Insider’s Guide: Creating and Maintaining Boundaries

The small college I graduated from had a working farm in a beautiful valley with a river flowing through the middle. Students worked on the farm 15-20 hours per week planting corn, fixing tractors, and cleaning out the pig stalls. Our farm had a herd of cows that loved to poop, eat grass, drink from the streams and get into trouble. The college hired a farm manager who decided our primary focus should be keeping the cows out of trouble by fixing existing fences and building new ones with high-tensile wire (electric fencing) with solar chargers.

After months of slow progress, the cows were fenced-in and safe from their naughty excursions. But they continued trying to bust out of the new fancy fences so the farm manager said out next job was to create a ‘salad bar’ in each pasture. We removed massive thistles, dug up weeds, and filled in mysterious holes. We planted clover, fescues and other plants cows love. After a full season of work, the cows no longer tried to bust out.

They had a) strong fences and b) healthy pasture. The perfect combination of keeping cattle happy and in a good spot.

Image result for cows

Humans can be like those cows, especially young humans (teens and young adults). If we don’t build boundaries around them, they wonder-off into the world. We don’t want the boundaries too tight or they suffocate and don’t learn how to handle freedom. If the boundaries are inconsistent and full of gaps, they don’t have structure to lean on when the world gets hostile. Boundaries, like fences, require maintenance. Talking about your limits and the consequences if they are unmet is maintenance. Telling your son or daughter you are appreciative they came home by curphew last night is maintenance. Keep the fence maintained and it will be easier than looking for cows at 2:00am (I’ve done that before).

It’s also important to create that healthy pasture for kids. Create positive experiences at home, provide healthy food and love and attention. Give opportunities for engagement, ownership and rebounding from screw-ups. This is the healthy pasture for kids. Pastures also need maintenance. Checking in with kids and revisiting what you are providing as a homebase is essential. What sort of place is your home? Safe and welcoming or something to be avoided? Talk this out, don’t make assumptions.

Healthy fencing plus healthy pasture equals healthy cows. A simple experience I had which holds true today for families I work with.

 

Rewards, Consequences, Punishment…What’s the Best Way to Parent Teens and College Kids?

A simpler what to think of this post is “How to Change Behavior.” That’s really the primary function of a reward or consequence.

There are more books on how to change kids’ behavior than just about any other topic. Ironically (or sadly), they all say the same thing. Punishment does not work; rewards work consequences for choices work. How can this be? Let’s kick the tires on the history and research behind this. If you hate history and research, jump ahead a few pages to the ‘how-to’ portion.

Context: Let’s Look Back First

For thousands of years before the Industrial Revolution, children were assets in an agrarian system (most humans up to that point farmed). We had lots and lots of kids since a) children were relatively cheap labor, b) most died during childbirth or as children and c) adult children became financial support systems for parents – the more children parents had, the more financial support and broader financial base.

In 1916, Congress passed the the first federal child labor law. However, pressure from big companies forced the U.S. Supreme Court to strike down the law two years later. Following the Great Depression adults had become so desperate for jobs that they would work for the same wage as children.

In 1938, President Roosevelt signed the Fair Labor Standards Act, which limited most forms of child labor (but excluded agricultural work). This was the beginning of our modern view of children needing protection, love and nurturing. A pendulum was set in motion.

In 1946, another revolution took place. Dr. Benjamin Spock published his first book titled Dr. Spock’s Baby & Child Care (also titled The Common Sense Book of Baby and Child Care). Though a medical doctor by education and training, Dr. Spock’s books put children at the center of parenting rather than the adults. He encouraged responding to and engaging with babies and children rather than ignoring which was the advice up to then. The pendulum’s momentum builds.

Finally, we add in money and work. In the early 80’s, adults were working more, making more money and, as a result, needing to leave their children at home (the so-called ‘latch-key’ kids). Children would get dropped off from the bus and walk into an empty home. Cartoons and snacks were gorged upon till mom and dad came home. Guilt stricken parents with extra cash (…or more accurately extra room on their new credit cards) went and bought Ataris, Nintendos and the new wave of electronics and toys for kids. We were now descending into entitlement. About this time, school districts were changing punishment in schools (no more spankings).

How can old-school grandma and grandpa who raised 15 kids have been so wrong? All the kids turned out great, right? Well, let’s break this down a bit. First of all, it was a different time. No devices, internet and certainly little to no advertising directed towards children. All marketing was targeting stay at home mothers.

I also want to point out that most of these old school versions of parenting created some pretty nasty problems which is why the fastest growing demographics for substance abuse treatment are the Baby Boomers and the elderly. Old school punishment, drinking habits, and expectations led to a generation that was not well-equipped to handle stressors.

Now for the Goods

Here are the best ways to change behavior and encourage healthy choices. I’ve taught these, studied these and continue to stand by these effective strategies:

Commit to the Path

  1. Drawn into accidentally energizing and rewarding negativity leads to a battle – Be intentional about being positive
  2. Intentionally energize and nurture success
  3. Provide a true and deep consequence when a rule is broken – something that is proportional to the infraction
  4. Reward for what you want to see.
  5. Ignore behaviors you want see less of.

Establish Expectations and Boundaries

  1. Detailed rules/expectations and no grey area – kids are MASTER negotiators and litigators
  2. Chores and Expectations – daily schedule or list
  3. Bonus behaviors – Things you wish to increase
  4. Menu of privileges – Can include anything beyond basic needs
  5. Extend Structure – At school, friends house, soccer practice, etc.

Consequences

  1. Relentless pursuit of positives: Biased towards seeing your kid’s great choices.
  2. Strictness and Clarity: Be like a videogame – if a rule is broken, a consequence is administered no matter how you are feeling.
  3. No Leaking: Accidentally rewarding behavior with negative energy but they contribute to your kid behaving badly.
  4. Finite: Consequences do not expand and are tied to a specific behavior/event.

Rewards

  1. Catch them doing things right: When I run parent groups I ask parents to list the amount of things they caught their kids doing wrong in the last month. Easy list to make. Then I ask them to list three things they caught them doing right. Much harder. We are programmed to find faults in this attempt to modify kids behaviors towards compliance – making bad choices is the loud, obvious indication they are out of line. We we fail to see are the million little choices they make each day which are well-thought out and positive. Focus on those. Highlight those. “Hey Julian, I noticed you put the dishes away without anyone asking you to do it. Great job.” …And then move on. No need to get mushy and turn it into an Oprah interview about thoughts and feelings.
  2. Types of rewards: Your eye contact and facial expression are huge rewards for younger kids. Rather than giving kids an iPhone or XBox, I encourage parents to give time on each device or toy as a reward. Have you ever kept the car you rented at the airport? No, you paid them to borrow it for a specific amount of time and then returned it. There are few instances where I encourage parents to buy something to give to their kids as a reward. Time, praise, and access to cool things is often way better for everyone.
  3. Negotiating: If you find yourself constantly reminder, encouraging, begging, etc. for you kids to do A so they get access to B, you are violating your own rules. You are now negotiating.
  4. List of Rewards: In 2007, one parent I was working with could not understand why their teenage son was not motivated by the reward of time on their Blackberry (same year iPhone introduced). If they are not doing chores, getting good grades or engaging in the behavior you want to see, your rewards may be incongruent with their desires. Ask them to tell you what they’re into. Maybe its an allowance, money for iTunes or they want to borrow the car.

And Lastly…Own Your Home

This is a hard one for parents (… and most kids) but until responsibility for the mortgage, bills and everything that makes a home function is shared among all family members – parents rule. There is no such thing as the ‘kid’s’ room. Everything, every room, every toy, every piece of clothing is the parents’. Great parents allow their kids to use those things. Remember…privilges are not rights and kids get to own their choices, not their TV.

Good Luck.

Is CRAFT the Best Unused Substance Abuse Treatment?

Community Reinforcement Approach and Family Training

Today I’d like to introduce you to one of the most effective treatments/interventions for substance abuse that is rarely used and even-more rarely discussed. It’s called CRAFT and is a behavior therapy approach designed primarily for those with substance abuse issues. Developed by Nate Azrin in the 1970s, his technique focused on operant conditioning to help people learn to reduce the power of their addictions and enjoy healthy lifestyle. CRA was later combined with the FT (…family training), which equips family and friends with supportive techniques to encourage their loved ones to begin and continue treatment, and provides defenses against addiction’s damaging effects on loved ones.

The first part of this acronym – Community Reinforcement Approach (CRA) was originally created for individuals with alcohol issues. Clinicians later went on to apply it to a variety of substance use disorders for more than 35 years. The clinical premise is based on operant conditioning (…type of learning in which an individual’s behavior is modified by its antecedents and consequences), basically, CRA helps rearrange the client’s life so that healthy, drug-free living becomes more interesting/stimulating and thereby competes with substance use.

CRA is designed to be a time-limited intervention. The time limit is decided upon between the clinician and client. For example, a set number of sessions (for example, 16 sessions) or time limit (for example, one year) may be decided upon either at the very beginning of therapy or within the early stages of therapy.

One major goal of CRAFT is to increase the odds of the substance user who is refusing treatment to enter treatment through close support of family members, as well as improve the lives of the concerned family members. CRAFT clinician and participants teach and reinforce the use of healthy rewards to encourage positive behaviors. Additionally,  it focuses on helping both the substance user and the family strengthen their relationships which is often torn apart.

In the model, the following terms are used:

  • Identified Patient (IP) – the individual with the substance abuse issues that is refusing treatment
  • Concerned Significant Others (CSOs) – the relevant family and friends of the IP.

Three goals

When a loved one is abusing substances and refusing to get help, CRAFT is designed to help families learn practical and effective ways to accomplish these three goals:

  1. Move their loved one toward treatment
  2. Reduce their loved one’s substance use
  3. Improve their own lives

This comprehensive behavioral program accomplishes these objectives while avoiding both the detachment espoused by Al-Anon and the confrontational style taught to families by the Johnson Institute Intervention.

CRAFT and these traditional approaches all have been found to improve CSO functioning and increase CSO-IP relationship satisfaction. However, CRAFT has proven to be significantly more effective in engaging treatment-resistant substance users in comparison to the Johnson Institute Intervention and Al-Anon (or Nar-Anon) facilitation therapy. 

CRA Breakdown of Treatment

The following CRA procedures and descriptions are typical recommended clinical content areas for the substance user:

  1. Functional Analysis of Substance
    • explore the antecedents of a client’s substance use
    • explore the positive and negative consequences of a client’s substance use
  2. Sobriety Sampling
    • a gentle movement toward long-term abstinence that begins with a client’s agreement to sample a time-limited period of abstinence
  3. CRA Treatment Plan
    • establish meaningful, objective goals in client-selected areas
    • establish highly specified methods for obtaining those goals
    • tools: Happiness Scale, and Goals of Counseling form
  4. Behavior Skills Training
    • teach three basic skills through instruction and role-playing:
    1. Problem-solving
      • break overwhelming problems into smaller ones
      • address smaller problems
    2. Communication skills
      • a positive interaction style
    3. Drink/drug refusal training
      • identify high-risk situations
      • teach assertiveness
  5. Job Skills Training
    • provide basic steps for obtaining and keeping a valued job
  6. Social and Recreational Counseling
    • provide opportunities to sample new social and recreational activities
  7. Relapse Prevention
    • teach clients how to identify high-risk situations
    • teach clients how to anticipate and cope with a relapse
  8. Relationship Counseling
    • improve the interaction between the client and his or her partner

Communication 

With CRAFT, CSOs are trained in various strategies, including positive reinforcement, various communication skills and natural consequences. One of the big pieces that has a lot of influence over all the other strategies is positive communication. 

Here are the seven steps in the CRAFT model for implementing positive communication strategies.

  1. Be Brief
  2. Be Positive
  3. Refer to Specific Behaviors
  4. Label your Feelings
  5. Offer an Understanding Statement – For example, “I appreciate that you have these concerns, … [or] I understand that you really want to talk right now, and that this feels urgent, … [or] I would love to be there for you.”
  6. Accept Partial Responsibility – This step “is really designed to decrease defensiveness on the part of your loved one. … It’s not about accepting responsibility for things you are not responsible for. … [Rather, it’s to] direct you towards the piece that you can own for yourself. … [For example, ] what you can take responsibility for are the ways that you communicate,” etc.
  7. Offer to help

Take home message – Help decrease defensiveness on the part of the loved one that you are speaking to, and increase the chances that your message is really going to be heard—so, increasing the ability that you have to really get across the message that you want. 

Consequences with specific limits/expectations being in place is essential in terms of communicating your message, but it’s also really important, maybe even more so, to be consistent in following through with those consequences and rewards.

Al-Anon 

As an organization, Al-Anon does not currently adopt, hold, or promote the view that CSOs can make a positive, direct, and active contribution to arrest compulsive drinking, which is the opposite premise of CRAFT. Al-Anon is a fellowship with a focus on helping families and friends, themselves, without promoting a direct intervention process for alcoholics. Because “no one ever graduates” from Al-Anon, it can be viewed as an open-ended program, not time-limited.

Al-Anon view

Regarding the CSO’s relationship to alcoholism and sobriety, the view from the Al-Anon organization can be summarized:

  1. PowerlessnessAl-Anon‘s First Step promotes a powerless view for families and friends, “We admitted we were powerless over alcohol—that our lives had become unmanageable.”
  2. Disease viewAl-Anon writes, “As the American Medical Association will attest, alcoholism is a disease.” Al-Anon also states, “Although it can be arrested, alcoholism has no known cure.”
  3. Three C’sAl-Anon has a dictum called “the Three C’s—I didn’t cause alcoholism; I can’t control it; and I can’t cure it.”
  4. Loving detachment. Al-Anon “advocates ‘loving detachment’ from the substance abuser.”
  5. Family illnessAl-Anon writes, “Alcoholism is a family disease,” and “we believe alcoholism is a family illness and that changed attitudes can aid recovery.”

Summary

CRAFT is not perfect and is not easy to implement partially due to lack of clinician training and also because of having multiple people involved (ie. IP, concerned others, and clinician). Programs, agencies and clinicians may not even be aware of CRAFT if you ask so if you or a loved one are in need of a non-residential approach that’s well researched and effective, find a substance abuse therapist able and willing to use it. 

Time to Start Thinking about Cyberbullying Again

Cyberbullying: The Fist of Technology

By Mary Hannah Ellis

Most of you probably remember your school bully at each level of your education – the tall fifth grader who liked to knock over kindergartners on the playground, or the burly, egotistical jock who made everyone else feel inferior with his brash jokes. However, a student could mostly avoid these school bullies by staying out of their way. Today, technology has enabled a new, ubiquitous form of bullying called “cyberbullying.” Cyberbullying involves a minor’s harassment, tormenting, humiliation, embarrassment, threatening, or otherwise targeting of another minor via technology.

Cyberbullying occurs through a variety of media, including social networking sites, text messages, online chat services, and email messages, to name a few. Facebook and twitter are some of the most active sites for cyberbullying

Do you suspect that your child or teen is a cyberbully or a victim of cyberbullying? Here are some warning signs to consider:

Your child or teen may be engaging in cyberbullying if he/she:

• Constantly uses the computer, even at all hours of the night

• Is secretive about his/her activities on the computer

• Appears nervous when using the computer or cell phone

• Quickly stops using the computer or switches screens when someone approaches

• Becomes excessively angry when cell phone or computer privileges are revoked

• Uses multiple accounts on different websites

Your child or teen may be a victim of cyberbullying if he/she:

• Unexpectedly stops using the computer or cell phone

• Avoids talking about what he/she is doing on the computer or cell phone

• Appears nervous upon receiving a text message, chat message, or email message

• Appears angry, depressed, upset, or frustrated after using the computer or cell phone

• Withdraws from interacting with usual friends

• Seems uneasy about going to school or going out in public

Children and teens who are victims of cyberbullying are more likely to use alcohol and drugs, have lower self-esteem, skip school, experience physical bullying, have poor academic performance, and have more physical health problems. Interestingly enough, cyberbullies themselves are also more likely to be bullied in real life and to have low self-esteem. There is also a significant risk of suicidal ideation associated with cyberbullying. With very little warning, a victimized kid could snap and hurt themselves or others. Without a doubt, cyberbullies and victims of cyberbullying could benefit from counseling or psychological intervention.

Contact us to find out how we can help.

Fonthill Founder Interview on StayHappilyMarried.com

Fonthill Counseling Founder and Clinical Director, Rob Danzman, was recently interviewed by the good folks at StayHappilyMarried.com.

The topic was how wealth impacts marriages and parenting. Rob talked about several key issues:

  • The different types of wealth and how they influence behavior, thoughts and feelings
  • How underserved the affluent generally are when it comes to counseling and couples work
  • How wealth impacts parenting
  • Three main problems – Lack of Boundaries, Lack of Trust, Lack of Consequences
  • What parents, clinicians and professionals can do to repair marriages and improve parenting

To read the transcript or listen to the whole interview, head over here.

Fonthill Response to Vice Article: AMERICAN TEENS ARE BEING TRAPPED IN ABUSIVE ‘DRUG REHAB CENTRES’

To those outside our field of therapeutic schools and programs, it makes sense that Matt Shea‘s article from May 2013 in Vice titled American Teens are Being Trapped in ‘Abusive Drug Rehab Centres’ is alarming.

To those of us in the field it’s a joke. You can read the whole article here: http://goo.gl/zW43F and judge for yourself. It’s a joke not because it’s inaccurate and not because there are no failures within the industry. It’s a joke because, just like so many other ‘journalists’ he paints a picture with such broad strokes that Mr. Shea fails to really understand the pressures, the people and, as cliche as it may sound, the passion with which so many in this field work. Mr. Shea fails to sort out the fiction from fact.

But how else can a budding journalist get retweeted and get his name out there without this version of quicky-journalism? Had Mr. Shea visited programs like many of us in the mental health and educational consulting world do, he would quickly meet and have experiences  which deepen his 2 dimensional paradigm. He would have been driven out into the remote and hot Utah desert to meet with small groups of teens guided by thoughtful and well-trained staff working on individual enrichment projects. He would leave thankful he never had to endure a Spring or Summer like they do yet, somehow, understands that this programming is providing a level of nurturing and structure significantly lacking in their home lives.

Let’s address the reference and correlation Mr. Shea makes between the therapeutic industry and Josh Shipp of MTV fame. Let’s revisit part of Mr. Shea’s article now…

Shipp is your classic Jerry Springer brand of therapist – no real qualifications, a huge ego and a penchant for money and entertaining TV over science and genuine psychology. “I’m a teen behaviour specialist,” he says in the intro. “My approach is gritty, gutsy and in your face.”

If he had actually spent time with Josh Shipp AND real mental/behavioral health and substance abuse professionals – he would very quickly understand that Mr. Shipp (…Mr. is used loosely here) does not represent the values of folks in this industry, an industry that is run by licensed clinicians and professionals. Mr. Shipp is nothing more than a court jester providing entertainment. He’s a monkey with two cymbals making noise and no signal for his ‘edgy’ reality-TV pushers at MTV (MTV is still around?). Occasionally, I’m sure there are teens and even parents (and maybe the rare delusion clinician) that hear the Shipp-Clown-message and it connects with them – changing their lives forever. But an overwhelming majority spend no more energy than a giggle or slight frown. Mr. Shipp does not have a degree, license or any sort of evidence-based training. He graduated from “Life Experience College” which sounds ‘super cool’ to the teens and teen parents he markets his wares to but there is no depth. He’s a can of soda full of empty calories. The therapeutic industry and Mr. Shipp are as polar-opposite as a Kardashian and Bill Moyers. And yes, we recognize as cold as it may sound, it’s an industry.  Just like cancer treatment, just like teaching, and just like daycare. If it were not an industry and did not have the same oversight as other industries, there would be little oversight. Trust me, you want therapy to be part of an industry. Industrialization provides codes of conduct, ethical guidelines, evidence-based treatment standards, inter-disciplinary work and research. NATSAP is an example of this type of self-imposed quality control.

FYI – Therapeutic wilderness programs are not boot camps. Therapeutic boarding schools are not military schools. There may have been some greedy, old-school meat-heads that sold parents on boot camps decades ago, but in the therapeutic world, those non-clinical programs as a laughable as Josh Shipp which may be why he talks about them in his MTV show. Boot camps and military schools are dying out and, thankfully, being replaced by sophisticated, evidence-based programs with transparency and clinical integrity. Not every program is awesome but, neither is every physician or dentist.

Mr. Shea, I make a challenge to you. Join me on a tour to visit 5 therapeutic programs. Together, you and I will kick the tires, dig through the closets and truly get to the bottom of whether this universe of programs is as detrimental as you propose. We’ll spend 2 days out in the back-country, in storage rooms with gear, and circled up in treatment centers. After that, I challenge you to write the same article blasting this world that has helped so many families. Not likely to happen.

5 Things Your Education Consultant/Case Manager Should Be Doing Right Now

This is our raw, irreverent guide on what in our humble opinion education consultants and case managers should be doing right now to provide the highest quality service to you. This list is valid regardless of the type of mental, behavioral health or substance abuse treatment you or your loved one is receiving (eg. therapeutic wilderness program, therapeutic boarding school, individual outpatient therapy, psychological assessment). If you go through the list and your well-compensated professional is providing you with anything less than what we discuss below, copy and paste this into an email and let them know you’ll keep them hired only if they get on board.

1. Consistent Contact

When we first started Fonthill, we were so focused on accomplishing all the goals and objectives we developed with parents and families that we failed to keep everyone informed and on the same page. We learned from our mistakes that weekly contact (at a minimum) is essential. Your education consultant / case manager should be providing you (and the whole team) with regular email or text updates. These are not updates you should need to respond to, just information letting you know an application was submitted, insurance claim was accepted or that the psychologist doing your son’s assessment will be available about 30 minutes earlier if that works for you. Parents count on us to keep them informed.

2. Proactive Planning

Here is another mistake we made. Our teams are experts on working with behavioral acting out, crisis, intervention, parenting, and families but what we quickly learned we needed to do just as well was developing a treatment plan that included more than just what the parents thought was the issue. We expanded our planning WAY beyond what we estimated our involvement to be so that after we had worked ourselves out of a job (…another hallmark of good work) the family had a set of instructions, a road map, a guide if you will on who should be doing what and by when. Make sure that your education consultant / case manager is developing a plan that considers the big picture since treatment and life do not stop when the professional’s final payment is received. Seriously, they should be mapping out way far into the future to mitigate obstacles and pot-holes you are not even thinking of (eg. Financial literacy for your son entering substance abuse treatment).

3. Saying ‘No’

A really good way to determine if your education consultant / case manager is worth their weight in gold (…or Rhodium) is how often they say ‘no’ to 1. New Clients, 2. Current Clients and 3. Professionals on your team.

Let me explain. New clients – We make it very clear to perspective clients that not everyone that contacts us becomes a client. We could become the Wal-Mart of family services but quality would go WAY down. Education consulting, case management, family counseling and our parent education and consulting would become commodities. Many desperate professionals say ‘yes’ when leads are low and expenses are high (…McMansions are cheap ya know). Current clients – A really valuable and important education consultant and case manager is hired to set a course, develop a plan and make sure the heading if followed. Parents often, with the best intentions, attempt to deviate from the course when kids get unruly or their own fears start to percolate. Professionals – One of  our most important jobs as case managers is working out issues behind the scenes (eg. Setting a limit on the ‘add-ons’ a program may want to push on parents). Being able to effectively and respectfully say ‘no’ to other professionals is an essential skill that should be in your case manager’s repertoire.

4. Billing Fairly

Have you ever lost your mind when you looked over your hospital bill from the Cedars-Sinai Medical Center that showed that the Aspirin they gave you cost $1000? Yeah, we don’t like that either. We think billing should be fair and transparent. There are many, many families that we work with that make a bazillion dollars. There are also just as many families that are have very modest incomes. We charge the same for them all and we are upfront with our costs. We also don’t think it’s appropriate to gouge our clients with ridiculous initial consultation fees ($5,000 for an initial meeting? Get real.) We also don’t like contracts for X number of months. Life happens and we know families sometimes need to make drastic changes. Being on the hook for a service that’s supposed to solve problems and not create new ones is important to consider when signing up with an education consultant  or case manager. We recommend the shortest term necessary with flexibility built in. For instance, rather than expecting payment everytime we meet, we invoice clients monthly for the work completed (…not for the upcoming month like a landlord). Make sure you understand your bill and that all the expenses are for things you agreed to.

5. Maintaining Boundaries

Oh this one really gets us frustrated. To be able to have the healthiest working relationship with your education consultant and case manager they should constantly maintain professional boundaries similar to Licensed Professional Counselors – No dual roles (eg. Your professional is not also your CPA) and No merging of personal/professional relationships (eg. Your professional is not discussing non-work related issues). This may seem like small stuff but, think about it this way. You hired this person to provide objective analysis and recommendations to advance your family through some obstacle. This creates what in mental health parlance is referred to as a power differential. A power differential is when one party has greater power than the other (eg. Judge vs. defendant). In this case, the professional has power over the parents because the parents are in a vulnerable position, meaning they are counting on advice, but also relying on the professional to protect their confidential information, reputation as well as their emotional and psychological health. If your education consultant has crossed any line that’s not clearly stated in their scope of service, consider talking with them directly and asking them to respect the professional relationship you want with them by limiting the personal sharing and interaction. It may feel uncomfortable, but consider this – what happens if you are not happy with something they did? What happens if the treatment program they recommended turns out to be crap? It’s much easier to confront someone who has maintained professional boundaries throughout the process.

This list is not exhaustive but a starting point to ensure you have some reasonable expectations of what to expect in your relationship with an education consultant/case manager. Contact us at Fonthill if you need more help or if you’re not sure how to best use your current professional support.