Building Relationships With Your Therapist

building relationships with your BCBA

Last week I discussed 6 benefits to parent training, which you can read more about here. Today, I want to talk about why it’s important for you and your BCBA (board certified behavior therapist) to be comfortable with one another and on the same page regarding short and long-term goals. Because of the nature of applied behavior analysis (ABA), BCBAs will ask very personal questions about your daily routines, family dynamics, and struggles. So, it is important to find someone you trust.

In the post “What to Expect Before Starting ABA,” I wrote about the top questions to ask when looking for an ABA provider. Specific to parent training, it’s important to make sure the child’s BCBA offers parent training on a regular basis. Frequency is based on need and availability; however, I strongly suggest setting up consistent appointments for future events so both you and the BCBA are making time for it. If you cannot make regular appointments like the first Friday of every month (or every other month), then set up one appointment. Then, once you are in a parent session with a BCBA, be sure to look ahead and schedule another appointment for follow-up and more parent training. It’s better to get the ball rolling, otherwise months or even years can go by.

Parent sessions become very personal for the reasons I mentioned above, so it can be hard to be vulnerable and share if things are not going well at home. For example, it might be hard to admit that getting your child dressed in the morning, which should take ten minutes, ends up taking an hour and a half, or you don’t understand why your child behaves with other people but not you. Just remember that these details help BCBAs create a behavior plan by determining the function of behavior.

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BCBAs consider all environmental factors as well. For example, are the clothes your child’s wearing comfortable? Perhaps offering your child choices between the dinosaur shirt vs. the Star Wars shirt would help. Another factor could be the setting. It might be easier to get dressed in the bathroom instead of the bedroom to minimize distraction from toys (or getting back into bed!). It all depends on function. Maybe your child doesn't like the clothes (or going to school); they might be communicating they don’t want to do it (i.e. escape from demand). If your child is in the bedroom, they might be running off to play with their toys (i.e. access to tangible). Being honest with your responses helps build a better intervention plan that works for your family.

Being able to trust your BCBA also helps ease your mind about your child making progress toward their goals. Building a relationship with your BCBA makes everything run more smoothly because you're comfortable asking questions (even ones you think are small), and the BCBA can make adjustments to a behavior plan because they know your child in the environment. Here are some things to help you build a relationship with your therapist:

1. Be truthful and keep the BCBA in the loop with any changes that are going on at home.

Changes in family dynamics, like a grandparent moving in or a parent separation, are sometimes difficult to talk about, but important.

Another example would be changing the dosage in medication. Changes in medication tend to change your behavior (sleepy or energized). Let your BCBA know so they can take note of it and understand potential reasons why the child is acting a bit differently.

2. Ask questions about a behavior plan.

Although some programs in your child’s behavior plan are done during their sessions, there are a few things you can be doing at home so you are consistent with your words and actions. A behavior plan can be lengthy and hard to follow. Ask your BCBA to explain 1 or 2 things that are highest priority and what you can do at home to be consistent.

3. Keep your appointments

Regular interactions with your BCBA naturally build that relationship you need to continue to show progress in and outside of therapy. I notice when an appointment needs to be rescheduled, it tends to continue to be pushed back. Try the best you can to keep your appointments so you’re learning as much as you can about your child’s sessions.

While building a relationship is important, I must also make note of our ethical boundaries to remain professional, which are called “multiple relationships.” The compliance code is there to protect both the parent and professional from taking advantage of services and favoritism. Furthermore, unlike school and daycare teachers, therapists are not allowed to accept gifts from clients. Although there are days devoted to show appreciation to teachers and holidays that offer gift giving, it is best practice to limit appreciation to a verbal “thank you.”

To keep track of parent notes, I’ve created a note sheet to organize your thoughts as well as remind you to make a future appointment so parent training does not get pushed behind. Click to download!