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PERMIAN BASIN COMMUNITY CENTERS

PERMIAN BASIN COMMUNITY CENTERS BEHAVIOR TREATMENT: A SUCCESS STORY

A STORM

CALLED

MARY

Mary is bright, with the ability to read and write; she is social

and well informed on current events; both in the lives of staff and the community! She can identify the cost of items and pay for them with minimal assistance. She is capable of taking care of all of her ADL’s, but may refuse. She is kind and cruel; helpful and obstructive; caring and destructive; loveable and unbearable.


The Perfect Storm

• Small Window of Opportunity

• Torrential Downpour in the Home

Individual 1 with behaviors physically and medically dangerous to self and others

Individual 2 with severe uncontrolled atypical seizures as well as behaviors dangerous to self and others

• Overt Despair of Staff and 1st Level Supervisor

• Requirement of Least Restrictive Environment

• Meeting Needs in a Behavioral Crisis (in the community)


TAKING COVER

• Converge with professionals

• Open communication with staff & management

• Vanquish negativity

• Ensure regular meetings with staff and management

• Require availability of management staff


PLAN BASICS

1. If Mary chooses to engage in fecal digging and smearing, Mary must complete the following activities prior to engaging in Day Hab or other activities of her choice:

Clean and sanitize all visible evidence of digging or smearing

Refrain from exhibiting physical or verbal abuse toward others

2. If Mary chooses to visit her grandmother on Saturdays, she will: refrain from digging or smearing on Friday night and from exhibiting physical or verbal abuse toward others on Saturday morning.

3. If Mary chooses to participate in community outings (including dining out on Tuesdays and Fridays and at Breaking Bread on Wednesdays) she will refrain from exhibiting physical or verbal abuse toward others.


Selling The Plan

To Staff:

• Provide easy and precise training of the plan

staff cheat sheet for easy access

• Leave room for flexibility

• Absolve staff from responsibility of controlling the behavior

• Note to staff that their mindset must change from authoritarian to the mentor, ask staff to reframe their requests, to remind the individual what their plan says, to keep responses minimal and to stay calm – mentor staff whenever possible. Provide feedback to staff as well.


Selling The Plan

To Mary and her Grandmother:

• Validated Mary’s worth

• Validated her need for interpersonal relationships

• Talked to her about the target behaviors, anal digging, fecal smearing, bullying, and non-compliance

• Asked her if she wanted help

• Let her know she was in control of her behaviors


THREE WEEKS OF SHOCK AND AWESOME


GOING HOME


GOING FORWARD

• We as Providers and the Local Authority must be more aware of the implications of:

Federal Rulings and Mandates

Implementation of those by the State of Texas and DADS

Petition for tools to implement the rulings and mandates before they become law


GOOD NEWS


Permian Basin Community Centers

401 E. Illinois

Midland, TX 79701

Pam Shurley, LPA

Director IDD Provider Services

DADS Certified Psychologist

[email protected]

432-570-3385

mailto:[email protected]

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