TBL Newsletter – August 31, 2020


Researchers at the Yale Child Study Center have recently completed a pilot study to determine if their behavioral approach to treating children with anxiety is effective. It is entirely parent-mediated, and it’s showing promise.

The approach, called SPACE (Supportive Parenting for Anxious Childhood Emotions), seeks to help parents decrease their “accommodating behaviors” while helping the child work through anxiety more independently.

Accommodating behaviors are those behaviors that tend to reward or perpetuate a child’s anxiety.

Children with anxiety often exhibit such distress that the family begins to shelter them. This is necessary at times, but in some cases the protection provided may fuel the child’s anxiety.

The SPACE approach helps parents identify behaviors that may be intensifying or perpetuating their child’s inability to self-regulate. It also teaches parents how to help their child learn better coping skills.

SPACE is being positioned as an alternative to Cognitive Behavioral Therapy, CBT, and the results of the study show that it could be similarly effective. This is great news for children who refuse to participate in therapies like CBT.

What I like about the approach:

— it’s entirely parent-mediated, but it doesn’t require the parents to become amatuer therapists
— it focuses on changing the parents’ behavior first, which then changes the child’s behavior

— it helps the parents become more mindful of the ways in which they contribute to the child’s behavior

— it empowers the parent to be the leader

— it focuses on teaching the parents to understand their own self-regulation abilities

You can probably think of a few children from your past who could have benefited from this type of approach, at least in principle. It’s an interesting paper to consider.

I do have concerns about the implementation of the approach, especially with children who may have comorbidities or who have a large gap between their cognitive maturity and their social-emotional maturity.

Some of my highly sensitive patients with anxiety would likely become more anxious if their external supports were removed. Still, I’m all for any approach that focuses on improving parenting skills around self-regulation.

If you are interested, you can read the study here.


I didn’t expect to fall in love with a post on a random investment company’s blog, but here we are.

This recent article by Morgan Housel for the Collaborative Fund is a great reminder that the emotional intelligence skills that we develop over a lifetime expand our lives in unique ways.

Most careers allow you to develop specific technical skills that are necessary for the job. Some of those skills “expire” – they become less useful and sought after over time.

Permanent skills are useful forever, in every context.

There have been skills in my career that have expired and would not help me make a dime at this point. Making hand splints from scratch comes to mind.

But OT has taught me lots of permanent skills….skills that I found really useful when I took a brief break from the profession and became a software engineer.

I found that I had more empathy for my customers.  And I could break any problem down into much smaller pieces, which helped a lot with project planning.

The best permanent skill of all, though, was my ability to co-regulate the anxious people around me. Software engineering can be intensely stressful, and I found myself using my OT “super powers” on a daily basis.

This is a great article to read when you are having one of those days where you feel like your only role is to hand out pencil grips and wipe noses. It may help you think bigger about where your career/life is going.

One permanent skill listed in the article really resonated with me:

“Accepting a certain degree of hassle and nonsense when reality demands it.”

If that’s not emblematic of 2020, and pediatric therapy,  I don’t know what is.

Check it out.


Amy Lynn Andrews is a blogger who blogs about blogging. That may seem irrelevant, but she is very practical about business, and her advice is usually dead on.

This is an oldie but a goodie: “7 Questions I Ask as a Minimalist Business Owner.”

These are the questions I wish I would have asked before I started my first private practice.

After blundering my way through private practice for a few years, I ended up in a completely unsustainable situation. The reason was because I never had a real vision for my practice, or my life, to begin with.

Once I developed a vision of how I wanted to live my life, I was able to steer my practice into a direction that finally made sense.

Amy’s 7 questions are very similar to the questions I started asking myself when I developed my career vision.

Don’t be fooled by their simplicity. Each one is powerful. Especially if you take the time to jot down your answers and revisit them frequently.

Her number one question is my number one question: “How do you want to spend your days?”

Answer that question (which is not as easy as it seems), and the rest starts falling into place.

Read it here.


“Children who have developed a greater capacity to tolerate anxiety and frustration—children who believe that this work, however onerous, is temporary and therefore bearable and, especially, children who believe that their work will result in some success (and recognition of their success)—will more effectively cope with this (or any) difficult task.”

-Kenneth Barish, Ph.D., Pride And Joy


What have I learned about life and work in the last 5 years? Knowing what I know now, what would I have done differently 5 years ago? What 1 thing could I start changing for the better today?

Have a great week!

Ashley King, MSR, OTR/L

Founding Editor


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P.P.S. What’s Poppin’:  Mrs. Williams & Mrs. Evans, ASL style