Sunday, October 25, 2009

Violence in the lives of people with disabilities

Gosh, I hardly finish publishing a blog about music therapists getting hurt on the job and I hear this on the news. It's truly a horrible, often hidden epidemic, and it must be stopped.

FLATBUSH (WABC) -- There are allegations of abuse Sunday against a state-certified care facility in Brooklyn.

The family of a 43-year-old mentally and physically challenged man claim he was brutally assaulted at the Institute of Community Living in Flatbush, and no one is saying how it happened.
Kimberly Creary is determined to get to the bottom of things, how and why her mentally challenged brother, Colbert, ended up hurt.
"His eye was closed, purple and burgundy, it was horrible," she said.
Colbert, who has limited speech, has lived at the Institute of Community Living for 15 years. The small, state-run facility houses those with mental and physical disabilities.

Kimberly got a call from staff on September 23, saying Colbert had been rushed to Kingsbrook Jewish Medical Center, suffering from an eye abrasion. But when she saw him, she was stunned.
"They don't know what happened," she said. "They told me he got up in the morning, took a shower and was fine and came to downstairs with eye like that."
Darrel Creary remembers his uncle being very agitated.
"He was very angry, pushing everyone away," he said. "I tried to feed him, and he wasn't trying to have that."
Frustrated, Kimberly called police. Officers from the 67th Precinct went to the facility, but Kimberly says staff told them that Colbert was not able to talk and was sleeping. So the officers left.
Then, a preliminary investigation by the state indicated that a worker had been placed on administrative leave, although it's not clear why.
The facility says that because of confidentiality laws, it could not discuss the matter. But Kimberly believes there is more to this story, possible criminal negligence and assault. She is meeting with the district attorney Monday.

No matter how many people in staff and support positions get hurt doing this work, folks with disabilities are way more vulnerable to abuse. I'm not saying it's okay that anyone gets hurt, but this is a difficult reality, and it needs to keep being noticed and brought out into the open so it can stop happening.

When we are injured by our clients

One of the scarier things about being a music therapist is that sometimes we get hurt on the job by our clients.

This is something I've been meaning to write about for some time now, but I've been procrastinating. I mention it now, because, recently Todd Henry, a man identified as a music therapist, was actually killed by one of his students.

It's a real issue when we provide services to people who are not always able to control their behavior. Or those who have gotten used to using violence as a means of communication. Or who have serious mental illnesses and aren't able to distinguish between what is reality and what is generated in the mind.

I've been hurt at times by my clients. I've been smacked, bitten, scratched, had my hair yanked, my fingers squashed, I've been head butted, grabbed, in a headlock, pushed, kicked, and pinched. Depending on the day, the situation, the context, and how violent the situation was, I've felt varying levels of distressed.

In general when I get hurt, my immediate reaction is that I feel uncomfortable, angry, frightened, ashamed, uncertain, violated, powerless, and with a general sense of not being sure how to proceed after it has happened (other than to say, "we need to stop the session for today.").

Because I work the way I do (using an object relations approach), I absolutely believe that the feelings I experience in reaction to getting hurt are more than likely the feelings my clients either are, or have, experienced in their lives (hello, projective identification).

As such, part of moving forward with my clients after violent behavior is addressing what happened in the following session(s), talking about how it impacted me and what I think my client may have been trying to communicate to me (i.e., that s/he was feeling powerless, ashamed, angry, frightened, etc.).

I work with people who live in an institution. By that very fact alone, they have experienced trauma. Never mind the many other forms of physical, sexual, emotional trauma they've likely endured over the years. When a person doesn't use speech, and doesn't feel as if s/he's being listened to, and s/he is fresh out of coping skills, violence is sometimes the result.

This issue isn't talked about much, if ever, when we're in school and learning to become music therapists. It's also not a topic that I see coming up in music therapy conferences either.

One of the reasons I don't usually bring it up is that it scares people. Another reason is that I don't like the idea that people see my clients' violent behavior as being a factor of their disability. I don't think most of my clients are violent (and not all of them are) because they have autism or some other intellectual or developmental disability. I believe it's usually a result of their life and not having learned better ways to cope with extremely challenging situations.

So I'm bringing it up today. And I'm wondering what your experiences (whether you're a music, creative arts, or other sort of therapist or supporter/caregiver) have been with this issue.