March 1, 2019
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National Leaders in the Mental Health Aspects
of Intellectual and Developmental Disabilities

The Hard Road to PERMA

by Sara Stanton, MA, NCC – NC START East Clinical Team Lead

The job of a START team member isn’t always an easy one. There are never enough hours in the day and the small successes often come after hours of hard work. This is one reason a team’s cohesiveness is important. We seek opportunities to learn from the hard work of our team members and celebrate victories as they come. When we’re lucky, we have the honor of learning from the individuals we work with every day and this article is to celebrate one of those stories.
Ratravis has really been a joy for our team to work with. He has been an active START client since 2014. Even when his system has been in crisis, he has approached his team meetings and the world around him with a positivity that is inspirational. He is an amazing advocate for himself and works very hard towards any goals that are in place for him. In early 2018, Ratravis had many changes in staff and began having an increase in challenging behaviors. He was experiencing a lot of anxiety and was especially struggling in his home environment. Our team made a referral for Ratravis to begin receiving START Therapeutic Coaching (STC) services to assist with the intensity of challenges in the home.

Some of the additional reasons that Ratravis was initially referred for our STC program was to work with him and his provider on increasing his safety awareness with social relationships at home and in the community and to identify some positive coping skills to deal with his anxiety and anger. Ratravis and his system were active participants in identifying his goals and they all became immediately invested in the coaching process.
The coach working with Ratravis wanted to help him and his system in identifying his current relationships. They wanted to have an understanding of Ratravis’ perspective of his interpersonal relationships. Creatively, the coach proposed that he create his own eco map as a means of identifying relationship goals.
The START team, his system, and his guardian were surprised to learn about the positive relationships that Ratravis had. In fact, until this point, his team had not realized he had any contact with his biological family. “It was enlightening to acquire this information and get Ratravis’ input on the support and strength he feels he receives from these individuals” (Karen Dew, BSW, NC START East Therapeutic Coach). This eco map assisted his team in identifying untapped resources and gave his coach a way to begin the discussion around safe relationships.
Ratravis successfully completed coaching and surpassed all of the goals that were outlined during coaching. At the end of coaching, Ratravis’ support system knew a lot more about his abilities and how to support him to continue to learn about new skills and interests. One example is that Ratravis is great in the kitchen and cooking is something that he really enjoys. During this time, the system was also challenged to think about Ratravis’ medical needs with his diagnosis of Huntington’s and how this may affect the challenges he experiences. Through advocacy, his team learned more about his diagnosis and on-going needs as this disease progresses. Overall, the system increased communication and collaboration regarding supporting Ratravis through this time. He also learned how to continue to advocate for himself by preparing for team meetings and even led a few of these systems meetings. Our team received the following e-mail after his discharge planning meeting from his START coordinator:

We don't get the easy cases, but that makes the victories so much more meaningful. So I thought I would take a moment, and share a tremendous victory for our team.  

This afternoon I attended an STC discharge meeting for a client who has met tremendous adversity in his life.  Through losses of services and lack of staff, to medical problems and a void of natural supports this gentleman has every right to be exhausted.  But the man I saw today was full of hope and laughter, happiness and joy.  He spoke a great deal about how his coordinators always have his back, the resource center is a place of refuge, and how STC has given him the tools to be a better person.  It seemed the perfect example of how we as a team, working in solidarity with one another, can bring about great change.  

We all work so hard, we get frustrated, and it becomes easy to convince yourself that we aren't making progress.  But please believe me when I say that what we do matters.  What each of you do, matters.

I want to leave you with a quote from this gentleman from the end of the meeting.  At the time he was speaking to Karen and Kerri, but in truth I believe he was speaking to all of us: 

"Miss Karen (STC Coach) has made me a better person, I learn so much from her. I was at the resource center and a guy there that never played any games wanted to play a game with me. It taught me that I had a positive effect on the people around me. When I have bad days, my coordinators always have my back and they support me. I like to learn and believe that if you don’t learn nothing, you won’t be nothing. I’m going to continue to use these tools. Thank you so much for having this good person be part of my life. I will use this for the rest of my life."

Ratravis, NC START East Member

I don't think I could have more completely captured the holistic goal of coordination, STC and the resource center if you gave me a thousand years to think about it.

Thank you everyone, for all the things you do.
C. Shane Miller, NC START East Coordinator

Our team has learned a lot from Ratravis. Our hope is that this small piece of his story can serve as an inspiration and breathe of fresh air for the rest of our team nationally. The challenging road to PERMA is worth the fight. The hard work and countless hours make a difference. Our services make a difference. You make a difference.

Happy Friday,
Special note: NC START East refers to START In-Home Therapeutic Coaching as START Therapeutic Coaching or “STC”. Our crisis house is called the “resource center.”

Permission to share this story and accompanying photographs was granted by Ratravis and his legal guardian.
Thanks for reading and happy Friday,

The Center for START Services

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Institute on Disability at the University of New Hampshire