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From: Ellen-Marie Silverman
Date: 11 Oct 2007
Time: 09:07:31 -0500
Remote Name: 64.12.117.18
[[. . . Sometimes the children and adults have so many outside and personal issues that they are not open to fully receive therapy."] >>> Dear Alaina, When that is so, and it often seems to be, then, a very detailed and pointed conversation needs to take place with the parents about what therapy can and can not do, emphasizing the active role required of caregivers that goes far beyond providing transportation. If caregivers state directly and indirectly they are unwilling or unable to take that necessary level of involvement to help their child, a very hard decision needs to be made, i.e., is this the time to enroll the child in therapy, knowing it is quite unlikely the experience will be a successful one that enriches the child and the parent-child relationship? If the parents can not and the child is struggling to speak and dealing with embarrassment, then some therapist might offer a less intense therapy encounter which monitors the child's communication and socialization, but I would advise against that engagement because it is not only unlikely to bring about positive changes but could trigger some negative possibilities, such as the conclusion that therapy can not help which may discourage or delay the child participating fully in therapy later on, and, subconsciously, encourage the therapist to also believe therapy can not help. So, all in all, we do not want to offer what we believe from the get-go will not only provide no real benefit other than siphoning off some of the stress and, possible, guilt caregivers feel because their children experiences difficulty speaking and socializing, but, perhaps, may discourage them to seek therapy when they are willing to take the time to participate because the diluted therapy offered provided no relief, and they concluded speech therapy isn't helpful. >>> Thank you for taking the time to offer this comment. The situation you identified is very real and very common, and I hope the abbreviated response I have written helps you recognize and think through the necessary decision-making at these times with a little more clarity. Ellen-Marie Silverman