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difficult child discharge Wed
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<blockquote data-quote="Nomad" data-source="post: 190587"><p>Re: intentially "bad" behavior from those suffering with mental illness</p><p> </p><p>It is a hard call to make...but I believe I have seen this to a degree.</p><p>I have worked in a program at a school for severally mentally ill young children.</p><p> </p><p>I recall not too long ago, they had a child (ChildX) whose behavior was probably WORSE than anything I have read here. I am not suppose to be privy to diagnosis's...but the implication was that he was a child suffering with bipolar illness. Additionally, he had a difficult home life and medication not given to him regularly.</p><p> </p><p>HOWEVER, he was NOT the only child who fit this profile.</p><p> </p><p>Fortunately, these children had two very qualified, energetic teachers. They used a good point system, etc.</p><p> </p><p>One thing I noticed is that ChildX never even attempted to use coping skills that were taught to him or that he observed other students employing.</p><p> </p><p>Other kids would have very bad moments, but then gather themselves in a minute or two. It was obvious that these kids had problems, but with effort or some help from an assistant...they could re-enter "a better place" relatively quickly.</p><p> </p><p>Child X caused great havoc for himself and everyone OFTEN. When I say "great," this would be an understatement.</p><p> </p><p>If he wanted something...he would throw physical fits. The teacher had been consistently removing him from the room every time he had a "fit."</p><p> </p><p>One day, the teacher was preparing cake to give to the students and I was watching them. I saw his little eyes go up...as if thinking about having a fit. He wanted a piece of cake BEFORE the other kids. This type of behavior rarely, if ever PAID OFF...but either he was too immature or too manipulative or too impulsive to project the possible bad outcome on his own.</p><p> </p><p>Instead, I looked at him seconds before the "fit" and said "What do you think would happen if you threw a fit right now?" He got quiet. Then I said "Do you think you will be getting cake anytime soon?" He shook his head no and stayed quiet.</p><p> </p><p>IT was a REAL lesson for me. In fact, he was a little more quiet than many of the other children when cake was being served.</p><p> </p><p>Many teachers had THOUGHT that he had ABSOLUTELY NO CONTROL of himself. Some were beginning to think he was totally hopeless. I agree, this situation was VERY BAD...really awful... This child did NOT have much control and I'm sure when under pressure...might have NONE. HOWEVER, he was CHOOSING to exercise NONE ALL the time. Seems his control, although limited and less than most folks, was on a continnuim, etc. </p><p>Some teachers bought into the idea that he had no control and were hoping against hope that he would figure it out one day that he could do better.</p><p> </p><p>in my humble opinion, it is difficult and confusing to talk about personal control when discussing mental illness. Surely we have seen instsances were it seems like it could very well be impossible for the individual to gain control of themselves.AND it's vital that docs don't play the game of assuming those with mental illness are not trying...when in fact they might be doing there very best. The mentally ill are so often victims of bias, etc. It takes observation and understanding...this is not a simple thing.</p><p> </p><p> But the risk of manipulation is there (human nature), esp. with children and we don't do them any good (favors) if we are not well aware of this possibility.</p></blockquote><p></p>
[QUOTE="Nomad, post: 190587"] Re: intentially "bad" behavior from those suffering with mental illness It is a hard call to make...but I believe I have seen this to a degree. I have worked in a program at a school for severally mentally ill young children. I recall not too long ago, they had a child (ChildX) whose behavior was probably WORSE than anything I have read here. I am not suppose to be privy to diagnosis's...but the implication was that he was a child suffering with bipolar illness. Additionally, he had a difficult home life and medication not given to him regularly. HOWEVER, he was NOT the only child who fit this profile. Fortunately, these children had two very qualified, energetic teachers. They used a good point system, etc. One thing I noticed is that ChildX never even attempted to use coping skills that were taught to him or that he observed other students employing. Other kids would have very bad moments, but then gather themselves in a minute or two. It was obvious that these kids had problems, but with effort or some help from an assistant...they could re-enter "a better place" relatively quickly. Child X caused great havoc for himself and everyone OFTEN. When I say "great," this would be an understatement. If he wanted something...he would throw physical fits. The teacher had been consistently removing him from the room every time he had a "fit." One day, the teacher was preparing cake to give to the students and I was watching them. I saw his little eyes go up...as if thinking about having a fit. He wanted a piece of cake BEFORE the other kids. This type of behavior rarely, if ever PAID OFF...but either he was too immature or too manipulative or too impulsive to project the possible bad outcome on his own. Instead, I looked at him seconds before the "fit" and said "What do you think would happen if you threw a fit right now?" He got quiet. Then I said "Do you think you will be getting cake anytime soon?" He shook his head no and stayed quiet. IT was a REAL lesson for me. In fact, he was a little more quiet than many of the other children when cake was being served. Many teachers had THOUGHT that he had ABSOLUTELY NO CONTROL of himself. Some were beginning to think he was totally hopeless. I agree, this situation was VERY BAD...really awful... This child did NOT have much control and I'm sure when under pressure...might have NONE. HOWEVER, he was CHOOSING to exercise NONE ALL the time. Seems his control, although limited and less than most folks, was on a continnuim, etc. Some teachers bought into the idea that he had no control and were hoping against hope that he would figure it out one day that he could do better. in my humble opinion, it is difficult and confusing to talk about personal control when discussing mental illness. Surely we have seen instsances were it seems like it could very well be impossible for the individual to gain control of themselves.AND it's vital that docs don't play the game of assuming those with mental illness are not trying...when in fact they might be doing there very best. The mentally ill are so often victims of bias, etc. It takes observation and understanding...this is not a simple thing. But the risk of manipulation is there (human nature), esp. with children and we don't do them any good (favors) if we are not well aware of this possibility. [/QUOTE]
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