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The Gray Part of Therapy

Some people see the world as black and white. You either do option A or option B. How boring would life be if there were only two options for everything?! Our lives could be somewhat unique, but there would always be someone who was the same.
As in life, there are shades of gray in therapy. These gray areas can be the way the therapists adapts the session specifically to the client or it could be a grey area because there is not much research on the topic. Before I got into OT school, I was observing in an out patient that specialized in the treatment of children with Autism. This clinic offers OT, PT, speech, and food therapy. I was observing a session with a therapist and she warned me that the next kid was a bit stubborn and would probably fight with us about some issue. We do the session and there were no issues. I thought the kid was having a great day. The therapist asks the kid to put on his shoes, cue the meltdown. The child started to stomp and scream that he was NOT going to put his shoes on and there was nothing we could do about it. The therapist asks nicely, a couple more times, for the kid to put his shoes on, but he continued to protest. The therapist then tries to do hand over hand to put the kids shoes on and the wrestling match ensues. I am standing back in disbelief that the therapist is having a wrestle mania session with the kid over putting on his shoes. Wouldn't it be easier to just let the kid "win" this battle and let him go on his way? The therapist then says "Ella! Either help me or go get someone who will!" So I join in on the wrestle mania session. Long story short, it took 4 adults to get the kid to put his shoes on. Later that day, I asked the therapist why she was so insistent on having the kid wear his shoes. She said "My mind set is if I ask a kid to do something that I know they can do,  I expect them to do it. This kid has an issue of defiance and if I let him get away with something once, he continually tries to get away with the same thing over and over. His Mom also has a disability and has extreme difficulty getting his shoes on. So me asking him to put on his shoes is something he is able to do and it helps his Mom. So that is why we wrestled."
At the time I thought it was easier to let the kid just leave the session without his shoes, but the therapist knew he needed to leave with his shoes on. This is an example of a gray area in therapy. Depending on your position, you might let the kid leave without his shoes or you could see the importance of the kid wearing his shoes. At the time, I thought the therapist was pushing the kid a bit too hard by asking him to put on his shoes, but once I got the background information on the situation I understood.

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