Dr. Jantz notes that one-on-one direct service hours nearly doubled over five years. Which statements are plausible explanations for this change?

Dr. Jantz notes that one-on-one direct service hours nearly doubled over five years. Which statements are plausible explanations for this change?

• A. Both increased referrals due to familiarity and staff training leading to more symptom identification are plausible explanations
• B. Increased referrals due to familiarity is the only plausible explanation
• C. Psychologists' preference for one-on-one work fully explains the increase
• D. External policy changes are the primary cause

Answer: (A)

When one-on-one direct service hours rise over several years, it's most plausible that multiple factors are at play: as staff become more familiar with the program, referrals naturally increase, and as their training improves, clinicians become better at identifying students in need, which also drives more direct services. This combination fits real-world practice, where both awareness and competency grow together and expand service use. If we consider only increased referrals due to familiarity, we’re missing the push from better symptom recognition caused by training. Conversely, attributing the rise to psychologists’ preference alone ignores how systemwide factors and growing expertise shape how services are used. External policy changes could influence hours, but they’re unlikely to be the sole or primary driver without supporting evidence.

When one-on-one direct service hours rise over several years, it's most plausible that multiple factors are at play: as staff become more familiar with the program, referrals naturally increase, and as their training improves, clinicians become better at identifying students in need, which also drives more direct services. This combination fits real-world practice, where both awareness and competency grow together and expand service use.

If we consider only increased referrals due to familiarity, we’re missing the push from better symptom recognition caused by training. Conversely, attributing the rise to psychologists’ preference alone ignores how systemwide factors and growing expertise shape how services are used. External policy changes could influence hours, but they’re unlikely to be the sole or primary driver without supporting evidence.