Family, Speech & Language, Uncategorized

Changing Therapists

Will someone please cue Neil Sedaka?


They say that breaking up is hard to do. Now I know, I know that it’s true.

I’ve had a number of people ask me recently, “How do I know if it’s time to change therapists?”

This is a loaded question with lots to consider. I’m going to base the initial question of switching therapists on the assumption: There is someone your child can switch to.

The first thing I want you to know is,

It’s okay to change.

First, ask yourself some questions:

  1. Is your desire to change because of your child’s lack of progress with your current therapist?
  2. Does your child seem to work effectively with the therapist but the two of you don’t connect? Maybe reversed? You like the SLP, but your child does not work well with them?
  3. Does your therapist tell you, “I don’t know what else to do.”

Lack of Progress

Reason #1. Your child consistently attends therapy and despite home carryover progress appears very slow or non-existent. Please talk to your SLP. At times it’s difficult to see the progress your child is making because you’re together every day. Ask about the goals the progress made toward them. Be up front about your concerns. I’ve had situations where I’ve been able to pull goals and say, “When we started Tommy could only say 5 words. Now he uses 20 words on his own!”

Conversely, a parent’s concern is sometimes a segue to a conversation about other potential diagnoses or how to change treatment strategies. The take-away here is: there should be progress. Hopefully a conversation will help alleviate some concerns.

Lack of Connection

Reason #2. You don’t connect with the SLP but your child does. Tough one. The fit for your child is important.  BUT, if it significantly hinders you from being a part of the therapy plan – look elsewhere.

If your child doesn’t connect initially I recommend talking to the SLP and trying 2-3 more sessions. Children (and therapists) need time to establish rapport and build a relationship. Talk to the SLP about what’s worked for other children. Visual schedules, alternating work/play tasks, a timer…There’s a difference between acting out/shutting down because communication is difficult and a personality conflict.

If the therapist suggests you leave the session make sure there is someway to know what’s going on – observation via 2-way mirror or video. Avoid situations where you are asked to stay in the waiting room the entire time especially when your child is young. With due diligence on the part of yourself and the SLP, if a child still doesn’t connect it may be time to explore other provider options.

“I don’t know what else to do.”

Reason #3. “I don’t know what else to do,” masks a number of underlying sentiments from “I’m limited in my background and I’m truly at a loss” to “I’m tapped out (for various reasons) and you need a new therapist.” An SLP doesn’t have to be a specialist in DS but does need the desire and interest to learn about your child.

If your therapist has run out of ideas – and it’s happened to every SLP at one time or another – ask for a reference to another provider. For instance, I’m very aware that past a certain point I’m not a good fit for a child advancing with assistive technology. I will transfer care because I know another provider whose skills better match this need.

Don’t be afraid to ask questions. Go with your gut. Make the choice that works for you and your child, guilt free.

For more on parenting decisions related to treatment see: Beyond Therapy Burnout and Parent Guilt

Have you had to “break up” with a therapist? What did you learn from the experience?