Navigating Child and Adult Therapy Coexistence in a Group Practice: Expectations, Communication, and the ‘Why’

In this episode, I address a question from an anonymous listener who called in. This listener works in a multi-disciplinary practice where child-centered play therapy coexists with adult therapy. The practice owner is considering implementing restrictive rules for children’s behavior in common areas, raising the listener’s concerns about potential shame or guilt for families.

I discuss three main points to handle this situation: setting clear expectations, effective communication, and understanding the ‘why’ behind the proposed changes. I emphasize that working with children inherently involves noise, mess, and emotional dysregulation, which must be accepted when choosing to include child therapy in a practice.

I stress the importance of setting expectations from the beginning and having personal conversations with existing clients about any changes, rather than simply posting signs. I also explore potential reasons for the owner’s concerns, such as safety, liability, or client discomfort, and how understanding these can guide appropriate solutions. Finally, I offer practical suggestions for noise reduction in the practice without restricting children’s behavior.If you would like to ask me questions directly, check out www.ccptcollective.com, where I host two weekly Zoom calls filled with advanced CCPT case studies and session reviews, as well as member Q&A. You can take advantage of the two-week free trial to see if the CCPT Collective is right for you.

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Navigating the Noise and Behavior Challenges of Child Clients in a Mixed Child-Adult Group Practice

As child-centered play therapists, we often find ourselves working in mixed clinical settings. Today, we’re addressing a common challenge: how to manage the inherent noise and activity of child therapy in a practice that also serves adult clients. An anonymous listener who works in such a multi-disciplinary environment called in this scenario, and that is the topic of discussion on today’s podcast episode.

The Scenario: A Practice at a Crossroads

Our listener shared that their practice, which initially had only one child-centered play therapist, has grown to include several. However, the practice also serves adult clients who require a quieter therapy environment. The practice owner, concerned about noise and disruptions, is considering implementing restrictive rules for children’s behavior in common areas.

Understanding the Core Issues

Before we dive into solutions, it’s crucial to understand some fundamental aspects of working with children in therapy:

• Children coming for play therapy often have dysregulation issues.
• There’s usually a parenting component to the child’s therapy needs.
• Families seeking therapy are often already stressed and overwhelmed.

These factors combined mean that behavioral issues with the client, their siblings, or even parents are almost predictable.

Accepting the Nature of Child Therapy

It’s important to recognize that when a practice chooses to work with children, they are also choosing to accept:

• Noise
• Mess
• Dysregulation
• Emotional outbursts
• Behavioral challenges

This is not meant as criticism, but as a reality check. Working with children inherently involves these elements, and they can’t be entirely eliminated without compromising the therapy itself.

Three Key Approaches to Managing the Situation

1. Setting Clear Expectations

Almost any situation can be addressed with clear expectations, but these need to be communicated from the very beginning. Introducing new rules after families have been coming for a while can lead to negative outcomes.

2. Effective Communication

For existing clients, personal conversations are crucial. This is not a situation where simply posting a sign will suffice. Each child-centered play therapist should have individual conversations with their client families to explain any new policies or expectations.

3. Understanding the ‘Why’

It’s essential to understand the reasons behind the proposed changes. Is it a safety concern? A liability issue? Are adult clients expressing discomfort? Or is it the owner’s personal discomfort with the noise level? The ‘why’ will dictate the most appropriate solution.

The Importance of Personal Communication

When communicating with families about any changes, consider the following approach:

• Have the conversation come from the therapist who already has a relationship with the family.
• Explain the situation neutrally and without blame.
• Provide the context for the changes (e.g., “We’ve had some adult clients express difficulty concentrating during their sessions due to noise levels”).
• Ensure consistency in messaging across all therapists.

Alternative Solutions to Consider

Instead of implementing restrictive rules, consider these noise-reduction strategies:

• Install white noise machines in adult therapy rooms.
• Play background music in hallways and lobbies.
• Use TVs in waiting areas to mask other sounds.
• Install sound-absorbing panels in playrooms and adult therapy rooms.
• Use door sweeps to prevent sound from traveling under doors.
• Place rugs on hard floor surfaces to reduce echo.

Managing a multi-disciplinary practice that includes child-centered play therapy alongside adult therapy services can be challenging. However, with clear expectations, effective communication, and an understanding of why certain changes might be necessary, it’s possible to create an environment that works for all clients and therapists.

Remember, the goal is to preserve the therapeutic relationship and the integrity of child-centered play therapy while being considerate of the needs of adult clients and the practice as a whole. By approaching this challenge thoughtfully and communicatively, we can continue to provide effective therapy for children while coexisting harmoniously with other therapeutic modalities.