Gaining Deborah’s trust

The verbs used to describe Deborah’s behaviour are intense: hitting, kicking, pinching, biting, threatening… She is a 22-year-old woman with a moderate intellectual disability. When things aren’t going well, she could be put in isolation and restraints as many as seven times in a single day. Her carers are afraid of her. As a result, she has been transferred to other institutions on thirteen separate occasions. Where she lives now, she is unable to break anything. At all. Even her cutlery is plastic.

How is she doing now?

Deborah says: “I’m doing very well! I’m even going on holiday now and I’ve never been on holiday before!” Her life has become more normal. Pictures now hang on the walls of her formerly bare apartment. She eats with normal cutlery. She enjoys running errands and she is visibly proud that she accompanies another client on walks. Deborah says she is less angry nowadays. If a situation becomes too stressful for her, she can tell her carers. They now have the skills to de-escalate the situation by talking to Deborah, or by tweaking her tasks. Weeks go by without carers resorting to isolation or restraints.

Kyra Althanning is Deborah’s behavioural specialist and she describes how they managed to change Deborah’s and her carers’ lives.