Will a Therapy Break Cause Regression? Caregiver Burnout & Therapeutic Breaks

Don't skip this episode because you hear "break in therapy" and think… "not for us." Stay with us for a minute.

We see you. You're the nurse, the therapist, the caregiver, and the mom — all before lunchtime, most days. You've been white-knuckling it through every session for months, maybe years, and quietly wondering if you have anything left to give. But the second the word "break" comes up, something in you panics. What if my kid loses everything we've worked for? What if we lose our spot? What if I'm the reason they don't progress?

So you keep going. Even when you're running on empty. Even when your kid is tired of it too. Even when some small, quiet part of you just wants permission to stop for a minute.

This week, Pam sits down with Heather Anderson, PTA, who works with some of the most medically complex kids in the field — and she gently dismantles every fear you've been carrying about stepping back.

In this episode:

• Why a therapeutic break almost never means starting from scratch — and what the research actually shows
• What to do (and who to call) if you do see regression, so you're never stuck waiting
• How to ask for a break without losing your therapy spot or your therapist
• The burnout that's just as real for you as it is for your child — and why it matters
• Simple ways to keep the progress going at home, even without a weekly session

You are the nurse, the therapist, the caregiver, and the mom — and you are allowed to rest. Your child is allowed to just be a kid for a season. This episode is the permission slip you didn't know you needed.

Transcript

00;00;00;14 - 00;00;26;19
Unknown
Hi moms. Welcome to help! I have kids podcasts. We're so glad you're back. If you're new here, welcome. If you've been a listener, we're very glad that you're listening this time. If you have children in therapy, maybe ot speech, or maybe you're thinking about therapy, we are going to give you a little bit to think about today and your child's therapy journey.

00;00;26;20 - 00;00;59;10
Unknown
It might be something different than you've heard before and give you a permission slip you didn't know you needed. So what are we talking about? It's therapeutic breaks. And my guest today is my friend Heather Anderson. Glad to have you. Thank you. Pam, it's nice to be here. Yeah. And Heather is a physical therapy assistant, and she absolutely adores children and loves making a difference in their life with movement and physical therapy.

00;00;59;13 - 00;01;27;15
Unknown
And she has some expertise in this area. She works a lot with kids with neurologic impairment and complex, medically complex children. She's actually a part of our intensive team. So they will have kids that come from all over the country, really, and some local people to work intensively with, with their child. So we're talking about therapeutic break. What in the world even is that?

00;01;27;17 - 00;01;50;14
Unknown
Heather. So the first time you say therapeutic break, people look at you like you want me to do what? So what I'm talking about is you come into therapy, we set a goal or two, and we meet those goals. And when we're done with those goals, we take a break. So maybe you come to therapy for 3 to 6 months, and we've met that goal, and now we're going to take a break.

00;01;50;14 - 00;02;14;07
Unknown
And you get to go home and you and your child work towards making that goal better. Maybe further distances, maybe a longer time, maybe just seeing how well they pertain to it and they're able to maintain what they've made. Also, during that break, let's let that kid be a kid. Yeah. Let's play. Well, I'm sure when you first say this to parents, they're like, what?

00;02;14;11 - 00;02;39;12
Unknown
There are lots of parents, especially parents have been in the therapy world for years who have never heard about a therapeutic break that are just kind of like, wait a minute. If I do a break, what my kid lose what they have? Or aren't they going to regress? No, no they not, they're not. Because one, you're a caregiver, so you're going to work on things at home if you want to maintain that skill.

00;02;39;17 - 00;03;06;48
Unknown
Also, children want that time to just be a kid. And caregivers need a break. You need that permission to say, yeah, it's okay to sit on the couch today and just watch movies and not have to worry about going to therapy. Yeah. And parents, you may have heard the term episodes of care. It is a common term that's used, but back in it's probably been about 15 years ago.

00;03;06;51 - 00;03;51;29
Unknown
I know a lot of children's hospitals were doing research on, you know, opt speech with children, specifically pediatric therapy, and began developing these episodes of care like what it should look like. And some children's hospitals put out sort of protocols like, like these different diagnoses or these different, you know, goals. Might you say goals that we're going to have take 12 weeks or these take six weeks, or we're going to do, you know, three weeks of three times a week and two weeks of two times a week and one week of or three weeks of three times or one time a week, something like that.

00;03;51;34 - 00;04;16;27
Unknown
And that's called an episode of care. And then they would discharge. So they would as the parent was signing up for therapy, they would present that episode of care as, here's a start date and here's an end date. And then, I don't know, that kind of slipped away for a while. But here in Kentucky, sometimes we tend to be a little behind on, you know, adopting some of these things.

00;04;16;29 - 00;04;39;35
Unknown
Nobody likes changing. No, not so much. But and I know there's a fear moms. We want to talk about that. You know, a fear of letting go or a fear of oh, my child's been in therapy for so long and I'm afraid to take a break, or I'm afraid to to let go of my therapy slot or time, or my therapist whom I love or whatever.

00;04;39;44 - 00;05;05;18
Unknown
When, how how can we assure moms or what something we can tell them that gives them kind of the okay or the permission to secure what I say to my family is so we start the conversation of breaks day one, like where you're going to come in, we're going to work on these things. We're going to take a break and we'll let you go home and do things.

00;05;05;18 - 00;05;30;38
Unknown
But for them that get really concerned or fearful that they're going to lose their spot because those spots are hard to come by or those times that they really like, oh, they're concerned and regression. My conversation is so when we're going to do a therapeutic break, I'm going to discharge you, and I'm going to discharge as a therapeutic break so that when the time is up, if we set a time for three months or six months, you can let me know.

00;05;30;38 - 00;05;54;15
Unknown
Hey, we need to come back in. We we've mastered that goal pretty well, or we are starting to show new skills and we need to work on something else. Oh, if you see a regression and I say this very openly, if you see a regression before the three months is up or before the six months is up, you go ahead and let me know and we're going to get you.

00;05;54;20 - 00;06;21;46
Unknown
Go back to the doctor, get you a new order, and let's get you back into therapy. Yeah. Get in quickly. Get in quickly. And these kids are more of your narrow kids are your lifelong kids. So I also say, like some of these kids, especially your children who are really young, we're going to say, you know, you take this break and then if something happens and you regress, let me know and we can get you back in quickly so that you're not waiting on a wait list for a year.

00;06;21;46 - 00;06;48;47
Unknown
So, parents, you can be proactive. You can talk to your therapists before a break and kind of get that agreement and do that. So when parents are at home, you know, that's another thing that I think is a misunderstanding is parents. We therapists expect you to be part of the therapeutic process. You know, that we want you engage.

00;06;48;47 - 00;07;18;59
Unknown
We want you learning. We want you focused at home and building things into routines that help your child meet, meet their goals. So it's really an opportunity for you to shine on that therapeutic break, because you are as much a therapist as your therapists are, really. I mean, there are lots of sessions. If I don't have extra hands, the parent is the one helping because they know how to move their child.

00;07;18;59 - 00;07;40;10
Unknown
They know how to work with their child. Also the episodic care. It helps parents build confidence because they're in that session with you. They're helping you. They're learning how to facilitate that movement. They're learning how to put the child in that position. So then when they go home, they should feel more confident in being able to do those positions without a therapist there.

00;07;40;12 - 00;08;07;17
Unknown
Yeah. Also, let's let these families be a part of their communities, right? So that they're not in therapy or they can't say, oh, I can't do that today because we have therapy appointments. Right? Just to have a season where you're not running to therapy. Okay. Have a random question for you. What's something really funny a kid did in one of your sessions lately?

00;08;07;31 - 00;08;37;03
Unknown
And they're all real funny. But I have one little boy who is down syndrome. And of course, everybody in the clinic thinks he's adorable because he is adorable, but he also wants to try to get by with not having to do what miss Heather wants him to do. So he the other day decided he was going to go try to do a little somersault on the crashed pet because he had everybody's attention and he wanted everybody to see that he could do this.

00;08;37;17 - 00;08;59;59
Unknown
And I'm like, what are you doing? Which were also nonverbal. So we have some sounds. And we just looked at me and went, Like he just like acted like he didn't know what you were talking. No clue what I was talking about. And then I give him the little stink eye that I give him, and he just smiles.

00;09;00;08 - 00;09;25;38
Unknown
So those darn kids, they do the funniest things, don't. They're real. Says. Yeah, they are. And I'm sure you miss them terribly when they're on their therapeutic break. But you know, that break is so good for them because there is there's a bond. Your close knit relationship with them and the parents, parents, we know you bond with your therapists and they're sort of you're going to miss them when you go on break.

00;09;25;38 - 00;09;47;58
Unknown
But you also need time for friendships too. Sometimes you just need to have nothing to do or time to go to the park, or time to read a book, or time to just be. And we understand that as therapists, I also understand there are. And so therapeutic breaks and episodic care is different. It's not going to be the same for every child.

00;09;48;03 - 00;10;10;52
Unknown
I do have one child that I know that we took a break for a couple of months because she went to Michigan to visit family, and she came back and had a regression, and mom had a really hard time with that. And I'm like, it's okay. Like, yeah, we've had a little setback, but it's not the end of the world.

00;10;10;52 - 00;10;35;33
Unknown
We'll just work harder and we'll hit it again. So I have found with that child that maybe I can't do a full three month break, but I can do like a three week break a few times throughout the year. So just recently she goes to school year round and school is out for three weeks. And I was like, okay, it's a perfect time for you to take a three week break, go to the zoo, go to the water park.

00;10;35;36 - 00;10;59;51
Unknown
Yeah, go be a kid and enjoy. Do some of those fun things. Go on vacation, parents, we want you to go on vacation. Like. And you should be able to do that for sure. What's the research on therapeutic breaks? What does that look like? So there's research being done. There's lots of therapists out there that are talking more and more about it.

00;10;59;56 - 00;11;32;10
Unknown
There are studies that are coming out showing that progress is about the same. If you're coming once a week for a year, or if you're coming two times a week for 3 to 6 months. Also, there is a lot of therapists out there talking about how we need to be able to provide services to more people, and the only way to be able to do that is be able to take breaks with this group of kids, and another group of kids come in.

00;11;32;15 - 00;11;53;57
Unknown
Yeah, or I even will sometimes do for some of my kids, I will do. What we have is the flex schedule at Marshall. So like we've met this goal and mom's concerned we're going to regress. So I'm going to I'm going to compromise with you. I'm going to give you two months on my flex schedule. And I just check in with you once a month.

00;11;54;01 - 00;12;19;35
Unknown
If we've maintained that progress, then we're going to take a break, because you've already shown that you can maintain the progress without me for two months. I update your HP each month. You go work on it. You all are parents. I say all the time. Most parents that have children with any kind of diagnosis, that is a medical complex, you can pretty much be a nurse.

00;12;19;35 - 00;12;41;05
Unknown
You could be an OT, you could be a PT. Yeah, you're doing it all. You're doing it all. You are getting all of these, this information and you're having to carry it over at home. Yeah. So have confidence in yourself that you know what you're doing because you do. Yeah. It's it's true. You parents you do it all and it can lead to burnout.

00;12;41;05 - 00;13;06;05
Unknown
So if we talk about caregiver burnout and, you know, being in multiple therapies, not utilizing, you know, some kids are on waiver and they have access to respite care and some of those type of things. And being on therapeutic breaks maybe allows you to do some of that, is access some of your respite hours and get some respite care.

00;13;06;05 - 00;13;34;42
Unknown
So maybe you just need a great date with your spouse, or you need to get away overnight or something just, you know, right. Right there. The burnout is real. And, you know, hopefully you found some other parents. I know a lot of parents are finding groups and groups and communities to be in on social media, especially Facebook mom type groups for your type of child's disability.

00;13;34;42 - 00;13;56;41
Unknown
That's a great way to connect to other moms. But I do know some moms over the years that would trade, that had special needs kids and had a relationship and would trade. You know, I'll we'll keep your kid for a weekend, you keep hours and that kind of thing. But now with the respite care, I feel like that is an option for people to be able to.

00;13;56;45 - 00;14;23;45
Unknown
And I feel it's an option that caregivers don't utilize enough because I think for one, they're nervous. Yeah, to leaving their child with somebody. But just think about it. Most of the time you get to choose that respite person. That's right. So you're going to know who you're going to trust your child with. Caregiver burnout is just as real as the child having burnout from coming to therapy.

00;14;23;48 - 00;14;41;37
Unknown
Yeah, because you're having to bring them. You're having to sit through the whole session. You're usually a part of the session. And I will sometimes even say to my parent when they come in, and you can just see it on their face that they are exhausted. Yeah, go take the hour and go take a nap in the car.

00;14;41;42 - 00;15;05;56
Unknown
Yeah. I will call you if I need you. Yeah, I will have someone come and get you. But for this hour, go give yourself a break. So, parents, we do understand. You are tired, worn out, and you need a break. Sometimes, like we, we get that we're not in your shoes. You know, I can't say I. I'm in your shoes.

00;15;05;56 - 00;15;30;48
Unknown
I'm not. But we want you to feel heard and understood. And I think your relationship with your therapy team is so important. And for you to speak up and be assertive and say, yep, it's time for us to take a break. If they're not offering it you, you proactively ask for it and plan for it. I think that's a good way to do it.

00;15;30;53 - 00;16;03;23
Unknown
Is there anything you recommend, like some topics you recommend talking about before a family takes a therapeutic break? Like I talk to them about activities. So their biggest concern is the child not being involved in therapy or not getting the movement that they may be get with therapy. So we'll talk about activities that maybe the child would benefit from, whether it be Miracle League playing in the Miracle League, whether it be swimming, whether it be hippo therapy or adaptive horseriding, so that they can become a part of that.

00;16;03;23 - 00;16;27;46
Unknown
There's a lot of that in Kentucky. I don't know if you moms have it in your area, but there is a lot of adaptive riding here, and I feel like that helps, because if we can find a way for you to for that child to be getting an activity and you feel like they're still getting some of the benefit of therapy, it gives them a little bit more of a mindset of, okay, we can do this.

00;16;27;48 - 00;16;54;49
Unknown
This is not going to limit the progress my child is going to make. We have a plan. We also go through a home exercise program. So I will give you exercises that I want you to work on. And we will go over those exercises together for a few weeks before I say, okay, now you're on your own. I will also ask the parent or the caregiver, is there anything you're uncertain about?

00;16;54;51 - 00;17;14;30
Unknown
Is there a position that I'm asking you to do that you don't know if you can do it, or that you're afraid of doing it wrong? Because we can do it together. Because if I can have you do the position or do the exercises, me being there, I can walk you through it, correct your handling or your hand positioning.

00;17;14;35 - 00;17;39;36
Unknown
Yeah. And then I can make you feel more confident in yourself. Yeah. That's good. So good. So, you know, progress. I think the most important thing for parents to hear is progress doesn't just happen because of your therapy team. And you moms, you really know this in your gut. It happens because you're you're facilitating the progress. It's happening everyday routines at the dinner table.

00;17;39;36 - 00;18;09;07
Unknown
It's happening, you know, as you change a diaper, as you dress or do outside activities or go about your daily routines, even driving in the car can happen there too. So we hope you feel heard and seen. Moms like you need to know that it's okay thing. It's a good thing for your child to have a therapeutic break.

00;18;09;09 - 00;18;36;20
Unknown
It's a good thing for you to take a break, to have a pause, to have a a rest. And if you haven't done that in a while, we highly recommend we think you ought to make that happen with your with your therapy team. So you're doing something so hard. And we're so glad you stopped to listen to this episode that you know, you're learning and listening.

00;18;36;25 - 00;18;56;02
Unknown
What's the right next step? And this may be the right next step for you and for your child. So if this episode has helped you think about taking a break and maybe you've not done that before, share it. Share it with someone, we'd love for you to subscribe. We love for you to come back and hear more episodes.

00;18;56;04 - 00;19;18;36
Unknown
Go back and listen to some past ones. It's shocking that we've been at this almost a year, I think now, not quite. Almost. And yeah, we just love giving education and tools to you moms who need it. So thanks for being here and we'll see you next week. Thank you.