In individual therapy involving children, we therapists sometimes limit progress by making insufficient use of parents’ energy and ideas.
Each participant in therapy can get locked into a habitual pattern that is not really productive, even though each person may think they are “doing their job.” The parent delivers the child to the child’s individual session. While the parent dutifully waits in another room for an hour, the therapist diligently applies their therapeutic repertoire. The child is then returned to the parent until next week’s session.
In family therapy, the therapist’s role is clearly spelled out as we help family members to resolve conflicts and improve communication. But when the child is the designated client in individual therapy, the parents [in this article, this includes other adult guardians as well] often spend too much time in the waiting room with wasted potential.
This article explores ways that we therapists can optimize the therapeutic potential of families in individual therapy.
Whenever possible, for the intake session I ask parents to bring in written information, in addition to the standard intake form, regarding the child. This is not only enormously helpful when I am putting together the patient history, but it empowers the parent from the start regarding the importance of their own contribution to therapy.
I believe that many parents overestimate the therapist’s ability to get a well-rounded impression of how the child is faring in between sessions. I have often used “Waiting Room Update” forms for this reason.
Over a number of years, about 70 percent of my individual clients have been on the autism spectrum. For my sessions to be really worthwhile, I have often needed to be prepared with specific materials and activities ready to go. A few emailed sentences from a parent can be a real blessing when preparing for an individual session.
Another benefit of expecting the parent send a short email is to remind them of their stake in the therapy enterprise. It can help them to think, “What are my priorities this week helping my child? What is something that the therapist and I can troubleshoot together with my child?”
It is important to maintain proper boundaries when having them email between sessions. First, use encrypted email and use your professional email exclusively. Second, email is for you to receive brief information, and not for you to email back and provide advice – that is for the session only.
This is derived from a tip I got 30 years ago in a workshop by Bill O’Hanlon.
The idea is to convey to families that a good idea or beneficial movement towards change might happen at any time and be initiated by anybody – the therapist, the parent or the child. Many times, it seems as if families begin to solve a problem on the way to the session and then the therapist’s role is to refine, reinforce and endorse that change. If the family ends contributing more to the problem’s resolution than the therapist, that is the best possible outcome.
People often drive a long way to and from their appointments with us therapists. Their whole therapy experience might be viewed as lasting three hours – an hour to get to the appointment, an hour of therapy and an hour to get home. I have often “assigned” families to talk about a certain aspect of the session, or practice a certain skill, during at least part of the drive home.
Planning the right kinds of parent meetings, with the right frequency, is important for maintaining alliances with parents.
Many times, parents don’t really need to have separate parent meetings. But some parents don’t communicate clearly, or only speak in euphemisms, when the child is present. Or they might have their own issues that could affect the child’s presenting problem. For example, a mother disclosed to me in a parent meeting that memories of her own childhood abuse were being triggered by certain aspects of her child’s behavior.
I have found that having parents participate in creative therapy activities has been enjoyable and productive. Most parents seem to look forward to participating in this way. For example, I have often involved parents in the creation of these customizable behavior meters, which is one of the free downloads on this website.
Many of these therapy activities just go better if parents are there to observe and take part. And quite a few therapy activities I do in individual therapy actually require multiple participants. This is especially true with carrying out with role plays, even more so if we are videoing the role plays to play back.
The free resource shown here is Anime Emotion Worksheets.
It has been a great experience for me as a therapist over the years to meet and to work with the helpful siblings of my autistic clients. Many of these siblings of special needs kids have already grown into the helping role at home and their participation in sessions can be invaluable.
Here are just a few of ways that siblings have helped in sessions:
*Being the video camera operator during the recording of role plays
*Operating the laminator when we are creating therapy materials to take home
*Serving as informants regarding the designated client’s social relations at home and in the neighborhood.
The resource shown above is one of 17 therapeutic paper fortune tellers you can download on this website.
Of course, increasing parent involvement in sessions is not always helpful. Inviting parents into individual sessions should not become automatic by any means.
Fellow therapist, I hope you find some of these ideas helpful to you in your own work.
