Hillside Family of Agencies is actually a combination of different types of services for families and children. Hillside operates in over 30 different counties in central and western New York with over 40 different sites. Unfortunately there are no Hillside locations in the Buffalo area. Some of the different services that Hillside offers are developmental disabilities services for youth, home and community based services, outpatient treatment services, non-secure detention services, therapeutic foster families, and residential services. My internship was in the residential services area which requires a 24-hours-a-day, 7-days-a-week care and treatment due to the severity of the children’s emotional disturbances. They live in one of the many cottages on hillsides 30-acre campus while receiving individual and group therapy. The cottage that I interned at had children between the ages of 12 and 18 with severe behavioral problems, due to their severe emotional disturbances, that could not function properly in a normal school environment or at home. The campus also contains a school that any resident child must attend, a gym, indoor swimming pool, and outdoor recreational field are all located on the campus as well. The cottages themselves feature single and double rooms, much like in a college dorm, with a large living room area and kitchen and dining room where meals are prepared by staff every day.

Training 7/20/09 – 7/24/09

Training week consisted of 2 days of Therapeutic Crisis Intervention (TCI), 1 day of different types of documentation, food safety, sanitation, and blood and poison control training, and 2 days of restraint training. TCI, which was developed at Cornell University, is what Hillside staff is trained with in order to correctly handle situations with clients at the cottages and in the school. The program teaches staff how the clients feel during a crisis and how they respond to a stressful or triggering event. The program also teaches staff how to best communicate and interact with a client before, during, and after a crisis. During the training we had to split up into groups of 2 with other new hillside staff several times in order to role-play different situations from the client and counselor point of view. This helped us tremendously when applying the techniques in the real life situations while working at Hillside. It is a very good program in my opinion and while I was at hillside I definitely noticed myself using the different techniques that I learned during the training with great success. Documentation, etc. training was rather boring, but very important obviously. Everything that happens in a cottage at Hillside is properly documented and filed for later use, so knowing how to document an incident report or a progress note is extremely important. Restraint training was completely different than anything else we did that week. We spend 2 whole days learning and practicing different techniques of avoiding being injured by a client and taking down and restraining the client. The training was rather fun but when you think about it, it is rather a sad thing that we have to apply such techniques regularly while working at Hillside. We learned 3 different restraints. 2 two-person restraints where one counselor is holding the arms in different ways depending on the situation and the other person holds the legs together. We also learned 1 three-person restraint where 2 staff members are holding the clients are arms above his head while pushing down on their shoulders and the third staff member holds the legs. All of the restraints take place on the ground after the client has been taking down in the least painful way possible. They tried to teach us to pull the client down with you rather then to throw them to the ground and to do it on a softer surface rather than concrete or hard floors. Obviously, depending on the situation, that isn’t always possible and clients do sometimes get injured during a restraint.

7/28/09

Today was a pretty rough day at the cottage. Only 3 kids were on green group and 2 were on yellow. The rest were on red and therefore had all of their privileges removed. This is never a good thing because having everyone cooped up inside without anything to do is just asking for a crisis to occur. When I first got there I just went around like I usually do and said hello to everyone and then proceeded to sit in the living room area. One of the boys was trying to make a phone call and repeatedly asked one of the female staff members if he could use the phone to call his parents. She told him that he was not allowed to do so at that moment because since they had just gotten back from school he was supposed to be in his room for a half hour of quiet time. Then he wanted to know if he could go outside on a stress walk but again she told him no because he was on RFP (Removed From Privileges) status which means that he had had a crisis at some point in the last 2 days and would automatically be on red group for 48 hours. She told him that he would be off RFP by tomorrow morning but he was under the impression that he should have been off RFP today. She checked his file and told him again that he would be off RFP tomorrow and he was not happy about it. Even though she wasn’t the one who had originally put him on RFP status he was targeting her with insults and started throwing things at her like a nearby newspaper and calling her a bitch and all kinds of other insults. She kept trying to calm him down by saying that it wasn’t her fault that he had been put on RFP because she hadn’t been here in like 3 days or so but he just kept on escalating further. The other staff had to remove him from the living room into his room where he proceeded to go into a crisis and started throwing around everything in his room and hitting and kicking the door as hard as he could. This particular client is known to be destructive to the environment when he goes into crisis. The supervisor had to remove herself from the situation completely since she was the target of his anger at the moment. After about 5 minutes of him destroying his room and kicking the door over and over again he tried to run out of his room and chase after the supervisor so 2 other staff members that had been standing outside his door immediately grabbed him and had to drag him into the time away room where they performed a restraint on him.

8/2/09

As soon as I arrived today I was sent outside with the green group for their recreational activities time. We walked up to the rec. field and I played a little bit of soccer with the kids and a little bit of basketball after that. It was really hot outside so after about 30 minutes everyone wanted to go back inside. Once we came back in I sat down and helped one of the other kids who was on AFP make invitations for his birthday party which is tomorrow. He got some colored paper and some markers and told me what to write and to whom and I made a few invitations for him. I also helped him make some decorative posters for the party. After lunch time they had to do quiet time which went pretty smoothly since not a lot of people were there because a lot of the kids go on home visits on the weekends. After quiet time I played some UNO and Apples to Apples with some of the kids. Right before I had to leave there was some conflict once again between 2 of the clients, one of them was the boy who I helped make birthday invitations. The other one was the girl that is in the room next to his who’s birthday happened to be today. they don’t really ever get along and were saying mean things to each other which resulted in the boy escalating and having to go on a stress walk over to special services before he could have a full blown crisis. Other than that everything went pretty smoothly.

8/4/09

Pretty quiet day today. Most of the kids did really well in school and were therefore on green group and got to go on trip day. We only had about 5 kids stay behind so it ended up being an easy day. I played some scrabble with the kids and won even though I was trying my hardest not to use any difficult words. An odd thing happened at the end of the night though. I was sitting in the far hallway making sure all of the red groupers were getting ready for bed and getting them to stay in their rooms when one of the kids called me over to his room. He told me that he was feeling sort of weird and I asked if he was feeling sick or something. He said that he wasn’t feeling sick, but instead he was feeling “sexual.” I was not expecting him to say that and it caught me completely off guard. I didn’t really know what to do, but he seemed really concerned so I talked to him about it and told him that it was normal for his age to sometimes feel that way. He was still worried and wanted me to call the nurse so she could talk to him. After I got the nurse he asked me at what age feeling like this is allowed and I couldn’t help but laugh and told him that there really is no age limit and that it just happens when you get older. Some of the staff told me to tell him that he could just close his door and “handle his business” if he wanted to after I told them what had happened. They were also really surprised by this and even those who have worked there for years now said that not once has one of the clients told them something like this. I think that some of the kids like me a lot and can trust me more because I’m closer to their age than most of the other staff, also since I’m just interning with them I cannot do any of the restraints so they don’t really see me as a threat. It was kind of an awkward moment, but I think I handled it pretty well even though there was nothing that could have really prepared me for it. I finished off the night by reading a book to one of the other kids so they could fall asleep better.

8/6/09

When I got there today I was surprised to see that most of the kids were on green group and were already out on their trip to play golf at the Genesee Valley golf course. I spent some time with the red group kids after they got out of quiet time. We played some scrabble which turned out to be a pretty difficult task because some of the younger kids are not capable of making up their own words or can only come up with really simple words. I had to help them make up higher scoring words while trying to come up with words myself, so in the end I was playing scrabble with myself. Once green group returned from their golfing trip and everybody had dinner they did their usual goals routine. After that I got to go with the green group to the pool. They got to swim for an hour while I sat with the counselors and observed them, making sure they weren’t fighting or trying to drown each other and also making sure they stayed in the pool. In order to swim in the deep end they have to take a test each time they come to the pool. It requires them to swim 1 lap around the pool, going to all 4 corners, without touching their feet to the bottom of the pool. The rest of the night went pretty smoothly. They finally got a new TV in the cottage (one of the kids destroyed the old one during a tantrum), so green group got to watch an hour of TV before it was time for bed. 

8/11/09-8/13/09