When my son was 9, we had our first in home therapist. This was a brand spanking new idea at the time so we could– and did — invent the service as we went along. My son had had 6 hospitalizations, tried 20-something combinations of medications and gone to countless outpatient visits at that point. Some of these treatments were quite successful — for a while. Some were pretty ineffective. But it was all the system had to offer and all my insurance would pay for. I used to grumble that our choices were inpatient, outpatient and see-you-later-alligator.
Then we were offered this new thing — someone who would come to my house and work with all of us — my son, me and his brother. What a concept.
Ian was a social worker cast from a different mold. He talked about his own experiences when it seemed important or to build common ground. He suggested new approaches and things to try based on his observations and sometimes, his best guess. He listened to my ideas (herbal supplements, meditation tapes, yelling at ‘the voices’) and helped me implement them. He didn’t insult me by suggesting star charts or baffle me with gobbledegook. Instead, he partnered. He shared, he asked and he listened. He was respectful and interested. He wasn’t afraid to admit to bad ideas and applaud the ones that worked. He was eager to hear about resources I found and learn about strategies that were new to him.
In short, he really and truly partnered. He wasn’t the leader and me the sidekick. He wasn’t the expert (though his expertise was wonderful) and me the learner. It was clear from the start that we were doing this together.
Several years ago, when the children’s mental health world talked about partnering with families, we focused on defining what the family member would need in order to be a good partner. We worked to ensure that their voices were heard and their participation was supported. The word was out: families were welcomed, accommodated, included and recruited. We changed the environment and the team composition. But here’s the catch. Parents have always come to the table–whether it’s the treatment, IEP or policy table–and they always worry they might feel blamed or mistrusted or seen as unsuccessful (what parent has not been unsuccessful?). Being included is not being asked to partner. In order to partner, a parent has to feel they have a meaningful impact, not just a role. Parents can’t make that happen by themselves.
What hasn’t been done so well is define what the professional, the provider, the state agency person (or whoever it is) looks like when they partner. Some, like Ian, know how to do it and do it right. For others, it’s not easy or intuitive.
There are a lot of ways to define partnering and to measure it. One of the best lists I’ve seen is from Brian O’Neill at the National Park Service. In his 21 Partnership Success Factors he notes that partnership needs to be a way of thinking that includes trust, leaving your ego at the door and respecting the right to disagree.
We talk about systems partners and family partners. We discuss parents partnering in primary care, behavioral health and education. But while the frameworks have grown and the opportunities are there, we have a long way to go.
A lot of the partnering we do comes from a head space, a thinking space; somewhere made of definitions and verbal structures. But it’s not something we experience from the outside looking in. It comes from trust and from hope and from belief. Trust in one another and trust in the path forward. Hope that we can accomplish something, maybe even something small, that will amaze us, and fortify us and validate us. And belief that even in a still-broken system and the experience of many failures that there is a near future and a far future that is better than right now.
Once you’ve been a full partner, nothing less will do. And to be fair, it’s a more demanding role for parents too. We have to do the work we’ve committed to even when we are tired, listen with the same respect and interest that we want in return and often stretch beyond what we thought we knew. When we look around the table to see that parents are participants and stakeholders, we need to up our game and expect that meaningful partnerships should be the norm for all of us.