Is anyone willing to share their therapeutic interventions for hyperactivity and inattention? I've heard a lot of behavior charts are good, but there is bound to better ideas.
I would also like to know if anyone has techniques for working with oppositional / aggressive children, especially techniques for they are in a moment of rage. Needless to say, I do not have much experience with these types of behaviors and have a very challenging child that I just started working with.
One last question: Behavior Management Programs that aren't points-based. Got ideas? Please share.
Much thanks.
-SWS
Showing posts with label mental health. Show all posts
Showing posts with label mental health. Show all posts
Saturday, September 10, 2011
Sunday, August 28, 2011
Almost a month in…
My third week of seeing clients and I’m still alive. *fist pump* I will admit that I am quite enjoying the actual work with the clients, but dealing with parents can be tough. Real tough. Some parents/caretakers are resistant, even the ones that called in the referral. I won’t begin to try and understand what they are feeling, but I do my best to ensure them I’m not there to remove their kids, judge them, etc. Once I get in the door, I think they realize that, but getting into the home is the hard part…
We had a mandatory meeting at work on Friday. It was Cultural Heritage day so we got learn about each other’s backgrounds. They also invited some people from the UM Eye Institute to talk about working with deaf children. They taught us the science behind hearing problems, the kind of devices to assist with hearing, auditory verbal therapy, etc. I especially find cochlear implants to be quite incredible. We also talked about Deaf culture, and the very different opinions found within this population. It was quite interesting!
Now, on to the interesting topic. One of my cases is a 16 year old girl who was diagnosed with Undersocialized Conduct Disorder, Aggressive Type. The biopyschosocial also talked about some reported psychosis. When I met with the teen for the first time, she was quite fascinating and a bit scary in her perception/attitude. She does not like school and does her schoolwork only when she feels like it. She likes to fight with people and has no interest in friends. She socially isolates, sits in her bedroom alone and talks to herself. She reported hearing command hallucinations, "random" voices that make her laugh and sometimes tell her to do "dangerous things", like fight and do drugs. She denied any drug use or any thoughts/commands of self-harm. She also mentioned going to her boyfriend’s house and just sitting in the front room alone. I noticed she had psychomotor agitation as she constantly used her hands during the session. She made little eye contact with me and giggled to self occasionally. Her affect was pretty blunt but her mood was normal.
She lacks compassion for her younger siblings, as evidenced by her statement "I hate them" as she broke their crayons. She reported that she loves her mother, and when asked if she ever tells her mother: “I don’t tell anyone I love them.” She doesn’t follow rules, and I’m serious when I say this, she could give a bleep about anyone or anything. I encouraged her to be honest and gave her feedback on her interaction with her mother and siblings. She constantly reminded me that she does what she wants to, not what anyone tells her. I praised her substance-free choices and validated her report of hallucinations. I did not challenge them. I tested her insight and her judgment, and I think both are pretty poor. One great thing is that she is willing to comply with treatment/medication. I gave her mother the contact information for a pysch eval, and if she hasn’t called when I go back Tuesday, we’ll call together. She needs one, stat!
I’m praying she isn’t developing Schizophrenia. I, of course, am not licensed or an expert, by any means, but doesn’t it sound like it? She’s having both positive (hallucinations/psychomotor agitation) and negative (blunted/flat affect, lack of interest, social isolation) symptoms. I read through the biopyschosocial and mother reported depression with psychosis and drug use on her end, but no mental illness that she’s aware of on dad’s end. I know there’s a strong genetic component. I think you have a 10% chance of developing it of one parent has it, and a 50% if both parents have it. But, what if mom’s diagnosis was wrong and she’s actually Schizoaffective? That would put her in the spectrum. Mom also used crack/marijuana for many years, so the child could have some prenatal factors, like stress, malnutrition, infection. And she was born in the Spring. Research shows that viral exposure in utero can up your chances of developing Schizophrenia. And then there is the environment piece. Living in an urban environment, social isolation, poor housing, family dysfunction and childhood exposure to trauma are all risk factors.
What do you think?
-SWS
Resources:
We had a mandatory meeting at work on Friday. It was Cultural Heritage day so we got learn about each other’s backgrounds. They also invited some people from the UM Eye Institute to talk about working with deaf children. They taught us the science behind hearing problems, the kind of devices to assist with hearing, auditory verbal therapy, etc. I especially find cochlear implants to be quite incredible. We also talked about Deaf culture, and the very different opinions found within this population. It was quite interesting!
Now, on to the interesting topic. One of my cases is a 16 year old girl who was diagnosed with Undersocialized Conduct Disorder, Aggressive Type. The biopyschosocial also talked about some reported psychosis. When I met with the teen for the first time, she was quite fascinating and a bit scary in her perception/attitude. She does not like school and does her schoolwork only when she feels like it. She likes to fight with people and has no interest in friends. She socially isolates, sits in her bedroom alone and talks to herself. She reported hearing command hallucinations, "random" voices that make her laugh and sometimes tell her to do "dangerous things", like fight and do drugs. She denied any drug use or any thoughts/commands of self-harm. She also mentioned going to her boyfriend’s house and just sitting in the front room alone. I noticed she had psychomotor agitation as she constantly used her hands during the session. She made little eye contact with me and giggled to self occasionally. Her affect was pretty blunt but her mood was normal.
She lacks compassion for her younger siblings, as evidenced by her statement "I hate them" as she broke their crayons. She reported that she loves her mother, and when asked if she ever tells her mother: “I don’t tell anyone I love them.” She doesn’t follow rules, and I’m serious when I say this, she could give a bleep about anyone or anything. I encouraged her to be honest and gave her feedback on her interaction with her mother and siblings. She constantly reminded me that she does what she wants to, not what anyone tells her. I praised her substance-free choices and validated her report of hallucinations. I did not challenge them. I tested her insight and her judgment, and I think both are pretty poor. One great thing is that she is willing to comply with treatment/medication. I gave her mother the contact information for a pysch eval, and if she hasn’t called when I go back Tuesday, we’ll call together. She needs one, stat!
I’m praying she isn’t developing Schizophrenia. I, of course, am not licensed or an expert, by any means, but doesn’t it sound like it? She’s having both positive (hallucinations/psychomotor agitation) and negative (blunted/flat affect, lack of interest, social isolation) symptoms. I read through the biopyschosocial and mother reported depression with psychosis and drug use on her end, but no mental illness that she’s aware of on dad’s end. I know there’s a strong genetic component. I think you have a 10% chance of developing it of one parent has it, and a 50% if both parents have it. But, what if mom’s diagnosis was wrong and she’s actually Schizoaffective? That would put her in the spectrum. Mom also used crack/marijuana for many years, so the child could have some prenatal factors, like stress, malnutrition, infection. And she was born in the Spring. Research shows that viral exposure in utero can up your chances of developing Schizophrenia. And then there is the environment piece. Living in an urban environment, social isolation, poor housing, family dysfunction and childhood exposure to trauma are all risk factors.
What do you think?
-SWS
Resources:
Saturday, August 6, 2011
First week on the job…
Well, my first week at my new job went off without a hitch. All the employees are really nice and helpful. I spent the entire week in orientations for everything from benefits to processes to trainings. Thankfully, their processes and procedures are streamlined. Amen! I sat with my supervisor for the clinical training and process piece. She is very nice and knowledgeable. She complemented my preparation (me, prepared??? heh) and said she can tell I will catch on quickly. To say the paperwork is overwhelming is an understatement, but that is social work for ya.
We discussed ethics, privacy, compliance and the like. The HR person described some ethical issues in the past, and honestly, I am shocked at some of the choices people make. One employee had to get something signed over the weekend, so she stopped by the home with a car full of people. Um, seriously? Major HIPAA breach. Another employee had a home for rent and rented it out to his client. Yes, this is a nice gesture, but it is absolutely forbidden to enter into any sort of dual relationship with your client, during and after service.
I was assigned my first 4 clients yesterday. I have not yet made contact because I am waiting to hear from the employee I will be shadowing next week. I plan to call Monday and set up first appointments at the end of the week. I also have to do a ton of online trainings next week on-site.
As far as my clients go, what a doozy! Four males. Three of them have been treated by the agency before, two of them have a Conduct Disorder Dx, two have ADHD/Anxiety. One of them is a refugee from Africa! THAT is way amazing, for me, because it is a population I am extremely interested in working with. To say I am hella nervous about meeting these people next week is putting it mildly…
-SWS
We discussed ethics, privacy, compliance and the like. The HR person described some ethical issues in the past, and honestly, I am shocked at some of the choices people make. One employee had to get something signed over the weekend, so she stopped by the home with a car full of people. Um, seriously? Major HIPAA breach. Another employee had a home for rent and rented it out to his client. Yes, this is a nice gesture, but it is absolutely forbidden to enter into any sort of dual relationship with your client, during and after service.
I was assigned my first 4 clients yesterday. I have not yet made contact because I am waiting to hear from the employee I will be shadowing next week. I plan to call Monday and set up first appointments at the end of the week. I also have to do a ton of online trainings next week on-site.
As far as my clients go, what a doozy! Four males. Three of them have been treated by the agency before, two of them have a Conduct Disorder Dx, two have ADHD/Anxiety. One of them is a refugee from Africa! THAT is way amazing, for me, because it is a population I am extremely interested in working with. To say I am hella nervous about meeting these people next week is putting it mildly…
-SWS
Sunday, August 29, 2010
And I will try to fix you.
This semester I am taking Psychopathology in Clinical Practice. If you’ve been following my blog, you know that I am not interested in Clinical Practice at this point. I would much rather be on the services or macro side of Social Work, although I am quite aware that counseling skills are needed across the board. That being said, I have yet to experience a mental health setting so I could very well change my mind. In fact, I will be in a clinical setting at my Domestic Violence internship. I will mainly be working with the children who have witnessed the abuse. The victims and their children will no doubt exhibit a myriad of issues. Maybe I will end up enjoy this setting…who knows. I will admit that I am uber excited to experience Play Therapy. :)
Anyway, in our first class of Psychopathology, the professor played the video below, which looks to remove the stigma that mental illness receives. I know all about this stigma, as I come from a family entrenched in abuse and mental disorders. It has never been easy for any of them to ask for help, or to even accept their situation. A lot of it is pride, not accepting their reality, etc. But, a lot of it is related to the stigma surrounding these disorders, I’m sure.
Take a moment to watch the video and reflect on how you feel about mental health disorders. You can help fight the stigma that these people have unfairly hanging over their heads.
Lights will guide you home
And ignite your bones
And I will try to fix you
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