Talking about implementing a family centered approach during your home visits sounds on paper fairly simple.  However, as Vicky has found out, it is not as easy as it sounds.  Here is an email she sent to me recently…….

“It is not easy to switch the strategy and get more mothers involve.  I talked with a mom about using her own materials, but the truth is other therapists walk in with their own materials. Even when I do bring in new toys many times the child still does not interact even with new material and only wants hugs from mom. Mom is so frustrated at this point that she pushes her child toward me to see if I can do something.”

Vicky brings up some valid issues.  It can be confusing to be the only clinician on a child’s team who arrives to the home empty handed.  This also raises a level of frustration for the child and the parent, as Vicky found out. Can you think of any possible solutions?  Here are a few:

  • Communicate! Start and end every session with a quick conversation about family centered care and why you do the sessions the way you do.
  • Touch base with other members of the IFSP team and discuss your approach versus theirs. Offer to let them observe part of your session.
  • The proof is in the pudding – actually getting better results is what parents and caregivers are most interested in.  Find out what routine or activity in their day presents the most challenges.  If you can make that moment run more smoothly you will have just gained a new best friend!
  • Shift from skill focused to routine focused while explaining the math behind it – expanding learning opportunities throughout the week versus just the one hour you are in the home.
  • This mommy was frustrated and that is where I would start the conversation – “seems like your daughter is fairly clingy to you, at least while I am here.  Does that happen during other times?  Would you like for her to be more independent?  Let’s problem solve that together – I might have some ideas!”. 

Those are just a few ideas from me.  Do any of you have other suggestions or have faced similar situations? Reply to this blog and give Vicky some support!