Resolving therapeutic impasses in medical settings: A case study

This paper uses a case study to illustrate a framework for identifying and then resolving therapeutic impasses in medical settings. A pediatric case study involving a 12-year-old girl with Acute Lymphoblastic Leukemia who is unable to swallow the required oral medications is used to illustrate the framework. Impasses can be identified through a two-part ABC cycle: Affect which is negative; Behavior that binds the patient and therapist; and Consequences such as isolation, distance, and fragmentation in relationships. The solution to the impasse lies in the second half of the ABC cycle: Accessing relationships, Balancing the intervention between resolving the identified symptom and building relationships, and focusing on the Competencies of all involved parties.