JF&CS News Winter 2016

All children misbehave. They hit, scream, and shout, even if they don't have any diagnosable condition. But what happens when a child has also been identified as having autism spectrum disorder, behavioral diagnoses, substance use issues, depression, and/or other mood disorders? In these situations, where can families find the extra support they need?

JF&CS In-Home Services for Children & Adolescents addresses these issues by helping children and families learn new ways to communicate their needs, deescalate frustration or stress, and increase their knowledge of their child's symptoms and diagnoses to understand healthy, safe, and acceptable behavior. We offer three programs to assist youth (ages three to 20) and their families with their behavioral needs. Employing an individualized, strengths-based, and person-centered approach, these unique programs are offered in the home or wherever the child and family would feel most comfortable, such as in a school or community center.

Gerald: A Work in Progress

Gerald is a 17-year-old who has been diagnosed with autism spectrum disorder (ASD), body dysmorphic disorder (BDD), obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), and an unspecified depressive disorder.

Gerald obsesses about his nose – specifically that it will grow bigger as a result of certain actions, such as smiling, eating chewy foods, wearing his eyeglasses, exercising, and deep breathing. He frequently checks the mirror to reassure himself that his nose has not become enlarged.

Gerald missed close to 30 days of school last year. When stressed, he would frequently call or text his mother to see if she could pick him up early from school. When he grew particularly fearful, he would spend time with the school speech language pathologist. His anxiety prevented him from participating in sports and other activities during the school year.

A JF&CS In-Home Therapist worked with Gerald in an exposure therapy program. They created a hierarchy of symptoms, thoughts, and fears, which they frequently revised. The goal was not only to decrease his anxiety but also to educate his family regarding his obsessive compulsive behaviors and rituals and make them a part of his long-term treatment plan. They set boundaries so that Gerald would have to limit the number of times he would call or text his mother and his therapist when he felt stressed, anxious, or wanted reassurance that his nose had not grown.

Soon, Gerald worked with the In-Home Therapist to create an exercise program. He started slowly walking around the house and gradually increased the duration and speed of the walking. During one session, Gerald's 10-year-old sister watched from the family's front porch, cheering him on and giving him a medal when he was finished. With encouragement from the JF&CS In-Home Therapist and his family, Gerald recently was able to jog half a mile in his neighborhood. This was quite an accomplishment for someone who just months before would not exercise at all.

Recently, on his doctor's recommendation, Gerald was admitted to McLean Hospital's OCD Children & Adolescent program. The JF&CS In-Home Therapy team thought that Gerald would benefit from the intensive therapeutic services offered by the program. After three months, Gerald will return home and resume services with JF&CS. Gerald's family is grateful for the remarkable improvement they have witnessed in Gerald's behavior and for all the resources that were brought to their attention by JF&CS In-Home Services.