How Amy conquered her challenges through the DBT programme!

Amy*, a young woman in her 20’s, has a severe learning disability. When she needed to move on from her specialist residential school, commissioners found it difficult to find suitable placements to meet her needs, which were extremely complex.

Alongside her learning disability, Amy also has an autism spectrum condition and epilepsy and had never been in a hospital before. At first when she moved on, she was supported in the community in a specialist residential home with other people, but she began to experience a lot of challenges, becoming extremely agitated and angry.

Some of the behaviours she experienced were extremely anti-social including violence towards staff, spitting and kicking. After just a few months, a more robust setting where Amy could have her complex needs met was needed and she moved to Lakeside as an emergency admission as her service just could not cope.

Amy’s extreme behavioural challenges continued for the first three months of her time at Lakeside and there was a time when it was thought a secure setting may be more appropriate for her. However, with perseverance, relationship building and an increased understanding of Amy and her needs, Lakeside was able to put strategies into place to ensure Amy received the right support at the right time.

The team discovered Amy could be very easily overwhelmed, which led to agitation and excitement which she then, in turn, could not regulate appropriately, leading to behavioural episodes. Through careful care planning, Amy was supported in positive ways, such as only having one of her many toys at a time, to help her better manage her emotions.

Amy was also supported to communicate via sign language, as communication had been a challenge for her with a minimal vocabulary and conversation. Other triggers such as family visits, where again she became over-stimulated and excited, were also carefully care planned so they could be positive and enjoyable events for everyone.

From a physical perspective, hormonal changes during the menstrual cycle were also found to be a trigger for Amy’s difficulties and so appropriate medication was prescribed. This had a massively positive impact, and Amy was able to then engage with Lakeside’s dialectical behaviour therapy programme which has been modified for people with a learning disability. This DBT-informed programme was also very positive for Amy, helping her to learn how to regulate her emotions.

Two of her medications were able to be stopped entirely. Amy is now ready for a move to the community, she can manage her excitement and has had no incidents. The person who commissions her placement at Lakeside said:

“They have turned her life around. She is a different person, it’s so good to see.

“She has been supported so robustly, with really tailored care and support including a modified DBT plan and a clear clinical pathway, and she has made amazing progress.


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