Beyond the B.A.S.I.C.S. Blog

Building Client Rapport

November 6, 2015


 

Building Rapport

Prior to initial meeting:

  • Review the information, if available, about your client prior to your first meeting
    • If there is an FBA or client intake information available use this to your advantage. These documents usually contain information that can give you an idea of a client’s reinforcing items if the report directly lists them or not.
      • If these documents are not available, contact the supervisor and ask if information can be provided.
    • These forms can also produce information on a client’s dislikes.
    • Both reinforcements and dislikes can be informative and shape what you do prior to, during, and after your first session in particular and every session after.
    • Once you have this information, plan. We talk about our client’s ABCs, well as a clinician use this information to help you form ideas of activity and items you may want to bring to increase the likelihood that YOUR antecedents and materials are catered to the client.
      • Example: if you know your client is a 10-year-old verbal boy who likes to play basketball you would not bring bubbles.
      • Example: If you know your client likes a particular show, spend time watching a clip of the show to get an idea of the characters, plot, etc. so that you have a common interest to either talk about, create reinforcements with, or facilitate language with.
    • Reviewing and planning prior to your first meeting will make a difference. You won’t always have a child’s most desired item in your reinforcement inventory, but if you have the knowledge then you can ask the guardians once you get there to utilize these items if they are appropriate and available.
  • The reinforcing items should be what you pack in your therapy bag.
  • If you do not have information on a client prior to your initial meeting, you as a skilled clinician can:
    • Use your resources:
      • Ask the guardians
      • Use your own bag of RX that you brought
    • Assess what RX the client is gravitating towards
    • Make a list of the items that are reinforcing to the client
  • Luckily, most of our clients have similar interests since a lot of our incoming clients are early intervention. For example, bubbles, sensory toys (balls, pull toys, slinky, etc), cause and effect toys, legos, pop- up books, potato head, cars/ trucks, puzzles, play dough, and apps on the ipad.
  • If there is no reported or observed reinforcing items you can utilize and run a paired choice reinforce assessment that you learned about during training. Copies are available in dropbox.

During initial meeting:

  • Greet the client warmly
  • Let the client pick the first few activities/ toys
    • Verbal request or waiting and allowing them explore the space and see where they gravitate towards
  • Observe, play, and engage with the activity.
    • Your level of involvement will be dependent on the client IE will you just have a shared space and different toys, parallel play, joint play etc.
  • Throughout the first session run fewer goals and trials in comparison to a normal session.
  • Try to remember that you are there for a reason and expect that this session will not define your rapport with this client.
    • For example, you are playing with a client (you press a button on a game and it lights up) and he starts flapping his arms and engages in self-injurious behavior (bites himself). He might do this because he is overly stimulated and/ or doesn’t have the language to say, “Again!” or “more”
      • This does not mean you do not have or are not building good rapport.

After initial meeting:

  • Whether you had information prior to or not won’t matter at this point. Now, you’ve spent time with the client and have the knowledge. Tailor reinforcements to each client. The more reinforcing your Rxs are the more reinforcing you become. Then, the client is likely to be more motivated to respond to you and making that positive connection with you.
  • Rapport building is not just about the materials you bring however. It is important to remember that utilizing the behavior plans, reinforcement schedules, and reinforcement supports (visuals, token boards, etc) are crucial to building and fostering your rapport with your clients. Consistency and expectation is key for a lot of our clients. If you as a clinician are inconsistent in presenting, trialing and reinforcing it will not foster trust, which is built every session with every client whether they are verbal/ nonverbal, infant/ adult, etc.

Consequently, rapport building is all about what YOU can do as a clinician. If you start to think about rapport building in that way versus “the client….. (didn’t play with me, didn’t respond to me, etc.) and remember that at the end of the day our clients are people and sense your responses it will promote positive rapport.

Chrissy Burke

BASICS ABA Therapy, LLC

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