Learning to self-infuse

In this scenario, a mother and her preteen son discuss his interest in attending a school trip that would require him to stay overnight. The mother has been administering the son’s infusions, but if the son wants to attend the school trip, he’ll need to learn how to self-infuse. We’ll explore this scenario using the “directive” and “constructive” approaches to see which approach leads the son to agree to learn how to self-infuse. Each approach is followed by commentary to provide background on why one approach may have been more effective than the other. 

TRANSCRIPT

Transcript

  • Mother:

    “How was school today? Anything new?”
  • Son:

    “Ms. Jones said the whole 7th grade is going on a 2-day field trip to Washington, DC. During lunch, all my friends said how much fun they’re gonna have, especially cause they’re staying at a hotel.”
  • Mother:

    “Well, you’d be able to go too if you just let me teach you how to self-infuse.”
  • Son:

    “Who wants to go to DC anyway!! I don’t get why I have to learn. It’s so much easier for you to do it for me. And besides, I’m too busy with homework and school and stuff.”
  • Mother:

    “Look, it’s about time you learned cause you’re not a little kid anymore, and I can’t do everything for you. It’s time you took responsibility for your hemophilia.”
  • Son:

    “You don’t do everything for me! And besides, I don’t have time for this. I have to do my homework.”
  • Mother:

    “Look, you have to learn sometime. You might as well start tomorrow.”
  • Son:

    “Whatever... if you say so.”
  • Dawn Rotellini:

    “Did you find this to be an effective discussion? The mother was forceful and didn’t explore her son’s concerns around learning to self-infuse. The mother puts a lot of pressure on the son and blames him for being unwilling to take responsibility for his infusions. The son feels defensive and reacts to the conversation. He thinks his mother is giving him the standard lecture about growing up and taking responsibility for himself and this conversation is no longer about the school trip or the son’s feelings. What are the chances that the son will be engaged in the process of learning how to self-infuse? Even though he reluctantly agreed with his mother’s request to learn tomorrow, do you think he is really committed to doing it? Let’s take a look at this same scenario using a more constructive approach.”
  • Mother:

    “So how was school today? Anything new?”
  • Son:

    “Ms. Jones said the whole 7th grade is going on a 2-day field trip to Washington, DC. At lunch, all my friends were talking about how much fun they’re gonna have, especially cause they’re staying over at a hotel.”
  • Mother:

    “Yeah. Sounds like they’re gonna have a good time. Do you wanna go? Sounds like fun.”
  • Son:

    “I do, but because all my friends already said they’re definitely gonna be going… but who’s going to do my infusions? No offense mom, but if I bring you, you’re just gonna embarrass me. No one’s bringing their parents along.”
  • Mother:

    “Well, how would you feel about learning to self-infuse? Then you wouldn’t have to miss the trip.”
  • Son:

    “I don’t know. Do you think I can do it by myself? I’m kinda nervous about it.”
  • Mother:

    “I really do think you can do it. I know you’re nervous because you’ve never done it before, but—how does this sound: What if we did it together at first, and then when you felt more comfortable, you can start doing it on your own. What do you think? We can take it step by step.”
  • Son:

    “OK… I do want to go, but only if I feel comfortable.”
  • Mother:

    “Well that makes sense… When’s the DC trip? And what do you think about starting tomorrow?”
  • Son:

    “DC is still in a few weeks, but do I really have to start tomorrow?”
  • Mother:

    “Well, if we start tomorrow… and you can tell me how much you want to do on your own and how much you want me to guide you... That will give us more time to make sure that you’re comfortable. The more time that you give yourself, the more time you can practice. What do you think about that?”
  • Son:

    “Well if you want me to start tomorrow, we can start tomorrow.”
  • Dawn Rotellini:

    “Overall, do you believe this was a more effective conversation? The mother is willing and able to explore her son’s desire to go to Washington DC with his class, and understands his reluctance to go on the trip because he doesn’t know how to self-infuse. To alleviate his concerns and nervousness, the mother suggests that he learns how to self-infuse by taking it step-by-step and asks her son for his opinion on this approach. The son recognizes that in order for him to go on the trip, he will need to learn the process sooner rather than later. With his mother’s support, although the son has self-doubt, he is willing begin learning how to self-infuse tomorrow so he can join his friends on the trip. . Overall, the mother listens to her son and respects his concerns about learning how to self-infuse without being forceful throughout the conversation. The mother allowed the conversation to proceed in a way which enabled the son to make the decision for himself.”

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