Ear checks can be difficult with young children particularly if they have sensory difficulties, behavioral concerns, and/or autism. The following are a couple strategies to try to make the process less upsetting and difficult.
- Set up a reward system ahead of time. For example, earning a small toy, sticker, activity of their choice with a parent for no yelling or hitting when getting their ear examined.
- Try using a distraction such as a tablet, playing music, or having an item that they can fidget with.
- If you know your child has an ear exam coming up you can help them feel more comfortable about the exam by practicing at home first by pretending to check your ears and then practicing on them (you may have to practice an ear check in steps for example, the first time touching them on their arm, then their face by their ear and working your way up to touching their ear).
- Use a count down timer for them to visualize how long the ear exam will last.
- Teach your child how to take a few belly breathes to help him/her self soothe.
- If your child has sensory issues a weighted blanket may be helpful in making your child feel calmer and safe during the procedure.
When you are first starting in an integrated primary care setting it will be important to get an understanding of what the doctor’s are looking for in both a consultation and the type of patient they are looking for assistance with. Don’t be surprised if initially the majority of your consults are on patients with primarily mental health concerns such as anxiety and depression. It may take a few months for primary care doctors to feel comfortable asking you to consult with their patients that have health related behaviors that you can be helpful with. A few possible reasons for this is the idea that psychologists help with psychological concerns and medicine helps with medical concerns. Also primary care doctors are used to trying to manage these patients on their own or with the help of specialists in the medical field, it may take some time for them to feel comfortable in what they see as asking for help with their patient.
One of the simplest and best ways to build trust with the doctors in your office as well as your patient base is for the doctors and staff of the office to get to know you and your skill level. This will partially come with time, often patients will report back to their doctor that you were helpful or they will tell family members about you and you are likely to get more referrals. You also have to make a concerted effort to be visible and get to know the doctors and their preferences for how they work.
Here are some suggestions to help build a practice in integrated primary care.
- Provide education to the doctors and staff on what types of problems you can help with.
- Create flyers that describe how your services can be helpful and have them posted and available in areas where patients will see them.
- Build a library of resources for your office where staff can easily grab a pamphlet or information packet to give to patient on how a psychologist can be helpful on different topics.
- Be a member of the team. Attend staff meetings, eat lunch with the staff and doctors, check-in frequently with the doctors to give them an update on patients.
- If you have electronic records you may be able to run report that identify patients who have psychological or health related behaviors that are appropriate referrals.
- While you don’t want to become the staff therapist it can be helpful to provide staff with basic stress management and communication techniques either informally or at a staff meeting.
It is important to be honest about why you are coming in and not to surprise a child with the information. It will make it more difficult and uncomfortable to have a discussion about why the child is in therapy if the child feels they were tricked or caught off guard especially when they are meeting someone new the first time. It is better to prepare to talk to your child ahead of time. Wait for a calm moment and identify the concern. Offer empathy and compassion, such as “it must be really hard”, “we want to help”. You can let your child know that he/she will have an opportunity to talk without a parent in the room as well and bring up any ideas or concerns they have.
The following are recommendations for talking points:
- It’s important to explain that your child will just be talking. There is no physical examination or shots
- You can talk to your child about how the therapist has helped a lot of kids and if they met with her the therapist might help the family to understand the concern better and to help generate ideas that may help.
- Let your child know that they will have an opportunity to talk without the parent in the room and they can discuss any concerns or issues or ideas that they are having.
- You can talk about the concerns as family matters, instead of placing the blame on the individual child. Talk to the child about how the therapist may have different ideas for the family to try out.
- Mention that it’s helpful to get advice from someone who is “neutral”.
- If your child refuses to go or says that they will go or won’t talk try to get them just to go just for one appointment. Most children and teenagers will feel comfortable and empowered to talk to the therapist once they meet the person.
- Let your child know that what they talk to the therapist about will be private and the therapist will not share what they talk about unless they want the therapist to (unless the therapist believes they are someone else is in danger).