Nicole Walters-De-institutionalization: Changing perceptions of mental disorders

Looking back on who I was just a month ago, it is almost funny to realize how much I have changed and learned in such a short amount of time. In a way, I am a lot less uncertain about areas of my life now, but I also have a lot more questions that I am looking at answers for. When you spend time in a field that you would like to pursue you get asked sooner or later, when did you know this was the field for you or when did you realize this is what you wanted to work on. The stories range from in-depth and interesting tales to short, quick blurbs and a, yeah that's it stories. Mine in a  way falls in the middle, I knew that I wanted to work a job that helps people and I wanted to deal with them in a hands-on situation. Later in high school, I took a psychology class and realized that mental health was an interest of mine as well so I combined the two passions and got to the therapy side of behavioral health. From then on it was just class after class, taking what I could to learn the...

FINAL DAY As the final day arrives and my time here at the Wexford offices comes to close it is time to wrap things up. My final day was just like all the others, typing up about previous days and looking at all the ways that the therapists, counselors and doctors methods overlap support and work together. Each session is different but they all follow central themes of production. There is always a warm up, causally talking about how the day has been, what the patient had been up to. Then begins the questions about the patient's disorder than how treatment has been going, any rising concerns, and then new ways to handle the disorder. It really has been a fun time and a great learning experience and if you would like to read more about my reflection and personal thoughts please refer to my  Self assessment  page and  Life after Magellan  page. My final day I had to sit down with Dr. Schlesinger and review all the entries I had made about the sessions that I...

DAY ELEVEEN Today I was with Colleen again and was able to follow her through sessions with ADHD and extreme task avoidance. A group Collen knew of to help combat this behavoirla issue was an  organization called ADHD across the life span. This was a summer program set up to help train kids who suffered from ADHD to keep a planner and stick to the jobs they placed on the dates and to improve their executive functioning.  Involving someone else in a pateints aciviteswas one of the best ways to keep them accountable to complete the job. Colleen made sure that all the activities would get done before their due dates but also not so too much work was put on one day. If that were the case, the over abundance of work would be setting the patient up to fail by making it even more difficult to complete the work. The second case involved PCIT and had "special play time" every week so that the parents can practice mastering their CDI skills. When they do the skills a...

DAY NINE Day nine here at the office turned into a quiet one due to the nature of the patient's cases that were coming into the TiPS offices that day. To begin, my presence here and in the doctor's offices, getting to sit in and watch professionals work is a privilege and a luxury, one that could be terminated by the patient's wish for privacy or due to the nature of their case. An important part of my project was recognizing that people have always been less likely to talk about a mental disorder than they were to talk about a physical aliment. Having out-patient centers like the Children's office in Wexford was a place to combat that fear, this office was more rurally located and didn't require people to travel to Western Psych in Pittsburgh. The out patient office are a lot less intimidating and appear more comforting to patients who are nervous for their appointments. Even still, with the sunny, open offices, and the kind looking staff, it can be nerve ra...

DAY SEVEN On day seven I shadaowed Colleen and was able to learn some new teqniques to help cope with performance anxeity. Colleen discussed the calming method called coping cat, which is a technique used with younger patients suffering from anxiety. The coping cat has four steps that the patient goes through to help reduce his or her anxiety. First, the patient is to try and recognize and understand their emotional and physical reactions to the source of the anxiety. For a theoretical example, a patient begins to have a panic attack and they recognize that it is because a new school year will be starting. The second step is to clarify thoughts and feelings in anxious situations, so the patient has recognized they are anxious over the new school year so why? They clarify their thoughts and realize that they are nervous because they will have class with people they don't know and will start the school year sitting by themselves. The third step is to make a plan to deal with their...

DAY FIVE Day five consisted of sitting in with Stephanie again for a patient who had been coming for therapy sessions for a few weeks now and was involved in the CDI ( child directive interaction) training of PCIT ( parental care interactive therapy). Every patient who comes for CDI is part of the PCIT program to fully complete the therapy training to help the behavioral issues. This training is primarily for children ages two to seven years old, once they get older the training is not as effective. These training sessions last around twelve to twenty weeks long. The goal of CDI is to train the parents to have the proper reactions and disciplinary moves to fix their child's misbehavior. The lesson goes on through two rooms connected by a one way glass window. One parent goes in with the child for "special play time" and this parent had a ear piece that the therapist talks to them through in the other room watching via the glass window. For each parent they had to gi...

DAY THREE On the third day of working in the Wexford offices I shadowed Dr. Schlesinger exclusively on her clinical day with patients that were non-TiPS and were coming to the offices under Children's. The patients that we saw on this day were all ones that she had been seeing for some time now and these appointments were all follow ups or check-ups for these kids.  Since Dr. Schlesinger is a child psychiatrist all of her cases deal with some sort of need for medication, but always with a side of therapy. The cases she works with range from the more simple cases where the patient was diagnosed easily and placed on an effective medication plan, these patients are coming in for routine check ups; to cases that have new problems popping and need their treatment adapted each time they come in. Selective Serotonin Inhibitors are used to treat depression and anxiety in children and adolescents. They need to be...

DAY ONE The first day of my Magellan, June 5th 2017, I met with Dr. Abigail Schlesinger at a Park N Ride in Harmony Pennslyvania. Dr. Schlesinger, who is a child psychiatrist and the major brains behind the TiPs program centered here in Wexford, was meeting me to drive to Erie Pa. That day we would be driving up through Erie and trying to visit as many family pediatric offices as possible. These visits were quick stops and Dr. Schlesinger joked that these visits felt a little like a drug representative's job, but it was an necessary evil to get as many offices signed up through the TiPs program as possible. The most effective way to get these offices  involved was by introducing the TiPs program in person. Dr. Schlesinger makes several driving trips like this one to Erie every year, but to other counties that the TiPs program covers. She would also have to go and visit the offices that had al...