• Time to break from 6-year-old's therapist?

Time to break from 6-year-old's therapist?

My six-year-old son has been in play therapy, twice a week, for 2 years. Many of the behaviors for which I brought him there are now resolved (whether because of therapy, maturity, or the many other changes that happen over the course of 2 years, I don't know). Still, he retains serious problems with his behavior, particularly among his peers (on the playground and in school). His therapist has not given him a firm diagnosis.

After 2 years of therapy twice a week (not to mention weekly sessions with a tutor for his dyslexia and dysgraphia), I want to try taking a break from the therapy (and the frantic schedule) and put my son in an aikido class, or maybe a social- skills day camp, or maybe just take him to the park more--just something else, something new. Having no other experience with child therapy, I have no frame of reference as to whether or not this therapist is really helping, and whether or not it would harm him to break from the therapy for a while. My questions are:
- Could it really harm him to take a hiatus?
- How can I answer the therapist's belief that he should stay in therapy with her? To hear a therapist tell you that your child will be harmed by removing him from her care, even temporarily, is a difficult thing to argue with, especially if you have no science to counter with.
- Finally, are there local support groups for socially difficult kids (simply put, he's an antagonist, inordinately afraid of being vulnerable)? Are there local support groups for the PARENTS of kids like mine?
Flummoxed Parent

Since he has already experienced individual therapy for a period of time, and since it seems his issues are now primarily social ones, I would say that group therapy of some form would be ideal for your son at this point. I'm sure some BPN parents can point you in the direction of some appropriate group leaders, but what springs to mind is Jim Beatty http://www.hahathisaway.com/, though I haven't observed these groups personally.

I would also encourage you to pursue something more physical, such as martial arts (aikido, capoeira, etc), that can help your son ground himself in his body and learn impulse control in a group setting, if that's something your son seems capable of. Speak to the teacher first about any concerns you may have and make sure you feeel it will be a success-oriented experience for him, rather than something that may knock his self esteem and trigger negative behaviours.

And finally, I am a board certified music therapist with extensive experience with children and adolescents. This fall I plan to be running social skills groups for children using the medium of music. Music therapy is a non-threatening and engaging medium that is ideal for addressing social, emotional and behavioural issues. More can be read at www.musictherapy.org. I will post further info on BPN nearer the time but feel free to contact me with any questions. Best of luck, Maya

What's your relationship like with your son's therapist? Do you have bi-weekly or monthly meetings to talk about how your child is doing (in therapy and in his life at school and at home)? Do you trust your therapist to make recommendations? If your son's therapist says that taking a break from therapy would ''harm'' him, I would inquire about what the therapist means, specifically. Is he saying that a sudden, unprepared for separation from a beloved therapist might be harmful? Or is he trying to say that there are symptoms that your son still has that would benefit from therapy? Whichever he means, he should certainly be prepared to be specific in delineating your child's accomplishments and where he still might need help. He should also be able to point you in the direction of other things you might do (akido, support groups for you etc.) that you might do to help your son

It is also important to periodically check in directly with the therapist to assess where the treatment is going, and to also check in about what you are seeing at home and school. The therapist should encourage this dialogue. What are the current goals. Is going to therapy 2x a week addressing those goals? Is the therapist also having sessions with the parents to go over what's happening, hear about what's happening at home and create a bridge between the therapy work and the real world? Just meeting with a child so young without connecting directly with parents feels like treating the child in a vaccuum. I don't know if that's what's occurring here...but a child spends much more time in school and at home then with a therapist.

Therapy is a relationship, and the termination of therapy can have an effect on a child. Endings or pauses in therapy can also be done sensitively, with the door left open for future visits.

Your child has been in therapy two times a week, since age 4...without a diagnosis? Has your therapist suggested that a full neuropsychological report might be useful to help find a direction for treatment?

You are your child's primary relationship. I encourage you to feel empowered to get specific with the therapist about their treatment rationale, and to see if there's a compromise position available.

Many kids have a less structured schedule during the summer...for some kids this is wonderful; for those who may need more external structure, summer can be chaotic and confusing. Perhaps with the structure of school ending, making too drastic a change in other activities could be contraindicated. anonymous

I now believe (1) that if therapy doesn't seem to be helping, it probably isn't, and (2) if therapy isn't helping, there's a real chance that it's doing harm. It can be harmful if the therapist misunderstands the root causes of the child's behavior or if the child feels blamed for things they can't yet control or don't understand. One of my kids came to believe that therapists don't understand and can't help, and now resists therapy that I believe would help. Spending time in unproductive therapy deprived my kids of the benefit of appropriate treatment at an earlier age, when it would have been more effective. It also left them less time for other activities and social interaction.

I now believe that a framework for understanding the child, such as a meaningful and accurate diagnosis, is the best foundation for therapy. Much has been learned about the brain since the time when many practicing therapists were trained, and there are many new insights as well as help from other disciplines, such as occupational therapy and speech and language. In our case, a thorough neuropsychological evaluation set us on the road to helpful treatment. An eval isn't cheap, but compared to the cost of twice-weekly therapy it's not bad.

Therapists can have a powerful influence, and it can take a lot of courage to trust your instincts against the strong beliefs of a professional. And other professionals, even if they disagreed strongly with the therapist, were reluctant to encourage us to switch. As much as we worried about it, when we discussed discontinuing therapy, it turned out to be what the child wanted -- it obviously was no longer meaningful to the child, and we've never had any reason to regret the decision. I've only regretted not making the change sooner.
a mom