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From: Judy Kuster
Date: 17 Oct 2010
Time: 08:14:08 -0500
Remote Name: 76.17.183.48
I don't think I can "make" a client do anything. My "job" as a clinician in a case like you describe is working to join the client in the journey to self-discovery - in this case to "see how severely avoidance behavior has impacted his or her life" -- if it has. Not all avoidance behavior is "bad" -- we have learned to avoid touching a hot stove for example. Maybe avoiding a certain person on a day when you know you don't have a lot of time for visiting or you know he is really busy and his office door is shut isn't a bad thing either. An early goal might be just to talk about avoidance behavior in general - maybe just starting a conversation about things we would like to avoid - raking the leaves, emptying the dishwasher, making an appointment for the dentist, going to a scary movie, etc. and discuss the potential negative consequences of those avoidances, if there are any. Perhaps that will lead to things that are more speech related - not taking a speech class in college, not asking for directions when you are lost, not going through a drive-in at McDonalds, not having a telephone, not saying the "s" word (stuttering), refusing to read in class, etc. and discuss the possible consequences of those avoidances, too. When a client recognizes and is ready to address those kinds of avoidances, we would then work out a plan together, choosing one he wants to work on, and developing a heirarchy as I mentioned in a post above.