Treatment (cont.)

 
I'm reminded of my work with OCD kids and how "stuck" they get, how they freeze and have no ability to get out of their tightly shut box and how therapists are constantly trying to change their behaviors through all sorts of behavioral techniques that have little if any long- lasting effects. It seems to me such therapists can't get through to these kids because they, themselves, are stuck. Isn't it time we changed our thinking or at least develop the ability to ask this basic question: "If behavior modification techniques aren't working with these kids, then why do we keep insisting on implementing them?" I think that hasn't happened because therapists can't ask that question. They can't and don't ask it because they are stuck. They need to let go of their notions of "I'll try it again because maybe this time the outcome will be different." Perhaps though, they just don't have a clue about how to do it differently; they have no options. In the meantime these kids and their parents have gone through numerous behavioral treatment plans, arguments about following or not following the treatment directives and utter frustration (and at times, despair) that the whole kit-n-kaboodle is a bust. BTC offers an alternative to this never-ending cycle of ineffective treatment.  
 
The BTC approach demands that the therapist not only work with the client, but also with the parents, teachers, treating physician or psychiatrist and various others associated with the case as a team coordinator. While possibly idealistic and not always feasible due to cost concerns or practical due to geographic or time constraints, the approach here outlined is, nonetheless, what is necessary to have the best chance of being successful. In dealing with the client and others associated with the case, the role of the therapist is actually that of a therapeutic manager and coach. It is the therapist who coordinates and directs interventions with the conscious intent of helping the client achieve stability and consistency with regard to their "condition," hallmarks of mental health treatment. 
 
The key coaching word is discipline. All of us institute some form of discipline in our lives to give it structure, purpose and meaning. It is the basis of our daily routines. For Moms, raising kids is their discipline for many years, often today not at the exclusion of their other numerous endeavors such as career or advocating strenuously for services for their kids. Dads, when the primary breadwinner, effect their disciplined routines by going to work and developing a career path. Kids go to school, college students go to class, some people pursue martial arts, some yoga, some work out at the Y, some read daily, etc. All of these routine activities afford the person doing them, discipline. Such discipline is crucial to those with neurological disorders. It is through a disciplined approach to dealing with their disorder(s) that they can effect stability and consistency in their lives. The BTC approach is the medium or tool that affords one the opportunity to generate appropriate and meaningful discipline, one that is specifically established and instituted to attend to neuro-biological disorders. 
 
We all have work to do on ourselves in order to improve, to advance, to lead a more enjoyable and fruitful life. Someone with diabetes needs to pay attention to that condition as it has clear health implications and risks if they do not. For instance, blood sugar levels need to be taken on a regular basis and diet and weight need to be regulated, activities that require discipline. In other words, consistent attention and appropriate action is necessary. The same concepts are true for those with mental disorders.  
 
Going to therapy itself, let's say once a week in an office or out-patient clinic setting, can be helpful. When working with children and adolescents with neuro-biological disorders, though, more is required. In my work, I spend at least a couple hours with someone. We go to McDonald's, pizza places (and other food joints), the mall and parks or play video games. We take walks, go bowling, miniature golfing and many other activities that allow for a more casual therapeutic environment. These outings or endeavors, and this is crucial, present the client with actual, real-life situations with which to interact. If, for example, one wants to help a kid with OCD, one needs to see how that kid experiences OCD in their life. "In vivo" situations allow the therapeutic coach to not only "see" what really happens, more importantly, it provides an opportunity for an actual, real-time intervention to occur.

Treatment - Page 2 of 4      [1] [2] [3] [4]

All material on this website ©2009 by Bridging the Chasm and Garry L. Earles, L.I.C.S.W.