Family and Caregiver Schizophrenia Discussion Forum

LEAP Role Play - Help Requested

I would appreciate help in learning how to implement the LEAP process with my son, specifically around his inability to use a heater to stay warm at night (30 degree temps) and his inability to eat anything more than one meal a day or $4 worth of candy.

Is there anyone available to coach me through this?

I can start by role playing my son, when I first arrive to check on him. I say hello, and ask him how he is. He says fine.

What would you say next?

I would reply, with a smile, “I’m glad you’re fine”.

I was able to remember my iTunes password and have been listening to music.

I’ve done role play several times as a mock patient for Occupational Therapists in training. It’s difficult to fully improv, so I ended up attempting to play my past self and scenarios back. Even knowing my history intimately it was difficult and I found myself breaking character to help out the OTs who were interviewing me. My suggestion would be to do less of a role play and more of an analysis of previous interactions with coaching and brainstorming of better approaches.

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“You must be happy that you could listen to your music.”

If my son looks talkative, I might go further and ask him about his music - “what are you listening to?”

@Maggotbrane is making a good point - if you review your past conversations you can see where you (maybe) tried to steer the conversation toward your goal instead of working LEAP.

I can’t remember if it was @Hereandhere or @Day-by-Day that taught me the open ended - “is there anything I can do for you today?” My son always appreciates that question.

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If I asked about anything I could do for him, he would say no. He Is fiercely independent.

Back to the role play, if you please…

My son would say I like Pink Floyd.

…and I downloaded some classical music.

We might have the same son when it comes to music.

“Pink Floyd and some new classical music- anything you think I would like?

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Sometimes my son will play the music for me. I offer to do his dishes (there’s a medical reason he can’t do dishes right now)

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From time to time I will remind him of the things I do take care of for him. Like “I did send the stuff to Social Security, your money will continue” He usually responds “thanks Mom”

His last psychiatrist said she would remind him of things I did for him, she also said she was disappointed that she didn’t have things to remind him that his dad had done for him.

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I offered to clean off his stovetop yesterday but he can’t tolerate that right now. He will say, “Oh, I did that around six months ago.”

I do a lot (much of it is behind the scenes.) He is always grateful, and when he has opportunity to say thank you, he does. :blush:

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Past tense? Is Dad out of the picture? My son lost his Dad when he was 11.

Another trick I learned about effective role play from multiple therapists (my present psychiatrist mentioned this too) is you should play the role of your son rather than yourself and mirror your idea of his responses. This way the person coaching you gets information about your perception and projections onto the person, gets objective context and can better model effective responses and introspection.

Notice that Dr. Amador in his TEDx talk takes a similar approach in his role play. He instructs people how to play the patients which has added effect of putting themselves in their places as well as coaching them on better following his directions and practice objectivity. A pair of peers could also swap back and forth, each playing each other’s charges with supervision.

I was glad someone told me about formula 409 for my son’s stovetop - yes, I have the same situation, sometimes he can’t tolerate me hanging around that long.

This doctor worked with cognitive behavior therapy, I believe she was trying to help him examine his situation. He would have concerns (delusions) about me and she was able to point out things that she knew I was doing for him.

I am so sorry your son lost his dad. No, my son’s dad is in the picture. We made a lot of mistakes in the early years of my son’s scz. My husband didn’t understand the importance of LEAP for building trust. My husband would question my son’s delusions and would tell him that he had a mental illness. As they say can happen if we challenge their delusions, my husband “became” a part of the delusions. Little by little, my son began to focus on his dad. My husband grew extremely fearful of our son - especially after a mom from our Family to Family class was killed (along with her husband) by their smi son.

Long story short, my husband stopped interacting with our son in any way. That’s why the doctor didn’t have anything she could use to build a positive case “for” my husband.

I have continued to make sure my son does know the things I do and over time he does trust me enough to let me know when he needs helps. I hope this relationship of ours will lead to meds at some point in the future. Currently we had agreed to disagree on the subject of meds. Current Plan we have Partnered on - is he runs the show and I support his decisions.

Our sons sound similar, both are determined to do things their way, they live on their own with life supports in place and both have anosognosia.

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Family to Family had us do the role playing as you are suggesting. The people who were struggling with this sort of communicating portrayed their family member with smi while others practiced LEAP. You could see people’s minds suddenly open up - we all have conversational patterns that have to be relearned to practice LEAP.

I worked LEAP for months and finally learned to hear opportunities when my son would mention something he wanted. I was so used to thinking “no he can’t do that” as an auto response.

Yes, the eye opener for me, was Dr Amador’s approach in this manner in the Tedx talk and in an earlier video. When I think about someone trying to convince me that any part of my life isn’t real and how hard I would resist any sort of suggestion of that nature - I could see the problem. My son’s life is just as real to him as my life is to me.

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I think I’ve mentioned my love/hate with the movie A Beautiful Mind. My mother mentioned the dual reveal of ‘agent Karcher’ and ‘roommate Charles’ as delusions opened her eyes in a similar way. I was probably more surprised at her surprise. It felt as if she hadn’t listened to me much at all or hadn’t understood my struggles because most of those discussions happened in therapy sessions where I was painfully aware of my delusions and was unsure what was real.

So tonight I drove over to check on him. I have been doing this for three weeks straight. He had one wet blanket covering him, a wet pillow, and a zip lock bag filled with ice on his forehead. I asked if I could put the ice in the freezer and he said he needed it to stay on his head for 40 minutes, and then he was going to drink orange juice. He talked about how the weather has changed so much lately. And how he wanted to drive a boat remotely across water. I listened and offered supportive comments.

I covered him with several more blankets, offering to switch the wet blanket for a dry one, and he didn’t answer. I stayed longer than usual, sitting beside him. I always wonder if this will be the last time I see him, this side of heaven. It is agonizing.