When Should I Reveal to NT Client She's Being Lied To?

Post Reply New Topic

I work twice a week as a "direct support professional" for a 38-year-old NT woman, "Stella," with a mild intellectual disability (she believes her IQ is in the 80s). She's very high functioning and once worked part time doing stock work at a large retailer. Stella lives in a host provider home with two lower functioning adults whom she's always talking about how bad their critical thinking skills are and how childish they are.

She's had an NT friend, "Bill," for many years who's 34. She often brings him up in conversation. Nearly every time she brings him up, he has a new job title. Bill is in a day program (they met at one). So he obviously has some sort of cognitive impairment. His mother gets paid by Medicaid to "take care of him," as Stella says. She's well aware that Bill has never lived on his own and has never had a driver's license. She acknowledges he has "disabilities." When I asked what they were, all she could come up with was seizures and ADHD.

In the year I've worked with Stella, I've learned that Bill is an ER doctor, a doctor specializing in cerebral palsy, a paramedic, a psychologist, a lawyer, a detective, a former Walmart manager "in charge of the special needs department," a former chef for the Broadmore (high-end resort), used to help people buy cars, and has owned several businesses.

It flabbergasts me that Stella is naive enough to believe all this while at the same time knows the other facts about him (day program for years, never lived on his own, Mom gets paid to "take care of him").

It infuriates me that this arrogant pr*ck has played Stella for a fool for years and that their platonic friendship is based on his extensive lying about himself. It vexes me that Stella has failed to ask herself why a doctor/lawyer/detective would be in a day program, or flipside, how someone with special needs who qualifies for a day program could also be a doctor/lawyer/detective/store manager/high-end chef.

I'm flummoxed that she believes he works nights at a specific local hospital, yet at the same time needs his mother to take care of him.

I SO DESPERATELY want to tell her he's lying his head off, and as an autistic person, I have a very heightened sense of justice and can't stand that he's brainwashed her, especially since often, she talks about how good her critical thinking skills are.

What keeps me from sitting her down and explaining just what it takes to become a doctor/lawyer/chef and HOW MANY YEARS all of this would take (e.g., the Broadmore requires a 24 month internship ON TOP of two previous years in the culinary field or a four-year culinary degree), is that she might become so upset that she won't want to work with me anymore.

I REALLY need this job, though. I recently moved and must drive quite a distance to pick her up, so currently, I'm looking for local work. At some point I anticipate getting local work and phasing out from working with Stella. As that time approaches, I DO intend on sitting her down in a quite area of a cafe and very carefully explaining why someone who's disabled enough to qualify for a Medicaid waiver to pay for a day program couldn't possibly have the brain bandwidth to EVEN PASS THE STANDARD TEST TO GET INTO MEDICAL SCHOOL in the first place!

Anyways, I'm just curious about you guys' opinion on this, seeing it through your autistic lens.

Do you think Bill poses some kind of threat to Stella There's some reason he's lying. & if you think he could be a threat does your role as support professional require you to intervene to keep clients safe

He's not a threat to her safety, but she's told me that she has gotten medical advice from him "under the table," meaning, in her mind she was getting free medical guidance from someone she thinks is a real doctor. There's always that chance she could one day tell him about a new symptom; he tells her it's nothing to worry about; it gets worse; she goes to an actual doctor and is diagnosed with late cancer. I'm sure he's told other people in his day program he's a doctor and they believe him. Of course, no DSP would ever believe it. But nobody wants to come forward and bust him. I'm sure Stella's host home providers know she thinks he's a doctor. My take is that they won't say anything because 1) they don't see it as a problem, 2) they don't want to pop her balloon (meaning, destroy the fantasy that her good friend is a DOCTOR, and/or 3) say nothing hoping she'll come to her senses on her own, kind of like not telling a 9 year old who still believes in Santa Claus that there's no such thing.

She's going to eventually get the truth from me (pending getting local employment so I can then know when my last day with her will be). And being the true autist that I am, I've already rehearsed several times what I'm going to tell her.

And , how will telling her help (serve)you ? And our sense of justice,might be abit high, compared to many others .
And it " IS " the right thing ..... but , please say,Is she uncomfortable about her beliefs in this guy? What are they providing to her mentally . She does have some kind of outside care? That are closer involved in her daily Life?.
<If you can offer it as advice? and not as a overseer> . It most likely still is within ,legal protections in your line of work? If in fact that is even revolent ?
To offer caution . In her given situation . With the man of many talents .
[of course after physical proving/confirmation that such a man exists in real life]

Maestra Elgee,

As a DSP, part of you job definition is to promote independence.
So in this regard helping her estimate interactions and persons in their proper context is part of the job.

But, Jakki's point is also very valid; what we see as a lifting of the veil of ignorance for the person themselves is not the proper analogy: for them, they have found a mental anchor in this person and seem to benefit(on an emotional level) from their interactions and perhaps for Bill as well. He is clearly invested enough to be keeping up the appearance...

for what an internet forum's advise is worth, my 2 cents:
I would propose to try and help teach Stella some critical thinking skills, or a set of tools, methodologies to help them evaluate situations/people.
Act as a “guide on the side” rather than focusing solely on getting the “right answer.”
Encourage her to think out loud and express their ideas, even if they are unsure.
This builds confidence and allows you to understand their thought process.
Introduce visual aids (charts, pictures, storyboards) to help map out problems and solutions.
Use technology tools such as speech-to-text or graphic organizers to reduce barriers and focus on thinking rather than mechanics.
By modeling critical thinking, providing supportive tools, and creating opportunities for practice and reflection, you help her build resilience and independence.
Even if formal “teaching” is slow, consistent exposure to these strategies and tools will gradually foster more thoughtful decision-making and problem-solving skills.

As a realization made by themselves will always the most powerful.

A miniature end note: when helping to develop her evaluation, critical thinking skills also take some time into how to handle exit strategies (from a conversation or social context), leaving her not just with the tools to realize but also to act.

Kind regards,
Kada