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 at home with out Colleen's help, they can be more confident in their comments after getting to practice special play time in the Children's office. Some cases can go smoothly and some can be a struggle, when they are  astruggle it is part of Colleen's job to recognize this and keep the patinet where they are in the PCIT and make sure they are ready before moving them on. A well rounded knowledge of the patient and their home life is an important aspect of the therapy because if Colleen had not been aware of the extra stressors in her patient's home life she would have advanced him and set him back on his behavioral progress.

DAY TWELVE

Day twelve fell on a Friday and on a Friday at the Children's behavioral special center it gets a little crazy. Since there is more therapy work that goes on in this center than anything else it is usually fairly quiet in the office. On Fridays though, there are always two child psychiatrists that are in the office to do consults for patients on medication or patients that need to be put on medications. This means that these patients need to get their vitals checked, which keeps the nurses fairly busy and the hallways a little bit louder.  This was the first Friday of the month that I had actually got to spend in the Children's offices and was able to see the organized madness of the child physiatrists at work.

I started of my day with getting to sit in on a phone call with Colleen who was calling directly to a mom who's daughter was a TiPS patient. This was an information collecting call becuase this particular case was too far out to come into the office. Since this case was a little different it did not have the thirty minute clock on it like all the TIPS responses.

The last behavoral issue I was able to observe was a case of anxeity in the form of social worries. I am mentioning this case not becuase it was a new one that I had the chance to observe but more becuase it was the end. This presentation had become dealable and the session was a graduation from therapry and was a perfecft way to end my time at the Wexford offices.

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