The decline of the therapeutic relationship and why you don’t have to stand for it.

By Laura Smith|November 15, 2016|Apraxia, apraxia blog, Apraxia client stories, developmental coordination disorder, occupational therapy|

I’ve noticed something since I’ve had my daughter in therapy.  Therapy offices that are small, with only a couple therapists and an actively involved owner, yield happy clients.  Conversely, therapy offices only interested in expanding their brand, that staff numerous therapists and have a relatively un-involved owner, have more unhappy clients.

I used to work at a place this happened actually.  The owner was fantastic.  Smart, personable and caring, her clients improved, her families were happy, and her reputation grew.  Soon, she was staffing multiple therapists from two different disciplines and opened up a second location.  She became  stretched so thin, that she outlined a list of policies and procedures, and then delegated a supervisor and receptionist to enforcing them.  The result?  Common sense flies out the window.  The parent/therapist relationship becomes strained.  People leave.  I know personally now why this happened.

Recently I was on the receiving end of this.  I took my daughter to what was supposed to be a well reputed therapy place in Denver, Amaryllis Therapy Network in the Highlands.  I wasn’t too pleased with the evaluation, because Ashlynn has been evaluated three times before with the very same test and this time she scored 20 points lower.  20??  I had to ask myself if that was really accurate and I had quite a long conversation with the therapist who said attention could have played a factor or this or that.  Ok.  Fine.

However, then she was transferred to a different OT for treatment.  They initially wanted to have her see an assistant.  I have no problems with assistants.  I used to be an SLPA (which is an SLP assistant) and an assistant is more than capable of doing therapy.  However, what they are not able to do, no let me correct that, what they are not allowed to do,  is  change a treatment plan when they see something isn’t working.  They are required to consult with the supervising therapist who IS qualified to develop treatment plans before they change it, and that’s just assuming you have an assistant who is experienced enough to know it needs changing.  Anyway,   I needed someone who can change a treatment mid session if they see something is or isn’t working.  My daughter is not a typical case.  She’s involved and I don’t want to waste time.  I’m not trying to sound rude, but it’s just the way it is.  As a side note though, it does make we wonder how many parents reading this even know if their child is seeing an SLPA or a CODA.  If they are, just know that you want to make sure a supervising therapist is really staying on top of things in regard to your child’s treatment approach…just sayin.

Anyway, they complied, and I was given a different OT.  I wanted a conference call set up between the new OT, me, and Ashlynn’s school OT who is also my colleague, a therapist I trust, and has been with Ashlynn since preschool.  When she called, it was clear she had not thoroughly read Ashlynn’s report and then mentioned how Ashlynn had done a “group” therapy.

I’m sorry what? Group therapy?  Ashlynn can get group therapy in school.  I’m paying for private therapy.  I need INTENSE private therapy.  She quickly reassured me it was still 1:1 kid to therapist just participating in a group activity.  Ok…maybe….but that’s not what I was paying for which even furthered my resolve that we needed a group conference call.  I asked if she would email me and she agreed to set up a time.  I NEVER received an email.

I’m reasonable.  Ok.  Maybe she entered my email address wrong?  I call the next week before another session has come and gone and tell the receptionist I never received an email, would she email me again.  She check the email address on file.  It’s correct.  Hmm.  Okay.  She’ll send another one.  Perfect, thanks.

ANOTHER week goes by.  NO email.  My husband is the one that takes Ashlynn so I can’t just bring it up.  I’m pretty ticked about this to be honest, but it can still be dealt with…worked through.  Probably an honest mistake.  However, I’m going out of town and I don’t think I can make the carpool arrangements work to get Ashlynn there this week.

Now, yes.  I know I signed  48 HOUR cancellation policy paper.  I actually remember signing it because it struck me as outrageous.  Who has a 48 hour cancellation policy?  Oh well.  There are people who do chronically abuse the system, and cancellation policies are in place to protect and respect the therapist’s time.  I get that….not only because I just get that…but because I AM A THERAPIST WHO DOES THIS EXACT SAME THING AS A JOB.

Dang!  Why is that in caps you ask? Well, it’s because even when therapists, or doctors, or people in a field where they are to care about people have a cancellation policy, it’s usually only enforced to the chronic problem clients.  Any person with a heart and common sense, understands that things come up.  If someone is abusing the system, then yes.  A cancellation policy should be enforced.  I was NOT abusing the system.  I called 30 hours in advance, choosing to wait until the morning instead of the hour they closed.

This was my first time cancelling, we aren’t late, and my husband probably spends close to 3 hours round trip getting her down there through rush hour traffic and back home. Not to mention the financial hardships families are already going through. You would think someone who actually has a heart and interest in caring about children would have been understanding. I know I am! I don’t even have my clients sign a cancellation fee policy, and if I did…I would give them chances. Unbelievable and SO sad. It’s not right we go through this when we are already bled dry from the cost of therapy. So now, I have to find a NEW place and begin the process again.

Oh, and one more thing. The email situation?  The supervisor said it was documented she emailed me twice.  “Maybe I didn’t get it due to spam filters?”  I went along with it.  Afterall, I hadn’t yet checked spam, even though it’s ironic that I DO get all of THEIR spam email.  Well, low and behold I DID check, and by check I mean SCOUR my spam email and there was nothing.  NOTHING.  NO email from her…so now on top of it I can add lying.

Anyway, I digress.  I have to find a new place and begin the process again.

Oh…but I WILL begin it again, because I know there are places and therapists who do not feel the need to run their therapy office like a corporation and treat people, actual human beings, as only dollar signs.  I know, because I’m one of those people, and I know many, many other good therapists who are ALSO one of those people.

My message to any parent reading, is if you feel like your child and your appointments are nothing but a dollar sign, then you need to leave.  That is so unacceptable.

My message to any professional reading this, is you need to know and understand we are counting on you! We are putting our faith and literally our children’s success and outcomes in your hands.  Meet us halfway. We are your paycheck, but we are also human.  If you are a person running a therapy office like a corporation, take heed.  YOU may be an honest and awesome therapist, but don’t get caught in some black and white policy and procedures BS.  These are humans, humans with disabilities no less, that you are dealing with.  Have some freaking compassion beyond your rules and regulations.

Oh, and for anyone considering Amaryllis Therapy Network in Denver, scratch them off your list and move on.  Developmental Fx is where I’m headed, and unlike Amaryllis, I know many families who have been happy with the outcome.

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