHAVIOR AND DATA GATHERING  
Use definition sheet developed in CPII.  Restate the target behavior and definition for the group.  How did keeping track of the behavior work for you in the classroom or at home? Let's look at look at the information you gathered.

Home:

School:
						
BEHAVIOR STRENGTH ACROSS SETTINGS

According to the information you gathered, it looks like we have a good picture of what is happening in your classroom/home.  Over the past week, you saw (child's name) display the (target concern) ___ times. 

Home:

School:

BEHAVIOR GOAL

We have talked about some changes that would help (child's name) be more successful.  It will be helpful to get an idea for what our specific goal is for (child’s name).  This will help ensure that we are making progress in the right direction. At first, it is helpful to set a goal that (child's name) can reach, so he/she experiences some success or accomplishment about him/herself.  What would be a reasonable goal for (child's name) behavior at home/at school?   
* Note: The goal should be directly related to the target behavior and the baseline data.  It should be set at a level that is easily achievable.

Home:

School:
FUNCTIONAL ASSESSMENT               

In our last meeting, we talked a little about what might have happened before, after, and while (target behavior) occurs. Now that we have had a chance to watch what actually happens at home and school, we can discuss important observations you have had.  This will help us to get a good idea about what leads up to (target behavior), the typical outcome, and other patterns that might be occurring.  If we can pinpoint these things, we may be able to make some important changes.

a.  Describe what happens before (target behavior) occurs.  What do you notice that leads up to (target behavior)?  Some things may have occurred outside of the direct observation of the parent and teacher.  Ask about the possibility of such events, such as noteworthy things that may have happened in other settings prior to the behavior occurring in the target setting or things that happened before school or before returning home on problem days.  Refer to baseline data!
						 
	Home:

	School:

b.  What did you notice after ( target behavior )?  What are some typical consequences? These could include actions taken by adults, response of peers, or actions that may have an effect on the child’s future behavior. They can be things (or consequences) that happen immediately after ( target behavior ), or they can occur minutes or even hours later.

	Home:

	School:

c. What else was happening when (target behavior) occurred?  What patterns did you notice, such as persons who were present, types of situations, day of the week, time of day?

	Home:

	School: 			

Summarize/Validate Behavior Strength/Conditions

BEHAVIOR INTERPRETATION

We’ve talked about what happens before and after (target behavior) occurs.  We also discussed things occurring in the environment that might be related, such as..... (summarize conditions and functions if necessary).  The more we understand these events or situations, the better able we’ll be to develop a plan that can address them.  It will also help us pinpoint things that are most related to the concern and that we can change.  Based on what we have just discussed, what do you think might be some of the main reasons that ( child's name ) displayed that behavior?  It sounds like the behavior might also be related to...(i.e., wanting attention; avoiding work; not understanding the assignments; needing more structure or guidance; or lacking necessary skills to perform the task). 
			
Home:

School:						

PLAN DEVELOPMENT ACROSS HOME AND SCHOOL

You have both/all invested a lot of time and energy to help (child's name) be more successful.  Through working together, we have a much better understanding of events that trigger or affect (child's name) behavior as well as some of his/her strengths we can use to motivate him/her.  We have also been able to share our points of view about why the (target behavior) behavior is occurring.  How can we use our understanding to develop a plan to help (child's name) be more successful?  What can we try to at both home and school to reach our goal of (restate goal)? -- Tie in/build on child's strengths/hobbies in plan development.  Refer back to ABC's if needed. 

Home:

School:

Summarize/Validate Plan Across Settings   

*** Write down a summary of steps on a consultation plan worksheet for parents and teachers.

DATA RECORDING PROCEDURES 

It would be very helpful if we could continue to keep track of (target behavior) just as we did before.  This will keep us informed about how (child’s name) is doing and if progress is being made.  It’s important that procedures are identical to those used previously.  Can we continue the same recording procedure as before?

| Home | School

What will be recorded?  
( target behavior )

Where will recording occur? | |
How will it be recorded? | |
When will recording begin? | |

*** Provide data collection sheets to consultees	

Summarize/Validate Data Collection Procedures

NEXT APPOINTMENT

When can we all get together again to discuss how the plan is going and determine where to go from here?

CLOSING 

Remind consultees that you will call them to see how things are going with the plan.  It may be helpful to establish a time to do this.  Also, let them know that they are free to call you with questions, concerns, or problems.  Be sure that phone numbers and e-mail addresses are exchanged.

Revised 7/24/03

Conjoint Treatment Evaluation Interview (CTEI)

Child's Name: _____________________________________	Date: ____________

Parent's Name: ____________________________________	Age: ____________

Teacher's Name: ___________________________________	Grade: ___________

School: __________________________________________

Consultant's Name: _________________________________

Consultant's Note: The goals of the CTEI are to:

Behavioral goals:

•	Determine if the goals of consultation have been obtained across settings.

•	Evaluate the effectiveness of the treatment plan across settings.

•	Discuss strategies and tactics regarding the continuation, modification, or termination of the treatment plan.

•	Schedule additional interviews if necessary, or terminate consultation.

Relationship building goals:

•	Continue to promote open communication and problem-solving across the home and school settings.

•	Reinforce joint efforts in addressing concerns

•	Assess parents' and teachers' perception of acceptability of the CBC model and the treatment plan.

•	Highlight the consultees' skills in addressing future concerns for the child.

•	Establish means for parents and teachers to continue to partner in the future.

Conjoint Treatment Evaluation Interview (CTEI)

GREETING

GENERAL STATEMENT TO OPEN CONSULTATION MEETING

There are several goals for today's meeting.  We will evaluate (_child's name )'s progress and the effectiveness of the plan.  If the information you've collected shows that progress is being made, we can discuss options for gradually discontinuing the plan.  If  (_child's name_) has not met the goals that we set for him/her, we will change the plan to make it more effective in helping (_child's name_) be successful. 

GENERAL PROCEDURES AND OUTCOME
											
Restate target behavior and plan.  How did things go with the plan? 

Home:

School:						

GOAL ATTAINMENT ACROSS SETTINGS

At the beginning of this process we set a goal of    (state goal).  Let’s take a look at the information you collected to see if this goal was met.  Collect data sheets or record data here.

Home:

School:						
						
IF GOALS HAVE NOT BEEN ATTAINED, DISCUSS:

PLAN MODIFICATIONS

How can we modify the plan so it is more effective in helping ( child's name ) be more successful?  What parts of the plan were most useful in your classroom / at home?  Were some parts of the plan didn't fit into your home / school routine? Identify which components of the plan should be retained and which should be changed.  Emphasize the skills the consultees have demonstrated in making the plan successful.

Home:

School:

** Make plan modifications or create new plan and provide a new treatment worksheet and data collection sheets to consultees.
NEXT APPOINTMENT

When can we meet again to discuss the effectiveness of our new or modified plan?  

IF GOALS HAVE BEEN ATTAINED, DISCUSS:

POST-IMPLEMENTATION PLANNING

At this point we need to decide how to proceed.  Should we leave the plan in effect for a while longer?

Home:

School:

PROCEDURES FOR GENERALIZATION/MAINTENANCE

We want to make sure that (child's name) progress continues, and that he/she can show similar improvements in other situations, or with other behaviors. What can we do to make sure that the behavior change continues over time?  For example, sometimes gradually removing the plan helps maintain the positive changes.

If applicable, ask:  Could the plan that we developed be used with other behavioral or academic concerns you might have with (child's name)?   

If applicable, ask:  How can we encourage the child to display these behavior changes in other settings or with other behaviors? 

PLAN EFFECTIVENESS ACROSS SETTINGS

It is important to know whether the plan we developed helped ( child's name ) be successful and meet the goal we set or if something else was responsible for his/her progress. Do you think the plan we developed was responsible for the (child's name)'s success?  What else do you think might have caused the change?
	
Home:  

School:

EXTERNAL VALIDITY OF PLAN

One goal of the process is to ensure that everybody feels comfortable addressing future concerns for (child’s name) or other students/children.  Some of the ideas that we have come up with and you have used over the past few weeks include (e.g., positive verbal praise, open and regular communication across home and school).  How comfortable are you using some of these ideas if (child's name) has other needs in the future?  Do you think the plan we created would work with another child in your classroom/home with similar difficulties?

Home:

School:

FUTURE PARTERNING AND PROBLEM SOLVING
	
Another goal of this process is to join parents and teachers together and generate some ideas to address current and future concerns. How comfortable are you working together to address concerns for (child's name) in the future?  How comfortable are you using a similar problem solving approach together in the future?

Home:

School:

SOCIAL VALIDITY OF THE PLAN
	
It will also be beneficial to get your point of view regarding the helpfulness of the problem solving approach we used to better meet (child's name)'s needs.  How well did the plan we developed fit into your classroom/home schedule and routine?  How satisfied are you with the problem-solving approach?  

Home:

School:

FOLLOW-UP ASSESSMENT PROCEDURES

We have been keeping track of progress all the way through this process.  This same system can be used to ensure that positive changes continue.  For example, you might track the behavior once a week or once every other week.  Provide consultees with data collection sheets and treatment plan worksheets.

NEED FOR FUTURE INTERVIEWS

Would you like to meet again to check the child's progress?  What might be some informal ways that you can check on (child's name)'s progress at home and at school?

Home:

School:

TERMINATION OF CONSULTATION (if appropriate)

** Inform consultees that they are free to contact you with concerns, problems or questions in the future.   

 

Revised 7/24/03