As therapists, we spend considerable time thinking about intervention strategies.

But perhaps we need to spend just as much time thinking about when we use them.

A child may know a breathing strategy, understand an emotional regulation tool or be capable of problem-solving when settled. Yet during a period of increasing dysregulation, those same skills may suddenly appear inaccessible.

It can be tempting to conclude that the strategy hasn't worked. But what if the strategy isn't the problem? What if the child's capacity to access it has changed?

Regulation is not static. A child's ability to process language, tolerate demands, think flexibly, communicate and problem-solve can fluctuate considerably across environments, and even within the same therapy session.

This means intervention cannot simply be about selecting the right strategy. We also need to consider the child's current regulation capacity. There may be moments when our role is to teach. There may be moments when we need to scaffold. And there may be moments when the most clinically appropriate intervention is simply to stabilise, reduce demands and provide co-regulation.

The same child may need all three within a relatively short period of time.

Perhaps this is where some interventions appear to "stop working". We continue delivering a strategy that requires a level of capacity the child no longer has access to in that moment.

Good clinical reasoning therefore asks more than:

"What strategy does this child need?"

It also asks:

"Is this the right time for this strategy?"

Because the right strategy at the wrong time can look remarkably like the wrong strategy.

Timing is therapy!

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