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Jennifer L. Beaver
5/31/17
In deciding what to do for my Capstone Project, I met with my project supervisor, Andrew
Henderson, to discuss possible ideas. The final decision to create a new History of Challenging Behaviors
document came about due to need. I have been a residential manager for ten years. When I first
started, we were sent three different residential applications for review and discussion. We were able
to discuss with staff and determine the participant who we felt would be the best fit for the house, due
to the current resident dynamic. Approximately five years ago, that ended. Due to budget cuts and the
closing of the State Hospitals, we were given one application and told to, Make it work. If we dont
feel that we can support them, it is very challenging to refuse placement, as there is nowhere else for
them to go. The History of Challenging Behaviors form was created to help us better prepare for new
participants, see what supports were necessary and if we could support them. Unfortunately, the form
was poorly designed, and difficult to use. I found that the scale we were to use for each category was
obscure and never really fit with the presenting issues. Sometimes it was split between three areas! It
was discontinued two years ago, with the idea of revising the form. It was never revived.
When I was a child, I had a grandfather that repeatedly molested me. I HATED going over to his
house. I also was unfortunate enough to have another member of my family molesting me at home.
My parents were divorced, so when I went to my Dads, we always went to my grandparents house.
This was in the 70s, and I never told anyone, fearing I would get into trouble. It took me years to realize
that all the idiosyncrasies that I had were because of never feeling safe. I would double and triple check
the locks, walk by locked exterior doors and touch the door. Strange things to others, but normal
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Integrative Processing Model
behavior to me. I bought my house because it had a sunroom, and I love to watch it rain or snow,
knowing I am safe, warm, and dry inside. Therapy is a great tool. I am now much more self-aware, but
cant seem to break the habits. This spills over into my workplace. As the site manager, safety of my
staff as well as the participants is paramount to me. Having a document, a way to accurately assess risky
behavior, would help me keep everyone safe. I think that is what ultimately made me choose to create
In doing some research, as well as personal account from the field, violence against staff in the
Mental Health field is rising. House Bill 2899, passed in 2000, addresses violence in health care. This bill
requires mental health hospitals to provide violence prevention training to all staff annually. The
hospitals must have procedures in place to report acts of violence and to respond to physical and verbal
assaults. In July, 2014, a psychiatric patient of Dr. Lee Silverman, Mercy Fitzgerald Hospital, was shot by
a patient during an office visit. The patient came with his case manager, who worked for Horizon House,
Inc., part time. He shot and killed her, while Dr. Silverman shot back with his own gun. This was a true
wakeup call for the agency, as well as the community. Safety needs to be a priority. Federal and State
budget cuts make it harder and harder to properly serve our participants and keep the staff safe. I am
I struggle at times not to inject my personal feelings and fears in regards to safety onto my staff.
I am not overly afraid of something happening; this is a deep-rooted need to feel safe. I dont always
agree with some of the agencys decisions in regards to the new safety measures implemented. For
instance, we take a Crisis Prevention Intervention training each year, that teaches us basic avoidance
techniques, but not any true strategies to defend ourselves. It is still meant to protect the participant,
but what about the staff? I was moved into my own office last year, to allow for more space in the staff
office so they could have clear escape routes. I dont. I have one exit, that will probably be blocked by
the participant. They promised me a panic button last year. Im still waiting. I will have a lot of input
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from Directors, Managers, and Clinical Specialists about my form. I am sure there will be much
I am still in the early stages of the creation of my form, but so far I feel that I have learned much
more than I thought I would. I have learned how to research other agencies, who have similar
documents, and get ideas for mine. I have learned that wording counts when setting up a scale. Some
categories, such as Communication, were more challenging than others to elaborate on each number on
the scale. Suicidality and Homicidality were easier for me to fill out. Communication gave me pause, as
that was not a previously incorporated category. I learned more about nuances and subtle distinctions
between numbers. This will help me later on when the final review takes place. My personal
communication skills are expanding, as taking the input from others in regards to my project is frankly
hard sometimes. When someone tells me that a category that I felt really worked was inaccurate or just
bad, it hurt. Learning to take the constructive criticism well will help me in the future. I have never
created a document before, so its kind of my baby. I have to be objective and strive for the greater
good, not just my ego. Upon reflection of my growth since I began my Masters program, I have seen
myself grow more thoughtful and willing to discuss alternative viewpoints. I noticed that I took a hard
stance on an issue, and was resistant to other views. Now, I want to look at a problem from all sides and
make a well thought out decision. I find that I am liking the leader than I am becoming.
Collaboration is the right path for my project. I have created a framework, scoring scale, and
detailed categories, but I alone am not going to use this form. Many others throughout the agency will
be using it, so I need everyone to review it in terms of how it will work with their own programs. If I
created this form in a vacuum, I would be setting it and myself up to fail. It is a group effort to finalize
and implement this document. It will represent not just my Capstone Project, but Horizon House, Inc. as
an agency.