Have you ever wondered what makes a therapist a good fit for your family? Or struggled to know what kinds of questions would help you figure that out?
The Interagency Committee on Adoption (IACOA) in Delaware has made a useful tip sheet for families surrounding how to seek out therapy for your child. They also have a monthly newsletter that any Delaware adoptive family can sign up to receive, containing updates on trainings available to adoptive families.
We thought it would be useful to include the content of the tip sheet below, but HERE is a pdf link as well. You're also encouraged to reach out to Laurie Lattomus, Post Adoption/Post Permanent Guardianship Program Support Navigator with A Better Chance for Our Children with any questions you may have. She is a great resource right in our own backyard.
TIP SHEET: SEEKING THERAPY FOR YOUR CHILD
General Tips
• It’s your job to ask questions and advocate for your child, so never apologize for it.
• The therapeutic relationship is a key component to the success of therapy, so finding the right fit is vital. If a provider doesn’t seem to have the correct expertise or the relationship isn’t strong, it’s important to move on.
• Children who have experienced early trauma will need “bottom-up” approaches that focus on the lower region of the brain (the survival and emotional parts of the brain).
o Approaches that work for the lower brain are movement, rhythm, music, and sensory play, then play therapy and art therapy.
• “Top-down” (cognitive) approaches generally won’t work as well for your child until the other regions of the brain have been addressed.
o These include traditional talk therapy approaches (Cognitive Behavioral Therapy (CBT), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Insight Oriented Therapies, Narrative/Storytelling Approaches).
• A focus on attachment is necessary. Building safety and trust with caregivers must be the guiding star.
• Treatment needs to include FAMILY therapy. The frequency of family therapy will be different for each family.
• A provider with clinical licensure is preferred (LCSW, LPCMH).
• Try to find someone with several years of experience.
Ask Questions
• If a provider is labeled “trauma-informed”, ask about what specific framework, trainings, and/or books are the foundation of their trauma knowledge.
o Books by Bruce Perry, Daniel Siegel, Bessel van der Kolk, Daniel Hughes, Jon Baylin are examples.
o Knowledge of developmental trauma is key.
o An attachment-focused framework is ideal.
• Ask about a provider’s experience working with foster and adoptive families.
• Ask about their experience with “brain-based” approaches to treatment.
• Ask about their familiarity with the impact of prenatal exposure to drugs and alcohol.
• Ask provider about modalities besides talk therapy. This question is relevant regardless of kid’s age.
• Specific modalities to ask about include:
o Eye Movement Desensitization and Reprocessing (EMDR)
o Trust-Based Relational Intervention (TBRI)
o Parent-Child Interaction Therapy (PCIT) 2
o Functional Family Therapy (FFT)
o Dyadic developmental psychotherapy (DDP)
o Neurofeedback
• Ask about their approach to family work. Any therapy with one of our kids must include family therapy.
o The amount of individual work vs. family work that should take place will depend on the kid and family.
o If a provider does not agree with this perspective, they are not the right fit.
Additional Considerations
• Parents often benefit from their own support. This may include individual therapy or couples’ therapy. Parenting a child with significant challenges takes a toll on caregivers.
• Even when we know how much a child needs support, if they aren’t ready for therapy, we have to give them time and pursue other supports. Pushing therapy may end up doing more harm than good.
• Occupational or Physical Therapy: Our kids often have regulation and sensory issues that can be helped by OT or PT; this helps with their overall regulation. o You can ask for an evaluation through their school or ask your child’s primary care physician for a referral. You can also explore services through Theraplay.
• HALT: Hungry, Angry, Lonely, Tired – None of us do well when we’re struggling with these! Make sure kids are getting the fuel they need – if they aren’t eating enough or are only eating carbohydrates, they don’t have the energy they need for optimal functioning. Create and encourage opportunities for connection. For some of our kids, addressing sleep issues can make a huge difference, so follow up with their Primary Care Provider if there are any sleep concerns.
Questions? Call me! Laurie Lattomus, LCSW Post Adoption/Post Permanent Guardianship Program Support Navigator A Better Chance for Our Children 1307 Philadelphia Pike Wilmington, Delaware 19809 (302) 746-7265 (office) (302) 345-1212 (cell) llattomus@abcfoc.org