A graduate professor of mine, Dr. Reuschling, said in class all the time, “I got stuff, you got stuff, we all got stuff”…but most of humanity is able to handle their “stuff” in an appropriate manner. When someone is unable to handle their own stuff then they become our client, either voluntarily or by force. Children usually do not have a choice to come and talk with a counselor so all who interact with children, including myself, have one more obstacle to hurdle. It is a challenge to win over a child who is displaying crazy behavior but not impossible.
A tremendous amount of thinking is going on within a counselor’s mind during the first few seconds of contact with a new client. Will the client like me…will the parent like me…will the client be disruptive or compliant…how will I handle irresponsible behavior…will the client be able to understand my thought pattern…will I get enough information to arrive at an appropriate diagnosis…etc. All of these thoughts plus thousands more occur within the first few seconds of initial contact with a client and the family.
When a client displays crazy behavior, the parent gives me the “see this is what I am going through” look. The word ‘crazy’ usually does not unveil its head during the assessment but it is implied heavily. As I try to find out the etiology of the presenting problem, I willingly open myself up to eccentric thought processes. In my experiences, most of the crazy behavior that is demonstrated by the child client is learned from a chaotic environment. In the chaotic environment there is a lot of disconnection between relationships. When there is disconnect with relationships there will be coping skills that appear crazy or irresponsible.
It is good to make note of this crazy behavior in the mental status exam section of the assessment. How the client reacts physically, verbally, emotionally during the assessment should be recorded and weighed carefully during the clinical recommendations. During the entire assessment, I am processing any clinically significant impairment or distress that would help determine medical necessity of counseling services. Just because a client displays crazy behavior does not mean it is clinically significant for counseling services.
My view of crazy or irresponsible behavior follows the teaching of William Glasser’s Reality Therapy. Glasser says that irresponsible behavior is our best attempt at the time to meet our needs. If we didn’t have crazy or irresponsible behavior to rely on, we would inevitably choose death. Our crazy actions prove that we have been endowed with an extremely creative mind that wants to preserve its nourishment, namely the body, from destroying itself. If crazy or irresponsible behaviors and actions preserve the body then, at that moment, the craziness is working and meeting the need of survival.
So, don’t immediately label someone crazy just because they are displaying crazy behavior. Labeling someone crazy just gives approval for the crazy behavior to continue. Crazy, for the most part, is not inherited or genetic but instead a coping mechanism for survival. We as counselors must equip our clients, who have been labeled crazy, with proper and positive coping skills that ignite insight into why the choice of crazy was ultimately chosen. When a client changes the crazy or irresponsible behavior to responsible behavior then we have done our job and hopefully made a lasting connection in their quality world.
Josh Andrews is a counselor at a behavioral health agency working with children, adolescents, and families. His professional interests include the spiritual side of humankind, cognitive behavior therapy, reality therapy, and advancing the knowledge and practice of professional counseling.