CASE: Pull It Together
RESULTS: Support and Trust
Overview: Barbara is a 38-year old woman with a diagnosis of Moderate Intellectual Disability; Bipolar Disorder; Intermittent Explosive Disorder and Pervasive Developmental Disorder. Barbara exhibits several serious challenging behaviors including Property Destruction; Aggression; Self-Injurious Behaviors and has a history Pica. In 2003, she was a psychiatrically hospitalized for verbal and physical aggression to her family and strangers and it was no longer safe for her to reside with her family, as she needed 24/7 supervision and care.
Although Barbara was getting support, she frequently called 911 when feeling anxious or bored
Challenge: She is friendly and outgoing but may need reminders to maintain appropriate social boundaries. Barbara can be very sensitive to how others feel and their perception of her. When she becomes anxious, Barbara can often be overheard telling herself to “calm down” or “pull it together.” Barbara may go through periods of severe deterioration of emotional stability and adaptive function. Although Barbara was getting support, she frequently called 911 when feeling anxious or bored; or if she perceives that others are not responding to her requests in a timely manner.
Solution: Our SYC Behaviorist spent a lot of time getting to know Barbara and gaining trust. Previously, Barbara would physically attack people she did not trust and use loud and derogatory language. Over time, she began to trust her behaviorist and would take her proactive suggestions. The two developed a plan, which included getting Barbara connected to a therapist to manage her untreated anxiety, replacement activities instead of calling 911, and coping skills to help manage stressful situations.
Results: Barbara is no longer calling 911. She has developed friendships outside of the home and has a circle of friends that she is able to call each day. Barbara is better able to structure her leisure time and has a variety of activities that she enjoys participating in. She now calls her SYC Behaviorist to share when she is having a good day, instead of calling when she is in crisis.