@Gina Schultz thank you! I also recently had to discharge a young adult who refused to participate in treatment goals, which included teaching skills via multiple exemplar training such as role plays, video modeling, behavior relaxation training, identifying and challenging thinking errors, etc. it was sad because his anxiety and rigidity kept him in a vicious cycle of self sabotage. Despite multiple strategies to promote engagement, all of which he was unmotivated by, I had the ethical responsibility to discontinue treatment - that was tough & sad!