Sometimes in life we are turned to look at ourselves and our own social emotional well-being. Life presents us with a challenge, a loss, a change so we turn to our support system and to ourselves. Us therapists are human beings too. We make mistakes. We go through life’s trials and tribulations. I need to recognize that families have the same types of experiences in their own lives too. A family may not be in a place to implement a strategy one week. I get it. I briefly talked about meeting families where they are at on their journey in my first post. I do my best to perspective take within each family unit. Why? Because, it is my belief that is my job.
I worked in a clinic setting for a decade. When early intervention shifted to home-based services it was a change for me. I am still evolving as a home-based therapist. I am not perfect. (I am getting older too!) I still bring my bag in for some sessions. Let’s just be honest about it. I incorporate some families more than others into my sessions although each family is provided hands on opportunities. Sometimes it is about using clinical judgment and other times it is about accepting limitations. And in my opinion, although no one asked me, there should not be a one-size fits all way to conduct therapy in early intervention. I feel it goes against best practice if I attempt the same approach with all families. We would all be on the same diet plan, if one worked for all, right? If everyone liked the same car, we would all be driving that make and model. If all kids liked Sesame Street, they would only be watching that.
In the clinic setting the philosophy I remember was very direct therapy for one on one sessions, with limited expectation of parent involvement. Within the groups we conducted, the parent was the facilitator of every activity presented by the therapist. I loved this concept and especially the groups. Not only were there opportunities for role models, sharing and turn-taking; but this concept allowed for parental networking. At the end of the day, I would rather have you as a parent be successful with your child than with me. I often tell families, I would rather have him talk during the day with you than during the snippet that I am here. I often receive the surprised face with that statement. One of my goals today is for you to be successful with your child. As a younger, clinic-based therapist I had not considered that.
There are occasions where I just listen and that is my job. Very little hands on may occur on occasion because the family has questions or is struggling. There are sessions where I take pictures to print and laminate at home. We discuss how the pictures can be used within the family’s daily routine. I may use some of my toys to see what works with a child. Then, we go through the family’s toys and determine how some similar toys can be used to encourage language development. I am also a believer that if a child is crying every week upon a therapist’s arrival, then the therapist is in charge of changing their mind and their approach for that child. The sooner the relationship is fostered, the more that child will accomplish for you.
I tend to lean towards a behavioralist approach in my practice, but I am a firm believer that each of us as therapists need to look at the social emotional development and well-being of each family. I’ve had the privilege of having two bosses who are licensed clinical professional counselors. (Sarah Martinez – currently an adjunct faculty member at Erikson and involved in the Fussy Baby Network and Infant Mental Health Association and Patti Boheme – the Vice President of the Little Friends Center for Autism). If I’m going to do a good job I need to take into account where the family is at on their journey. Some have just received a diagnosis of autism; some parents are grieving. Some parents are concerned about their child’s future. Some are looking for answers on how to best help their child at home. Wherever it is, I meet that family there.
I remember one mom who said “Tracy, I feel like we incorporate all of your suggestions within our routines, but I don’t know that we can do anymore”. I remember looking at her and saying, “You are doing enough. You always do. Everyday”. I asked if she may be feeling guilty that she was not doing enough. I told her that in my eyes she had nothing to feel guilty about. Our relationship shifted at that point. I was always concerned that I was not doing enough and so was she until that day and that conversation. From that day forward our parent-therapist relationship was no longer strained.
I have experienced sessions in which the family practically runs from the room upon my arrival, almost as if a break is needed. That is the family I invite in for a few minutes the next session specifically to lead an activity that has worked in therapy. I went to a training facilitated by one of my mentors and previous boss. The presenter encouraged us to ask the parent, “I noticed that you leave the room when I come. What is going on that makes it difficult to stay in our session?” Thought-provoking question I have used on occasion.
I am often asked how many children I have, and my response is twenty or more every week. I am grateful to be an early intervention provider and I continue to evolve as a therapist. Thank you for reading my blog this week. If you enjoyed this or any previous posts (11 so far!) consider sharing with a friend, a therapist, a parent…