I’m happy to focus a little on a topic that many of you have reached out to me about. In the past, I’ve written mostly on the programming as it relates directly to your client. You know, like teaching imitation, listener responding, using negative reinforcement, etc. However, this week I’m happy to focus on a topic that many of you have suggested: Parent Training.
We’ll talk about some of our preconceptions regarding parent training and I will recommend a few shifts in focus regarding the way we look at it. Next week, I’ll focus on specific strategies that might help you gain a little ground in the parent training department.
Let’s begin with an observation I’ve made regarding a common approach to parent training.
It’s an afterthought.
Parent training becomes an afterthought for many clinicians for a variety of reasons. First, it’s simply NOT what you think of when you think of ABA therapy. You think of kids, sitting on the floor or at a table, with an adult (the RBT), using the power of reinforcement to change their lives. You think visual schedules. You think colorful toys. You think of: if-then boards, pictures of common items laid out in complex arrays, PECS boards, circle time, etc. In other words, when a picture of ABA comes to mind the parent isn’t in it.
Another reason parent training is an afterthought has to do with the amount of time we’re simply required to spend with the parent. Especially in terms of how that time compares to our other requirements with a learner. Direct therapy can make up for as much as 40 hours a week. Our requirements for direct consultation with the RBT and the learner can make up 2-8 hours of our week. Parent trainings might be required at an hour per month. Our attention tends to follow whatever our job requires of us. If parent trainings are 5-10% of what we do, then they might be getting only a fraction of our attention and effort.
So, whether we like it or not, we’re already coming in with a few preconceived notions about parent trainings. And—of course—there are idiosyncratic situations, as well. Some parents are hard to get a hold of. Maybe our caseload size is so large that it doesn’t allow us adequate time to even reach out to them. Maybe some families are more confrontational. There are additional barriers. It can be really hard.
Identifying and questioning our vision on what successful parent trainings and parent relationships should look like is a great starting point.
Change what you focus on when you think about parents. Here are a few places to start…
Pursue a quality relationship with the family as hard as you pursue progress with their child.
Like we just talked about, our attention can take us all over the place. If we continue to maintain a vision of a job where parent training is an afterthought, it’ll continue to be an afterthought. It can’t be. I’ll say it again: It can’t be.
It’s the parent that allows services to happen.
It’s the parent that ultimately manages the learner’s environment.
It’s the parent that has the most skin in the game.
A quality relationship is the through line to learner success. It’s the lynchpin. It’s the first domino. Start by making a quality relationship with your client’s parent(s) a priority as much as clinical progress is. Seriously.
When evaluating how your learner is progressing overall, you’ll likely ask yourself whether or not their problem behavior is decreasing. You’ll likely ask yourself whether or not skills are increasing. Now, in addition, ask yourself whether or not you have a quality relationship with your learner’s parents. Do they trust you? Do they feel comfortable with you? Do they feel connected to you?
If the answer is “I don’t know”, then it’s time to work on your relationship with them.
Be the “go-to” professional.
What do I mean by that?
I’ll start by talking about what I don’t mean. I don’t mean to practice beyond your scope. You’re not offering medical advice here. You’re not counseling them. You’re a BCBA. Remember the BACB ethics code. Don’t do something you aren’t professionally capable of doing.
With that said, caregivers need to trust you. One way that you can earn their trust is through ensuring that they know that you care about them and their kiddo. So much so that you’re willing to reach out or work with other professionals on their behalf to get them the help they need when they need it. If you think about it, most caregivers have to juggle speech sessions, OT sessions, relationships with teachers and staff at school, and routine check ups with physicians and neurologists. Thats a lot of feedback and opinions from a lot of different people.
Being their “go to” professional means being the professional that supports, facilitates, unites, and advocates for them when working with other professionals. All too often BCBAs seem to only occupy a spot at the table if they’re at the table at all.
Be the pro that communicates with other pros. Send weekly updates to caregivers and other professionals who are working with the child. Update them when major progress has been made. Make a concerted effort to clue everyone in…and do so frequently.*
Be the pro that brings other pros into the fold. If an issue arises with the learner or family that is outside your scope of practice, don’t just recommend another professional. Reach out to that professional, explain in detail what is going on, make an introduction, and continue to be involved in that communication going forward. You’re in this together.
Be the pro that brings the other pros together. Look to schedule frequent meetings with caregivers and other service providers. Don’t wait for someone to invite you to the table. Instead, be the one that makes the table happen in the first place. Try to schedule quarterly meetings that bring the other professionals together to share insights.
Facilitating and advocating are a couple key components to building that trust. Parents are often left to organize the complexities of a multi-disciplinary approach…all by themselves. Taking that load off and letting them know that you’re involved and here to help will offer some well deserved relief.
Manage and revisit your expectations frequently.
Don’t expect caregivers to be the parents they are not.
When I was a new BCBA I admittedly was not privy to this piece of wisdom. I would tirelessly advise them on reactive strategies for a behavior plan. I would model behaviors in grocery stores on Sunday afternoons. I travelled across counties. I stayed late for meetings that fit their schedules. Sometimes they followed through with my recommendations and sometimes they didn’t. When follow through did not occur, I was frustrated.
The fact of the matter is that I made a variety of assumptions that were inaccurate about them. I probably assumed that they understood what I was talking about and that they felt that the information I was giving them was as important as I thought it was. That there wasn’t anything else more important in their life that could possibly distract them from what I was telling them. And, that they would prioritize me over all other stressors. I probably assumed that they were good at asking questions. I could go on and on.
The problem, of course, was not the parent. It was me and my expectations.
Certainly, when someone doesn’t follow through the way you’d like them to it can be frustrating. But, in most cases, it comes down to faulty assumptions and mismanaged expectations.
Behavior change—whether it’s our own, our learners’, and our caregivers’—is a game of inches. For some, it’s a game of centimeters. Some days, you’ll see leaps and bounds.
At the end of the day, it’s about keeping the needle moving in the right direction.
I’ll publish more specifics on parent trainings next week.
*When pulling in other professionals, make sure to work with your supervisor to ensure all corresponding releases and permissions are completed.
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