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CHAPTER 32 Phil Barker 647

How this affected me: “I don’t know. I have Humane Society right now.” “I have a really nice
been in jail for 4 months before coming here. They picture of me and my mom.”
told me I killed my father. I don’t remember much Ideas about life that are important: “Able to fit in.”
except that I kept hammering his head; I just re- Evaluating the problems: “My main problems
member I was standing in a pool of blood.” “They are loneliness and what’s going to happen in my
told me my mother is still in the hospital; I haven’t future. My whole life is complex!” I would rate my
seen her since.” “I’m scared. I can’t sleep.” loneliness as an 8 for distress, an 8 for disturbance,
How I felt in the beginning: It “just devastated and a 2 for control. My future and what’s going to
me, turned me upside down.” “I felt awful even happen would be a 10 for distress, a 10 for distur-
though I hated him so much; he never listened to bance, and I have no control, a zero.”
me; no one ever listened to me or believes me.” “I How will I know the problem has been solved?
hate him because I watched him beating my “I’ll know the problem has been solved maybe
mother all my life.” when the voices stop talking to me, when I get out
How things have changed over time: “It got of jail and out of the hospital.”
worse when my stepbrother ran away. My father What needs to change for this to happen?
was a sinner, a drunk, wife beater, even conspired “Maybe I need to take medication, maybe I just
with the Communists. I was not allowed to leave have to start talking to real people, not the voices.”
the house except school, my mother stayed in all The nurse recognized that Scott needed some
day to do farm work, he was the only one that ran help to feel more emotionally secure. She engaged
errands outside the house.” “I’ve always been a bit him in a security assessment and they developed a
scared and angry too.” Personal Security Plan together.
The effect on my relationships: “I don’t have Later in the week, the nurses noted that Scott
any relationships with anyone; I don’t like people was spending a lot of time in his room. Instead of
because nobody likes me.” encouraging Scott to participate in ward activities,
How do I feel now? “Well, I feel nervous, very his primary nurse shared her observation and
shaky and scared. I don’t know what to expect, I asked Scott how it was helpful to him to spend so
don’t know what is going to happen.” “Confused, I much time lying on his bed, alone in the room.
guess, and I’m tired.” Scott’s reply was, “The voices don’t bother me so
What do I think this means? “I don’t know, much.” This opened a conversation, helping the
that was my question, maybe I will go back to jail, nurse begin to understand what this was like for
maybe it means I needed help.” “It means I have a Scott and what might be helpful for him.
lot of challenges to meet.” In another conversation, the primary nurse
What does all this say about me as a person? asked “the miracle question.” “Suppose that to-
“I just want to be a better person, I want to be well, night, while you are asleep, the problem you have
and I want to take care of my mother.” was miraculously solved. How would you know?
What needs to happen now? “Well, I suppose What would be the first difference you noticed
I’m here for an assessment.” when you woke up?” Scott’s unexpected reply—
What do I expect the nurse to do for me? ”I’d have a friend.” By exploring—rather than
“Continue to talk to me the way you are talking closing down—the narrative, the nurse began
to me. No one ever talks to me like this. You are to involve Scott in “what needed to be done” to
listening, and it seems like you believe me. This is help him.
so different from jail and anywhere else.” The Holistic Assessment and the Personal
The people who are important: “My mother is Security Plan represent the first steps in helping
the only important person in this world. My step- Scott reclaim ownership of the story of his diffi-
brother came back only for the money.” culties and/or distress: beginning to explore
Things that are important: “Well, able to share what action needs to be taken—by Scott and/or
with others.” “My dog—Pepper, but he is at the others—to reduce his distress and address his
Continued