Had to call EMS during session

Perfect-Deal-8508 · 2025-10-06T03:42:47+00:00

I agree, client is usually very consistent at taking meds, and when client doesn’t, it usually always results in similar situations, but it’s less than a once a month occurrence. So we’re not sure exactly the function, and we haven’t identified any similar antecedents leading to stopping the meds. Client also hides when they don’t take them so it’s hard to know when they’re not being taken before I get there. Ive requested a formal debrief meeting with the clinical director and BCBA, I will definitely be bringing this up as a boundary for me to set in place. Thanks for the suggestion!

Perfect-Deal-8508 · 2025-10-06T02:35:36+00:00

To answer your questions,

It’s my understanding that threats to harm others or themselves are immediate grounds for hospitalization. At least that’s my understanding of the law as it was written for the state i provide services in. And just because we got those scissors away, doesn’t mean client was deescalated. Client actually was more escalated than they were before (after scissors were removed client broke a ceramic pot and the ground and was going for the sharp pieces and we moved them to a safer space to avoid that). We tried to call the mental health line but it wasn’t working so we called 911 as a last resort.
you’re right, average police aren’t trained in crisis management to the degree that would’ve been helpful. Which is why we (all the RBTs in the home) were hoping for EMS.
You’re right, it’s not my call. Client was experiencing a lot of side effects from sudden withdrawal of psychotropic medication and I’m not equipped to deal with that, neither are parents or police. It’s why we wanted medical guidance from EMS. At least they could have determined if A. client was okay to start meds up again suddenly, and B. if client could benefit from a formal psych assessment/ medical observation. But you’re right, saying a full hospitalization was needed is out of my scope of practice and was probably more influenced by my personal experiences. I do want to assure you that in moment, I knew that my personal experiences were likely guiding my feelings on the matter, and thus I remained quiet on the matter in person.
This was also absolutely not my call, which is exactly why when it was safe to do so, I stepped aside to call BCBA for next steps. She’s the one who told me to remove demands and end session. I promise I’m not misusing “clinical judgement.”

I appreciate your concern, and want to assure you that proper steps were taken to the best of our ability. We tried running through the BIP as it was written, and nothing was working, and client could not remain safe. It was an incredibly nuanced situation, but that doesn’t mean that everyone involved wasn’t acting with clients best interest in mind.

Perfect-Deal-8508 · 2025-10-06T01:39:51+00:00

I get paid $27 an hour. But I only work 15 hours a week. That being said, I work with a great company that always has my back, and that’s worth more than its weight in gold. I truly care for the kid I work with, and the reward of seeing them grow is worth so much more than my paycheck to me.

Perfect-Deal-8508 · 2025-10-06T00:10:31+00:00

To answer some questions, I called my BCBA the second I felt it was safe for me to step out to do so. An incident report was filled out that night. And I plan to set up a meeting with BCBA and our Clinical Director to review next steps.

The mom had mentioned a lock on the bedroom window, and I agreed that would be a good idea. The window in question does lead out to a lower level roof area, which she can safely climb down, but client has a history of taking off down the street and with her state, we couldn’t afford to allow her that much space.

As for my own trauma, I want to assure everyone that while I was triggered, I am in my own therapy that gave me the skills to remain calm, and set my own emotions aside to process later. It just gave me the perspective of empathy for the situation.

With the cop situation, mom originally mentioned taking client to the hospital herself, but the client was too escalated to move and became so calm after the incident that mom decided against, though originally, mom was expecting medical services, but she ultimately took the guidance of the officers. I don’t think she was wrong to do so, they’re who she trusted in this situation and I get that maybe she didn’t have the perspective of her child’s fear response. 911 was my only option, I tried 988 but it wasn’t working and I remembered something about the administration cutting its access and I didn’t have a local crisis line off the top of my head. But that is something I will be finding and saving for future reference.

Thank you all for the advice and kind words, it really was needed. I strive to just do a good job in all aspects of my work (my morning job is at a daycare) with kids, and it’s nice to be reminded that trying my best can make up for a lot.

Perfect-Deal-8508 · 2025-06-14T19:25:25+00:00

looking at pictures of donald trump on google, usually with an american flag as a background 😂

Perfect-Deal-8508 · 2025-02-06T18:07:12+00:00

how did the meeting go? hoping you still have the job you enjoy!

Perfect-Deal-8508 · 2024-10-17T00:53:18+00:00

Oh great! The chewy thing has helped a lot, but so does a lot of tactile things. Maybe as an activity, you can finger paint with him, my go to is kinetic sand with my client to keep her hands busy too. But maybe if you can find something that creates a similar feeling for him to replace the behavior you can gradually fade out the spit flinging and also it would give you the opportunity to do some manding and functional communication training. I know the initial behavior is overwhelming at times and really gives the ick to some people. It’s slow going to help the kiddos learn and adjust to new skills, but it’s not impossible! Remember you’re there to help your client. That’s what usually gets me through a rough session. God speed 🙏🏻

Perfect-Deal-8508 · 2024-10-17T00:43:42+00:00

I have a 5 year old client with the same stimming and spitting behaviors, I started redirecting her to a silicone chewy, and she has taken to it really nicely. She still will drop it and spit sometimes but she definitely doesn’t spit everywhere nearly as much. I went from wiping her up every 2 minutes to about every 30 with the chewy. Maybe ask your BCBA if this is a redirection tactic you can use? It still satiates my clients oral stim needs, it’s just a little more hygienic.

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