Zoe is a 13 year old girl who presented with “unruly behaviour and tantrums” at home, according to her parents. She refuses to attend school and the school reports that when in attendance, she causes extreme disruption and intimidates the other children.
The notes indicate that she doesn’t respond at sessions with Pastoral Care, teaching staff and most recently CAMHS (Child & Adolescent Mental Health Services and whistles softly while professionals talk. Zoe is accompanied by her parents at the session and sits in between them.
Parents have indicated to professionals that she rules the home and that they have great difficulty managing her. Eileen Murphy takes the session.
EM: Enters room after all are seated, introduces herself and asks parents if she might address them by their first names? They agree.
EM: Zoe, good to meet you – this is only a short meeting so I will be brief.
.
Zoe: [NO ANSWER but looks confused]
EM: Let me give you an idea of how I work Zoe, if I may? I work in a specific approach and once I have explained it to you – I will be asking you if you think you could work that way too. If not, then I’ll be asking you what kind of help you would prefer and I’ll do my best to find someone else. Ok?
Zoe: [LOOKS SUSPICIOUSLY AT PARENTS] “Suppose”
EM: I use an approach that looks at what is working now…. .what has worked a little…. and a focus on visualising about tomorrow rather than talking about yesterday. Does that make sense to you?
Zoe: [SARCASTICALLY]: What? “seeing” tomorrow?
EM: Mmm – kind of like this: If you were going to a party next Saturday and you could only wear what you had in your wardrobe right now – what would you wear Zoe?
Zoe: What?????
EM: Shall I repeat the question?
Zoe: Erm, I dunno, er – bloody hell…this is mad. Er, my Parka and black dress
EM: Okay. It’s a bit like that Zoe. You didn’t have a problem seeing yourself in a dress in a week’s time. Visualising is nothing more “Wooo” than that really. Okay, I’m leaving now while you think it over and in 6 minutes, I will come back for your decision. Is that long enough?
Zoe: Nods
EM LEAVES THE ROOM: Transcriber remains:
Father: Zoe – do you want to work with her?
Mother: She’s a bit weird isn’t she?
Zoe: Everyone’s weird to you
Father: You can stop that right now
Zoe: I don’t mind, suppose…… but I’m not going back to school.
Father: I don’t think that’s an option if you stay with her – that’s the whole point I think….
Zoe: How long has she gone? She said six minutes – we’ve only got a couple of minutes left….
Mother: If you don’t wanna work with her…just say so
Zoe: I didn’t say that. What time is it now?
Father: [LOOKING AT ROOM CLOCK]: One and half minutes left
Zoe: F**** hell, pressure man
Mother looks at transcriber: Sorry
Zoe: He ain’t going type that, are ya?
Transcriber: nods
Zoe: Ok, suppose. Whatever, f****…hell, this is murder
EM re-enters the room and stays standing
EM: Hi – can you tell me your decision Zoe?
Zoe: [SHARPLY] Yes! Ok! I will!
EM: Then I’ll put your name forward as an applicant and will let you know the outcome by 3pm tomorrow
Zoe: What???? I have to apply? like a job or something?????
EM: We have to assess whether the applicant is up to it Zoe – whether they have experience of keeping to their word; ability to monitor themselves, attend sessions on time etc. Do you have any experience of this?
Zoe: I’ve got a Saturday job in my Aunt’s hairdressers – I have to get there at 8am and I can’t leave till I’ve swept up and cleaned the basins and I fill in my own timesheet!
EM: That’ll go down great on the application – I’ll mention it.
Zoe: [CONFUSED] When will I know?
EM: By 3pm tomorrow if your application is successful.
Zoe: How?
EM: One of the team will call you – do we have your contact details?
Zoe: REELS OFF HOME AND MOBILE NUMBERS
EM: Ok. Thank you for attending and you’ll hear tomorrow.
FAMILY LEAVE
This first session with the “resistant” Zoe lasted in total 12 minutes. Eileen Murphy spoke quickly and to the point from the outset. The purpose of this introduction was to “confuse” the negative pattern that Zoe brought into the room.
Having great experience of sitting with various professionals who are keen to help, Zoe appeared to know what they were going to say, before they said it. She was in a pattern of “professional enters the room, recaps on the presenting problem, asks parents for their views, asks Zoe why she does what she does” and often the professional would then plan to “diagnose and treat”
The thinking here is that if that approach was going to work – it would have worked by now, so it was deemed essential to confuse the pattern in order to create a new one.
ZOE WAS CALLED THE FOLLOWING DAY AT 2.45pm
Zoe’s mother called Zoe to the ‘phone, she appeared to be located very near the ‘phone.
A member of the team advised her that her “application had been successful” and offered her the choice of two appointments: later that week or the middle of the following week. Zoe chose later that week. The team member then advised her to arrive 5 minutes before her appointment time and to bring a hard-back note-pad and pen.
Zoe arrived 5 minutes before her appointment time, with the required equipment. We implemented the Change Balloon with her as the first step and in liaison with the school who put her name on the Notice Board (cost free resource we devised that alerts Teachers to be alert to the efforts of named pupil on specific Monitoring tasks), she used her Monitoring Charts on:
Self-discipline (Zoe’s “keeping her cool” chart)
Focused Student (Zoe’s “purpose learning” chart)
There were some minor outbursts within the first month with one major row with a teacher that almost resulted in her exclusion. Other than this, outbursts were limited and within two and a half months, full attendance and acceptable behaviour restored. This success was due to the agreed “influencing” of teaching staff: “Zoe, good to see you on track for the lesson……” and “Zoe – you appear to be upset, would you like a member of staff to leave the room with you or are you okay being on your own in the corridor?”.
This left Zoe in no doubt that there is no choice about whether she leaves the room – her choice is whether she would like to be accompanied or stay alone.
NOTES from Eileen Murphy:
If Zoe had no history of resisting interventions, if she had a demeanour that suggested she was willing and able to collaborate in solving the difficulties at home and school – this short, rather sharp, introductory approach would have been unnecessary and the session would have begun as normal. I would have introduced the model, referring to “reported exceptions to the presenting issue from the referrer” and elicited “exceptions” from the family.
I also like to “distract” the client from their “prepared resistance” and the announcement at the top of the session that I “will be brief” is not something the client is expecting and often too, an announcement that I will be back in “six minutes” or “eight minutes” is something they actually hear and focus on because all of us have an understanding of “I will be back in five minutes” which is often taken as “I will be back at some point shortly, nothing definite or focused”. The client is distracted from their resistance for a moment – “Six minutes? What is that all about?” It is exactly the distraction I need in order to create a new pattern for the session.
“I am keen on introducing the concept of “an application to work with us” when working with resistant and challenging young people – my thinking is that young people are often bereft of opportunities to “win” anything; to “succeed” at anything and the whole concept of “waiting to hear if they are successful in their application” is only something that they see on TV or hear adults talking about but they know only too well that its an achievement of sorts. Its also a truism, of course, that as Socrates noted: “We only value what we have to pay for” (or win, perhaps).
If Zoe had been collaborative or not as resistant as she had presented – I would then have opened the session with : “We will talk a lot, no doubt, in this session, about what needs to change – I would like to collect, if I might, from each of you, things you hope never changes about your relationship” This ensures the opportunity for us and the family to hear, straight away, what is working already for them.
Once we have collected everyone’s responses, we may question further on each one, i.e. if a response is: “they listen to me” then we might ask “how will this aspect of your relationship be helpful in resolving the current issue, Zoe?”
We are always “listening with a different ear” for any opportunity to hear the little that is working in order that we can build on it. Just having one person in any meeting who is designated to listen for exceptions, listen for any small recent change, designated to spot a strength that the rest of the room might miss, can be extraordinarily powerful in changing the negative pattern.
We listen for the exception to any problem pattern can lead us to new conversations. If we are told “She caused the staff difficulties on Monday, she was sent to a detention room for the whole day on Wednesday. Things escalated on Thursday, causing her exclusion on Friday”.
Our first question is: What happened on Tuesday?
It may well be that on Tuesday – she stayed in bed and didn’t bother going to school but if we don’t ask the question, we won’t hear the answer.
The approach is about changing our mindset to seeing “Tuesday” as immediately alerting our curiosity because it could well be that on Tuesday, she just behaved himself, in relation to the other days, and didn’t “kick off” or “disrupt”.
By putting a “magnifying glass” over Tuesday and eliciting and examining exceptions to the problem behaviour may be where any small success or positive cause can be built on. If we do not “listen for and become curious about” any time at all when the pattern is different, better, even slightly better…… we would miss an opportunity to do more of what works.
It is essential, when looking for change that we recognise where change is already occurring in any small way. Using the approach ensure that all involved can hear about times when they contribute to the exception; deliberate or random which gives further discussion for “doing more of the little that works”.
Staff, under great pressure to maintain a safe environment for all, are often unaware of the potential importance of an “untroubled day” and regard it as a “one off”, a “fluke”.
Solution Focused thinking holds “one-offs” and “flukes” as a great focus for our curiosity.
