When behavior is motivated by revenge.

It is particularly challenging for me to design an effective intervention when disruptive and destructive behavior is motivated by revenge. I work with adult criminals in a mental hospital. One challenge I am facing is with an individual who uses with a flurry of false abuse reports to various agencies in response to any attempt from our staff to redirect forbidden behavior . The approach I am having our staff use is to act unaffected by the revenge, to assure the patient that we are concerned about his safety, and then develop logical consequences that directly relate to his lies. For example, after being redirected from sexually inappropriate activity, the patient registered multiple complaints of falling multiple times without staff reporting or recognizing the falls and that a particular staff member has caused him to fall on occasion. Medical, neurological, criminal, licensing, patient rights, and environmental investigations were all prompted by his official complaints. No medical evidence has been found to support his claim of falls. This is typical. In the criminal investigation the staff member will most likely have to be reassigned and a note will be placed on the staff record that an investigation has taken place. We have responded by placing the patient on 24 hour one to one observation and by requiring him to use a wheel chair to ambulate. We are also having him go to physical therapy to closely monitor his gate and to help him with new skills that will prevent falls. We have made the treatment plan to last for one month. This seems to be a good logical consequence because it will address the lie and interfere with the his goal of being able to do what he wants to do when ever he wants to do it. The staff are directed to only express concern for the fall risk and to act unaffected by his continuing reports of abuse. The are to cheerfully offer complaint forms. It is also typical for this patient to make a retraction statement in a few months after all the damage is done from the criminal investigation. I would welcome criticism of this approach. I would like any suggestions for what can be done to enhance effectiveness in increasing the patient's awareness of the uselessness of this approach for meeting his self interest.

Craig

Replies:

Re:When behavior is motivated by revenge., by Craig T., 04/30/02 Re:When behavior is motivated by revenge., by Henry Stein, 05/07/02 Re:When behavior is motivated by revenge., by Craig T., 05/12/02

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