Get over your FEAR of speaking with clients/parents 😱

Tuesday, January 17, 2023

I met a parent last week who brought her 4-year-old child who was recently diagnosed with Autism to see me. She mentioned that her pediatrician never clearly told her that her child met the criteria for Autism, even though she reported that the symptoms were "obvious." This is a story I have heard many times before (and a personal pet peeve of mine). But let's give this pediatrician the benefit of the doubt. Maybe she wasn’t well trained in identifying the symptoms or just feared having this conversation with the parent. It can be a difficult conversation to have. But wasn't her responsibility as a health care professional to tell the parent?

I would think so…

Sometimes we fear having tough conversations with parents. Let me start by saying that you aren't the only one. What do I mean by "fear"? It's not necessarily that we are afraid to speak with parents but having conversations about certain topics may be difficult; your hands begin to sweat, and you feel a knot in your throat, making it nearly impossible for the words to come out. People generally don't like to confront even when there's that obvious pink elephant in the room.

I have spoken to you about building rapport with parents but see, this is not a unilateral process; it's a RECIPROCAL one. So, in the same way, that you want parents to perceive that they have rapport with you for their sake, you also want to feel like you have rapport with them for your sake.

When we fear bringing up certain topics like "why is the parent canceling sessions with a certain therapist all the time." Or referring parents to couples counseling because they are not on the same page, we should question WHY we feel skeptical about bringing these topics to their attention. Perhaps it's a lack of perceived rapport?

But you can still have a wonderful rapport with parents and still feel intimidated to bring up difficult topics. So, what else can you do?

Follow these 4 "tips."

1) Evoke: People are more likely not to become offended if they are the ones coming up with the solutions to their dilemmas. Therefore, use open-ended questions to evoke their response. Sometimes this will be exactly the solution you were planning on suggesting, and other times they may mention an even better solution to their dilemma.

2) Use parallel examples: Speak about other clients (honoring the confidentiality, of course) that have been experiencing a similar dilemma and mention what has helped them. Like this, "I worked with these parents last year, and they were both going through a rough patch. It didn't concern me until I saw how it impacted their consistency in the implementation of our behavior plan, they sought therapy, and it really helped."

3) Phrase a doubt to normalize ambivalence and then ask the "miracle question": Something like this, "This intervention may or may not help your child with his behaviors; what would happen if it did? How would your life or his/her life be different?"

4) Remind yourself that we have a responsibility to report not only abuse or neglect but, to be honest with our clients about what we perceive as professionals. The key is knowing how to have these sometimes-dreaded conversations. If you are "stuck," another tool to use is EPE (Elicit, Provide-with permission, and Elicit- check in").

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