Examples from the Road: Mindlessness In-Home

Clinicians reflect on in-home therapy in the following manner:

“As I drive up to the house, I have the sense that I am an intruder, that those I am visiting are ambivalent at best about me coming into their home. I park a couple spots away from the house, wondering if my client will be walking down the street from her bus stop, past my car. What should I be doing as she walks past? I think of her foster mother, who is fed up with her and accuses me of being too soft on her because I don't demand information out of her the way she does. I get out of my car, sleepy from the drive, my eyes having been glued to the road for over an hour.

I walk across the street, nervous about what to address in today's session. If I decide to introduce something, it is certain to lead to bouts of silence. I always feel a bit silly walking with my play/art kit, which is translucent. I walk over the grass, since the car is blocking the driveway. I never thought to ask if it's okay that I walk on the grass. Maybe I should have.

As I approach the door, I become a therapist, and for a moment I realize that working in my client's home is a privilege. This thought quickly dissipates and I continue to feel me becoming the therapist. This therapist is me, only not; it's me, but only certain parts of me.

The other parts of me push and yell to be seen, but I beat them back with conscience and pride. I am sort of a therapist/supervisor with her foster mother, so I let out more parts with her, but it's still a battle, albeit in the good war. I want to scream at her that she needs to meet with me and ease up on her expectations, and please tell your foster child that you love her, and oh, be nice to me while you're at it… but that wouldn't be therapeutic. I become a receptor of information. Moving slowly, taking everything in. Planning my next move. There is no such thing as routine or automatic.

There is a moment when I begin to panic. I wonder about myself: how others – my clients – see