A Therapeutic Top Ten List: Why Therapists Should Incorporate Parents into Therapy Sessions

ATN is delighted to welcome Carol Lozier as a guest voice on Touching Trauma at its Heart.  Carol, a member of ATN's Board of Directors, is a clinical social worker in private practice in Louisville, Kentucky.  Her website, www.forever-families.com, offers a blog, free downloadable tools for families, an excerpt of her book, and a supportive community of adoptive and foster parents.

Today’s post is written to my colleagues -- therapists who work with adopted or foster children and their families.  In educational workshops parents are instructed:  Remain in the room during your child’s psychotherapy. Yet, most therapists are trained to do the opposite.   Most therapists meet with the parents and child separately, and then work with both parties together for a short time. While this practice is commonplace, it is not optimal for adoptive or foster families.

A long time ago, I decided to keep parents in the session.  At first, it did feel odd but not only have I become accustomed to it, I prefer it. So with that in mind, here are my top ten reasons therapists should incorporate parents into their child’s session:

1.  Parents Are Our Co-Therapists. In an effective therapy session, one of the parent’s roles is to partner with us as they know their child better than we do.  In addition, issues come up at home and parents need to be equipped to work on them as they arise. One adoptive mom, Amy, explained that “[t]he therapist is teaching me how to therapeutically parent my child by modeling the wording. . . .  In speech, OT, PT, there are exercises that you do between visits, and the same is true with ‘feelings therapy'. Besides, she is with him for one hour a week; I am with him the other 167 hours that week and I have to know how to help him.” 

2.  Parents Aid in Healing the Past. Parents need to be included in the session as an aid to the healing process. In therapy, when a therapist and child re-create past trauma, a parent’s presence offers emotional protection to the child while they work on difficult or scary past events. Also, when a parent is available, they can make corrective, healing statements during the therapy process, and their statements are far more powerful than ours.

3.  Clarify and Add Essential Information. When a parent is in the therapy room, they can clarify information or fill in gaps of missing information about the child’s past. In addition, often parents can identify a negative belief or trigger that we were unaware of.  Adoptive mom Amy explains: “[T]he therapist … may incorrectly interpret my child’s silence, or withdrawal or hyperness.  At those times, I can point out, ‘he does this when x happens,’ and then we can work together to address what to do when x happens at home and she's not there.”

4.  Correct Inaccurate Information. Along the same lines, if the parent is in the room, they can correct information that the child misunderstood or misquoted.

5.  The Child Can Turn to Their Parent. During the session, the child may have  numerous needs from simple questions to reassurance to needing to use the restroom; the parent has to be accessible so that the child can turn to them for help. We want the child to lean on their parent for help, and not us.

6.  Encourage The Child. One of the parent’s roles in therapy is to encourage their child’s hard work. At times, the child will encounter difficult emotions or issues, and it is necessary for the parent to praise and support the child through this time. It is another opportunity for the child to lean on his or her parent, and to turn to them instead of away from them.

7.  Honesty. Let’s face it, there are times when children are not honest. They are not honest because they do not want to feel embarrassed or get in trouble, and sometimes because they do not want to admit to their wrongdoing. When the parent is present it ensures honesty from the child. This is important for a multitude of reasons, but especially because a dishonest answer can lead us down the wrong path, wasting precious time for the child.

8.  Be A Role Model. We are a role model for parents. They learn valuable skills when they watch us work with their child, and it is a great opportunity for us to coach them on parenting and therapeutic skills. Adoptive mom, Lynn, shares: “Being in the room allows me to be a better parent at home. …. I'm able to learn how to respond to things better.”  Similarly, another mom, Cheryl, explains: “Today, I was able to help my son connect back and work through an issue. . . . I don't think I would have been able to help him work through that had I not sat in on his therapy. .. . My perspective has changed so much since being a part of his therapy; it has helped me as his mom.”

9.  Communicate What Was Instructed. As the counselor, it is our job is to teach the child healthier skills. If the parent is not a participant, they are not familiar with the instruction and cannot encourage their child to practice the new skill.

10.  Bonding. There will be times when a child feels upset in session, and we want parents to comfort their child. If the parent is not in the room that task is left to us and then the wrong person is connecting with the child!

I understand that the majority of therapists have been trained to separate parent and child during the therapy process, and trying something new is initially daunting.  Nonetheless, I hope that the potential benefits, and the parent’s heartfelt comments spur you to consider changing your practice. I hope you will experience the value it has for you as well as for the parent and child.

Note: All names have been changed to maintain the confidentiality of families.