Tony Mantor: Why Not Me ? - Patrick Sisk: Blending Comedy and Therapy for Extraordinary Outcomes in Autism

Episode Date: October 18, 2023

Send us a text What happens when comedy converges with therapy? The result is an extraordinary connection and engagement with autistic clients, as explained by our guest, Patrick Sisk, a registered behavioral technician and stand-up comedian. Patrick brings a whole new dimension to therapy, using humor as a tool to navigate through the complexities of autism. He shares his unique experiences of working with clients of varying ages in their homes and the support provided by a supervisor to ensure effective therapy. Patrick's story isn’t just about therapy, but also about the challenges he's faced, and how he's used comedy as a de-escalation tool. We take a closer look at one particular case, an adopted 8-year-old girl with autism, and how Patrick has encouraged her to be mindful of her words and actions. This episode promises to keep you engaged and inspired as therapy and comedy coalesce to create extraordinary outcomes. Don't miss out on this heartening conversation that beautifully illustrates the power of laughter and understanding in making a difference in someone's life. https://tonymantor.com https://Facebook.com/tonymantor https://instagram.com/tonymantor https://twitter.com/tonymantor https://youtube.com/tonymantormusic intro/outro music bed written by T. Wild Why Not Me the World music published by Mantor Music (BMI) The content on Why Not Me: Embracing Autism amd Mental Health Worldwide, including discussions on mental health, autism, and related topics, is provided for informational and entertainment purposes only. The views and opinions expressed by guests are their own and do not reflect those of the podcast, its hosts, or affiliates.Why Not Me is not a medical or mental health professional and does not endorse or verify the accuracy, efficacy, safety of any treatments, programs, or advice discussed.Listeners should consult qualified healthcare professionals, such as licensed therapists, psychologists, or physicians, before making decisions about mental health or autism- related care.Reliance on this podcast's contents is at the listener's own risk. Why Not Me is not liable for any outcomes, financial or otherwise, resulting from actions taken based on the information provided. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Welcome to Why Not Me The World Podcast, hosted by Tony Mantor. Broadcasting from Music City, USA, Nashville, Tennessee. Join us as our guests tell us their stories. Some will make your laugh, some will make you cry. Real life people who will inspire and show that you are not alone in this world. hopefully you gain more awareness, acceptance, and a better understanding for autism around the world. Hi, I'm Tony Mantor. Welcome to Why Not Me the World.

Today's guest is Patrick Sisk. He's an ABA therapist by day, comedian by night, and the stories he has to tell are just outstanding. So welcome to the show, Patrick. I appreciate you coming on. Yeah, thank you so much for having me. It's my pleasure. So you're an ABA therapist living in Florida. If you could tell us a little bit more about yourself and expand on what you do.

Yeah, so I am a registered behavioral technician. So I work with different clients that we have doing ABA therapy. And so what I personally do is called NET. I'd said a DTT, which those are two different styles of ABA. NET is natural environment teaching. So it's much more, and basically the word said is not to sound like I'm talking to out anybody, but it's natural environment.

So one of my clients right now hates people. She hate going out in public. Cuffs is a lot. I mean, she's my affluent favorite client. Yeah, you never know what's going to come out of Vermont. But she said words that I had to live. look up. And I was like, oh, wow, that's an impressive cuff work. And I'm a stand-up comedian. So I'm like, oh, wow, okay, good. I'll have to write that one down. But so I help her or any of my

clients to just go through their daily life in a much more natural environment where ETT would be much more of a classroom setting, sitting down at a table, and more of a directive. So if it was, they didn't know their colors. Okay, point at the green card. No, that's not the green card. That's the green card. And you go through that way. But so with me, I go in home and I work with the kids on a one-to-one basis

and really get to know them and get involved in their family. And I, you know, they obviously, they've a line that is drawn, but they quickly become like parts of my family. maybe because I'm in the house element. Sure, that makes sense. So tell me, what age groups is it that you generally work with most of the time? So I have worked, I used to work in a clinic doing VGG, and now when I lived in Indiana, then we moved down to Florida.

And so now I work with all sorts of age groups. The youngest I've ever worked with was, I believe, furry. And the oldest I've worked with is 19. currently my oldest client is an 18 year old and I have two 10 year olds as well. So is this a situation of where you go into the house on a daily basis or is it just once in a while? How does that work? Yeah, it depends on the client. So I sit down with their parents and map out a schedule and then also look at what Medicaid has given them.

So Medicaid gives them hours of how many, based on their acuity and based on their diagnosis and what problem behaviors are presented. So I have one girl who had SIB self-induced behaviors. So she gets more hours than one of my kids who just streams. So it really depends on the acuity of the cake. and so it's a case by case. So I have one girl who get 25 hours or can get up to 25 hours. And then the other two, I think you get 12 hours apiece.

So in those groups, I can do 40 hours billable time. If you've got one client that can do 25 hours and you've got another client can do 10 hours. And so do you have other people that you work with that you might go into that one person's house once a week and then the other person comes in? Or do you try and take and keep that familiarity going to where you see that person 25 hours and let somebody else handle the others? So we've done it both ways. The girl that I work with now, who adds to 25 hours, we used to split it up between three of us.

It was just nobody's schedule could quite handle all 25 hours. And it was very quick, we were very quick to realize that she gravitated towards myself. And she and I have pitted off. She worked well for me. And again, she was the one who hate people. So it was like, you like me? This is new territory. I'm not used to people liking me.

This is weird. But so I ended up being able to figure out my schedule to work so I could go do. all 25 hours or close to it 20 to 25 hours there and that I do I split it up between the other two as well. So I've seen it work in both ways. It becomes you have to have a lot of good communication. There's going to be multiple people on the case. But for what we do, so there's an RBT that goes into the home. And then our supervisor, which is known as a BCBA. And that stands for? A board certified behavioral analyst, I believe, is what the letter stands for. And there are our supervisor. And so my supervisor comes in once a week to each face and just kind of monitor, make sure everything's going well,

answers any questions that I may have, or answers any question mom or even the client may have. and it's a time to sit down and really go, okay, hey, this is what I saw this week with her. And she got real upset about this, but I think it's because of this. And then, you know, she can go, well, yeah, now that does make sense. Have you tried this? It's basically just another set of eyes to help me. So even though I am one-on-one with this client, I also have my supervisor who's coming in, who's giving me the directives.

So I can't make any directives of my own. Okay. So if I think, hey, she needs to work on and, and X is walking down the street without mom being present. So that's something we are working on. So you can't do anything really on your own without having a supervisor or prove what you want? Right. I have to talk to my BCBA and say, hey, this is something I've seen as an issue.

what do you say. And then we can collaborate and work towards that goal. But I can't just one day wake up and go, I think I'm going to make her do this. Oh, okay. Yeah. Because it is not in my scope of practice to be able to do that. I have to have an RBT has to have a B-CBA. Okay.

So when you get out there, have you seen that when you split it up, that it works, like in this particular case, the girl like you and compared to the, the other was so you took it over. Have you seen the reverse happen to where it's where you've had like three people go in for one person and it all worked out with all three of them? Um, I've seen it work some, not with a client of mine, but I've seen it work in other homes where, uh, we've, we've talked and shared information. It worked. I prefer, uh, if I'm going into their home, that it's just me. And, and it's a much more personal. They know my mannerisms.

And then I know theirs, obviously. So it's called, in our realm of work, it's called pairing. So we're pairing. So we're getting to know each other. It's like you would do if you were getting to know somebody. Hey, let's go out for a dream. Let's go play pot. Let's do this.

Let's do that. And so obviously it's nothing to that extent. Right. So I sat down with her the very first day. And this girl who doesn't like to talk doesn't like a lot of things. And so, so I have a job. giant child of heart so I just looked at her I said hey me what's your favorite animal I thought about it for a second should a tarantula and it's my god I love plancholas and I went on an tangent about

tarantulas and I just so happened to know this song or the tarantula song that says tarantulas trantulas um uh if there's no way you fudge where your hand through the one was it's probably because of tarantula and I mean it's a kid song but it's goofy it's It's dumb. I was like, let's play this. And she played it. And she's like, that's the greatest song I've ever heard. And for the next three weeks, she wouldn't say anything but that song.

And so it was just the small thing where I said, okay, let me dive into this. I can't standturing to us. I don't blame you there. I've been into the Dominican Republic on mission trip where one has crawled up under my backpack. And I was like, oh, okay, I'm going to get to meet Jesus today. That's cool. He was almost at a heart attack. But where this girl found that excitement, and I met her where she was at.

Sure. I didn't try to bring her to me. I met her where she's at. And that's where I think so many times as successful RBT, that's what we do is we meet our clients where they're at. We don't sit there and go, we got to be here. We can bring them there later. Yeah, that makes sense. You've got to get them to get to know you and feel comfortable with you being there. Right, exactly. So what I worked at a clinic back in Indiana, the way the clinic would work was in the morning we would start with one client and then around lunchtime we would forward to another client.

And we would have about five or six different clients that we would rotate throughout the whole week. But with here, it's much more direct. I've got three clients. And I see it. them every week. And for me, I personally like NET and big in-home, just because it's so much more laid back. Sure. Have you had anyone that you've gone to in after a couple of days or a couple of weeks? You said to yourself, you know, I just don't think this is going to work right? We add one client to that I walked in and it was, and I'm a very optimistic person. I am an Optimistic person by by nature and even I see you know I can look at someone who's the worst person go oh man but they're they sure did this well and I walked I walked into this one home

and the client hadn't had or hated taking showers had had a shower in three months wow and hadn't cut his fingernail so he had very long fingernails but he also was just verbally and physically aggressive. And he was about 16 years old. And I remember looking at my supervisor that day and said, I don't think this one's going to work. And she said, why not? And I said, I said, this kid needs more than us coming into his house,

two to three types of week. Because sometimes, unfortunately, when whether autism, they go to undiagnosed or whatever goes undiagnosed, then there's a mental health aspect to it. Okay. There was a huge mental health issue with it where he was living with grandma. He was unwanted by birth parents. And so there was so much stuff that I just, I remember telling my boss, I don't think

this is going to work. And she was like, well, let's just try it. And with the end, two months, we had to excuse herself from the case because of the safety for myself and just we just didn't feel safe going into the only I became that violent and that scary and I mean I'm a big dude and so it wasn't so much and I'm scared for my life but at the same extent I was scared for my career scared for okay so what happened when this kid swings on me because I told him he needed to think of back so why so it became a very interesting

situation I bet so you're a a therapist by day and a comedian by night. Is that right? Yes. Yes. Yes. Yes. I do stand up at night. So do you find a way of using your comedy to help alleviate some of the situations you might run in on a day-to-day basis? Yes. Yes. So actually all my clients know that I'm a stand-up comedian. And so there was one of my clients that I would go into her school with her. And she would very, very, very, very quickly if jokes ever came up, she would be like, you know, my therapist, he's a comedian, he'll tell you a joke. And she was. And honestly, like, that's one of my biggest pet thieves as a comedian is when someone, tell me a joke. I'm like, okay, fine. But so with her, it always warmed my heart that we had like, she was, it was, it was the first person who was truly

proud of me. That's awesome. And so I was like, yeah, that's my girl. But I, I find myself using comedy and I can, whether it's a tantrum and it's de-escalating the situation going, hey, let's calm down or I crack a joke or I do this, that. I find myself using humor and comedy in therapy because I think it's very needed. It's very, it cracks that tension. And then also flip side, I use real-wife situations that are funny that are in my comic. I talk to the parents. I'll be like, hey, can I, I'll even run bit by them and go, this is what I want to say.

They'll be like, man, that's, that's great. So, yeah, so it definitely works hand at hand. And it's really cool how two things that I never thought could work together, work so beautifully together. That's awesome to hear. So have you gone into a house, looked at it, looked around, and then said to yourself, I don't know, I don't think this is going to work. But then after whatever period of time, it does. Yeah.

So my client that I go to now who has, that I see the most, she was two different therapists had already been in that house and had left and removed themselves. It was just not a good fit. And I heard about how just this girl was. and how she was very actually, she was apparently abusive towards animals and all this stuff. And so I was like, okay, so I remember walking in and going, oh my goodness, this is going to be the worst thing in the world.

And that was the day that I sat down and talked to her about tarantulas and realized that she wasn't what she was on paper. Everybody had said, she, this, this, and this. and I realized that they just didn't get to know her. And so all of a sudden, and she and I started to bond, and we started to really communicate. And don't get me wrong,

there are days where she'll tell me that she hates me. Wow. And, I mean, she'd be her, and we're too brutally honest. Like, one day she looked at me and she said,

Pat her, you're getting fat. Wow. And I looked at her and I was like, girl, I've been fat. There's no getting fat. I am fat. And she goes, yeah, that's true.

And so she's so funny. She's brutally honest. But I was nervous that I wouldn't work. But now I've been there for over a year and a half. And it's one of my favorite houses to be in. So when she gets brutally honest with you or gets upset, how do you handle it? I mean, so that you can take and bring her back. So with, you know, one thing you have to understand that every client is different.

Yes. Every client is different. And unfortunately, ABA therapy has gotten a bad rat together the packs. This is how you do with it. A, B, and C. And unfortunately, that's not how life works. Right. And not with kids with autism, not with life in general.

That's not how, it's not a black and white world. There's some great. Sure. So with her, you kind of just have to let her bit for a little bit. You have to let her get it out of her system. Or you have to sit there. She loves a McDonald's. And so I'll sit there and, you know, I'll just politely remind her.

I'll be like, well, that's no way to talk to someone you call your friend that you want to bring a McDonald's. Or just remind her, you know, hey, remember who we're talking to. You know, let's shoot her words carefully. And it's really cool because you can tell sometimes what she's really upset. And then she starts to come back down and she's like, hey, Patty, I'm sorry. Nice.

And she'll apologize and she'll, you can see it where her remorse is. Yeah. Instead of just, she's not sitting there at you at this. Right. And she doesn't care. She genuinely does start to come back down when she's angry after she's angry,

go, okay, yeah, I see where I messed up. And how old is she? She is eight feet. She just turned 18. So you tell me that she doesn't like people. What's her world looks? like within her house, in her home. And what's the world like outside of the home when you're not there to help her and teach her? So she, yeah, so she is in a single parent home. Okay. It's just,

it's just her mom and then her two brothers. Okay. And all three are adopted. Oh, wow. Well, all three are flat and the mom is white. So it is, It is an interesting family dynamic, to say the least. The oldest brother and her are biologically siblings. And then third brother is just another child that was adopted and brought into the situation. She interacts okay with them. You know, she treats them with love and kindness than someday. But like anybody else who have brothers, sometimes she hates her gut.

sure sure you know if brother a steal something from her then you know it's the worst brother in the world not hate us guns okay well i get it i understand why you would be upset and then and we work through that but yeah it's totally understandable my six year old yeah my six year old if my my son stole her candies she would be like he's the worst brother ever sure absolutely so so working through that with her um just interacting with her brothers and it's been a challenge at times, especially because her oldest brother is also on the spectrum. Oh, okay. Her oldest brother is, uh, had fetal alcohol syndrome, is on the spectrum, have a lot of issues. And an adult ABA is something totally different even than a VA, normal ABA for kids. And I, I don't. And so, so it's, it's a challenge to sometimes work through that

because she does this and she can do everything right. And then brother does something from left field. And it's like, great. Now we've got to figure out how to call them both of them to help. Okay. So they're both autistic. What level on the spectrum of autism are they? And how does that work with them far as their ability to interact with each other

and get along, at least most of the time? Does that happen? both of them are high functioning i believe they would be categorized maybe at a level two that my client um will not be able to live on her oh that's too bad and and to be fair uh her brother wouldn't either her youngest brother who's not on the spectrum um but he so but i i would doubt that they would ever be able to live on their own okay So you're in Florida, and I've heard in other states that there's like 21 is the age out situation. Is that true for where you're at as well?

So at 21, I believe it is Medicaid no longer let them do ABA, or at least in the sense that I'm doing it currently. Once you get it to older, I believe you have to be, you get ABA just. from a BCBA. There's no RBT involved. And it's a little bit different. And it's actually harder to come by, even though there are plenty of adults out there that have autism and need services. Well, sometimes the system seems to just got to go, oh, well, forget about them. And which is a very scary thing. Especially for parents that want to see their kids do well, or at least have the opportunity to do well. It seems like autism, for some reason is on the lower end of the funding for some of these programs.

So hopefully that will get better. Yeah. And so it's a really real thing. And I think the mom of my client is a little nervous for her daughter. But at the same extent, the progress that we've made is tremendous. And the year and a half that I've worked with her, we've gone from a year. girl who wouldn't step outside where she was so scared the moment she stepped outside she would start to throw up where she was at anxiety to chat to this girl who uh last what was it

october i think it was or november we went to seaworld oh that's great and uh we spent the day at seaworld and and she was around people and we rode rides and and then nothing more exciting um then a roller coaster in my opinion but to ride it with someone who was so scared of people and now she's overcoming her fears and she's having the time of her life it's like this is why i'm doing what i'm doing absolutely so that's a great success story so have you had some that you thought was going to be success but then after you got into it you realized that it probably wasn't going to work out the way that you had hoped it would? I would say that, you know, that for me personally, I've never really dealt with that

because I am one of those people who I won't give up unless I'm told what you about. Like, I wasn't going to give up on the one kid that we got pulled from their house until my administration said, look, you're not, you're not allowed to go back in them. For safety concerns, you're not allowed to go in there. I'm I'm my dad was a an old country boy from Tennessee and so he he taught me that you know not not give up and go the job to time so so for me personally it I've never dealt with that and with ABA it's interesting because it's not so much I don't go in thinking that I need to fix anyone but it's I go in thinking all right let's put some pieces together that maybe you have to put together and and and You know, it's, it's, I know, there's the puzzle that represents autism on the puzzle pieces. And so to me, it's just me bringing along a couple of puzzle being with going, hey, let's try it. And all of a sudden it works.

And so, so are there things that haven't gone exactly well? Yeah, I've got a client who, to this day, I've been with her for almost two years now. And she still sucks her bum as a means to calm herself. as a means to just when she's under stressful situation and fertility. And so we've got to figure out,

okay, how do we substitute that behavior? That behavior is not a behavior that you would like to see. You know, you don't see a lot of adults walking down down the street second year, so how do we get from A to B? Well, and it's been a challenge. So it's still

that's her go-to. So now we've gotten to the point where she doesn't do it in school, but she does it when she's at home. Okay, so now we've at least, we started to eliminate the behavior. So, so how do we fix it at home? Well, she normally does it when she's stressed. Okay, so what can we give her to do something else another than put her bigger in her mouth? So let's get her up fidgets then. Now, anytime you're board, let's just fidget with this. And so now she'd do it back. Or, okay, now maybe that doesn't work. So now we, we switch to this. So let's, let's go to drawing. Every time you're nervous, let's just draw a picture. So, and so it's doing something that now, her hand literally can't be in her

mouth. So you just brought up the school system. Have you had situations where you've had to go into the school system and guide them and help them. And how has that worked out overall for you? So it depends on the client. I have been in several different school systems. Some school systems are very easy to get into and they want to help and they want to work with you and say anything we can do to help or you let us know and they're great. There are other school systems. that I want to think that they know everything and have that big energy. And they go, well, no, you can't come in here. We've got our own people.

But yet their own people aren't doing it. So, so I'm sure that's how it is across the country. But I can speak only for Florida when it comes to school system, is that there are some school system and then private schools that work with us hand in hand. and want us to be there. But then there are some school systems and private schools that are like, nope, we got it covered. And it's like, nope, now you don't.

No, so let us help you. That's what we're for us to help. Sure. Now, let's switch gears just for a second. And I'm sure you must have a website for your comedy act. So you could tell us that too, if you would. Yes. So exactly just opening up.

We're finishing the final touches. It's just www.pavocsys.com. And so it's a new, we're totally getting it started. And, but, uh, but yeah, now this has been a crazy journey. And my, my job, my company that I work for is so supportive. And they know that I do comedy and they, they love it. And they told me, you know, they're like, look, whenever you need to step away from ABA, let us know. But we expect, you know, take it to your Netflix schedule.

And, uh, so I told them, I was like, yeah, when that happened, I'll let you know. find yourself traveling quite a lot now and then of course going back to your ABA after Stun? Yeah, so right now I try to stay around the Florida area. So I will do shows. I'm in Orlando, so I'll do shows all over Florida. The other last week, I had a show at West Palm Beach, which is about two hours away. And so Sunday night drove there, drove back, got an head. around 2.30 or so in the morning and then got up and was at my client's house by 9 o'clock. So, yeah, so it's, I definitely burn the candles on both in, both at times. And then I also have, you know, a family of my own with my wife and my two kids.

And so, wow. So it's definitely a challenge to, and but I find it funny because one of my kids that I work with, We work on schedule and okay, so let's, you've got to do this, you got to do this, and we've got to get it all in the day. And so I find myself learning from things that I'm teaching them or, you know, heading up a life lesson where I go, oh, okay, I can do that. Yeah, I've had a lot of people that I've talked with that will tell me that all of a sudden they've found themselves learning from the ones that they're supposed to be teaching. So it works quite well lots of times.

Yeah, yeah. I mean, like I said, they will keep you so much. And then they're also brutally honest. One of my girl looked at me one day and I did something really dumb. And she was like, are you sure you're not the one who needs therapy? And I just staring at her and excuse me. She goes, I'm sorry. I said, no.

I said, that would the funniest thing. I have it all day. Thank you. And like, trust me, I'd probably meet therapy too. And but they're just. They're so, they're so just with it sometimes. You're like, wow, you would. So, but yeah, no, comedy has definitely helped.

And, you know, and I, I'm on Instagram. I'm at Papixist comedy. So it's really weird when, when a kid, because we have to keep our lives separate to an extent. And so some kids were like, well, can I can watch you do comedy? I'm like, no, no. And they're like, well, do you have social media? Like, no, no.

You know, and so you have to play that role of, you want to be involved in their life. Absolutely, but you have to keep that distance for yourself too. Exactly, exactly. Yeah. So ethically, we have a warrant of ethics or, you know, a code of ethics that we go by. And, you know, so it's one of those things where they're very, you know, we try not to tow that lump, or we try to not go over the line by any means. here, but it's, it's okay. So, you know, it gets to the point where they say, well, can you come to my

birthday? And, you know, ethically, no, that's not part of it. We can't come to your birthday. But I tell you what, when I come on Monday, we'll have a big, well, I'll bring ice cream and we'll have a big party just meeting. So then, you know, so then you turn it into a way where, oh, okay, well, and so she, yeah, if it becomes not so disappointing, you know, the kid, you know, the kid, you know, the kid I don't understand. The kid just want one of their friends at their party. Exactly. Once you make it past that initial part of your journey with them,

they want and look at you as they would any friend or family. Right. So, of course, they're going to want to have you around because it's an important time in their life, so they want their friends and family around for that. Exactly. Exactly. So it's a challenge.

to tow that line to make sure, okay, we're, don't cross the line ethically, but at the same extent, you don't want to be cold when you walk in or like, hey, you're like, good, how are you? What good to work? So you've got to, it's, it's a balancing act. It really is. Yeah, it sure is. This has been a great conversation. You've given so much great information. Thanks for coming on. I really appreciate you being here today. Yeah, thank you so much. And anytime I can sit back down and talk with you again, man, leave, let me know. Oh, I certainly will. It's been a pleasure. So we'll be talking soon. Thanks again.

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