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Clinical Services Clients – Our Values in Practice

Here is a selection of case studies illustrating our values in practice – for more comprehensive see clinical support

Emma – 48 yrs – regular visits to emergency as ‘ill’ now just visits hospital as part of Studio 3 plan

Emma is a 48 year old woman who when stressed often presentation emergency medicine departments complaining that she is ill.  This had led to numerous admissions and expensive medical investigations. It is our view that she truly believes that she is unwell in these circumstances and regardless of her treatment by staff (which is variable) she appears to feel safe in hospitals. We introduced a goal of her avoiding overnight stays and set up a regular visit routine to hospitals, without her need to be ill. She is doing really well at present.

Paul – 42 yrs – moved from regular self injury to become much more settled with Studio 3 input

Paul is 42 years old and lives on his own supervised by support staff. He has had episodes of of SIB, property destruction and overdosing on paracetamol. He is much more settled and these incidents are now rare. A recent review of his service revealed that in 9 years he has been aggressive directly with a member of staff once in all this time. He was asked why this was the case and he replied ‘ why would I hit someone I liked?’

Joanna – 14 yrs – refuses to go to school – now going to school on a sessional basis.

Joanna is 14 years old and refuses to go to school. This refusal process occurred gradually, but, became worse after the sudden death of her younger brother. She sleeps mostly in the day and is often awake at night playing computer games. Her parents sought help. We explained to them that she was highly stressed and her cortisol levels (the stress hormone) were very high at night and too low in the day.  This meant that biologically she struggled to sleep.  Our intervention focussed on stabilising her cortisol levels by increasing cardiac exercise and attempting a trial of melatonin. She is now less stressed and going to school on a sessional basis.

James – 15 yrs – anger management – Studio 3 support him to understand and help him develop friendships

James is 15 and has lived in several care homes. He has major issues with anger and has been described as ‘difficult to like’.  James has a very. Difficult relationship with some of his brothers and sisters. Our staff have supported him to understand why he gets angry and to help him develop friendships. In our view James is a lonely and frightened young man. He is making slow but, significant progress.

Lisa – 38 yrs – has severe intellectual disabilities and autism – Studio 3 developed stress relieving techniques

Lisa is a 38 year old woman with severe intellectual disabilities and autism. She will sometimes strip of her clothes in public areas for ‘no apparent reason’ . We established that this behaviour although distressing was quite rare and tended to occur when her senses ‘modulated’, usually when she was highly stressed. This behaviour was clearly escape related as staff sometimes inadvertently placed too much pressure on her by staying out in social settings for overlong periods of time this led to her becoming ‘panicky’. It is not surprising that she needed to get out of these situation. We taught her a symbol for ‘stop, I want to leave’. The behaviour became not necessary for her as she had a new way to communicate to her support staff.

Martin has a history of mental health issues – ongoing support from Studio has developed a positive approach

Martin has a history of mental  health issues. He lives on his own in a small town. He has limited supports from a small team of staff. In the past Martin has been in trouble with police, these involve violent acts usually after he consumes  large amounts of alcohol. Our staff have supported him to develop a positive approach to his wellbeing, this includes a physical health plan and a strategy for avoiding drinking excessively. His support is ongoing.

Hans – 17 yrs – presented some risks to childern – Studio 3 support plan developed for family

Hans is 17 years old and lives with his mother in a small town. Hans has been ‘noticed’ to be spending a great deal of his time watching children at the local school. Our team spent time with Hans to establish his ‘interests’. It was clear that he did present some risks to children. Our team established a support plan for his family to follow.

Joe has Asperger Syndrome – Supported by Studio 3 to live in community

Joe has a diagnosis of Asperger Syndrome. He has spent over 20 years in the mental health system. Joe struggles with understanding the mindset of staff.  He views the world from a concrete ‘black and white’ perspective. He has sensory processing issues and s in a state of hyperarousal. Our work has focussed on his stress management. We have supported him to live on his own in the community. The story continues.

Campbell – 37 yrs – extremely stressed and aggressive now understands how to manage based on Studio 3 support

Campbell is 37 and can become extremely stressed which leads to aggressive behaviours. We have established that 2 hours every day of cardiac exercise has a positive effect on his level of physiological arousal. We are encouraging him to monitor his stress by checking his heart rate. He now realises that exercise for him is more powerful than medication.

Sally – 31 yrs – moved to a community service from a secure hospital setting with Studio 3 support

Sally is 31 years old and with some specialist training inputs she was moved to a community service from a secure hospital setting. Studio 3 staff trained and supported her team of supporters. In the first six months they adopted a non restraint policy. This meant that Sally would often ‘run off’. It was clear that she was not unsafe in these situations and would communicate with staff using a mobile phone. She was encouraged to learn to safely self regulate. Over 6 months this behaviour became less and less common. She now has greater control over her life and relatively few behaviours of concern. Now when she becomes upset she will often request her support  staff  to leave her house. She is beginning the process of learning to self regulate.

Sarah has an intellectual disability and self harms

Sarah has an intellectual disability. She regularly bangs her head and has needed to receive medical treatment.  Her behaviour support team gets specialist advice from Studio 3.  It has been established that her intense episodes of SIB are related to pain. In particular due to chronic stress she has bowel  and gastric issues?  There is less focus on her behaviour and more of an emphasis on her physical health?  She now has a health plan which is addressing these issues.

Liam – 11 yrs – Autism and ADHA – Support for school staff and family from Studio 3

Liam is 11 years old with a diagnosis of autism and ADHD. He has recently been excluded from his school because of behavioural issues. The school are being trained in low arusual approaches and a specialist member of the Studio 3 Team is working with his family and teaching staff to develop effective non aversive behaviour management strategies.

Michael – 32 yrs – Stress management programme developed by Studio 3

Michael is a 32 year old adult with Aspergers Syndrome. He lives on his own and is struggling to understand what his diagnosis means to him. He is supported by people who are trying to get him to understand that he is ‘hard wired’ to be stressed. He is be supported to develop stress management techniques (in particular cardiac exercise) to help him lead a fulfilled life.

Jane – 13 yrs – Abused and now Self Harming – support staff trained in Low Arousal

Jane is 13 and currently lives in a care home for children. She has had an abusive past and finds it difficult to cope with school work. She finds it difficult to trust people. At the moment her biggest issue is that she self harms. Her Studio 3 therapist has hoped her to understand that she engages in these behaviours to avoid thinking about the abuse she experienced in the past.

John – 22 yrs – behaviours of concern and Intellectual disabilities

John was a 22 year old man with many behaviours of concern and Intellectual disabilities. He had difficulties sleeping and is described as irritable. Many if his support staff are wary of him. We supported him by training the staff in low arousal approaches and helped them to understand that sometimes stress overwhelmed him. We also found that his daily activity schedule was too rigid. In the space of a year both the. Intensity and frequency of his behaviours of concern reduced , one of his supporters stated that ‘ when he begins together stressed, he needs space and time and it is really important that we appear calm as our behaviours impacts on him.

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