We still don't know if Kitty is coming home on Saturday. We're waiting for our funding source to get an extension approved. They'd asked for a summary letter with recommendations, this is what they received:
To Whom It May Concern:
This letter is review the progress of Kitty since entering The Center on 12/21/2011. The Center is a residential treatment center located in _______________. Kitty entered treatment in order to stabilize dangerous behaviors to self (suicidal statements, incidents of self harm) as well as dangerous behaviors to other (aggressive threats, physical aggression, property destruction). She entered our program in order to receive evidenced based treatments of Dialectical Behavior Therapy as well as Trauma Focused Cognitive Behavior Therapy as appropriate.
Kitty's engagement in treatment has fluctuated between initial readiness as evident by her willingness to comply and participate in treatment opportunities. She mentioned her preference for residential or inpatient treatments related to her comfort with less attachment expectations and avoidance of emotional cues (relationship attachments). After a time, she struggled with engagement related to group and community activities as her patterns of social struggles and emotional reactivity in response to interpersonal conflict increased. She has demonstrated increased stability in her behavior, willingness to engage in therapeutic activities, and ability to participate fully in individual and family therapy.
Kitty had positive responses to the skill set of Dialectical Behavior Therapy as well as the psyhoeducation and affect modulation focus on Trauma Focused Cognitive Behavior Therapy. Her developmental struggles and cognitive delays have interfered with her ability to fully apply skills at the pace of intensive residential. She has demonstrated awareness and understanding through individual focus and repetition.
Kitty has demonstrated positive responses to medication changes. She is currently being titrated on increasing doses of Lamict*l. She began 25 mg on 02/21/2012 and will increase after 7 days to 50 mg, 75 mg, and being at a full dose of 100 mg in the third week in April. She would benefit from maintaining consistent and stable environment during this time in order to note the effectiveness of Lamict*l. As related to past history of destabilization with change, we are recommending that Kitty remain in residential treatment until the third week in April. She has expressed anxiety and concern related to returning home due to changes in family structure (brother moved out) as well as changes in school and routine. Moving her from residential at this time would increase her environmental stress while she is adjusting to new medication.
Upon discharge from TC, the treatment team is recommending an intensive outpatient program to continue Kitty’s progress in the areas of skill acquisition and generalization as well as overall affect modulation. We are also recommending IOP due to Kitty’s vulnerabilities related to change and environmental stress and cues.
Kitty and her family have consistently participated in treatment and shown phenomenal commitment to overall wellness, recovery from Kitty’s abusive history, and attempts to focus on attachment and future aims. The treatment team recommends ongoing transitional support in order to maintain and translate her progress to her outpatient setting. We are recommending ongoing behavioral therapy related to Dialectical Behavior Therapy as well as continued work on social skills, transitional living skills, and Trauma Focused Cognitive Behavior Therapy.
For any further information or questions, please feel free to contact us.