Lessons from being Fired

I was fired today.  Not from my job in total, thank goodness, but from one patient.  My friend's son asked if I got "moved down a level."  Luckily, the answer to that is no, too.  I'm pretty glad life isn't like a video game in this instance.

I have to say that in 13 years of doing what I do, this is the first time I've had a parent be so blatant about her dislike of me and my approach(es).  I have had 2 other families cancel services with me and each time it is a blow to the ego, leaving me searching for reasons WHY.

Funny enough, my management duties often involve coaching other therapists through exactly this kind of situation & I've oft repeated that we all get fired in the course of treating for any length of time.  That's true.  The other nuggets of truth I'll add to that discussion are:

• Each time it stings, leads to questioning of skill, doubt in what you have to offer.  
• Questioning and reflection on skill is important, no matter how long you've been practicing your trade.
• Underlying that ego-blow is RELIEF.  
• If you so happen to dread interaction with a caregiver so much that you are nervous to tell about jury duty service, then that relief will wash through you with your second mixed drink--that spreading warmth a combination of a little buzz and the realization that you never have to take abuse from that particular parent ever. again.  HALLELUJAH.  

So much more I could say.  So.  Much.  But in the hopes of salvaging my professionalism, I'll stop. . . in a minute.  Just for the record, if I ever am in complete denial that my child needs limits or has failings, someone take me out back and beat some sense into me.  

**The part I left out was that after I left the home I was not the picture of calm.  It involved quite a bit of righteous indignation, well-timed curses & shaking with anger (no exaggeration).  I'll save that post for another day.

Do Your Part. NO Really.

I am a speech pathologist in my professional life.  A darn good one, most of the time.  I love what I do, I don't think I will ever feel not-challenged.  That's a positive.  I want to be challenged.  I want to keep learning.  It is a metaphorical back-flip moment when I see a child do something they have never done before because of my therapy.  Seriously.  Such a high, a sense of accomplishment to see a wee face and the parental excitement in the background as the child eats a piece of bread for the first time, tells their parent they are hungry or uses a computerized device for their voice & corrects me on the form of "it's" that I used.

Sometimes, though, I run aground.  I flounder and struggle for direction, for inspiration.  And sometimes I beat my head against the wall in frustration.  The thing is, an hour of really good speech therapy per week only gets you so far when it comes the hard things.  And if a kid has qualified for therapy, they need help with the hard things.  One hour spread over a couple of intense therapy sessions per week will bring fair results, at best.  Mediocre.  Middlin.'  That's with intense therapy.

Now change circumstances to therapy with a 'meh' level of intensity and little-to-no practice, reinforcement of skills and you get a teeny-tiny baby step of progress, if you get progress at all.  If a child spends the majority of a session not wanting to (and really, I get it, therapy is doing the hard things) & then caregivers don't feel compelled to, well, compel the child to cooperate; followed by haphazard follow-through on practice, results are poor.

Common sense, right?

Sigh.  Alas, it is not.

Recently I have had several parents feel like this was due to shoddy, less-than-stellar therapy on my part.  I know.  I am much more likely to blame myself for disappointing results  so I sure didn't want to write this off an inconsequential.  But when I took a step back, looked at the facts logically and turned the situation in my mind to examine all facets, I see this isn't a lack of good therapy, although there is always room for improvement, room for a different way.  This isn't a refusal of mine to accept poor outcomes.  This isn't because of a child that is unable to learn.  In fact, this isn't about the therapist or the child, for the most part.

So that leaves the parent.  The parent wishing for the magic wand that would cure autism, any syndrome, any sound disorder & entrusting therapist to "fix" their child.  I just can't. We can't.  It's a flaw in our profession, a limit of our humanity.  Progress on a skill that doesn't come naturally is really freakin' hard work.  So if that hard work is too much, for right now, forever, just STOP.  Stop blaming me. It is not an error that I want my toys back at the end of a session, just like a dentist doesn't give you their tools--it's the same thing.  Toys are my tools.  Stop therapy.  Really.  Sometimes a break is the best thing for everyone.  Therapy of any kind is only as effective as the 'want to' of the family.  Turns out that is one of the only things I can't provide--the want to. Sabotage rarely has the desired positive outcome.

That's my "Come to Jesus" talk (best term ever, thank you Dean Cowser), only a lot harsher than I can provide in my real world job.  For some reason, the fact that the whole entitlement generation-thing would effect my ability to affect change never occurred to me.  That was stupid.

To the rest of you, working your asses off to be consistent on what you stress to your kids, thank you.  When I shrug off compliments on how much I did to help your child it's because it's true.  The hard work happened when I wasn't there.

Perspective. The Heart-Warming Kind.

This.  On days like today when I am overwhelmed with my piddly problems, I need some perspective, especially perspective that doesn't come with sound because I often seek perspective when I'm rocking a baby to sleep.  Today, this was the solution.  Well, this and rum & Diet Coke.

Exorcism Needed?

I generally think, as every mom does, that I have the cutest, sweetest, most handsome boy around.  Not to mention smart.  I mean really.  Look at this:

I rest my case.

Only not really, because despite repeated warnings from more seasoned moms that "three is worse than two," I refused to believe that this would happen to my sweet boy.  I was wrong.  Incredibly, totally wrong.  This weekend he in turned charmed and cursed us.  Turned whining up to a new level.  Learned to selectively ignore me.  Started yelling that he wanted something "now."  Jumping on his bed after being put in bed for the night.  Beating on the wall after his father had reminded him to go to bed not once, but twice.  Refused to pick up his toys, only to then have a complete meltdown when said toys were removed from his bed because they were Mommy's now.  We've put him in his room more the past two weeks to gain his self-control than in his whole life.  Had to place the toilet paper on the high shelf in the guest/kid bath because of excessive TP abuse (Beware if you are visiting to think ahead before sitting).  Blue Blank (treasured blanket made by my aunt) moved to Mommy's room because it was just too much for him to pick up.

Chris looked at me tonight and said, "So he's just testing his boundaries, right?"  I'm wondering if I had answered no, if he might have asked to give him away to the highest bidder.  So the whole "It Gets Better" isn't just a campaign for LGBT teens--it's for parents of three year olds, too, right?