Are you Service Provider A or Service Provider B?
Service Provider A always brings a bag of toys to each visit because this allows her to plan ahead. Having a toy bag ensures that she has the materials that she knows will work, which is great because many children she sees don’t have many toys. The children like the toys too and pay attention better when she brings new things into the home.
Service Provider B used to bring toys, but now does what he calls “bagless therapy”. Rather than bringing toys into the home, he focuses his time with the family on helping them figure out how to use what they already have to encourage the child’s development. Provider B’s visits don’t revolve around toy play; instead he joins the parent and child in different daily routines which may or may not involve toys. He often teaches playfulness during these routines, and helps the parent practice using intervention strategies to motivate the child. The visits are less predictable than when he used to bring toys, but he finds that his intervention is more individualized now.
Which Provider are You?
Take a moment and reflect – which provider are you? Sometimes the line is not so clear cut. You might not bring a toy bag but you still bring a bottle of bubbles. Or maybe you do “bagless therapy” but you still primarily focus on playing with the child’s toys. These fuzzy lines are common because we have developed habits for how we work, we have to adapt to different environments, and frankly, it’s not always easy to purely practice as Service Provider A or B. Despite the difficulties with a black and white perspective, it’s important to step back and reflect on our practices. Are we truly using the practices that reflect the evidence-base for our field? Are the practices we use fully supporting the parent’s confidence and competence…or are we taking toys out to the home so that we feel secure and in control of the visit?
A Team Challenge
Another challenge to consider is this: What if you’re like Service Provider B but your other team members are more like Provider A? This can be extremely hard because one family can be receiving intervention from providers who use practices that look very different. And let’s be honest – a parent could very well prefer the toy bag version because her child enjoys it and she can step away to take a break while Provider A entertains her child. While this may be fun for the child and a relief for the parent, our evidence-base no longer supports this type of intervention as the best way to build the parent’s capacity to promote the child’s development. When some providers bring materials to the home and others don’t, or when some providers provide child-centered intervention as opposed to family-centered, routines-based intervention, the messages can be confusing for families. We are all on the same team, and when we provide services that follow a similar, evidence-based approach, everyone benefits.
When it’s all said and done, we all have a responsibility to provide intervention that’s grounded in our field’s best, evidence-based practices, and our literature supports routines-based intervention that focuses on supporting parent-child interaction. We get the best “bang for our buck” when we work with children and their caregivers in ways that prepare them for how to use intervention strategies throughout the week, when we aren’t there. Spending our time primarily playing with the child only helps the parent so much, and focusing only on toy play may help even less because toy play itself is probably a relatively small part of most families daily lives.
Strategies for Making It Easier
So what do you do? How do you evolve your practices from those of Service Provider A to B? Here are a few tips to consider:
Reflect on the toy bag as your security blanket – We are in control of a visit with a toy bag; we have to relinquish some control without it. But, when we do that, we are free. We are open to following the family’s lead and using our skills in more flexible, individualized ways. We also see that the family owns intervention and the child’s progress, and that’s what it’s all about.
Wean yourself one toy at a time – Maybe you can’t go cold turkey, and maybe you shouldn’t. Take one less toy to each visit to help wean yourself and the family from this approach. Replace the focus on toy play with a more broad focus to include and explore other routines as well.
Prepare families for bagless therapy – Either start this new approach with new families, or explain to current families that you want to support them in routines other than toy play. Spend a visit or two finding out what else they do with their child…then plan to join that.
Talk with the family at the first visit about why you don’t bring toys – This is especially important if you don’t but your colleagues still do. Help the family understand why you work this way because otherwise, they won’t know.
Talk to your leadership – If you struggle with working on teams with both types of Service Providers, talk to your supervisor. Maybe additional training could be offered to the entire team. Maybe you could shadow your colleagues and they could shadow you on visits, then you could share feedback about similarities and differences in your approaches. Stir up some communication about this topic, because it’s often an elephant in the room.
Whichever type of Provider you identified more with, I hope you’ll take the time to reflect on your practices. You’re probably doing great work, but we can always do just a little bit better. Remember to keep the focus on what the parent can do with the child when you are not in the home. When you do, it’s so much easier to leave the toys at the office and work as a true team.
Which provider did you identify with?
How do you manage the challenges of working on teams with a mix of these types of provider practices?
Share you thoughts in the comments below.