THERAPISTS NEED TO BE MODELS OF APPROPRIATE BEHAVIOR

I was reading an article on this website. I was a little concerned about the following statement:

"Set firm boundaries. “I will not tolerate being spoken to that way.” “I treat you respectfully, and I expect the same in return.” Statements such as these teach others how to treat therapy professionals and set precedence for future behavior."

I would never say that to a student, client, patient. I would say something like this: "I know that you are not happy right now. Let's try again." I would definitely document any distress that the client may be expressing and if the inappropriate language continued, I would ask a colleague to listen in. If it continued, I would say, "I don't think that this is working for either of us. Let's try another therapist." You are still sending a very clear message but not treating the client as a child. Heck, I would not say that to one of my students either. If you are in a school setting, and the student continued to act inappropriately, get an administrator or teacher in that room. That is why God made telephones and cell phones. A parent will need to be notified and may provide some insight as to why the student my be reacting in that way. If the student continues to act inappropriately in subsequent sessions, call for a meeting. Chances are the student is acting this way with others and a clear plan may need to be put in place.

If this were a client who was touching inappropriately, I would then gently brush his or her hand away with my open hand, document the incident and say something like, "I like you, too, but I am spoken for." Almost always, a client's touch is a sign of affection and not aggression.

If the touch was aggressive, I would make sure that the client was in a safe position and location and step away. I would clearly indicate to the client that this has to stop. I would say, "I think that you need a break, I will be stepping away for a few minutes." I would alert a colleague and have a colleague or care giver observe [if in home care]. I would definitely document the incident.

I think that we need to be respectful and careful in what we say to the client. Why would we be seeing this client if there were not a reason. Reasons for inappropriate language or aggressive behavior may include:

1. frustration at not being able to function normally
2. pain
3. cognitive impairment
4. emotional disorder

I would not ever reprimand a client in such a way. We are therapists and need to help our clients move forward---not backward. We need to be models of appropriate behavior and not part of the problem.

In many situations, I would never be alone with a client, particularly a younger client. I would always have an open door or have some visibility from the next room. In a school setting, the door should never be fully closed. If it is closed, there should be a glass panel in the door so that you are visible.

So, protect yourself. Offer the client a chance to regain composure and try again. If the client is not monitoring his or her own behavior, it may be time to step away.

We have to offer the client an opportunity to make a CHOICE. We can even say to the client, "You have a choice. If you need a break, I can step away." If the behavior continues again, look for the reasons. Get someone else involved in the session. A change in therapist might be what is needed. I don't always get along with everyone I meet. Do you?


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