Parenting a child with greater social, emotional, or behavioral needs can be draining for caregivers, as these kids often need more support or create bigger challenges for the family throughout the day. When a child or teen is struggling, and families reach out for support from mental health professionals, the request is often for individual therapy focused on the child or adolescent to help them better regulate their emotions and behaviors. While it may be true that a child’s emotional and behavioral challenges are the root of a family system’s challenges, individual therapy is not always the primary or only recommendation for effective treatment.
Caregivers are often surprised by the need for involvement in their child’s treatment, or even the recommendation that a first course of treatment involves mostly work with the caregivers. Getting the recommendation to engage with a parent-based treatment can bring forward a number of reactions from caregivers. Often, caregivers may feel that they are already taking on more than they can handle to manage their child as is and may be experiencing caregiver burnout. Or they may feel offended by the idea that even though their child is the “problem,” the child won’t be the one receiving treatment directly from the therapist. Sometimes, the idea that a therapist will be helping caregivers work on parenting skills can feel off-putting to caregivers who feel like they have tried everything and are doing their best. It is understandable to have these reactions to the idea of using a parent-based intervention, and your clinician likely understands that many of these things are true. Most parents have tried many different strategies to support their child; the emotional toll of caring for a child with greater needs is high. And, even though the child may not be in every session, they are still the clinician’s main client and concern.
So, why are parent-based interventions recommended, when the child’s challenges are placing strain on the family?
The truth is that children and teens often have a more limited ability than adults to regulate themselves and take individual responsibility to change their behaviors without an outside influence. The ability to make independent change can vary greatly across developmental stages and personal challenges, but more often than not, change is most effectively made when the system the child exists in supports that change.
Parenting is hard in a multitude of ways, and there is a lot of social pressure for parents to know what to do when things go wrong, even though no parent is given a “rulebook” for raising their child. The goal of parent-based interventions is to support and empower the caregivers by providing effective tools to manage behaviors, encourage pro-social behaviors, and strengthen their bonds with the child. Each parent-based treatment takes care to understand what has and has not worked for caregivers in the past, and to tailor interventions to the individual child and family system.
Therapists know that by the time caregivers come to mental health treatment for support, they have likely tried many strategies used in parent-based approaches before. The benefit of being supported in a systematic parenting approach by a therapist is that it provides a whole program for how to manage challenges, rather than selecting specific skills that may not work effectively on their own. Parenting-based interventions take skills that complement each other and put them into a comprehensive package. It’s like a workout plan. Maybe just going out for runs doesn’t help you achieve your goal, but a workout plan where you strategize for including different types of runs or incorporate cross training can make all the difference. With a parenting-based intervention, your therapist acts as your personal trainer, and helps you implement the plan in the most effective way, until you feel confident implementing it yourself and start to see results.
Being recommended a parent-based interventions is not a critique of a caregiver’s ability to raise their child, but it is an opportunity to team up with a professional who understands your child’s needs to provide guidance on the most effective strategies to support their healthy development.
Caregivers can make change for themselves and their child with the support of a clinician using evidence-based strategies for parent-child relationships. Skills could include structured and consistent reinforcement and consequence strategies to shape pro-social behavior and reduce challenging behaviors, positive relationship building techniques, clear communication methods, and shaping attention as a reinforcement. These skills can be used, individualized and adjusted for each child and their personal challenges with the help of a clinician.
In addition, participation in parent-based interventions can help families lay the foundation for individual therapy for the child to be more successful, if indicated by the child’s needs. Through parent-based approaches, caregivers learn to better understand the challenges their child faces, they become skillful at using positive reinforcement which is useful in motivating and supporting treatment engagement, and they become aware of common environmental pitfalls that can maintain the child’s challenges inadvertently.