nursingforsocialjustice

More and more I think that when we say that someone is “not ready for treatment” what we are really saying is that we, as clinicians, do not know how to best help this person right now, or that our service, as it currently exists, does not fit their needs so what we are going to do is reject the person and tell them to come back later, when they are ready to accept the restrictions of the service being provided. And we probably need to ask ourselves, does the restriction make sense? Is it in the best interest of the people we serve? Are we able to accommodate this need in the moment? If not for this one person, are there changes that can be made to accommodate other people who will have this same need when they approach this service a week from now, a month from now, a year from now?

When we say that we are ready to meet people where they are at, how do we ensure that we are able to do that? Perhaps this involves asking some questions that could include:

1) Asking the person about their life. Do they have stable housing? What is their social support system like? Who do they consider family?

2) What is their relationship with substances? What are the good things that they get out of using substances? What are some of the negative effects that they are seeing in their life?

3) What brought them here today? Is there anything that they want to change about their life? What do they want to change? And what kind of impact to they think those changes will have on their life?

4) What is stopping them?

We should be ready to work with someone who is oscillating between different stages of change, because we can learn those skills. We should develop services that meet the needs of the person. And, perhaps the better question would be, how can be adapt the service we are providing to meet the needs of the people who are accessing the service, not how can we screen and develop very fine exclusion criteria to ensure that only a select few are able to access the service. On our end, we need to ask ourselves some questions that could possibly include:

1) What are the judgments that we are making right now?

2) What do we see as potential obstacles? Are there ways to overcome these?

3) How can we best work in collaboration with the person that is sitting in front of us?

4) If this is not the best service for them, what is? Considering that they are sitting in front of us right now, what is the best that we can do for them?

Peace,

Michelle D.