I started my practicum at Brylin Hospitals today. Getting started was a long process. I had to go through various confidentiality forms, had two criminal background checks completed, as well as had my blood drawn and a drug test issued before I could actually begin. With that all said and done, today was my first day.

When I got to Brylin I was issued an ID badge that I must wear at all times, as well as a set of keys, for which I was instructed to use to unlock and relock every door I go through. My supervisor gave me a brief tour of the hospital, spending extra time on the child/adolescent unit where I will be spending the majority of the semester. Following the brief tour, I observed a children's group therapy, which I will soon be co-leading. There were five children in this particular group, one of which had to leave becuase of bad behavior. The children in the group displayed several different diagnoses: OCD, ADHD, Conduct Disorder, Depression, and various behavior problems. They were playing a game in which each child rolled a die, moved the rolled number of spaces, and picked up a card. The cards asked a variety of question such as: What do you like most about yourself? What is your favorite holiday and why? What makes you happy? Sad? The children began acting up towards the end of the session, picking on each other, kicking each other, and mumbling crude comments under their breath.

After the group therapy I had some time to look at the assessments and medical records of the children on the unit. I never realized how many questions were asked of these children, or how thorough the report is. The records consisted of everything from the reason to admission to what behaviors need to be exibited in order to be dischardged.

I was shadowing one of the councelors when she visited a patient. I observed the brief session. The young girl was psychotic, was experiencing hallucinations and delluisions, and suffers from severe anxiety and paranoia. She was very monotone, and her eyes were almost blank. During the session she kept looking over her shoulder as if she were expecting someone to be there. When asked if she was hearing voices she denied it. Her main concern was whether or not she would be allowed to go home by Friday. However, this is her second admittance to Brylin, and she is not getting any better, and is more than likely going to be sent to CPC (Children's Psychiatric Center).

Following this visit, on our way back to the social work office, there was a young boy about thirteen, who brutally kicked the social worker I was shadowing. As a result of his aggressive behavior, he was put in seclusion, a small room, where he is locked in alone. Later when I walked by him, he was sitting on the floor, a staff member assigned to prevent him hurting anyone, he looked at me and yelled, "Bitch!" I was floored. As I walked away I heard him cursing and punching the wall.

It was an eventful first day to say the least. I look forward to continuing my practicum there.

 

 

Day 2: 1/21/2008

 

Today, Bryling held an orientation for all new staff members and volunteers. I was required to attend from 8-5. We covered a variety of hospital policies, including appropriate attire, confidentiality expectations and rules, hospital policies, etc. Overall, it was not a very interesting day. Differen't members of the department came in and spoke with us, welcoming us and introducing expectations. At the conclusion of the orientation, we were required to take a test regarding the information presented to us.

 

Day 3: 1/22/2008

 

I was at Brylin today from 8 until 11. When I got there, I sat in on a staff meeting, which consisted of the doctors, social workers, and some nurses. These meetings are held Tuesday and Thursday mornings at 8:15 to discuss the progress, treatment, possible discharges, etc of the current patients. Each patient was discussed individually, including their treatment plans, medications, and progress since admission to the hospital.

Following the meeting, which was about an hour long, I shadowed one of the case workers to a family session. Last week, we had a young girl admitted that attempted suicide. She overdosed on 40 asprin and a bottle of vodka. Although I was not at her initial assessment, I had been filled in on her condition, progress, and family life. She suffers, as does a number of her family members from severe depression. This young girl is being discharged tomorrow. She has been referred to a psychologist as well as a councelor in her hometown. The meeting today was set to discuss the transition from the hospital home. Once the family was situated, the patient presented a number of "rules" she had created during her stay that she is agreeing to follow upon going home. Some of these rules were: cutting off her resources to alcohol and other drugs; informing her friends of her intentions to get better; getting more sleep which will be maintained by a normal bedtime, and writing in a journal which she will take to her counciling sessions each week. Her mother also presented rules, which she intends on enforcing. All the medications in the house are being locked up. Her daughter will leave her bedroom door open at all times unless she is changing, and someone will be at home at all times with her. While it is important to secure things for a while, the case worked stressed that the parents didn't want to impliment too many restrictions right away becuase then she might feel trapped.

I learned today how important "distance" is. I have a tendency to attach to the people I work with, and in this type of environment (Brylin is a hospital where patients are admitted when they are a threat to themselves or to someone else, they are assessed, stabalized, and then referred to either a councilor or long term care facility) it's important not to be emotionally attached. Some of the kids there are so adorable and innocent, it breaks my heart to see them there. But I have to realize that they are there for treatment, and will soon be leaving.

 

Day 4: 1/23/2008

 

I co-led my first children's therapy group today. There were eight children in the group. The case manager I was working with and I sat the kids in a circle. We had a "fishbowl" that contained a series of questions that the kids can pick from. Everything from what their biggest fear is, to the worst thing they ever did. Some of the kids acted out and left the group. The point of the group is that the kids can use it as a means of working towards going home. If they choose not to participate, no one is going to make them stay there, but they are not helping themselves. One of the children we were working with picked a card that i said... "I wish.." and he said "I wish my father would stop beating me..." I was completely stunned by his comment. Just prior to the therapy group I was helping him hang up pictures he colored in his room. He was showing me cards that his mom, dad, and sister sent him, and telling me about all the animals he has at home. After group I asked the case manager what protocol is followed if a child says something like that. She informed me that this is not the first time the child has made accusations about his father beating him, and that CPS is currently working with their family. The last time he said something like this, CPS said nothing was determined.

After group I was asked to complete some group reports about the children's performance and participation. Everything at Brylin is documented and filed into the child's binder. Following the reports I sat in on an assessment with a young girl admitted to the hospital yesterday. She was admitted for the threat of suicide. She told her mother that if she made her go back to school she would drink Dranol, a cleaning product. Her mother said that after they moved to a new school her daughter had become increasingly withdrawn and isolated herself. She's an excellent student, but is having difficulty with the move, and several individuals within the school. There were problems with one boy in particular, which the young girl claims is saying things about her making the entire class hate her and not talk to her. She is very uncomfortable with her image, and her athletic abilities. She also says that this is not the first time she has had suicidal ideation. In fact, her depression has been occuring for a few years now. After talking with the school, upon her return, the want to set up a peer mediation, where the two can talk and work things out. The girl refuses to even be in the same room with this boy, claiming that if they make her talk to him, she will refuse to go to school....

I also worked with a young boy, who has a history of severe trauma. At a very young age he witnessed a gun shooting, in which two people died. He also started using drugs at the age of ten, and was admitted after breaking into a house. The boys father has recently been sentenced to 15 years in jail; reason unknown. We talked a bit with this young boy when he saught out a social worker to speak with when another boy on the unit hit him. He is intent on returning home, and is afraid of doing something that could prolong his stay. So instead of acting out, which he normally would do, he saught someone to talk to.

 

Day 5: 1/28/2008

I co-led children's group therapy today. We did an exercise called problems and solutions. Each child was to list two things in their life they felt were a problem, and then on the reverse side of the page they were to write down solutions they thought would help them manage those problems. This proved to be a difficult task for some of the children; not so much becuase they couldn't come up with anything, but becuase they did not want to participate in the group. However, one of the children's answers shocked everyone. His problem was that he hated being picked on by other kids. His solution to this problem was to use his dad's rifle. We redirected his response in order to help him understand that violence was not the appropriate reaction and asked him to think other ways; which he then proposed walking away from the situation. Following the group therapy I wrote up group notes that go into the children's charts based on their performance during group.

One of own newest editions admitted this weekend, attempted suicide. I observed her assessment, and she reported having a history of self abuse, and that this was not her first psychiatric hospital stay. She showed us her scars, which were on the inside of her arm near the elbow joint. After being asked why she cut in that particular place she claimed that located in the upper arm is a major artery, which after I researched it, was true. She also had scars on both wrists. I was asked to contact her former psychiatric hospital, fax over the consent forms, and retrive for her current doctor, records from her last stay.

At this point in the day, it was almost time for me to go. I followed up with the patient's former hospital to make sure they recieved the faxed consent forms, filed they daily logs required, and clocked out. Tomorrow morning, I am sitting in on a multi meeting which is held every Tuesday and Thursday morning to discuss current patients, treatment plans, and status.

 

Day 6: 1/29/2008

Today started out with multi: a meeting where the case managers, head nurse, and doctors meet to discuss current patients, treatment plans, and status. It was very brief; a few new patients were admitted over the weekend, and only two patients are being discharged this week as of this morning. Following the multi meeting, I was introduced to discharge planning. The CM (case manager) I was working with set up an appointment with CATS: child and adolescent treatment services following the discharge of a particular patient. She also showed me to how and what to fill out in terms of records that need to be sent to CATS and other facilities the child was referred to. Also, involved in discharging a patient is setting up a meeting with the family to discuss the transition from the hospital to home as well as creating a list of discharge goals and a crisis plan.

One girl, 16, who was admitted becuase she threatened to drink Drano if her parents made her go back to school, is not only continuing to refuse peer mediation which was reccomended by the school, but is now refusing to return to school at all. The psychiatrists think she has Borderline Personality Disorder. She is refusing to eat or drink, claiming she is going to "starve herself to death" but an eating disorder was ruled out. The doctor arranged for the mother to come in for a meeting to discuss options. If this young girl refuses to go to school, CPS could be contacted and her parents could be accused of educational neglect. In our meeting, we openly discussed the possibility of a home tutor for the remainder of this school year, and placing this girl in a new school district next year.

I helped lead the adolescent therapy group today. We did an exercise called "Building Resources." There was a list of 5 questions each patient had to answer. They were to consider who they do or could turn to for help and support, what types of goals or activites that have for the near future, how they could learn about their diagnoses...etc. The group went well, with minimal argument. Some had to be prompted more than others to participate and be redirected when they got off task, but overall, the activity went well.

Following the group therapy, I wrote up group notes for each child's chart.

 

Day 7: 2/1/2008

I went to Brylin today instead of Wednesday becuase of the crazy weather. I followed the same routine as usual. I co-led the children's group therapy, and we played "emotions BINGO." I would pick a card which would be represented on the BINGO boards. The cards were emotions: happy, sad, frusterated, annoyed, etc. If a child had that emotion, they would put a checker on it, and they would have to tell us one time they felt that emotion and why. Overall, the group went very well, and the children participated without us prompting them to do so.

After Emotions BINGO I wrote up group notes and placed them into the children's charts. Then I helped one of the social workers make some calls to outpatient facilities requesting information and seeing if we could get our patients placed in their care upon discharge.

Once the social workers left for the day I opted to stay a bit longer. While the kids were having "down time" which means they can watch TV in the common room or play games, or do whatever they please (within reason) I took some of the kids I was working with and we played cards. I went to dinner with them in the cafe.

 

Day 8: 2/4/2008

Today was a very interesting day. OMH was at the facility following up a Grant that has recently been given to Brylin. So everyone was a little nervous. One of the girls I have been working with tried to commit suicide twice this weekend. Once by trying to strangle herself with a blanket and the other by banging her head on the bathroom stall. She's now on 24 hour watch, and we are working very hard at finding her a long term placement that can better assist her.

I pretty much led group today becuase the social worker I was co-leading with had to meet with OMH for part of the time. We played a game called "The Ungame" In this game, there is no winner. You roll the die and if you land on certain spaces you pick a card which gives a situation and/or asks a question about the child's life. We give each child an opportunity to answer the question. It really creates a comfortable environment for the children to express themselves without feeling pressures. Group went really well today.

After group I completed the group notes and filed them in the children's charts, I made some phone calls to Hutchind Psychiatric Center and then EPC (Elmira Psych Center) to see if we could find placement for our patient who is still attempting suicide. It's very difficult to place someone, and you have to have consents to speak with everyone. Confidentiality is a major part of social work and counceling. If you break confidentialty you could lose your liscence and could be charged with up to $250,000 dollars.

I spoke with my supervisor today, and we are going to meet again on Wed. She wants to have me take on certain kids and start meeting with them one on one to make up treatment plans, and go over certain goals and crisis prevention plans. I'm really excited. I'm definately getting a well rounded experience at Brylin. Everyone is willing to help me out and wants me to jump right into what I would be doing if I were an employee. (With supervision of course)

Tomorrow is our multi meeting. It will definately be interesting what our next actions are going to in regards to our patient that has been attempting suicide.

 

Day 9: 2/5/2008

We had our multi meeting today which went longer than usual. We discussed the the possibilty of discharging two patients. One of our boys had to start taking his meds on a routine basis in order to be released from the hospital, and the other had to continue acting apprpriately (not acting out aggressively towards other children, etc. After multi I sat in on a family meeting with one of our kids' mother and grandmother. He was admitted becuase of he is having behavioral problems at school and with other kids. He is extremely agressive and physical with his younger sister, and at times unable to calm down.

His mother was very upset that the school he was attending was not doing anything to help him, and was unhappy that the psychiatrist he sees continues to increase his meds without assessing him on a regular basis. Now, instead of helping his mental issues, the meds are creating physical ones. His liver levels have been higher than normal and his mother says he has gained a lot of weight from the meds.

 

Day 10: 2/6/2008

Today I helped co-lead group. We played a game called helping, sharing, and caring. The kids rolled the die and picked a card, and were given a situation that involved helping or sharing or caring with others. Some of the kids were more than willing to share their ideas while others were hesitant. We had some new admitions today, and things on the unit have been really crazy lately. In the past couple days there have been several holds on the unit, and several fights have broken out.

After group I wrote up the group notes to put in the children's charts I sat in while the social worker I was shadowing met with two of her kids to discuss their progress and create new goals in order to get closer to their discharge. After the meetings with the kids I documented what we discussed in their charts and left.

 

Day 11: 2/11/2008

Today I co-led group. We did an activity called Relaxation: Athetic Activities. We discussed how sports can serve as a means of releasing energy in a constructive manner, and asked the kids what kinds of sports they enjoyed and then they completed a crossword puzzle. After group I wrote up group notes and filed them in the children's charts.

The social worker I was working with today and I met with two children. One of the boys we met with was asked if he knew why he was in the hospital; what he did to end up there. He said becuase he was bad. He said that there was a boy in his class, Timmy, who has been mean to him, telling him to shut up and hitting him.  The reason this young boy was admitted was becuase he said that Timmy told him to stab his baby brother, and that if he didn't do it, he would kill him. Even though this young child did not act on this, he was referred to Brylin because Timmy has been telling him to do all sorts of bad things, and some of them he has done. When we followed up on this boy in his class, there was indeed a boy named Timmy, but he was nonverbal. This young child is very puzzling and we can't seem to figure him out just yet.

Another one of the kids that we met with is one that has been recently admitted becuase he was hearing voices. We questioned him to see if he was still hearing these voices, and he says no, that he thinks the medicine is working for him. He also told us that the voices he was hearing were his dad, who recently passed away. Isn't it normal for a child to still imagine having convsersations with or remember things about a deceased person? Especially a father? I asked the social worker this, and she said what was not normal about this particular case was that the "voices" were saying nasty things, and bad words.

Following these two meetings, I was able to meet one on one with a patient, by myself. This is the first time I was able to do such a thing. I met with one of the patients to review treatment plan goals (what she needs to achieve in order to be discharged from the hospital) and had to have her sign the treatment plan.

 So far, I am really enjoying my internship. This is definately something I would like to do long term.

 

Day 12 :2/12/2008:

We had multi today, and one of the main discussions was regarding one of the boys that has been at Brylin since the 8th of January. He has been acting out alot lately, having to be put in several holds, and at one time, put in seclusion. We, the social workers, think that he is acting out becuase he is one of the oldest boys there, and becuase he has been there for so long. He will also not be going home in the next two weeks, or at least until someone comes to do a sexual predator assessment on him. He is not handling being at Bylin very well, and is constantly bored, and seeking someone to talk to.

The director of social work and some of the charge nurses decided that it would be a good idea for him and I to spend some time together, just he and I. We can play card games, talk, write, whatever he wants to do. They think that having a one on one enhancement will be benificial to him. So I will be meeting with him every monday and wednesday for a half hour to an hour just to give him some sort of outlet. After multi I met with this patient to talk to him about what the other social workers and I were thinking about doing, and he was all for it.

 

Day 13: 2/13/2008

Today was different than any other day. There were speakers from the Wrap program coming in to discuss what they do. So for the time I was there I was listening to the speaker talk about the program. Basically what this program does is provide services to families with financial needs or transportation needs. There's programs such as the rise and shine program in which someone goes to a family's house and gets the child/children up and ready for school. There's mentoring programs, at home counciling/psychiatry...etc.

 

Day 14: 2/18/2008

Today had to be by far one of the most interesting days I've spent at Brylin. When I first got there, I had a one on one enhancement with "R" (I'll call him "R"). He brought his lunch up to the social work office, and we played some cards, and talked a little bit about the weekend. He's doing much better this week than last, and hasn't had to be put in any holds since last week.

After lunch, I coled group which was out of control. We had three kids in the group today, one of which was 6, and has severe ADHD. He was climbing all over the tables and chairs and running around the room. Nothing could settle him down. There was another girl who was also just admitted to Brylin over the weeked, who is one of the meanest kids I have ever met. She is such an instigator especially when it comes to the ADHD child who I will call J. Her and J got into a very physical fight, she was slapping him on the side of the head, and the social worker and I had to intervene immediately. I stepped in between the two children and she pulled the girl of J. He of course was trying to retailiate, but he is so small. Although he is six he looks like he is three.

After group I filled out the group notes and filed them in the kids' charts. Needless to say they were not the best reports. I met one on one with one of the new admissions who was admitted to Brylin for increased signs and symptoms of depression as well as suicidal ideations.We sat for about a half hour, colored some pictures, and talked about what's been going on with her.She seems to be, althought supposedly she was thought to be bipolar, that she is just a very anxious child. She just moved to a new school, doesn't have a lot of friends, comes from a big family of which she's not overly close with anyone, and the one person she was most attached with was her brother's girlfriend, and they broke up. There have been so many changes in her life recently that I think she's overwhelemed with everything and doesn't have the appropriate coping skills to deal with it all.

Just before I was going to leave for the day, one of the patients had a breakdown. He was trying to escape going to everydoor, pounding on every door and window.. he got so physically aggressive that he made his knuckles bleed. We finally got him calmed down and willing to let one of the aides clean his cuts.

I ended up staying a little longer and going to dinner with the kids, becuase my one to one asked if I would play Clue after dinner. Dinner went smoothly, and afterwards, we ended up playing games. I lost track of time and ended up staying until 730. Again, as I was about to leave, the charge nurse asked me if I could stay and help get the kids ready for bed seeing as that they were short staffed. So, I stayed to help get the younger kids situated. J was almost unbareable. He was running all over the place bouncing on beds, running into walls. There was just no calming him down. Eventually, the doctor had to come down and medicate him.

Overall, it today was one of the most eventful days and I loved every minute of it. This is definately the field for me.

 

Day 15: 2/19/2008

 

We had our multi meeting today. We discussed some of the things that had been going on. Ultimately, it was decided that I would be going on a one to one enhancement with two additional children who are at Brylin. Which basically means that two times a week I'm going to spend twenty or so minutes with these children, giving them an outlet and helping them to enhance their coping skills.

After the multi meeting I met with my supervisor for the rest of the time, and we went over how things have been going. She said that she was happy with how things have been going and that they would love to have me come back to work as a Mental Health Tech after my internship is over.

 

Day 16: 2/20/2008

I met with two out of my three enhancements today. First, I met with a little girl who was admitted for depression and thoughts of suicide. We brought some coloring books and markers into the "calming" room, and colored. At first she didn't say much when I asked her how things were going, she just kept coloring. Eventually, she started talking more and more to me telling me that she's always worried about her dad's health, and takes other people's problems on as her own. She says that school is really hard for her becuase she doesn't have any friends, and is worried that people, especially her mom is lying to her. After our session, I had to document that I met with her, and made note of the paranoia.

I met with my other one to one, and we played cards. He has been doing really well lately, and is working very hard to get a pass on Friday. In order to do so he can not exhibit any aggression and cannot have been put in any holds. This is very difficult for him becuase he tends to snap eaisly. So, we went over some of his "calming" methods, which is a list of things he can do when he feels himself getting angry.

My other one to one was not having a good day and didn't want to meet with me. I can't force a child to meet with me, so I let him do his own thing.

 After I met with my kids I co-led group. We played emotional BINGO. If the did get one of the emotions that was called they had to explain one time when they felt that emotion and why. Things got a little aggressice towards the end. One of the newer girls is a big instigator. She started hitting another girl and they started fighting. The leader and I had to intervene.

After group I wrote up group notes and filed them in the children's charts.

 

Day 16: 2/25/2008

Today I led group. We played the Ungame again which is a game that helps kids to explore their emotions as well as social situations and what they would or could do given a certain circumstance. Group went well for the most part. Towards the end, the kids started to get antsy and started instigating one another. After group I filled out group notes and filed them in the children's charts.

After that, I worked on some discharge planning with one of the social workers, and met with my one on one enhancement. He is starting to get a little anxious. This Wednesday a speciaslist is coming in to assess him as a "sexual predator" and to see whether or not he is at risk of doing something again. However, like I mentioned last time, this boys brother was the one who accused him sexually assaulting him, and at a family meeting ruined his credability by making up stories when we were right there to witness everything going on. I feel really bad for this boy becuase perhaps all this could have been prevented, or at least his stay could have been shortened. We'll have to wait until the assessment to see what our next steps are going to be.

 

Day 17: 2/26/2008

We had multi this morning. It was a very devestating multi to me. One of the boys who has been there for quite some time is thirteen. He is being charged for sexually molesting his brother and several other children he goes to school with. He has a strong history of sexual abuse from his biological parents, and his adoptive parents have completely abandoned him. They want to completely wash their hands of what has happened. It is so devestating to me. Here is this child that has a severe trauma history and was never taught the difference between right and wrong, and once he finally found a family to love him, they abandon him in a time of need. I understand that they are upset and may not have the ability and or resources to cope with what has happened, but they aren't even trying. As for what will happen to our patient, he has to go to court this month, and following court, he will either have to go to detention or to a long term facility, all without a family to support and love him throughout this. It makes me wonder what is going to happen to him.

 

3/5/2008

This week has been kind of slow at the hospital. There hasn't been anything too interesting to report. I helped out with some paperwork and making some phone calls, but up until today things have been pretty slow. The same routine of leading group on Monday and Wednesday, and then multi meeting on Tuesday. I met with my supervisor, and we decided that on Mondays and Tuesdays I'll be on the child adolescent floor, but on Wednesdays I'll be shadowing her on the adult unit. Today was my first time on the adult unit. It was much, much different.

I sat in on a session with a client who has been undergoing ECT. One of the effects of ECT is short term confusion. She was very disoriented and claimed she couldn't recall why she was even in the hospital. She was in the hospital becuase she was threatening to kill herself, and has had a long history of severe depression. MDD with psychotic features. It was hard to hold a conversation with her. She had a very flat affect, little eye contact, and a very childlike talk. She said repeatedly that she didn't think she wanted to hurt herself, and that she felt safe in Brylin. She got very anxious and started shaking when she talked about going home, and being "out there." referring to outside of Brylin. It was a very emotional session to see her being so detached from reality.

Following this session, I sat in on one more, another ECT patient being treated for MDD. He too, has suicidal thoughts. He had been going through ECT longer than the previous patient. He was not so confused, which made me wonder how much the woman prior to this session was really confused.He said that he was feeling better, and hope that with one or two more treatments he would be back ot his old self again.

I never really knew much about ECT, or that it was even still used. Although now a days, iits much less intense than as portrayed in media. My supervisor said that if I want to, she'll talk to the doctors about allowing me to watch an ECT session.

Also, after I finish my internship, I have recently been offered a perdium job as a MHT (Mental Health Tech). I willingly accepted! So this summer and into senior year I will be getting paid experience, which I am thrilled about!

 

3/10; 3/11

 The past two days at Brylin have been somewhat the same. There have been several new additions on the child and adolescent floor so it's been the process of admitting them, and doing the initial assessments with them. I have been sitting in on the assessments, observing what types of questions need to be asked, and learning the appropriate way to handle responses.

I got to review some treatment plans with a few children, and go over the progress they've made throughout their stay. One meeting I had with a 15 year old girl, I'll call her "M" was really interesting to me. She has been diagnosed with borderline personality disorder, and thrives off the attention given to her. She's a severe cutter and has been for some time now, and is not afraid to discuss the issue which convinces me even more that she is doing it for attention seeking purposes. Of course, I have to treat her with concern and understanding. I feel bad for her becuase she's a beautiful young girl with a lot of potential. And the ironic thing  is, as I'm sitting in this meeting with her, all I can think about is how she reminds me so much of the woman from Fatal Attraction. A little nerve racking.

Another case I've been observing is the child of a retired clinical psychologist. This case has proved to be quite difficult for Shannon, the social work this boy has been assigned to, becuase the mother is threatening that if she contacts her son's school, primary care doctor, or councelor, she will take legal action. However, as this came up in the multi meeting today, we don't know how legal it is that the mother can restrict contact with his primary doctor. Investigations are being made.

Which leads me to the most heartbreaking case I've seen so far. And that is my young boy that is 13, and being charged with sexual harassment. I have made previous mention of him in my logs prior to today as he as been at Brylin since before I started in early January. He has been accused and found guilty of sexually molesting his younger foster brother, and accusations of his molesting two children he goes to school with are under investigation. His foster parents, who adopted him, knowing of his history of sexual abuse by his biological father, have completely washed their hands of him. They don't want him in their lives anymore, and over the past weekend, the father had a nervous breakdown and was admitted to a local psych institution. It just breaks my heart. I see how this young boy has such a severe trauma history, is currently being abandoned by his family, and is facing criminal charges: which might put him in detention or even juvi. All the while, he still puts on a smile every time I see him, and is holding strong thoughout the whole thing. It just makes me wonder whats really going on inside his head. I mean, isn't he scared? Terrified even?

 

3/12/2008

I co-led group this afternoon. We played the Ungame, which allows kids to explore their feelings given a particular situation, and why they would feel that way. Group went fairly smoothly until the end when one of the newer boys started acting out. He started screaming and cursing and tipping over chairs. Finally, one of the MHT's came in and escorted him out of group since he would not leaving after being told he was being disruptive to the rest of the group.

After group I wrote up group notes and filed them in the children's charts. Then I observed a meeting with one of the newer kids, the one whose mom is threatening to take legal action if Brylin speaks with his school, counceler or primary doctor. He is a nice boy, very overweight, and is severaly depressed, exhibiting suicidal ideations. He is constantly picked on in school, and refuses to go back. Another problem for his is that he is dyslexic, so he is in special ed classes. Options being explored are home tutoring for the remainder of the year, and maybe placement in a different school next year.

There was a lot going on today. Several of the older boys were acting out. One was placed in a hold becuase he wouldn't calm down. He was cursing and punching walls and throwing things. Another boy, who is being transfered to CPC later this week, has been refusing to take his medications so that he does not have to go and also acted out. He is also a very large boy, about 200+ lbs. He got into a fit and ripped the desk out of his wall and had to be put in seclusion.

Needless to say, it was an interesting day. A lot going on. As per this afternoon, there were going to be three more admissions tonight, and all beds will be full.

 

3/17/2008

Today I co lead group. We played a game called sharing and caring. Basically it helped the children put themselves in and think about different situations with peers, and what good and bad responses to situations would be. After group there was an ice cream social for all the children and staff on the first floor so the other social workers and I attended that.

After the ice cream social I made some calls to EPC regarding one of the patients we currently have. I talked with the admissions director there to clarify what paperwork they needed, ect, in order to admit our patient. I also made a few other calls regarding discharge planning, and completed the group notes and filed them in the children's charts.

After that I shadowed my supervisor for an hour or so. She showed me how to fill out and create safety management plans for each resident, which is what I will be working on tomorrow after multi.

 

4/02/2008

I finished my internship between last week over spring break and this week. Last week I went through a three day course of CPI training, which is basically learning holds and restraints in case a patient becomes an imminent danger to himself or others. We learned a series of holds, what to do if someone comes after to you. The key to holds and restraints is to be on the defensive, only to use them as a last resort.

I was offered a position as an MHT (Mental Health Tech). I am going to be working mainly on the child/adolescent unit, helping with groups, doing one on ones, helping the kids learn every day tasks such as doing laundry, and making sure they maintain good hygeine, etc. Over all, the internship was an amazing experience, and I am excited to start working there!