How to Recover from a Terrible Treatment Experience

NOTE: When I recorded this video live, the video was displaying in the vertical direction and not horizontal as it is here. We were able to fix it in post-production. Just keepin' it real! 

We know that day to day, there will be ups and downs in our practice of pediatric acupuncture.

Some days we have a big win, the child responds well to treatment and is feeling better by the end of the session. It's easy for us to want to hang our hat on those wins: This is going great, my patient is healing. I'm an awesome practitioner!

But if usually, we hang our hat not only our wins but also on our losses. Which means it's easy for us to think that if my patient has a bad experience, it means I'm a bad practitioner.

I don't want anyone to get into this mindset, because it means your confidence will be constantly going up and down based on things you can't control, like whether a patient takes your advice or not, or how a child responds to being in your office.

There's a positive feedback loop between confidence and competence: with increased confidence, comes increased competence, and with increased competence, comes increased confidence.

We want to build a stable mindset that encourages this feedback loop, one that doesn't get caught up in the ups and downs of day to day practice. We want to be able to take our wins and use them to grow our confidence and competence. And when we have losses, we want to be able to respond to them in ways that don't kill our confidence.

THREE TIPS & AN IMPORTANT SCRIPT

There are three tips I have for maintaining a good mindset even when you've given what feels like a terrible treatment: first, don't take it personally, second, see what you can learn from it, and third, keep a journal of your wins. We're going to explain each of these in this blog post!

I'm also going to share with you a script that will help you deal with a common situation – when you're in the middle of a conflict between the child and their parents. Specifically, when the parents want the child to have acupuncture, but the child doesn't want to have anything do with needles. This can get really awkward, but it doesn't have to.

Armed with these three tips and the script I'm about to give you, you'll be able to get through the terrible treatments, or avoid them altogether.

#1 DON'T TAKE THINGS PERSONALLY

Let's begin with how to handle a situation that doesn't go well. There are many ways a treatment can go wrong: You could have a child who is screaming, hitting, kicking, biting, or just generally doesn't want anything to do with you.

Now you may be lucky enough to have never had a child cry yet. But I suspect if you're a pediatric acupuncturist, you probably have experienced this at least a few times! And the fact is, the more children that you see and the more you become known as the pediatric expert in your community, the more likely it is that you will have a treatment experience with a child that doesn't go smoothly.

So whether you've struggled with these scenarios in the past, or haven't gotten to that point yet in your practice, learning how to deal terrible treatment experiences is a necessary skill for anyone specializing in pediatrics.

When things go wrong, it's easy to beat ourselves up about how we made a mistake, screwed up, lost a patient, are a terrible acupuncturist, and other self-defeating, negative thoughts.

But if a child constantly acts out or is afraid of you, the first and most important thing is to not take it personally. This kind of reaction is usually a sign of past trauma. It has nothing to do with you, so don't make it about you! Do not take it personally if a child is frightened and doesn't want to receive treatment.

IT HAPPENED TO ME, TOO!

I'll never forget my first experience with this kind of patient. Ten or eleven years ago I was just getting established as the local pediatric specialist, and my friend referred a little girl to me who had eosinophilic esophagitis.

At our first appointment, I thought everything was going great. I was having a conversation with her mom, who had been filling me in on her medical history. Before seeing me, this little girl had experienced a whole gamut of medical procedures. She had surgery, she had a feeding tube, and at one point had been hospitalized for two weeks. She also had regular blood draws which were so painful and traumatic for her that she had to be held down while they drew her blood.

Because of her history, we weren't even going to try acupuncture on our first visit. So I took out my Pointer Plus, and while I was still walking toward her, the little girl started screaming. Screaming turned to thrashing, thrashing turned to hitting, and hitting turned into full-on tantrum mode!

I tried some of my usual tricks when this happens – I left the patient with her mother, so she could calm her down. When they seemed to have settled, I came back to the room and immediately the little girl started screaming again. She was so upset I wasn't able to perform the treatment at all. Her screaming had been so loud that after she left, my next door neighbors came over to see if everything was okay. They were worried I was torturing this little girl, when I hadn't even touched her!

I even got the mom to come back a second time and give it another try, but the second time it wasn't any better.

I was really dumbfounded since this was the first time this had ever happened to me. I didn't know what to make of it. Was I a bad acupuncturist?

No.

What had happened was that this little girl had a medical trauma, and simply wasn't willing to let anyone she didn't know get close to her. Because of the nature of what had happened to her, building trust with her was going to take more than just one or two sessions. She simply needed more time to recover.

Her reaction had nothing to do with me personally, or with my skills as an acupuncturist, and everything to do with her history of trauma.

#2 ASK WHAT YOU CAN LEARN

Sometimes we make mistakes that can compromise a treatment. What's important is that rather than dwelling on them, or on the feelings of disappointment that come from a bad treatment experience, we learn from them.

Here's an example of a time I made a mistake, and what I learned from it:

I was treating a little girl on the autistic spectrum. Autism can present with either hypersensitivity or hyposensitivity, and when I asked what this patient's presentation was, her parents told me she was hyposensitive. But they also warned me she had problems regulating herself – she would get extremely emotional whenever she was hurt or upset, and was not able to stop herself from crying or screaming.

Even though I'd heard this, somehow it didn't quite register, because I saw her playing so quietly and sweetly in my clinic's waiting room. She seemed so well behaved, and her parents told me she was in the hyposensitive class, so I figured we could try acupuncture on this first visit.

I thought I did everything right. I got down on her level, explained to her about the needles and everything we were going to do. I put the first needle in and she seemed fine. But the second needle must have hurt, because immediately after I inserted that needle she started crying.

And crying.

And crying!

I still had to explain my treatment plan to her parents and she cried throughout this continuously. At that time I didn't have a front desk person, so I had to check her out myself, reschedule her, and give my prescriptions, all with this little girl still crying. I heard her crying in the parking lot even after they left my office, all the way to their car. Now I understood what her parents had to deal with at home, and what they had tried to tell me earlier.

I realized at this point I had made a huge mistake. And it wasn't that I used needles. It was that I didn't really listen to the parents. They had told me how she tended to react, and what some of her triggers were, and yet it just didn't click for me what would happen if she had a reaction to a needle.

Now when we have a bad treatment, it's disappointing that we didn't get to help a child that we wanted to help, but rather than getting caught up in that disappointment, we should be asking ourselves what we can learn from the experience. What can we do differently next time? How can we serve our patients better if we find ourselves in a similar situation?

Unfortunately, that little girl and her parents never came back. I never had a chance to help her, but I did take this as an opportunity to learn about the importance of listening. And from using what learned from this experience, I have been able to help countless other children!

#3 KEEP A JOURNAL OF YOUR WINS

The final suggestion I have is the practice of keeping a journal of your wins. I call this the Book of Awesome, or sometimes, the Book of Inspiration!

The practice is simple: at the end of the day, write down the things that went really well in your journal. Record all of your patient wins for that day, and do this every day. Do not write down anything that didn't go well; this book is only for the wins.

I recommend this for two reasons. First, this is a high vibrational activity. When you focus on your wins, you attract more of them into your practice. You attract more patients who will follow your advice and do the things you ask them to do, which will improve your clinical outcomes!

Second, when you have a day where it seems like things aren't going well, you can look at your Book of Awesome and remind yourself of the things that are going well, and all the kids you've helped. The journal is a record of proof that you are here for a reason, doing the work you are meant to do, and having a positive impact on people's lives.

Whenever I'm having a bad day, I look at my Book of Awesome and think of all the kids I've helped over the last 15 years, and it never fails to lift my spirits. I really can't recommend this enough!

A SCRIPT FOR PARENTS WHO INSIST ON NEEDLES

The three suggestions above are for changing your mindset so you know how to recover from a terrible treatment. But wouldn't it be even better to avoid terrible treatments altogether?

Take a common situation: The parent who is adamant that their child receives acupuncture, the child who wants nothing to do with it, and the poor acupuncturist caught in the middle.

This is such a sticky position to be in when we're in the treatment room!

Sometimes the parent threatens to take away the child's privileges – which makes a bad situation even worse! “If you don't get acupuncture, we'll take away your birthday!” We do not want our child patients to be in a situation where coming to our office is associated with negative experiences and emotions. Instead of negative reinforcement, we want positive reinforcement.

So how do we avoid this situation? 

It's all about setting expectations. If this scenario hasn't happened to you yet, and you get into the habit of setting the proper expectations it probably never will.

It's absolutely vital that during your initial consultation, or when your receptionist is setting up a first appointment, that you explain what is going to happen during the first visit and that you set expectations accordingly.

More specifically, you need to communicate two important things to the parents:

First, your goal is to build rapport and trust with the child so that you can have a long term therapeutic relationship. Most of our patients are seeing us for problems that will take multiple treatments to resolve; hardly anything we see in the clinic is a “one and done”. So if the child feels scared, or ashamed, or forced to be there, they are not going to get the most out of their treatment! This is why trust and rapport are primary, and you must always communicate this to the parents. This is why negative reinforcement, like threatening to take away privileges, ultimately gets in the way of a treatment plan.

The second important thing to communicate: there is more than one treatment modality you can use! I cannot emphasize the importance of this enough. There is a very specific script you should use to get this message across. Here it is:

“Whether or not your child wants to do acupuncture, I have non-needle tools that have a similar therapeutic effect as acupuncture, and we will use those instead. This will help your child build trust with me and eventually, I promise we will be able to use needles. I have used these non-needle tools for many years, the benefits they provide are very similar to acupuncture, and I feel very positive we will have a good outcome with them.”

The key phrase here is similar therapeutic effect as acupuncture.

That's really what you want to convey, and if you can do this, most parents will be fine with non-needle therapies! Really, parents don't know that these tools exist and work just as well, which is why they can be so attached to acupuncture and insistent on their child getting needled.

Now of course as practitioners, we understand the subtle differences between needle and non-needle modalities, but for the purposes of managing parent expectations, these differences simply do not matter. We want to emphasize their similarities and express this with confidence.

Finally, when it comes to reinforcement, there are ways you can manage expectations as well.

For example, some parents want to use an “incentive plan”, like offering to buy their child a teddy bear if they receive treatment.

This is fine, but I always recommend that parents discuss this with their children before they come to the office. I tell them to think about what you want to give their child and discuss this ahead of time, so the child already knows she's getting a teddy bear if she cooperates.

Otherwise, the parent tends to wind up trying to negotiate in the office - “Okay, okay, if you get acupuncture, I'll give you a teddy bear, and I'll throw in some Pokemon Cards as well!” Before you know it, the parent is spending $100 or more just to get their child to try acupuncture!

SUMMARY

We covered a lot of ground in this blog post! To summarize, the best way to recover from terrible treatment experiences is to cultivate the right mindset: don't take things personally, always ask what you can learn, and keep a journal of your positive treatment experiences. You will be amazed at what a huge impact these simple shifts in perspective will have on your confidence and flow in the clinic!

When it comes to parents insisting on needles, manage their expectations before the first visit! Make sure they understand the importance of building trust with their child, and that they understand the similar therapeutic effects of non-needle therapies. And always tell parents that if they're going to reward their child, figure it out in advance, do not negotiate, keep it simple, and above all, do not shame the child or engage in negative reinforcement.

I hope this blog post was informative and helpful! Have you ever struggled after a terrible treatment experience? If so, leave us a comment and let us know how you dealt with it, and please know you're not alone!