Robert Trout (00:01.528)
Hello and welcome to the Parent Problems Today podcast. Today you’re listening to Robert Trout and Mary Zahnbrecher, both from the Parent Trainers team. And today’s topic that we’re coming, I guess to kind of delve into and try to define, this feels very much like a let us define what this is and kind of the beginning conversations around this topic. And it’s a little bit of a two-parter.
because what we’re going to look at today is treatment fatigue and resistance. And a part of this is letting families know that these are two very different things. OK, so I’ll start with that and then Mary, I’ll kind of pass it to you to kind of open the conversation. So I’ll start with treatment fatigue. When we are talking about treatment fatigue, this is an individual
that very often we see this with tweens and teens a lot. Sometimes older adults and younger kids, things like that, but tweens and teens definitely have a capacity for accepting circumstances that they’re either in the beginning feeling hopeful about, or they’re feeling a level of being forced into a process that we would clarify as, or…
I guess classify as treatment. But that can be everything from just going to see a therapist to having to go to an IOP or a hospitalization stay or a treatment or therapeutic boarding school or intervention program, whatever it might be. But treatment fatigue is recognizing a pattern that happens that when a individual tries, they show up on some level to say, fine, I have to do this.
or maybe this will help or etc. And they’re put into a process. You have a limited timeline is the truth and reality of this because each individual has a different level of capacity. And on that imaginary timeline, what you’re watching for is recognizing that at a certain point, for example, kids who have seen a therapist for two years straight,
Robert Trout (02:21.94)
every week or every other week for two years. We see it very often that this individual has reached a point where the kid is saying, why am I doing this? I don’t want to do this. And that’s not even resistance. We’re not even to that yet. This is just them saying, this doesn’t do anything for me. They feel like it’s a waste of time. And they’re not even trying to fight back against the parents or the hope of change. It literally is just a capacity point.
where the process they’re in no longer serves the goals that were initially set. Okay? The second part to this is looking at treatment resistance. And like I said in the beginning, this is very different. These are very different things because fatigue is this individual showed up, they tried, they went through a process, and it’s just overrun, right? The timeline has dragged past their capacity to care or to change.
within that timeline. Treatment resistance, this is where we start to see individuals who these people are fighting back. They don’t want to go to therapy. They don’t want to go to treatment or have an intervention or to stop the behaviors or addiction patterns or whatever it might be. These individuals are showing up with energy to really step in and fight this. Okay, so there’s all kinds of processes
that need to be looked at when someone is treatment resistant because this individual is going to fight back and the parents and the family have to be aware that that’s kind of a natural thing to do, especially if the kid doesn’t think they’re the problem or that they have a problem. And there’s certain approaches that have to be kind of stepped into by the family or the parents to help them get through that resistance.
and not make it worse because very often if you fight back against the fight, now it’s just a civil war. And this is where we see resistance become parent relational problems that are very ingrained and it starts cycles of behavior within the family system that can go on sometimes for years and create resentments and angers and processes that require their own time to kind of dig into. So.
Robert Trout (04:44.398)
I’ll pause there, Mary, with those two definitions, where do your thoughts go on these two issues for families?
Mary (04:51.469)
Yeah, I think clearly, you know, there’s a difference in those two kind of states of being for for humans. And my head just immediately goes to this idea of what is the container like and what is the capacity of the family system for either. Right. Because we’re looking at, you know, what comes up for parents usually initially when their kid says, I don’t want to.
which is usually an anxiety based off of some past event or situation, right? And so when we get caught up as loved ones in that anxiety, what we can’t think through is the why behind this happening. We can’t think through, okay, what else? What else is there? What else can we do? And our own actual
capacity to work with your child where they are at. Right. And that doesn’t mean that we just throw our hands up in the air and say, well, this is my kid. There’s nothing I can do. Right. But when when parents are faced with either of these, I’ve seen the anxiety just shoot through the roof to a point where, you know, a parent’s mind can get so narrow and narrowly focused on
this is the end all be all for my child, right? I had a parent who called me after probably two years. I saw this child in a primary kind of treatment way and she had gone on to therapeutic boarding school or something and the mom gets in touch with me. She says, my gosh, she doesn’t wanna do therapy anymore. I said, I’m
doing therapy anymore. It’s okay, right? Well, there are ebbs and flows in our process. And when we can’t step back and recognize and give our kids the grace and give ourselves the grace to say, there are other options, right? It’s usually because we’re locked up in anxiety.
Robert Trout (07:04.206)
Absolutely. And I mean, that’s a great example of that treatment fatigue. When someone has gone through an intensive program like an IOP or even like a six month family intensive process for family therapy and things, there is a recognition for a lot of us who are clinical who look at it and say, you do have to take a break. You have to take what has been processed and open.
Mary (07:10.255)
Mm-hmm.
Mary (07:29.103)
Yeah.
Robert Trout (07:33.29)
and go try to live in a new way. Which I think is why parent trainers went so skills focused in the work that we do because it was always the problem for most of the families who found us where they’d done therapy for a year and nothing was different. And there is that like, okay, you can do therapy. It’s a great tool. And.
Mary (07:47.023)
Mm-hmm.
Robert Trout (08:00.066)
There’s a certain point where you need to stop processing the past, for example, if that’s what’s happening, and step into the present and initialize a new way of being for each individual in the family, not just the kid, but the parents and the whole family system needs to be in a new way of being, utilizing skills and boundaries and processes that are new for everyone to try on. Like, how does it feel that we do it like this now? And if you can create change,
on a practical action level, then you can take a break from the process work and the things that really do burn a lot of kids out. And they reach that fatigue state because they’ve heard the same complaint or the same story every week for a year. And they’re really tired of hearing that story. And there’s also a level of that where when you really get into it, they also just kind of ingrain what other parents say and say, great.
That’s the story, that’s what you’ve made me, so I’m just gonna be that.
Mary (09:03.075)
Right?
Robert Trout (09:04.92)
So there’s some things that need to be cracked open and then make new from that. But so many people fall into the therapeutic trap. I mean, it feels like a trap, especially to the kid. They use that metaphor all the time.
Mary (09:18.019)
Right. Yeah. I mean, what I keep thinking of is just this idea of, yeah, we’ve got to let it marinate, right? Like we’ve got to actually see all this conceptual thing that I’m talking about, right? What we do at Parent Trainers is we say, okay, yes, we have some concepts. Now let’s talk about action steps and what do we actually do in the moments that get hard? Yeah, we know why they get hard.
We know our patterns, but what actually creates change in the day to day? And there’s so many times, especially for teens and tweens, right? That they actually need more time to just let things kind of sink in and try things on and see what works and what doesn’t. And we oftentimes, I think, forget about the complexity of life that they’re dealing with at that age.
and that we dealt with it at that age because it’s so far in the past, right? And when we continue to think that, you know, one way is the answer, we really pigeonhole ourselves. And not to say that therapy is, you know, for everyone or not for everyone, but what are the ways that we are truly doing what we need as a system, as a village, right, for our kids?
Robert Trout (10:41.24)
Yes. I have a professional colleague that has a statement that comes into all the speeches he does and everything where he says, therapy is over prescribed. And I really love that context of saying like therapy, like it’s become a buzzword and thank God it’s become more normalized. Like, Hey, getting therapy isn’t this awful thing. Like doing self work and family work, et cetera. What a great thing. But there is a level of over prescription.
where people really believe that if I go and I sit and I talk about this thing every week, eventually I get better. And people have lost sight of the context of processing doesn’t create change. It doesn’t. Now, processing can open you up to change, because sometimes you’re stuck, and we all need to do that work. So if you’re out there and you’re wondering about treatment fatigue,
Mary (11:25.348)
Right.
Robert Trout (11:37.75)
That’s what we’re really gonna get to at the root of this for your child is yes, you needed to look at things. They needed to look at things, you needed to look at things. Treatment fatigue comes from looking and looking and looking and looking and looking and nothing ever changes. So you didn’t teach that kid any new skills to enact. You didn’t drop in to a new like paradigm of them being able to be different than what they used to be.
I mean, there’s so many elements to that where it’s like treatment fatigue comes from repetitive action with no result. It’s just as stuck as not doing therapy and being stuck in the action of behavior. It’s just moving the stuck from one point to another. So the action orientation is what’s so important here when it comes to treatment fatigue and the result of that. So for any parent listening to this podcast right now and wanting to split this into two parts, the
First and primary step to treatment fatigue is to stop treatment. I want to be clear about that. That doesn’t mean stop doing everything. It means back off from the way it’s been and try something different now. And that can be everything from getting that kid a mentor and not doing therapy anymore, traditional therapy models, or doing a family camp over the summer or, you know, relationship work between the two of you.
that’s unmediated, things like that, it’s just creating change. So if you can recognize we’re stuck in this pattern, then the answer always is to crack that open and create something new. I don’t care what it is. New creates opportunity for change. So that’s what we’re really looking at there. The second part to that is looking at, I’m going to say fatigue from a wide angle.
Mary (13:22.479)
and we’ll see
Robert Trout (13:31.566)
Sometimes they need a break from you because if you were in family therapy You there is a point in that fatigue where you’re gonna have to say, okay We’re gonna change things and one of those changes is I’m stepping back from you and giving you an opportunity to be different You’re still there. You’re still a parent etc But figuring out a way to create space between you so that both of you can be different might also be equally as important
as the initial change and doing something different.
Mary (14:04.365)
Yeah. And it’s developmentally appropriate. Right. And that’s, you know, that’s something that I think a lot of parents get really shocked at when, when I’m working with them is like, well, no one explained this to me or no one told me it like it needed to be this way. Right. It’s this idea that, you know, can I trust in my child’s capabilities because of what I’ve already taught them and, and who I am allowing them to become.
Robert Trout (14:07.459)
Yeah.
Mary (14:34.221)
Right. And so this idea of, yeah, what are the, the, those places in your child’s life that, yeah, maybe you back off of therapy and it’s twice a month or once a month, right. Or, Hey, let’s do a three month break and reassess. but what are the voids in their life that maybe you can say, great, I am so willing to.
you know, have you stepped back from this because you’ve been doing so much work? What else, you know, can we introduce something into your life that you’ve never tried or done, or is there a hobby that you’ll have more time for? How can I, you know, continue to get my child out of the house or be social? So really creating, you know, some hallmarks for yourself as a parent, I think, and some ways to measure kind of, okay, I,
and let go of this. I can trust that, you know, the answer isn’t always therapy. The answer is a mentor. The answer is, you know, going out with friends and just experiencing life and scraping our knees, you know, metaphorically too. Yeah. And just appreciating that sometimes that change in and of itself allows for so much growth, right? Rather than just this, yeah, kind of back and forth.
talk therapy, which is becoming less popular for that reason, right? Yeah.
Robert Trout (16:05.55)
Yes, and is one of the reasons that coaching, like what we do with families, is becoming so much more popular is because it’s action oriented. We’re looking at facilitating change. The processing is over prescribed. So it’s time to move into an action oriented family process that’s not just about the kids, but on everybody in the family system. So I think that’s a good like switch point for the listener.
Mary (16:14.126)
Right?
Robert Trout (16:33.28)
Now we should talk about the treatment resistance because they are two very different things because when it comes to fatigue the answer is always going to be change things Like you have to back off and change things. It really is that simple as a starting point now There’s nuance and you know finesse to that later and that’s something families can dig into with us or someone else but jumping from that treatment resistance treatment resistance is a whole other
where I mean we see kids that they refuse to get out of bed they refuse to get in the car because they know they’re supposed to go to therapy they refuse to log on to the zoom call to do whatever I mean it’s just on the larger scale at least in my experience I see refusal as the weapon utilized by the kid to resist getting help and this is tweens teens young adults across the board
They don’t wanna. And that’s it. And the trap that I think everyone needs to be very very aware of is for you to step into that conflict and try to demand that they attend. If you start stepping into that trap, they’ve got you because they know how much this means to you and if they owe you, they want to hurt you, they
gonna cause conflict so you have a fight so then you don’t have to go because you spent your whole hour fighting versus getting the help you were looking for in the first place. I mean these are very conscious and unconscious reactionary tactics that are very very useful for these kids. So when we see that refusal step one as a parent is to don’t step in to the fight because you’re gonna lose.
You’re just gonna lose. There is no like, I’m gonna make you go to therapy to make you get better. I have lots of therapist friends. Okay. And we all kind of talk about the kids that they show up to the office. If those parents can even get them there, they show up, they walk in, they sit on the end of the couch and they stare at the ground and they don’t say a word for an hour.
Robert Trout (18:54.414)
And we still bill the parents because we’re there to provide service, but this kid, we’re not going to help them. We know we’re not going to help them. And I’m going to say on an ethical level, there’s that acknowledgement at like session two or three where it’s like, there’s no breakthrough here. On an ethics level, there has to be an acknowledgement of there’s a level of treatment resistance here that I’m not going to be able to get through. So they need something else. Higher level of intervention or strategy or just parental process at home.
And I do know a lot of people that step into what I would call step one of the process or actionable steps for this, which is to send the kid away and just work with the parents. If we can get the family system to be different, if the parents are starting to be different and interact at home, there is high likelihood of change and interaction differences and things that can start to happen over time. But very often the way to the kid is through the parents.
So there’s a part of that to be aware of.
Robert Trout (19:59.502)
Now from that, when we look at treatment resistance, the second part is going to be really looking at this kid saying, all right, I want to, I’m going to say own the responsibility of witnessing that resistance, right? So the parents have to witness the resistance and own the responsibility of being the one who most likely said,
You have to do this program or you have to do this therapy or etc. You put that on your kid. So if you can own that Then start stepping back and in I’m going to say introducing it to them Then you get into strategies so the two top strategies I give families and then Mary I’ll pass it to you strategy number one have the kid interview three different therapists and Say to them you’re gonna meet these three people
you decide who you want to talk to because they are far more likely to work with someone they chose than the person you chose for them. That’s strategy number one. Strategy number two to this resistance factor is to look outside the box of therapy. Look towards that like getting into sports or group work or team building activities or a summer camp or whatever it is.
to get them interacting with people who can be positive mentors for them to get feedback about their actions and behaviors from someone other than you. So important to recognize that that’s a way that you can do this. It doesn’t have to be therapy or programming or something like that. You can just use life and things around life. And I actually had a family once say, oh my God, but I don’t want to pay $2,500 for this kid to go to summer camp for a week.
And I went, how much money are you going to spend on a therapist in the next two months? And they counted it up and went, we’ll send them to summer camp for a week, because it was actually cheaper than all the hours they would have paid for a therapist. So just there’s a perspective shift is, guess, what I would say to any parent that’s listening. Mary, what’s your thoughts on resistance?
Mary (22:11.757)
Yeah.
Mary (22:19.791)
Oh yeah, mean everything you’ve said, absolutely, 100%. You know, when I work with families and I see kids who are resistant, you know, immediately what I tell parents is we’ve got to focus in on what’s going on.
Mary (23:33.21)
- Hi.
Mary (23:42.144)
Can you hear me?
Robert Trout (23:43.822)
Again, yeah, we’ll cut out the sections. Why don’t you jump right into that? Your thoughts on.
Mary (23:47.328)
Yeah. 100 % what you’re saying is we’ve got to look at alternative options, even just to get them out of the house and into life. Right. Because a lot of times we’re trying to look at this reason of why they are resistant to therapy. And rather than focus on that, like how can we focus on getting them into life, getting them some real time feedback from someone who’s not their parents.
right? And creating then the relationship between yourself and your child to where as they’re getting this feedback or as they’re experiencing life, right? They can process it with you or a mentor or, you know, someone else in their life. It’s scary to change. know adults who don’t want to engage in this process, right? Because change is unknown.
and our brains just don’t want to do what’s unknown. So it’s basic human biology, right? So having compassion for your child in that moment and then saying, yeah, what are the other resources we have that aren’t necessarily, you know, exactly 100 % what we think might, you know, be the best support, but that can support them in having life experiences that then lead to interactions with people who
you know, their ears are open and they say, that’s cool person. And, you know, maybe they’ve, you know, had a hard time in life or maybe they’ve been to therapy or right. It’s about really getting them to a place where you as a parent can have space and space enough to just kind of work with someone like us on, you know, what, what else can we do?
and where you can give your child opportunities. And then that’s kind of the second thing for me is this idea of, so often we look at the other person as needing support or the lanes kind of narrowed or some sort of help, right? And we don’t recognize that the interactions that we’re having with them are actually
Mary (26:09.97)
a catalyst for them to have those pathways carved out for them or that support, right? And you can do it in so many ways. It’s not about giving advice. It’s not about, right, it’s about being able to change as a parent how you interact, when you interact, what you’re willing to interact about, what you’re not willing to interact about, right? And changing up the way that you are communicating.
and holding boundaries and really just showing up to the table and to your child’s life 24 seven. And that’s where, you know, we as parent trainers come in because we really do believe that, you know, if I can make the change, if I can show up differently, you know, it doesn’t always lead to a smooth, easy road, but it creates this change within the system.
Right? Where each individual has to shift. And if nothing else, we’re getting more data for what might work. Yeah.
Robert Trout (27:16.066)
Yes. Absolutely. Yeah, well, I guess let’s move into final thoughts for the families that are listening. I mean, for me, this is pretty straightforward. Recognize that if you start treatment, that there is a timeline. You have a set amount of time for the capacity of your child to gain benefit from any treatment model because there is a timeline for all of it.
doesn’t matter which one it is. And if they are resistant to treatment, you need to be the one to slow down. Step back, reassess, and start with yourself, and then find a way to invite them to accept help. That’s really it. I mean, when we boil it down, those are going to be key starting points for anyone on this journey. That’d be what I’d want people to take.
Mary (28:15.134)
Yeah, and I’d also say just think about what the family system needs. And sometimes it’s just more structure, less structure, more conversations about how are you as a human and less conversations about the issue and really just inviting everyone to change up their day to day.
and that can look a million different ways. And that’s where creating kind an individualized plan for yourself, having your co-parent do that and inviting your children to think about that. And so working with someone to look at an action oriented plan.
Robert Trout (29:00.526)
Absolutely. Well, if you’re out there and going through either one of these, give us a call if you’re looking for support. Join one of our intensive trainings in our community so that you’re not alone. Because you’re not alone. These things are major issues that we see across the board for so many families in so many situations. So come find us at parenttrainers.com. And we look forward to seeing you there.
