Is Therapy Actually Working? Tracking Progress With Three Simple Questions

Tracking progress in therapy can seem to be a difficult task. Children who are brought to therapy for some sort of behavior problem (like not following directions, hitting people or disrupting class) often continue to exhibit these behaviors even after therapy has started.

Baseline Measurements:

In order to truly track progress, you really need to have an accurate baseline.

Baseline is a way to refer to behaviors BEFORE therapy started.

If your therapist gets a good indication of your child’s baseline behaviors, then you can avoid this frustrating weekly check in conversation.

It will probably sound like this:

Weekly  Check-In on Progress

Therapist: How are things going with Johnny?

Parent: Oh, about the same. 

You might repeat that week after week for months.

So, if that is how it feels in your life, I would encourage you to ask a different question.

Three different questions, actually.

In fact, tracking progress in therapy (or even in gymnastics, or spelling or anything else) becomes much easier when you focus on three key areas.

Therapist Secret Tracking Measures Revealed

The three areas that will help you tell if your child is actually making progress in therapy are:

  • Frequency
  • Intensity
  • Duration

Tracking Progress: Frequency

One key way to determine progress is to look at the FREQUENCY of behaviors.

How many times does the behavior occur in a day or a week or a month?

If this is a negative behavior like hitting, then you would want the behavior to go DOWN.

If it is a positive behavior like saying thank you, then you would want the frequency to go UP.

So, when a parent comes in a says, “Johnny is still hitting” that is a true statement and as a parent, you might be frustrated.

But if the FREQUENCY of hitting went down from 3 times per day to even twice a day, then he is making progress! And over the course of therapy, it should continue to go down in frequency to just maybe once in a month.  And then to zero.

If you want to start exercising five days a week and you usually work out zero days per week, then increasing the frequency to even once per week is progress! Just because you haven’t hit the goal, that doesn’t mean that you are not working!

Tracking Progress:  Intensity

The second measure of progress in therapy is to look at the INTENSITY of behaviors.

How strong is the behavior?

This is usually done with some type of rating scale.  Again, if this is a negative behavior, you want the intensity to go DOWN. If it is a positive behavior, you want the intensity to go UP.

So, you might look at the intensity of a meltdown and rate it on a scale of 1-10.  10 being the most intense ever and 1 being very mild.  If Johnny’s tantrums are typically an 8 or 9 and now they are about a 5 or 6, then he is making progress.

Again, as the parent, you are still probably annoyed (or exhausted) from dealing with the tantrums, but the truth is that your child is slowly acquiring a new skill.  So, that is good.

Tracking Progress: Duration

A third way to measure progress is to look at the DURATION of a behavior.

How long does the behavior last?

Remember the pattern, negative behaviors should go DOWN in duration and positive behaviors should go UP.

If you have a child that is having meltdowns, were they usually 30 minutes and now they are only ten? That is progress.

As a parent, dealing with a five minute tantrum is much easier than dealing with a 45 minute meltdown.

Putting All Three Together

For some behaviors, you might be looking at only one of those three areas.  But for many behaviors, you can track all three and hopefully notice a trend across the board.

Final Thoughts:

So, before you give up on therapy and say “this isn’t working” I would encourage you to really think about the baseline behaviors.

Where did you start from? And what is the frequency, intensity and duration of a behavior that you are working on now?

And don’t try to change everything at once.  Start with ONE or TWO (at most) behaviors.  If you start to see a change in those three areas, then you are seeing progress.  Keep working!

Jennifer Taylor, LCSW, RPT is an experienced child and family therapist and public speaker who specializes in trauma, ADHD, and conduct problems. Discover more about her diverse clinical background and family. Reach out to Jennifer with questions or comments by emailing at info@jentaylorplaytherapy.com

Leave a Comment

Your email address will not be published. Required fields are marked *