Communicating with parents in pediatric settings can be a stressful part of the collaborative therapy process, especially for new grads. Here, I'll cover some practical strategies to enable effective communication between the OT and the parent.
Parents play an essential role in therapy outcomes as they must carry over the skills and strategies used in sessions into the child’s environment outside of therapy (i.e. in the home). While working in difficult situations with different types of parents – from parents who have questions about the child’s diagnosis that you are not qualified to answer, to parents who do not buy into occupational therapy, even to parents who believe that OT is the answer to all their problems.
The Role of the Parent
Beliefs regarding parent and family involvement in occupational therapy have evolved significantly over the past few decades. Traditionally, services for children with disabilities were child-centered and the therapist was seen as the expert. In recent times, the parents’ role has changed dramatically, and parents are now seen as teachers and therapists in the home and are essential to carry over of therapy (Hanna & Rodger, 2002).
This paradigm shift in care provision has resulted in a family-centered therapy model, where the child’s needs is placed in the context of the family and community, and therapy is provided in collaboration with the child and family to meet these needs (MacKean et al., 2005).
A key competency of occupational therapists working with children and families is effective communication skills. OTs are typically known for their excellent interpersonal skills. When interacting with parents, therapists must communicate in an honest and open manner, and actively listen to parents, valuing the information they provide (Case-Smith & O'Brien, 2013).
1. Begin with strengths
Always start off a conversation focusing on a child’s strengths. No one wants to hear only negative comments. By giving positive feedback you are reinforcing the parent’s sense of competence and self-esteem. Also, this will aid in building a rapport with parents as they will appreciate that you can recognize all the things their child is good at.
2. Do not use jargon
Avoid complicated medical terminology when expressing your concerns for their child e.g. bilateral coordination, proprioception, sensory processing etc. Use of complex terms may result in misinterpretation of information. Explain concepts in full, using everyday language, and check in with the parent that they have understood what you have said.
3. Provide appropriate and accurate information
Meeting the parents’ information needs is a key element in increasing parental satisfaction and decreasing parental stress. It is essential to pace the provision of information in line with the needs of each parent (taking into account if they have recently received a diagnosis, potential levels of distress, and the level of information requested). The therapist should provide sufficient information whilst avoiding information overload.
4. Avoid judgement
If the child is the firstborn in a family, parents may not always recognize delays in the child’s development. Allow parents to express feelings without judgement. Parenting styles may differ among families; it is important that the therapist remains open and non-judgmental when discussing the incorporation of strategies in the home, particularly behavioral management skills.
5. Be patient
You may be the first person to tell the parents that their child may need some extra help. Give them time to digest the information and realize that their child may benefit from occupational therapy intervention. Be patient by allowing parents plenty of time for questions. If you do not have time to address each question before your next scheduled appointment arrange a time to follow up on unanswered questions.
6. Be culturally mindful
As countries become more culturally diverse, it is critical that OTs remain culturally sensitive throughout practice. It is important to recognise that the roles, routines and traditions of children with different backgrounds may differ. The OT should also be aware of different perceptions of disability. It may be useful to discuss the beliefs of family members regarding how this disability can improve and how family members can aid this process. This approach will effectively integrate intervention recommendations into the family’s cultural practices.
Make sure you listen to the parent’s concerns. Although the OT may have the knowledge of the most appropriate interventions, the parents usually have the best insight into their own child, and can provide you with valuable information to guide therapy.
It is important to consistently reflect on and be aware of our own behavior when interacting with parents. A reflective diary will allow you to reflect on conversations with parents and gain insight into how to use the above techniques to improve your communication, with the overall aim of improving outcomes for each child on your caseload.
Effective communication between parents and therapists is key to the success of a family-centered approach to therapy. By actively incorporating the above strategies into practice OTs can build positive relationships with parents from the first meeting and maintain open lines of communication throughout the therapy process. Effective communication, accompanied with an understanding of the parent’s unique perspective will allow for clearly defined roles within the therapist-parent partnership, with both the OT and the family working towards the child’s goals in harmony.