Karen arrived at the Bradley Center in need of trauma-informed care. Karen was 15 years old and had a history of multiple placements in various mental health settings including 5 inpatient hospitalizations, 2 previous RTF settings, 2 shelter placements as well as one foster home placement. Karen also suffered from a long history of complex trauma beginning at the age of 5 and ending at the age of 12 when Karen was removed from her mother’s home by CYF. Karen also had a history of suicidal ideations and gestures, running away from home, and a history of self-injury. Karen tended to decompensate whenever she discussed her future as she had feelings of hopelessness due to the lack of contact with her family. Karen also reported experiencing flashbacks of her previous abuse that were triggered by males. Karen also reported witnessing domestic violence.
The Bradley Center, as a Sanctuary Certified agency, was able to recognize Karen’s trauma and slowly began the process of helping Karen discuss and heal from her past abuse. This process began within the milieu of the unit where Karen was admitted. Karen was introduced to her treatment team including her therapist and other members of the unit staff. Karen was encouraged to build healthy relationships with the members of her team and in therapy begin to discuss and process her past trauma. The process of encouraging a child to tell their story is part of the effort to help the child put their trauma into the context of the past. Karen’s recovery began slowly and there were many times when her progress appeared to be non-existent. This is not uncommon during a child’s stay at the Bradley Center. There are often times when a child’s outward behavior regresses as they get closer to dealing with and discussing their past trauma. With the support of the staff the child is able to work through their struggles through the relationships they build during their stay at the Bradley Center.
The Bradley Center also addressed Karen’s struggles through the treatment team including regular consultation with the psychiatrist. The use of medications to address the symptoms of Karen’s mental health difficulties were part of the process of Karen’s treatment. Karen was also encouraged to be an active participant in her own treatment by discussing with the psychiatrist the efficacy of her prescribed medication. Encouraging children to advocate for themselves is not only a life skill that they can use outside of the Bradley Center but is also a part of the healing process from trauma. Having a voice and the strength and willingness to use it enables children to learn the skills necessary to overcome their past trauma and protect themselves in the future.
Karen’s ability to control her own behavior was also a part of the healing process. As mentioned earlier Karen had come to the Bradley Center with a significant history of physical aggression toward others as well as a significant history of aggression toward herself in the form of self-injurious behavior.
Initially there was not a cohesive plan for Karen’s future. The uncertainty about her future often added to her stress and anxiety resulting in an inability for Karen to control herself. Karen’s community team identified a family resource for Karen as a possible option for discharge. Karen began visiting with her aunt at the Bradley Center. The success of these visits resulted in Karen being able to visit with her aunt in the community for several hours and then to full day visits. The success of these visits built to the point where Karen’s aunt was now considered as a discharge option and Karen was able to begin weekend overnight therapeutic visits.
After six week of successful weekend overnight therapeutic visits, Karen was successfully discharged to her aunt’s care. Since that time Karen has been able to reintegrate back into the community. Karen has been able to return to the public school setting and she has had the courage to try out to be a cheerleader at her school. Karen was able to transform herself from a person who felt hopeless and struggled with anxiety to a confident and focused adolescent.
Nancy came to the Bradley Center with a long history of delinquent behavior, running away from home, experimenting with drugs and alcohol, skipping school and getting into minor trouble with the law. These behaviors began at the age of 11 and continued throughout high school. When Nancy arrived at the Bradley Center she was 17 years of age and she had a long history of failed placements. Nancy was particularly depressed about being back in placement when she arrived at the Bradley Center. Upon arriving, Nancy made several suicidal statements and was placed on Special Observation so that the staff could keep a close eye on her and maintain her safety if Nancy could not.
Needless to say this was a rocky beginning to Nancy’s stay here at the Bradley Center. Undaunted by Nancy’s initial presentation the staff members approached Nancy’s case from a trauma informed perspective and were able to help her begin to verbalize her past trauma as well as verbalize and recognize her mental health struggles. The staff and Nancy began to recognize patterns to her aggression, self-injurious behaviors, and with her sleep patterns. Nancy’s aggression and self-injury appeared to coincide with an inability to sleep. Nancy would be awake for many hours often drawing or writing in her journal until 4:00 am or 5:00 am and sleeping for an hour or two before going to school. The pattern and presentation of Nancy’s behavior appeared to have a distinct pattern as she would have increased aggression and energy as well as a decreased need for sleep for a week to ten days every four weeks. The team investigated this situation further and assessed Nancy for Bi-Polar Disorder. A large part of the process of treatment at the Bradley Center is proper diagnosis and treatment. Another part of the treatment process is helping a child and their family recognize the signs of their disorder as well as helping them understand that prescribing the best medication is only part of the whole picture. Part of the process of treatment is helping the child understand the need for the medication and to follow through with taking the medication as prescribed. There are many times that children will use medication refusal as a way to show others that they have the ultimate control over themselves and their bodies. It the job of the treatment team to help the child understand the need for their medication as well as to continually discuss their response to their medication with their doctor. Another part of the team’s duty is to help the child recognize the signs and symptoms of their disorder, in this case helping Nancy understand the signs of mania (decreased need for sleep, increased aggression, and increased energy) and the importance of taking her medication regularly. Helping Nancy understand the signs of her Bipolar Disorder, as well as helping Nancy discuss and process her past trauma was an ongoing effort throughout Nancy’s stay at the Bradley Center.
Nancy was successfully discharged from the Bradley Center and became a peer advocate with her home county for several years. Nancy has kept in touch with members of the treatment team that are still employed by the Bradley Center through phone calls and letters to the Bradley Center. Nancy has called in periodically over the past six years and has reported that she has moved out of state and has enrolled in college. Nancy most recently reported that she has married and is the proud mother of a healthy baby boy. She is still attending college part time and reports that she is “still taking her medications because they help.”