Wednesday, November 5, 2014

Private Therapy: To Do or Not To Do

One question that many parents of children with special needs often ask themselves is: Should I get extra therapy for my child outside of the school therapy program? I have asked myself this question several times over the past several years.

There are many factors to consider when thinking about obtaining therapy from a speech-language pathologist, occupational therapist, or physical therapy in private practice, at a clinic, or in a hospital setting. (Keep in mind, I'm writing this as a mom and a speech-language pathologist.)

Why are you wanting private therapy??
First, as a parent, you have to understand why you want private therapy for your child. Is it because your child has a diagnosis that warrants extra time in therapy? Do you want your child to learn something specific? Is there a problem with therapy from the school?

I have put Jaycee in private therapy at different times in the past few years for a few reasons. The first time Jaycee had private therapy was at 3 years old because she was not feeding herself. I sought out an occupational therapist with experience with Down syndrome with hope to attain the specific skill of self-feeding. I really wanted her to become independent at meals. There have been other times I've gotten Jaycee private therapy because she was recovering from an illness and not attending school. Private therapy replaced school therapy until she started school again. I have also sought out private therapy for issues that the school therapist didn't seem to understand how to address. After the evaluations, I shared the reports with the school, so they could address the problems. In other words, I used private therapy to get someone's expertise in a particular area.

It is really important to understand why you want private therapy and what you hope the outcome will be. When you answer this question, that will help you determine if private therapy will be done short term or a long term undefined amount of time. Three of my private therapy experiences have been short term (around 3 months). But, once I had Jaycee in a long term, undefined therapy situation that lasted over a year. For me, I will never do the long term thing again!

Here's some things to consider:

Pros of private therapy
-Private therapy is almost always a one-on-one session.
-Typically, sessions are 45 minutes to an hour, so private therapy may mean more time in session compared to sessions at the school.
-In private therapy, you will most likely have more of a say on what is being addressed. If there is a particular skill that is important to you, you can ask that therapy address it.
-Because you are taking your child to and from private therapy, you often have more opportunities to speak directly to the therapist, ask questions, and get feedback on how your child is doing.
-If your child has had the same therapist at the school for a number of years, private therapy allows you to get another person's professional opinion. Sometimes, change is good and finding a person with a fresh perspective may make a difference.
-You might find someone with a speciality that isn't available at the school. Sometimes, you don't always have a choice of therapist when it comes to who works with your child at the school. But that isn't the case with private therapy. You can research therapists, find out if anyone has experience with your child's condition, and possibly find someone who has been trained in approaches that interest you.

Cons of private therapy
-Private therapist does NOT always equal better. Sometimes parents think a school therapist isn't as "good" as a private therapist. The truth is that every therapist is unique with their own treatment approaches and experiences guiding them. One is not better than the other. So, don't automatically assume the private therapist is going to be a magic worker. Do your research on the therapist's experience before starting therapy! There are good and bad therapist everywhere!
-Private therapy will most likely bill your insurance or medical card, which can evoke major headaches! So, you will need to do your homework to find out what your insurance covers and if there is a cap on the number of visits a year your child can receive. For instance, some plans will allow 25 visits per year. You will need to know this information and keep track of the number of sessions so you don't go over. Don't assume the private therapist will keep accurate records of this. If your insurance has a cap on the number of visits per year, I recommend you use those visits over the summer when the school may not be providing therapy.
-Private therapy can be very expensive. If you have insurance co-pays or if your insurance doesn't cover the therapy, you may be stuck with an expensive bill. I have personally seen charges for $100-250 per session, so that can add up very quickly if you are paying for it!
-Burnout happens! You do not want to burn your child out of therapy especially if you are paying for it! If your child is going to school, receiving therapy at school, or involved in other activities, private therapy could be too much. I found that private therapy after school was totally pointless for Jaycee because she was so tired. Sometimes, the private therapy in addition to my job and home responsibilities was just too much for me, so I got burned out first.

In the end.....
there are reasons why private therapy may be a good idea. But, it is not for every child and every family. It is a difficult decision to make, especially if you are really concerned with your child's development. I personally always recommend that a child receives therapy from the school since your tax dollars are paying for it. And if you decide to add extra therapy on, I think it's important to understand why you are choosing private therapy for your child, what you hope to get out of it, and how it will affect your family. That will help you determine if the therapy is a success or not.

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