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When and How to Switch Therapists for Your Child: A SEL Approach

Reviewed by Rajini D, M.Sc. SLP (AIISH)··7 min read
TL;DR — Switching therapists can impact your child's emotional growth. Explore signs indicating it's time to switch, ways to address issues first, and how to transition smoothly. Focus on social-emotional learning to support responsible decision-making and relationship skills.
A child and therapist in a therapy room engaged in a positive, trust-building session.
📘 Part of our complete guide to Generalization: From Therapy to Real Life (Why Skills Don't Transfer)

Switching therapists is a significant decision that can impact your child's progress and emotional well-being. This article is part of our complete guide to Generalization: From Therapy to Real Life, where we explore why skills may not transfer from therapy to everyday life. Understanding when it's truly necessary to switch therapists involves careful consideration of several factors.

Why Switching Has Costs

Switching therapists isn't just a logistical change; it's a relationship reset. Building a therapeutic alliance takes time. This relationship is critical as it forms the foundation of trust and understanding your child needs to thrive. Trust-building is a key element of social-emotional learning (SEL), fostering self-awareness and relationship skills in children.

In my practice, I've seen many parents eager to switch therapists at the first sign of difficulty. However, it's essential to remember that establishing a connection can take three months or more. During this period, therapists learn about your child's specific needs and preferences, which is crucial for effective therapy.

The Emotional Impact of Switching

Changing therapists can be challenging for children, especially those who have developed a bond with their current therapist. This transition can affect their emotional security and confidence. The process of re-establishing trust with a new therapist requires emotional resilience from the child, which is an important aspect of SEL. Parents should weigh these emotional costs against potential benefits carefully, as moving too quickly can disrupt a child's sense of stability.

3 Signs You're Switching Too Soon

Before making a switch, consider whether these scenarios apply:

  1. Initial Adjustment Period: It’s normal for children to take time to adjust to a new therapist. This period can involve some resistance or discomfort.
  2. Communication Gaps: Sometimes, what seems like a mismatch might just be a communication issue. Ensure open dialogue with the therapist.
  3. Parental Expectations: Assess whether expectations are realistic. Progress in therapy is often gradual and requires patience.

Worked Example: Initial Resistance

Imagine your child has just started with a new therapist. Initially, they might say, “I don't want to go.” This resistance is typical during the first few sessions as they adjust to new settings and people. Instead of switching, focus on encouraging open conversations about their feelings and experiences.

In my practice, I've seen children overcome initial resistance by engaging in shared activities with the therapist that align with their interests, such as drawing or building blocks. These activities help children feel more comfortable and open up gradually.

7 Signs It's Actually Time

There are situations where switching is necessary for your child's growth:

  1. Lack of Progress: If there's no progress over several months, it might indicate a need for change.
  2. Mismatch in Goals: If the therapist’s goals don't align with your child’s needs or your family’s values.
  3. Communication Issues: Persistent issues in communication despite attempts to resolve them.
  4. Therapist's Lack of Engagement: If the therapist seems uninterested or uninspired by their work with your child.
  5. Safety Concerns: Any behavior that raises safety concerns should prompt immediate action.
  6. Frequent Cancellations: Regular cancellations can disrupt the therapy’s effectiveness.
  7. Child’s Discomfort: If your child consistently feels uncomfortable or anxious with the therapist.

Scripted Dialogue: Addressing Progress

You might say, “I’ve noticed there hasn’t been much progress recently. Can we discuss our current goals and strategies?” This dialogue opens the door to understanding and potentially improving the situation without an immediate switch.

A family and therapist having a discussion about therapy progress in a comfortable setting.

Approach 1: Direct Conversation First

Before making any changes, have a direct conversation with your therapist. This approach aligns with SEL by enhancing your child’s self-management and relationship skills.

  • Prepare Your Thoughts: List specific concerns and examples.
  • Be Open to Feedback: The therapist may offer insights or solutions you hadn’t considered.

In-My-Practice Moment

In my practice, I’ve advised families to express their concerns directly. One parent said, “I’m worried about the lack of progress. What strategies can we try?” This led to a productive discussion and renewed focus on therapy goals.

Building Communication Skills

By initiating these discussions, parents and children can also build their communication skills. This process involves active listening, expressing concerns respectfully, and working collaboratively towards solutions, which are core components of SEL. These skills not only help in therapy but also in broader life contexts, enhancing your child’s ability to navigate social interactions effectively.

Approach 2: Trial of Expanded Sessions

Sometimes, what’s needed is more intensive therapy, not a new therapist. Consider a trial of expanded sessions.

  • Intensify Frequency: Increase the number of sessions per week.
  • Diversify Activities: Incorporate new activities or techniques.

This strategy can enhance the generalization of skills from therapy to home, as discussed in our article on Carryover Plans That Actually Work.

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Example: Diversifying Activities

Imagine your child struggles with expressive language. By incorporating play-based activities, such as storytelling or role-playing, therapists can engage children in a way that feels less like therapy and more like fun. This approach not only keeps the child engaged but also helps them apply their skills in different contexts, improving generalization.

Approach 3: Switch to a Different Specialty

If the issue is specific to certain skills, consider switching to a therapist with a different specialty. For example, if speech therapy isn't addressing sensory needs, an occupational therapist might be more appropriate.

  • Evaluate Needs: Identify what skills or areas need focus.
  • Consult Experts: Speak with specialists to see if a switch is warranted.

Real-Life Scenario: Specialty Switch

Consider a child who needs both speech and sensory integration support. Initially working with a speech therapist, the family noticed limited progress due to sensory challenges. Transitioning to an occupational therapist with expertise in sensory processing allowed for a more comprehensive approach, leading to noticeable improvements in both communication and sensory regulation.

Insurance + Waitlist Realities

Switching therapists might involve dealing with insurance limitations and waitlists. These factors can delay the process and add stress.

  • Check Coverage: Confirm if the new therapist is covered under your plan.
  • Prepare for Waitlists: Be ready for potential waiting periods for new appointments.

Navigating Insurance

Families often find navigating insurance coverage for therapy challenging. It's vital to understand the details of your plan, including covered services and any pre-authorization requirements. Being proactive in managing these aspects can prevent unexpected barriers to accessing the necessary support for your child.

How to Switch Graciously

If you decide to switch, do so graciously. This process models responsible decision-making and relationship skills for your child.

  • Notify the Therapist: Inform them of your decision respectfully and professionally.
  • Transfer Records: Ensure all records and progress notes are transferred to the new therapist.

Real-Life Script for Switching

“When we started therapy, we hoped for progress in speech. We’ve decided to explore other options, but we appreciate your efforts and care.”

Switching therapists can be a complex process, but approaching it with SEL principles ensures that both you and your child navigate the transition smoothly. By focusing on relationship skills and responsible decision-making, this change can ultimately lead to better alignment with your child's needs.

Infographic showing steps for switching therapists: Notify, Transfer Records, Explore Options.

References

1 Turnbull, A. (2020). Families, Professionals, and Exceptionality. Pearson. 2 ASHA. School-based services for SLPs. Retrieved from https://www.asha.org/SLP/schools/

Try It This Week

Reading is the easy part. Skills build through small, repeated practice — here's a low-pressure plan you can try with your child.

  1. 1
    Have an open conversationDay 1
    Discuss with your child their feelings about therapy. Helps them develop self-awareness and communication skills.
    👉 What this looks like
    After dinner, sit with your child and say, 'I noticed you seemed upset about therapy. Can you tell me more about how you feel?' Listen without interrupting and validate their feelings by saying, 'It's okay to feel that way.' This shows you value their emotions and opinions.
  2. 2
    Evaluate therapy goals togetherThis weekend
    Review therapy goals with your child. Aligns family and therapist objectives, promoting shared understanding.
    👉 What this looks like
    Gather as a family, including your child, and review the therapy goals. Ask, 'What do you think about these goals? Are there any you'd like to change or add?' This encourages your child to take an active role in their therapy journey.
  3. 3
    Try a new activity in therapyDay 3
    Introduce a new game or activity to sessions. Encourages flexibility and engagement.
    👉 What this looks like
    Suggest to your therapist a new activity your child enjoys, like a favorite board game. Playing this game in therapy can make sessions more enjoyable and help keep your child engaged, fostering a positive attitude toward therapy.
  4. 4
    Role-play communication skillsDaily, 5 min
    Practice communication scenarios. Builds your child's ability to express thoughts and feelings effectively.
    👉 What this looks like
    Each day, take a few minutes to role-play a scenario with your child. Say, 'Let's pretend I'm your therapist. How would you tell me about your day?' This practice helps them articulate thoughts more clearly in actual sessions.
    use this story →
  5. 5
    Monitor progress and feelingsOnce a week
    Keep a simple log of therapy sessions. Observes changes and emotional responses over time.
    👉 What this looks like
    Once a week, sit down with your child and review a simple diary of their therapy sessions. Note any changes in mood or progress by asking, 'How do you feel therapy is going this week?' This helps track their emotional journey and development.

Frequently Asked Questions

How long should my child try a new therapist before switching?
It can take three months or more for a child to adjust to a new therapist. This period allows time for building trust and understanding.
What are the main reasons to switch therapists?
Main reasons include lack of progress, mismatched goals, communication issues, and safety concerns.
How can I ensure a smooth transition when switching therapists?
Communicate openly with your current therapist, ensure all records are transferred, and prepare your child for the change.
How do insurance and waitlists affect switching therapists?
Insurance may limit options, and waitlists can delay start times. It's important to check coverage and plan for potential waits.
What if my child resists going to therapy?
Initial resistance is normal. Encourage open conversations about their feelings and give them time to adjust.

References

  1. Turnbull, A. (2020). Families, Professionals, and Exceptionality. Pearson.
  2. ASHA. School-based services for SLPs. Retrieved from https://www.asha.org/SLP/schools/
Rajini Darugupally, Speech-Language Pathologist
Rajini Darugupally
Speech-Language Pathologist · M.Sc. SLP (AIISH) · 10+ years of clinical experience
More about Rajini & the team →

Educational, not medical advice. This article is for informational purposes and is not a substitute for professional medical or therapeutic advice. If you have clinical concerns about your child, please talk to your pediatrician, speech-language pathologist, or other qualified professional.