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lilydodge · 5 years

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How is therapeutic parenting different from regular parenting?

This is part of a series for Foster Care Awareness Month, where I answer questions submitted via facebook or tumblr about my work as a therapeutic foster parent. Ask your own question here!

It’s easiest for me to use narrative examples in explanations like this, but I don’t tell stories about my youth online, so all of these are hypotheticals based on my experiences and training.

Therapeutic parenting is different in a few key ways. One is that it has therapeutic goals - a youth that you’re parenting may have specific behaviors, trauma symptoms, or thought patterns that you’re actively trying to work on.

For instance, say you have a 15 year old young woman who is really struggling with self esteem and feeling like she has something to contribute to the world. Therapeutic parenting might include things like:

Subscribing to a meal kit service and cooking with her every evening, slowly building up her sense of confidence and agency in the kitchen. Providing lots of accurate and appropriate praise as you eat together so she experiences you enjoying the food she made.

Reaching out to her school to identify clubs she might be interested in joining, and working with school staff to come up with a healthy and supportive way to encourage and welcome her to participate.

Working with her on a list of “Things I Am Proud Of.” Keeping an eye out for opportunities to add to that list, and to help her refer back to that list in times of struggle. Developing language and coping skills with her around self-image, anxiety, and shame.

Throughout this process, the therapeutic parent will be tracking what’s going on, often documenting it in an official way. They’ll be figuring out what works and what doesn’t work - maybe she absolutely HATED staying after school for the lit mag club, but after she helped you clean the kitchen, she was beaming when you pointed out the next day how pleasant and nice to use it was. You’ll share these strategies with whatever other therapeutic professionals you’re working with, and advocate for them to be used at school as well.

Because of these clearly stated behavioral, emotional, and relational goals, therapeutic parenting is a lot more big-picture focused. In-the-moment choices about discipline, consequences, and parental responses often look very different from “standard parenting.”

You have to keep in mind the overall goals, and whether your choices in the moment support the overall goals.

For example, say you have a 10 year old boy who struggles with lying. Typically, kids with trauma who tell lies are doing it out of knee-jerk self-preservation and fear. So punishing the lies doesn’t “teach them better,” it just deepens that sense of “adults are not safe” and encourages the behavior.

Say you’re heading out and you ask him if he has his jacket in his backpack. He says yes. You get there, and he’s cold. He didn’t bring his jacket. Standard parenting might suggest that you scold the youth: you told me it was in your backpack! We’ve talked about telling lies!

But in this case, his “lie” was because, in the moment, he was being asked something by a parent figure, which sends his traumatized brain into fight-or-flight mode. His brain said “I’m supposed to do something, so the safest thing to do is just say yes, I did it.” It’s not thinking toward future consequences; brains are not good at that. He may not have even processed that I was asking about his jacket’s location - he may have just heard me ask something and said “yes” out of a self-preservation instinct.

So if I want the behavior to actually stop long-term, I need to challenge that fear response by being entirely safe. He told me the truth - that he didn’t have his jacket - so I respond by speaking softly and gently, thanking him for letting me know, and problem-solving with him about whether we need to go back home or whether there’s another jacket in the car, etc.

Of course this isn’t a long-term solution; lying as a behavior can be maddening, and at some point he’ll need to learn how to process and follow instructions, manage his own belongings, etc. But kids don’t learn through fear, shame, and scolding.

What I’d do about the backpack-jacket situation going forward, as a therapeutic parent, is to not give him another opportunity to lie. Because therapeutic parenting is about meeting the youth where they are, and not demanding anything else.

I now know that being asked to make sure he has his jacket isn’t working for this kid. So from now on, I just grab his jacket on the way out the door. He has enough to worry about, and it’s not worth the potential power struggle of trying to make him do it on his own. Could another 10 year old be asked to bring his jacket? Probably. It’s a developmentally appropriate expectation in general, but not for this child.

So I’d just bring the jacket. Slowly, as we work on “listening” and other behaviors, maybe I’d ask him to bring his jacket, then go to his bedroom and watch or help him put it in his backpack. Then, ask him to bring it, and check his backpack once we get into the car. Each of these small moments will be a battle I’ve decided to pick, and he may be aggressive, defiant, frustrated, or annoyed. But my end goal is “he is able to manage his own belongings and respond to reasonable reminders,” so I work toward that goal.

Keeping those goals in mind is so crucial. Because in the moment, it’s so hard to lose sight of them. Suddenly, your goal becomes short-term: “Get him to admit that he lied and apologize,” or your goal becomes unrelated to their emotional wellbeing: “Get him to respect me as the parent.” Acting in pursuit of those goals often runs counter to the other goals, so you’ve got to keep the big-picture goals in mind.

Often, my therapeutic parenting looks like “rewarding the behavior.” But it’s all about understanding that behavior is communication. If my youth has had a destructive, raging tantrum, that's because they are too overwhelmed by their trauma symptoms and Big Feelings. They are feeling ashamed, unsafe, afraid, angry, confused, anxious, etc. And so if I want the behavior to resolve, I have to address the feelings underneath it.

After a tantrum or other violent incident, my first goal is to let the youth know that they are safe, and it’s okay. That I still love them no matter what their behavior is. I often help them clean up, or clean it up for them. I wrap them in a cuddly blanket (usually a weighted blanket), give them a comfort food for a snack, and put on their favorite TV show. If they’re okay with my physical touch, I’ll hug or hold or snuggle them.

This does not, contrary to popular parenting wisdom, teach the youth that “If I throw a tantrum and break Lily’s things, she will reward me with ice cream, TV, and fun time. Therefore, I will continue to break Lily’s things.” Instead, it teaches the youth that “I am safe, I am loved, I am capable of calming down, my Big Feelings do not make me worthless and they do not run my life.” The behaviors are coming from somewhere - you have to be willing to get behind the behaviors and be creative.

We do often have “natural consequences” - whatever the youth broke, they have to repair, or pay to replace, or it just doesn’t get replaced. After they’ve calmed down, we talk about what happened, how it made us feel, and what wasn’t okay. I offer suggestions for managing the same feelings, and we work on coping skills - like smashing approved things in the “angry box,” or punching a pillow, or just asking me for “ice cream and cuddles” to calm down instead of going through the whole escalation first.

This often looks like choosing your battles - and they may be very different battles than a “regular” parent chooses. Therapeutic parenting requires you to really understand what rules and boundaries you’re setting, and why, and what you’re willing to do to enforce them. If a kid gets so angry around food and dinnertime that they keep stabbing forks into your wooden dining table, maybe just get plastic silverware for the time being, or get a cheap Goodwill table, so you don’t have to worry about managing that behavior. The more breaks you give your youth, the more breaks you give yourself. The fewer battles you pick, the more energy you have to pick the really important ones. Karyn Purvis talks about “filling the yes tank” - saying “yes” as often as possible, unless you really have a good reason not to.

All of this requires you to be trained and trauma informed. Therapeutic parenting is not “common sense,” it’s not “just do what your parents did,” it’s not even “how I raised my biological kids who came out fine. Therapeutic parenting requires an understanding of how trauma impacts the brain and body, and using evidence-based, goal-oriented strategies to respond to the youth’s needs. There’s a lot of creativity and flexibility and improvisation, but it has to be driven by a background awareness of what you’re trying to do, and why, and how.

This ran long, so I’ll wrap it up here - if you have more questions about specific aspects of therapeutic parenting, please let me know!

#foster care #foster parenting #therapeutic parenting #trauma #parenting

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