Trauma-Informed Therapy: Finding the Right Fit for Your Family

What should you look for when you are considering therapy for your child or your family? How do you find the right fit for your child's needs? We talk today with Kelly Raudenbush, Executive Director of The Sparrow Fund, a non-profit that provides therapeutic services for foster and adoptive children and their grown-ups. She is a child and family therapist with an MA degree in counseling and a certificate in clinical infant and early childhood mental health. She's also an adoptive mom.

In this episode, we discuss:

• What are some of the common reasons families seek therapy for their child or family unit? 
• When is it time to seek a therapist?
• What types of professionals can provide therapy?
• Is there a difference between therapy and counseling? 
• What makes a therapist trauma-informed?
• What’s the difference between being adoption-competent and adoption-informed?
• What should parents look for to determine if a potential therapist is competent to handle the trauma, adoption, or foster issues they are facing?
• Where can parents or caregivers go to find a therapist with the lived experience of being adopted? What might the benefits be in seeking a therapist with this lived experience?
• Can you list the more common therapeutic models of treatment that adoptive, foster, or relative caregiver families might consider? 
• When should therapy with our kids involve just the child, or the child and the parent? 
• What questions can parents or caregivers ask to determine if the therapist is a good fit for the child and family? 
• Are there additional or specific considerations for therapy that should be addressed if our child has experienced sexual abuse?
• What is home-based therapy and what are the advantages to this type of therapy for adoptive, foster, or relative caregiving families?
• Is therapy via tele-health or via teleconferencing as effective as in-person for our families? 

Additional Resources:

• https://sparrow-fund.org/
• Therapy Resources for Adoptive, Foster, and Kinship Families
• Adoptee and Foster Alumni Voices
• Therapists: Parents Should Be With Their Kids for Adoptive or Foster Therapy Sessions
• A Guide to Selecting An Adoption Or Foster Therapist
• Family Centered Treatment 

Transcript

Please pardon any errors, this is an automated transcript.

Hello and welcome to Creating a Family. Talk about adoption, foster care, and kinship
care. I'm Tracy Whitney, your host for today's interview about trauma -informed
therapy. I am the content manager of Creating a Family and now the host of both of
the Creating Family podcasts. Whether you're new here or you're a regular listener, I
am really glad you made time for today's interview. Our guest today is Kelly
Raddenbush. She is the executive director of the Sparrow Fund, a non -profit in the
Philadelphia area that cares for foster and adopted children and their grown -ups in
a number of ways. This includes specialized therapeutic services for foster and
adoptive families, and she is also a child and family therapist with an MA degree
in counseling and a clinical infant and early childhood mental health certificate.
That's unmouthable. - It really is. - And to top it all off, she's an adoptive mom
also. We're gonna talk today about trauma -informed therapy, how to find the right
fit for your family, how do you know what services you need, and Kelly is uniquely
positioned to talk with us about these questions. So let's dive right in.
The first question is kind of the one that most families are asking themselves when
they come to this conversation, what are the common reasons that a family would seek
therapy for either their child or for their whole family unit?
I think there's a lot of different things that draw families to even consider
getting help. Probably most commonly that we see is a behavioral concern,
whether that is at home or at school, that behavior is getting in the way, in some
way, socially, relationally, school performance, something like that. But it could also
be sibling relationships, parent, like a felt connection or lack of connection with
their kid. Maybe they're sensing that their kid is dealing with a lot of anxiety, a
lot of sadness. Maybe there's conversations that are coming up about birth family or
history or country or place of origin that the parents don't feel completely equipped
to handle. And so that could prompt why they're reaching out. There's there's so
many reasons that could draw someone to even consider accessing a clinician or help
for their family. Okay. If you're uncertain about when you should be seeking therapy,
what are some things that parents could be looking for or thinking about that would
kind of maybe push them to that phone call or to that online contact information.
I guess I would say like a sense of stuckness. Oh,
that's good. I don't even know. I don't know if that's a word. I'm making that
word up. We're going to make it up. Yeah. I'm going to go with that word. Like a
sense of like we're not moving forward and we're feeling stuck in whatever area it
may be. Sometimes parents reach out proactively, like they're not maybe feeling that
sense of stuckness, but they're wanting to do everything they can for their kid.
And some families, some parents really see therapeutic services as like an expression
of being a good parent. You know, of just like, hey, nothing is particularly wrong.
We just wanna make sure we're not missing anything. And that's okay too. So it
doesn't need to be that you're like in crisis or like feeling some sort of urgency
of like, ah, we're in overhead, we don't know what we're doing. It could be that
you're like, hey, I just wanna tick all the boxes and make sure that we're doing
everything we can as parents to support our kid and help them to be like the best
version of themselves. That would also be okay. - Yeah, I would love more families
to do that on the proactive side, right? - Yeah, I mean, the other thing to
consider is a lot of clinicians have pretty long waiting lists. - Oh, yeah,
so we're fine to do that, right? Yeah, we feel that. So like, sometimes if you
think you might be wanting some help. It may be better to be a little more
proactive and not wait until you're like desperate to have help because you might
have to wait a good while unfortunately before you can actually get that going.
Yeah, yeah. So is there a difference between therapy and counseling and how do you
determine What is the right path for your family? This is a question that I think
a lot of professionals kind of get into the nitty -nitty about. The reality is, yes,
there's a difference, but in actual practice and how we use the words like as lay
people as families, we use them pretty interchangeably. It tends to be more regional
of like what areas are saying therapy versus counseling because some region,
some states, the word counseling is protected legally because it has to be a
licensed credentialed like professional counselor who can use that term. So you may
see therapy doesn't have that same kind of legal shield around it because Therapy is
used in so many different fields. You know, speech therapist, occupational therapist,
massage therapist, like we use that term more broadly. So in actuality,
the terms are pretty interchangeable of how we use them, but professionals might
discriminate and use different terms based on their own credentials. - Right, I had
never even considered that before. - Yeah, yeah, it's - Clearing that up. - For most
people though, we're using it in the same way. - So when you're at that point where
you've decided it's time to seek some professional help, whether it's in crisis or
you're proactively doing so, what type of professional should you be looking for?
- This is also a pretty wide range. Not just because there's different professionals
who can provide counseling, but you may not need like clinical therapeutic help.
It could be that you could access someone through your adoption agency who could
provide some scaffolding or some coaching and maybe that's enough. You know, like
that maybe you don't need something that like long -term that's more clinical. Some
people might seek out a parent coach. You know, someone who may not have the
credentials as a therapist or counselor, but someone who knows this area who could
support you. Some people might access someone at their church or faith body who
could come alongside them to help with something. So there's like some options for
people who may not be as like the formal counseling. Now, if you're looking for
something a bit more clinical, that could be a social worker, That could be a
psychotherapist. That could be a psychiatrist. Typically,
psychiatrists don't provide like a more holistic, therapeutic type of relationship,
but some do, some do. So like that could be an option. Certainly a licensed
professional counselor, child life specialist might be able to provide some support.
It's so diverse. That's why I'm like, even that question is like,
wait it because it's not like one type of person who can be a helper. There's lots
of helpers who might be able to give you some support. It just depends on what you
feel like you need. Is this a parenting, like you want the support as a parent,
or do you feel like your child needs to be with someone you know that it could be
different. So actually that answer even just in my parental experience feels like a
lot of weight lifted off it kind of opens the the gates a little bit be more
creative in the solutions that we're seeking for our kids so I appreciate it. I
mean it's it's like a range of diversity there. It's a little bit of both right
because like there's not one right way to do it. That is both freeing and
terrifying. I really like manuals.
I really like right ways. Tell me what to do and I will do it.
I like following the right way. This is not
Yeah, that's that is freeing because you can think creatively about like what is it
that we feel like we need and who do we already Have around us who may be able
to provide some of that? And if that's not enough, where do we go to find
something more, right? But also that means you have to be like thinking and creative
about it and sometimes I'm like, please just tell me what to do
That for sure. Yes, there's definitely times that, you know, when you're in this
journey of trying to support your children the very best that you can and give them
all the resources that you know can be of such value, sometimes the plethora of
choices is overwhelming. But again, it's interesting to hear and helpful to hear that
the plethora of choices exist. So. - Yes, now that's not the case. That's not the
case for everyone in every part of the world. And I recognize that. And I recognize
that you all have an audience who is all over the world. - Right, right. - Where I
am in the Philadelphia area, there is a plethora of resources. But even in this
area, not everyone experiences that. You know, even in this area, some people may
feel like, I I feel like there's a plethora of resources at my disposal. So, and
there may be people who are listeners to your podcast who feel like, okay, that
makes sense, but I don't have access to all the people that you just named. So
that's why I said, like, consider who it is who is already around you. - Yeah.
- And then start to explore, if that is not enough, then start to explore the next
kind of ring around you. Like, who else this that we can access. Yeah. Right.
Let me pause here for a moment and let you know that when you leave us a
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strengthen all kinds of adoptive, foster, and relative caregiving families. Thanks so
much, and now back to our interview.
Let's talk about what makes a therapist trauma -informed because we are parents and
caregivers who understand that our kids have experienced some really hard things up
to this moment where we've decided it's time to get some help. So what makes a
therapist or provider trauma informed. And then we're going to talk a little bit
about from that the outflow of that is what's the difference between being adoption
competent and being adoption informed related to being trauma informed. Sure.
I'm not going to have a great answer to your question. And I admit that and part
of the reason is because trauma has become a bit of a buzzword.
And in all honesty, I am really grateful for that. Like I am very grateful that
people are talking about trauma, that popular books about trauma are on the best
seller list, that it is way more commonly used.
It was a term that was clinical years ago, and now it's a word that's being talked
about a lot In the kitchen it goes from clinical to the kitchen of like just this
is a word. We're all using But in some ways that's hard because I think a lot of
people are using the word trauma in different ways So when someone says they're
trauma -informed, we don't entirely know what that means. There's not like I Can't
answer your question to say well if someone calls themselves trauma -informed that
means they've gone through this class No, that doesn't exist. There's no,
there's no one class that is making clinicians trauma informed. That doesn't,
that doesn't exist. That's not a credential that is universally accepted. I would pay
attention to someone who's saying that they're trauma informed because at least they
know that it matters. I would also want to assume, I'm going to assume that someone
who's using the term trauma -informed to describe themself is going to have integrated
into their practice that our histories matter, that our experiences,
our life stories have impacted us physically emotionally in all sorts of ways that
impact our functioning and our relationships going forward. Like in a very general
sense, that'd be my expectation when someone uses the term trauma -informed.
You may also see variations of this descriptor. There is a whole movement,
I feel like, among clinicians to use different language here. So you might see
trauma -informed, you might see trauma -competent, you might see trauma -sensitive,
or trauma -responsive. These are all terms that people are using to try to get at
the fact of like we are aware of trauma and how it affects us. We're trying to
address it. Okay. Not in a way that is figuring it out. Right.
There's a sense when we use terminology like trauma competent, it sounds so final.
That's - That's a great point. It does sound very final. - It sounds like we've got
our degree in it. - Yep. - And now we know, and we know the exact way to address
it. We've mastered it, it's done, it's done. So I kind of steer away from the
language of competence, but this is like such a, I'm like a word person.
So this resonates with me, but I don't know if everyone thinks quite so intensely
about this, but I might use terminology more like trauma responsive to just say like
hey I'm aware and I'm going to adapt my practice to be sensitive and flexible with
understanding how trauma has affected you. That's great. We've been hearing in our
circles we've been hearing a lot more of the trauma sensitive and the trauma you
know in conjunction with the already established trauma informed. So yeah my guess is
that we're going to move more towards that language going forward to send that
general message of like humility and responsiveness rather than like that finality of
like I've made it and there's nothing left more to learn. There's always more to
learn. There is always more to learn. Yes. So can you explain to us how that
differs from someone who's telling on their website or on their social media accounts
that they are adoption competent because I know that there are some differences there
with that language. Yeah, I don't know. Like I really don't know what the difference
is. It's I wouldn't use that language to describe myself even though like my
practice is exclusively with foster and adoptive families. I don't use the terminology
like adoption informed or adoption competent. competent. My guess is that when people
use it, they're trying to express that they have experience in adoption, like as a
professional. Okay, I don't think that it's something that we need to necessarily
look for, or like, not consider someone if they don't describe themselves in that
way. I think it might just be trying to let people know that they have worked with
adoptive families, and they're familiar is some of the unique challenges that adoptive
families face. - Okay, so when parents are trying to figure out if their potential
therapist that they're considering is going to be up for the challenge of handling a
child or a family's trauma, adoption story, foster story, what are some of the key
things that parents can look for either when they're reviewing a website or reviewing
their social media accounts, trying to track down that information. Like you've
already mentioned that trauma sensitive, trauma responsive, those kinds of words. What
are some of the things that they could look for that would help them start to get
to the right path? Yeah. I think the paths that you mentioned already are good
indicators of a vibe at least of a person, like how their website,
their social media, the type of messages that they're putting out there. But a lot
of really good clinicians don't even have those things, you know, or maybe have like
a static website, but aren't doing social media and like putting out content. So
honestly, I think the best predictor of determining like some sense of goodness of
fit would be like talking to people. Find out who the people around you have gotten
help from and ask them about it. Don't just get a recommendation of like, who did
you use? Ask them questions like, oh, you liked them. Why? What did you like about
them? What was helpful? What did you learn through it? How did you feel before and
after you met with them on a regular basis? what was it like experientially? What
did your kids say about it? You know, asking those types of questions, I think are
probably the most helpful. And then I would say like, most helpers,
most clinicians will offer 15 minutes, at least, sometimes a lot more,
I typically offer a lot more of like an intro conversation to help families discern
goodness of fit. Okay, so that would be like a consultation or an interview where I
parent is kind of interviewing and asking the questions that concern me or you know
would make me want to. Yeah, it's like, honestly, I, I compare this and this is
probably not a fair comparison, but I will say to people like choosing a therapist
is kind of like choosing a hairdresser. I mean, Okay, not a totally fair comparison,
except I will say I'm very discerning with my hairdresser, but
And our hairdressers get a lot of our do a lot of therapy do a lot of therapy.
That's right. That's right They're therapeutic in them themselves. There may be a
hairdresser that you Tracy love But you have curly hair,
right and they may not be good for me. So just because someone close to you really
loved this particular clinician and this helper does not mean that they were
necessarily a good fit for you and your family. So these intro calls, I like to
put it this way, I want families to know that they want to be in the room with
me. Like, do they want to be in a room with me? I am not a good fit for every
person. I have a unique way of communicating. I'm high in structure, I'm high in
nurture, but like some people that doesn't resonate with. - Right. - And that's okay.
I don't need to be all things for all families. Like there's a lot of helpers out
there. So these intro calls are a way for you to like ask some questions,
but you don't have to have all the right questions. Just kind of gauge like, how
do I feel on the phone with them? Do I feel like they're bossy and like they're
telling me what to do already and they don't even know me? Or are they like
leaving me wanting more and I'm like, I can't wait to talk to them again? Like,
what is their presence like? What's the sound of their voice like? Can you imagine
your child connecting with them? Like there's just it's, it's very experiential.
Like, there's a lot of research that tells us that what's called the therapeutic
alliance, which is that relationship we have between clinician and the healthy,
you know, that like connection, more predictive of transformation than the model of
therapy or any other like part of the therapeutic process. It's that relationship.
Yeah, I mean, it makes sense, right? Right. It really does. We're such relational
creatures. Yes. We need that. Yeah, that initial connection. That's right. That's
right. So that's important to kind of test from the get go to say, like, can I
imagine being in a room with them? Can I imagine growing and learning with them?
Do I want to? But if you're like, uh, I don't know. Talk to someone else.
And that's okay, yeah. - One thing I've found to be incredibly valuable in working
with different practices over the years is when they preemptively say to me, so
let's have this first meeting. And if after the first meeting or two, you feel like
this isn't a great fit, we've got lots of other practitioners in this practice that
might be a better fit for you. And kind of setting that standard in advance of
saying we recognize not everybody's gonna be a good fit with everybody else, so
we've got options for you and we are committed to your healing and your thriving
and so we're willing to offer you the other options. I get very wary when a
practitioner is kind of not open to that conversation, not open to kind of it's my
way or the highway, is there someone else we can add to the team seems to be like
a threat to them or seems to be undermining them in some way. That's almost always
a red flag for me. - I completely agree. That would be a red flag for me, for any
professional who has that mentality of like my way or the highway. Like that's not
comfortable for anybody. I think like the reality is practitioners want this too.
- Right. - I don't want people to start and stop. that doesn't let me thrive and
like feel successful in what I'm doing, which matters to me too. Like I want to
help a family, but I also want to like feel good about what I'm offering and like
enjoy what I'm doing every day. So offering that call quite honestly is like for
the family's benefit and my own because I don't want someone to start and then like
figure out that this is not what they wanted. Right. Yeah. So, I'd like to talk a
little bit about there's a current awareness of the value of working with therapists
and practitioners who have lived experience themselves. So, adult adoptees who identify
as adult adoptees in their practice of therapy. Can you talk a little bit about
what you perceive those valuable contributions to be and then I've got a link that
we can share for families that are interested in something like that. - Yeah, I
think it is valuable to give our children in particular exposure to people with
lived experience and adoption as an adoptee, not just as an adoptive parent or maybe
someone who's like worked in the adoption field or something like that. I also think
it's valuable to us as parents to learn from adult adoptees and pay attention to
what they, their lived experience has been so that we can learn from them and, and
continue to do better as parents in general, like for all of us generationally,
systemically, at the same time, I don't think it is essential to access someone with
lived experience. And that's across the board with like every type of challenge. If
we could only go to clinicians who had lived experience in the thing that we are
struggling with, we would become a very siloed field of clinicians. - That's a great
point, yes. - And I don't think that's healthy. I think that we should be a bit
more holistic in our care, bit more integrated. So like, yes,
like giving our children access to adult adoptees, awesome. Like just,
that's a great idea. Also giving our kids access to people of the same gender.
Like this is a field that it's a lot of women in this field. And you may want to
seek out a clinician who's a man. That may really matter. Or maybe the same color,
the same race as your child, the same ethnic background. Maybe someone who is like
a transracial family. Maybe the the clinician is not the same race as your child,
but maybe they have some experience with that because they also live in a
transracial family. Maybe you want a particular age, maybe you're looking like maybe
you've got a teenager and you want to have someone a little younger who like the
teenager might resonate a little more with instead of seeing the clinician is more
like a peer to their parents. There's a lot of things that we may consider when
we're looking at clinicians. And being an adult adoptee is definitely a big one. And
that's valuable, but it's not everything. - Right, that's great. If you are interested
listeners in finding an adult adoptee therapist or practitioner,
you can go to creatingafamily .org, go to the adoption topics landing site,
and we have an entire resource page that we've titled "Adopty Voices." And within
that page, there's links and resources to many such organizations and practitioners.
I'm sorry to interrupt, but I wanted to let you know that creating a family, talk
about adoption, foster care, and kinship care is now in video format on YouTube. You
can subscribe to our channel simply at creating a family and catch every episode
from today forward when you do so. You can also keep an eye out for which Tigger
mug I'm gonna be using from week to week. Thanks so much, and now back to the
interview. Can you list some of the most common models of therapy and treatment that
adoptive foster or relative caregiver families should at least be aware of even if
they don't fully understand the total definition and actual implementation of each of
these, just to help them get a working knowledge. We're also going to list all of
these in our show notes for families to go ahead and capture the title of the
model and do their research and help them become self -informed. - Sure,
I'll start by saying the models that I'm aware of, it's definitely not an exhaustive
list like this is a list that probably could be updated monthly as different
thinkers out there and practitioners even name their own practice. You know,
there's a lot of practitioners who are starting to like kind of figure out what
their practice is unique, how it's unique and like naming that. So this list is
changing and dynamic like all the time. But I think some of the more popular, like
well -established, long -term recognized, I guess, if we can call it that, models
would include dyadic developmental psychotherapy. That's basically a model that I think
Dan Hughes was probably the original kind of founder of that. And the word dyadic
is kind of the key to this. It just means like, this is therapy that's for a
parent and a child. It's looking at that dyad, it's looking at that relationship. So
dyadic developmental psychotherapy, therapy is a very well known, very relational,
engaging therapy that's great for younger kids. Narrative therapy is focusing on life
stories, experiences, EMDR, that's a well recognized trauma,
treatment that is accessing like bilateral stimulation. For those of you who like
those are big psychology words, I know that like, what does that mean? It basically
is like bringing in ways to stimulate their body physically using both sides of
their brain in a way to help them in the physical and emotional repair of trauma.
PCIT, which is parent -child interaction therapy.
That's another one that is like literally having a clinician scaffold and support
interactions between a parent and a young child. Trauma -focused CBT.
CBT is cognitive behavioral therapy in and of itself. That's a model. But trauma
-focused CBT is specifically a trauma -based, relational -based model that's directed at
children in the family system. Something important to note that comes up a lot as
people reach out to us is that TBRI, Trust -Based Relational Intervention,
is not a therapy model. So we often have people contact us and say,
do you do TBRI therapy?" And I will respond and say, "I am a TBRI practitioner.
I have gone through the program to learn TBRI. I practice TBRI, but TBRI is a
parenting model. It is not a therapy model." So if you're looking for a TBRI
therapist, know that you will struggle to find one. And if anyone says they're a
TBRI therapist, You may want to ask some more questions because it's not a therapy
model. It is a parenting model that therapists can support. Okay.
What does that look like when you say that therapists can support? They can help
parents in executing like figuring out how to practice TBRI in their family.
So TBRI has come a long way And becoming very accessible to parents,
there's a lot of like really good clinicians and programs and content creators that
will help like put stuff out there on what TBRI is and like how to do it as a
family, what it looks like. A lot of parents struggle with translating that content
into like, what does this look like with my kid and my family? - Right, right. - So
a therapist can help with that translation. - Great. - They can teach the strategies
too. Like they're, you know, they can do that. But they can also help families who
are like, I know what TBRI is, I've gone to conferences or like I read the
accounts or I read the books or whatever it might be. But I don't know like, how
do I do TBRI when my kid just lied to me about stealing. - Okay.
- How do I respond in a TBRI congruent way when my kids are in the playroom and
they're throwing toys at each other? Like whatever it might be that that family is
facing, it can be very helpful to have another brain to help you figure out how do
you translate the knowledge that you have about TBRI into practice in your specific
family with your children? Well, that leads us quite well into the next question.
When should therapy or therapeutic relationship involve just us as the adults and the
therapist or us with the child or the whole family? Kind of parse some of that out
for us. This is such a hard question to a hard question to figure out. We're not
throwing you softballs today. No, I mean, I wrestle with this a lot. I mean,
I only see children with a parent present. That is my model.
But that does not mean that that is the only helpful model. So there are a lot of
different ways to do this. Sometimes Meetings with parents only could be enough.
And you may prefer that. You may decide, like, you know what? Maybe you decide, I
want to meet with a therapist first to make sure that, like, we even want to stick
with them before I even introduce my child to them. Like, that's not a bad idea.
- Right, especially if you have a child that struggles with attachment and-- - Yeah,
like that's a good idea. But there are some therapists who only work like with kids
may not see parents. And in those cases, I'd say,
hey, good work can be done. Don't write them off. But partnering with parents,
engaging parents in the process matters. So a good question to ask any clinician is
how do you partner with parents. How are you going to help me be a better parent?
Like, am I involved in this process? Because ideally, a clinician should be working
themselves out of a job. That is the ideal. We should be wanting to equip parents
to be therapeutic parents as best they can, so that we work ourselves out of a job
and were distant memory to their kids. I want the kids to be closer and stronger,
stronger relationships with their parents. And you know, if they remember me when
they're 30, that's great, but I'm also really okay if they don't. Okay. That makes
really good sense, especially in the field where we're listening to parents talk
about their attachment concerns and you know do I have this secure attachment with
my child and if I don't where do I go to help to make it more secure? Yeah yeah
so I think like asking that question of any clinician how do you typically partner
with parents and how can parents be involved is a good question to ask and you may
be emotionally at the point that you're like please let me just drop my kid off
and sit in the waiting room and scroll on my phone, and it's not what I do, but
I am so sensitive and empathetic to that, and I get it. And if that's the case,
like start there, just start that, just find someone who will let you do that and
start there and grow to the point where maybe you can be more involved if you need
that type of respite and some help, but you're not ready to engage at. That would
make sense to me. So you've alluded to it a couple times, but I'd like to maybe
bring it kind of down to a little bit more of a listing structure. What are some
of the very specific questions parents can ask when they pick up that phone or when
they submit that contact form? Just kind of a starter few to get the ball rolling.
And then Let's also talk about some of the questions that they can ask themselves
or the therapist once they've met with that therapist a couple times Hmm Definitely
the one about engaging the parents. I think is like probably the most critical Mm
-hmm. I would avoid yes. No questions. Okay. Good tip. So rather than saying like do
you have experience in x y or z? I want to ask something like,
"Can you tell me about your experience with X, Y, or Z?" And see what the
clinician shares with you. What do they see as their best thing that they want to
share with families? That is kind of telling of what do they use as the way to
promote what makes them who they are. You might want to ask, like, what is unique
about your practice? How long typically do families stay with you? That might help,
like, get at what the, like, cycle of therapy looks like. And if they see
themselves as, like, a long -term solution or a short -term solution, certainly
logistics, I would say. Like, I encourage is to literally like look up what the
drive is. Ask about what parking is like. Ask for photos of the waiting room and
the clinical room. That sounds like kind of silly. - No, it does not. - To me,
the physical space matters a lot. - Yep. - So like, I don't know if I've ever
actually had a family like ask me for photos of like my clinical space.
But I can say I pay a lot of attention to it and I'm ready if they do. Because
I feel like it matters so much. So like considering even that, like,
what is the experience like? What could we expect it looking like if we were to
work with you? And certainly, like, I wouldn't discount some of the more logistical,
practical questions of like, what is the cost?
What does this cost us? You know, one that someone shared with me recently that
I've kind of added to my list of good questions to ask is when do you typically
see families? Because there was a family who started with a clinician and like felt
really good about the relationship. And then the clinician told them that she only
saw people like during business hours, like typical business hours and like finished
her day by like 4pm every day. And that just like didn't work for this particular
family. So like, don't be afraid to ask some like very logistical type of questions
too of like, what is the cost? Is there any sort of like financial assistance
offered or like discounts for families and financial need? If that's an you for you
and asking about like typical hours and like how hard is it to get appointments and
do books far out? Yeah, like those questions matter experientially too.
Yeah, and I think I so appreciate you bringing up the logistics part of this
conversation because these are parents and caregivers that are already experiencing
pretty high degrees of stress and anxiety about their kids' safety or their kids'
ability to thrive and adding more stress about parking or how to pay for parking or
do we get our tickets validated for parking or does insurance cover this?
And if it doesn't cover it, what benefits do you offer to help families access it
anyway? There's already so around so much being a,
you know, a humble parent that says, I need help. I need more. Yeah. Yeah. I so
appreciate that you brought that up. And I think parents should feel so empowered to
say, yeah, what does your waiting room look like and feel like? Is it going to
feel like the waiting room of a hospital? Or is it going to feel like a soft
haven where I can let down and relax and get the best out of me and get the best
out of my kid in order to make this productive and healthy. So logistics,
but I'm with you on the aesthetics. Those things always, I always say, I need my
house to be functional, but I also need it to be pretty. And I feel the same way
about therapeutic relationships. I need that to be a functional space,
but I also need to feel soft and welcomed in that. So I appreciate it.
Yeah, it matters. I think that matters. Yeah. And of course, it won't matter to
everyone, but if it does matter to you, you should feel free as a parent or a
caregiver and empowered to go ahead and ask it. Yeah. I mean, the other thing is
it helps you to prepare your kid. Yeah. You know, a lot of parents will say to
me, "How do I even introduce this to my child?" You know,
if you have a child is, hasn't experienced therapy or counseling before that part of
like prepping your kid is, is anxiety producing as a parent to be like, I don't
want them to think that like there are problem that needs to be fixed. I don't, I
don't want them to think we're taking them to like another doctor for testing. They
might have been through all of that again. And like, how do I even introduce this
to my kid? And having some of that information about what the experiences like or
having photos will help you as a parent to prep your kid more fully and more
comfortably. Yeah. Yeah. Like my kids recently had to attend their first funeral.
And so I said, Hey, here's what we're going to do. This is what the space is
going to look like. Yeah. Yeah. This is who's going to talk. You don't have to
feel the need to interact with anybody that you don't know. This is not, we're not
here for us. We're here to support the person who's grieving. And so I kind of
gave them like the lay of the land in advance. And I said, and any questions that
you have, feel free to ask me now. And then when we get back in the car after
the graveside service, you can ask anything you need to know. And I feel like when
we can prepare our kids in those ways for the logistics, for the environment,
for things that they might consider and they might think if they don't have space
or freedom to voice it, they might think that's a stupid question, I would never
ask that. But giving them the information in advance preemptively, they can say
whatever they need to say in therapy and it's okay 'cause that's a safe space to
do that. - Yeah. - So let's talk about Some of our families in our community are
raising kids that may have been abused sexually or experienced some sort of sexual
inappropriateness, whether it was actual abuse or not. They may have questions about
whether or not the child was abused sexually. Are there special considerations or
questions that parents should be asking if that's what's maybe driving them to
therapy? I mean, ideally, all therapists would be comfortable with addressing this.
Okay. I don't know if that's the case though. And I'm sympathetic to that,
so that like, I could be wrong. I'm not, I'm not sure on this. I think it's worth
in that intro conversation sharing that you, you don't have to share any specifics,
but sharing even generally, like, we have a concern that our child may have
experienced a history of sexual abuse or that, you know,
I have a concern that my child may be acting out sexually, whatever the case may
be, and asking, like I suggested earlier, asking, like, what has your experience been
with families who are dealing with this, who are navigating this? And That may give
you a sense of like how comfortable the clinician is, him or herself,
in even using the language. Right. Right? Like, I mean,
just at the very entry level, like, how does the clinician even respond to your
question? If, if you sense that there's like, I don't know, hesitation, then maybe
you say, like, Okay, this might be a great clinician for other things, and maybe we
access them for other things, but maybe we need to find someone else who might be
more comfortable with talking about very vulnerable and sensitive things, 'cause the
reality is sexuality, a lot of people do have come with their own history and
things that are entering the room that might make those conversations a little bit
more weighted. But my hope is that clinicians who are familiar with trauma,
who are experienced in this world, unfortunately likely have had experience with
serving families who are navigating this. - That's really, yeah. It's a really hard
topic for a lot of families to pick up the phone and talk about. - A lot of
humans, like this is just, this is like across the board, just like really hard.
It's like, it's a different kind of brokenness. So I get that it's like very, very
sensitive for both parents, gosh, I shouldn't even use the word both 'cause it's
like for parents, for children, for teenagers, for the clinicians, like this is just
really hard stuff to talk about. - Yeah, yeah. And finding someone who makes your
family feel safe to explore the intricacies of that pain and that is paramount.
Yeah, who builds the safety and also gets the fact that this is really hard to
talk about. Yep, yep. Who gives you, like, a long on -ramp. Yeah.
You know, so that you have your own kind of, like, that gives you enough space to
work up to, like, being able to use specific words. Some people are, like, really
good at that. Right. Some people will enter into these conversations and use all the
words with no the words with no hesitation. I don't even need to say the words
because I know people might be listening with lots of little ears. So I'm not going
to use the words here, but some people are more comfortable with the language and
some parents need a longer on ramp to even recognize what they're bringing into the
room and how they were raised and all the impacts on them of like how we talk
about these things. So just like sensitivity all around for everybody in the room
and for the people who are not even in the room but play a part in this
conversation. Right and I think the only other thing I would add to that is look
for a practitioner who will speak with hopefulness for the long term of the journey
because these kids can heal and they can go on to thrive and just live vibrant
full lives and we want that that for kids and when we suspect that that may have
been part of their history, we want to find someone that will imbue them with that
same hope. Yes, I would like to say that goes without saying, but maybe it doesn't
go without saying. I don't. In my experience talking to parents who've had
therapeutic relationships, I don't think that that always will go without saying. I
to find, we have to find that ground where we are sensing that hope from a
practitioner. There's just a lot of stigmas around it and obviously therapists are
not immune to some of those stigmas and we want to make sure that the priority is
making sure that our kids know that we've got their back and that there is hope.
Yeah, I mean that would apply to every challenge. - Right? - Right, like if you
don't, I like the way that you worded it. I think you said, if we don't receive
that hope, I think was the word you just used. I think that's actually key because
my hope would be, my hope would be that every clinician like has hope for healing
and change. If they did not, then I'd be like, why are you doing your job? Like
that's like the basis of our work, right? That there's like, that change is
possible, transformation is possible. If that wasn't true, then we wouldn't have jobs.
So like my guess is that every clinician holds that hope, but maybe it's not
getting communicated as readily or not communicated in a way that you're receiving
it. So that's where it's paying attention to, yeah. - Yeah, and kind of check in
with yourself, how you feel about that when you think about those. Yeah, yeah. For
sure. And our kids will pick up on how we feel about it and how we understand it
or how we've received it. Our kids will pick that up. So it's real important that
we pay attention to those. But hope for, again, as you wisely pointed out, hope for
any of the challenges that bring us to therapy. We want to sense from the people
that are going to be influencing and, you of speaking life into and over our kids
that life and hope are there and within Grasp. - Yeah, yeah.
- I wanna pause here for a minute and say a special thank you to the Jockey Being
Family Foundation. Thanks to their partnership, we are able to offer a library of 15
free online courses all designed to strengthen your family. If you check out the
library of titles at bit .ly /jbfsupport, You'll see the variety of topics that we
offer and you can take one or all 15 go to bit .ly /JBFsupport.
That's B -I -T dot L -Y slash J -B -F support.
And thank you to the Jockey Being Family Foundation.
Let's switch gears just a little bit and talk about home -based therapy. It's not as
common and not as many people know about it. So, if you could kind of tell us
what it is and then what you would see as the advantages or disadvantages to
pursuing this kind of therapy. Sure. I mean, very simply put, home -based therapy
would be when the practitioner who's helping you is entering into your space rather
than you leaving your space and coming into theirs. I think it could be really
helpful when you're coming into therapy because of challenging behaviors.
There's a higher likelihood that your clinician is going to see the behaviors in the
child's natural environment. They're going to see that. That's right.
That's right. That's the language I was going for. I was like picturing the accent
saying it and Um, yeah, I think there's more likelihood that the clinician is going
to see those behaviors at home rather than like in the clinical space. In some
areas, like in our state in Pennsylvania, the state can offer home based services.
So like if you go on medical assistance, if you're able to do that, that's a way
to access home based services. I don't know what the case is everywhere, but I know
in Pennsylvania, that's a possibility. And I'm sure there's third party providers as
well, but it's like you said, less common. But there are also some things to
consider if you're like, you know, maybe at first you're like, "Yes, that's what I
want. "I want someone to come in and see what I'm dealing with "and tell me I'm
not crazy," right? Like, and tell me that this is actually a problem or whatever.
- Right, right. - At the same time, you know, the other side would be going to a
different place can be very helpful, removing yourself from the home environment,
which may be very chaotic, even if you only have maybe a single child,
especially if you have more than one child, that home environment can be really
chaotic, leaving your space driving somewhere,
like the If itself can provide a bit of a buffer and space to get you ready for
whatever is going to happen when you get there and also provide really useful time
to debrief after a session. You know, there's something very valuable about car
rides. Like most children, not all children, I know for those who have children over
five foot and who can sit in the front maybe like this might be different but like
you're not typically getting eye contact when you're driving your child that might
open up some conversations that are harder to have at the dinner table or at
bedtime that distance might actually be helpful for some conversations. Some kids do
really really well with having a space that it becomes like, this is where I do
this work, right? And they're able to focus and do it there in a way that they
may not be able to do in their living room. Right. Right. It can be hard then to
translate that to home. Right. That's where partnering with parents can be really
helpful to say like, okay, they're doing really well here. How do we help translate
this into other contacts and to, you know, the home and school and peer
relationships and all of that. But I think there can be a lot of value in leaving
your home space to do it as well. Yeah. So if you are looking for a therapist to
come to your home, one of the resources that we've found as an organization that
can be helpful is familycenteredtreatment .org. We'll put the link in the show notes
And families can investigate that and do some research to see if that might work
for them. I love the, here's the advantages, here's the disadvantages, there are
definitely things for us to consider. I think if access is an issue for you or
mobility in and out of your home is an issue for you, or if the challenging
behaviors only ever occur in your home and you just need an extra set of eyes to
say, like you said earlier, hey, this is not atypical, it can be managed and
healed. And that would be a great time to consider home -based therapy. But I do
really resonate with your thoughts on the neutral territory, as we call it here at
our house, of a separate place to go for therapy. But that leads really well into
a conversation, you know, since the pandemic, the onset or advent of telehealth has
just blown up. It's just so accessible now and so available to families. I would
imagine then that there's probably some of the similar pros and cons, advantages,
disadvantages to telehealth. But because it is so popular, could you talk a little
bit about when it can be effective for a family and how might we,
as parents and caregivers, increase its potential for effectiveness in our homes if
that's the option? Yeah, yeah, yeah. I asked a colleague a similar question as we
were like in that transition from like when we went from all telehealth and then we
were like restarting kind of in person And there was a lot of like in between, you
know, in that in between space, I asked a colleague this and I loved her response.
She said, telehealth is 100 % better than nothing. That's thing.
Wow. And I have held on to that because I don't like telehealth as a practitioner
or as a receiver. Right now,
while this isn't a therapy appointment with us, I recognize that, but we're on Zoom
right now. We're on Zoom. I can't see the rest of your body. I don't hear the
sounds in the room that you are also experiencing if there's a buzz of a light or
like a child. Whatever it might be, Right? I'm not experiencing that with you.
There are a lot of things that you are experiencing and that I'm experiencing that
are siloed and we're not sharing. Right. I can't see if your foot is bouncing.
I don't feel that with you. If you were in the room with me, I would have way
more information about what's going on for you that I'm just missing.
- Right. - Now sometimes like for a podcast like this, we have to do it this way.
Well, I guess we could do it in person, but like that would be really challenging.
Like this is the platform. So I get the fact that like sometimes telehealth is like
the only way or the most logistically convenient way. Like it works,
right? But be aware of what's being missed. Right. I would also say like your
question at the end, which I really liked of like, how can we make it more
effective? Right. Get childcare for any other kids.
Yeah, that's such a great tip. I would never have thought of that. I think a lot
of parents, while I've learned this through experience, I think a lot of parents are
like, "Oh, if we can do it on telehealth, that we don't have to get a babysitter,"
right? Which is like true, like that is true. Like if you're coming to therapy in
my office, you do need to get a babysitter for your other kids who are not coming
with you. Like I get that and that saves money to not have to get a babysitter.
It saves you time and effort and all of the things, right?
However, you will be very distracted if you're doing a telehealth appointment and you
are aware that in the room next to you, your kids are watching a movie that ends
in 20 minutes. - Right. - And I have no awareness of that. I'm not feeling that.
And you may be like hearing them calling your name and then feeling divided that
like, you have to respond to them. Like, of course you have to respond to them.
And like it just makes it a little, you may be a lot less present in the
appointment. So like even if the telehealth is for your child, if you're going to
be part of it and like wanting to be present or needing to be present in any sort
of way, like make sure the other kids in your home like have a grown up or a
responsible person so that you can be freed up and have the capacity to engage.
Yeah, that's fantastic. That's a really good and that's actually a good advice for
any of the therapeutic models that we Follow when you can set yourself free from
all of those other concerns Present whether it's present with your child or present
just you and the therapist alone while you're learning tools to you know cope with
or manage your child and their behavior or Whatever applies and like Yeah.
Home -based, I would say that's a great idea to have like childcare for whoever's
not involved if you're doing the home -based. Another like practical tip, whether it's
therapy in person, telehealth or home -based would be like put your phone on do not
disturb if you're able to. Yeah. Yeah. If you're not able to because you have kids
at home and like you don't want to just be like unavailable if like, you know,
you're a parent and you're still like aware. If both parents are in the therapy,
like maybe just have one of you have your phone like accessible. Yeah. There is
nothing more distracting than hearing the vibrating like notifications in the room for
multiple people. Right. Right. Yeah. And we're used to it.
Like this is a part of our digital life, like this is the age we live in, but
it's so much easier to focus on like what we're experiencing collaboratively in the
moment if we're not also feeling the demands of what's happening outside the room or
potentially happening outside the room. Yeah. Well, this was excellent.
And I so appreciate the time that you took with us today, Kelly. I appreciate your
passion for seeing Please heal. That's been my experience with you in all the years
that I've known you. I appreciate that consistency and that diligence and I
appreciate the very candid pros and cons of all of these things that we've talked
about today helping parse that out for families. If you are a family who is looking
for therapeutic services please feel free to check out the therapy resources page on
our website at creatingafamily .org and we'll list some of those things in our show
notes and thank you Kelly Raddenbush from the Sparrow Fund for your input and
insight today. It was greatly appreciated. - Thanks for including me.