The Beginning
It is the beginning of my very first meeting with the Lowe family, and as we sit on their front porch during a hot summer day, Mr. Lowe plops 200 pages of copied material on my lap. Intrigued, I ask what it is. He lets out a sigh and tells me this is the paperwork from all the intensive behavioral treatments his grandson, Tim, has gone through the past 8 years since being in their care.
The list of unsuccessful interventions and treatments is exhaustive:
- 2 inpatient treatments in a psychiatric hospital
- 6-month residential program
- Section 28 in-home behavioral services
- HCT – section 65 advanced in-home behavioral services
- Virtual residential program – intensive in-home behavioral services
- Police response
- 2 crisis interventions at the hospital emergency room
- 3 neuropsychological evaluations
- Psychiatric counseling
- School IEP and special education program
Nothing has seemed to work. Mr. Lowe tells me that some programs even created more problems rather than solving existing ones. He mentions a dangerous incident with a former in-home service provider who attempted to teach the family how to restrain Tim—even though the Lowe’s stated that restraints caused him to respond aggressively. The incident triggered Tim, causing him to have a violent outburst that left the in-home worker with injuries.
As it turns out, Tim has been aggressive in all areas of his life—home, school and community. I’m informed that some of his frequent behaviors include fire setting, physical violence and anger—often requiring 2-3 school staff to manage—destruction of property, and common meltdowns. The meltdowns are characterized by screaming, swearing, hitting, kicking, biting, and spitting. Most recently, Tim punched his neighbor’s 3-year-old grandchild.
Mr. and Mrs. Lowe explain to me that they’ve been primary care providers for Tim since he was a toddler. Tim’s early childhood experience is marked by neglect due to his mother struggling with addiction, and his father not being present. Despite this hardship, the family has clear strengths: Tim is deeply connected to his grandparents, and they to him. The family has a strong spiritual community and connection. His grandmother is retired and able to be available to Tim whenever needed. The home is sober and free from all substances, and the family lives in a safe and sustainable home in a residential community. The family is even up front with their needs and weaknesses, and open to the treatments we would soon implement.
Treatment
In addition to a carefully-crafted treatment plan for Tim, Mr. and Mrs. Lowe were taught problem-solving skills of their own—which helped them prevent Tim’s access and availability to situations that triggered his outbursts. And for the times that they didn’t quite know what to do, the family had MST’s on-call service to assist them wherever and whenever needed—24 hours a day, 7 days a week. For example, even though the Lowes exhibited success early on, Tim had a situation where he was caught secretly lighting matches in the home and being dishonest about it. The Lowes addressed this behavior and received immediate support from the MST team. This support, along with the foundational skills that specifically addressed Tim’s needs, gave the Lowes hope and knowledge for the future.
Post-Treatment
Tim’s family reports that MST has been the only successful model of care that gave them the confidence and sustainable skills needed to treat Tim’s aggressive behaviors. In addition, MST worked closely with his school as well, giving the staff the tools and support needed to help Tim in the classroom setting. Mrs. Lowe emphasized that by rewarding Tim for positive behaviors and using consequences for undesirable behaviors, this ultimately caused Tim to decide to do the right thing.
Today, the Lowes are in their late seventies, but managing Tim’s behavior with great success. They are no longer worried about the potential for a physical assault by a quickly-growing Tim. The family expresses deep appreciation for increasing the peace in their household and shifting the focus of their responses to be proactive and planned, rather than reactive and escalated. The Lowe family graduated MST reporting elimination of physical aggression in the home, community and school, reduction of verbal aggression and elimination of fire-setting behaviors. Mr. and Mrs. Lowe now have confidence in handling the awaiting parenting challenges they may encounter as Tim grows and enters high school.
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