Minimizing Distractions in Home-Based Therapy

Distractions in a home environment can be considered inevitable. Just ask all of the employees working from home during the pandemic. Home-based therapists face the extra hurdle of providing services in a usually unfamiliar space.  Whether it’s a visitor stopping by unannounced or a toddler trying to pull out your hair, interruptions during home visits can derail the entire session due to the unstructured nature of home-based therapy. Distractions or interruptions can be out of the therapists’ and the client’s control. At best they can lead to ineffective services, and, at their worst, they can be threats to the clients’ or therapists’ safety. Keep reading for more information on distractions in the home and learn how to address and hopefully minimize these distractions.

Examples of Distractions:

  • Phone calls
  • Children
  • Family members
  • Pets
  • Visitors
  • Television
  • Another visiting professional
  • Bad weather

Advantages to Distractions

In some ways, distractions can be an advantage to the visiting mental health professional. Occurrences that might be considered distractions can provide contextual information about clients and their households. 

For example, what shows does the client watch on the television? What is the family cooking for dinner? Who cooks and cleans in the household? When the parents ask the child to stop running, does the child listen? Why does the client’s boyfriend call six times throughout the session? 

The therapist can use all of this additional information to form a more complete psychosocial history of the client and/or family or to better understand family functioning. 

Disadvantages to Distractions

As stated before, distractions are so numerous in a household setting that they can derail a session in an already unstructured environment. If the therapist continues to attend to distractions, it can send the message that the therapist 1) has given all power in the session to the client or to the distraction 2) is uncomfortable setting boundaries around therapy and 3) does not value therapy enough to set boundaries around these distractions.

Addressing Distractions

When it comes to addressing distractions, it appears there are two schools of thought in the literature at varying degrees: work with the distraction or work to stop distraction.

When working with the distraction, the therapist might recognize that the distraction serves a genuine purpose for the client. For example, the client might turn away from the therapist to focus on distraction to avoid an uncomfortable or upsetting topic. The therapist can also recognize that attending to the distraction with the client can help build rapport. Lawson suggested that the mental health professional might use nontherapeutic moments to meet therapeutic goals. For example, the therapist might take moments to engage in tasks with the clients such as folding laundry, working on a car, or playing basketball to learn more about the family and to build rapport. Additionally, therapists can use the actual home environment to improve the session. For instance, the therapist might suggest to the client who lives in a household with other people to turn up the volume on the television or the radio when discussing topics they do not wish to be overheard and to protect confidentiality in general. 

When working to stop the distraction, the therapist recognizes which distractions are harmful to the efficacy of therapy and actively works to address the distraction. Directly addressing the distraction helps to maintain boundaries, minimizes chaos, takes the counselor out of a crisis cycle, and helps prevent client or counselor burnout. 

The therapist can use several interventions to address these distractions. First, they can confront the client on this distraction and offer psychoeducation on why distractions work against the client’s goals in therapy. Check out this step by step guide to confronting a client on a boundary. The therapist can also model how to stop distractions and how to prioritize services by asking other family members to turn down the television. The therapist can also empower the clients to address distractions themselves by role playing how to set boundaries around therapy (i.e. asking a visitor to leave or asking a family member to watch a child or pet). See below for some ideas on how to address a distraction in a home environment:

Addressing distractions in a home setting is hard; there is often the idea that being a “guest” in a home comes with its own rules concerning respect. It can be much more difficult to ask the “host” to change their own environment. That is why it is important for therapists in this setting to remember their roles as a professional. By asking the client to prioritize therapy above potential distractions, you are sending the message that you prioritize the client and honor their time. What are some other ways you’ve minimized distractions in the home?

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