Rescue Me

Allen Level 4 patients can be very tough customers.  Not believing anything is wrong with them and anything that is wrong is everyone else's fault...makes for a patient that likes to refuse therapy.  Establish rapport to treat a 4 :)  One technique that helps when you get refused by a Level 4 is the Rescue Technique.  The therapist who gets refused or told to "walk back out that door" needs to try to approach the patient again and while the patient is refusing...have a 2nd therapist walk in and say something like "I can't believe you're in here again, didn't you tell me she didn't want to exercise today?  Leave her alone; I'll bet you've never even been in a hospital before.. you don't know what she's been through"  The 2nd therapist now takes over the therapy and rapport will have already been established in that one little interaction.  Rescue strategy works almost everytime.  It's documented as Rescue approach initiated to elicit patient participation in therapy tasks.