Pop Quiz: What is the activity that families report in the literature as the most helpful thing that happens on EI visits?
Are you surprised? It makes so much sense when you think about how much you talk with families about their challenges – teaching the 18 month old to sit in the grocery chart, understanding a toddler who uses elaborate jargon and no true words, helping an infant feed without aspiration, etc. Being a resource for families is an important part of what we do. However, being a resource does NOT mean that we have all of the answers. Giving answers isn’t the same thing as problem-solving.
Consider this Scenario
Jason asks Camilla (the occupational therapist) how to help his daughter, Breanna, eat a wider variety of foods. Right now, all she will eat is macaroni and cheese and Pringles chips. Camilla suggests that Jason start offering an unfamiliar food along with Branna’s favorites at each meal to expose her to different foods and maybe offer a cheesy dipping sauce since she likes mac and cheese. She also says that she will bring a great handout with some ideas to her next visit. Then, they return to working on Camilla’s ability to use a spoon to feed herself.
Clearly, Camilla did not do any problem-solving here. She spouted a few general suggestions and promised a handout without any idea of what Jason has already tried, why this was important to him, or how he envisioned success. Problem-solving with Jason would require much more effort and attention to what is unique about Jason’s and Breanna’s situation. It requires flexibility to allow the activity of an intervention visit to veer away from what was planned, to go where the family needs it to go. It also requires that Camilla step out of her standard answers and dig deeper into what the parent needs. These are not always easy for service providers (or service coordinators, who often find themselves in similar situations when asked for resources or to help out in a crisis).
Tips for Collaborative Problem-Solving
Collaborative problem-solving is a reciprocal process that focuses on a real situation for a child and family. Whenever possible, it works best when it happens in the moment, rather than by discussing a hypothetical situation. For instance, the service provider observes a challenging situation with the parent and child, then the parent and provider problem-solve together about how to improve it. Here are a few strategies for problem-solving with families:
Ask for the parent’s perspective first – Ask the parent “What did you think about that?” or “How did that feel to you?” Another good idea would be to ask the parent what he has already tried. This reinforces the importance of the parent’s perspective on solving the problem and gives you valuable information.
Find out the parent’s goal – A great next question would be “If this situation was better, what would that look like to you?” Again, find out what the parent’s goal is for improving the situation because it may be different from yours. Then, ask “What could be done differently here to get closer to that goal?” Let the parent think a bit before offering suggestions.
Offer suggestions if needed – Many of us skip straight to this step because we have so many child development strategies floating around in our heads. Collaborative problem-solving involves helping the parent solve his own problem, with your support. If you just give general suggestions, I guarantee that most of them will bounce right off the parent because they won’t be obvious to him how he can use them. Taking the first three steps first will help you link the right solution to the actual goal. Just be careful to avoid the “have you tried…?” trap.
Be specific, especially when the parent lacks the experience to offer a solution – Parents are great problem-solvers, but when they ask for your help, they often really need it. This doesn’t mean you have to spout answers, though. Offer information, maybe a choice of possible strategies, then let the parent decide what to try.
Let the parent decide – Let him choose how to solve the problem, then let him try out his choice with your support nearby. Coach him through using the strategy if needed, then reflect on the success of the strategy together.
Loop back to the original goal – This is an easy step to forget. Once the parent has a plan, wrap back around to the original challenge by asking if the parent feels that this plan will address his goal for the situation. If not, work through it some more. If yes, write it down with the parent so he has a record of the steps to solve the problem. This will help him remember what to do between visits when you aren’t there.
Follow-up on your next visit – Always.
Instead of telling Jason what to do, Camille may have been more helpful had she taken the time to explore Jason’s question more fully. Then, she would have learned that he had already tried offering other foods but Breanna seems to choke on anything chunky like meats. He’s also noticed that she gags really easily and seems to have a hard time moving food around in her mouth. The solutions to this problem are unlikely to be found by simply offering more foods or dipping sauce or reading a handout.
When a challenge surfaces, seize the opportunity to collaboratively problem-solve with the parent. It’s in this problem-solving that we can make such a big difference in the quality of life for a child and family.
If you were Camille, what would you do next?
What challenges do you face with trying to help families problem-solve?
What’s your biggest problem-solving success story?
Share your ideas and experiences in the comments below!