Describe how the residence has ensured that it is a therapeutic environment. Why is it therapeutic?
First and foremost, patients in the residence are managed by trained professionals to include psychiatrists, therapists and nurses who utilize evidence-based knowledge and skills in the management of the patients. These professionals are responsible for assessing the patients’ needs, making appropriate diagnosis, planning and implementing the interventions they deem appropriate for their clients. More importantly, they are responsible for initiating and maintaining a therapeutic relationship with all the clients in the residence.
Secondly, patient care in the residence is individualized to meet the needs of each and every youth. Based on the findings of patient assessments, the professionals caring for the youth identify, plan and implement interventions that are tailored to meet the needs of each youth. The client is actively involved in all the aforementioned stages for example they help determine how long their therapy sessions should last or their frequency. Involvement of the youth in the planning and implementation of interventions increases their sense of control. Various forms of psychotherapy to include group therapy for the clients together with their families, cognitive behavioral therapies like systemic desensitization and graded exposure therapy, psycho education and Socratic questioning are employed in the management of the youths and their families. These forms of therapy help the clients to identify abnormal thinking patterns that contribute to their conditions for example, repeated intrusive thoughts that lead to a lot of anxiety and hence contribute to the development of obsessive-compulsive disorders.
The third aspect that contributes to the therapeutic environment of the residence is the manner in which activities are planned; all activities are meant to advance the goals of the patient management process. For instance, all therapy sessions have a set agenda which is normally agreed upon by the all the parties involved that is the therapist, youth and other family members. In addition, the therapy sessions are time-limited in nature and have a clear structure and thus provide the youth with ample opportunity for repetitive practice thus enhancing the client’s sense of control which is one of the goals of therapy.
Last but not least, the physical environment of the residence is structured in a manner that is conducive for therapy for example it is located in a quiet environment that allows for activities like meditation and relaxation which have therapeutic effects. In addition, it is structured in a manner that promotes optimal interactions between the residence staff and their patients which is important for activities like assessment of patient behaviors as well as monitoring of the patient’s progress which are part and parcel of the therapy.
Describe a "teachable moment" that you had with a youth while in an informal situation. What was the issue and what did you say that made it a teachable moment? Why do you believe this specific situation was important to you and the youth/child you were working with?
I was working with an adolescent girl who had been diagnosed with obsessive-compulsive disorder and who also happens to be non-verbal; she kept staring at certain set of pictures on the wall that were used during therapy sessions. Noting her keen interest on the pictures, I explained to her via gesturing that the pictures were used during therapy sessions. I further explained to her how unrealistic thoughts contributed to the marked anxiety associated with her condition and how she could counter these unreasonable thoughts with positive thinking learnt via interventions that were being employed in her management for example the pictures. To illustrate how the pictures were used, I explained to her via gestures that the pictures depicted a situation whereby a school girl had accidentally stepped on mud while at school and splashed it on her uniform. Further I showed her the different scenarios depicted in the pictures as occurring after the incident. In one of the pictures, the girl is shown to be anxious thinking that everybody would think that she is dirty and end up discriminating her, in another, she thinks that other students would feel sorry for her and offer to help and in the last one, she thinks that other students would tease her. I requested the girl I was working with via gestures to identify which amongst the three scenarios showed in the pictures was most likely to happen and she chose the one on being helped by fellow students.
This experience was a teachable moment because it provided me with the opportunity to educate the girl on how the therapy she was receiving works. It was important for me because I was able to effectively utilize some of the knowledge I have gained so far in helping a client and thus contributing to the therapeutic process. I felt that it was important for her since it helped her gain more insight into her condition via the recognition that she has the ability to identify different perspectives of thinking about a situation which may otherwise elicit a lot of anxiety.
