A key element in determining whether something works in the “real world” is how satisfied the parents are with the treatment. Sometimes we see objective evidence of success in therapy, but the behavior changes aren’t generalizing to natural situations. Of course, we want to see both. If it hasn’t generalized to the real world, we aren’t finished yet.
Something that is often overlooked is that it is possible (even common in my experience) to have objective evidence of success and parent satisfaction, but still not be on the right track. That’s because it is possible that we are getting fooled by positive data. What happens is that sophisticated behavioral interventions that are successful in the short-run can hide the long-term problems.
It is essential to obtain objective evidence of success in therapy. It is essential that parents are satisfied with the results. Parents are often thrilled when a short-term problem is solved. It is definitely a reason for celebration! But professionals should be aware that short-term success often doesn’t last. Our goal is to make a socially significant difference in the child’s life. That means focusing on the things that will last and matter in the long run. If the change doesn’t last, the parent satisfaction likely won’t either.
We need to have parent satisfaction and we need to make a socially significant difference in the child’s life. Often, we think of them as the same thing – they aren’t.