“Serving Jennel is part science, part art,” says Justin Kelly, Clinical Director of the May Center for Adult Services in Eastern Massachusetts.
When we first met Jennel, she was in a hospital crisis stabilization unit. Unfortunately, there was no place for her to go; other providers were reluctant to serve her.
Jennel is a funny, outgoing woman with minor intellectual disabilities, complex mental health challenges, and intense medical concerns. Her difficulties began at an early age. Adopted into a family with 10 children, she was placed in a residential facility for children with severe developmental disabilities and behavioral disorders at the age of 15. As an adult, Jennel has received services at a number of facilities. She has experienced many failed placements.
“There were not many options left for Jennel,” says Justin. “When I first met her at the time of her assessment, she really tried to ‘pitch’ herself to us. She had a lot of challenges. However, we pride ourselves on serving people with complex diagnoses, and I knew we could help Jennel. She is very smart and capable. I knew it would require significant resources, but I was confident we could provide the structure and the environment she needed to flourish. She is savvy and sophisticated,” he continues. “Consistency is critical when working with her.”
Jennel seeks attention, and cannot discriminate between positive and negative attention. When she first came to live at a May Institute residence, she frequently sought attention by insisting on accessing medical services. Sometimes she would declare herself “unsafe” when she was out in the community, knowing that a concerned citizen would call 911. “It’s the attention that she wants,” says Justin.
To effectively care for Jennel and help her overcome some of the debilitating challenges she faced, we trained staff to use Dialectical Behavior Therapy (DBT), an evidence-based therapy that has proven effective for people with mental health challenges. DBT skills include mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.
DBT worked for Jennel by helping her develop a number of coping skills, including journaling. Now, when she is unable to get the undivided attention she craves from a staff person, she writes her thoughts and feelings in the journal and schedules time with a staff member to review what she had written.
“We also gave Jennel appropriate access to highly trained nurses who can help her with her medical concerns and reduce the likelihood that she will seek inappropriate emergency services,” adds Justin.
Jennel has made significant progress in the past year. Our approach of combining evidence-based therapy with compassionate care has really work for her. “I think other providers failed with her because they underestimated her abilities,” says Justin.
Jennel is eager to please, be accepted, and develop relationships. She has worked exceptionally hard to lose more than 50 pounds since she has been with us. With staff support, she has been utilizing local gyms, accessing nutritionists, and using exercise equipment within the home.
Looking to the future, Jennel’s caregivers are hopeful that she will be able to overcome challenges in order to hold down a part-time job, continue to be a strong advocate for herself, and perhaps become an advocate for other people with special needs.
Jennel is hopeful as well. “Everybody gives up on me,” she says. “I’m really lucky that May didn’t give up on me. Now I’m getting better.”
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