For the past few days, my social media has been bombarded with retweets and shares of summaries of the article printed by the Journal of the American Medical Association.  The JAMA article looked at the Parent Education vs. Parent Training models  and their effectiveness, per parent report, in the reduction of disruptive behavior in child(ren) diagnosed with Autism.  Disruptive behavior being defined in this article as a hallmark of autism.  This study looked at the efficacy of what is commonly coined as parent training.  The difference between the Education and Training was in the core classes, number of home visits, and follow-up; with the Training getting more of the customized piece.  This study was critical considering that advocacy groups supporting insurance reform not only advocate for reimbursement for direct services, but also for program supervision, and sometimes training.

As a provider, I have seen training look different within and across facilities.  Mildly put, not much standardization in methodology when it comes to training parents.  This huge reduction in quality assurance opened the door for platforms such as ReThink Autism to really provide families with something that they yearned….to be better informed.  To know what we know as providers and how to do it!  I have spent part of my sabbatical in the last few months looking at how we train families.  Do we customize based upon cultural differences?  Do we understand the family dynamic enough, better yet, do we respect the family dynamic enough to be influential in our training?  Parents are pretty smart.  They have at their fingertips YouTube, seminars, and literature.  They need to us to know and we need to respect the intellect they enter with in our training sessions.

When we provide parent trainings, the therapist is placed in a leadership position (ready or not) regardless of where we are in personal development.  With this, the instinct may be to Teach and Tell rather than Listen and Connect.  In using our Relational Intelligence, the Emotional Quotient (EQ) should be highlighted rather than our IQ.  Parent Training require that parents become immediately vulnerable with people with whom they have no relationship.  Dr. Brene Brown discusses  how courageous it is to be vulnerable.  Parent Training puts parents in an immediate place of vulnerability without relationship, an immediate factor in non carryover of technique.  Therapists are placed in the knowledge position.  Parent Training is the place for the seasoned therapist not in years but in EQ development.  The therapist who knows that relationships built on sarcasm, sattire, or mutual dislike for another will be short.  Parent Training is for the therapist who is ready to be vulnerable and disrobe (“I know this, but I don’t know that…let me find out”.  The therapist who can say “I don’t know”.  Making the training about the client and making you as therapist a Servant-Leader.

The JAMA article provided that Parent Training had better efficacy as these parent participants had more core sessions, home visits, and telephone sessions.  I would like to suggest, that there was more time to customize the strategies learned in the core classes through the home and personalized phone visits.

Five Essential Ingredients for Parent Training

1.  Customized to family culture and dynamic.

2. Include parent understanding of evaluation reports, progress notes, and questions they should ask inclusive of expectations for providers.

3. Always answer the evolving question of what does progress look like and how can parents carry out the techniques in the home, neighbors house, and other community interests.

4. Broaden expectations of what their child can become.  And I say this because unfortunately some parents may have providers who implicitly teach from the “he never will standpoint”.  Partnering with the “he never will” therapists will delay your child’s progress and potential.

5. Emphasize that treatment should always make your child grow and evolve with them.

These five ingredients are essential and important to emphasize for families.   It is critical that the parent training provide information and the stories of children and people who are employed, go to college, drive, communicate with technology in the workplace, and move forward.  Teaching Hope and Belief are important to the Parent Training tool bag.  It is in the believing that parent advocates are born.  Parents who are empowered, push the envelope.

The therapist as servant -leader is a concept not commonly discussed in our field.  But training from this perspective, opens the doors to authentic connection and maintenance of the time and talent invested in the parent training.

Be Empowered to THRIVE…and then pass it on.


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