Real-Life Decision Making -- Solution
You stop seeing Sue as a client.
"Well, Sue. It sounds like you made your decision. If you'd rather
go back on the streets, that's your choice. I can't help you anymore."
You really feel like dropping Sue off your caseload was the best thing.
After all, her moods are angry and sullen, she is fighting again and she craves
her old life. In short, you felt like everything you worked for is lost. You
don't ask what Sue thinks -- after all, isn't it obvious?
But wait -- what about how Sue felt? As her behavioral analyst, Sue relied
on you for support and guidance. Yes, she did experience a setback. However,
what you didn't know (because you didn't ask) is Sue's reward
system was working against Sue -- not for her.
Every time Sue received a special privilege, the other kids gave her a
hard time. Soon, she felt like an outcast, with everyone calling her "Queenie"
and "Princess." Sue wanted to fit in -- and she felt she would never fit in
with her residential group when she kept getting special things. That's
the reason she was fighting again -- not because she didn't want to change.
After stopping therapy with Sue, she eventually dropped out of the program.
One day, you hear from another client that Sue is back on the streets -- tired,
strung out and miserable. You wonder if asking Sue why she was acting out
rather than dropping her from treatment would have made a difference.
"The less correct way [to handle treatment stalls] is to assume that your
client has not made any real progress. Progress may be that the youth is no
longer swearing and trying to smoke in your office! Progress is often very
subtle," says Tannis Antonio, behavioral analyst.