Real-Life Decision Making
You're getting frustrated.
You've worked with Sue for about a year. Sue originally came to your
teenage residential facility because she was having behavioral problems. What
was once a happy, healthy 15-year-old girl has changed into a street-smart
16-year-old.
Sue has run away from home numerous times, dabbled in drug use and dropped
out of school. She frequently used to fight with the other girls, believing
she needed to "prove her toughness" before anyone would like or respect her.
Is there hope for Sue? You bet. Many times, Sue disclosed she wants to
change. She's tired of the fights, drug use and living on the street.
She dreams about being a "normal" girl, with a life full of school dances
and college plans. And, two times a week, you've helped her work toward
her goal.
You started Sue on her new life with little baby steps. For each month
she doesn't fight, she gets special privileges. As Sue's behavioral
analyst, you know you have to offer positive reinforcement (special privileges)
to reinforce her new behavior (no fighting).
Through behavioral techniques, Sue slowly transforms into the person she
wants to become. Everything is successful.
Without warning, it all changes. You learn from a residential counselor
that Sue is fighting again and becoming verbally abusive. Immediately, Sue's
"special" privileges are revoked as punishment. That only seems to make it
worse.
You call Sue into your office, curious about her sudden change. You outline
all the progress Sue has made and praise her for her hard work. Sue seems
unfazed by the conversation. All she wants, says Sue, is to break out of "prison"
(her nickname for the residential facility) and hook up with her street friends.
She's tired of being such a "goody-goody" and she wants to party.
She doesn't care about losing her special privileges. She doesn't
want to go back to school. She wants her old life back -- and she wants it
now!
Worse, the professional relationship you shared with Sue seems to be deteriorating.
She used to act like she trusted you. Now, you see nothing but a sullen, angry
teenager. Everything you say gets an exasperated sigh. In short, you're
wondering if you can help Sue anymore -- or if Sue is destined for street
life.
You ask Sue if she still wants to talk with you -- but her only reply is
a shrug and "I don't know." You're torn between working with Sue
and dropping her off your caseload. What do you do?