Meredith Brauns

Reflection #1

Journal #1: What is the overarching goal at this facility? What are some of the cultural
challenges the clients here face? What has struck you the most about this setting that you did
not anticipate?

The overarching goal of this facility is to guide children and adolescents on their road to
recovery. Because this is not a long-term treatment facility, patients often move from here on
to a residential facility where they can receive further treatment. During their time on unit T5,
patients are actively taught coping and self-regulation skills that can be applied in their various
environments that they will encounter upon discharge. It seems like most of the patients here
are coming from unimaginably difficult backgrounds that include a lot of trauma and abuse.
Returning back to their home is not an option for many, either because they are not ready or
because their home is no longer safe. I did not expect so many of the patients to end up in
residential facilities or foster homes after discharge, but they often seem like the only safe
option left for them.

I was not really sure what sort of behaviors and presentations to expect from the
patients here, but I was surprised by the overall calm nature of most of them. Most of the
patients are admitted for suicide ideation and are battling intense depression and anxiety. On
most interactions, they present as very "normal", just extremely sad and unengaged with other
people. Some of them have intermittent outbursts, triggered often by seemingly nothing.
Witnessing the manual holds of these patients can be very difficult. You start to build
relationships with some of them, see small steps of progress, then watch it crumble down as
they scream, thrash, and are held down by staff for their violent outbursts.

Unlike other settings I have observed in, I have been very impressed with the clinicians'
and staffs' overall care for their patients. They have very difficult jobs - being cursed at daily,
surrounded by negativity and sadness, and talking about traumatic abuse every day. Yet, they
rarely seem to be burdened down by the hardships of the job. They balance their attitudes by
mourning for their patients' pasts and building up hope for their futures. I think this allows
them to not grow numb to their patients' experiences and to stay optimistic during those long,
hard days.