Reconceptualizing Educational Contexts: The Imperative for Interprofessional and Interagency Collaboration in School Psychology

Abstract

The increasingly diverse and complex student population school psychologists serve necessitates a reconceptualization of the field with explicit emphasis on interprofessional, interagency collaborations (IIC) to promote equitable and high-quality services for all students. School psychologists are positioned to play a central role in IIC with specific training and experience in consultation, psychology, education, and multidisciplinary knowledge to ensure effectiveness. We highlight the historical context of IIC in the field and advocate for school psychologists to engage in IIC to better meet the needs of all students and families through coordinated and streamlined services. We conceptualize this paradigm shift through three multidisciplinary frameworks: (a) interprofessional team-based care, (b) population health, and (c) implementation science. We posit that school psychologists are ideal school professionals to engage in IIC, which has been adopted
by other fields; educational and mental health inequities may be improved through effective IIC; and that implementation science concepts, which are familiar to the field of school psychology, can be applied to successfully implement IIC in schools. We conclude by providing recommendations that span graduate training, practice, and research in an effort to stimulate meaningful change in graduate training and preparation, practice, and research in the area of IIC.

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School Psychology Review
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Reconceptualizing Educational Contexts: The
Imperative for Interprofessional and Interagency
Collaboration in School Psychology
Maryellen Brunson McClain, Jeffrey D. Shahidullah, Bryn Harris, Laura Lee
McIntyre & Gazi Azad
To cite this article: Maryellen Brunson McClain, Jeffrey D. Shahidullah, Bryn Harris, Laura
Lee McIntyre & Gazi Azad (2021): Reconceptualizing Educational Contexts: The Imperative for
Interprofessional and Interagency Collaboration in School Psychology, School Psychology Review,
DOI: 10.1080/2372966X.2021.1949247
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SCHOOL PSYCHOLOGY REVIEW
Reconceptualizing Educational Contexts: The Imperative for Interprofessional
and Interagency Collaboration in School Psychology
Maryellen Brunson McClaina, Jeffrey D. Shahidullahb, Bryn Harrisc, Laura Lee McIntyred, and Gazi Azade
aUtah State University; bThe University of Texas at Austin; cUniversity of Colorado Denver; dUniversity of Oregon; eColumbia University Medical Center
ABSTRACT
The increasingly diverse and complex student population school psychologists serve necessitates
a reconceptualization of the field with explicit emphasis on interprofessional, interagency
collaborations (IIC) to promote equitable and high-quality services for all students. School
psychologists are positioned to play a central role in IIC with specific training and experience in
consultation, psychology, education, and multidisciplinary knowledge to ensure effectiveness. We
highlight the historical context of IIC in the field and advocate for school psychologists to engage
in IIC to better meet the needs of all students and families through coordinated and streamlined
services. We conceptualize this paradigm shift through three multidisciplinary frameworks: (a)
interprofessional team-based care, (b) population health, and (c) implementation science. We posit
that school psychologists are ideal school professionals to engage in IIC, which has been adopted
by other fields; educational and mental health inequities may be improved through effective IIC;
and that implementation science concepts, which are familiar to the field of school psychology,
can be applied to successfully implement IIC in schools. We conclude by providing recommendations
that span graduate training, practice, and research in an effort to stimulate meaningful change in
graduate training and preparation, practice, and research in the area of IIC.
IMPACT STATEMENT
The increasingly diverse student population that school psychologists serve warrants a paradigm
shift in the field with explicit emphasis on interprofessional, interagency collaborations (IIC) to
promote efficient, equitable, and high-quality services for all students. School psychologists are
well-positioned to play a central role in this effort, but their training may require expansion to include
a specific focus on IIC and comprehensive service delivery. We advocate that IIC can be embedded
in school psychologists’ roles and informed by three multidisciplinary frameworks: (a) interprofessional
team-based care, (b) population health, and (c) implementation science.
The increasingly diverse and complex student population
that school psychologists serve necessitates a paradigm
shift in the field with explicit emphasis on interprofes-
sional, interagency collaborations (IIC) to promote equi-
table and high-quality services for all students.
Interprofessional1 collaboration refers to professionals
from two or more disciplines working together in service
provision (World Health Organization, 2010). Interagency
collaboration refers to when multiple professionals from
different agencies or organizations collaborate in service
provision across systems (Cooper et al., 2016). In IIC,
individuals representing different disciplines (e.g., school
psychology, pediatrics, social work) across agencies (e.g.,
schools, primary care, hospitals) collaborate in service
provision (e.g., social, educational, behavioral, medical).
Although not all IIC is necessarily interprofessional in
nature, it is likely to be the case for many school
psychologists.
The current role of school psychologists broadly
involves supporting students’ academic achievement and
social–emotional–behavioral health (National Association
of School Psychologists [NASP], 2020). School psycholo-
gists are trained in several areas including assessment,
intervention, consultation and collaboration, law and eth-
ics, crisis response, data-based decision-making, child
development, and program evaluation (NASP, 2020).
School psychologists are also expected to engage in team-
based service provision with professionals from other dis-
ciplines in the school setting (e.g., speech–language
pathologists, special education teachers; NASP, 2020).
Although NASP acknowledges the importance of
within-school interdisciplinary collaboration, the field’s
This article has been corrected with minor changes. These changes do not impact the academic content of the article.
© 2021 National Association of School Psychologists
CONTACT Maryellen Brunson McClain maryellen.mcclainverdoes@usu.edu Utah State University, Logan, Utah, USA.
KEYWORDS
community-school
collaboration, professional
issues in school psychology,
training in school psychology
https://doi.org/10.1080/2372966X.2021.1949247
ARTICLE HISTORY
Received December 7, 2020
Accepted June 23, 2021
ASSOCIATE EDITOR
Amanda Sullivan
SPECIAL SERIES

2 School Psychology Review DOI: 10.1080/2372966X.2021.1949247
stance on and definition of “interdisciplinary” has not
adequately evolved given that the most recent NASP
Practice Model (2020) presents the identical statement to
their 2010 Practice Model. Without an expanded defini-
tion of interdisciplinary collaboration to include other
child-serving systems (i.e., interagency), school psychol-
ogists may be limited in their capacity to serve the increas-
ingly complex health needs in the next decades of the 21st
century.
School psychologists are positioned to play a central
role in IIC (Nastasi, 2003; Shahidullah et al., 2020).
However, to be effective in their role, training may require
expansion to include a specific focus on IIC and compre-
hensive service delivery. In this paper we2 highlight the
historical context of IIC in school psychology and advocate
for a paradigm shift that expands the role of school psy-
chologists to engage in IIC with organizations outside of
the school context (e.g., community, early childhood, med-
ical) to better meet the needs of all students and families
by providing more coordinated and streamlined services.
We conceptualize this shift through three multidisci-
plinary frameworks: (a) interprofessional team-based care,
(b) population health, and (c) implementation science.
Historical Context of IICs in School Psychology
The call for school psychologists to engage in IIC is not
novel. In 1979, Janzen argued the clear advantages of inter-
disciplinary collaboration for school psychologists given
the increasing breadth of role expectations and the asso-
ciated required skillsets. Almost two decades later,
Romualdi and Sandoval (1995) promoted a similar idea
that school psychologists should engage in collaboration
outside of the school context. To achieve necessary skills
for this role, Kramer and Epps (1991) suggested additional
training and education in IIC for school psychologists. In
the early 2000s, Johnson et al. (2004) called for all applied
psychology fields to provide more training in interprofes-
sional collaborations in professional psychology programs.
Although less specific to IIC, Sheridan and Gutkin (2000)
reiterated the importance of the broader context, including
families and communities, to promote effective prevention
and intervention efforts. One of the broad themes of the
2002 Conference on the Future of School Psychology was
“reliance on collaboration across professions in education
and across specialties in psychology,” which advocated for
more collaboration to reduce redundant effort (Dawson
et al., 2003, p.118). In 2003, School Psychology Review pub-
lished a special issue on the importance of interprofes-
sional and interagency partnerships between schools and
community providers to adequately address child mental
health needs. In the introduction to this special issue,
Power (2003) outlined the need for improvements in
access to, frequency, and quality of mental health services
for children, which may be addressed through increased
collaborations. The NASP Best Practices series also rec-
ognizes the importance of IIC and includes chapters on
collaborating with medical personnel (Glaser & Shaw,
2014) and connecting with health providers for children
with complex medical conditions (Power & Bradley-
Klug, 2014).
Research on IIC in school contexts has focused broadly
on the benefits and limitations of school psychologists’
engagement with interdisciplinary and interagency prac-
tices (e.g., Margison & Shore, 2009; McMahon et al., 2000)
and application to specific contexts, such as response to
intervention (RtI) frameworks (Sulkowski et al., 2011),
working with medical providers (e.g., Bradley-Klug et al.,
2010; 2013; Bradley-Klug & Armstrong, 2014; Shaw et al.,
2011; Sulkowski et al., 2009), and for students with dis-
abilities such as autism spectrum disorder, attention-defi-
cit/hyperactivity disorder, and pediatric health conditions
(e.g., Bradley-Klug et al., 2010; McClain et al., 2020a;
Power et al., 2013). Unfortunately, several studies have also
identified disconnects between research and practice, sug-
gesting that school psychologists do not regularly collab-
orate with professionals outside of schools. Specific to
collaborations with medical professionals, although phy-
sicians report a desire for more contact with schools in
clinical decision-making, only 31% reported receiving
information from schools (HaileMariam et al., 2002).
Similarly, few school psychologists reported collaborating
with physicians to coordinate and monitor care for stu-
dents prescribed with psychotropic medications for behav-
ioral health concerns (Shahidullah & Carlson, 2014).
Bradley-Klug and colleagues (2010) considered pediatri-
cians’ perspectives on collaborating with schools and
found that pediatricians had more frequent contact with
school nurses and classroom teachers than school psychol-
ogists, which may be in part due to a lack of training in
IIC with schools (Shahidullah et al., 2019).
In a study examining IIC between schools and commu-
nity organizations in serving youth with mental health
concerns, school psychologists reported most frequently
collaborating with community counselors and therapists
(Walsh, 2013). However, in another study, brief commu-
nications between school psychologists and community
providers were noted as more typical than on-going col-
laborative partnerships (Villarreal, 2018). These studies
indicate that when collaboration occurs between agencies
it is less interprofessional in nature (i.e., pediatricians
engage with school nurses and psychologists engage with
counselors). Barriers and facilitators to engaging in IIC
have also been explored in depth. School psychologists
have noted a lack of time and accessibility issues,

Reconceptualizing Educational Contexts: The Imperative for Interprofessional and Interagency Collaboration in School Psychology 3
difficulties obtaining parent consent and navigating pri-
vacy laws (e.g., FERPA, HIPAA), limited financial and
administrative support, and cross-discipline communica-
tion challenges (McClain et al., 2020a; Walsh, 2013).
Conversely, school psychologists noted that shared deci-
sion-making, preemptively establishing collaboration
methods, and community provider knowledge and under-
standing of the school and special education systems
improve IIC (McClain et al., 2020a). More adequate edu-
cation and training in relevant topics, such as team-based
care, population health, and implementation science may
better equip school psychologists with the skills necessary
to engage in IIC (Arora et al., 2018).
INTERPROFESSIONAL TEAM-BASED CARE
The concept of team science has grown substantially over
the last three decades and has become ubiquitous across
several sectors including the military (Dalenberg et al.,
2009); science, technology, engineering, and mathematics
(STEM) fields (Kniffin & Hanks, 2018); and healthcare
(Hughes et al., 2016). With the growing influence in
healthcare settings, team-based care has demonstrated
improvements in patient outcomes, efficiency of care, and
provider well-being and satisfaction (Smith et al., 2018).
Collaborative teaming can be more effective than individ-
uals practicing in isolation as teams combine their diverse
skills, expertise, and complementary capabilities; monitor
one another to reduce errors; and adapt workloads as
needed, including task-shifting in the face of workforce
shortages (Goodwin et al., 2018). Collaborative teaming
and care coordination are also particularly necessary for
United States (U.S.) school systems as they are tasked with
serving an increasingly diverse and complex student pop-
ulation, necessitating expertise and input from multiple
professionals.
Using the parallel of the primary care medical home
model, the school (or educational home) is an appropriate
organizational conduit in which to link and deliver core
functions of child health and wellness, of which education
and learning are but one of many component parts
(Shahidullah et al., 2018). The medical home concept was
coined by the American Academy of Pediatrics in 1967 to
describe a central context in which to coordinate children’s
care, particularly for children with special healthcare needs
(Lerner & Klitzner, 2017; Sia et al., 2004). The medical
home model was endorsed within the Patient Protection
and Affordable Care Act (2010) as a model emphasizing
a partnership between the patient, family, primary care
clinician, specialists, and community supports whose goals
are to provide comprehensive care and to minimize gaps,
duplication, and fragmentation in care from poor care
coordination (Burwell, 2015; Romaire et al., 2012).
Features of the model specify that care should be accessi-
ble, family-centered, continuous, comprehensive, coordi-
nated, culturally-effective, and team-based, while
emphasizing quality and safety through data-based deci-
sion making in performance measurement and improve-
ment (Shahidullah et al., 2018). The medical home model
has been associated with reductions in emergency depart-
ment visits (Christensen et al., 2015; Klitzner et al., 2010)
and hospitalizations (Cooley et al., 2009; Mosquera et al.,
2014), increased patient satisfaction (Palfrey et al., 2004),
and decreased unmet health care needs (Benedict, 2008;
Boudreau et al., 2014).
Similarly, the educational home offers a longitudinal,
continuous setting where children spend a majority of
their time and a multidisciplinary team of providers can
access children in a performance-based setting in which
social–emotional, behavioral, academic, and physical
health needs are readily apparent. Schools can leverage
this platform to serve as comprehensive delivery systems
in which screening, prevention, intervention, and care
coordination across stakeholders can occur in a way that
is financially and logistically accessible (services are free
and on-site) and less-stigmatizing, making schools an
equitable service coordination platform for IIC. Many
schools have multitiered system of supports (MTSS)
frameworks positioned to enhance care coordination
efforts and function as performance monitoring systems.
Several specialists employed by schools, including nurses,
school psychologists, and social workers, are equipped to
link the numerous child-serving systems (e.g., family,
community, social, early childhood, healthcare) that serve
essential functions in student health and wellness.
School psychologists are ideal candidates to lead IIC
efforts (Shahidullah et al., 2018). As such, there is a com-
pelling need for school psychologists to develop necessary
attitudes, knowledge, and skill sets to engage in collabo-
rative teaming and care coordination with other service
systems. Moreover, specific training in IIC is important
for professionals to develop the skills to engage in effective
partnerships and provide quality services (McClain et al.,
2020a). Fortunately, there are pre-existing training com-
petencies and frameworks that can be useful for training
efforts in school psychology.
The Interprofessional Education Collaborative (IPEC)
2016 has developed four core competencies for interpro-
fessional education and collaboration: (a) interprofessional
teamwork and team-based practice, (b) roles and respon-
sibilities for collaborative practice, (c) interprofessional
communication practices, and (d) values/ethics for inter-
professional practice. While many professional organiza-
tions that represent a variety of disciplines have committed
to interprofessional training and are members of IPEC

4 School Psychology Review DOI: 10.1080/2372966X.2021.1949247
(e.g., American Psychological Association (APA),
American Speech and Hearing Association, American
Association of Colleges of Nursing, Association of
American Medical Colleges), NASP is unfortunately not
a member. These IPEC competencies necessarily require
moving beyond discipline-specific educational efforts to
engage students of different disciplines to interactively
learn with individuals from other disciplines and about
other disciplines (Interprofessional Education
Collaborative [IPEC], 2016).
A specific training initiative in team-based care,
TeamSTEPPS® 2.0, was developed by the Agency for
Healthcare Research and Quality (AHRQ, n.d.) of the US
Department of Health and Human Services. TeamSTEPPS
is an evidence-based communication framework com-
monly used in medical schools and healthcare settings
nationally for training in team structure, communication,
leadership, situation monitoring, and mutual support—
key components of effective team-based care. Efforts are
currently underway to adapt TeamSTEPPS for school
mental health teams (see Wolk et al., 2019).
A growing number of school psychology graduate pro-
grams have transformed their values, norms, and training
structures to emphasize a collaborative and interprofes-
sional approach where students gain experience working
with other disciplines across child-serving systems. One
method is through developing internship training consor-
tiums in partnership with clinics and hospitals. For exam-
ple, Michigan State University’s School Psychology PhD
program has developed the Mid-Michigan Psychology
Internship Consortium (MMPIC; see https://education.
msu.edu/cepse/school-psychology/mmpic/intern-
ship-sites/) which includes placements at The University
of Michigan C. S. Mott Children’s Hospital. Predoctoral
interns as well as externs/practicum students are able to
train in inpatient and outpatient settings working as part
of multidisciplinary teams around children with chronic
and acute medical conditions.
Another method is through subspecializations at the
graduate training level. For example, Lehigh University
has developed a pediatric school psychology sub-special-
ization that PhD-level students can earn through required
coursework, practicum/internship, research, and leader-
ship training (see https://ed.lehigh.edu/academics/
degrees/doctoral/phdschpsych/phd_pedi). The sub-spe-
cialization focuses on developing school psychologists
who can facilitate linkages among school, health, mental
health, and family systems. Students participate in inten-
sive practicum experiences spending 3 days per week in
healthcare sites, including primary care and hospitals, and
schools to develop competencies and serve as liaisons in
addressing the healthcare, educational, and psychological
needs of children. Students also participate in an
accompanying leadership project and supplemental
required coursework pertaining to interprofessional care
coordination competencies including systems level change;
service delivery in urban, high poverty, consistently poor
performing settings; policy/advocacy leadership develop-
ment; and research methodology, generation, and dissem-
ination around coordinated health promotion/service
delivery. These training opportunities prepare school psy-
chologists to be key leaders in interprofessional care and
function across settings to better address the needs of stu-
dents, with a key emphasis on addressing the educational,
mental health, and health disparities through population
health approaches while promoting access to evi-
dence-based care and services.
Although the Michigan State University and Lehigh
University models are well positioned to increase the num-
ber of school psychologists who are trained to bridge the
gap between schools and other child-serving systems,
there is a compelling need for more programs at the mas-
ters/educational specialist level to also develop similar
training experiences as the majority of practicing school
psychologists are not at the doctoral level (see
“Recommendations for Training, Practice, and Research”
section for options for addressing training within masters/
specialist-level programs).
POPULATION HEALTH
Population health is conceptualized as an interdisciplinary,
customizable approach to health promotion consisting of
non-traditional partnerships among various sectors of the
community (Centers for Disease Control and Prevention
[CDC], 2021b). These sectors may include public health,
industry, academia, health care, government, schools, and
other settings with a unified goal of promoting positive
health outcomes among all populations (CDC, 2021b).
Diverse groups across geographic regions, nations, and
communities can be defined as populations as well as
groups such as employees, ethnic groups, people with dis/
abilities, and children. Population health researchers and
policy makers study the determinants of health among
various populations that can influence health outcomes
such as medical care systems and social or physical envi-
ronments (Kindig & Stoddart, 2003). Determinants of
health are influenced by complex and pervasive systemic
and institutional constructs such as racism, socioeconomic
conditions, neighborhood dynamics, education, and
access (e.g., food, housing, transportation). Distribution
of health outcomes is disparate among various popula-
tions, particularly among racially and ethnically minori-
tized and economically vulnerable individuals. The
impacts of these determinants can be pervasive and

Reconceptualizing Educational Contexts: The Imperative for Interprofessional and Interagency Collaboration in School Psychology 5
generational and are often maintained by systemic ineq-
uities across sectors (Braveman et al., 2011a).
To improve population health, the CDC has employed
a new strategy that aims for “health in all policies” to close
health gaps as a goal that should be shared across all areas
of government (U.S. Department of Health & Human
Services, 2021). One comprehensive example of a popu-
lation health initiative is the CDC’s Health Impact in 5
Years (HI-5) initiative. At the foundation of this initiative
is awareness and advocacy pertaining to the social deter-
minants of health (SDoH) that with systemic intervention
to reduce SDoHs, allows populations to access new oppor-
tunities and make different choices that will directly
impact health outcomes. The HI-5 initiative compiles
non-clinical, community-wide evidence-based approaches
that have: (a) positive health impacts, (b) results within
5 years, and (c) cost effectiveness among the population.
Three of the evidence-based interventions compiled in the
HI-5 directly include school settings (school-based pro-
grams to increase physical activity, school-based violence
prevention, and safe routes to school; Health Impact in 5
Years, 2021a).
School psychologists and school psychology training
programs must serve as population health advocates that
promote social justice and disrupt systems that can lead
to health disparities and inequitable services. Engagement
in IIC as a school psychologist is one way to improve pop-
ulation health and ultimately, health outcomes. Children
and families served in U.S. public school systems are
increasingly diverse with respect to various demographic
factors including, race, ethnicity, and setting (e.g., urba-
nicity; Frey, 2020). Due to the interconnected nature of
various racial and cultural identifications, intersectionality
often exists and can complexly contribute both positively
and negatively to family experiences and outcomes (Farber
et al., 2017). Schools must be prepared and responsive to
the needs of the children, families, and communities they
serve, and have an understanding for the population and
community contexts that can lead to favorable and prob-
lematic health outcomes.
Every health difference is not considered a health dis-
parity as disparities are preventable, systematic health
differences that negatively impact certain populations as
a result of a social injustice (Braveman et al., 2011b). For
example, people with disabilities are more likely to be
obese (Altman & Bernstein, 2008), mortality risk is great-
est among people living in economically vulnerable situ-
ations (Braveman & Gottlieb, 2014), and mental health
outcomes are poorer for Black sexual minoritized women
(Calabrese et al., 2015). These trends are not merely attrib-
utable to individual behaviors but rather have root causes
in systems of oppression (e.g., ableism, racism, capitalism)
and resulting structural inequity reflected in health,
economic, and residential policies and practices that con-
tribute to systematic differences in individuals’ and groups’
access, opportunity, and participation in various social
systems and sectors or care. Health disparities also con-
tribute to various outcomes such as poor access to and
utilization of health care, trauma, and suboptimal social
situations (e.g., housing, neighborhoods; Friedman, 2019).
The World Health Organization (2010) states, “the
roots of most health inequalities and of the bulk of human
suffering are social: the social determinants of health” (p.
39). Thus, attention must be made to SDoH when attempt-
ing to promote health equity. For example, income
inequality, economic vulnerability, discrimination, sexism,
ableism and various forms of prejudice can also contribute
to health inequity and can be seen as SDoH (Compton &
Shim, 2015). To fully understand these inequities and
identify potential solutions, a historical understanding of
systems of oppression and structural racism must be
undertaken (see Sullivan et al., 2020 for a review of these
systems as they relate to schools). Schools can be concep-
tualized as one critical dimension of SDoH (Office of
Disease Prevention and Health Promotion, 2021).
Health disparities and SDoH have a greater impact on
younger children, particularly those that are between the
ages of 0–5 years (Office of Disease Prevention and Health
Promotion, 2021). It is within this age range that stressors
and other disparities can be the most impactful and con-
tribute to cumulative positive or negative outcomes that
can influence a child’s health and wellness trajectory for
decades. For example, adverse childhood experiences can
disrupt neurologic, metabolic, and immunologic systems
(National Scientific Council on the Developing Child,
2014). IIC, through compensatory, coordinated services
involving school systems and early intervention systems
aligned with health and community systems, have the
opportunity to disrupt and remediate these trajectories.
Driven by advances in developmental neuroscience,
biology, and epigenetics, the Ecobiodevelopmental Model
emphasizes the dynamic continuum between wellness and
disease while emphasizing the lasting effect that early
experiences have on learning, behavior, and health
(Garner, 2016). This model purports that effective health-
care requires an understanding of the interaction of ecol-
ogy and biology over a life trajectory. Furthermore, the
impact of early childhood experiences promotes or
impedes health, as well as academic and economic out-
comes. This Ecobiodevelopmental conceptualization can
be beneficial for school psychologists not only to under-
stand the SDoH for the families they serve, but also to
identify supports and positive factors in children’s lives
that can be maintained and bolstered. When engaging in
IIC efforts as a school psychologist, understanding of the
Ecobiodevelopmental model can facilitate stronger

6 School Psychology Review DOI: 10.1080/2372966X.2021.1949247
prioritization of service alignment and coordination, par
-
ticularly among early childhood populations. Furthermore,
the conceptualization of the role of the school psychologist
as focused on wellness promotion can be expanded within
existing prevention endeavors and an essential part of the
creation of new IIC initiatives.
At the time of this writing, the current context of the
COVID-19 pandemic has elucidated and exacerbated dis-
parities that intersect with existing SDoH. Culturally and
linguistically minoritized (CLM) children and those that
are economically vulnerable are more likely to be exposed
and contract COVID-19 than White children and those
of middle to higher socioeconomic status (Goyal et al.,
2020). Access to educational and school services (such as
mental health) has also occurred at disparate rates for pop-
ulations in diverse cultural, linguistic and economic
groups (Lee, 2020). Similar disparities have occurred in
health settings using telehealth formats, where poorer
internet service opportunities and living in rural settings
have been found to contribute to less healthcare access
(Menon & Belcher, 2020). Furthermore, CLM families are
disproportionality represented in essential work settings,
are less likely to access affordable and quality housing, have
less wealth accumulation (thus the necessity to work in
conditions that may be more likely to promote virus con-
tamination), live in more crowded environments, rely on
public transportation, and have poorer access to health
care (CDC, 2020). Each of these factors can influence the
ability to social distance and practice recommended guide-
lines for COVID-19 protection. These challenges may
increase parental stress levels, and symptoms of anxiety
and depression, which can increase susceptibility for abuse
and neglect, particularly among children with disabilities
(Cohen & Bosk, 2020; Russell et al., 2020). The COVID-19
pandemic illustrates the complexity of social and health
disparities and highlights the critical need for systemic
prevention efforts now and following the pandemic.
As free, compulsory, public systems for children and
families, it is incumbent upon schools to reduce health
disparities by focusing on preventive systems that support
wellness efforts of not only children, but also the increas-
ingly diverse families and communities that they serve.
Education also serves an important bidirectional role in
health as people with greater educational opportunities
are healthier and people who are healthier have greater
educational opportunities (Braveman & Gottlieb, 2014).
Employment opportunities, and thus financial implica-
tions, also exacerbate health disparities related to educa-
tion. Although schools remain vital systems of care for
children and families, these systems are overwhelmingly
fragmented which can exacerbate health disparities. For
example, special education eligibility practices (e.g., Maki
et al., 2015), healthcare reimbursement policies (Spencer
et al., 2013), and early intervention services vary by state
(e.g., Bottema-Beutel et al., 2020) and school-based health
centers are limited and have significant barriers to optimal
service provision (e.g., Keeton et al., 2012), and services
may not be responsive to cultural or linguistic needs of
children or families (e.g., Harris et al., 2019). These ineq-
uities can contribute to generations of widening health
disparities.
Population health approaches are needed within school
psychology to promote better IIC between healthcare,
community, and school systems. At the school level, Huang
et al. (2013) conceptualized “school determinants of
health” into six categories: (a) physical and structural envi-
ronment (e.g., air quality, activity space), (b) health poli-
cies (e.g., health education and safety), (c) health programs
(e.g., prevention/intervention, health services), (d) health
resources (e.g., availability of nurses and mental health
professionals), (e) school climate (e.g., teacher-child rela-
tionships, family-school partnerships), and (f) school
composition (e.g., demographic factors, SES). At each of
these domains, school psychologists can advocate and
influence change. School psychologists can improve align-
ment and coordination between medical, community, and
other systems, targeting efforts on early, preventative ser-
vices that are responsive to the needs of the children, fam-
ilies and communities they serve. Advocacy for equitable
access (e.g., food, housing, transportation) and improved
educational and neighborhood conditions must be con-
ceptualized as part of the school psychologist’s role and
central to the success of IIC. School psychologists must
conceptualize IIC as the opportunity for wellness promo-
tion at all levels of systemic and institutional constructs,
including those that are complex and pervasive (e.g., rac-
ism, socioeconomic conditions).
IMPLEMENTATION SCIENCE
In addition to team-based care and population health,
implementation science is another perspective that may
help promote IIC in schools and shift the field of school
psychology. Implementation science is the scientific study
of methods to promote the uptake of evidence-based prac-
tices (EBPs) or interventions (EBIs) into routine practice
and consequentially to improve the quality and effective-
ness of services (Bauer et al., 2015; Eccles & Mittman,
2006). Borrowing from the field of implementation sci-
ence, there are a number of strategies and methods that
can aid in the application of IIC within schools. In this
paper, we argue that although IIC is not an EBP or inter-
vention per se, scaling up (i.e., increasing the impact of)

Reconceptualizing Educational Contexts: The Imperative for Interprofessional and Interagency Collaboration in School Psychology 7
this “innovation” follows the same process of moving any
EBP into routine practice.
A guiding principle in implementation science is that
any innovation’s reception is contingent on the social con-
text (Dingfelder & Mandell, 2011; Herlitz et al., 2020).
Scaling up IIC requires a thoughtful and systematic exam-
ination of the school context that is grounded in a theo-
retical framework. Although there are many frameworks
to consider in implementation science, the Consolidated
Framework for Implementation Research (CFIR) is well-
suited for school-based implementation efforts. The CFIR
can be defined as an overarching typology to promote
what works, where, and why (Damschroder et al., 2009).
The CFIR is composed of five domains, including the (a)
intervention characteristics, (b) inner setting, (c) outer
setting, (d) characteristics of the individuals involved, and
the (e) process of implementation, with each domain fur-
ther divided into sub-domains.
For the purposes of this paper, it is critical to think
about the characteristics of IIC (i.e., “the intervention”)
and the individuals involved in that process. For example,
what is the evidence strength and quality, as well as relative
advantage and costs, associated with IIC? Do school psy-
chologists have the knowledge, training, and self-efficacy
to adequately engage in these collaborations? The inner
setting relates to the school culture and climate, and
whether there is strong leadership to support collabora-
tions with community-based providers in other agencies.
Some considerations for the outer setting are district pol-
icies and incentives, as well as peer pressure (or lack
thereof) to engage in IICs. Finally, it is important to con-
sider where these collaborative efforts are in the process
of implementation (i.e., planning, engaging, executing, or
reflecting and evaluating; Damschroder et al., 2009).
Without careful consideration of each of these domains,
successful implementation in any organization, including
schools, is unlikely. Although not grounded in the CFIR,
some school psychology scholars have already begun to
think about the “context” of implementation as it relates
to school-wide efforts, such as the implementation of
MTSS (e.g., Forman & Crystal, 2015; Kittleman et al., 2018;
Herlitz et al., 2020). Given their training at the individual-
and systems-levels, school psychologists are ideally posi-
tioned to draw from implementation frameworks and
apply them to other school-wide efforts, such as collabo-
rations with professionals in other agencies. These collab-
orations are especially important for sustainability efforts.
Research suggests that the sustainability of effective inter-
ventions (after external funds or other resources are
depleted) depends on the extent to which schools have
senior leaders and staff who are knowledgeable, skilled,
and motived to continue delivering services (Herlitz et al.,
2020). Engaging in IIC may be one way to ensure conti-
nuity of services.
In addition to implementation frameworks, school psy-
chologists must consider implementation strategies nec-
essary to scale-up IIC. Implementation strategies are
techniques used to facilitate the adoption, use, and sus-
tainment of EBPs (Cook et al., 2019; Lyon and Bruns,
2019). Powell et al. (2015) compiled a list of 73 implemen-
tation strategies and Cook et al. (2019) adapted these strat
-
egies to be applicable in schools (and added two more),
resulting in 75 school-based implementation strategies.
These strategies are organized into nine categories includ-
ing: (a) using evaluative and iterative strategies, (b) pro-
viding interactive assistance, (c) adapting and tailoring to
context, (d) developing stakeholders’ interrelationships,
(e) training and educating stakeholders, (f) supporting
educators, (g) engaging consumers, (h) using financial
strategies, and (i) changing infrastructure.
Although a thorough consideration of each of these
categories is beyond the scope of this paper, there are
several strategies within each of these domains that are
pertinent to IIC. For example, assessing for readiness
and identifying barriers and facilitators (under using
evaluating and iterative strategies) may be the first step
to initiating collaborations with professionals in other
agencies. In the category of developing stakeholder inter-
relationships, it is imperative to consider building part-
nerships with specific community-based clinics,
identifying and preparing dedicated champions, learn-
ing from the experiences of early adopters within a
school or district, and training leadership to engage in
behaviors that support the new practice. School psychol-
ogists may be more familiar with the strategies associ-
ated with training and educating stakeholders, such as
conducting meetings and developing educational mate-
rials. However, they may not have considered strategies
related to engaging consumers, such as increasing
demand and expectations for implementation and
involving family members or other staff (Cook et al.,
2019). However, it is important to consider both the
feasibility and importance of these strategies. In a sample
of 200 school-based consultants, Lyon and Bruns (2019)
reported that these strategies fell into four quadrants
including, both feasible and important, important but
not feasible, feasible but not important, and neither fea-
sible nor important.
Although IIC is intuitively appealing, it is challenging
to implement in practice (McClain et al., 2020a) and lack
of time is not the only barrier to IIC. To understand why
attempts to collaborate with professionals in other agencies
often fail, we return to a foundational concept in imple-
mentation science and one that is familiar to school

8 School Psychology Review DOI: 10.1080/2372966X.2021.1949247
psychologists – fidelity. When fidelity is poor, the cause
may be organizational or individual implementer charac-
teristics that are impeding implementation, and/or use of
faulty implementation strategies (Forman et al., 2009).
One way to scale up IIC is to consider the breadth and
depth of factors impacting IIC and tailoring strategies to
facilitate adoption, implementation, and sustainment.
DISCUSSION
We discussed the benefits of IIC and described the grow-
ing need to reach outside of schools and school-based
professionals to meet the changing needs of students and
to address the ever-widening disparities in academic,
social and emotional development, and physical health
outcomes using both population health and implementa-
tion science frameworks to guide this work. We also argue
that school psychologists may be able to address educa-
tional and mental health inequities by engaging in IIC.
School psychologists who routinely partner with profes-
sionals outside of school systems will be more familiar
with services and resources appropriate for families and
help families navigate the service delivery systems that are
often uncoordinated. Indeed, re-imagining the role of the
school psychologist as one that serves all students, not just
special education eligible students, allows the purview of
the school psychologist to widen and real partnerships
with outside agencies to begin. By recognizing the SDoH
articulated in a population health paradigm, as well as the
need to intervene more holistically with professionals from
other disciplines, we can broaden the impact of school
psychologists. In this paper, we described a paradigm shift
that reaffirms our commitment to IIC and acknowledge
the barriers in knowledge, skills, motivation, resources,
and training opportunities (particularly within the con-
straints of NASP accreditation standards), and limited
availability of IIC-focused supervisors at practica and
internship sites, to support this work. Given the inherent
barriers, we offer recommendations that span practice,
graduate training, and research in an effort to stimulate
meaningful change in school psychology practice, gradu-
ate training and preparation, and research in the area of IIC.
Recommendations for Practice
School psychologists can use the NASP Practice Standards
(NASP, 2020) to guide scaling up comprehensive and inte-
grated school psychological services through an imple-
mentation science framework. Specifically, this model
describes 10 domains of practice that are the core compo-
nents of school psychological services. Although each of
these domains may be loosely related to interprofessional
IIC, the practice domains of data-based decision-making
(domain 1); consultation and collaboration (domain 2);
mental and behavioral health services (domain 4); family,
school, and community collaboration (domain 7); and
equitable practices for diverse populations (domain 8) may
be most relevant. When making data-based decisions
(domain 1), data from other professionals and other con-
text settings may be related. For example, input from med-
ical providers who may be developing a medication
management program for a student may be an important
consideration when making changes to a student’s Tier 3
behavior intervention plan. Along those same lines, con-
sultation and collaboration (domain 2) and family, school,
and community collaboration (domain 7) may be
enhanced when collaboration occurs with professionals
in other contexts, such as input from home-based provid-
ers delivering applied behavior analysis services to a young
student with autism spectrum disorder, input from after
school care providing homework support for a struggling
student, or input from community mental health providers
for a student receiving wraparound services.
Considering the myriad of agencies that may provide
mental and behavioral health services outside of schools,
students may be best served when school psychologists
collaborate with these community mental health providers
(domain 4) further strengthening the educational home
(Shahidullah et al., 2018). When school psychologists are
at the helm and schools play a larger role in coordinating
the provision of academic, social, behavioral, mental
health, and physical health services, more equitable access
to services for diverse students will be achieved (domain
8), aligning with a population health framework. The cur-
rent fragmented model of service provision leaves mar-
ginalized groups more disadvantaged, while coordinating
and centralizing services in schools may promote equity
and reduce stigma associated with specialized services
(e.g., mental and behavioral health services).
Using the interprofessional team-based care lens,
school psychologists can champion IIC in their building,
district, or agency by sponsoring trainings, routinely con-
sulting with and communicating with professionals out-
side of schools, and through ongoing meaningful
collaborations with professionals in agencies in medical,
early childhood, mental health, or other outside settings.
School psychologists can also promote change from within
through hosting practicum students and interns who have
been trained in the tradition of IIC. Through the infusion
of trainees and a willingness to partner and learn from
outside professionals, the role of school psychologists can
meaningfully expand. School psychologists may use data
on student outcomes to inform the use of IIC practices,
particularly as it relates to students with complex medical,

Reconceptualizing Educational Contexts: The Imperative for Interprofessional and Interagency Collaboration in School Psychology 9
developmental, academic, and/or mental health support
needs that require input and expertise from professionals
spanning a number of disciplines.
Recommendations for Graduate Training
As previously described, in order to be effective in IIC,
school psychologists’ roles need to expand, as does train-
ing to support the expanded roles. Graduate programs that
expose school psychology trainees to opportunities to
learn about interprofessional team-based care, including
outside agencies such as medical, community, and early
childhood programs and services, will be better equipped
to partner with professionals from these disciplines and
in these agencies. Didactic training, including formal
coursework in implementation science and IIC will
broaden knowledge and enrich school-based practices. In
many situations a standalone course on the topic is not
feasible; however, such content can be integrated in already
established school psychology requirements that align
with the APA and NASP standards and program compe-
tencies such as coursework (e.g., diversity, assessment,
intervention, consultation) and practica training (e.g.,
collaborate with on-site supervisors to require an IIC expe-
rience). Trainers may also consider inviting guest speakers
or lecturers from other disciplines and agencies. Doctoral
trainees will have more opportunities for advanced prac-
tica in a range of settings, while specialist-level trainees
will likely be limited to 1 year (or possibly 2 years) of
practicum prior to internship. University-based clinics
that involve multiple disciplines (e.g., speech language
pathology, couples and family therapy, social work, etc.)
can provide knowledge and skill-based activities in inter-
professional collaborations. There are pre-existing training
competencies and frameworks developed by the
Interprofessional Education Collaborative, for example,
that can be useful for training efforts in school psychology
(IPEC, 2016).
School psychology students will benefit from training
opportunities that involve peers in different disciplines
and will benefit from coursework and practica offered by
faculty and supervisors who reflect varied backgrounds
and perspectives. One example of an interprofessional
training program is the Leadership Education in
Neurodevelopmental and Related Disabilities (LEND)
program (McClain et al., 2020b). There are 52 LEND pro-
grams in the United States that are affiliated with univer-
sities or medical schools that provide graduate level
interdisciplinary training and interdisciplinary services
and care for professionals who work with infant, children,
and youth with developmental disabilities (Association of
University Centers on Disabilities (AUCD), 2011). School
psychology trainees are strongly encouraged to seek out
this opportunity if available. Although not every program
or university will have opportunities for students to be
involved in a LEND program, there are aspects of the inter-
disciplinary and IIC that can be emulated in school psy-
chology graduate preparation programs, particularly at the
doctoral level when specialized practica may be available
in non-school settings.
Recommendations for Research
Research to support the paradigm shift we are advocating
for is needed to convince key stakeholders that a focus on
IIC is worth the investment. Research that adopts an
implementation science framework to deploy the use of
IIC in school contexts is necessary to more thoughtfully
address the barriers and facilitators of implementation and
support long-term and wide scale use. Research questions
that focus on the critical elements of IIC — such as the
knowledge, skills, and attitudes necessary to implement
IIC and the necessary infrastructure and administrative
and leadership support are all germane to effective imple-
mentation — through an interprofessional team-based
care lens is essential. Further determining the role IIC may
play in addressing population health issues is also critical.
There may also be lessons learned from our implementa-
tion science colleagues who think about effective scal-
ing-up when moving a set of principles or evidence-based
practices into large scale implementation (e.g., MTSS; e.g.,
Freeman et al., 2015). Although IIC is a relatively nascent
specialty area within school psychology, the concept of
collaborating across disciplines is not new and we have a
literature base to draw on from team science, population
health, and implementation science to support scaling up
these practices within schools.
We conclude with a call to action for the field to take
meaningful steps to address the barriers to engaging in
IIC in practice, graduate training, and research and by
conceptualizing this shift through three frameworks –
population health, interprofessional team-based care, and
implementation science. Involvement in IIC has the
potential to improve coordination and efficiency of ser-
vices; reduce disparities; and improve educational, health,
and developmental outcomes for children, youth, and
families.
NOTES
1. The terms interprofessional and interdisciplinary are
used interchangeably in the broader literature and subse-
quently both are used in this paper.

10 School Psychology Review DOI: 10.1080/2372966X.2021.1949247
2. The authors represent White, Asian, and biracial/bi-
cultural racial ethnic groups; English, Bengali, and
Spanish languages; female and male genders; and het-
erosexual and queer sexualities. All have doctoral de-
grees in school psychology and engage in autism/
neurodevelopmental disabilities, health disparities,
and school-community-family collaboration scholar-
ship rooted in quantitative, qualitative, and mixed
methodologies.
DISCLOSURE
The authors have no conflicts of interest to report.
REFERENCES
Altman, B., & Bernstein, A. (2008). Disability and health in the
United States, 2001–2005. National Center for Health
Statistics.
Arora, P. G., Levine, J. L., & Goldstein, T. R. (2018). School psy-
chologists’ interprofessional collaboration with medical pro-
viders: An initial examination of training, preparedness, and
current practices. Psychology in the Schools, 56(4), 554–568.
https://doi.org/10.1002/pits.22208
Association of University Centers on Disabilities (AUCD).
(2011). About LEND. https://www.aucd.org/template/page.
cfm?id=473
Bauer, M. S., Damschroder, L., Hagedorn, H., Smith, J., &
Kilbourne, A. M. (2015). An introduction to implementa-
tion science for the non-specialist. BMC Psychology, 3(1), 32.
https://doi.org/10.1186/s40359-015-0089-9
Benedict, R. E. (2008). Quality medical homes: Meeting chil-
dren’s needs for therapeutic and supportive services.
PEDIATRICS, 121(1), e127–134. https://doi.org/10.1542/
peds.2007-0066
Bottema-Beutel, K., Cuda, J., & Kim, S. Y. (2020). Understanding
legislation, health insurance, and disparities in service provi-
sion in autism early intervention. In G. Vivanti, K. Bottema-
Beutel, L. Turner-Brown (Eds.), Clinical guide to early inter-
ventions for children with autism (pp. 163–171). Springer.
Boudreau, A. A., Perrin, J. M., Goodman, E., Kurowski, D.,
Cooley, C., & Kuhlthau, K. (2014). Care coordination and un-
met specialty care among children with special health care
needs. Pediatrics, 133(6), 1046–1053. https://doi.org/ 10.1542/
peds.2013-2174
Bradley-Klug, K. L., & Armstrong, K. H. (2014, January).
Preparing school psychologists as partners in integrated
health care delivery: A training model. Trainers Forum:
Journal of the Trainers of School Psychologists, 32, 67–83.
Bradley-Klug, K. L., Jeffries-DeLoatche, K. L., St, J., Walsh, A.,
Bateman, L. P., Nadeau, J., Powers, D. J., & Cunningham, J.
(2013). School psychologists’ perceptions of primary care
partnerships: Implications for building the collaborative
bridge. Advances in School Mental Health Promotion, 6(1),
51–67. https://doi.org/10.1080/1754730X.2012.760921
Bradley-Klug, K. L., Sundman, A. N., Nadeau, J., Cunningham,
J., & Ogg, J. (2010). Communication and collaboration with
schools: Pediatricians’ perspectives. Journal of Applied School
Psychology, 26(4), 263–281. https://doi.org/10.1080/1537790
3.2010.518583
Braveman, P., & Gottlieb, L. (2014). The social determinants of
health: it’s time to consider the causes of the causes. Public
Health Reports, 129(1_suppl2), 19–31. https://doi.org/10.117
7/00333549141291S206
Braveman, P., Egerter, S., & Williams, D. R. (2011a). The social
determinants of health: coming of age. Annual Review of
Public Health, 32, 381–398.
Braveman, P. A., Kumanyika, S., Fielding, J., LaVeist, T., Borrell,
L. N., Manderscheid, R., & Troutman, A. (2011b). Health
disparities and health equity: the issue is justice. American
Journal of Public Health, 101(S1), S149–S155. https://doi.
org/10.2105/AJPH.2010.300062
Burwell, S. M. (2015). Setting value-based payment goals—
HHS efforts to improve U.S. health care. New England Journal
of Medicine, 372(10), 897–899. https://doi.org/10.1056/NE-
JMp1500445
Calabrese, S. K., Meyer, I. H., Overstreet, N. M., Haile, R., &
Hansen, N. B. (2015). Exploring discrimination and mental
health disparities faced by Black sexual minority women using
a minority stress framework. Psychology of Women Quarterly,
39(3), 287–304. https://doi.org/10.1177/0361684314560730
Centers for Disease Control and Prevention. (2020). COVID-19
racial and ethnic disparities. Retrieved from https://www.
cdc.gov/coronavirus/2019-ncov/community/health-equity/
racial-ethnic-disparities/index.html
Centers for Disease Control and Prevention. (2021a). Health
Impact in 5 Years. Retrieved from https://www.cdc.gov/poli-
cy/hst/hi5/
Centers for Disease Control and Prevention. (2021b). What is
population health? Retrieved from https://www.cdc.gov/
pophealthtraining/whatis.html
Christensen, A. L., Zickafoose, J. S., Natzke, B., McMorrow, S.,
Ireys, H. T. (2015). Association between practice-reported
medical homeness and health care utilization among public-
ly insured children. Academic Pediatrics, 15, 267–274.
Cohen, R. I. S., & Bosk, E. A. (2020). Vulnerable youth and the
COVID-19 pandemic. Pediatrics, 146(1), e20201306. https://
doi.org/10.1542/peds.2020-1306
Compton, M. T., & Shim, R. S. (2015). The social determinants
of mental health. FOCUS, 13(4), 419–425. https://doi.
org/10.1176/appi.focus.20150017
Cook, C. R., Lyon, A. R., Locke, J., Waltz, T., & Powell, B. J.
(2019). Adapting a compilation of implementation strategies
to advance school-based implementation research and prac-
tice. Prevention Science, 20(6), 914–935. https://doi.
org/10.1007/s11121-019-01017-1
Cooley, W. C., McAllister, J. W., Sherrieb, K., & Kuhlthau, K.
(2009). Improved outcomes associated with medical home
implementation in pediatric primary care. Pediatrics, 124(1),
358–364. https://doi.org/10.1542/peds.2008-2600
Cooper, M., Evans, Y., & Pybis, J. (2016). Interagency collabora-
tion in children and young people’s mental health: A system-
atic review of outcomes, facilitating factors and inhibiting
factors. Child Care Health Development, 42(3), 325–342.
https://doi.org/10.1111/cch.12322
Dalenberg, S., Vogelaar, A. L., & Beersma, B. (2009). The effect
of a team strategy discussion on military team performance.
Military Psychology, 21(sup2), S31–S46. https://doi.
org/10.1080/08995600903249107
Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R.,
Alexander, J. A., & Lowery, J. C. (2009). Fostering implemen-
tation of health services research findings into practice: A con-

Reconceptualizing Educational Contexts: The Imperative for Interprofessional and Interagency Collaboration in School Psychology 11
solidated framework for advancing implementation science.
Implementation Science, 4(1), 50. https://doi.org/10.1186/1748-
5908-4-50
Dawson, M., Cummings, J. A., Harrison, P. L., Short, R. J.,
Gorin, S., & Palomares, R. (2003). The 2002 multisite confer-
ence on the future of school psychology: Next steps. School
Psychology Quarterly, 18(4), 497–509. https://doi.org/10.152
1/scpq.18.4.497.26998
Dingfelder, H. E., & Mandell, D. S. (2011). Bridging the re-
search-to-practice gap in autism intervention: An applica-
tion of diffusion of innovation theory. Journal of Autism
and Developmental Disorders, 41(5), 597–609. https://doi.
org/10.1007/s10803-010-1081-0
Eccles, M. P., & Mittman, B. S. (2006). Welcome to implemen-
tation science. Implementation Science, 1(1), 1. https://doi.
org/10.1186/1748-5908-1-1
Farber, E. W., Ali, M. K., Van Sickle, K. S., & Kaslow, N. J.
(2017). Psychology in patient-centered medical homes:
Reducing health disparities and promoting health equity.
American Psychologist, 72(1), 28–41. https://doi.org/10.1037/
a0040358
Forman, S. G., & Crystal, C. D. (2015). Systems consultation for
multitiered systems of supports (MTSS): Implementation is-
sues. Journal of Educational and Psychological Consultation,
25(2–3), 276–285. https://doi.org/10.1080/10474412.2014.9
63226
Forman, S. G., Olin, S. S., Hoagwood, K. E., Crowe, M., & Saka,
N. (2009). Evidence-based interventions in schools:
Developers’ views of implementation barriers and facilita-
tors. School Mental Health, 1(1), 26–36. https://doi.
org/10.1007/s12310-008-9002-5
Freeman, R., Miller, D., & Newcomer, L. (2015). Integration of
academic and behavioral MTSS at the district level using im-
plementation science. Learning Disabilities: A Contemporary
Journal, 13, 59–72.
Frey, W. H. (2020). The nation is diversifying even faster than
predicted, according to new. Brookings Institution.
Retrieved from https://www.brookings.edu/research/new-
census-data-shows-the-nation-is-diversifying-even-faster-
than-predicted/
Friedman, C. (2019). Ableism, racism, and subminimum wage
in the United States. Disability Studies Quarterly, 39(4).
https://doi.org/10.18061/dsq.v39i4.6604
Garner, A. S. (2016). Thinking developmentally: the next evo-
lution in models of health. Journal of Developmental and
Behavioral Pediatrics, 37(7), 579–584. https://doi.
org/10.1097/DBP.0000000000000326
Glaser, S. E., & Shaw, S. R. (2014). Best practices in collaborat-
ing with medical personnel (pp. 375–388). In Best practices
in school psychology. National Association of School
Psychologists.
Goodwin, G. F., Blacksmith, N., & Coats, M. R. (2018). The
science of teams in the military. Contributions from over 60
years of research. American Psychologist, 73(4), 322–333.
https://doi.org/10.1037/amp0000259
Goyal, M. K., Simpson, J. N., Boyle, M. D., Badolato, G. M.,
Delaney, M., McCarter, R., & Cora-Bramble, D. (2020).
Racial and/or ethnic and socioeconomic disparities of SARS-
CoV-2 infection among children. Pediatrics, 146(4),
e2020009951. https://doi.org/10.1542/peds.2020-009951
HaileMariam, A., Bradley-Johnson, S., & Johnson, C. M.
(2002). Pediatricians’ preferences for ADHD information
from schools. School Psychology Review, 31(1), 94–105.
https://doi.org/10.1080/02796015.2002.12086144
Harris, B., McClain, M. B., Haverkamp, C. R., Cruz, R. A.,
Benallie, K. J., & Benney, C. M. (2019). School-based assess-
ment of autism spectrum disorder among culturally and lin-
guistically diverse children. Professional Psychology: Research
and Practice, 50(5), 323–332. https://doi.org/10.1037/
pro0000256
Herlitz, L., MacIntyre, H., Osborn, T., & Bosell, C. (2020). The
sustainability of public health interventions in schools: A
systematic review. Implementation Science, 15(4), 1–28.
Huang, K. Y., Cheng, S., & Theise, R. (2013). School contexts as
social determinants of child health: current practices and
implications for future public health practice. Public Health
Reports, 128(6_suppl3), 21–28. https://doi.org/10.1177/0033
3549131286S304
Hughes, A. M., Gregory, M. E., Joseph, D. L., Sonesh, S. C.,
Marlow, S. L., Lacerenza, C. N., Benishek, L. E., King, H. B.,
& Salas, E. (2016). Saving lives: A meta-analysis of team
training in healthcare. The Journal of Applied Psychology,
101(9), 1266–1304. https://doi.org/10.1037/apl0000120
Interprofessional Education Collaborative (IPEC). (2016).
Core competencies for interprofessional collaborative practice:
2016 update. Interprofessional Education Collaborative.
Retrieved from https://nebula.wsimg.com/2f68a39520b-
03336b41038c370497473?AccessKeyId=DC06780E69ED-
19E2B3A5&disposition=0&alloworigin=1
Janzen, H. L. (1979). The advantages of inter-disciplinary
team collaboration to school psychological services. School
Psychology International, 1(2), 14–16. https://doi.
org/10.1177/014303437900100205
Johnson, C. E., Stewart, A. L., Brabeck, M. M., Huber, V. S., &
Rubin, H. (2004). Interprofessional collaboration:
Implications for Combined-Integrated doctoral training in
professional psychology. Journal of Clinical Psychology,
60(10), 995–1010. https://doi.org/10.1002/jclp.20031
Keeton, V., Soleimanpour, S., & Brindis, C. D. (2012). School-
based health centers in an era of health care reform: Building
on history. Current Problems in Pediatric and Adolescent
Health Care, 42(6), 132–156. https://doi.org/10.1016/j.cp-
peds.2012.03.002
Kindig, D., & Stoddart, G. (2003). What is population health?
American Journal of Public Health, 93(3), 380–383. https://
doi.org/10.2105/ajph.93.3.380
Kittleman, A., Eliason, B. M., Dickey, C. R., & McIntosh, K.
(2018, June). How are schools using the SWPBIS tiered fidel-
ity inventory (TFI)? Eugene, OR: University of Oregon,
OSEP Technical Assistance Center on Positive Behaviors
Interventions and Supports. Retrieved from https://www.
pbis.org/resource/how-are-schools-using-the-swpbis-
tiered-fidelity-inventory-tfi
Klitzner, T. S., Rabbitt, L. A., & Chang, R. K. (2010). Benefits of
care coordination for children with complex disease: A pilot
medical home project in a resident teaching clinic. The
Journal of Pediatrics, 156(6), 1006–1010. https://doi.
org/10.1016/j.jpeds.2009.12.012
Kniffin, K. M., & Hanks, A. S. (2018). The trade-offs of team-
work among STEM doctoral graduates. American Psychologist,
73(4), 420–432. https://doi.org/10.1037/amp0000288
Kramer, J. J., & Epps, S. (1991). Expanding professional oppor-
tunities and improving the quality of training: A look toward
the next generation of school psychologists. School

12 School Psychology Review DOI: 10.1080/2372966X.2021.1949247
Psychology Review, 20(4), 452–461. https://doi.org/10.1080/
02796015.1991.12085569
Lee, N. T. (2020). What the coronavirus reveals about the digi-
tal divide between schools and communities. Brookings
Institution, 17.
Lerner, C. F., & Klitzner, T. S. (2017). The medical home at 50:
Are children with medical complexity the key to proving its
value?Academic Pediatrics, 17(6), 581–588. https://doi.
org/10.1016/j.acap.2017.04.010
Lyon, A. R., & Bruns, E. J. (2019). From evidence to impact:
Joining our best school mental health practices with our best
implementation strategies. School Mental Health, 11(1), 106–
114. https://doi.org/10.1007/s12310-018-09306-w
Maki, K. E., Floyd, R. G., & Roberson, T. (2015). State learning
disability eligibility criteria: A comprehensive review. School
Psychology Quarterly, 30(4), 457–469. https://doi.org/10.1037/
spq0000109
Margison, J. A., & Shore, B. M. (2009). Interprofessional prac-
tice and education in health care: Their relevance to school
psychology. Canadian Journal of School Psychology, 24(2),
125–139. https://doi.org/10.1177/0829573509336537
McClain, M. B., Haverkamp, C. R., Holt, J., Peacock, G. G., &
Winter, S. (2020a). Interprofessional Education and Training.
In M. B. McClain, J. D. Shahidullah, & K. R. Mezher (Eds.),
Interprofessional care coordination for pediatric autism spec-
trum disorder (pp. 369–383). Springer.
McClain, M. B., Shahidullah, J. D., Mezher, K. R., Haverkamp,
C. R., Benallie, K. J., & Schwartz, S. E. (2020b). School-
clinic care coordination for youth with ASD: A national
survey of school psychologists. Journal of Autism and
Developmental Disorders, 50(9), 3081–3091. https://doi.
org/10.1007/s10803-019-03985-3
McMahon, T., Ward, N., Kline Pruett, M., Davidson, L., &
Griffith, E. (2000). Building full-service schools: Lessons
learned in the development of interagency collaboratives.
Journal of Educational and Psychological Consultation, 11(1),
65–92. https://doi.org/10.1207/S1532768XJEPC1101_5
Menon, D. U., & Belcher, H. M. (2020). COVID-19 pandemic
health disparities and pediatric health care—The promise of
telehealth. JAMA Pediatrics, 175(4), 345–346. https://doi.
org/10.1001/jamapediatrics.2020.5097
Mosquera, R. A., Avritscher, E. B. C., Samuels, C. L., Harris, T.
S., Pedroza, C., Evans, P., Navarro, F., Wootton, S. H., Pacheco,
S., Clifton, G., Moody, S., Franzini, L., Zupancic, J., & Tyson,
J. E. (2014). Effect of an enhanced medical home on serious
illness and cost of care among high-risk children with chron-
ic illness: a randomized clinical trial. JAMA, 312(24), 2640–
2648. https://doi.org/10.1001/jama.2014.16419
Nastasi, B. K. (2003). Commentary: Challenges of forging part-
nerships to advance mental health science and practice. School
Psychology Review, 32(1), 48–52. https://doi.org/10.1080/
02796015.2003.12086181
National Association of School Psychologists. (2010). Model for
comprehensive and integrated school psychological services,
NASP practice model. NASP. http://www.nasponline.org/
standardsandcertification/nasppracticemodel/aboutthe-
nasppractice-model
National Association of School Psychologists. (2020).
Professional standards of the National Association of School
Psychologists: Model for comprehensive and integrated school
psychological services. NASP. https://www.nasponline.org/
standards-and-certification/nasp-2020-professional-stan-
dards-adopted
National Scientific Council on the Developing Child. (2014).
Excessive stress disrupts the architecture of the developing
brain: Working paper 3. Updated Edition. http://www.devel-
opingchild.harvard.edu
Office of Disease Prevention and Health Promotion. (2021).
Social determinants of health. Healthy People 2030. U.S.
Department of Health and Human Services. Retrieved from
https://health.gov/healthypeople/objectives-and-data/so-
cial-determinants-health
Palfrey, J. S., Sofis, L. A., Davidson, E. J., Jihong, L., Freeman, L.,
& Ganz, M. L. ( 2004). Pediatric Alliance for Coordinated
Care: Evaluation of a medical home model. Pediatrics, 113(5
Suppl), 1507–1516. R etrieved from https://pediatrics.aap-
publications.org/content/113/Supplement_4/1507
Patient Protection and Affordable Care Act (ACA) of 2010, 42
U.S. C. § 18001. (2010). Retrieved from http://www.gpo.gov/
fdsys/pkg/PLAW-111publ148/ pdf/PLAW-111publ148.pdf
Powell, B. J., Waltz, T. J., Chinman, M. J., Damschroder, L. J.,
Smith, J. L., Matthieu, M. M., Proctor, E. K., & Kirchner, J. E.
(2015). A refined compilation of implementation strategies:
Results from the Expert Recommendations for Implementing
Change (ERIC) project. Implementation Science, 10(1), 21.
https://doi.org/10.1186/s13012-015-0209-1
Power, T. J. (2003). Promoting children’s mental health: Reform
through interdisciplinary and community partnerships. School
Psychology Review, 32(1), 3–16. https://doi.org/10.1080/
02796015.2003.12086177
Power, T. J., Blum, N. J., Guevara, J. P., Jones, H. A., & Leslie, L.
K. (2013). Coordinating mental health care across primary
care and schools: ADHD as a case example. Advances in
School Mental Health Promotion, 6(1), 68–80. https://doi.org
/10.1080/1754730X.2013.749089
Power, T., & Bradley-Klug, K. L. (2014). Best practices in pediat-
ric school psychology (pp. 335–346). In Best practices in school
psychology. National Association of School Psychologists.
Romaire, M. A., Bell, J. F., & Grossman, D. C. (2012). Health
care use and expenditures associated with access to the med-
ical home for children and youth. Medical Care, 50(3), 262–
269. https://doi.org/10.1097/MLR.0b013e318244d345
Romualdi, V., & Sandoval, J. (1995). Comprehensive school-linked
services: Implications for school psychologists. Psychology in
the Schools, 32(4 ), 306–317. https://doi.org/10.1002/1520-
6807(199510)32:4<306::AID-PITS2310320409>3.0.CO;2-K
Russell, B. S., Hutchison, M., Tambling, R., Tomkunas, A. J., &
Horton, A. L. (2020). Initial challenges of caregiving during
COVID-19: Caregiver burden, mental health, and the par-
ent-child relationship. Child Psychiatry & Human Development,
51(5), 671–682. https://doi.org/10.1007/s10578-020-01037-x
Shahidullah, J. D., Azad, G. F., Mezher, K., McClain, M. B., &
McIntyre, L. L. (2018). Linking the medical and educational
home to support children with autism spectrum disorder:
Practice recommendations . Clinical Pediatrics, 57(13),
1496–1505. https://doi.org/10.1177/0009922818774344
Shahidullah, J. D., & Carlson, J. S. (2014). Survey of Nationally
Certified School Psychologists’ roles and training in psycho-
pharmacology. Psycholo gy in the Schools, 51(7), 705–721.
https://doi.org/10.1002/pits.21776
Shahidullah, J. D., Forman, S. G., Palejwala, M. H., Shafrir, R.,
Barone, C., Pincus, L. E., Chaudhuri, A., & Lee, E. (2019).

Reconceptualizing Educational Contexts: The Imperative for Interprofessional and Interagency Collaboration in School Psychology 13
National survey of chief pediatric residents’ attitudes, prac-
tices, and training in collaborating with schools. Journal of
Interprofessional Education & Practice, 15, 82–87. https://doi.
org/10.1016/j.xjep.2019.02.008
Shahidullah, J. D., McClain, M. B., Azad, G., Mezher, K., &
McIntyre, L. L. (2020). Coordinating autism care across
schools and medical settings: Considerations for school psy-
chologists. Intervention in School and Clinic, 56(2), 107–114.
https://doi.org/10.1177/1053451220914891
Shaw, S. R., Glaser, S. E., & Ouimet, T. (2011). Developing the
medical liaison role in school settings. Journal of Educational
and Psychological Consultation, 23(2), 106–117.
Sheridan, S. M., & Gutkin, T. B. (2000). The ecology of school
psychology: Examining and changing our paradigm for the
21st century. School Psychology Review, 29(4), 485–502.
https://doi.org/10.1080/02796015.2000.12086032
Sia, C., Tonniges, T. F., Osterhus, E., & Taba, S. (2004). History of
the medical home concept. Pediatrics, 113(5 Suppl), 1473–1478.
Smith, C. D., Balatbat, C., Corbridge, S., Dopp, A. L., Fried, J.,
Harter, R., Landfeld, S., Martin, C. Y., Opelka, F., Sandy, L., &
Sato, L. (2018). Implementing optimal team-based care to
reduce clinician burnout. NAM Perspectives. Retrieved from
https://nam.edu/implementing-optimal-team-based-care-
to-reduce-clinician-burnout
Spencer, C. S., Gaskin, D. J., & Roberts, E. T. (2013). The quali-
ty of care delivered to patients within the same hospital var-
ies by insurance type. Health Affairs (Project Hope), 32(10),
1731–1739. https://doi.org/10.1377/hlthaff.2012.1400
Sulkowski, M. L., Jordan, C., & Nguyen, M. L. (2009). Current
practices and future directions in psychopharmacological
training and collaboration in school psychology. Canadian
Journal of School Psychology, 24(3), 237–244.
Sulkowski, M. L., Wingfield, R. J., Jones, D., & Coulter, W. A.
(2011). Response to intervention and interdisciplinary col-
laboration: Joining hands to support children’s healthy de-
velopment. Journal of Applied School Psychology, 27(2), 118–
133. https://doi.org/10.1080/15377903.2011.565264
Sullivan, A. L., Weeks, M., Kulkarni, T., Nguyen, T., Kendrick-
Dunn, T. B., & Barrett, C. (2020). Historical foundations of
health disparities: A primer for school psychologists to ad-
vance social justice. NASP Communiqué, 49(2), 30–32.
TeamSTEPPS 2.0. (n.d.). Agency for Healthcare Research and
Quality, Rockville, MD. Retrieved from https://www.ahrq.
gove/teamstepps/instructor/index.html
U.S. Department of Health and Human Services. (2021).
Healthy people: Social determinants of health. Retrieved
from: https://www.healthypeople.gov/2020/topics-objec-
tives/topic/social-determinants-of-health
Villarreal, V. (2018). Mental health collaboration: A survey of
practicing school psychologists. Journal of Applied School
Psychology, 34(1), 1–17. https://doi.org/10.1080/15377903.2
017.1328626
Walsh, A. S. J. (2013). Interdisciplinary collaboration for youth
mental health: A National Study [Graduate Theses and
Dissertations]. University of South Florida. http://scholarco-
mmons.usf.edu/etd/4605
Wolk, C. B., Stewart, R. E., Eiraldi, R., Cronholm, P., Salas, E., &
Mandell, D. S. (2019). The implementation of a team training
intervention for school mental health: Lessons learned.
Psychotherapy, 56(1), 83–90. https://doi.org/10.1037/pst0000179
World Health Organization. (2010). Framework for action on
interprofessional education and collaborative practice.
AUTHOR BIOGRAPHICAL STATEMENTS
Maryellen Brunson McClain, PhD, is an Assistant Professor of
Psychology (School Psychology Program) at Utah State
University and a nationally certified school psychologist licensed
psychologist. Her research interests are related to autism and
other neurodevelopmental disabilities (ND); identification dis-
parities and culturally responsive assessment and identification
of autism/ND; professional development and training in school
psychology and allied disciplines; and interprofessional and
interagency education, training, and collaboration.
Jeffrey D. Shahidullah, PhD, is an Assistant Professor of
Psychiatry at Dell Medical School and an Adjunct Assistant
Professor of Educational Psychology within the College of
Education at The University of Texas (UT) at Austin. He is also
a licensed pediatric psychologist in UT Health Austin Pediatric
Psychiatry at Dell Children’s Medical Center where he practices
within the department of developmental and behavioral pedi-
atrics. Dr. Shahidullah is also a faculty affiliate at the Center for
Health Interprofessional Practice and Education and co-direc-
tor of research in developmental and behavioral pediatrics at
Dell Children’s Medical Group.
Bryn Harris, PhD, is an Associate Professor in the School
Psychology doctoral program in the School of Education and
Human Development at the University of Colorado Denver.
She has a secondary appointment in the Department of
Pediatrics (Developmental Pediatrics) at the University of
Colorado Denver Anschutz Medical Campus. Her primary
research interests include the psychological assessment of bilin-
gual learners, culturally and linguistically responsive assess-
ment of autism spectrum disorder, health disparities among
children with autism spectrum disorder, and improving mental
health access and opportunity within traditionally underserved
populations. Dr. Harris is the director and founder of the bilin-
gual school psychology program at the University of Colorado
Denver. She is also a bilingual (Spanish) licensed psychologist
and nationally certified school psychologist.
Laura Lee McIntyre, PhD is a Professor of School Psychology,
Department Head of Special Education and Clinical Sciences,
and Director of the Prevention Science Institute at the University
of Oregon. Her research interests focus on family-centered
interventions and parent-professional partnerships to enhance
family involvement in education to promote positive outcomes
for students with disabilities and reduce disparities in access
and outcomes.
Gazi Azad, PhD, is an Assistant Professor in the Division of
Child and Adolescent Psychiatry at Columbia University and
the New York State Psychiatric Institute. She also is an Adjunct
Assistant Professor at the Center for Autism and the Developing
Brain at Weill Cornell Medicine. Dr. Azad is a licensed psychol-
ogist and nationally certified school psychologist. Her research
focuses on using the principles of implementation science to
optimize continuity of services across home and school for chil-
dren with autism.