For today’s post, I chatted with Kristin O’Rourke, a licensed clinical social worker in the state of New York. Kristin heads a group practice in Rockland County, where she and her team specialize in working with children and families.
Included in this post is a section of our conversation, during which Kristin details how she engages parents in therapy, when a child is the identified patient.
Kristin: We treat children as young as three, and we go all the way up to college age kids. So we really do treat a lot of different populations in the community. There's a great need for children and family work, so yeah, there's been a very positive response to it in our community.
Ili: I know that one of the main challenges for therapists not only in private practice, but also school counselors, is getting parents on board with participating in therapy. Please share how you have been able to do that.
Kristin: It's definitely more challenging, I think, when you're in the school population as a counselor to engage parents. Mainly, because they're not always on site with you. So you're working with the kids and you know, they're not there, as opposed to when you're at a practice, and they’re bringing their child to therapy.
1 | Educate Parents About Therapy
But I think it's really important to first educate parents on why it's important for them to be involved. They don't always understand. They think the therapy process is just between you and the child, and that's not the case.
I say, “I spend 30 minutes a week with this child, or 45 minutes a week with this child, but you are with them the remainder of the time. So, for anything that I'm working on with the child, it’s really important that there's follow-through at home.” And so, it's important for me to educate parents on strategies that we're working on, or to help them understand where the behaviors are coming from, or what's triggering the child’s behaviors.
2 | Empower, and Partner with, Parents
I also tell parents that we can't always control the child's behavior, but we can control our reaction to it. I ask, “How will you respond to the anxiety (or the behavioral issue, or impulsivity, or whatever it is that the child is struggling with)?” Oftentimes, we'll see a change in behavior just based off of the response of the parent and the change in the way that the parent is responding to their child. So, it's really important for them to be involved in the process.
3 | Structure Your Therapy Sessions
In my practice, I have the session set up as 45 minutes long, and 30 minutes are spent with the child, and 15 minutes are spent with the parent every single session.
Now, this really incorporates them into the process. It's mandatory. I always let parents know that we like to involve parents, and their involvement is really important for the process. I tell them that if they're looking for change, they need to be very active. So, the parent must attend every session. They may wait for half an hour, but they have to be there, essentially, because otherwise they'll miss their 15 minutes.
4 | Be Flexible, Based On The Child’s Age
We do treat teens, and so that's a little bit different.
When kids are younger, it's more natural for their parents to be involved actively [in the session]. But, when they're a little bit older, sometimes it feels a little uncomfortable for the child when parent is involved [in the session]. Either way, I do have my therapists have some sort of communication with the parent, if they can't be present at the session on a weekly basis. So, therapists are following up with a phone call.
But generally, the parents are there, and we are communicating every every week.
5 | Set Expectations
Ili: This is so important. So, I want to just take some time and talk a little bit here, because I'm trained as a marriage and family therapist. And, traditionally in my field, therapists don't really separate the family in therapy. And I'm not suggesting that there's a problem with separating them. But I'm using this as an example to say that at the minimum, everyone in the family is available to the therapist, however the therapist wants to divide the session time.
But, I’ve talked to therapists and supervisees who initiate the therapeutic relationship with a family with the assumption that they're going to work individually with the child, and then they encounter a lot of difficulty when they want to engage the parent(s). So, my suggestion is always: It will be difficult to go back and fix that, because you kind of set up the structure that way. But in the future, set it up with the expectation that the parents be available, because it's better for the child and for the whole family.
And so, is that something that you came to or was it something that you naturally did from the beginning of your practice?
Kristin: Yes, always, because I was treating younger kids, and I felt like the stamina of a younger child is not super long. And, a 45-minute session was long for a seven-year-old, and so I split it up, so that there was time spent with both—for people who were calling me initially for behavioral cases.
I feel personally it's impossible to treat a child and see results, especially when we're dealing with behavior and anxiety, without involving the parent. And, I had so many people, so many parents, calling me saying, “I never even met the child's therapist, or I never even had a conversation with my child's therapist,” and that just seemed so strange to me. So from the beginning, I just would tell people in our initial conversation, and I still do: “This is the format of the session. And, every week you'll be meeting with the therapist at the end of the session for at least 15 minutes.”
That’s how I set up the expectation from the beginning. And nobody questions it. We have found it to be highly effective in involving the parents, because again, they're the ones that are really implementing a lot of these things at home, and they're the ones that are raising these children and responding to them on a daily basis. That can really help or hurt a child when they're struggling.
Thanks to Kristin O’Rourke, LCSW, for sharing her expertise! Learn more about Kristin at inhomelcsw.com.
Also, take a look at more resources from Kristin:
For more on engaging children and parents in family therapy, see the children in family therapy series:
What one tip, from Kristin, will help you in your work with children and families?