A Retrospective Analysis of Therapists’ Coaching Behavior When Directing Parents to Conduct Behavioral Assessments and Treatments Via Telehealth

Larsen et al. (2023) watched recorded telehealth sessions. They wanted to see how therapists actually coach parents during FA and FCT.

The team coded every 30-second chunk of video. They noted when the therapist praised, gave instructions, or corrected the parent.

Therapists talked most to keep parents engaged. Praise and friendly chat showed up far more than any other code.

When sessions moved from FA to FCT, coaches changed their style. They cut back on setting up test conditions and spent more time teaching the new communication response.

Lindgren et al. (2020) ran an RCT of the same telehealth FCT package. Kids in that study had a 98% drop in problem behavior. Larsen's group did not track child gains, so the papers do not clash; they simply look at different sides of the same treatment.

Spackman et al. (2025) replicated the full model and found 80% behavior reduction in 17 families. Their data confirm the package works, while Larsen shows what the coach actually does minute-by-minute.

Davis et al. (2023) also coached parents through FA and FCT on Zoom. They focused on whether moms could run trial-based FAs correctly. Larsen zooms in on the therapist's real-time moves, adding the 'how-to-coach' layer.

If you run telehealth FA/FCT, mirror the winning pattern: keep parents feeling supported first, then shift from testing to teaching. Use lots of social praise and brief check-ins. When you switch to FCT, spend less time on antecedent set-ups and more on consequence timing for the new mand. This simple style map can save you from over-explaining and keep families engaged across sessions.