Engagement/Barriers
What is Resistance?
The CSBBH hotline phone number is 814-245-0754. If the client or family cannot get through to the CSBBH hotline they should (name one): ______________.
-Call the local county crisis hotline (i.e., elk co is 1-800-652-0562)
-Call or text 988 (national suicide hotline)
-Go to the nearest emergency department or call 911
There are four common types of client resistance, name and define one.
1. Reluctance--points to hesitancy for full engagement in the therapeutic process
2. Opposition--a manifestation of a client's overt disagreement with the therapist or course of the therapeutic process
3. Sabotage--can be both conscious or unconscious; actions from a client that disrupt their own progress or progression of the therapeutic process
4. Transference--where a client projects their feelings from a past relationship or person on to the therapist
1. If you are uncertain about if something needs to be reported to ChildLine, you should ________________.
2. The ChildLine procedure for Dickinson Center, Inc. is to: __________________________________________________________________________________.
1. Contact a MT, and if there is not answer: Tonya or Amanda to ensure that agency and ethical procedures are being followed.
2. talk to your supervisor, make the childline report within 24 hours, document this on a CY-47 form, send the CY-47 form to your MT, Tonya, Jim Prosper, and Lynne Childs.
When a client is resistant, sometimes it can help to "FVI" to support the client and redirect the therapy session. The skill "FVI" refers to: _______________.
F- FORGET the therapy agenda (unless a safety concern)
V-Validate the client's OWN experience
I- Identify the client's intrinsic perspective or motivation for change (ex., what does the client want out of the therapy session, where you can support them, getting on the same page, etc.)
True or False (WITH an explanation): The CSBBH hotline is via phone and does not require a CSBBH staff member to go in person ever due to the CSBBH staffs' ability to always de-escalate via phone.
NOPITY NOPE NOPE!
While the CSBBH crisis hotline's role is predominantly and preferably via phone, each family has a different need. Sometimes a kiddo may need to have an in-person check or assistance in facilitating a warm handoff to the ED. While we do not want a family to abuse requesting in-person crisis responses, they are an option.
A kiddo presents in your office for your first session with their arms crossed, looks around, limited eye contact, and a sassy attitude. You ask the kiddo "what do you hope to get out of the CSBBH program" and the kiddo responds with "Pfft, nothing. There's nothing wrong and nothing to talk about."
Pick 3 best skills to practice to support this kiddo:
1. Challenge the client to be the best version of themselves
2. Respect that the client's resistance is a protecting agent
3. Normalize the client's resistance and reinforce that they are in the driver's seat
4. Engage the client in change activation to promote shifting their perspective about therapy
5. Practice active listening and empathy while the client is ambivalence
The correct answers are numbers: 2, 3, and 5.
Numbers 1 and 4 point to the agenda the helper has. If a client is resistant, we cannot put them in a state of change (think MI) meet them at their level if we are challenging them to do something they are not ready for.
Verbal discussion but key factors should include:
-De-escalation, establishing safety, removing client from their weapon/razor, call parent or 911 if an emergency, re-evaluate with a CSSRS, engage client/family in a warm handoff to the ER, etc.