Treatment (cont.)

In working with a teenage girl diagnosed with TS, OCD, ADHD and gosh knows what else, we usually ventured out into public. This young lady was so "on top of things" that even during neighborhood walks she would warn me about uneven pavements, as if I'd never seen a sidewalk, let alone had ever walked on one. During regular "talk therapy time," we discussed this "attitude" of her's. As a result of these chats, she said, "I'm too bossy," a wonderful insight that clearly indicated a need for some work. Doing it with me, though, was one thing. Seeing how it might manifest in public was another. 
On one of our sojourns we went to play miniature golf. It was an outing that had been planned (another whole series of interventions) and we waited for a nice day. Such activities afforded her the opportunity to be playful and more light-hearted, a distinct contrast to her usual worrisome, irritated demeanor. While enjoying the nice day and the activity, it didn't take long for her "bossiness" to rear its head. Long about the fifth hole, amidst having a rather delightful time, she began interacting with others in the vicinity. As I'm quite personable, I knew she was modeling me here as she had done on other occasions. Rather than merely make idle friendly chatter, however, she began telling them how to play the game, how the hole was laid out (we were ahead of them) and how best to hit the ball. It was obvious to me that the others were annoyed by this intrusion. As I endeavor not to embarrass anyone, I needed to wait for an appropriate opportunity to discuss this with her.  
I pointed out to her that she had plenty to do to play her own game which was a lead-in to bringing her attention to her interactions with the other players on the course. Over the next ensuing holes we continued to discuss her desire to talk and to be friendly with people vis a vis her urge to be bossy. The intent was to help her become aware, through a real-life interaction, that what she needed to do for herself and what she imagined others needing from her, were not the same. In miniature golf, being more concerned about how someone else is playing and being more focused on correcting their play will definitely decrease one's enjoyment in playing their own game with their own companions. With her, these situations occurred regularly and afforded numerous intervention opportunities, all geared toward helping her confront her OCD and to find ways to lessen its impact on her life. I refer to these situations as practice times. Direct intervention during the actual episode carried a lot more weight than having an office discussion about it, if in fact it would have even come up  
As should be obvious, I'm an active participant in the process. I believe strongly that such an approach is required to treat this population with these disorders. I work to get them in shape (trainer) by demanding that they practice more and try harder. I urge and encourage them (cheerleader) to improve and applaud them when they do (and yes, lots of pats on the back and hugs too). I go to bat (advocate) for them with others such as parents and teachers. I listen to their life story (therapist), help them feel better (healer) about themselves and I correct them (disciplinarian) in an appropriate, non-embarrassing fashion. I do this by developing a real, trusting relationship with them, by believing they want to get better, by hanging out with them when many others won't and by showing them (role-model) that their life can not only be different, it can be better. This is done in real-time with real-life situations, not in an artificial, sterile setting.  
There's an additional role I play, often with parents and teachers and other support personnel, that of educator. In this role I explain the various disorders, suggest books and articles to read or direct them to additional internet resources. Adequate and appropriate information goes a long way in helping parents and others put the child's situation in perspective and help allay fears and misgivings they may have about these conditions.  
The above illustration is but one example of therapeutically coaching someone about improving their own disorder's impact on their life. To me, those with neuro-biological disorders need to be in training. The training requires a lot of time, commitment, and persistence over the long haul. As such, it requires resources in time and money. Some invest in health club memberships, go to the club on a regular basis and reap the benefits of that consistent discipline over time. Some do not. The old adage of you get out of it what you put into it is never so true with regard to physical and mental health.

Treatment - Page 3 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.