Issue 25: The Coach Approach: Parent Training as Recommended Treatment | Elaine Taylor-Klaus

Raising complex children – children who struggle with developmental delays in life, learning, behavior, or social-emotional growth – is arguably more complicated than many parents and professionals might expect. Whether children are diagnosed with chronic neurological conditions (such as attention deficit hyperactivity disorder (ADHD), anxiety, depression, autism, learning disabilities and related challenges), or are struggling but have no diagnosis at all, parents are called upon to make complicated medical decisions with limited education. As a result, when children struggle to hit typical milestones, parents tend to feel scared, angry, or overwhelmed – or all at the same time.

Historically, parents of complex kids have had few resources for their own support: they could seek therapy to address emotional strains; they could ask consultants for advice, such as recommending appropriate schools; and they might be referred to general parenting courses if things got really bad.

In my first decade as a parent, I tried them all. But after seeking expert advice that didn’t meet my quirky kids’ needs, I often felt more of a failure as a parent than before my search began. My own undiagnosed challenges with attention and learning added to the confusion, causing considerable frustration and feelings of inadequacy.

In hindsight, I didn’t need therapy, consulting, or even general parenting advice. Instead, I needed someone to help me understand my unique neurodiverse children. Someone to help me make sense of the unusual circumstances we found ourselves in. And someone to guide me to trust myself to make the best decisions I could for my complex family.

It turned out, the change I wanted for them started with training, coaching, and support for me.

The Importance of “Behavior Therapy" and What it Actually Means

Parents today have many more options available to them than even a decade ago. Many therapists, social workers, and coaches offer support that focuses on both parent and child behaviors. In addition to medication and school accommodations, training and support for parents – known as “Behavior Therapy” – is actually part of recommended treatment for children and teens with ADHD and autism. Behavior Therapy is not – as the phrase may suggest – intended to suggest a therapist working directly with a child. Rather, behavior therapy means training parents to more thoroughly understand the challenges their children face – whether they be learning, executive function, or behaviorally based (or all, as is often the case) – to create an environment that sets up their child for success.

“Behavior therapy” can be a confusing term for both parents and professionals; its definition varies depending on the source and is often referred to as BMT (Behavior Management Training) or BPT (Behavior Parent Training). Regardless of its definition, the purpose of behavior therapy is clear: to create environments and relationships in a child’s life so that the child can, as the Centers for Disease Control (CDC) puts it, “learn or strengthen positive behaviors and eliminate unwanted or problem behaviors.”

‘Behavior therapy’ means training parents to more thoroughly understand the challenges their children face … to create an environment that sets up their child for success.”

According to the late Dr. William Pelham, a leading researcher in the field, parent training that leans on behavioral strategies “is the only therapy that works.” In the webinar “More Than Meds: A Parent’s Guide to Using Behavior Therapy,” Pelham said, “Teaching parenting skills is the single most effective and important intervention for treating kids with ADHD.” This also applies to diagnoses outside or in tandem with ADHD, complexities such as autism, 2e, dyslexia, anxiety, depression, and learning disabilities. Pelham continued, “There’s no therapy that a therapist can do in their office with a child who has ADHD that will have any impact on that child’s behavior.”

According to the CDC, whether done in classes, groups, or private sessions, parent training in behavior therapy should help adults learn how to "better understand their child’s behavioral issues and learn…skills specific to these problems.” Training in behavior management is generally provided by coaches, educational therapists, counselors, psychologists, and social workers. Sometimes, professionals are trained to provide behavior therapy directly to children, which provides support for the child, though it can risk bypassing the compounding benefit of parent education.

Game Plan: The Neurodiversity-Informed Coach Approach to Parent Support

It takes more to manage complex kids than a prescription and a star chart. Parents need providers to guide and encourage them to seek training and support. To do this, professionals must understand the complexity of behavioral change and embrace the importance of parent involvement.

When young people have problems with life or learning, their parents should be part of any comprehensive treatment plan for many reasons. For example, when medication is recommended as part of a child’s treatment, its effectiveness is enhanced when parents receive training and learn to manage challenging behaviors. Training for parents in a coaching framework can be delivered at a significantly lower price point than traditional therapeutic modalities.

Beyond training, evidence now points to success for families when parents receive coaching. Taking a page from the book of professional coaching, this innovative method supports behavior change, offering empowering and practical positive guidance that parents and their families need.

With complex kids, a parent’s role goes beyond coordination of treatment. Behavioral change is complicated and nuanced, best achieved when parents communicate non-judgmentally, set realistic expectations, and participate collaboratively with their children or teens. Parents modeling this behavior often experience a positive response: Their child feels encouraged to collaborate and communicate more openly. Their learning often improves, as does their ability to self-manage with greater success. Feelings of shame and futility are reduced, replaced by confidence and self-esteem.