356 | Attrition: The Hidden Crisis in Play Therapy (Special Episode)

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You're listening to the Play Therapy Podcast with Dr. Brenna Hicks,

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your source for centered and focused play therapy coaching.

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Hi,

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I'm Dr. Brenna Hicks,

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The Kid Counselor.

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This is the Play Therapy Podcast where you get

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a master class in child-centered play therapy

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and practical support and application for your

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work with children and their families.

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Today,

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I want to talk about attrition

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and how to combat that as child-centered play therapists.

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It's been very interesting to me to realize

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in conversations with therapists all over the world,

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how infrequently I believe

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natural termination occurs

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with clients.

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And I think that this might be a pretty

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severe situation for us as play therapists globally,

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and I don't think that there's enough dialogue and conversation

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about this issue

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because

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I've always,

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from the start of my practice more than 20 years ago,

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I've always had natural termination with clients,

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and I would begin with a family and we would work for however long it

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took until we were in agreement that the child was ready to wrap up.

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And that seemed normal to me.

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And when I started speaking with other therapists

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and one of their consistent concerns and complaints

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is that parents pull their children

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prematurely

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and all of a sudden they get a phone call or

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an email that says we're not going to attend sessions anymore

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and what they're supposed to do to keep parents

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bought in and invested in the process.

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And it shocked me because that has never been my experience,

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and we've put things in place at my center

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that have prevented that early attrition from happening,

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and this is something that I believe we absolutely have to address as a field

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and specifically as child-centered play therapists

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if we want to be effective

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in truly helping children and their families.

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If they end the process early,

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they're not getting the outcomes that they could.

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And that falls on us to make sure that

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we are attacking this intentionally and with purpose,

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and we're going to talk about just how to do that today.

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I think the most helpful place to start is

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how do we know when a child is actually ready to terminate.

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I think that's part of the issue

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because I would argue that therapists often don't fully

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understand when a child is ready to wrap up

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and therefore,

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of course,

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parents don't either.

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And so you have the stakeholders and the therapist both confused

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about what termination looks like

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and therefore it's easy to just say,

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well,

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we might as well do it now

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rather than actually having a formulaic criteria

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that would allow you to determine whether or not it makes sense to wrap up.

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So the four termination criteria that are the most helpful to

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consider when determining if a child is moving into termination phase.

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are two clinically in nature and two environmentally in nature,

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so we'll look at all four.

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The first clinical consideration

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is whether or not any new themes have been emerging in the playroom.

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So over the last several weeks,

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4 or 5 sessions,

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have you noticed any new themes cropping up in the playroom?

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And if so,

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that likely means that the child is still actively working on things.

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Second clinical consideration

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is any existing themes or persistent themes that are still present.

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Do we see any major shifts within those themes?

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It's very common later on in the process

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for a child to still be doing self-esteem work.

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So if we have a theme of self-esteem building.

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It's important to realize that that would be stable and static.

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We would not see shifts

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in big ways in their self-esteem work,

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even if self-esteem was still existent.

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So those are the two clinical considerations.

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The two environmental considerations

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is the reason or reasons for which the child was originally in therapy

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reduced or resolved?

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If the child was highly anxious,

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have we seen reduction or resolution of the anxiety?

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If a child was aggressive,

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have we seen reduction or resolution of the aggression?

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We expect that over time,

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if the child has worked through everything they need to,

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we will no longer have

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the severity

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of the concerns that we saw before.

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And then second,

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environmental considerations,

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do we see regulation

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across all environments?

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At home,

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at school,

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with peers,

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in the playroom,

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at church,

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wherever the child goes,

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do we see an increase in regulation

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and the ability to maintain that regulation

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no matter where the child is.

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If we look at those four criteria

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and we sit down with the parents

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for our traditional consult every 5 weeks we meet,

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so

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if we're sitting down for that 5 week consultation.

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We want to hear from the parents how they think things are going.

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If they report that things are calm and stable and regulated

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and

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there's no issues at school,

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there's no issues at home,

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the original issues

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have been reduced or resolved.

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That is parents' indication that termination might be

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in the future.

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We're going to assess the same things.

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Do we see regulation in the playroom?

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Do we see resolution of those issues?

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If so,

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Then we would say,

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OK,

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that we might be ready to terminate.

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Then we are going to weigh in with the clinical considerations.

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Obviously parents don't have any ability to do that.

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We're going to evaluate,

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are there any new themes?

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And if there are any persistent themes,

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do we see major shifts recently?

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If the answer

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to both of those questions is no.

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Then we obviously can justify

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beginning the termination process,

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and I want to be really clear,

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the child moving into termination does not mean we're done.

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It means we move into the termination phase.

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We actually give children a stretch of sessions

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to process

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closing out therapy.

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So it's not we decide that we're done and that's the final session.

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We actually move them into the termination phase.

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But interestingly,

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here's what traditionally happens.

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So now we understand

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these are the criteria by which we can establish termination readiness.

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What often happens is parents will just quietly pull the child.

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They'll give a pleasant reason.

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They'll give a polite reason.

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We just are so busy right now with the holidays coming up.

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It's going to be very hectic.

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We started violin lessons and so it's going to conflict with our therapy time.

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We can't afford it anymore.

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There's a polite reason that parents will provide.

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That's never the real reason.

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And parents will just give us an email,

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give us a message that says we're not going to attend any more sessions.

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And here's unfortunately what that implies.

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We don't know as a therapist that they were dissatisfied.

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We don't know that they feel like it wasn't helping.

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We don't know that they

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feel like it wasn't successful.

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And in this case,

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we are actually never able to have closure

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and the child is not able to finalize the work that they need to do.

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When the child does not finish the therapeutic process,

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that can be detrimental to the child.

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Imagine

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yourself in therapy,

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for example.

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You get to the apex

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of your work

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and then you just quit going.

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There's so much more left to do

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and there's kind of a flow or an arc if you will,

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of therapy.

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If a child gets pulled and they're not at the other side of that journey,

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that can be damaging for the child because where can they process

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the rest of that stuff when they no longer come to sessions.

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And I think the biggest concern

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of what typically happens,

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I mean,

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in addition to all the things that I just mentioned,

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most therapists do not track

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data.

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There are no metrics.

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There's no measure by which therapists can say,

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I know that I have this many sessions on average with a child.

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I know that when I start with a family,

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I'm likely to finish this many months later.

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I know that at this number of weeks,

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most kids

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that I've worked with

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have been ready to move into termination.

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There's no statistics,

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no analysis

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when

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therapists are working with families.

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And so when I ask therapists,

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especially ones that I coach,

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because this is something we talk about a lot in coaching,

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when I ask therapists with whom I'm coaching.

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What,

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what are you tracking?

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What are your numbers?

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How many calls are you getting?

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How many are becoming clients?

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How many of those are staying with you for the entire

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phase of treatment

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and they're with you the entire time until natural termination occurs?

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Most of the time,

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the answer is none.

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That is alarming to me

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because we can't know

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what we need to work on and we can't know what we need to fix

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when we don't have numbers

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to support the adjustments that need to be made.

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If you are not seeing

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a long stretch with most of your clients and if you

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are not seeing natural termination with most of your clients.

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There's something in your process that needs to be adjusted.

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We know based on the meta-analytic data

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that the average number of sessions across all of the studies is 30 to 40 weeks,

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with the magic number or the the most consistent number being 37.

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Are you getting in that 30 to 40 range with your clients?

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With the majority of them,

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almost all of them,

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if almost all of them are landing in your 30 to 40 week range,

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then you probably have appropriate attrition levels.

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If you're saying,

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oh my gosh,

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I don't make it past 15 weeks with most of my kids,

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why?

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You have to have numbers.

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You have to have data

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so that you can analyze what's going on

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and make adjustments to your process,

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to your communication,

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to your articulation,

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to getting parents to buy in.

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There are all kinds of components woven in

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to making sure that attrition does not affect your practice and your work with kids.

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So speaking of data,

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let me give you some numbers on what we have found.

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So after coaching so many people all over the world,

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and I ask these questions,

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one of the things that has come back consistently

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is most therapists

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assume that silent attrition is normal.

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That's something that I've heard over and over again.

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I thought it was just kind of normal that when when a parent says,

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OK,

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we're just going to be done for now,

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that

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that was just the way that it goes.

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First of all,

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that's not the way it goes.

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Second of all,

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it shouldn't be the way that it goes.

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If we have statistics supporting a 30 to 40 week average,

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that means that we should be getting to 30 to 40 weeks with most of our kids.

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Most

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therapists report natural termination rates under 25%.

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So only 1 in 4 of their kids

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00:11:14,140 --> 00:11:16,739
are actually getting to that 30 to 40 week mark.

272
00:11:17,260 --> 00:11:17,650
Why?

273
00:11:17,820 --> 00:11:20,969
I actually would argue for some people I think it's lower than that.

274
00:11:21,419 --> 00:11:23,080
I think 1 in 10 maybe

275
00:11:23,219 --> 00:11:25,150
are getting to the 30 to 40 week mark.

276
00:11:25,539 --> 00:11:26,739
Very few know their numbers,

277
00:11:26,820 --> 00:11:29,159
so it's hard to determine in the grand scheme of things.

278
00:11:30,020 --> 00:11:34,919
But why are we having such low numbers of families

279
00:11:35,340 --> 00:11:37,070
complete the entire process with us?

280
00:11:37,299 --> 00:11:39,380
I would argue it's because no one's tracking it.

281
00:11:40,150 --> 00:11:43,859
And how are we defining successful

282
00:11:44,200 --> 00:11:45,000
completion

283
00:11:45,239 --> 00:11:45,919
of treatment?

284
00:11:46,859 --> 00:11:48,849
If you're not using a criteria,

285
00:11:49,109 --> 00:11:50,210
it's arbitrary.

286
00:11:50,559 --> 00:11:50,700
Well,

287
00:11:50,760 --> 00:11:52,109
I think it's time to wrap up.

288
00:11:52,190 --> 00:11:54,270
I think maybe we should be done for now.

289
00:11:54,349 --> 00:11:56,369
I think that it sounds like a good idea.

290
00:11:56,989 --> 00:11:58,969
Nothing should be vague

291
00:11:59,270 --> 00:12:00,659
and nebulous like that.

292
00:12:00,830 --> 00:12:03,340
Everything about what we do is clinical.

293
00:12:03,789 --> 00:12:06,130
Everything about what we do has a framework.

294
00:12:07,059 --> 00:12:10,520
Just the same way we have termination criteria,

295
00:12:11,099 --> 00:12:14,780
because if a parent weighs in and we weigh in and we say yes,

296
00:12:14,900 --> 00:12:16,979
we have met these four criteria,

297
00:12:17,219 --> 00:12:19,880
we're all in agreement we should move toward termination,

298
00:12:20,260 --> 00:12:23,419
now we have a definition of successful completion.

299
00:12:23,739 --> 00:12:24,960
We know

300
00:12:25,539 --> 00:12:27,330
when a child is ready to wrap up,

301
00:12:27,340 --> 00:12:29,330
and if we don't meet criteria,

302
00:12:29,659 --> 00:12:34,979
we have justification and rationale for saying let's do another round of 5.

303
00:12:35,750 --> 00:12:38,580
I want to wait and see what happened with this new theme

304
00:12:39,000 --> 00:12:39,719
that came up.

305
00:12:39,960 --> 00:12:42,080
I want to wait to see what that shift was.

306
00:12:42,320 --> 00:12:45,929
I want to wait until we have regulation completely at school as well.

307
00:12:46,320 --> 00:12:48,099
You can give reasoning

308
00:12:48,479 --> 00:12:51,280
for saying a child needs more sessions.

309
00:12:52,080 --> 00:12:55,099
no one has any way to know when it's time to wrap up.

310
00:12:55,559 --> 00:12:55,919
So

311
00:12:56,080 --> 00:12:58,820
if we don't have a standardized definition of success,

312
00:12:59,400 --> 00:13:01,419
that's going to hurt us with attrition rates,

313
00:13:01,719 --> 00:13:04,539
if we don't have training and knowledge

314
00:13:04,679 --> 00:13:07,219
of what the process looks like,

315
00:13:07,719 --> 00:13:09,780
that's going to influence our numbers.

316
00:13:10,239 --> 00:13:11,429
And unfortunately,

317
00:13:11,520 --> 00:13:12,979
a lot of systems

318
00:13:13,320 --> 00:13:14,900
in the play therapy field,

319
00:13:15,119 --> 00:13:16,710
I guess in the mental health field as a whole,

320
00:13:16,760 --> 00:13:18,700
but also in play therapy specifically.

321
00:13:19,219 --> 00:13:21,460
The systems are working against this.

322
00:13:22,289 --> 00:13:25,039
Because systems say you get 12 sessions.

323
00:13:25,599 --> 00:13:26,750
Systems say

324
00:13:27,409 --> 00:13:28,849
insurance will only cover this much.

325
00:13:29,359 --> 00:13:30,789
Systems say we need

326
00:13:31,280 --> 00:13:32,239
solution-focused,

327
00:13:32,250 --> 00:13:33,070
quick fix.

328
00:13:33,450 --> 00:13:34,409
Systems say,

329
00:13:34,650 --> 00:13:34,929
well,

330
00:13:35,030 --> 00:13:35,039
I,

331
00:13:35,169 --> 00:13:37,349
I mean it can't take a kid 40 weeks to,

332
00:13:37,460 --> 00:13:39,030
to work through their trauma.

333
00:13:39,799 --> 00:13:41,890
So we have all of this outside pressure

334
00:13:42,330 --> 00:13:43,270
implying

335
00:13:43,409 --> 00:13:45,510
that it should be quick and easy.

336
00:13:46,179 --> 00:13:46,539
First of all,

337
00:13:46,619 --> 00:13:48,700
nothing worth doing is quick and easy in this world.

338
00:13:48,979 --> 00:13:51,039
That's just a general rule to live by.

339
00:13:51,460 --> 00:13:52,409
Second of all,

340
00:13:52,780 --> 00:13:54,159
we have to understand

341
00:13:54,380 --> 00:13:56,380
that kids are not rational.

342
00:13:57,609 --> 00:13:58,150
So

343
00:13:58,330 --> 00:14:01,359
children are not going to think their way through their problems.

344
00:14:01,679 --> 00:14:04,750
They need time to experience and feel it out

345
00:14:05,210 --> 00:14:07,030
and practice and learn

346
00:14:07,130 --> 00:14:07,549
and

347
00:14:07,849 --> 00:14:09,419
sort stuff out that's going on.

348
00:14:09,489 --> 00:14:12,299
That's all done experientially and emotionally in play.

349
00:14:12,960 --> 00:14:14,539
That doesn't happen quickly,

350
00:14:15,000 --> 00:14:18,479
so we understand why it's 30 to 40 on average.

351
00:14:19,039 --> 00:14:21,500
Kids can't think their way through their problems.

352
00:14:22,000 --> 00:14:24,059
And if we focus on techniques.

353
00:14:24,679 --> 00:14:25,479
We need a worksheet.

354
00:14:25,520 --> 00:14:26,320
We need an activity.

355
00:14:26,369 --> 00:14:27,559
We need to have a discussion.

356
00:14:27,809 --> 00:14:28,960
We need to deep breathe.

357
00:14:29,169 --> 00:14:30,309
We need to

358
00:14:30,570 --> 00:14:31,099
whatever,

359
00:14:31,340 --> 00:14:31,609
color.

360
00:14:31,729 --> 00:14:32,349
I don't know.

361
00:14:33,010 --> 00:14:33,789
That's not my wheelhouse.

362
00:14:33,820 --> 00:14:35,979
I have no idea what activities or techniques you would do.

363
00:14:36,119 --> 00:14:36,510
However,

364
00:14:36,849 --> 00:14:38,549
if that becomes the focus,

365
00:14:38,929 --> 00:14:40,770
we lose the whole point,

366
00:14:40,969 --> 00:14:41,750
which is

367
00:14:41,929 --> 00:14:44,869
the child has their own journey toward healing,

368
00:14:45,210 --> 00:14:46,609
and they get themselves there.

369
00:14:47,469 --> 00:14:48,400
I say it all the time.

370
00:14:48,479 --> 00:14:50,479
We can't put a band-aid on a gaping wound.

371
00:14:51,260 --> 00:14:53,919
If the issue is my child is aggressive.

372
00:14:54,590 --> 00:14:55,690
And the agenda

373
00:14:56,150 --> 00:14:57,409
or the technique

374
00:14:57,789 --> 00:14:58,409
becomes

375
00:14:58,630 --> 00:15:00,190
get the child to stop hitting.

376
00:15:01,109 --> 00:15:01,630
Well,

377
00:15:02,150 --> 00:15:02,890
maybe

378
00:15:03,080 --> 00:15:05,450
the technique could get the child to stop hitting,

379
00:15:05,950 --> 00:15:08,590
but does that actually justify termination?

380
00:15:08,909 --> 00:15:11,590
Has the child addressed the underlying aggression?

381
00:15:11,869 --> 00:15:14,619
Has the child addressed the underlying low self-esteem?

382
00:15:14,869 --> 00:15:17,809
Has the child addressed the underlying dysregulation?

383
00:15:18,619 --> 00:15:19,599
I'm sure not,

384
00:15:19,979 --> 00:15:23,219
unless they've gone through the whole process of therapy.

385
00:15:23,609 --> 00:15:26,549
That's why we have the ebb and flow,

386
00:15:26,739 --> 00:15:28,359
and there's actually that arc,

387
00:15:29,059 --> 00:15:30,460
because it's a process.

388
00:15:31,229 --> 00:15:33,780
And if we don't help parents understand that,

389
00:15:33,789 --> 00:15:35,739
and if we don't understand that ourselves,

390
00:15:36,229 --> 00:15:38,530
then parents are going to lose confidence

391
00:15:38,830 --> 00:15:40,859
long before progress is visible.

392
00:15:41,349 --> 00:15:42,710
Progress is always taking place,

393
00:15:42,719 --> 00:15:43,219
y'all.

394
00:15:43,429 --> 00:15:44,960
Don't get caught up in,

395
00:15:45,070 --> 00:15:46,849
I need to be able to see something.

396
00:15:47,030 --> 00:15:49,130
We were just talking about this on a Collective last week.

397
00:15:49,669 --> 00:15:50,609
Hope is slow,

398
00:15:51,049 --> 00:15:52,049
change is slow,

399
00:15:52,710 --> 00:15:54,450
and it's sometimes it's invisible.

400
00:15:55,070 --> 00:15:55,710
However,

401
00:15:55,830 --> 00:15:56,650
it is there.

402
00:15:57,250 --> 00:16:00,570
But unfortunately what will happen is parents will lose confidence

403
00:16:00,780 --> 00:16:05,229
and parents will feel confused and they bail long before it's visible.

404
00:16:05,260 --> 00:16:06,989
It's not that progress hasn't been made.

405
00:16:07,070 --> 00:16:08,890
They just have no evidence of it yet.

406
00:16:10,000 --> 00:16:15,090
So all of this influences our need to not only have this discussion

407
00:16:15,469 --> 00:16:19,890
but also understand there is a system that you can put in place

408
00:16:20,109 --> 00:16:21,010
to address

409
00:16:21,270 --> 00:16:22,400
high levels of attrition.

410
00:16:22,669 --> 00:16:25,890
We want kids to go through the entire process

411
00:16:26,270 --> 00:16:27,309
that is best for them.

412
00:16:27,429 --> 00:16:28,950
We have the best outcomes.

413
00:16:29,330 --> 00:16:31,570
That is the best experience for parents.

414
00:16:32,270 --> 00:16:34,409
You want a parent to get to the end and say

415
00:16:34,750 --> 00:16:37,929
this was absolutely the best decision that we ever made.

416
00:16:38,429 --> 00:16:40,690
You certainly don't want them week 8 to say

417
00:16:40,900 --> 00:16:42,049
this isn't working

418
00:16:42,510 --> 00:16:44,130
and move on to something else.

419
00:16:44,950 --> 00:16:48,929
It's very important that we have a sense of what we're doing and why

420
00:16:49,150 --> 00:16:50,690
to address the attrition levels.

421
00:16:51,109 --> 00:16:53,650
One of my greatest concerns about high

422
00:16:53,650 --> 00:16:56,150
levels of attrition and unnatural termination,

423
00:16:56,469 --> 00:16:56,969
meaning

424
00:16:57,270 --> 00:17:01,489
child gets pulled before we're all in agreement that we're ready to wrap up,

425
00:17:02,190 --> 00:17:03,609
I think that it

426
00:17:04,150 --> 00:17:07,569
puts a bad taste in the mouths of people in the community

427
00:17:07,989 --> 00:17:08,569
for

428
00:17:08,750 --> 00:17:09,630
mental health,

429
00:17:10,229 --> 00:17:13,709
specifically play therapy and more specifically child-centered play therapy.

430
00:17:15,148 --> 00:17:17,688
I think that it gives a negative impression,

431
00:17:17,999 --> 00:17:20,458
and I think people have a misperception

432
00:17:20,598 --> 00:17:21,808
of its efficacy,

433
00:17:22,159 --> 00:17:22,798
and honestly,

434
00:17:22,838 --> 00:17:25,417
I think that CCPT appears weak.

435
00:17:26,329 --> 00:17:26,339
Because

436
00:17:26,739 --> 00:17:28,660
the process isn't finished.

437
00:17:29,099 --> 00:17:29,109
If,

438
00:17:29,310 --> 00:17:31,069
if a parent pulls a child at 8,

439
00:17:31,209 --> 00:17:33,339
12, 16 weeks in.

440
00:17:34,170 --> 00:17:35,510
Their impressions

441
00:17:35,739 --> 00:17:37,270
are usually pretty negative

442
00:17:37,569 --> 00:17:39,229
or at the minimum

443
00:17:39,530 --> 00:17:40,209
neutral.

444
00:17:40,890 --> 00:17:41,969
They could take it or leave it.

445
00:17:42,050 --> 00:17:42,160
Well,

446
00:17:42,209 --> 00:17:42,369
I mean,

447
00:17:42,410 --> 00:17:43,410
I don't think it did any harm,

448
00:17:43,449 --> 00:17:44,869
but I don't really think it did any good.

449
00:17:45,170 --> 00:17:45,469
Or

450
00:17:45,949 --> 00:17:47,569
worst case scenario is they're like,

451
00:17:47,650 --> 00:17:48,130
oh my gosh,

452
00:17:48,209 --> 00:17:49,069
that was a waste of time.

453
00:17:49,119 --> 00:17:49,944
It was such A joke.

454
00:17:50,104 --> 00:17:51,145
I mean they just played.

455
00:17:51,224 --> 00:17:52,354
They didn't even do anything.

456
00:17:52,425 --> 00:17:53,685
I don't even think it helped at all.

457
00:17:54,104 --> 00:17:54,265
OK,

458
00:17:54,344 --> 00:17:56,214
when we have that kind of response,

459
00:17:56,574 --> 00:17:58,204
it weakens our model.

460
00:17:58,344 --> 00:18:00,094
It weakens efficacy.

461
00:18:00,305 --> 00:18:02,025
It weakens the reputation

462
00:18:02,175 --> 00:18:02,984
of CCPT.

463
00:18:03,155 --> 00:18:03,344
Y'all,

464
00:18:03,425 --> 00:18:04,984
we know CCPT works.

465
00:18:05,545 --> 00:18:07,545
Not only do we know that because of our own

466
00:18:07,545 --> 00:18:10,135
experience and because we have anecdotal evidence of that,

467
00:18:10,305 --> 00:18:10,964
I could give

468
00:18:11,145 --> 00:18:12,925
hundreds of stories

469
00:18:13,584 --> 00:18:15,015
of CCPT successes,

470
00:18:15,224 --> 00:18:16,545
probably thousands actually.

471
00:18:16,744 --> 00:18:17,025
I could,

472
00:18:17,104 --> 00:18:19,084
I could tell thousands of stories.

473
00:18:19,819 --> 00:18:21,069
That's just my experience.

474
00:18:21,319 --> 00:18:23,270
We also have data and research,

475
00:18:23,630 --> 00:18:26,469
empirical support for CCPT's effectiveness.

476
00:18:26,589 --> 00:18:27,209
We know

477
00:18:27,670 --> 00:18:29,729
that this works because data proves it.

478
00:18:30,270 --> 00:18:31,979
So our own experience confirms it.

479
00:18:32,140 --> 00:18:33,270
The data confirms it,

480
00:18:33,430 --> 00:18:34,770
and parents walk away and go,

481
00:18:35,229 --> 00:18:35,790
that was a joke.

482
00:18:35,869 --> 00:18:36,819
That didn't work at all.

483
00:18:37,170 --> 00:18:39,689
Let me go to a talk therapist for my six year old.

484
00:18:40,270 --> 00:18:42,329
Let me go do CBT with my 8-year-old.

485
00:18:43,030 --> 00:18:43,189
Y'all,

486
00:18:43,270 --> 00:18:44,510
the onus is on us to stop that.

487
00:18:46,069 --> 00:18:49,599
If we do not carefully think about.

488
00:18:50,270 --> 00:18:52,560
Process and systems

489
00:18:52,739 --> 00:18:55,319
and templates so that we know

490
00:18:55,459 --> 00:18:57,160
that we are getting parents on board

491
00:18:57,300 --> 00:18:59,099
and that they're willing to stick it out.

492
00:18:59,579 --> 00:19:00,890
They're willing to buy in.

493
00:19:01,099 --> 00:19:03,599
They're willing to have longevity in the work.

494
00:19:04,250 --> 00:19:07,699
Kids are on a therapeutic journey and they need to be able to complete it.

495
00:19:08,449 --> 00:19:11,550
That's honoring and respecting of the child's pace

496
00:19:11,650 --> 00:19:13,069
and the child's process.

497
00:19:13,880 --> 00:19:14,969
7 sessions in,

498
00:19:15,010 --> 00:19:18,290
a child is not going to have sorted out everything that they need to.

499
00:19:19,079 --> 00:19:20,260
But a lot of kids

500
00:19:20,800 --> 00:19:22,459
see a therapist 7 times.

501
00:19:23,199 --> 00:19:25,000
That's doing a disservice to our kids,

502
00:19:25,119 --> 00:19:25,719
to our families,

503
00:19:25,839 --> 00:19:26,449
to our communities,

504
00:19:26,560 --> 00:19:27,339
to the model.

505
00:19:27,839 --> 00:19:28,140
So

506
00:19:28,280 --> 00:19:29,619
what actually works?

507
00:19:29,900 --> 00:19:31,140
What can we do

508
00:19:31,400 --> 00:19:35,839
so that we can address the high levels of attrition and the early termination?

509
00:19:36,280 --> 00:19:36,420
Well,

510
00:19:36,489 --> 00:19:39,400
you really need to build strong parental relationships.

511
00:19:40,599 --> 00:19:40,859
I've,

512
00:19:40,959 --> 00:19:41,520
I've seen,

513
00:19:41,640 --> 00:19:46,660
I'm seeing lots of play therapy training topics emerge recently

514
00:19:46,959 --> 00:19:48,439
about engaging parents,

515
00:19:48,520 --> 00:19:49,630
working with parents,

516
00:19:50,199 --> 00:19:53,239
supporting process of getting buy-in from parents.

517
00:19:53,439 --> 00:19:54,479
It's been interesting.

518
00:19:54,520 --> 00:19:56,459
That's a huge uptick right now

519
00:19:56,760 --> 00:19:57,760
in working with parents.

520
00:19:58,119 --> 00:19:59,400
Rise Van Fleet put out,

521
00:19:59,520 --> 00:19:59,839
y'all,

522
00:19:59,910 --> 00:20:00,040
OK,

523
00:20:00,119 --> 00:20:00,229
here,

524
00:20:00,280 --> 00:20:01,339
I'm going to date myself.

525
00:20:01,880 --> 00:20:07,579
I ordered Rise Van Fleet's Engaging Parents in the Process in like the early 2000s,

526
00:20:08,000 --> 00:20:10,180
and she mailed me a VHS tape.

527
00:20:10,750 --> 00:20:13,000
With a folder with papers in it.

528
00:20:13,670 --> 00:20:16,130
And I put it in my VCR and I watched her

529
00:20:16,589 --> 00:20:17,829
talk about engaging parents.

530
00:20:17,910 --> 00:20:18,209
I mean,

531
00:20:18,550 --> 00:20:18,560
we,

532
00:20:18,790 --> 00:20:21,150
we've known this isn't a priority for years.

533
00:20:21,229 --> 00:20:22,969
That was back in the early 2000s.

534
00:20:23,469 --> 00:20:25,670
Can you imagine someone mailing a VHS tape these days?

535
00:20:25,760 --> 00:20:26,300
That's crazy.

536
00:20:26,589 --> 00:20:29,170
But that's literally what we've been doing all along.

537
00:20:29,310 --> 00:20:30,810
How do we engage parents?

538
00:20:31,150 --> 00:20:32,650
And I think often we fail

539
00:20:32,910 --> 00:20:34,819
because we don't learn this stuff in grad school.

540
00:20:35,030 --> 00:20:36,890
We don't learn this stuff in trainings.

541
00:20:37,540 --> 00:20:39,209
You learn it in my coaching programs,

542
00:20:39,430 --> 00:20:42,180
but you're not going to go to a CCPT training and you're

543
00:20:42,180 --> 00:20:45,920
not going to understand what it means to work with parents.

544
00:20:46,500 --> 00:20:47,449
But we have to,

545
00:20:47,569 --> 00:20:48,219
it's critical.

546
00:20:48,380 --> 00:20:51,020
We have to build relationships with our parents.

547
00:20:51,380 --> 00:20:52,099
They have to know,

548
00:20:52,219 --> 00:20:52,410
like,

549
00:20:52,420 --> 00:20:53,520
and trust us,

550
00:20:54,099 --> 00:20:55,920
and they have to understand

551
00:20:56,099 --> 00:20:56,979
what to expect.

552
00:20:57,219 --> 00:20:59,400
So that brings us to articulation.

553
00:20:59,900 --> 00:21:01,959
We have to educate parents

554
00:21:02,369 --> 00:21:04,839
from the very first meeting we have with them

555
00:21:05,300 --> 00:21:06,319
what to expect.

556
00:21:06,780 --> 00:21:08,410
What CCPT involves,

557
00:21:08,689 --> 00:21:09,859
what are the phases,

558
00:21:10,180 --> 00:21:11,400
what's going to happen.

559
00:21:11,619 --> 00:21:13,770
Here are things that you need to be prepared for.

560
00:21:14,140 --> 00:21:16,760
Here's likely how this is going to unfold.

561
00:21:17,300 --> 00:21:20,300
You're going to not see progress as quickly as you want.

562
00:21:20,540 --> 00:21:21,849
Here's how you handle that.

563
00:21:22,260 --> 00:21:23,660
This is an articulation,

564
00:21:23,739 --> 00:21:24,619
communication,

565
00:21:25,260 --> 00:21:26,099
education thing.

566
00:21:27,079 --> 00:21:30,359
From the very first meeting we have to address this stuff.

567
00:21:30,479 --> 00:21:30,640
Why?

568
00:21:30,800 --> 00:21:32,280
Because we know it's real for them.

569
00:21:32,520 --> 00:21:34,079
We know they're going to struggle with it.

570
00:21:34,280 --> 00:21:37,500
We anticipate the obstacles and we address them

571
00:21:37,760 --> 00:21:39,579
from the very first get-go.

572
00:21:40,160 --> 00:21:40,420
Why?

573
00:21:40,800 --> 00:21:42,739
Because if we articulate the process

574
00:21:42,959 --> 00:21:44,380
and the expectations

575
00:21:44,560 --> 00:21:47,180
and we help them understand CCPT,

576
00:21:47,560 --> 00:21:48,420
they won't

577
00:21:48,880 --> 00:21:50,140
rush the pace.

578
00:21:50,599 --> 00:21:51,530
They'll want to,

579
00:21:52,000 --> 00:21:52,869
but they won't.

580
00:21:53,239 --> 00:21:56,060
They won't have unrealistic timelines.

581
00:21:56,959 --> 00:21:57,719
They won't go,

582
00:21:58,030 --> 00:21:58,119
Well,

583
00:21:58,199 --> 00:21:59,109
we're 6 sessions in,

584
00:21:59,119 --> 00:22:00,479
and I haven't seen any change,

585
00:22:00,560 --> 00:22:02,160
so this obviously isn't working.

586
00:22:02,560 --> 00:22:03,540
They will be patient.

587
00:22:04,760 --> 00:22:07,060
There is a slow pace to CCPT.

588
00:22:07,479 --> 00:22:09,219
It's a process of becoming.

589
00:22:10,209 --> 00:22:11,979
We're not addressing a behavior,

590
00:22:12,290 --> 00:22:12,770
never.

591
00:22:13,619 --> 00:22:14,900
Do behaviors get addressed?

592
00:22:14,939 --> 00:22:15,359
Of course,

593
00:22:15,780 --> 00:22:17,800
but we're not addressing a behavior.

594
00:22:18,060 --> 00:22:19,780
It's a process of becoming.

595
00:22:20,819 --> 00:22:22,000
And that is slow.

596
00:22:22,949 --> 00:22:24,069
Some kids are molasses.

597
00:22:24,219 --> 00:22:25,030
Landreth says that.

598
00:22:25,150 --> 00:22:25,390
Why?

599
00:22:25,630 --> 00:22:26,689
Because it's just

600
00:22:26,869 --> 00:22:29,489
a very slow moving evolution

601
00:22:29,630 --> 00:22:30,300
of change.

602
00:22:30,630 --> 00:22:32,150
Parents need to understand that.

603
00:22:32,630 --> 00:22:35,209
They also need to understand that sometimes

604
00:22:35,209 --> 00:22:36,670
things get worse before they get better.

605
00:22:36,869 --> 00:22:39,489
If you don't prepare a parent for resistance,

606
00:22:40,229 --> 00:22:40,949
they're gone.

607
00:22:42,089 --> 00:22:46,560
If you don't help them know that things might get worse before they get better

608
00:22:46,699 --> 00:22:48,979
and kids might go off the rails for a few

609
00:22:48,979 --> 00:22:51,260
weeks and kids might refuse to come back to a play

610
00:22:51,260 --> 00:22:54,180
session and kids might refuse to get in the car and

611
00:22:54,180 --> 00:22:57,199
kids might say they hate the therapist and they hate therapy

612
00:22:57,300 --> 00:22:58,520
and they hate the whole thing,

613
00:22:58,900 --> 00:23:02,020
you know how scary that is and overwhelming that is and concerning

614
00:23:02,020 --> 00:23:04,459
that is for a parent that hasn't been prepared for that.

615
00:23:05,160 --> 00:23:06,339
That falls on us.

616
00:23:07,150 --> 00:23:08,680
If we don't communicate that stuff,

617
00:23:08,760 --> 00:23:09,520
they don't know.

618
00:23:09,819 --> 00:23:11,359
Parents don't know what they don't know.

619
00:23:11,800 --> 00:23:14,660
We tend to live in a CCPT bubble at times.

620
00:23:15,359 --> 00:23:17,079
My husband calls me out on this all the time.

621
00:23:17,400 --> 00:23:18,040
He's like,

622
00:23:19,119 --> 00:23:20,839
The rest of the world doesn't know that.

623
00:23:21,239 --> 00:23:23,119
You can't expect everyone to understand that.

624
00:23:23,319 --> 00:23:24,359
No one knows what that means,

625
00:23:24,400 --> 00:23:24,800
and I'm like,

626
00:23:24,869 --> 00:23:25,060
yes,

627
00:23:25,119 --> 00:23:25,560
they do.

628
00:23:25,800 --> 00:23:28,359
And then when I get myself out of my CCPT bubble,

629
00:23:28,560 --> 00:23:29,140
I'm like,

630
00:23:29,400 --> 00:23:29,839
Oh,

631
00:23:30,079 --> 00:23:32,640
I wouldn't have known that before I did CCPT.

632
00:23:33,150 --> 00:23:33,439
Oh,

633
00:23:33,560 --> 00:23:37,449
I don't know that that is common knowledge if I'm outside of the mental health space.

634
00:23:37,959 --> 00:23:39,020
We forget

635
00:23:39,199 --> 00:23:41,579
that parents have no idea about this stuff.

636
00:23:42,410 --> 00:23:42,949
So

637
00:23:43,329 --> 00:23:45,209
they need to understand.

638
00:23:46,050 --> 00:23:48,130
That presenting issues will get addressed,

639
00:23:48,209 --> 00:23:51,510
but it may not look like a linear process because it's not.

640
00:23:52,239 --> 00:23:53,869
Think about an x y axis

641
00:23:54,000 --> 00:23:55,969
and up and right is the direction we're going.

642
00:23:56,050 --> 00:23:57,150
It's not a line.

643
00:23:57,859 --> 00:24:01,260
It's a loop de loop roller coaster sliding backwards all over

644
00:24:01,260 --> 00:24:03,819
the place with some barrel rolls and some flips and whatever.

645
00:24:04,180 --> 00:24:04,420
Why?

646
00:24:04,660 --> 00:24:06,880
Because we're going in that direction,

647
00:24:07,339 --> 00:24:08,630
but it's certainly not linear.

648
00:24:08,739 --> 00:24:12,520
They track progress differently when we've communicated appropriately.

649
00:24:12,979 --> 00:24:15,780
They understand that sometimes progress takes

650
00:24:15,780 --> 00:24:17,579
place in one environment before another.

651
00:24:18,579 --> 00:24:22,650
We might see huge gains in the playroom long before a parent sees it at home.

652
00:24:23,260 --> 00:24:24,329
They need to understand that.

653
00:24:24,380 --> 00:24:25,839
They need to be supportive of that.

654
00:24:26,099 --> 00:24:27,939
They need to celebrate what's happening in the

655
00:24:27,939 --> 00:24:30,479
playroom even when home life is still awful.

656
00:24:31,170 --> 00:24:31,180
Why?

657
00:24:32,050 --> 00:24:33,750
Because progress is being made.

658
00:24:34,880 --> 00:24:35,810
And look,

659
00:24:36,280 --> 00:24:37,209
you above all else,

660
00:24:37,290 --> 00:24:39,739
you have to prepare parents for the termination phase.

661
00:24:39,969 --> 00:24:41,310
They need to understand

662
00:24:41,469 --> 00:24:45,750
that that is just as much a part of the process as the other three phases.

663
00:24:46,290 --> 00:24:48,569
They're going to let a kid have the initiation phase.

664
00:24:48,770 --> 00:24:50,650
They're going to suffer through resistance phase,

665
00:24:50,890 --> 00:24:53,050
and the kid's going to get into work usually.

666
00:24:54,280 --> 00:24:58,099
If they don't understand that termination is the 4th and final phase,

667
00:24:58,680 --> 00:25:01,959
they don't have any buy-in to let the child have an actual phase with you.

668
00:25:02,040 --> 00:25:02,439
They just go,

669
00:25:02,520 --> 00:25:02,699
OK,

670
00:25:02,800 --> 00:25:03,219
great.

671
00:25:03,859 --> 00:25:03,869
See,

672
00:25:04,020 --> 00:25:04,030
we,

673
00:25:04,119 --> 00:25:04,959
we won't see you anymore.

674
00:25:05,079 --> 00:25:05,520
Bye.

675
00:25:06,640 --> 00:25:09,930
We have to set expectations of the fact that that is a countdown.

676
00:25:10,880 --> 00:25:11,540
And look,

677
00:25:11,880 --> 00:25:12,829
above all else,

678
00:25:13,050 --> 00:25:14,500
we're building hope

679
00:25:14,770 --> 00:25:15,560
and trust.

680
00:25:16,390 --> 00:25:18,770
In the transformation that will happen.

681
00:25:19,770 --> 00:25:21,219
Therapy does go somewhere.

682
00:25:22,060 --> 00:25:22,300
You know,

683
00:25:22,729 --> 00:25:22,939
interestingly,

684
00:25:23,060 --> 00:25:25,780
therapy works whether the person thinks it's going to work or not.

685
00:25:26,219 --> 00:25:27,699
So the most resistant child,

686
00:25:27,859 --> 00:25:29,319
the most resistant adult,

687
00:25:29,819 --> 00:25:31,290
an adult can hate therapy,

688
00:25:31,489 --> 00:25:32,739
they can hate the therapist,

689
00:25:32,900 --> 00:25:34,500
they can think that it's not even going to work,

690
00:25:34,540 --> 00:25:34,939
and guess what,

691
00:25:34,979 --> 00:25:35,939
it's going to work anyway.

692
00:25:37,199 --> 00:25:38,209
Same thing with kids.

693
00:25:38,250 --> 00:25:40,550
It doesn't matter how they come into the process.

694
00:25:40,880 --> 00:25:42,180
Therapy goes somewhere.

695
00:25:42,630 --> 00:25:43,280
It's effective,

696
00:25:43,339 --> 00:25:43,869
it works.

697
00:25:43,959 --> 00:25:44,719
We know this.

698
00:25:45,680 --> 00:25:48,300
So parents have to get on board and they have to be

699
00:25:49,079 --> 00:25:50,310
made aware of this stuff.

700
00:25:50,719 --> 00:25:52,380
We communicate this

701
00:25:52,839 --> 00:25:54,020
to prevent them

702
00:25:54,199 --> 00:25:55,619
from pulling the plug and saying,

703
00:25:55,640 --> 00:25:56,300
never mind.

704
00:25:57,339 --> 00:25:58,760
What if we as a field.

705
00:26:00,510 --> 00:26:02,170
Committed to natural termination.

706
00:26:03,199 --> 00:26:05,359
What if we tracked completion?

707
00:26:06,359 --> 00:26:08,270
As carefully as we tracked.

708
00:26:09,109 --> 00:26:10,439
How many sessions we have.

709
00:26:10,910 --> 00:26:15,250
What if we define success in a way that parents can support

710
00:26:15,469 --> 00:26:16,569
and understand

711
00:26:16,790 --> 00:26:17,989
and buy into?

712
00:26:18,839 --> 00:26:21,069
What if attrition stopped being normal?

713
00:26:21,319 --> 00:26:26,119
What if we completed an entire therapeutic journey with almost all of our children?

714
00:26:27,010 --> 00:26:29,959
I think that if we stop accepting

715
00:26:30,099 --> 00:26:32,180
early termination and attrition

716
00:26:32,310 --> 00:26:33,319
as normal,

717
00:26:33,979 --> 00:26:38,000
I think that we can start treating it as an ethical responsibility

718
00:26:38,540 --> 00:26:39,880
to have full

719
00:26:40,060 --> 00:26:41,560
treatment with a child.

720
00:26:41,979 --> 00:26:44,239
There are definable criteria

721
00:26:44,459 --> 00:26:46,219
for when a child is ready to wrap up.

722
00:26:46,300 --> 00:26:47,979
If we don't reach that yet,

723
00:26:48,339 --> 00:26:49,300
they're not done.

724
00:26:50,069 --> 00:26:51,670
And I think that

725
00:26:52,010 --> 00:26:53,060
as a field

726
00:26:53,319 --> 00:26:55,109
we've gotten hung up in

727
00:26:55,939 --> 00:26:59,619
Measurable goals and outcomes and we need strategies and

728
00:26:59,619 --> 00:27:01,339
we have to be able to see progress,

729
00:27:01,770 --> 00:27:02,020
yes,

730
00:27:02,180 --> 00:27:03,719
to all of those things to a degree,

731
00:27:04,020 --> 00:27:05,719
but child-centered play therapy

732
00:27:06,020 --> 00:27:07,180
has a different approach.

733
00:27:07,380 --> 00:27:08,339
It's a process.

734
00:27:09,250 --> 00:27:11,660
And the process involves parents.

735
00:27:11,900 --> 00:27:13,760
We know outcomes are better

736
00:27:13,900 --> 00:27:15,260
when parents are involved.

737
00:27:15,459 --> 00:27:17,109
We know that gains

738
00:27:17,380 --> 00:27:20,160
are more longitudinal if we have buy-in.

739
00:27:20,500 --> 00:27:21,869
We can't do this alone.

740
00:27:22,099 --> 00:27:23,800
I've had so many therapists say

741
00:27:24,099 --> 00:27:26,579
if I could do CCPT and not work with parents,

742
00:27:26,619 --> 00:27:27,680
it would be easier.

743
00:27:28,140 --> 00:27:28,979
It's a package deal,

744
00:27:29,020 --> 00:27:29,560
y'all.

745
00:27:29,900 --> 00:27:30,199
We,

746
00:27:30,380 --> 00:27:32,520
we accept parents when we accept children.

747
00:27:32,699 --> 00:27:35,400
It's the nature of being a child-centered play therapist.

748
00:27:35,959 --> 00:27:37,229
But it's not just

749
00:27:37,489 --> 00:27:38,869
they come along for the ride.

750
00:27:39,050 --> 00:27:40,250
They need to be partners.

751
00:27:40,329 --> 00:27:41,530
They need to be aware.

752
00:27:41,609 --> 00:27:42,880
They need to be informed.

753
00:27:43,170 --> 00:27:44,609
They need to feel that they've had

754
00:27:44,609 --> 00:27:48,589
appropriate expectations set and that we've communicated effectively

755
00:27:49,050 --> 00:27:50,030
what's to come.

756
00:27:50,560 --> 00:27:52,109
People can handle anything

757
00:27:52,270 --> 00:27:53,670
if they are prepared.

758
00:27:54,170 --> 00:27:57,930
What gets us is when something completely catches us off guard.

759
00:27:58,540 --> 00:28:00,969
When we feel completely shocked by something

760
00:28:01,109 --> 00:28:02,780
and it came out of the blue,

761
00:28:03,349 --> 00:28:07,469
we understand as child-centered play therapists what the process looks like.

762
00:28:08,349 --> 00:28:09,849
We know how things unfold.

763
00:28:10,270 --> 00:28:11,969
We know the trajectory.

764
00:28:12,229 --> 00:28:15,209
We know the phases and the stages and the timeline.

765
00:28:16,239 --> 00:28:18,030
These are things that we

766
00:28:18,290 --> 00:28:20,790
spend time learning and equipping ourselves

767
00:28:21,010 --> 00:28:21,910
with the knowledge

768
00:28:22,069 --> 00:28:24,030
so that we can then share that with parents.

769
00:28:24,810 --> 00:28:27,469
The more effective we are at communicating

770
00:28:28,010 --> 00:28:29,890
the entirety of the journey,

771
00:28:30,250 --> 00:28:32,170
the more likely they are to stick around.

772
00:28:32,869 --> 00:28:34,199
And this is complex,

773
00:28:34,589 --> 00:28:36,390
especially if you have managed care involved,

774
00:28:36,550 --> 00:28:39,170
especially if you are working in a school and you're only

775
00:28:39,489 --> 00:28:41,050
allowed a certain number of sessions.

776
00:28:41,400 --> 00:28:44,380
If you're working in other agencies or community centers

777
00:28:44,380 --> 00:28:47,199
or whatever and parents don't even engage with you,

778
00:28:47,589 --> 00:28:51,510
there's lots and lots of hurdles and there's a lot of complexity here.

779
00:28:51,589 --> 00:28:51,930
So

780
00:28:52,670 --> 00:28:53,650
understanding that.

781
00:28:54,729 --> 00:28:55,310
We

782
00:28:55,449 --> 00:28:57,329
are making a difference every single day.

783
00:28:58,329 --> 00:28:58,989
And

784
00:28:59,209 --> 00:29:02,040
no matter how many sessions a child attends with us,

785
00:29:02,369 --> 00:29:03,310
that was meaningful.

786
00:29:03,369 --> 00:29:04,089
It was helpful.

787
00:29:04,130 --> 00:29:05,069
It was powerful.

788
00:29:05,489 --> 00:29:07,689
They get value from the time that they spent,

789
00:29:07,849 --> 00:29:09,770
no matter what that duration is.

790
00:29:10,290 --> 00:29:12,689
We just want to ensure from our end.

791
00:29:13,400 --> 00:29:18,819
That we are setting the situation up to be the most effective long term

792
00:29:19,239 --> 00:29:21,479
and that kids are able to finish their journey.

793
00:29:22,390 --> 00:29:24,540
We never want a child to feel like,

794
00:29:24,790 --> 00:29:24,869
well,

795
00:29:24,910 --> 00:29:28,810
I only got to go to therapy for a little while and then I'm left with all of this junk.

796
00:29:29,310 --> 00:29:32,170
If we give them the full therapeutic process,

797
00:29:32,670 --> 00:29:34,630
we have control over some of that.

798
00:29:34,939 --> 00:29:36,300
Some of it is out of our control,

799
00:29:36,390 --> 00:29:37,219
we acknowledge,

800
00:29:37,709 --> 00:29:41,969
but we can put systems in place and we can have process as part of our work

801
00:29:42,630 --> 00:29:44,530
that really prevents attrition

802
00:29:44,869 --> 00:29:47,469
because parents understand the importance of it,

803
00:29:47,589 --> 00:29:48,459
the value of it,

804
00:29:48,670 --> 00:29:50,329
the length of time that's required.

805
00:29:51,069 --> 00:29:54,540
You can have these systems as part of your practice.

806
00:29:55,030 --> 00:29:58,010
You can be courageous to say the things that need to say.

807
00:29:58,510 --> 00:30:00,130
You can be brave and bold

808
00:30:00,349 --> 00:30:03,209
to communicate expectations from the get-go.

809
00:30:03,709 --> 00:30:05,270
They're committing to 5 at a time.

810
00:30:06,410 --> 00:30:10,150
They don't have to feel overwhelmed by a 30 to 40 week number.

811
00:30:10,689 --> 00:30:13,930
Every 5 weeks we're going to meet and we're going to reevaluate

812
00:30:14,089 --> 00:30:17,790
whether or not we need to continue or whether we're ready to move into termination.

813
00:30:18,719 --> 00:30:20,619
If you set expectations

814
00:30:20,719 --> 00:30:22,520
that every 5 weeks

815
00:30:22,880 --> 00:30:27,089
we're going to evaluate whether or not it makes sense to keep doing more therapy.

816
00:30:27,939 --> 00:30:30,140
That feels manageable for parents.

817
00:30:30,319 --> 00:30:31,750
That keeps them bought in.

818
00:30:31,989 --> 00:30:33,439
That's why we have systems.

819
00:30:33,489 --> 00:30:35,050
That's why we have process,

820
00:30:35,439 --> 00:30:37,280
because it sets us up for success and

821
00:30:37,280 --> 00:30:38,650
ultimately when we set ourselves up for success,

822
00:30:40,650 --> 00:30:43,300
we set parents and children up for success too.

823
00:30:43,839 --> 00:30:44,880
Imagine what

824
00:30:45,199 --> 00:30:46,780
our field would look like

825
00:30:47,239 --> 00:30:49,729
if natural termination became the norm.

826
00:30:50,239 --> 00:30:51,099
That's the goal.

827
00:30:51,689 --> 00:30:54,689
That every single child completes therapy,

828
00:30:54,979 --> 00:30:56,079
they get to the other side.

829
00:30:56,459 --> 00:30:57,459
They are well adjusted.

830
00:30:57,540 --> 00:30:58,420
They're regulated.

831
00:30:58,500 --> 00:30:59,170
They're calm.

832
00:30:59,260 --> 00:30:59,900
They're happy.

833
00:30:59,979 --> 00:31:00,780
They're content.

834
00:31:01,699 --> 00:31:01,709
Because

835
00:31:02,099 --> 00:31:03,959
they did all the work that they needed to do.

836
00:31:04,839 --> 00:31:08,349
That falls back on us for a large portion of that.

837
00:31:08,510 --> 00:31:10,449
children deserve the full

838
00:31:11,189 --> 00:31:11,430
process,

839
00:31:11,550 --> 00:31:13,060
not just the first segment.

840
00:31:14,060 --> 00:31:14,449
So

841
00:31:14,660 --> 00:31:15,520
our goal

842
00:31:15,699 --> 00:31:18,040
is to be intentional

843
00:31:18,140 --> 00:31:19,319
and purposeful

844
00:31:19,900 --> 00:31:21,989
in making sure that from our end,

845
00:31:22,180 --> 00:31:23,969
we've done everything we can.

846
00:31:24,380 --> 00:31:26,380
There are times when no matter what you do.

847
00:31:27,920 --> 00:31:29,270
A child's going to get pulled.

848
00:31:30,160 --> 00:31:30,819
And

849
00:31:31,000 --> 00:31:32,290
those are hard moments,

850
00:31:32,439 --> 00:31:34,119
those are heart-wrenching moments,

851
00:31:34,400 --> 00:31:37,060
and you just wish that you could do something about it,

852
00:31:37,150 --> 00:31:38,180
but sometimes

853
00:31:38,599 --> 00:31:39,300
we can't.

854
00:31:39,920 --> 00:31:42,160
But if we've done everything that we can.

855
00:31:43,089 --> 00:31:45,310
We rest our head at night and we say

856
00:31:45,770 --> 00:31:49,150
the child got what the child needed for the time that they were with me.

857
00:31:50,540 --> 00:31:52,219
That's the beauty of CCPT.

858
00:31:52,500 --> 00:31:53,780
Even for one hour,

859
00:31:53,979 --> 00:31:55,439
it makes a difference for a child.

860
00:31:56,380 --> 00:31:57,000
So,

861
00:31:57,579 --> 00:31:59,369
no matter how many sessions you have,

862
00:31:59,540 --> 00:32:01,160
there's meaning and purpose and value

863
00:32:01,819 --> 00:32:02,930
in your work with kids.

864
00:32:03,339 --> 00:32:07,319
We just want as much as possible to make sure they get the whole span

865
00:32:07,579 --> 00:32:08,260
of their work.

866
00:32:08,900 --> 00:32:10,270
So I hope that encourages you.

867
00:32:10,540 --> 00:32:13,699
I hope that that gives you a sense of how to manage attrition,

868
00:32:13,900 --> 00:32:16,780
how to ensure longevity in your work with families.

869
00:32:17,020 --> 00:32:20,250
Your termination criteria will be hugely beneficial for you,

870
00:32:20,459 --> 00:32:23,880
for actually helping a parent to understand when we're ready to wrap up.

871
00:32:24,300 --> 00:32:27,030
I hope this gives you some confidence in the process

872
00:32:27,260 --> 00:32:29,599
and equips you to be effective

873
00:32:29,739 --> 00:32:32,020
in making sure that your kids are with you for as long as

874
00:32:32,020 --> 00:32:34,560
they can be and for as long as they need to be.

875
00:32:35,060 --> 00:32:35,699
I love y'all.

876
00:32:35,819 --> 00:32:36,540
Thanks for hanging out.

877
00:32:36,619 --> 00:32:37,459
We'll talk again soon.

878
00:32:37,660 --> 00:32:37,939
Bye.

879
00:32:38,989 --> 00:32:42,780
Thank you for listening to the Play Therapy Podcast with Dr. Brenna Hicks.

880
00:32:43,030 --> 00:32:44,949
For more episodes and resources,

881
00:32:45,109 --> 00:32:49,869
please go to www.playtherapypodcast.com.