Sarah was 17-years-old when she came to KVC Prairie Ridge Hospital in February 2017. She had experienced physical abuse from her mother who would lock her in her room for long periods of time. Sarah also lived in an unsafe neighborhood and regularly witnessed gun violence. She was facing several medical, behavioral and ecological barriers to treatment due to the developmental trauma and medical neglect she had experienced and had run out of options for treatment in her home community of St. Louis, Missouri.
Sarah was born with Erb’s Palsy, a paralysis which caused a lack of feeling in her right arm. Due to the trauma and neglect, she had experienced, this arm became Sarah’s choice arm for self-injurious behaviors. She would pick at the skin until it bled, and since she couldn’t feel any pain, her self-injury reached a critical level where intervention was needed in order to maintain her safety and the safety of others. Not only was Sarah hurting herself during these heightened emotional experiences, she was aggressive towards others who tried to help her. A judge had to intervene and ordered that Sarah to be evaluated by a hospital. Due to the safety risk she posed to herself and others, many locations refused to take her into care.
When Sarah arrived at KVC Prairie Ridge children’s psychiatric hospital, our staff uncovered a host of medical conditions which had previously gone undiagnosed. Sarah was plagued by headaches, fatigue, vomiting, and constipation. She would use maladaptive coping skills such as picking at her arm and screaming in order to alleviate what she was experiencing. During Sarah’s treatment, she had several acute episodes of self-injurious behavior where she would scratch and bite her arm with Erb’s Palsy causing it to bleed.
As we explored Sarah’s symptom profile further, we discovered that a local children’s hospital had diagnosed that she had water on her brain, a rumination syndrome which was causing the majority of her vomiting and impacting her ability to properly consume food or medication.
Psychiatric Team Collaborates to Provide Excellent Care
Throughout Sarah’s treatment, direct care, clinical and medical staff team members joined together to provide Sarah with excellent care to address her medical and behavioral issues. Sarah soon developed a trusting relationship with the KVC team. Her therapist and staff members created innovative support plans and engagement tools to help Sarah, which she was very responsive to.
While at the hospital, Sarah learned a feeding protocol that allowed her to get the nutrition she needed to be healthy and take her prescribed medications. She learned how to cope with the anger and anxiety she had been feeling and express those feelings in a positive way rather than self-injuring. Sarah learned that she loved walking and listening to music, so she used these activities to help her cope with her emotions and pain. She also discovered that she enjoyed group and individual music therapy sessions. Sarah increased her emotional regulation skills and improved her interpersonal skills. She even made a friend during her stay at the hospital.
Sarah Finds Her Voice
As Sarah started feeling safer in her environment, she began to voice her wishes and desires, not only for treatment but for her life in general. Sarah had a strong desire to be able to advocate for herself and have a choice in where she would live once she discharged from treatment. She hoped to live more independently and live a life as close to a neurotypical teenager as possible. Previously, she had had very little choice in her life circumstances as well as in her treatment options. Due to this desire, Sarah’s therapist began to coordinate placement interviews so that she had a say in her next living situation and her potential new home could see how much more there was to this young lady.
Sarah’s team was determined to support her during this process and she began practicing how to advocate for herself in a style very similar to preparing for a job interview. This was a new process for her and required a lot of patience in order to learn how to engage others in a way that would accurately express her concerns. In addition to sharing her concerns and wishes, Sarah wanted to share the things she had learned while in treatment. The team worked with her daily and right before every interview to help Sarah gain the confidence she needed to be able to give voice to her wishes.
Achieving Independence and Thriving In A New Environment
Sarah did an AMAZING job in each interview and we were so proud to see her growth! After several interviews, she was finally connected with a supported living program close to her home community in Missouri where she would be living in her own house with 24/7 staff support. We were all ELATED!!
Sarah’s therapist and another hospital staff member accompanied her on the six-hour trip. Sarah’s anxiety mounted along the way, and she was grateful for the support she had with her.
The transition was successful and Sarah absolutely LOVED her new home. Our staff was able to provide her new caregivers with information and demonstrations that would help Sarah continue to succeed. As the KVC team was leaving, Sarah expressed her sincere gratitude. Everyone was excited to see this journey through to its completion. Sarah asked that we tell everyone at KVC Prairie Ridge Hospital the following message:
“Thank you for not giving up on me; even my own mom gave up on me but you guys never gave up on me, even when I gave you guys hell.” – Sarah
The positive change in Sarah was remarkable. She came to KVC Prairie Ridge Hospital with feelings of hopelessness, despair, and an overall lack of trust of those around her. Over time, she revealed herself to be a young woman who was spunky, creative, funny, and full of life with an AMAZING personality.
Sarah’s story is not one that I will soon forget. The lessons I learned from her case, both professionally and personally, have broadened my view as to what it means to never give up on a child. It takes a village and that’s exactly what we became – Sarah’s village.
*Name has been changed and a stock photo has been used to protect Sarah’s identity.
Each year, KVC Hospitals serves thousands of children and teens who struggle with depression, anxiety, trauma, substance abuse, suicidal ideation and other behavioral health issues. Learn more about how our treatment engages and teaches new skills to youth for processing trauma, managing difficult emotions and moving beyond traumatic experiences.