To ensure that a SchoolKit Clinic flows smoothly, that the right style of communication is established from the outset, and that everyone’s time is used as efficiently and effectively as possible, it is important that roles and responsibilities are clear and understood from the very beginning of the clinic.
Typically, it is the school principal (as host) and the senior medical consultant (often a paediatrician) who lead the SchoolKit Clinic and take responsibility for running it. The roles of chairperson and co-chair are useful to consider and either leader may potentially take either role. Generally, the senior medical consultant would take the role of chairperson, with the school principal as co-chair.
Strategically it might be better in some instances, however, for these roles to be reversed, for example, where a family has had a bad experience with a doctor in the past and has a good relationship of trust with the school.
During the SchoolKit Clinic the chairperson will take responsibility for:
- Opening the clinic and welcoming all participants;
- Introducing themselves and inviting everyone else to do the same (providing a list of participants and their role can be useful);
- Outlining the aims and objectives of the clinic (providing an agenda can be useful);
- Explaining how the clinic will work – from a discussion of where things are now to agreement on what to do next;
- Opening discussion and inviting contributions from participants;
- Keeping discussion on track and relevant to the agenda;
- Ensuring progress is made in a timely manner;
- Being alert to and managing any problems between participants or in the flow of discussion as they come up;
- Summarising decisions at the conclusion of the clinic;
- Thanking participants and bringing the clinic to a close.
The co-chair will also play an active role in facilitating and encouraging discussion. The co-chair may take particular responsibility for keeping an eye on participants, especially the parents or carer and family members, to track their reactions and responses to what is being said and decided in the clinic.
Close attention needs to be paid throughout to non-verbal communication. It may be agreed that it is the co-chair’s responsibility to halt conversation to adjust the way things are developing. This will be especially relevant if distress on the part of a parent or carer becomes apparent or conflict emerges between clinic participants.
The roles of chairperson and co-chair are complementary and interrelated. In practice, they provide a vivid demonstration to the family and all other participants of how professionals from different sectors can work in partnership to achieve shared goals.
Over time, after a school principal and senior medical consultant have lead many SchoolKit Clinics together, the balance and division of roles may shift and develop organically of its own accord. As this happens, and the professional relationship between them develops, the clinic process can only become stronger and stronger.
Establishing clear leadership roles is especially important when establishing SchoolKit Clinics for new school clinic teams (i.e. a new partnership of education, health and other professionals) and in new schools. Clear leadership roles for the facilitation of a clinic will establish a good collaborative process from the start, ensuring optimal outcomes and avoiding anyone stepping on anyone else’s toes.
Accommodating Complex Family Issues
A meeting between the school principal and senior medical consultant prior to the SchoolKit Clinic getting underway is essential to establish and review their leadership roles and to highlight any specific information about the child, family or other agencies that may need consideration. This is particularly important where there are complex issues impacting relationships between family members.
Key matters for consideration include an awareness of, and respect for, hierarchy within the family and organisations present. Consideration is also given to safety, comfort and other complex relationship issues that may play out within the clinic.
The following additional issues are worth consideration. An understanding of how they might apply should be established before the clinic, where possible. In many cases the school is likely to be already aware of the issues relevant for each family.
- Are there significant family relationship issues, including parental separation, divorce or conflict? Each parent brings different resources to their child and optimising the inclusion of both parents, especially in contexts of marital conflict and divorce is important. This is in keeping with legislation – both parents have responsibility for their child even after divorce, unless there are specific orders otherwise.
- Have the parents’ preferences and thoughts been clarified on whether they are seen together or separately?
- How might the chairperson structure the session and invite the parents or carer to seat themselves in a way that is appropriate and most comfortable for them?
- How may a marginalised parent be included in a respectful way?
- How may other members of the extended family (for example, a grandparent, or a sibling), who have significant influence but do not attend the clinic, be considered in the development of strategies for caring for the child and their family?
- Has parental conflict ever escalated to domestic violence? Are there orders in place (for example, an AVO) which may forbid the parents attending a school clinic together? (Put a copy of such orders on file if possible so that it is available to help guide safe processes.)
- Are there any parent-child issues that also warrant similar consideration of safety and session structuring? Has conflict escalated to violence in the past? It might be best if they are seen separately, or only briefly together.
- Are there cultural issues which may impact on hierarchy and seating? With a family from a patriarchal culture, for example, it may be appropriate for the senior male in the family to be honoured as the spokesperson.
- Are there issues about access and mobility for any participants? Choosing a room and seating that can permit wheelchair access may be necessary.
- What previous relationships need to be taken into consideration? Most especially, is there any pre-existing conflict between a family and particular professionals or agencies. For example, a family may be wary of a child protection agency.
In particularly complex situations consideration may be given to holding a Whole of Family Needs Assessment (WFNA) Clinic.