The reluctant or resistant caregiver

Excerpted from Part 4: Special Issues - TAPP-C: Clinician’s Manual for Preventing and Treating Juvenile Fire Involvement.

Considerations

As a clinician, you will invariably encounter caregivers who indicate either an inability or reluctance to follow through with intervention suggestions, such as home searches for fire materials, restricting access to ignition sources, and/or increasing the supervision of the child. In these instances, it is important to explore with the caregiver the reasons for the apprehension or reluctance to complete the assigned tasks or intervention recommendations.

For instance, if a caregiver’s reluctance to comply with treatment recommendations is a motivation issue, find ways to engage the caregiver in the treatment, and help him or her to understand the importance of fire safety.

Likewise, some caregivers may not feel a specific intervention is necessary in their home or for their child. Discussing this openly with the caregiver may help clarify any (mis)conceptions they have about fire-related behaviour.

Others may feel unable to succeed with an intervention, expecting that their child will not comply or that they do not have the resources to meet certain treatment requests.

Another common complaint that caregivers voice is the lack of time or energy to complete certain interventions.

The parents of children who engage in firesetting often have limited resources to cope with the demands of their daily life, and feel overwhelmed. To ask them to perform further household and parenting tasks (like searching the home for fire materials and increasing the supervision of their child) can often strain an already weary parent. Part of the clinician’s job is to access the caregiver’s internal resources and build in more external resources so that they can follow through on necessary interventions. Asking the caregiver who else in his or her life may be able to help institute various recommendations is often a beginning to making a fire-safety treatment plan with a caregiver.

Intervention modifications

For instance, supervision is often an issue for working parents in the late afternoon, after their child returns home from school but before the parent gets home from work. The clinician could use a problem-solving approach with the caregiver to brainstorm a number of supervision possibilities for the child during the late afternoon. Drawing on extended family members, family friends and neighbours, or taking advantage of after-school groups or structured activities are often viable supervision alternatives when caregivers are unavailable.

Another practical suggestion for supervising children is to establish a “safe” area in the home in which the child can play, and not be directly supervised by an adult. It is imperative that the “safe” area be void of any fire materials, as well as other potential safety hazards, so that the caregiver can take care of other demands or duties in the home while the child is allowed to play safely.

The clinician will need to work collaboratively with the caregiver to understand the nature of the resistance or reluctance, break down the problem or obstacle into manageable pieces, and use a problem-solving approach to develop strategies to implement needed intervention.

In addition to the direct benefits of the fire-safety interventions themselves, following through on such interventions sends an important message to the child or teenager that fire safety is important in the family’s home. It also allows the caregiver to model fire-safe behaviour.

In an effort to prevent obstacles from interfering with a caregiver’s (or child’s) participation in the program, and to increase the family’s chances of success, it is helpful to continuously ask for client input, especially regarding the likelihood of their being able to implement the suggested interventions. Treatment recommendations can then be adapted accordingly.

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