Ep. 16: Mental Heath Treatment for Clients with Developmental Differences

04/05/22 • 37 min

Mental health clinicians are often reluctant to treat people who have intellectual and developmental differences (IDDs) for fear of doing something that could worsen rather than improve the client’s condition.

In this episode of Justice in Action, two JRI clinicians, Dr. Jacquelyn Kraps, Metrowest Area Director and Clinical Director of Outpatient Services, and Bailey McCombs, Licensed Metal Health Counselor and Expressive Arts Therapist, talk about the rewards and challenges of working with children with a range of differences, from autism spectrum disorder to chromosomal differences, cognitive challenges, and traumatic brain injury.

Dr. Kraps and McCombs have helped establish the Developmental Differences Specialty Team to assist other JRI therapists to work effectively with clients with both IDDs and mental health needs, including complex trauma.

Services for those individuals have long been siloed because they have been seen as separate and distinct. JRI is breaking new ground by having a single provider address the entirety of the client’s service needs.

Treating clients with both complex trauma and IDDs draw heavily on a therapist’s creativity, flexibility, and powers of observation, Dr. Kraps and McComb say. Sometimes it requires teasing out which problems are caused by trauma and which are part of the individual’s developmental difference.

They advise other clinicians to be curious, open, and willing to say the wrong thing. If an approach doesn’t work, they can always shift course. Sometimes a client — especially a non-verbal client — can communicate most successfully by writing, drawing, or moving their body.

Individuals with IDDs deserve effective treatment for mental health needs, which they are at least as likely to experience as the rest of the community, and they can enjoy positive, healthier outcomes with the right therapeutic approach. For more information, visit jri.org.

A note about language: IDD often stands for intellectual and development disabilities. JRI choses to use the word differences instead of disabilities to be as inclusive as possible, and honors that each individual and family get to decide how they identify.

Previous Episode

Ep. 15: Data and research improve treatment of complex trauma

Few social service agencies are as committed as JRI to improving treatment through research and data.

In today’s episode of Justice in Action, we talk to Hilary Hodgdon, Research Director at Justice Resource Institute, and Lia Martin, Senior Associate Director of Quality Management. Together, they are part of a data and research division that is unusual among social service agencies for its size and scope.

JRI clients suffer from complex trauma. On average, a child or adolescent seeing a JRI therapist has experienced three different types of trauma, such as neglect, physical abuse or psychological abuse. That number rises to five or six for clients in residential programs. In addition, these young people may face racism or other types of bias These traumas can affect children’s attachment to their parents or other caregiver, as well as how they think of themselves in the world and whether they see the world as a safe or dangerous place.

The data that Hilary and Lia gather and analyze help guide, assess and improve treatments for these young victims of complex trauma. JRI also uses the data to evaluate the effectiveness of its programs.

The heart of the data and research work is the Client Assessment Tracking System, or CATS, a tool developed by JRI to gather and analyze information about clients and families. Hilary and Lia use the data not only to support the work of JRI clinicians and programs, but also to examine specific research questions, such as how gender, race and an individual’s personal history with trauma affect treatment outcomes. They learned, for instance, that while females tend to present with more and stronger symptoms than males, both genders benefit equally from trauma-informed care.

Smaller agencies that lack a complete research department of their own also benefit from JRI’s research program. Clinicians from those agencies can feed their clients’ data into CATS and benefit from the analysis in the treatment of their clients. In addition, Hilary and Lia are having a nationwide impact on trauma-informed care through training, presentations and the peer-reviewed articles they write and publish.

For more information on JRI’s data and research work, visit jri.org

Next Episode

Ep. 17: Substance Use Recovery

Guiding our clients toward recovery

from substance use disorder

The opioid epidemic has increased the demand for effective recovery services, and Justice Resource Institute’s Mary Chao is leading the organization’s training program for clinicians and other staff members to aid them in helping clients recover.

Chao has been with JRI for nine years and works with the agency’s health, training and community-based services divisions, developing and coordinating substance use programming throughout the agency. She works closely with clients ages 12 to 24 and the JRI clinicians who help them to address problematic substance use.

Problematic use of substances, including opioids, cannabis and alcohol, often accompanies other problems, including homelessness, sexual abuse and violence that JRI programs also address.

Chao and JRI use ACRA (Adolescent Community Reinforcement Approach), an evidence-based treatment model that focuses on developing relationships with clients to help them understand what motivates them to use drugs or alcohol and looks to increase opportunities for clients to do “social, fun things” with the goal of helping them reduce or eliminate substance use.

But recovery doesn’t necessarily mean lifelong abstinence from drugs or alcohol.

“Abstinence is definitely not the only way to be in recovery,” she said. “Someone with substance use disorder can struggle for years, even decades....It’s important to recognize that relapse doesn’t mean failure.”

In addition, while substance use by youth and young adults can be frightening for friends and family, “Not every person who uses a substance needs treatment.” The need for treatment becomes clearer when substance use has a serious effect on their life or the lives of others. And it is important that treatment for substance use disorder be integrated into a client’s overall care plan.

“Recovery is possible for everyone, and every family, and every community,” Chao said.

Listen here to our conversation with Mary Chao about substance use disorder, treatment and recovery.