Experiences in Establishing School Consultation

The author explores issues faced by clinicians trained in child guidance as they adapt their skills to the more broadly based orientation of school mental health consultation. He cites examples showing how establishment and maintenance of such services were hindered by the consultee's resistance, the consultant's over- or underinvolvement, and professional narcissism. The author hopes his experience will help others to cope with the disparities between theory and practice in consultation and to mitigate existing polarization of attitudes about it.