Having observed how differently our clients behaved outside, in a non-clinical environment we resolved to consider how we, as well intentioned therapists, were failing them. Instead of helping them deal with the real challenges that they faced, we, unwittingly, compelled them to comply with a helpless, pathologized role.

So we went back to the drawing board. That always begins with questions: What did these clients really need? What could we, in our roles as psychiatrists and social workers, do to meet those needs?

We began to listen much more closely to what the clients had to say. By ‘say’ we kept in mind that verbal communication could not be the only bridge to understanding. We needed to listen deeply, looking for subtle nuances and clues, abandoning our preconceived notions. When possible, we turned to people in their living and work environment to help us understand our clients’ needs, We spoke with parents and siblings. We spoke with supervisors at the stores where they worked.

A great deal of information emerged. We learned, for instance, that these young people wanted to have relationships that were deeper than the ‘special needs’ label that earned them politeness but little else. We learned that their families, as loving and supportive as they were, kept them in boxes intended to keep them safe but unable to explore, improvise, and find some mastery and joy in the rich world that they lived in.

So what did we do?

Stay tuned!