Comic 2

Comic 2
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  • Liz
  • Thank you for your insight! What I am hearing from that schedule is that you might not be scrubbing your body enough, and that it might help to introduce shampoo into your shower routine.  How do you feel about implementing a wash cloth and shampoo into your shower- would you be willing to try out these suggestions? 
  • Tim
  • Ari
  • Ritchie
  •   Absolutely!  All of that sounds easy and doable and I think you are right I should be scrubbing more in the shower and maybe showering a little bit more often my sister always says that I will only get a job if I am clean so who knows maybe this change will help me get a job- what do you guys think? 
  • Tim
  • Go for it man.  Being clean might help you, but all that change is too hard for me.  Too many unknowns, man.  I don't need to change.  
  • Ritchie
  • Liz affirms what Tim is saying after allowing him to go through his process without judgement or criticism.  She summarizes that he may not be scrubbing or cleaning himself as well as he should be, and offers some suggestions.  She asks if these are okay, and does not say that he should try them, but whether he would like to- offering up some autonomy and power of control, hopefully leading to increased self-management skills. 
  • Liz
  • Thank you for sharing, Ritchie. I know it can be difficult to accept that we need to sometimes change how we do things- especially in hygiene.  For instance, I definitely do not floss my teeth as much as I should, and am working to do so more.  However, I do like how supportive you are of Tim, that is very friendly of you.  Tim, I would like you to make a plan of action for tonight's shower.  
  • Tim agrees with these suggestions and offers that he will try implementing them into his shower schedule.  Note that the frequency of showering is not something that was brought up, as it is important to work on skills from a bottom up approach before trying to complete a task many more times.  Tim begins to think about the affects that this change can have on his future occupations- another key of self-management, and asks the group for their thoughts.
  • I'm going to go home and take a shower and I'm going to wash my body with soap and a wash cloth and wet my hair and rub my hair with shampoo and then rinse it and rinse my body and then get dressed and THEN I will play video games 
  • Tim
  • Ritchie has paranoid schizophrenia, and responds to Tim.  He encourages him to try these skills in the hopes of advancing Tim through the stages of TTM.  However, he replies that he does not have the need to change in his own life, because he states that change is too hard, indicating that Ritchie is not self managing any of his noticeable hygiene needs. 
  • Liz
  • That sounds great, Tim.  I think that you have a great baseline for where to start in this self management of your hygiene skills, and I am glad that you are beginning to action in these areas of need!  And thank you Ari and Ritchie for your feedback to Tim.  Does anyone else have a hygiene need that they would like to express and work through? 
  •  Liz thanks Ritchie for responding to Tim.  Liz is aware that Ritchie has noticeable hygiene needs to work on such as cleanliness, body odor, and oral hygiene.  Because he is not aware of these issues and has no intention to change, he is in the precontemplation stage of TTM.  She self discloses that she too has trouble with some hygiene tasks that she admits she can improve on, in the hopes that Ritchie may begin to accept the need to modify some behaviors, too.  
  • Tim
  • Ari
  • Ritchie
  • By asking Tim directly his plan of action for tonight's shower, Liz is setting him up for success tonight.  He eagerly and confidently states a plan for his time after program ends, and understands that his hygiene needs are to come first before leisure occupations.  If he continues with this trend, he will be entering the action stage TTM next, increasing his self-management.
  • Once more, Liz thanks Tim for participating, and the group overall for their feedback and ideas to Tim.  She then continues the conversation about change and self management, opening up the floor to others in the group.  
  • Tim
  • Ari
  • Ritchie
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