Quotes from my Main House discharge summary letter
"Jo was not forthcoming with her needs or expressing how she was feeling, often waiting to see if other community members recognised that she was struggling and being angry because she felt overlooked. Jo would often remain silent as if keeping a secret."
"at times was able to express her anger verbally instead of sitting in angry silence"
"Jo was encouraged to look at how she repeatedly put herself into vulnerable situations."
"Jo did at times manage to show her vulnerable side and cried for the first time in therapy. Jo often made images in Art Therapy but was unable to show or discuss her work believing her image was not good enough"
"this is how Jo communicates her needs in an unconnected way, leaving people wondering what she needs"
"Jo presented in what seemed a false self, in a passive aggressive way withholding information regarding her risks, risk management, including her needs"
"Jo was a popular member of the community"
"Jo has the kind of difficulties our unit works with"
"Risk assessment:
"Jo felt she had made progress but still found it difficult to talk in groups despite encouragement from fellow residents, often feeling presurised into speaking."
"Jo was often ambivalent regarding remaining at Main House."
"When given suggestions from the community she often felt accused or criticised and was unable to recognise the support from the community."
"Jo engaged with the Psychodrama group and volunteered for a role"
"she began taking tentative steps talking in Psychotherapy group"
"Jo had recently been thinking about her eating and self-image issues with the community"
"Jo put herself on Intensive Treatment to think about why she missed so many Therapeutic opportunities, by not attending groups and crisis meetings"
"Jo did manage to use the community support after a period of absense and inform them of her risks"
"at times was able to express her anger verbally instead of sitting in angry silence"
"Jo was encouraged to look at how she repeatedly put herself into vulnerable situations."
"Jo did at times manage to show her vulnerable side and cried for the first time in therapy. Jo often made images in Art Therapy but was unable to show or discuss her work believing her image was not good enough"
"this is how Jo communicates her needs in an unconnected way, leaving people wondering what she needs"
"Jo presented in what seemed a false self, in a passive aggressive way withholding information regarding her risks, risk management, including her needs"
"Jo was a popular member of the community"
"Jo has the kind of difficulties our unit works with"
"Risk assessment:
- Accidental death due to self-harming and para-suicidal behaviours
- Jo struggles with strong urges to self-harm and intrusive thoughts of suicide and often acts impulsively
- Self-harm by cutting, has swallowed part of a razor in the past
- Alcohol abuse
- Illegal drug use
- Overdosing with Lorazepam, Propranolol or Paracetamol, it is worth noting that prior to being admitted to Main House Jo hoarded a large amount of medication this was disposed of at Main House but is a significant risk in the future
- Putting herself in vulneravle situations e.g. getting into cars with strangers
- Acting out her anger in destructive ways, being physically aggressive to property
- Jo has been verbally abusive to people in the past
- In the past Jo has walked along a live railway track endangering herself and others. Jo also attempted to jump from a bridge
- Jo has a history of forming inappropriate intense attachments with people who may present to her as a parental figure
- Jo's risks are increased when there is a change to her care team, or change of location
- Triggers to Jo's self-harm are feeling anxious (which causes dissociation) , rejection, and fear of being overlooked
- Jo is uncommunicative and with-holds information, she finds it difficult to cope in social settings. Jo is unable to communicate her needs and gets angry when they are not recognised by others.
- Various forms of self-harm and suicide attempts
- Cutting, overdosing, restrictive eating, sitting on railway tracks
- endangering others due to risk behaviours
- aggressive withholding
- risk pairing and inappropriate attachment
- sexual exploitation
- abandoning therapy
- isolation and feelings of being neglected
- perception of other judgemental attitudes linked toown experience of others
- triggers leading to risks
"Jo felt she had made progress but still found it difficult to talk in groups despite encouragement from fellow residents, often feeling presurised into speaking."
"Jo was often ambivalent regarding remaining at Main House."
"When given suggestions from the community she often felt accused or criticised and was unable to recognise the support from the community."
"Jo engaged with the Psychodrama group and volunteered for a role"
"she began taking tentative steps talking in Psychotherapy group"
"Jo had recently been thinking about her eating and self-image issues with the community"
"Jo put herself on Intensive Treatment to think about why she missed so many Therapeutic opportunities, by not attending groups and crisis meetings"
"Jo did manage to use the community support after a period of absense and inform them of her risks"