Have you ever asked to be taken off a case?

I've worked in this field for a while. No matter how difficult the kiddo is, I've never asked to be taken off a case. Then I started a new job and the company has been slow to give me my hours. One of my few consistent sessions is with a kid that routinely elopes. This kiddo has a lot going on in his personal life and is generally slow to warm up to new people. Still, I didn't think it would be a problem since he was smiley and receptive when I observed him with his other therapist.

Then I showed up for the first session and he screamed and preceded to run the whole time. This has gone on for about six sessions even though I do all his favorite things with him, and don't place a lot of demands. Finally, the BCBA shows up after about seven sessions. The kiddo screams as soon as he sees both of us. I spin him on this wheel the kiddo likes to play, then ask him to do these flash cards which he's done with his other BT. The little boy gets upset and runs off. The BCBA asked me why did I make him do the cards since there was no point in doing the cards. I explain I saw him go through the cards with his other BT. Then go chase the boy prompting him to ask for a break since he just eloped. When we come back to the room he goes to his spinning toy and I prompt him to say "I want spinner" (which 3 word mand is also part of his programs). The BCBA asks why did you prompt him to say " I want spinner, when he's already on the spinner."

The boy elopes again. The BCBA proceeded to instruct me how I should be playing with him more, like playing frisbee with him which she attempts to do, but the boy runs away and hides. Finally, I tell her, "I can't do this anymore." She tries to talk to me about it, consoles me somewhat, then adds, "I've worked with much more difficult kids." Why she felt the need to diminish my experience is beyond me. I'm just angry at how everything was handled. I don't know if I should quit the job or quit the kiddo. I just don't know how to proceed with this situation.

in ABAby Murgatroydinrising

96%

EntertainerFar2036

RBT

I'd refuse to work with that BCBA.

Yes, could you spend more time pairing? Absolutely. Sometimes it takes weeks to pair with a kid, and you should be doing enough targets though, like it sounds like you tried. You played with him enough to get paired, and then tried cards. And asking him to mand 3 words when you know for a FACT it's what he wants; is the BEST place to get mands.

It sounds like the BCBA doesn't know how to handle RBTs. There's 0 reason to tell you "this kid isn't even that difficult" cause not only is she disrespecting you; she's disrespecting and breaking the dignity of all of her clients by comparing them via bx.

Slevin424

I've dealt with hitters, biters, scratchers, screamers and tantrum throwers over everything. I found out my limitations though. I can't deal with sexual behaviors. Too awkward, cringy and way too dangerous legally. The parents know I'm a parent so that's probably why they're so trusting but I don't care.

I wouldn't leave my kid alone in a room with an RBT if I knew they had odd inappropriate behaviors like that. I'm being taken off the case and it scares me cause I'm worried someone will take advantage of this poor kid. Their close to being a teenager and they... how do I put it... enjoy sensations... without going into detail for anonymity sake, take how awkward puberty is for neurotypical kids and add autism. No social awareness, lack of understanding social cues and is immune to being embarrassed.

Yeah... I mean nothing crazy has happened. The behaviors are just inappropriate but I don't ever want to even be accused of something so disgusting as enabling those behaviors or even taking advantage of them in any way so I have asked to be removed for my own legal safety. I did tell the BCBA they need either a trustworthy RBT, or they need to be strictly doing sessions at the clinic with other people around. That way the kid will be safe, I'll have peace of mind and the next RBT will have others around to protect both of them.

Murgatroydinrising

That's more than valid. You have to protect yourself as well. I've had kiddo's that have a DO NOT WORK ALONE on their BIP for similar reasons.

grmrsan

Once, but it was more necause of the situation than the kid. I was pretty new, and omly a BT, no RBT training at all. He had some pretty aggreddive behaviors and would not do schoolwork. I worked really well with him and there was a TON of improvement. He had his issues, but he was a realky sweet kid.

Unfortunatly his principal was a nasty piece of work who hated him, his family, and absolutly despised that I was "spoiling him". She took every opportunity to goad him and disrespect me, until he was self harming, attacking everyone, and police were being involved regularly. And it was CLEARLY intentional on her part. She openly said she would get him "expelled or arrested, either one will get him out of my school"

And honestly, the parents weren't much better. They did care aboul him and loved him (at least Mom did) they were very stereotypical, uneduducated, rural flatearthers. Not terrible people but a bit...old fashioned.. about disclipline and raising boys.

When the parents started lawyering up, and people were trying to drag me into all that mess, I called the office and said I was not going back to that school.

Last I heard, the district refused to send anyone else to the school for at least a couple of years due ro how awful the principal was.

KindlyAdvantage6358

YES.... the kiddo was really having dangerous attention seeking behaviors an constant ISB. Everyone expressed their concerns but the BCBA did nothing for months an it just got worse to whereas I spent most of session running, swiping items or blocking. It was too much, an the BCBA just told us to let it happen just keep up with those prevention strategies.

I was exhausted, I asked to be removed for my mental health and her safety because I had reached my limit of patience. As my concerns had been ignored there's been no meeting addressing them or goals put in place to provide a better outlet. Everything was considered cute or the kiddo just being silly.

I was taken off an a year later the kiddo is still there an I don't regret it, because the behaviors are the same. An I feel for the other BTs on her team.

2muchcoff33

BCBA

The BCBA is the main problem here, tbf. This isn’t the way to give feedback or help in these situations. “Next time, let’s let him keep the spinner to build rapport. You can narrate to add language.”

As a BCBA I had a similar case where the kid was just not consenting to work with me. He was delightful with his previous BCBA and responded so well. We shadowed for one day and then I was on my own. This kid never warmed up to me. I followed his lead, we stayed on the trampoline till my legs were cramping but the moment I would try to place a demand we were done. It got to the point where I would arrive he would cry so hard the family and I thought he was ill or had a migraine. I called my boss and explained the situation and we moved everyone’s schedule around to get this kid a clinician he clicked with. No idea why he didn’t like me. Parents loved me, boss thought I was doing great. Kid wanted me gone.

EmbarrassedSong5737

No but had close encounters. Still, i learned to appreciate i dont have it that bad.

I saw today a scene between an rbt and his kid in the cafeteria. The kid never sat down, just walked around holding the plate of food like a waiter. Despite security trying to catch him he never dropped it once, his control was incredible. He never once touched a single bit of food, not one bite just walked around with it for some reason. Eventually he became distracted by the security and i came from behind him and took the plate off his hands. I then made him sit at a table like everyone else and then handed him back his food but that is when he tried to get up again to return to his cycle. I was blocking him from doing so but that is when he tried to grab my shirt and bite me. Came close too... Eventually i had to let him go because it was time to go back to class with my kid.

Murgatroydinrising

That sounds exhausting. Thankfully he didn't bite. I had a kiddo that used to bite. It was always like please don't break the skin.

EmbarrassedSong5737

Yikes, thankfully mines does not bite.

I am not really afraid of the bite itself but more of catching something from them. Imagine being so young and then getting hepatitis or something from one of this kids

dragonflygirl1961

Bite guards are invaluable! Champion makes some excellent bite guards. I have had to use them with two different clients.

EmbarrassedSong5737

I will just wear my hunting jacket and some gloves if i ever get one of these types. This jacket is tough

KingKetsa

I seriously considered quitting a case when a client began to spit on me. I'm a very patient person when it comes to bites, hits/kicks, eloping, potty training fiascos, tantrums, SIB, etc, but it was really difficult to continue that session with the same enthusiasm/passion that I started with, because I just felt disgusted and disrespected on the surface.

Murgatroydinrising

That's hard. I don't know how I'd handle that. Are you still with them?

Deanersaur

RBT

I’d ask to be removed from the case solely because the BCBA. If it’s hard to connect with her, she cannot deliver appropriate feedback, and she also doesn’t seem to know how to handle her clients case well. I’d request a different supervisor if possible. And that’s nothing to be ashamed of.

Also, her saying she’s had more difficult cases is so rude to you and also a very subjective comment. What is a difficult case to one person may be easy for another. I myself have no issue working on high magnitude aggression and some would consider that very difficult. But at the same time, I find elopement to be my weakness and very difficult for me to work on. It genuinely scares me because their safety is at risk and what happens if I’m not fast enough to catch the client before getting to danger? It causes me so much anxiety but some people find that to be an easy behavior to work through. So not only was that just comment just very inappropriate to make, it doesn’t hold much weight either since what’s “difficult” is subjective.

Murgatroydinrising

That's exactly what I felt. Thanks for validating my experience. I had a very serious elopement case where a student made false accusations against me. He had a history of doing this. In one case his family sued a teacher, and RBT. There was another witness that verified my account of what happened, but I still have that feeling of anxiety and fear when a kiddo elopes that I don't know well or have rapport with.

_File

You shouldnt be placing demands before rapport is built. Also, look into assent behaviors. You just need to be super interesting and do stuff he wants to come to you to play with. JUST PLAY. Use food if necessary. If nothing else, take ABC data.

Murgatroydinrising

I don't know if your comment is coming from a good place, but as I stated, I played with this kiddo for weeks. I played all their favorite activities and tried new ones as well. I brought different toys every time I visited. The kiddo also has a choking phobia, and will only eat baby food, so offering a snack is not an option. As for assent, I'm aware of what it means and did not push the child to do anything they didn't want to. With prompting, the kiddo in previous sessions manded for a break, and access to their spinner. The BCBA intervened when I prompted for the three-word mand because they wanted me to do it before the kiddo got to the spinner, or before they eloped. BTW, this was an already mastered skill in their three-word mands. All this to say, there was a major effort on my part to PLAY and build rapport.

I don't blame myself, nor do I think I should. I just came here to find out if anybody else had ever gotten to the point where they asked to be taken off a case. That's it.