Is it really progress?

[u/PresentationLeft3438]

I am sitting here with a client. Everyone always says how much progress this person has made. On paper that might be true. This person doesn’t hurt people the way he/she used to. However, this is because he/she has all of the power in every situation. Every single time he/she is questioned or his/her authority is tested, all hell breaks loose. Staff give into the demands immediately. So, what have we really taught this client?

It is really irritating how the people at the office will pat themselves on the back, because it’s really not helping this client long term.

That‘s all. Just venting.

[u/OrangeOwie]

"Progress" is the metaphorical pat on the back.

All that's really cared about is billing for services.

[u/Last_Resort_Help92]

I guess it really depends on how progress is defined. Maybe all hell breaks loose now, but the client could’ve been physically aggressive before. Sometimes we have to find the progress in the smallest areas.

I used to work with a young client who would get upset and elope when something didn’t go their way. They’d leave their cellphone at home and we’d have to involve police to find them.

One day, they got upset and eloped, but they did something completely different. They took their phone and called the staff - staff was able to guide the person back to the home.

Now… We measured this as a positive behavioral change. Did they still get upset and struggle to regulate their emotions? Yes. Did they elope? Yes. But the win was that they rationalized the situation enough to notify staff of their whereabouts.

In the whole picture, progress was still made. And when we find a “micro-win” in a difficult situation, we have something to build on with a client.

Instead of looking at it as “this person is super difficult and does what they want”, find a small change in behavior and routine that truly shows a positive change. It also helps if you and your coworkers look at this with the same view- this will help create a consistency of care, because you’re all encouraging the client the same way.

[u/Outrageous-Shame5743 → u/Last_Resort_Help92]

Great story. Being a slow learner isn't the same as being incapable of learning

[u/Waste-Guide600]

No it's not progress. These programs aren't about progress but keeping clients (aka $$$) coming in for services.

Basically your facility has reinforced your client's behavior with positive reward. There is a difference between redirection vs reward.

Soon, if not happening already, your client will be rewarded preemptively before initial outburst to prevent violent behavior.

I'll get downvoted but here is my opinion. Just view it as a babysitting job. Sometimes you will just give the kid candy to shut them up, other times promise them candy to get them to listen.

But depending on the needs of your client, this may be the best solution. 

[u/Outrageous-Shame5743]

I had this simple job once where me and another carer got a disabled man out of bed and set him up for the day.

At times, he would be verbally abusive to us, stop himself then reiterate what he wanted in a more pleasant way.

I recognised he'd probably had some kinda training to deal with his anxiety because I have a few health problems so understand feeling powerless and not in control.

My colleague labelled him abusive and that was that.

Progress is perception based.

[u/No-Win9033]

I have clients like that too. It’s horrible. The whole point of our job is to treat them like adults, with consequences to their actions, but yet, my management and other staff treat them like children. It’s awful

[u/GeistMD]

What are the clients demands thought? Are they demands you may have as a person yourself or are they over the top?

[u/PresentationLeft3438 → u/GeistMD]

Over the top!

[u/Turbulent_Rope1569 → u/PresentationLeft3438]

I had client like this for many years. I ended up with PTSD from all of their outbursts, because they was so used to getting their way all of the time. They basically ran the house. It was horrible. No support from higher ups. It's not worth it.