When Therapy Sessions Don't Go Well- 3 Tips to Save You!

When therapy sessions bomb! Looks-Like-Language
Every child is unique! Recently I've been thinking about how much I have learned from all of the students I worked with over the years. Every child has their own combination of strengths and weaknesses, along with their personal qualities, that makes our field continue to be interesting over the years. 

We have these 'AHA' moments when we realize what we need to do to reach that child. Then we bring those skills forward with us to all of the rest of the children we meet, continually adding to this skill set, but it is hard work along the way. Sometimes therapy sessions bomb!

I tried to figure out how many students I have worked with over the 40+ years (if you include my clinical years) and gave up on the math, but it is truly a huge learning experience! Almost all of these students had language problems, and most of them had multiple disabilities. 

So, how do we do it? I know that I currently use strategies and techniques with very difficult students, often not even thinking about it, but it took years of learning and more than a few less than perfect sessions to get to this point. So what can I offer to help you out along your way? Let's talk about low functioning students today, since they present with the most difficulties usually.

1. Consider it a learning experience.
When I am able to structure my approach correctly, I leave the therapy session feeling a connection with my students and that I have made an impact during our time together.  I love it! But I have learned a lot from my sessions that did not go well. It sends me back to the drawing board to examine where it broke down and figure out what I need to do differently next time.

Turning it around by Looks-Like-Language

2. What could have caused it?
Maybe it was just a bad day, but try thinking about all of these things:

*How much of the session had the student been attempting something new?
*Did I switch between easier and harder tasks?
*Did I provide enough breaks?
*What are my student's strengths?
*Did I utilize and build on strengths during the session?
*Examine the language demands: Did I jump up too fast? Was there an intermediate step that could be take to reduce the demand?
*Did I react to my student's warning signs or did I try to push through?
*Did I switch to a learned, enjoyable activity after a prompted response when I realized it wasn't going well so that the session could end positively?
*Is there a way to show the student visually what is expected?
*What supports can be added to the activity/task to make it easier?
*Are there pre-requisite skills that are missing and need to be taught first?
*Is this activity/skill really needed at this time?
3. Reduce demands the next session.
After a difficult therapy session, I always go home feeling upset and then feel apprehensive before the next session with that child. Think how much more so the child must be feeling! It is important to be able to keep your bond with the student intact so that learning can occur! 

Plan on entering the next session with the first activity being the most enjoyable one the student has. If that goes well, repeat the last activity that was learned and went well, to maintain skills, and then return to another easy and fun set of activities to end the session positively.

WHY? This benefits you by giving you more time to think about all of the questions and come up with an alternative plan. It is beneficial to both of you to have a positive experience, reduce the chance of building more communicative failure and thus behaviors, so both of you will enter the next therapy session with a more positive attitude.

No one likes those days when things don't go well. Not us, and not our students, either.  I would go home wondering if this is was really what I wanted to be doing and why in the word did all those years of schooling not prepare me for this.  

Thank goodness our caseloads are usually mixed, so there are some good sessions as well to balance out the day! The difficult sessions motivated me to learn more and to think more about my plan for that child. These steps (and quilting time, a glass of wine, or a good book that night!) helped me, so I hope you will find it useful as well!
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