FREE TO READ: Choosing a Therapist for your Child: Ten things to think about, talk about and ask!
October 22, 2016
1. What is your therapist’s experience and specialty interest? Ask your potential therapists how long ago they graduated, check that they are registered with the appropriate body (more info at https://www.ahpra.gov.au/) and what they’re really good at. A speechie may have graduated twenty years ago, but if they’ve only worked in aged care until this year, they may or may not be a good fit for your child. And a recently graduated OT may not have the skills to support your child’s behaviour needs, but maybe they have a senior therapist supporting them well? Ask questions!
2. Where does your therapist work? Therapists can work from a clinic base, in your home, at the playground, or in school. Purely clinic based work may not give your therapist a good idea of the challenges you have at home, and often children’s behaviour and needs are quite different in different places. If you have other kids, it might be really valuable for your therapists to see that interaction at home, and it might save you some stress getting the kids off to appointments. Some schools in SA are no longer allowing therapists in to work with children, so check with your school. And if your therapist can work with your child at school, do they pull them out of the classroom, or work with the teacher to make sure their work carries on for the rest of the week!
3. How does the therapist communicate with you? Does your therapist give you written “homework” after each visit, and is this useful for you or does it just sit on the fridge? What is the best way to share information with *you* and is the therapist willing to do that? There’s not a lot of point in a speechie visiting your child at school for a session every fortnight if you don’t know how to reinforce and carry on the work for the rest of time!
4. What does your therapist charge? Ask you therapist what their charges are – do they work with your child for a full hour, or 30 or 45 minutes? Do they charge travel time? Do they charge mileage costs? What are their charges for reports and assessments and is that included in the regular visit fee or is it extra? Also ask if they require up-front payment if you are Plan or Self managed. Here’s some information on provider travel for Agency managed NDIS plans: https://www.ndis.gov.au/provider-travel-information
5. How long is their waiting list? Many therapists have waiting lists – ask how long it’s likely to be for your therapist of choice. The waiting list may be short if they’ve just hired a new therapist to add to the team, but make sure you check out if their new therapist has the skills (or are well supported by seniors) and personality that you feel will work well with your child – don’t just go by the “brand” of the company or organisation.
6. What extra qualifications do they have? Some therapists have extra qualifications and actively engage in ongoing professional development, and are members of professional associations – I know a few OT’s who are also qualified in Circle of Security, and a Counsellor who is also an art therapist, and some psychologists qualified in equine therapy. You might even find a physio with training in Feldenkrais, so do ask! You might want to ask whether they have regular supervision or peer support.
7. What intensity and frequency of service is best for your child? Sometimes a short burst of frequent intensive therapy and practising time can do more to help reach a child’s goals than a regular fortnightly slog, but sometimes children need that regular consistency and slow relationship building. Ask your therapist how they work, and whether they (with you!) have any capacity for an intensive burst – these can be especially helpful during school holidays etc, so if you are working parents, you might have an opportunity to be more involved in your child’s work.
8. What is your therapist’s “exit strategy”? The ultimate goal of therapy (and parenting!) is to do themselves out of job! Talk to your therapists about how they measure progress, and at what point they think they may no longer be needed, or maybe only needed on an occasional consultative basis. I don’t know about you, but I certainly don’t think I’d like to have therapy three times a week for the rest of my life!
9. What is their approach to treatment and teamwork? I see too many children trot off to their individual therapy sessions each fortnight or week, with very little, if any, interaction between therapists. Yes, it *is* really important for your speechie and OT and counsellor and psychologist and physio etc to connect, and it might be up to you (or your support coordinator if you have one) to demand (and set up) those meetings, even if it is a bit like herding budgerigars! You might want to check if your therapist is OK with this. Have a think about group work too – children can learn an awful lot from being together, and so do parents – maybe a mix of group and 1:1 will help your child meet their goals much better than 1:1 only! If your therapist doesn’t do group work, can they point you in the direction of others who do? Also ask about their theoretical approach to treatment – this is especially important when seeking a psychologist’s support. There are many quality evidence based practises, and your psychologist should be able to explain some of these to you, and provide evidence of how well they work so you can make an informed choice.
10. Will the therapist help train your support workers? Chances are that for many children (and certainly adults), their support workers and parents will spend more time with the person with disability than the therapist. Is your therapist willing to work with your support workers to develop an individual program to build on therapy work outside of therapy visit hours? Can a physio give suggestions and support on how to encourage and practice skills at a playground, or in the back yard? I often suggest that the babysitter, grandma, or a support worker come to therapy sessions with parents and child to learn how to continue the good work.
Don’t forget, a therapist who works with your child one hour a fortnight is only with them .6% of their awake life. The other 99.4% of your child’s waking hours are with you!
And remember – with NDIS you *can* change your therapists!