What a Client's Avoidance Behaviors Tell You About Their Values

Moving away is also a toward, which is the line Brian Middleton drops in the talk that lands here: a learner named Fred who hit the wall twice, signed alone time, sat down, and breathed it out in five minutes flat, all on a plan that still used limited holds when it had to.

That last piece matters. The rest of this page is going to ask you to look at avoidance differently. Before we get there, the program Brian was running with Fred had limited holds inside it. This is not a "let them escape everything" page. It is a page about reading the avoidance first, then deciding what to do about the program second.

Every Avoidance Is Also an Approach#

When a kid pushes the worksheet off the table, the field has trained you to write "escape from demand." That is true. It is also half the story. The kid is escaping the worksheet and approaching something else at the same time. Maybe quiet. Maybe their own body in their own space. Maybe a chance to look at the thing they actually care about.

Brian frames it this way in the talk:

I'm going to put more energy into reflecting on what avoidance behaviors are moving toward. Because the moving away, also the other side is a toward.

If you grew up writing programs that only named the away, this is the small turn that changes the rest of your case. You start asking what the away is in service of. That answer is a values answer. Not preference. Not reinforcer. Value, in the ACT sense, meaning a direction the person wants to keep moving in.

The Hates List Is a Values List in Disguise#

The cleanest move in the workshop is this one. Brian takes a client he calls Jessica, writes out the things she hates, and then reads the same column back as values. Same data. Different lens.

The hates side:

• Puzzles
• Vegetables
• Being interrupted
• Being helped
• Unexpected changes
• Being told to take a break

Now flip the column. What is each of those an approach to?

• Control
• Autonomy
• Inclusion
• Consistency
• Independence
• Physical activity, movement, flow
• Familiarity and organization

Same list. Twice. Once as a behavior reduction target list, once as a treatment plan north star. The reader who has never done this exercise tends to feel a small click here. The hates list was the values list the whole time.

Worked Example: Reading Jessica's Avoidance as Autonomy#

Take "being helped" off the hates list. The old write-up was probably going to be a help-acceptance program. Tolerate two prompts. Tolerate three. Build it up.

Read it as autonomy instead. Now you have a different first question. Is there a way Jessica can do the task without help, even if it takes longer or looks different than the way you would do it? If yes, that goes first. The help-tolerance program does not vanish, but it stops being the lead.

Or take "unexpected changes." Old write-up: flexibility training. New read: this kid values consistency, organization, knowing what is coming next. So before you run a flexibility program, you make sure she has a visual schedule that is accurate, a person who tells her when it changes, and a heads-up window long enough to be real. Then, with that floor in place, you can shape some flexibility on top of it. Not the other way around.

This is the move the page wants you to walk away with. Avoidance pattern in. Value out. Programming decision third, not first.

What Changes in Your Session When You Treat It This Way#

Brian tells a story about Fred. Fred had limited vocals. He had a Proloquo on his iPad, though the iPad sometimes became a projectile. Fred's values, after a lot of work, came down to safety and alone time. The team built a safety thermometer with him. They built in choice.

The day Fred wanted to go home and his mom was at a doctor visit, he was upset. Old script for this kid would have been a fist to a face or a thrown iPad. Here is what Brian saw instead:

He went and he raised his fist up like this. And then he turned to the wall and hit it twice. Turned back to me and the other tech that was with him and signed alone time. Sat down, we backed off and he breathed it out beginning to end five minutes. It all started with values.

Two hits on the wall. A clear request. The team honoring it. Five minutes to baseline. None of that is possible if the team did not already know that alone time was a value for Fred and treat it like one. If you have not done the values work, the same scene ends with restraint paperwork.

That is what changes. The crisis still happens. The shape of the crisis is different because the kid has a way to move toward something he cares about that the adults in the room recognize.

Assent-Based Shaping vs Just Letting It Go (They Are Not the Same)#

The reader who has been in the field a while is going to push back here, and the push-back is fair. "So I just stop running the program?"

No. You shape it. Brian names the technology by its actual name:

PFA SBT. It's not new. It's shaping. It's a complex shaping procedure where we're introducing into and pushing forward, pulling back, pushing forward, pulling back. It's exposure therapy that's assent based and that is compassionate and is individual centered.

Push forward. Pull back. Push forward. Pull back. The kid signals when it is too much. You honor the signal. You come back to it later. Over weeks, the kid can tolerate more of the thing they used to escape, because the way you got there respected the value underneath it. That is not the same as letting the demand go forever. It is exposure with brakes the learner can actually reach.

When You Still Use a Limited Hold (and Why That Is Still Affirming)#

Here is the credibility line, said by the same person who built Fred's plan around alone time and autonomy:

Does this mean that we don't have restricted access that we don't use limited holds? No. Definitely not. Limited holds have a time and a place. With that token economy for that learner, Paul, we had to do limited holds for some of the things that he had access to.

A neurodiversity-affirming program is not a program with no contingencies. It is a program where the contingencies are picked because they line up with what the learner values, and where the rules around access make the day workable for both the learner and the people around them.

Limited holds are still on the table. So are token economies. So are denied requests. The difference is what came first. You read the avoidance as values data, you built the plan around the values, then you put in the contingencies you needed to keep the plan running. Order matters.

A Five-Minute Audit of Your Current Case List#

You can do this with a pen and paper before your next supervision.

1. Pick three clients. For each one, write down three things they consistently avoid or push back on. Not functions. Just the situations.
2. Next to each item, write the value that would be served by the avoidance. One word is fine. Autonomy. Quiet. Movement. Predictability. Inclusion. Safety.
3. Look at the current treatment plan for that client. Where is that value reflected? Anywhere? In the goals. In the schedule. In the way the day is set up.
4. If the answer is nowhere, that is the first place to make a change at your next plan update. Not a new behavior reduction target. A piece of the day that lets the value get expressed.
5. Then ask the harder one. Which of your current contingencies, limited holds, or restricted access pieces are doing real work for the learner, and which ones are there because of habit. Keep the first. Question the second.

That is a fifteen-minute version of what the workshop walks through over two hours. It will not catch everything. It will catch enough to start.

FAQ#

If a client avoids something, do I have to stop running that program?

No. You have to read the avoidance for the value underneath it, then decide if the program is shaped in a way that respects the value. If yes, keep it and look at how you are running it. If no, that is what the change is. Often the goal stays. The path to it changes.

How is this different from giving in to escape behavior?

Giving in is escape on demand with no plan. Shaping with assent is exposure that the learner can pause, with the program still moving forward across weeks. The learner is still building skill. The cost of building it is lower, because the work is happening in a direction the learner cares about.

How do I document this for insurance without sounding like I dropped goals?

Write the goal the same way you always would. In the procedures, name the shaping piece. Push forward, pull back, criterion for moving up. Note the assent measure. Note the value the program is in service of. The skill target stays. The how looks like a complex shaping procedure, because that is what it is.

Watch the Full Talk#

If this is the way you want to write plans going forward, the full workshop walks through more of these cases, including Fred, Jessica, and the Paul token economy. It is a free CEU on openceu.com.