Nowhere to Go
On August 24, 2021, GK arrived at his new home. This is a special home, where he has intensive staff supervision and his day is very structured with activities of his choosing. Staff take him for walks in the neighborhood and nearby parks. They also schedule recreational activities at Woods campus, like swimming, animal therapy, and visits to the playgrounds where he plays basketball.
In the six weeks since his arrival, GK’s progress has been extraordinary. Once withdrawn, he used to isolate himself to his own room, but now wants to be outside. He also enjoys playing board games with staff and socializing with residents at Woods. He has even begun to learn how to play the guitar and loves to sing and listen to music – his form of music therapy – and is looking forward to showcasing his musical flair in an upcoming talent show. Most importantly, he is happy.
But, life wasn’t always like this for GK – he had found himself trapped in a dark, dead-end. In August 2020, for the second time since graduating from a successful residential program, followed by placement in an adult community-based group home, GK was in crisis and required inpatient hospitalization. Unfortunately, this was not a typical short-term admission – it dragged on for more than a year!
Why did GK experience this trauma? At age 21, while living in the group home, his mental condition began to deteriorate, resulting in extremely aggressive behaviors that led to property damage and multiple injuries to staff. Staff at the group home no longer felt they could safely manage GK, so they sent him to the hospital. A return to their care was not an option. Alternative providers did not feel they had the infrastructure and supports to meet his complex needs. Because no other provider was willing to accept him, GK remained in the hospital with no light at the end of the tunnel.
Stuck with nowhere else to go, GK stayed in his room – isolated – with little to no opportunity to socialize with anyone other than hospital staff. Because he was placed on a medical floor vs. a psychiatric floor, he had limited access to any activities or areas outside of his room. The staff did their best to engage GK and keep him occupied, but they struggled to provide the structure and routine he needed. This led to frustration and explosive behaviors that resulted in property destruction and aggression that required lengthy wrist and ankle restraints, medication, and a great deal of staffing resources.
GK’s predicament came to the attention of Woods’ Admissions team early into his hospitalization. However, due to funding restrictions, Woods residential campus was not a viable option for GK, and Woods was not developing community-based group homes at that time. Several months later, with GK still languishing in the hospital, Woods was again approached about the development of a community-based group home. This was a combined approach between the state, county, and managed behavioral health officials suggesting a coordinated, collaborative effort to design, implement and fund a group home with the specific, person-centered supports needed to serve GK’s needs.
Woods stepped up to the challenge by creating a unique provider for adults who require the highest level of care and staffing – Woods Community Services (WCS ). WCS provides specialized community group homes for adults with intellectual and developmental disabilities (I/DD) and significant behavioral and/or medical complexities who cannot safely receive services in traditional group homes. WCS is an extension of Woods’ continuum of care – a home in the community with access to outpatient mental health care, medical care, and recreational supports.
Woods set out to welcome GK as the very first resident of WCS. A home with an open floor plan was found for him, as his outbursts would usually happen in tight areas that put himself and staff at risk. Staff also took time to make it welcoming for GK by incorporating his favorite colors and Spiderman accessories in the decor. They also created a sensory room where GK can engage in calming activities when he is feeling overwhelmed. During the two months leading up to his transition from the hospital, WCS clinician Wadeeha Henderson visited GK frequently. Working closely with the hospital staff, she focused on identifying his emotional triggers and developed measures to prevent his behaviors.
So much progress in so little time! Instead of choosing isolation, he now seeks opportunities to engage in activities with other people. And, once prone to explosive behaviors that resulted in lengthy wrist and ankle restraints, he has had no behavioral incidents since his arrival at WCS. GK’s mother, who visits him frequently, has told staff, “I’m so grateful for all the work you’ve done!”
Wadeeha, or “Miss Dee” as GK likes to call her, conducts therapy sessions with him multiple times a week and has found that his aggressive behaviors come from feelings he doesn’t understand and can’t articulate. She takes walks with him and gives him positive reinforcement that these feelings are ok – that we all get happy, sad, or angry sometimes. This has been key to GK’s success. He can now identify what he is feeling and is beginning to understand more complex feelings like confusion and frustration. Being able to identify these feelings and acknowledging why he is feeling that way (“I’m sad because I miss my mother” or “I’m angry because I can’t go swimming today”) is helping him to engage in more positive behaviors and social interactions. She is also teaching him life skills and coping strategies that help him deal with his emotions. For example, GK is very competitive, and losing has been a big trigger for him. Wadeeha has taught him that sometimes we win and sometimes we lose, but the point is to have fun. He has put this into practice. When he is playing basketball with someone and loses, instead of having a behavior, he says, “Good game . . . I had fun!”
Always looking for creative solutions, Wadeeha has also incorporated one aspect of the Sanctuary Model in GK’s treatment. Sanctuary is a trauma-informed, evidence-supported model based on actively creating and maintaining a nonviolent, democratic, productive community to help people heal from trauma. She works with GK during every therapy session on identifying daily goals and current feelings, and offers supports to help him achieve behavioral success. The activity (answering the same three questions) is written on a whiteboard in his sensory room. Left there during the day, it serves as an encouragement to achieve the behavior goals that he has identified.
Wadeeha has also spent a great deal of time training the direct support professionals who work with GK, so they know his triggers and what preventative measures are needed to avoid negative behaviors. And, because of GK’s history of aggressive behaviors that resulted in restraints, Wadeeha plans to reinforce Ukeru training for staff who work with him. The Ukeru Method is a proactive, trauma-informed, restraint-free crisis management system that is nationally recognized as a best practice in restraint reduction. As a part of Woods’ efforts to create a culture of comfort, rather than one of control, for both the individuals it serves and its staff, Woods engaged Grafton Integrated Health Network. In 2017, the network began providing technical assistance and training in Ukeru and it is achieving remarkable results. Since its implementation, Woods has achieved a 53.5% reduction in the use of physical restraints. Using role-play, Wadeeha will give staff practical training on how to use Ukeru to de-escalate the situation if GK has a behavior in the future.
Less than one month after coming to WCS, GK has had no negative, aggressive behaviors. He has experienced increased community and social integration, and has learned how to express himself in a more socially acceptable way. His success demonstrates the need for a setting like WCS. Other programs have failed to help GK overcome his behavioral challenges. His six weeks at WCS have proven that this new model can give him the skills, emotional support, and security he needs to succeed in life.
Sadly, there are hundreds of adults in Pennsylvania who, like GK, can’t find an appropriate placement or be served in a traditional group home. They get stuck on waiting lists, and some languish in hospitals, psychiatric wards, or state facilities. Woods is now preparing to welcome them to WCS.
GK’s story shows that there is no one-size-fits-all solution to the challenges faced by people with severe behavioral challenges. The right living arrangement and clinical supports can make all the difference. WCS is an extension of Woods’ continuum of care – a home in the community, access to outpatient mental health care, medical care, and recreational supports. People with intellectual/developmental disabilities and complex behavioral and/or medical challenges have the right to receive the services they need in the most appropriate setting. WCS is an example of how Woods is always looking for ways to improve its services and create more choices for individuals that support their health, safety, and well-being.
GK is no longer trapped. He is now in a place full of light and life. In keeping with one of his favorite songs, Coldplay’s Viva La Vida, GK said, “I’m living the life today!”
Your unrestricted gift to “Woods’ Greatest Need” gives Woods the flexible resources to develop new nonprofits, like WCS, that are aligned with Woods’ mission to meet the unique needs of individuals like G.K. who have the right to receive the services they need, in the setting that is most appropriate for them. Your gift today will make that possible!
What Makes Woods Community Services Unique?
Woods Community Services (WCS) provides specialized community group homes and outpatient mental health services for adults with intellectual and developmental disabilities (I/DD) and significant behavioral and/or medical complexities who reside in Pennsylvania and cannot be safely served in traditional group homes.
The need stems from individuals with I/DD who “age out” of their educational program when they turn 21. Approximately 25% of these individuals cannot secure an appropriate placement due to the intensity of their behavioral issues and/or medical complexities. The lack of community-based settings that can manage such challenges denies many individuals the opportunity to step down to a less restrictive setting and gain other independent living skills.
Woods and its affiliate, Legacy Treatment Services, have partnered to develop WCS as a provider of multiple group home settings in the surrounding Bucks County and Philadelphia areas with intensive programming and supports to serve the complex needs of these individuals. The homes will be near Woods campus, so that services and supports offered can be easily accessed, including comprehensive medical care, psychiatric services, vocational opportunities, and recreational activities. Additional services may also include mobile Behavioral Supports (BCBA), Family Therapy, or Allied Therapies.
Staff are Bachelor’s level and must have at least one-year of experience in residential and/or behavioral health care with experience working with behaviorally challenged individuals, including implementation of behavioral and therapeutic interventions and de-escalation.
Clinical staff must be licensed and direct support professionals (DSPs) receive more training than a typical DSP.
The WCS model implements trauma-informed care for individuals with the most challenging behaviors. WCS is also an extension of Woods’ continuum of care – a home in the community, access to outpatient mental health care, medical care, and recreational supports for individuals as they work toward achieving their goals and happiness.
