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111 MAY 2008 / CONTENTS/ BACK
ListenListen to this

practice

The way Robert sees it

Mark D. Freado and A. Katherine Wille

Many troubled youth distort the motives of helping adults and assume hostility where none exists. This world view makes sense to them based on prior experiences. The Reality Rub interview gently challenges this self-defeating pattern of thinking.

Robert, a 15-year-old resident in a residential treatment program, is diagnosed with significant hearing impairment, but no one in he building had any trouble hearing him. When we entered his cottage, Robert was walking around in a very agitated manner, cursing and yelling racial epithets at one of the staff on duty. Katie, a youth worker, was participating in Life Space Crisis Intervention training at the time and asked Mark Freado, the trainer, to make time to meet with this student. Robert is a very complex young man who communicates primarily through American Sign Language, although he speaks relatively well and has some hearing ability. He is very emotional and has been verbally and physically aggressive. He is also playful, charming, and intelligent.

As we entered the cottage, apparently no one was engaged with Robert while he was acting out as described above. There were four staff present as well as six of the ten other youth who reside in that cottage. Katie approached him and calmly said, “Robert, this is the man I wanted you to meet. He can talk with you now. Do you think you can calm down enough to do that now?” Robert responded that he “didn’t care.” Katie heard that as “yes” and suggested we go to the living room area of the cottage where we could talk privately. Without more dialogue than that, we proceeded to the living room, although along the way Robert uprooted a small plant sitting on a kitchen counter.

Stage 1: De-escalation
Katie and Robert have a safe relationship, especially from Robert’s perspective, and in her presence, he was able to calm down relatively quickly with only a few more minutes of prompts and the allowance of some time and space. He was also willing to meet and talk with a complete stranger right after a crisis for no other reason than she asked him. We refer to that as transfer of trust.

As we entered the room, Katie suggested that we settle in a near corner of the room. Freado stayed back to allow Robert more time to settle and for Katie to structure the communication we were about to attempt. How the communication is set up is important in many situations but especially so when there are more than one adult involved with one young person. In this case, it was even more significant since one of the adults was, until our brief introduction, a stranger and the young person was in crisis moments before. Robert settled into a large cushioned chair in the corner with Katie sitting on a coffee table in front of him to facilitate the interpreting that would be necessary for our intervention to progress. Freado sat to Robert’s left on the end of the fireplace hearth. This allowed Robert to have direct eye-contact with Katie and an area to his right so he could look away from either adult and even get up and walk out if he felt too threatened or uncomfortable.

As they began, Freado thanked Robert for his willingness to talk, especially since apparently something just happened that was very upsetting. Freado asked, “Is it all right if we talk about what just happened since it seems really important? Then maybe later we can just talk about other things.” Robert indicated that it was all right. As he seemed more relaxed, Katie explained that we were going to be talking in a way that staff were being taught during the week and that she would watch and help while Robert and Freado talked. Robert agreed and we began.

Freado: “Robert, thanks again for being willing to talk with me, especially since you were so upset and we never met before. You must really trust Katie to agree to do this.”

Stage 2: Timeline
Robert nodded and Stage 2, the Timeline, had begun. When beginning the Timeline Stage of the LSCI process, it is helpful to begin with the most immediate or observable aspect of the problem and then start to work backward. Using the Conflict Cycle as a map, we discuss what is happening in the present and then ask questions about feelings, thoughts, and preceding events until the life-span of the crisis is understood. That helps us understand what is most significant to the young person in this crisis experience and helps us accurately diagnose and find the most appropriate approach for teaching and support.

Freado: “When we came in you were really angry. We could see your anger in the way you looked and the things you were saying.”
Robert: “I hate David! I wish he would leave.”
Freado: “Was it David you had the problem with?”
Robert: “He said Richard was right and I know I didn’t do anything wrong.”
Freado: “So it sounds like you were having a problem with someone else and were upset before your problem with David. Is Richard a staff or a resident?”
Robert: “He’s a resident that I always have problems with. He’s a pest.”
Freado: “What was he doing to be a pest today?”
Robert: “I was trying to get along with him and he kept bothering me, saying stupid stuff, and getting in my way. I asked him to stop and tried to ignore him but he kept doing it.”
Katie: “we've been asking you to be more patient so it’s good that you tried like that. It takes a lot of practice and sometimes it’s hard.”
Robert: “I told David to make him stop and Richard said, “You don’t matter”. Then David said Richard was right.”
Freado: “He actually said Richard was right that you don’t matter?”
Robert: “Richard said, “What you say doesn’t matter” and then David agreed. Then I said, 'F--- you!” and just walked away. I hate him!”
Freado: “When he said that, were you pretty sure he was agreeing with Richard?”
Robert nodded yes.
Freado: “Do you usually get along with David?”
Robert shrugged his shoulders and looked away.
Freado: “Do you like to do things with David?”
Robert: “Today I asked him to play a game and he said he would in a little while. Then I asked him again and he said he didn’t want to.”
Katie: “Was he busy and other staff weren’t around because of the training?”
Robert: “No, he was just sitting there talking and laughing with the other staff working.”
Freado: “You think he could have done something with you and just didn’t and that hurt your feelings.”

Robert nodded affirmatively then started to talk about his family. He said he was angry with his mother for sending him here.

Robert came to this residential facility from a previous placement where he had been unsuccessful in the environment specific to his program. Robert displays low self-esteem and this skill deficiency has been traced back in his brief history to the incident of his father walking out on his family. When Robert looks back to the last time he can remember being the happiest, his memories are of a time when his father was still part of his family’s life. Robert’s mother has been caring for him and has been the sole parent of Robert for close to three years now. During a crucial developmental time in his life, Robert’s father walked out and left no means of contacting him. This event has been one of the most significant negative experiences influencing the way Robert’s behavior evolved. During talks with Robert, he often mentions the anger he has for his mother for “making” his father leave. During further discussion, he seems to have some insight that his father’s leaving is not his mother’s fault, but the pain surrounding this event is so great that his blame appears to be a defense mechanism. Robert equates his failure at his first placement, which was very close to home, as the reason his mother sent him further away from his home. Robert’s frequent distortions of reality make it difficult for him to take ownership and allow staff members to help him work through very challenging issues.

Robert’s time at this facility has been somewhat brief, but during this transition into a new placement, Robert has quickly formed a bond with David, the staff member specific to this new crisis. David's role in Robert’s life has become a stabilizing male role that he so desperately needs.

Freado: “It’s hard to carry those feelings around all the time. When things happen here, those feelings get stirred up pretty quickly, don’t they?”
Again, Robert nodded and then said, “David doesn’t like me so I hate him and wish he’d leave.” Freado: “You seem pretty sure he was agreeing with Richard that what you say doesn’t matter. Is it possible that his words didn’t mean what you thought?”
Robert: “No, that’s what he meant.”
Katie: “Did you ask him what he meant or just think that and get angry?”
Robert: “I didn’t have to ask him because I knew what he meant.”
Freado: “You really sound so sure of that. Do people ever get confused and think you meant something different than you really did?”
Robert: “I guess.”
Freado: “All I’m wondering now is if it’s possible that that’s what happened here with you and David. I don’t know him, so I don’t know if that’s something he usually does. You were asking him to do something with you earlier, so it seems like you and he might get along.”
Robert: “He didn’t do anything with me today, so I know that’s what he meant. He doesn’t like me.”

Stage 3: The central issue and diagnosis
In this particular crisis, Robert seemed to be really fixed on David's taking sides with the other student against him. He is also very sensitive to what he perceives as slights or criticisms that are unfair. Because of his strongly held, one-dimensional focus on David's being responsible for the problem, we determined that this was a Reality Rub crisis.

Sometimes there could be more than one diagnostic possibility, and the interviewer has to make a judgment about what there seems to be more of or what diagnostic cues come from finding the Central Issue. There were elements of Massaging Numb Values in Robert’s presentation, especially when he talked about his family and how hurt he was at his father’s leaving and his mother’s sending him away. It affected his self-esteem and there were elements of his sabotaging his own progress in the program. In this case, however, because of the presence of the high amount of anger and intense emotion at the beginning of the interview and his tunnel vision on David's role, we concluded that Reality Rub would be the best approach in this situation.

(Comment: We later agreed that David did have some responsibility for how this escalated, because he apparently did not make an effort to clarify his intentions in his comments when it was obvious Robert was very upset by what he thought about it. Instead, he stood by silently as Robert began to walk around agitated, tossing books and cursing. That issue would be addressed later in a supervision conversation with the staff member.)

Stage 4: The insight stage
This part of the intervention serves to help young people accept some responsibility for how things turn out. We want to help them also know that they can develop some control and power to make things turn out differently as these crisis situations happen again.

Freado: “Robert, I keep wondering what might have happened if you had asked David if he meant what you thought. If he didn’t mean that and had a chance to explain, it is possible that you wouldn’t have had all those hard, angry feelings and there wouldn’t be such a mess in the cottage. Could it be possible?”
Robert: “Maybe, but I don’t think so.”
Freado: “Well, thank you for at least saying it could be possible.”

In Reality Rub interviews, it is not uncommon for the interviewer to keep attempting to get the young person to see the light and agree that things really were different than what they believed. The result of that approach is that the young person can re-escalate as their beliefs are being attacked and a power struggle may ensue. It is not uncommon at all that people react strongly when their perceptions or beliefs are questioned. This interview requires the interviewer to be very patient, not only in the individual interviews but also as the process evolves over numerous similar crises and interviews. Over time, as more practice happens and trust is built, the interviewer helps the student recognize the repetitive patterns and begins making progress on teaching broadened perspective and thinking more systematically and logically.

Freado: “Can you think of ways this might have turned out differently if you asked David to explain what he meant?”
Robert did not respond initially, and we remained silent. After a few minutes Robert looked up and laughed. “What?” he said.
Katie repeated the question and said, “I know you can answer this because we talk about things like this sometimes.”
Robert smiled and said, “I don’t know.”
Freado: “It’s all right if we just leave it with the possibility that things could be different, because it’s hard sometimes to deal with things that are so different than what we think. Let’s talk for a little bit about how you could have asked David the question.”

Stage 5: The new skills stage
In this stage we focus on finding and supporting existing skills or identifying strength gaps and working to fill them with substance. Katie expressed her belief in Robert that he had the skills to do this differently and asked him to try.

Robert: “I could have said, “What do you mean? Are you agreeing with Richard?”–
Katie: “That’s really good. I knew you could do it.”
Freado: “It did seem pretty easy for you here, but it’s hard when you have angry feelings blasting around in you. That’s something you'll have to practice and get some reminders about. Are there people here you trust enough to practice with?”
Robert: “Katie, Andy (another staff member), and you.”

Robert indicated trust and willingness to practice with two staff members he had worked with for months and a consultant he just met 20 minutes before. It is not as unusual as it seems. We know that with many of the young people with whom we work, the basis of planting seeds of trust is well within our grasp. When asked how someone he just met can be someone he thought he could trust he said, “You listen to me.”

What Robert and hundreds of kids like him say to us is that we can become trustworthy in their eyes by using the simple and powerful skills of listening effectively, one of the essential skills of Life Space Crisis Intervention. It takes time and tests for us to really become trusted others in the lives of our students but the process can begin from the first interaction.

Freado: “I’m going to be here tomorrow, too, and I’d like to come back and talk with you again if that’s all right with you.”
Robert: “OK, what time?”
Freado: “After the training is done in the afternoon. We can talk about other things then and I’d like to talk just a little bit more about this, too, so I want to give you some homework.”
Robert: “No, no homework!” he said with a big smile.
Freado: “It’s not going to be too hard for you. I just want you to think about how you can approach David to try to get past this problem. We can talk a little bit about it and maybe practice a little bit.”

Stage 6: Transfer of training (or transfer of learning)
Robert agreed to do that. Katie asked if Robert wanted her to talk with David, and Robert indicated that it would be all right without that. She asked if he would go out and clean up some of the mess he had made, and Robert said he would. As we ended our conversation, Robert said, “Thank you for talking to me.” After gaining so much insight from Robert, it immediately became apparent to Katie that, despite David's obvious involvement in failing to see how his negative agreement with another resident would affect Robert’s self-esteem, Robert was also painfully aware that in the next few weeks, David would be moving and resigning from his position. Again, Robert would have to lose another male influence in his delicate existence.

In order to make a smooth transition from this intervention and help a young person re-integrate with the group, some bridging action must be taken. We were comfortable that Robert was very calm and thinking proactively when we finished. It is important to have as much support ready as possible in the staff and the group that will be present when the student returns. In this case, Katie did talk briefly to David about what happened. She also talked with Andy, who was also there for some time that evening and was also involved in the Life Space Crisis Intervention training.

Follow-up
The next day, we talked with Robert again. He indicated that he did make an attempt to talk with David, but it did not work very well. He said, “It’s all right, though, because I’m okay.” Katie continues to work with Robert, using the LSCI skills she recently acquired.

Staff conclusions: Perceptions from a new trainee (Katie)
Going through such an extensive training and finding so much prolific information about how to deal with crises that occur in young people’s lives, it has become painfully apparent that without complete trust and without all the members of a team on board, it is difficult to achieve a higher level of awareness and understanding. David and Katie spoke about this crisis that Robert has been going through in great extent. David's perception of how to handle this crisis was greatly skewed in the opposite direction of what Katie has just learned from the week-long training with Mark Freado. David felt that because Robert’s behavior had been unacceptable and, in his eyes, unwarranted, he decided that his comment was suitable and did not require an apology. David took ownership of his comment and, when Robert wanted to try to resolve the issue with him, David refused and Robert began to escalate again, further feeling rejected and discarded. The invaluable experience that Katie received opened her eyes to see that Robert’s ability, willingness, and need to talk with David after the crisis showed more courage than it did manipulation. David felt that because Robert’s behavior had been so trying on his patience, that Robert did not deserve to resolve when he wanted, but instead that he needed to wait until David was ready.

This feature: Freado, Mark D. and Wille, A. Katherine. The way Robert sees it. Reclaiming Children and Youth, 16, 3. pp. 36-40.

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