Tuesday, November 25, 2008

Coping Skill: Dog Walks


It had been a rough couple of days on our highest acuity unit. Sometimes children with severe mental illness do not mesh well with other children with severe mental illness. It's difficult to take care of yourself when others are aggravating you and you lack skills to handle stress in a healthy manner. In the average world, when a child states, "I'm going to blow out if I can't get out of here," people worry about that child causing trouble. In my world, when I hear that, I'm impressed by the child's ability to verbalize his/her frustration, concerns about needing help, and desire to have control over oneself.

As staff and I worked to keep as many children calm and safe as possible, I watched as one child paced the unit, telling staff as calmly as she could that she wasn't feeling like she could stay calm much longer. I watched as staff urged her to continue to be patient until they could do something more for her. I watched as she desperately tried to verbalize her need for help to the next person, before it was too late.

I was surprised to see her sit down on a couch, frustrated and disappointed, but still trying desperately to keep her cool. I approached and commented to the child and staff member what an awesome job she had been doing for many days, remaining safe under great measures of distress. Staff commented that she was trying to find someone to take the child out to play basketball, one of her "coping skills" (a healthy distress management tool), but that no one was available at the time due to the other kids needing their help to stay safe.

Assessing that the unit was beginning to calm and staff were managing it appropriately, I asked the girl if she would like to go see Ross, who was soundly sleeping in my office. Her face lit up immediately, and she excitedly took me up on the offer. We walked over to my office, where Ross got up from his bed to greet her. We then went into a meeting room, where Ross cuddled in her lap and kissed her face. After a few minutes, she requested to take Ross for a walk. We spent the next hour walking the perimeter of the large campus, as she spewed about things that she was anxious, upset, and happy about.

After passing the outdoor basketball court for the third or fourth time, she requested to go shoot some hoops. Upon entering the fenced area, I latched the gate behind us, took Ross' Halti and puppy coat off, and released him to "be a dog." Puppy scooties ensued, with Ross nearly spinning in place as his legs moved faster than his compressed body could follow. The girl laughed as she watched Ross race around the court, so excited to be a free puppy in the crisp fall air. As she practiced shooting hoops, she called for Ross to move, as he dumbly stood under the hoop just watching the ball. For Ross, it was a training opportunity for possible ball distractions (he wasn't at all distracted, more dumb founded), for the child, it was an opportunity to be a normal kid, playing outside with a ball and a dog. 

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