In talking to other parents, you may learn about an intervention that has helped someone else with a profile similar your child’s. These therapies are sometimes quite expensive, and many are not covered by insurance. How do you decide what to do?
The following questions can help.
What is the research evidence?
Some interventions have a long list of peer-reviewed research documenting their effectiveness. For example, studies validating the approach used in Cognitive Behavior Therapy as a treatment for anxiety disorders date to the 1950s. Other interventions are relatively recent, and may not have as many studies documenting a positive impact. Working memory training is an example of a recent intervention that has some evidence validating the approach, but there are still questions about whether it generalizes beyond the tasks it trains.
It is important to note that all interventions have to start somewhere, and just because there isn’t strong research support doesn’t mean the approach doesn’t work. But it does mean that it is more of a gamble than a therapy that has a long history of research documenting its efficacy.
What is the financial cost?
- How much does it cost?
- Does the provider take your insurance? Or are they out-of-network?
- How much will your insurance reimburse?
- What will your final out-of-pocket expense be?
- How many sessions will it take?
All these factors will help you calculate the actual cost of the therapy. Think through this ahead of time. Can your family afford it?
What is the emotional cost?
Therapy is hard work. Your child will be asked to do things that are quite hard. Does your child have the emotional reserves to do the work necessary to make progress?
There is also a cost to you. If your child is resistant, do you have the emotional reserves to deal with fighting with your child about doing the therapy?
How much time will it take?
Do you have the time and flexibility to work this therapy into your schedule?
- How long will it take to get there?
- How long is the appointment? What is the recommended frequency?
- Are you expected to do work between sessions? How long will that take? What is involved?
Could it harm my child?
The Hippocratic Oath is “Do no harm.” Unfortunately, some interventions have the potential to be harmful. Make sure you are aware of the side effects and potential disadvantages for a child with your profile before you expose your child to the therapy.
What exactly does the therapy do?
It sounds obvious, but make sure you understand exactly what issues the intervention will target. Make sure the issues you are targeting are high-priority so your child doesn’t burn out. (See “What is the emotional cost?”, above.)
Measure your baseline at the beginning of the therapy and again on a regular basis during the therapy. This will help you determine whether the therapy is having a positive impact. Ask the provider how long it will take for you to see changes. If you don’t notice a positive change, terminate the therapy.
I have a mantra: “You can’t boil the ocean”. It’s easy to think that if we enroll our children in as many therapies as possible, we can “fix” them. It’s better to pick one problem that is your highest priority and focus on that. Answering these questions will help you to strategically select interventions that have the potential to effectively address high-priority problems.