The Best Therapy is Usually Simple


Sometimes doing therapy can feel like a performance. You plan this beautiful hour, orchestrate it, and then wait for your applause and bow…

…and then the parents take their child back to regular life. Which is no performance at all. It’s rich and complicated and messy. And, usually, rushed.

What’s the point of these perfect therapy sessions? To show off? To make parents see what would be possible, if only they could spend two hours preparing for every one hour spent with their child?

I’ll admit, I’ve been guilty of these sessions at times. And let me tell you: they feel super good. But they are also extremely time consuming. And they have basically no real-world value. How many parents have time to spend an hour making a beautiful fine motor activity like the one they saw in OT today? And how many parents need more mom guilt (or dad guilt, or grandma guilt) about this one more thing they don’t have time to do?

The thing is, making a therapy session jam-packed with activities doesn’t really mean it’s better therapy.

Today I was consulting with an OT who told me how much deeper her sessions go when she puts away the plans and the billion pre-academic activities and does something simple, like playing with a ball. Rather than rushing through activity after activity, she and the family can sit on the floor with the ball and dive deep into play skills, social engagement, social communication, and so much more.

We talked about how these simpler, slower sessions can be so hard for parents, who understandably want to get everything possible out of their hour of therapy. But also how it makes therapy so much more accessible to parents. In this case, the parents went home and duplicated the activity with the ball. The child counted along with the 1-2-3-bounce! routine, and they had one of their best family play sessions yet. Everyone was ecstatic. And it was just what the child needed.

It can be hard to break out of busy-mode during OT. But there are things you can do that may help.


If you’re a parent, try these tips to slow down your therapy sessions and make sure you’re going deep instead of just racing through:

  • Make time to reflect after each activity or group of activities. Ask questions, tell the therapist your observations, or discuss how you can incorporate the activity into your home routines.

  • If you go to a clinic, bring items from home like toys or your child’s toothbrush and ask to show your therapist what’s happening with your child in your daily life. Then take time to brainstorm together and try new things that you could do at home.

  • If your therapy is at home and the therapist brings in a bag of items, ask if she can join you and your child in some real daily activities, like playing with your own toys or doing self-care skills. You’ll be much more likely to learn things you can use in your day-to-day life.


If you’re a therapist, these strategies may help you to get deep, rich work rather than impressive but impractical therapy:

  • If you go into the home, use things that are in the home already. It can feel hard to do therapy without a bag of exciting toys, and that’s okay. This gives you a sense of what it’s really like for the parent day to day, and you can help them much more without the novelty of your therapy bag.

  • Rather than filling the entire hour with activities, spend time before each group of tasks explaining to the parents what your goal is and what they might see during these activities. Afterwards, reflect together on what everyone observed, and what the parents might like to try during the week in between sessions.

  • If you’re in a clinic, use practical toys and activities that are similar to what families might have at home. You can even ask parents to set up the therapy activities together with you. This way they’ll feel more empowered and comfortable to try the strategies when they get home.

  • If parents need to make something new to work on goals in between sessions, consider incorporating a make-and-take into your session so that parents can go home with the activity ready-made.


When we stop rushing and filling the time just to feel successful, it opens up so many possibilities for our kids and families. We may do less in an hour, but what we do accomplish is likely to make a much deeper impact.

Browse More Posts

Making Schedules for Kids on the Spectrum

Learn how to make a schedule for your clients with autism that teaches independence and flexibility

Why Sensory and Fine Motor Aren’t Enough

There’s something controversial in the occupational therapy world….It’s what on earth we OTs are supposed to do.

Getting Unstuck with Self-Calming for Autism

When we work with kids on the autism spectrum, we often find that self-regulation is challenging. Our young clients begin to get upset…

The #1 Reason OTs Feel Ineffective with Kids On the Autism Spectrum

Most OTs want so badly to make a real impact in the lives of the people we work with. We want to feel like what we are doing matters for…

3 Essential Types of Visual Supports To Help Kids On the Autism Spectrum Succeed

Many parents and therapists have heard by now that visual supports can help kids make sense of their instructions. We know that receptive…

Rethinking Hand-Over-Hand Assistance for Kids On the Autism Spectrum

If you don’t have a toolbox full of autism-specific strategies, letting go of hand-over-hand can feel scary.