Build on He has good receptive language skills and he does have staff Fear response. Strengths he trusts. Have a trusted staff reassure him and explain that no one will hurt him now. Also explain that the splints are too tight and show him they Painful splints. – can be loosened up. He enjoys lots of activities. Distract him with something he When he gets upset. likes to do. Teach him some calming techniques. To give him some control when he is upset. Keep It Simple Reassign new staff to another program. Associations of bald new staff with former abuser. If figure out a way to desensitize Sam from that’s impossible, his presence perhaps with respectfully and gradually – increasing friendly contact. Positive Provide reassurance of safety by preferred staff. Fears. Behavior Give him maximum control of what he can control. Empower him as much as possible. Supports Behavior Plan Set up a plan to reward increasing amounts of time when he To help him manage frustration better and decrease the incidence of SIB. does not SIB or act aggressively. He might respond, for example, to a plan where he gets to play his favorite game on the computer for 10 minutes for every ½ hour where he We probably would have to build up to that time. doesn’t SIB. Medication Treat the ulcers. To manage stomach pain. Plan Arrange a consultation with his PCP, the pharmacist, and a We need to continue to check this out. psychiatrist for evaluation just in case – we’re missing something in terms of med interactions or side effects. Therapies Psychotherapy likely to be helpful with someone like Increase the repertoire of soothing skills to offer him to help him deal with events isn’t Sam. However, a clinician could teach staff how to teach him that upset him. some self-soothing techniques. Systems No changes seem to be indicated. Everyone who supports Consult Sam seems to be on the same page about his care.
Build on Strengths He has good receptive language skills and he does have staff he trusts. Have a trusted staff reassure him and explain that no one will hurt him now. Also – explain that the splints are too tight and show him they can be loosened up. He enjoys lots of activities. Distract him with something he likes to do. Teach him some calming techniques. Fear response. Painful splints. When he gets upset. To give him some control when he is upset. Keep It Simple Reassign new staff to another program. If that’s impossible, figure out a way to desensitize Sam from his presence – perhaps with respectfully and gradually increasing friendly contact. Associations of bald new staff with former abuser. Positive Behavior Supports Provide reassurance of safety by preferred staff. Give him maximum control of what he can control. Fears. Empower him as much as possible. Behavior Plan Set up a plan to reward increasing amounts of time when he does not SIB or act aggressively. He might respond, for example, to a plan where he gets to play his favorite game on the computer for 10 minutes for every ½ hour where he doesn’t SIB. We probably would have to build up to that time. To help him manage frustration better and decrease the incidence of SIB. Medication Plan Treat the ulcers. Arrange a consultation with his PCP, the pharmacist, and a psychiatrist for evaluation – just in case we’re missing something in terms of med interactions or side effects. To manage stomach pain. We need to continue to check this out. Therapies Psychotherapy isn’t likely to be helpful with someone like Sam. However, a clinician could teach staff how to teach him some self-soothing techniques. Increase the repertoire of soothing skills to offer him to help him deal with events that upset him. Systems Consult No changes seem to be indicated. Everyone who supports Sam seems to be on the same page about his care.
F12-MARIE_HARTWELL-WALKER.docx