Between Sessions: Tips for Parents to Support Children and Reinforce Treatment Progress

Yen-Ling Chen, M.A.
Practicum Trainee (2020-2022)

Parent involvement is the key to maximize child psychotherapy outcomes. Research has shown that therapy outcomes were better when parents were included (e.g., Dowell & Ogles, 2010). Parental support for seeking treatment, parent’s participation in therapy sessions, and effective communication with the therapist are all important aspects of success. Depending on the treatment modalities, the degree to which parents are involved in sessions varies significantly. For example, treatment can be primarily focused on the child as the client (e.g., treatment for older children and adolescents). Treatment can also be primarily working with parents in treating the child’s emotional and/or behavioral problems (e.g., parent management training), or it can be a combination of both. No matter your child’s age and what kind of psychotherapy you and your child are receiving, parent involvement “within sessions” and support “between sessions”are crucial and necessary. It is important to understand what skills are being targeted in treatment and know how you may support your child in practicing these skills between sessions. Here are four easy tips to maximize treatment progress for your child: Modeling, Prompting, Reinforcing, and Predicting (Friedberg, McClure, & Garcia, 2009). These tips can be useful for teachers to support students in the classroom, too!

Modeling: Parents are powerful role models for children. Whenever you feel the need to use skills, verbalize your feelings and how you would respond in that situation. Be specific. This can set a good example for your child. For example:

·      Model relaxation skills: “I have waited in the line for 30 minutes. This is very frustrating. I’m going to take some deep breaths to calm myself down.”

·      Model social skills: “I am nervous to meet my new supervisor tomorrow. But if I remember to make eye contact and smile, I will leave a good impression tomorrow.”

·      Model contingency management: “I worked really hard to get all my work done early, so I’m going to reward myself by watching a movie tonight!”

Prompting: When you notice warning signs that your child is getting upset (or anxious, frustrated, disappointed, etc.), it is a good time to prompt him or her to use skills. Again, be specific. You may invite your child to use skills together. This strategy would make them feel supported instead of feeling alone (“I’m the only one who has to use skills”). Giving choices can also be helpful, especially if your child already shows resistance to practice using skills. For example:

·      Prompt using relaxation skills: “You look upset. This might be a good time to use your calm-down box. Let’s see what’s in your calm-down box.”

·      Prompt using social skills: “One of your classmates is waving her hands and walking toward us. What skills can you use to start a conversation with her?”

·      Prompt effective contingency management: “Remember, if you finish your homework on time, this is a good chance for you to earn some points that you can use for more screen time.”

Reinforcing: Learning new skills and applying them to real life is hard! If your child makes attempts to use skills outside of sessions, remember to praise for his or her effort! If there is a reward system set up at home, adding this to the reward system can be very helpful. Even if the use of skills is not completely successful (e.g., still feeling very upset after taking several deep breaths), or the child is not highly motivated to use skills (e.g., showing a frowning face, not happy, complaining), you should still recognize the effort of trying. Remember, be genuine, specific, and immediate with your praises and/or rewards.

·      Reinforce using relaxation skills: “I’m proud of you for trying the deep breathing skill!”

·      Reinforce using social skills: “I noticed you said good morning to Mrs. Jones today. Great job!”

·      Reinforce contingency management: “Excellent job picking up your toys as I said! Here are two handfuls of beads for you!”

Predicting and Practicing: When you foresee a situation that will be challenging for your child, prepare him or her through role-plays. Problem-solve together and discuss how to better handle the approaching difficult situation. Practice skill use before the challenge comes. This will increase the predictability and confidence for your child and decrease stress in their life. If your child participates in this process, remember to praise for his or her effort, too!

·      Prepare for an upsetting situation: “Let’s pretend you are at the party tomorrow. You are very excited to see your friend John. But John is so busy with his other friends, and he doesn’t seem to be interested in talking to you. You get really upset with him and start to cry. What skills can you use to calm yourself down?” “Show me how you would do that.”

·      Prepare for a social situation: “Tomorrow you will be in the new classroom. There will be new kids whom you don’t know very well, but you want to play with them together. What can you say to them?”

·      Prepare for the contingency management plan: “I know Maya invited you and other friends for a sleepover at her house. What if you really want to go to Maya’s house this weekend, but you realize you don’t have enough points to do so?”

In summary, support and encouragement within and outside therapy sessions are important. You and your child are learning and building skills. Parents can play a crucial role in continuing to reinforce progress between sessions. These tips are important ways you can help your child. If you still feel ineffective and need additional support, be sure to check in with your therapist and look for additional advice!

If you are interested in initiating psychotherapy services for your child, please contact our Clinical Executive Director, Sarah Restori, at 702-508-9181 to schedule a teletherapy consultation or intake session.

No matter your child’s age, parent involvement in therapy is important. 

References:

Dowell, K. A., & Ogles, B. M. (2010). The effects of parent participation on child psychotherapy outcome: A meta-analytic review. Journal of Clinical Child and Adolescent Psychology, 39(2), 151–162. https://doi-org/10.1080/15374410903532585

Friedberg, R. D., McClure, J. M., & Garcia, J. H. (2009). Cognitive therapy techniques for children and adolescents: Tools for enhancing practice. Guilford Press.