Composed by Shunda Wallace
Real Life Case Study
An elderly consumer with no teeth was put on a special puréed and mechanical soft diet by her dietician/physician. After numerous meetings over the course of a year where the group home director agreed to comply, she came clean and flat out stated that she would not comply with the physician’s order. Once escalated to key members of the Department of Behavioral Health Services who did not implore compliance, the resident was subsequently served non puréed peas, corn and spaghetti causing the residential consumer to choke. The resident was also given whole foods that she could not chew which eventually caused the consumer to lose over 50 Ibs from starvation (being served foods that she could not consume). The end result – through family advocacy, the consumer eventually ended up moving to another group home where hopefully they will comply with the dietary needs with slightly better residential counselors. The old group home director however did not experience any kind of disciplinary action by any particular regulatory governing body. It was actually unclear on who to report the community residential facility director to in the District of Columbia. Are they reported to the Department of Health Regulation and Licensing Administration or DC Healthcare Finance or The Department of Behavioral Health? The punitive process for residential counselors, community residential facility directors and community support workers in the District of Columbia is and always has been an enigma wrapped up in a riddle.
Why did the group home director exhibit such hubris with neglect, lacking fear that her license to operate a community residential facility would be revoked? An equally important question, are group home directors licensed counselors? The short answer is that most are not. If a group home director refuses to comply with a physicians orders, thus demonstrating a behavior that is negligent in practice, shouldn’t there be consequences?
Most community residential facility directors as well as residential counselors are not properly trained in treating patients/consumers diagnosed with psychotic disorders and their subtypes. The New York Times published an article in September 2020 titled “Nursing Homes Oust Unwanted Patients With Claims of Psychosis.” The article touches on the lack of training among nursing home staff in psychosis and psychotic disorders in Atlanta. When carefully examined under a microscope – what professions in the clinical world do actually specialize in psychosis and psychotic disorders? The four that come to mind are LCSW (Clinical Social Workers), Psychiatrists, Psychologists and Psychiatric Nurses. So what would training look like for group home directors and residential counselors? I have provided below a listing of what some relevant coursework should look like for licensed residential counselors trained in the areas of psychopathology and psychotherapy.
RELEVANT COURSEWORK IN PSYCHOPATHOLOGY
Anxiety and Anxiety Disorders, Post Traumatic Stress Disorder, Mood and Mood Disorders, Psychological Stress and Physical Disorders, Eating Weight and Eating Disorders, Dissociative Disorders, Drug and Substance Abuse, Sex, Gender and Sexual Disorders, Psychosis and Schizophrenia, Cognitive Disorders, Antisocial Personality Disorder
RELEVANT COURSEWORK IN PSYCHOTHERAPY
Psychodynamic, Cognitive-Behavioral, Humanistic-Existentialism, Exposure Therapy, Family Systems Therapy, Adlerian Therapy, Gestalt Therapy, Person Centered Therapy, Ethical Issues in Counseling, Culture Centered Therapy. Along with relevant coursework in research to stay up on the latest research in Mental Health.
In short, full understanding of the DSM V should be essential when working with consumers diagnosed with mental health disorders (more specifically psychotic disorders) in District of Columbia Group Homes. Many District of Columbia consumers staying in community residential facilities aka group homes have been diagnosed with one or more of the aforementioned in the area of psychopathology. If residential counselors were licensed – would they be required to have a state and national regulatory body to ensure that residential counselors are in compliance. The short answer is yes absolutely.
Ms. Wallace holds a Bachelors of Music in Music Management from William Paterson University, Masters Degree in Jazz Arranging and Orchestration from William Paterson University in addition to an Advanced Level Certification in Music Therapy from Montclair State University.
Ms. Wallace’s research on Schizophrenia and Depression was published in Montclair State Universities “Forward Thinking” newsletter and presented/nominated for an award at Montclair State’s Research Symposium.
Shunda Wallace is a musician, composer/orchestrator, filmmaker, music psychotherapist and author. Visit Shunda on shundawallace.com (on any device) or shundawallace.com (on computer or laptop).