Talking about Choice
June 25, 2012 1 Comment
Was doing some supervision today and talking about a case of a very anxious mum who seemed over involved with a dependent and anxious child with a diagnosis of Aspergers. What she wanted – for any “help” – didn’t seem to match well our understanding that her relationship with the child was a part of the issues that we’d like to think about.
This raised a challenge of how do you get to a Choice point if your mutual understandings are miles apart. The clinician I was talking to had actually booked the family into a partnership as they “clearly needed help” (i agree) but not with any mutually agreed goal.
I think the “honest opinion” step of Choice maybe should have been used a bit more. Comments on how close they seemed. What did she think of that? Asking whether mum thought how she felt affected how the child felt or maybe what was her view of successful development or separation. Do you have any thoughts? I think this is trying to get at mums formulation of the situation rather that her experience of the situation…
Just goes to show that although CAPA definitely helps (we think) it doesn’t always make every situation easy!
About Steve and Ann
This is such a familiar situation to me. I agree with all of what you posted. I think that the “honest” conversation is by far the best but it is also, at least initially the most awkward. The CAPA problems i have from where the choice meeting has not found clear agreed goals are that the rest of the work becomes vague and potentially endless or fruitless. Starting a case at partnerhsip with no clear plan is often pretty messy. The next problem is how to raise it with the choice clinician in such a way that it will not be met with defensiveness.