Collaboration is the key to growth: How to facilitate the school-home-therapeutic relationship. By Jaime Marrus, PhD

Collaboration is crucial when working clinically with children in any setting to ensure generalization and carryover of skills to their everyday routines.  That is, the transference of skills across different environments.  One standard method to promote this is having parents actively involved in a child’s psychotherapy, whether that be through parent-child sessions, separate parent meetings with the clinician, or, ideally, both.  I always note that although our office has a waiting room, it is rarely ever used!  Parents are almost always involved in their child’s sessions in some way, and this provides them with the opportunity to learn strategies from the clinician’s modeling as well as more overt conversation to promote carryover to the home setting. 

Similarly, we need to ensure collaboration with the school team.  I often find myself encouraging and supporting parents in initiating more and more communication with their child’s teacher and school team.  Depending on the school setting (e.g., public, private, general education, special education), the teacher(s) and related service providers have various ways of communicating with families (e.g., communication notebooks; team meetings; phone calls).  Depending on the developmental level of the child, their own understanding of communication between their parents and teachers may have an impact on their behavior and functioning.  For example, knowing that their teacher is going to tell their parents about a really wonderful job they did on a project or a kindness they showed a classmate will likely lead to feelings of pride, validation, and excitement (and increase the likelihood of their demonstrating this positive behavior again).  Similarly, awareness of open communication between their parents and teachers when a challenging or perceived “negative” situation or behavior occurs may lead to a variety of feelings for a child as well.  In both cases, it is highly important for children to know and feel that all relevant parties are on the same page. 

It is ESPECIALLY important for children with developmental differences that parents, teachers, and clinicians are on that same page.  In her article, “Working resourcefully with parents of children who have severe disorders of relating and communicating,” Dr. Rebecca Shahmoon-Shanok wrote, “… how parents understand their child’s problem—is crucial to the eventual outcome.”  I would like to expand upon this notion to include the school team (and other providers)— that is, how EVERYONE in the child’s life understands the child’s challenge is an important factor to progress and outcome; so for children, who spend most of their time in school, it is essential for all parties—parents, teachers, providers—to be on the same page in terms of their understanding of a child’s strengths and weaknesses.  Dr. Shamoon-Shanok stated, “Frequent discussions, with every person learning and swapping ideas and support, are a cornerstone of [a] careful, intensive, and synthesizing approach,” which will only serve to promote progress for the child, and, just as importantly, comfort for the family.  It is a particular challenge for children with difficulties with forming relationships with others (e.g., children with autism spectrum disorder) to understand varying methodologies by their various supports and caregivers; we must decrease the fragmentation that may occur for these children and families.

So, how do we do this?  How do we create and nurture the family-school-clinician relationship?  I acknowledge this is no simple task, as it is often wrought with logistical challenges.  However, here are some ideas for parents to consider:

1. Provide consent for collaboration.  Giving your consent for a clinician to contact the child’s teacher will allow for the first step in this process.  To facilitate clinician-school contact, it is always helpful to send an e-mail to both parties indicating your consent (along with signing any necessary authorization forms) as well as an idea of what you hope to achieve by making this connection.  Schools are often more open to such collaboration when such communication gets off on the right foot and they understand that the clinician is seeking their impressions and observations of the child, with the understanding that the child spends so much of his/her time in school.  (maybe sounds better?)
2. Consider who would be the right person for this job. Is it the teacher? The school social worker? Guidance counselor? Psychologist on staff? Director/Principal?  Who is the person that will be best able to provide an understanding of your child’s functioning at school as well as take in and apply recommendations and strategies posed by an outside clinician?
3. Schedule a school observation for the clinician.  School observations do not have to be limited to an evaluation process.  It is often very helpful for clinicians to observe a child in their school setting (again, where they spend the majority of their time) in order to inform their treatment plan.  Similarly, it can be helpful for the school team to learn successful strategies and ideas from the outside clinician to apply to their interactions with the child in school.  I was recently conducting a school observation for an ongoing client when, in the middle of conversing with the child’s speech-language pathologist, the child appeared to notice my presence and initiated eye contact and big smiles in my direction.  She looked back at what she was doing, and then referenced me in the same way again. The teachers were so impressed by this connection between us—one that they reportedly had not experienced with the child themselves.  Their witness to this moment provides a great jumping off point for me to begin speaking with them about what they may be able to learn from and apply from my style to the child in school.
4. Ask whether the clinician can be included on pertinent emails between the school and parents.
5. Include regular consultation meetings (via telephone and/or confidential video conferencing) between clinician and school.

Reference: Shahmoon-Shanok, R. (1997). Giving back future’s promise: Working resourcefully with parents of children who have severe disorders of relating and communicating. In Greenspan, G.I, Kalmanson, B., Shahmoon-Shanok, R., Wieder, S., Williamson, G.G., & Anzalone, M. (Eds.). Zero to Three: National Center for Infants, Toddlers, and Families (37-48). Washington, D.C.: Zero to Three: National Center for Infants, Toddlers, and Families.