Practical Strategies, Service Coordination, Teamwork

“It’s Not You, It’s Me” – Navigating The Parent/Provider Breakup

Breaking Up Is Hard To Doshutterstock_100598773

So, I’m at the office and I can’t help but overhear a Service Coordinator on the phone with an early intervention provider making the call – you know, the break up call. She tried everything to soften the news – scheduling conflict, goodness of fit, it’s not you, the family thinks you’re great…When she got off of the phone, this poor Service Coordinator looked drained, “I hate having to make those calls!”  In a perfect world, there would be no need for these calls, right?  Parents and early interventionists would work it out together.  The day to day reality for many folks, though, is that that for a variety of reasons, parents often don’t feel comfortable and enlist the help of their Service Coordinator.

Don’t Take It Personally

I remembered back to the beginning of my practice, that “honeymoon period” when I didn’t even know what I didn’t know yet!  Maybe that’s why I was so devastated the first time I got the call from a Service Coordinator that a parent of mine wanted to change providers…I didn’t handle the breakup well. Have you ever been in that position?  It’s hard not to take it personally, right?  Thankfully, I had a Supervisor and a peer group of professionals who could offer support and strategies based on their experiences.

Families Initiating a Break Up is a Good Thing – Wait – What??

Take a bow – when a family requests a change in their team makeup it’s because we have been doing our job!!  Most of us don’t think all that much about procedural safeguards on a day to day basis; we hand out the booklets or pamphlets that our state’s system has created and make sure to document that the family has received information about their rights in early intervention.  We revisit and remind families of these rights at different points in the process, checking off again that the information was given, but what do these rights look like in practice?

Here’s an Example: During her monthly contact calls, Leslie noticed Eva’s mom sharing concerns about one member of her daughter’s early intervention team.  Leslie encouraged Eva’s mom to ask questions during her home visits, and share feedback and ideas from the home visits of another team member whose approach looked and felt a bit different.  A suggestion was also made to invite both providers to one or two joint home visits in order to promote partnership and collaboration.  When those efforts still didn’t improve the situation, Leslie reminded Eva’s mom about her right to request a change and encouraged her to have that conversation with the provider directly.  After the switch was made, the Service Coordinator could have left it here, but Leslie then made it a point to provide Eva’s mom with feedback…”I know that might have been tough for you, but wow, you did such a great job advocating for your rights and what you felt was best for your family – Eva is lucky to have you in her corner!”

Aha Moments and Burn and Learns!

So here I am- fast forward 20 plus years later from that first traumatic break up in early intervention.  Time, training, reflective supervision and all of the “aha moments” and “burn-n-learns” have shaped my practice along the way.   I’m more aware of the critical components that define my partnerships with families and am grateful to those who shared their strategies with me along the way.  Here a few I thought I’d share with you…

“Burn and Learn” – I needed to invest more time at the beginning of a relationship with a family before jumping into help giver mode.  While it is totally understandable to want to feel useful and productive, many situations that result in Service Coordinators needing to intervene stem from mismatched communication. Take the time when you first meet a family to establish shared expectations!

“Aha Moment” – Families won’t provide me with feedback if I don’t build that into our time together.  Sometimes the best thing to happen during a home visit is for a strategy or suggestion you make to be unsuccessful! Together you can say, “well, that didn’t work” and begin to wonder why, what could be done differently or what else could be tried.  This also helps families feel comfortable sharing not only what worked but what didn’t work as well during the week in between visits!

As a Service Coordinator, how have you handled it when a parent expresses concerns about another team member?  What has worked well for you in the past?  Do you have any “aha moments” or “burn and learns” you could share to help others?

As an Early Intervention Provider, what experiences have you had with either a family requesting a change or getting a break up call from a Service Coordinator? Do you have any “aha moments” or “burn and learns” you could share to help others?

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Resources to Add to Your Bag of Tricks:

Assuring the Families Role on the Early Intervention Team: Explaining Rights and Safeguards (NECTAC)

Illinois Resource: State of Illinois Infant/Toddler & Family Rights under IDEA for the Early Intervention System: “The Sooner We Start The Farther They’ll Go”

Virginia Resource: Notice of Child and Family Rights and Safeguards Including Facts about Family Cost Share

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Amy Cocorikis has been lucky enough to spend her career learning from infants and toddlers with special needs and the families who love them. She has also been fortunate to have worked with and learned from the many talented providers of all disciplines who shared their time and gifts with their team members. Her dedication to the teaming process, desire to grow and keep current in the field, and commitment to learning from and teaching others through professional development and training continues to fuel her passion for early intervention. Amy can be reached at c.a.r.e.consulting@hotmail.com

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15 Comments to ““It’s Not You, It’s Me” – Navigating The Parent/Provider Breakup”

  1. I remember my last breakup…the parent called the service coordinator to request a change because I had been “late” for our last visit. I had actually arrived a little early and then waited on the porch, knocking on the door, until 10 min past our scheduled time. In the end, I think the parent was overwhelmed with other personal issues and needed fewer people coming to her home. I had to work at not taking it personally and seeing this as her attempt to take control and tell us what she needed. It was a tough one though!

  2. That is tough,Dana! I’m so glad you brought up the issue of the home based “no-show”! How many of us have been standing on the front steps, knocking, ringing, calling – and wondering if families are avoiding us and why? I love that you also raise the issue of the family potentially being overwhelmed – many of us find that families say “yes” to services, plans, and schedules only to have no shows, cancellations, and requests for changes in service providers. We absolutely need to ask the tough, but necessary questions about the big picture!

  3. What a great article! The last breakup call I received from a coordinator came as both an “aha moment” and a burn and learn. I had been working with a family and EI team for some time along with a staff member of mine who was part of the team. I received a call from the service coordinator who said that the mother had elected to no longer continue with my services. When I asked the service coordinator if the mother stated why she stated that the mother simply stated that she felt that she did not need the service at this time and did not ask for a different therapist to replace me.

    I then took the time to speak with my staff member who continued on the team if she had any insight as to why the mother may have not wanted to continue the service as I was curious and if there was something that I could learn from this experience I would love to know. She than stated that in her discussion with the mother, the mother had mentioned that I had to reschedule or cancel appointments often and I did not always make attempts to make up sessions. She noticed that I may have been busy and she felt as though maybe her and her daughter might have not been a priority to me. WOW! my heart sank. I expressed my deepest gratitude to my staff member for her honesty and courage in discussing this with me.

    My “Burn and Learn”… Don’t bite off more than I can chew in my attempt to want to help others. When I took on this family on my caseload I was already very busy and had many other commitments. Better to have said I couldn’t see the family than try to squeeze them in my schedule and not serve them to the best of my ability.

    My “aha moment”… I was very proud of myself for creating a respectful and supportive relationship with my staff member that she felt comfortable enough having this discussion with me and allowing me to grow as a professional. It is these moments that make us better as therapist and help us be reminded that there is always room for growth. I am forever grateful for my colleagues and their honest input.

    There is an even happier end to this story. When the annual for this child came around. The mother requested that I come back and preform the annual evaluation for her child. I did so and with great delight had seen the wonderful progress that the child had been making without the need for my service and just the wonderful support of an amazing mother and father.

    • Benny…thank you for sharing your story! It includes some great opportunities for us to consider in our own work! The importance of communication, respecting a family’s time, and being open to feedback all helped you grow as a practitioner, and by sharing you are helping others grow too!

  4. I think the article really hits on a good topic. Although breakups don’t occur very often they are a part of our business. I highly encourage and seek feedback from families about what it was like for them in our program and get many comments that helps us improve our system. I do get disappointed when I hear from a family who has left or just about ready to leave our system and was not pleased with their provider for some reason. Not so much that they were not pleased but that the family did not feel comfortable to bring that concern to someone so it could be worked out and a change could have made if needed.

    A very critical component of Part C services is that families understand their rights and feel comfortable to express concerns in advocating for themselves and their child.

    • Allan I agree with you about how important it is for families to understand their rights and feel comfortable exercising them, and it is hard to hear that a family chose not to voice a concern until it’s too late! Have any families shared possible reasons for their reluctance? In our area there is a “shortage” of certain therapy providers, so some families have shared they are concerned about a lapse in service if they request a change.

  5. I’m a service coordinator with EI and I have had to “break-up” with many providers, for a family. Some families are quick to make a change, but most of them have mentioned concerns to me once, twice, or more- before they decide to change. Most times, if a family is willing to talk to a provider about their concerns- or let me talk to them- the problem can be resolved. I think it all falls apart when the family or myself, speaks to the provider about the concern- but nothing changes. Or there are situations where the family will not allow me to address their concerns with the provider. Of course, nothing changes because the provider is oblivious- and the family eventually decides to switch. For this reason- I do think it’s helpful to have a conversation with families and, from time to time, just ask them if they have any concerns or anything they would like to see changed. If you are a provider, and a parent or SC is sharing the family’s concerns, it’s important to take it seriously. You either recognize that the family is correct (ie- you are frequently late) and you change it- OR, it’s possible you may not want to make a change. For example, if a family doesn’t respond well to your style, but you are happy with your practice…there’s nothing wrong with being honest with the family. Let them know that this is how you work and that if they truly aren’t happy with the sessions- they do have a right to change providers. In some situations, I feel nothing can be done. You can’t “click” with every person you meet- and I think the same goes for providers and families. Any “break-up” is hard, for all the parties involved. But maybe the next family will benefit from what you learned this time around 🙂

    • Great insights, April. I think that talking with the family and provider periodically (and separately) just to check in to see if things are going well rather than waiting for a problem to develop is such a good idea! It’s really a key to providing good service coordination!

    • April, I’m glad you brought up the “goodness of fit” factor! While we have to be open to modifying our approach to partner with different families, you’re right in that if we don’t “click” with a family, it’s better to make a switch! I also agree that when we are open to reflecting on a situation, that the next family we meet benefits from those lessons learned. Thanks for sharing!

  6. I used to be a Service Coordinator for EI and I feel like I have dealt with all the above. I had many families who would express concerns about their providers not doing enough because they were not seeing improvements with their child. I would always encourage the family to discuss this with the provider because it will not get better unless they speak up. I also would ask the family if they wanted me to do it and some would say no because they did not want that “awkwardness” during the sessions. And I would also have families who would say yes please speak with the provider but let them go and get a different therapist because it is not working out. The “break-up” is really hard for everyone involved. Each individual invests so much time and to be let go for whatever reason is not always easy. I also have had situations where the family really likes their therapist but nothing is happening anymore and the therapist also agrees. There are times when it just does not “click” anymore or that chemistry is not there and I completely agree. There are so many different providers out there and they all have so any different ideas and strategies. That is why I always check in with families to make sure services are going well so there are no surprises.

    • Rosa, I think your examples definitely underscore the importance of communication with families! That monthly contact could just be a rote “How are things going?’, but when the Service Coordinator is well trained and well supported, we know that these discussions can be a vehicle for so much more! Thanks for reminding us how a “have to” in our day to day work can become such a great opportunity to partner with families!

  7. This conversation reminds me of one of my most important lightbulb moments in 1983 – as an eager early interventionist and pioneer in Birth to Three- out to show the world and families how important our work was…

    “Stephanie”, Michael’s mom said almost apologetically to me (after ‘determining what would be helpful’), “did you ever think of calling Early Intervention ‘Early Interference’?

    “No — I had not… ”

    Thank you Michael’s mom. I will always remember and do my best to practice those words and not take it personally! Fast forward 30 years, how can we help provide early intervention as a support rather than an interference – and not take it personally?

    Thank you Amy for providing this safe forum,
    Stephanie

    • “Early Interference”…yikes! I really do think that no matter how much we try to support families in their natural activities, EI is still something added to their life. I can understand this mother’s feelings. I also think, that, like Amy and many of the other commenters have said, it’s all about the relationship we build with the family and how well we all communicate that makes the difference between whether EI feels like an awkward burden or a support. Thanks for sharing your experience, Stephanie!

    • I love when folks share their lightbulb or aha moments so we can all benefit,thanks Stephanie! One tip I share with practitioners during training was something Robin McWilliam modeled during a workshop. He asked a family if (and I’m totally paraphrasing from memory here!)”the team had given them enough things to work on with their child – or if they had too much”…Giving the family an opportunity to let us know if they are overwhelmed by our helpful ideas and strategies can assist us in making sure our efforts are supportive rather than invasive! Stephanie, I too am thankful for the forum Dana and Cori and their program have created with this blog – and the chance for guest authors like me to contribute in a small way!

      • Thanks Amy! Your contribution is not small! The more insights and strategies we can share and the more we can pool our collective experiences, the better supports we all can provide to families! 🙂

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