Perceptions and Practices in School Social Worker-Teacher Perceptions and Practices in School Social Worker-Teacher Interprofessional Collaboration Interprofessional Collaboration

Abstract School social work requires significant skills for interprofessional collaboration, especially collaboration with teachers. While the value of such skills is increasingly recognized in fields such as healthcare, there has been limited attention to assessing or supporting interprofessional practice in education. This exploratory mixed-methods study analyzed survey data from 264 school social workers across the United States in order to understand their perceptions of teachers as collaborators and their practices relating to collaboration with teachers. Barriers to collaboration were also identified. Data suggested that school social workers had positive perceptions of teachers as collaborators generally, but saw limitations in the training and support of teachers to effectively respond to non-academic concerns; time and support for collaboration were identified as significant barriers to collaborative practice.


Perceptions and Practices in School Social Worker-Teacher Interprofessional Collaboration
Over the last four decades, pK-12 schools in the United States have steadily increased their ability to address the non-academic needs of students through expansion of special education services, adoption of models like Community Schools, and provision of school-based health and mental health services (Flaherty & Osher, 2003;Gherardi, 2017).As non-academic services in schools have grown, so has the imperative for effective collaboration between educators and service providers.In healthcare settings, the importance of effective interprofessional collaboration on multi-disciplinary teams has become a central component of training, professional development, and practice over the last decade, with research strongly supporting the value of interprofessional collaboration for improving patient outcomes (World Health Organization, 2010).Despite the importance of interprofessional collaboration between educators and service providers in schools, and despite the positive impact of interprofessional collaboration on student outcomes (Bates et al., 2019), the emphasis on interprofessional education and collaboration seen in healthcare has not been fully translated or integrated into educational settings.
The reality creates unique challenges for school social workers.Because most school social worker activities happen during teaching hours, their work is often less visible to others in the school and not always recognized as being a key factor in the school's mission or success (Kelly et. al, 2016).Additionally, the reality that many school social workers provide services to students with disabilities reinforces the perception that school social workers provide only specialized services or that they cannot play a role in addressing other needs (Sherman, 2016).
The training and theoretical perspectives of school social workers should support their ability to engage and collaborate with a range of stakeholders, including members of school-based interprofessional teams.However, evidence suggests social workers in schools are often isolated and there is rarely adequate time or support for collaborative practice (Kelly et. al., 2016;Sherman, 2016).
The relationship between school social workers and teachers is especially critical given the central role classroom teachers play in all aspects of student functioning at school, although there has been little research focused in this area.
Where it has been explored, research suggests a lack of understanding between teachers and social workers in schools leads to an underestimation of social work effects (Wicki et al., 2020).This is likely reinforced by inadequate support and opportunities for collaboration and challenges with role and boundary definition (Agresta, 2004;Gherardi & Whittlesey-Jerome, 2019;Isaaksson & Larsson, 2017).
Given the importance of effective interprofessional collaboration and documented misperceptions between social workers and teachers in schools, this study sought to add to the literature in this area by assessing school social worker perceptions of the teachers they work with, the nature of their collaborations with teachers, and challenges with teacher collaboration.The study sought to answer four central questions: 1) To what degree do social workers identify teacher collaboration as a critical function of their role and how confident are they in fulfilling this role?2) How do school social workers perceive teachers as partners in collaboration? 3) How do school social workers describe their practices relating to interprofessional collaboration with teachers?and 4) What barriers to effective collaboration with teachers do school social workers identify?The answers to these questions serve as a starting point to begin to identify next steps in formulating school-specific models for interprofessional collaboration that maximize skills and opportunities for school social work.

Supportive and Inhibiting Factors in Interprofessional Collaboration
A variety of internal and external factors contribute to the level and success of interprofessional collaboration within school communities.For school social workers, quality of collaboration can be significantly impacted by the orientation of their professional training as well as their assigned role within the school.School social workers tend to be trained in individual intervention strategies, rather than whole school intervention, which can make it difficult for social workers to identify opportunities for school-wide outreach and collaboration (Kelly et al., 2016).Additionally, school social workers' assigned role within the school, along with corresponding funding and responsibility silos, may limit the worker's ability to establish collaboration by limiting their time and capacity to take on new projects, leading to "turf wars" (Mellin, 2009).
Interprofessional collaboration can also be significantly inhibited by variations in professional orientations and values.For example, school social workers and teachers may have different beliefs about the school's responsibility to address students' mental health and other psychosocial needs (Stone & Charles, 2018).Additionally, teachers may lack the training and confidence to address mental health needs in class, leading to a fear of perceived incompetence that may make them hesitant to seek or accept collaborative support from school social workers (Berzin et al., 2011;Mellin & Weist, 2011).The buy-in of all school professionals is necessary for successfully implementing collaborative initiatives (Mellin & Weist, 2011) although there are organizational characteristics that support collaboration.Higher levels of successful collaboration are seen in schools where there is a history of collaboration (Mellin, 2009), where the principal participates in, and supports, the exploration of opportunities for collaboration (Stone & Charles, 2018), and where participating partners are able to maintain a sense of equality in their efforts (Weist et al., 2006).Additionally, it has been shown that school social workers with a MSW, license, or clinical license report higher levels of collaboration with their colleagues than unlicensed or bachelor-level social workers (Berzin et al., 2011).Isaksson and Larsson (2017) utilized the notion of jurisdiction to explore why social workers and teachers tend to agree on the need for school social work but often present with significantly divergent expectations of school social work roles (p.258).This reality was again observed in Stone and Charles (2018) finding that social workers were more likely to name teachers as collaborative partners than teachers were to identify social workers as collaborators.This is perhaps due to the teacher's lack of clarity about the social worker's role within the school, and a social worker's lack of visibility in day-to-day classroom experiences (Kelly et al., 2016).Given that issues relating to role clarity and history of collaboration are frequently identified in school social work literature as impacting the field broadly (Gherardi & Whittlesey-Jerome, 2018), frameworks to describe and improve approaches to interprofessional collaboration in school social work have the potential to benefit the field generally.Berzin et al. (2011) presented four broad descriptions of school social worker approaches to collaboration.They classified school social workers as 1) non collaborators, 2) system-level specialists, 3) consultants, or 4) well-balanced collaborators.In exploring how reported activities of school social workers fit into these classifications, they found while almost all respondents engaged in collaboration, most focused their activities as system-level specialists (connecting students and families to other resources) or consultants (providing support to teachers or others in order to support students).Few participants could be described as well-balanced collaborators, engaging in a wide range of collaborative activities (Berzin et al., 2011).

School Social Workers as Collaborators
In practical terms, the types of collaborative tasks school social workers may be responsible for include: supporting teachers and administrators as interventionists (Berzin et al., 2011) andSEL advisors (D'Agostino, 2013); administering mandatory prevention programs such as 504, Title I, alternative language services, and other special education services (Anderson-Butcher & Ashton, 2004); identifying opportunities to support and encourage parent involvement (D'Agostino, 2013); and offering in-class trainings, after school mentoring programs, and more (Anderson-Butcher & Ashton, 2004).Other specific examples of collaborative efforts school social workers may engage in include: codeveloping protocol and strategies for addressing mental health concerns (D'Agostino, 2013); coordinating family-centered engagement and problemsolving opportunities (Anderson-Butcher & Ashton, 2004); educating teachers to provide trauma-informed classroom interactions and offering in-service trainings on other socioemotional topics (D'Agostino, 2013); or advocating for other inschool professionals, such as school nurses, to receive more mental health training (Weist et al., 2006).

Outcomes Associated with Interprofessional Collaboration
Successful interprofessional collaboration between educators and schoolbased mental health or support providers (including social workers) has been linked to improved outcomes for students, for parents, and the broader community (Anderson-Butcher and Ashton, 2004;Bates, 2019;D'Agostino, 2013).Schools that engage in interprofessional collaboration have reported increased academic achievement and attendance, as well as enhanced quality of student learning (Anderson-Butcher and Ashton, 2004).Bates and colleagues (2019) documented significantly improved student outcomes across a range of measures including attendance, academic performance, and behavioral functioning in students attending Title I schools in which intentional interprofessional teams were established versus those in which they were not.In addition, social workers participating in Stone and Charles' (2018) survey reported that when their school engaged in interprofessional collaboration, they observed improved student academic achievement, as well as improvements in student health and mental health outcomes.
In addition to improved student outcomes, significant outcomes relating to improved internal processes have been documented.Literature shows successful interprofessional collaboration results in improved treatment planning, intervention strategies, and team decision-making (D'Agostino, 2013).Similarly, Anderson-Butcher and Ashton ( 2004) described interprofessional collaboration as leading to better integrated behavior modification plans and reinforced procedure fidelity.Mellin and Weist (2011) described the benefits of interprofessional collaboration as increased knowledge, resources, and social capital.Additionally, interprofessional collaboration allows linked partners to create opportunities they could not successfully implement alone (Bronstein, 2003) and reduces the likelihood of replicating services (Flaherty et al., 1998).This sharing of resources and responsibilities improves the sustainability of programs by linking assets, knowledge, and organizational buy-in (Flaherty et al.,1998).Teachers, school social workers, and other school-based or school-linked professionals report interprofessional collaboration enhances partners' understanding of each other's professional orientations and capacities, resulting in better communication, increased feelings of support, and shared accountability for results (Anderson-Butch & Ashton, 2004).This enhanced partnership increases capacity to address mental health needs within the school, improved outreach to individual students, and increased access to mental health supports (Weist, et al., 2006).

Methods
This study utilized data from an online survey of practicing school social workers and Master of Social Work (MSW) students who were completing an internship in a school setting in the United States.The survey was designed as an initial exploration into the centrality of teacher collaboration in school social workers' understanding of their roles, their perceptions of teachers as collaborative partners, their practices for collaborating with teachers, and barriers to this collaboration.The survey included closed ended items which underwent quantitative analysis and one open-ended item that underwent open-ended qualitative coding.

Data Collection and Instrument
Because research documenting the nature of collaboration and relationships between school social workers and teachers is limited at present, an exploratory survey instrument was utilized.The survey was designed to provide preliminary descriptive data that could inform four key areas of inquiry: 1) Centrality of and Confidence in Collaboration, 2) Perceptions of Teachers, 3) Collaborative Practices, and 4) Barriers to Collaboration.One additional question assessing whether school social workers had received training or professional development in collaboration with teachers was also included.These areas were informed by existing research described in the literature review as well as a partnership between the researchers, current school social workers, and teachers in one mid-size school district in the Southwest United States.Survey items were piloted among school social workers in this district who had sought consultation around collaborative relationships with teachers; items were modified based on their feedback.The first three areas of inquiry were assessed by Likert scale items on the survey.Participants responded to 20 questions using a scale of 1 to 5 with 1= Strongly Disagree, 2= Disagree, 3= Neither Agree nor Disagree, 4= Agree, 5= Strongly Agree.The fourth area of inquiry was addressed by the open-ended survey item which asked participants to describe barriers to teacher collaboration they had experienced.The study was approved by the authors' institutional IRB prior to data collection.

Sampling and Participants
The survey was disseminated online through several U.S.-based school social work specific list-serves and social media platforms including the School Social Work Association of America, the American Council for School Social Work, and several state associations for school social work.It is estimated that approximately 3,000 school social workers in the United States were contacted to participate through these efforts.While this approach to sampling limited the authors' ability to fully define the initial sample size or ensure a representative sample of school social workers in the United States, it supported the collection of exploratory data in this population.All survey respondents who reported they were current school social workers or school social work interns were included in the final sample for analysis.264 practicing school social workers or school social work interns completed the survey.The majority (97%) of the respondents were currently practicing school social workers and had obtained a master's degree (85%).Practice settings for respondents varied, with 55% serving in multiple schools, 35% at a single school, 10% serving at a district or program level, and 1% describing a practice setting outside of these categories.Participants were diverse in the age of the students they served spanning from pre-kindergarten through 12 th grade, with many respondents serving a range of grade-levels.Thirty-five states were represented with the largest cluster of respondents coming from the states of Louisiana (18%) and Illinois (17%).Demographic information collected from participants is reported in Table 1.

Data Analysis
Quantitative analysis was completed using SPSS.Basic descriptive statistics including means and standard deviation for each Likert Scale item were calculated; the percent of participants who agreed or strongly agreed (scores of four or higher) were also calculated for each item.Subsequently, researchers ran Spearman's Rank Order correlations between each of three key items and the rest of the items on the survey.The three items for which correlations were run included the following: Item 1: "I have received training or professional development in skills for teacher consultation/ collaboration"), Item 3: "At present, I am confident in my skills for teacher consultation and collaboration" and Item 18: "Supporting teachers is part of my job".These correlations were used to assess the relationship between school social worker perceptions of teachers and collaborative practices and experiences with training/professional development, confidence in skills for teacher collaboration, and belief in the centrality of collaboration.
Open-ended survey responses were coded manually using Microsoft Excel.Coding utilized an approach to inductive content analysis based on Creswell's (2012) description of a systematic grounded-theory design.The traditional systematic grounded-theory design utilized three stages of coding: 1) Open coding which constructs initial categories from the data, 2) axial coding which clusters the categories established in open coding, and 3) selective coding which generates theory by interpreting the relationships among axial codes (Chun Tie et al., 2019).For this study, two researchers independently conducted open coding, subsequently reviewing coded data and raw data to reconcile any discrepancies in interpretation and improve inter-rater reliability.After this reconciliation, 12 initial categories were established.These categories were then collaboratively consolidated into four central themes (axial coding) which were further analyzed to theorize a hierarchy of barriers to interprofessional collaboration between school social workers and teachers (selective coding).

Likert Scale Items
Table 2 lists the 20 survey items, their corresponding area of inquiry, descriptive statistics, and correlational statistics between each survey item and the three items for which correlations were run.Training or professional development for collaboration with teachers was only reported by 35.6% of participants.While only 32.5% agreed they were confident in their skills for collaboration when they began practice, a significant majority (84.5%) agreed they were confident in their skills at present.Regarding perceptions of teachers, significant majorities of participants perceived teachers as hard working (95.5%), caring (96.6%), and willing to consider social worker suggestions (81.0%), and participants generally reported positive relationships with teachers (90.5%).However, the percentage of participants who agreed that teachers had the necessary skills or supports for addressing a range of non-academic student needs was much smaller (Items 6-12, and 15); only the items assessing perceptions of teacher relationships with students (65.5%) or skills for classroom management (50.9%)reflected over 50% agreement.Confidence for consultation or collaboration was significantly correlated with all other items (Items 7, 9, 10, and 12 at the .05level and all others at the .01level).Participant agreement with the statement "supporting teachers is part of my job" (Item 18), was significantly correlated with all items except those assessing training, initial confidence, teacher time and support, teacher professional environment, and teacher relationships with students (Items 7 and 8 at the .05level and items 3, 4, 5, 6, 9, 13, 14, 15, 16, 17, 19, and 20 at the .01level).

Open-Ended Responses
Survey respondents were asked to describe barriers to interprofessional collaboration they had experienced within the school setting.Open-ended inductive coding of these responses produced 12 discrete codes which included: 1) lack of time and scheduling conflicts; 2) daily stress and workloads; 3) understaffing; 4) lack of administrative support; 5) teacher attitudes; 6) differences in teacher training and skills; and 7) school personnel's understanding of the role of a school social worker.Additional barriers identified at low frequencies (1-2% of responses) included: 8) lack of school resources for collaboration; 9) lack of parent involvement; 10) institutional emphasis on academic achievement and testing; 11) fear of failure; and 12) crisis-driven work environments.Three respondents reported that they experienced no barriers to collaboration but did not specify whether they were participating in any forms of collaboration.These discrete codes were combined into broader themes describing critical barriers to interprofessional collaboration between school social workers and teachers.These included: 1) limited resources or support, 2) institutional environment, 3) professional roles and training, and 4) personal factors.Themes, codes, and frequencies for codes are reflected in Table 3. Lack of time and scheduling was most frequently identified as a barrier to collaboration, with 43% of respondents describing challenges in finding time to meet with teachers or to collaborate throughout the day.One participant wrote, "There is no time for collaboration to be preventative.Usually, we are reacting to situations and then quickly consult to try to improve thereafter, but there is no time for true follow up as it should be done.It's all reactionary…" Another wrote, "Time is always a barrier, as all of us are committed to regular professional collaboration teams within our own disciplines, and many teachers have special assignments/projects/duties or activities to support students on campus."Across the board, survey participants described time and scheduling barriers as a structural issue, with limited non-instructional time that can be used to meet with teachers.
Daily stress and workload (11%) and understaffing (11%) tied for the second most cited barrier to collaboration.Survey participants described large student caseloads and excessive amounts of documentation and paperwork as taking up most of their workday.Participants noted this is experienced by both social workers and teachers.Additionally, survey participants described understaffing of school social workers within their districts resulting in social workers having caseloads upwards of 1,000 students and being responsible for serving multiple schools within a district.Participants described this as a barrier to collaboration not only because of the inherent time constraints these realities created, but because serving multiple schools slows the relationship-building process with teachers and other staff.One participant wrote, "Because I am district-based and serve multiple schools and programs, teacher interaction is on a case-by-case method."Another wrote, "… In my district social workers can be moved from year to year.When you consider the importance of relationship building, it is hard to do when you know that [a] social worker will be moved at the end of the school year." Eight percent of survey respondents described a lack of administrative support and understanding of the role of the social worker as a barrier to collaboration.Additionally, participants in this category described a lack of professional development opportunities, as well as a lack of support in accessing professional development opportunities that would meet their professional needs.A minority of participants described administrative environments that discourage interprofessional collaboration.
Nine percent of survey participants identified teacher attitudes as a challenge in implementing interprofessional collaborative efforts.Respondents described some teachers as hesitant to ask for or allow social workers to intervene in their classrooms or offer feedback, with veteran teachers described to be most hesitant, with new teachers and special education teachers described to be more open.Survey participants said that some teachers did not see the value in investing in socioemotional learning and support, and others simply do not have time to focus on it.Others described some teachers as having negative attitudes about the school and/or specific students that prevent them from engaging in collaborative efforts.Finally, survey participants described both differences in teacher training/skills and school personnel's understanding of the role of the social worker as barriers (4%).Participants said that there is wide variation in teachers' level of training in socioemotional learning, whole-child approaches, and specific trauma-informed classroom strategies.This, they said, influences whether a teacher is likely to welcome social workers' support in these areas or not.

Discussion
This study sought to answer four key questions: 1) To what degree do social workers identify teacher collaboration as a critical function of their role and how confident are they in fulfilling this role?2) How do school social workers perceive teachers as partners in collaboration? 3) How do school social workers describe their practices relating to interprofessional collaboration with teachers?and 4) What barriers to effective collaboration with teachers do school social workers identify?Below, we identify limitations of this study and revisit these questions to describe implications of this research.

Limitations
This exploratory study provided insight into the current state of perceptions and practices in interprofessional collaboration between school social workers and teachers.While the sample represented a large and diverse group of school social workers in the United States, it was not a random sample and is not statistically representative of this population.The use of an exploratory survey tool also limits the strength of the conclusions to be drawn from this data.As such, factor analysis and subsequent refinement and re-administration of the survey tool could be an important next step in gathering data that goes beyond an initial exploration into the topic of school social worker-teacher interprofessional collaboration.As presented in this study, the data provides a snapshot of how teacher collaboration is understood and enacted by social workers in a range of school-based settings across the United States, as well as their understanding of both the value of and barriers to these practices.

Centrality of and Confidence in Collaboration with Teachers
Overall, findings supported the notion that school social workers understood collaboration with teachers as a central part of their role, although this was not necessarily conferred in their pre-or in-service training.While training/professional development addressing collaboration with teachers was correlated with confidence in teacher collaboration, it was not significantly correlated with support for the notion that supporting teachers was part of participants' jobs.This may be largely due to the limited number of participants who had received such training juxtaposed with many who had developed these skills outside of specific training.These responses suggest the understood importance of collaboration and skills for collaborating with teachers were primarily developed on the job.This reality could be significant, especially considering literature describing the importance of understanding professional roles (Bronstein, 2003;Gherardi & Whittlesey-Jerome, 2019;Isaksson & Larsson, 2017;Stone & Charles, 2018) play in supporting and accelerating effective interprofessional collaboration.
Perhaps not surprisingly, confidence in skills for teacher consultation/ collaboration were positively correlated with all other items on the survey, even those items which were not correlated with centrality of collaboration.Interestingly, this item relating to confidence was associated with higher scores on items assessing perceptions of teacher attitudes toward students and the work environment whereas support for the centrality of collaboration and training/professional development were not.This suggests increased confidence in collaboration was more closely related to more positive perceptions of teachers than specific knowledge or beliefs about collaboration.This data and existing literature documenting history of collaboration as a key contributor to effective interprofessional relationships (Bronstein, 2003;Mellin, 2009) support the notion that interprofessional collaboration creates a feedback loop which increases school social worker skill and confidence for this work while also increasing their understanding of and empathy for teachers as collaborators (which further supports their confidence and skill development).

Collaborative Practices with Teachers
Significant majorities of school social workers in this study reported time spent providing consultation to and building relationships with teachers, although fewer than half of participants reported regularly spending time in classrooms during instruction and fewer than 70% reported having ever provided wholeclassroom interventions.Given the diversity and breadth of school social work roles, responses to these items are likely more reflective of the institutional environments supporting teacher-social worker collaboration than they are reflective of individual social workers' decisions about their practices.However, it does reinforce Berzin and colleagues (2011) findings that well-balanced collaboration is less frequent than collaborative roles as consultants or specialists for school social workers.
Interestingly, all items assessing collaborative practices had positive correlations with all three items for which correlations were reported (training, centrality of collaboration and confidence).Because training and centrality of collaboration were not, themselves, correlated with confidence, we suggest that school social worker engagement in collaborative practices (providing consultation, building relationships with teachers, spending time in the classroom, or providing interventions at the classroom level) is likely to catalyze the feedback loop described previously.Furthermore, we suggest that these practices, belief in the value of collaboration, and confidence in this work are developed in a concurrent rather than sequential process.

Perceptions of Teachers
Review of the descriptive statistics from the Likert Scale items assessing school social worker perceptions of teachers suggests that, overall, participants perceived teachers as willing collaborators who worked hard and did their best to support students, but who often lacked the knowledge, skills, or resources necessary to meaningfully supports student non-academic needs.We might characterize the general perception of teachers as collaborators as one of partners who are willing, but not always able to meet a broad range of student needs.Importantly, this lack of ability was not due entirely to perceived deficits in teacher motivation or skill.While agreement with statements about teacher knowledge or skills for supporting a range of student non-academic needs was generally low (at or below 50%), support for statements which assessed the resources teachers had to do help them do this work had the lowest means of all survey items.Simply put, school social workers in this study did not believe that teachers had the training, time, or support necessary to address non-academic issues or support the "whole child".These conclusions come into clear focus when we look specifically at barriers to collaboration identified by the open-ended survey item.

Barriers to Teacher Collaboration
School social workers largely identified structural factors (lack of time and administrative support, high workloads, and understaffing) as the primary barriers to effective collaboration.Findings clearly identify structural limitations or inadequate time, support, or staffing as the most significant barriers.Issues in the institutional environment were also significant (such as school culture that was focused on crisis response rather than wellness) as were issues relating to understanding of professional roles or training that could support collaborative practice.Finally, personal factors like fear of failure were also identified.
We suggest the themes identified in this data do not reflect discrete barriers to collaboration.Rather, they might be best understood as a hierarchy, within which personal/interpersonal issues inhibiting collaboration stem from professional roles that are poorly or rigidly defined, which is often the result of an institutional environment that is crisis driven or undervalues collaborative work, which, itself, often results from limited educational resources (Figure 1).While this hierarchy might be viewed as simply restating what most people who have worked in schools already know: resources are limited and this reality is limiting, it also presents a hopeful reality.If we can understand the central barriers to effective interprofessional collaboration not as barriers between school social workers and teachers, but as barriers between those who wish to support students and their diverse and multi-faceted needs and the resources necessary to meet those needs, new possibilities emerge.Such an understanding could yield a shift away from a focus on helping school social workers and teachers (and other school-based providers) to get along and toward a focus on how educators and providers can truly work together to dismantle shared obstacles and address student needs.

Implications for Practice and Research
While this study holds implications for social work practice, they are largely reflective of the need for organizational change that can effectively support interprofessional collaboration between teachers and social workers.While school social workers can and do dedicate time and attention to effective collaboration with teachers, these efforts can be bolstered by advocacy with school and district leadership around the necessity of intentional time and support for interprofessional work, including training and support for this collaboration.Manageable social work caseloads and the ability for social workers to serve a single school, when at all possible, can pay significant dividends extending the impact of school social work through the development of effective collaborative relationships.In addition to direct teacher support and consultation, the development of intentionally interdisciplinary student support teams and interdisciplinary involvement in school leadership are critical opportunities to address the barriers described in this study.
Because this study was exploratory in nature, there remain significant questions to be answered by further research.There is a definite need to develop tools for assessing and evaluating attitudes toward interprofessional collaboration in school settings.Such tools exist for healthcare professionals but have not yet been adapted or validated among school-based professionals.Further research is also needed to develop specific models for interprofessional education in this population and to further clarify effective models for social worker-teacher collaboration in schools.

Conclusion
Whether or not it is always recognized, the work school social workers do to support students or positively influence school systems largely happens with and through teachers.Effective interprofessional collaboration has the power to amplify the reach of school social work or inhibit the positive impact of services for students.This study suggests experienced school social workers recognize this reality and develop the skills necessary to do this work, although an explicit focus on building effective collaborative relationships between school social workers and teachers is not yet a substantive part of training or role definitions for school social workers.While positive relationships between school social workers and teachers are widespread, efforts to amplify the impact of these relationships through the development of effective structures and support for interprofessional collaboration is critical.New approaches to training and professional development could support these efforts as could the intentional creation of structures to encourage and support collaborative approaches.Other fields have demonstrated these efforts improve the individual practice of interprofessional team members while also improving their ability to function effectively as a member of a team, both of which lead to improved outcomes for clients.As such, the intentional adaption of frameworks for interprofessional education and interprofessional practice to pK-12 education settings represents an important next step for maximizing the efficacy of collaborative relationships between school social workers and teachers, and, ultimately, other members of interprofessional teams in school settings.
Significant correlations at the .05level were observed between training/professional development and the following items: Initial confidence in skills for collaboration (Item 2), positive perceptions of teacher knowledge of social-emotional development (Item 6), positive perceptions for teacher implementation of social worker suggestions (Item 15), and time spent on classroom-based interventions (Item 20).Training was correlated at the .01level with present confidence (Item 3), teacher training in non-academic needs (Item 8), teacher support/time (Item 10), teacher initiating of consultation (Item 13), teacher consideration of social worker suggestions (Item 14), time devoted to teacher relationships (Item 17), and time spent in classrooms during instruction (Item 19).