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heal

A publication of the Sheppard Pratt Health System • SUMMER 2015

PLUS UNDERSTANDING ADDICTION HELPING ADULTS WITH AUTISM A WORKSHOP IN AFRICA

Breaking New Ground After a $4 million renovation, the Steven S. Sharfstein, M.D. Integrated Health Care Center is completed.


In this issue.

SUMMER 2015

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12

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4 Breaking New Ground After a $4 million renovation, the Steven S. Sharfstein, M.D. Integrated Health Care Center is completed.

3

Helping Adults with Autism Spectrum Disorder

12

Philanthropy: You give. They heal.

6

Understanding Addiction

13

Raising Autism™: A Family Affair

7

Progress Report: Medication Management in the Dementia Population

15

Meet Our Team: Behavior Specialists Remy Chappell and Thomas Flis

8

In the News/Calendar

On the cover.

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Out of Africa

Steven S. Sharfstein, M.D., and Jeff Richardson cut the ribbon at the dedication of the new Steven S. Sharfstein, M.D. Integrated Health Care Center. Photo by David Stuck

This issue of heal. is dedicated to the late Czarina (Rina) Santos-Borja, M.D., director of geriatric services at Sheppard Pratt Health System who died in April of a sudden cranial aneurysm. She was a distinguished member of our medical staff and a long-standing part of the Sheppard Pratt family. We will never forget her determination, brilliant smile, and kind heart. CMYK / .eps

Connect with us.

facebook.com/SheppardPratt

heal. is published four times a year by the Marketing Department of the Sheppard Pratt Health System, one of the nation’s top mental health programs, providing compassionate solutions to help those suffering from mental illness and addiction recover and get back to their lives. Information provided is general in nature and should not be substituted for the medical advice of a physician. Please consult your health care provider for recommendations specific to your personal health, medical treatment, and medical conditions. If you wish to have your name removed from the list of those receiving communications from Sheppard Pratt Health System, please email the Marketing Department at marketing@sheppardpratt.org or call 410.938.3133.

@sheppardpratt

CMYK / .eps

CMYK / .eps

youtube.com/user/SheppardPrattHealth

Editor/Director of Marketing & PR

Jessica Kapustin

Outreach & Project Manager

Chelsea Soobitsky

Design, Production & Editorial

Mid-Atlantic Custom Media Cortney Geare, Jeni Mann, Geoffrey Melada, and Suzanne Pollak

Contributing Photographers

Brian Glock, Patti Prugh, and David Stuck


ADULT PSYCHIATRY

Helping Adults with Autism Spectrum Disorder RECOGNIZING AN URGENT NEED, SHEPPARD PRATT OPENS ADULT NEUROPSYCHIATRIC UNIT

SHEPPARD PRATT marked Autism Awareness Month this past April by reopening our seven-bed Adult Neuropsychiatric Unit, which provides inpatient treatment for adults with developmental and/or intellectual disabilities, including those diagnosed with Autism Spectrum Disorder (ASD) who are having an acute psychiatric emergency. This new unit, which I am privileged to lead, is the only inpatient unit of its kind in Maryland and one of only a handful in the country to specialize in treating patients with severe psychiatric and behavioral problems. It was filled to capacity in its first weekend of operation. Because some of the patients are nonverbal, diagnosing and treating mood disorders or other mental illnesses in this population can be difficult. Finding

ago, according to the U.S. Centers for

psychologists and nurses specially

Disease Control and Prevention.

trained to treat this patient population’s

As a result, programming and resources

needs is, admittedly, a challenge. But

must keep pace, or an enormous

meeting a need is the core of what we

burden falls on the caretakers. This

do at Sheppard Pratt.

need is particularly acute with the adult

To give you a better sense of that

population, as they age out of the

ROBERT WISNER-CARLSON, M.D.

need, one in every 68 children is

programs and services that were once

Robert Wisner-Carlson, M.D.,

diagnosed with ASD today, a number that

available to them when they were part

is service chief of the Adult

has increased from 1 in 88 just two years

of the educational system. Despite these challenges, it was critically important for us to move forward with this venture. And yet the opening of this new unit is just the beginning. In terms of securing state funding and program development to serve this adult population, there

Neuropsychiatric Unit and medical director of The Developmental Neuropsychiatry Clinic, part of the Neuropsychiatry Program at Sheppard Pratt. A graduate of University of Michigan Medical School, he trained in psychiatry at The Henry Phipps Psychiatric Clinic at Johns Hopkins Hospital and at Maudsley Hospital in London. He holds specialty certification in Behavioral Neurology and Neuropsychiatry from the United Council for Neurologic Subspecialties.

remains much work to be done.

sheppardpratt.org • heal.

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FEATURE/SHEPPARD PRATT

Steven S. Sharfstein, M.D., and Jeff Richardson cut the ribbon to officially open the new center.

Breaking New Ground

BY SUZANNE POLLAK

AFTER A $4 MILLION RENOVATION, THE STEVEN S. SHARFSTEIN, M.D. INTEGRATED HEALTH CARE CENTER IS COMPLETED

W

hen Kelly Damon finished

Care Center is named for the president and CEO of Sheppard Pratt

rehabilitation program, she walked

psychiatry, addiction, primary care, and

Health System.

away with a certificate, a 30-day supply

pain management — in one facility,

of medicine, and nowhere to go.

making it easier for its clients to get the

his leadership position in July of 2016 but

Sharfstein, who will step down from

help they need,” said executive director

continue to be involved in clinical work,

someone talking about Mosaic

Jeff Richardson. That approach has

has presided over a period of exponential

Community Services. She went there

paved the way for Mosaic, part of the

that very day, beginning what became

Sheppard Pratt Health System since

an eight-year relationship that she

1995, to become Maryland’s largest

believes saved her life.

community-based behavioral health

Six months later, Damon overheard

The 51-year-old Baltimore native started using drugs when she was 19 and

4

“Mosaic’s integrated care combines a range of services — including

a year-long, state-run

services provider. Today, that growth continues,

soon became addicted to heroin. She

with the reopening of The Harry and

had attempted suicide six times. But

Jeannette Weinberg Building in May,

through Mosaic’s classes and therapies,

including a new $4 million integrated

she said she has learned to control her

health care center on North Charles

anger, better deal with her family, and

Street in Baltimore. The Steven S.

even lose 70 pounds.

Sharfstein, M.D. Integrated Health

heal. • Sheppard Pratt Health System

The writing’s on the wall: Community members gathered in May to dedicate the newly launched Steven S. Sharfstein, M.D. Integrated Health Care Center.


Mosaic treats a wide range of people, from those who need immediate hospitalization to others who can be best helped with short-term interventions. growth for Sheppard Pratt — from the

of the brain, he said. Removing

single hospital he joined in 1986 to

the societal stigma attached to

a health system today spawning

mental illness remains a critical

38 locations throughout Maryland.

priority. Increasing funding

When he started, Sheppard Pratt had 850 employees and a $40 million

is another. “We still struggle with

annual budget. It now has 2,700

these illnesses,” Sharfstein said.

employees and a $350 million annual

“They are poorly understood.

budget. The health system, which

We do a good job, but we can

had 1,000 admissions in his first year

do better.”

and extremely long lengths of stay,

The building opened in 1959

Kelly Damon uses Mosaic’s classes and therapies to help take charge of her life.

now provides services for 10,000

and was renovated to include the

admitted patients and another

brand new center that bears his

70,000 outpatients annually.

name in an effort to redesign its

with short-term interventions. It provides

space to accommodate the needs of the

medical and psychiatric services, as

clients by offering a variety of services

well as residential, vocational, and

About 27,000 people received assistance from Mosaic last year.

under one roof. Mosaic offers patients a

crisis services. “We will go to a bridge.

and medications designed to treat

team-based approach, coordinating care

We will go to a hospital. We go to

mental illness have been developed

for its clients among professionals in

where the people are, where they live,

since Sharfstein began his psychiatry

different fields.

wherever and whenever they need us,”

Although numerous therapies

career in Boston more than 40 years

Statistics show that, on average,

Richardson said.

ago, there is still much to learn in the

people with mental health problems

field, he said.

die 25 years earlier than the general

a discrete illness by guiding individuals

population largely due to treatable

back into society.

For one, scientists are only beginning to understand the workings

medical conditions. Mosaic is battling

Jeff Richardson, Mosaic’s executive director and Steven S. Sharfstein, M.D., Sheppard Pratt’s president and CEO.

The goal is to do more than treat

Damon said she has been clean

this early mortality rate

and sober for more than eight years

by embedding primary

now. She believes Mosaic is successful,

care into a behavioral

because “they actually take time out

health setting so that

to find out what’s wrong with you.

people coming in with

They talk to you, not at you.” She tried

mental health and

other programs and failed. Mosaic

addiction issues, for

was different.

instance, can access

“They don’t talk down to you,

services to help stop

and I never had a program that did that.”

smoking, lose weight,

Damon lives with her husband in

and make other

Mosaic housing and has a part-time job

behavioral changes.

helping a child with special needs learn

Mosaic treats

in an integrated classroom setting. She is

a wide range of

taking care of herself, too. Her weight

people, from those

loss has enabled her to control her blood

who need immediate

pressure. She is no longer suicidal.

hospitalization to

If not for Mosaic, she said, putting

others who can

it bluntly: “I don’t think that I’d be here

best be helped

right now.”

sheppardpratt.org • heal.

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THE RETREAT

Understanding Addiction WHAT sort of person do you picture

Addiction does not happen

when you think of a drug addict or an

overnight. It is a progressive

alcoholic? Film and television give us

disease. How quickly one becomes

caricatures — a homeless man, collapsed

an addict depends on a number

in an alley, clutching a bottle wrapped

of factors, both genetic and

in a brown paper bag.

environmental. No one signs up to

The truth is that most people who

be an addict or alcoholic. And once

suffer with drug addiction or alcoholism

the brain is altered from addiction,

cannot easily be spotted in a crowd.

recovery is not simply a matter

In fact, chances are good you know

of “Just Say No!” As a disease,

someone who has a substance use

addiction requires intervention

disorder. Addiction affects every ethnic

like any other.

group, gender, and tax bracket. Most people are introduced to alcohol or drugs by someone close to them, an influencer — a parent, sibling,

There is good news: Recovery from addiction is possible. Like addiction itself, though,

or friend. Some unwittingly become

recovery is a process — not a single

addicted after taking prescription

event. Inpatient, intensive outpatient,

medications lawfully prescribed by

and outpatient substance abuse

their doctors.

programs are first steps on that path.

The reasons people abuse drugs

In early recovery, medications are

and alcohol also vary. Some find

available to help patients combat

temporary relief from emotional and

powerful, physical urges to return to

it is important for family and friends

physical pain or from boredom and

substance abuse, while self-help

to educate themselves about addiction

loneliness. For others, they simply like

groups such as Alcoholics Anonymous,

and recovery. Al-Anon, Alateen, and

the way substances make them feel, at

Narcotics Anonymous, and SMART

Nar-Anon are self-help programs for

least until addiction takes hold.

Recovery provide emotional support.

people coping with someone else’s

When used in tandem, these treatment

addiction or alcoholism.

Addiction, which includes alcoholism, is a brain disease. It is not a

approaches work.

If you, or someone you know is

moral deficiency. The American Society

Because addiction is a process,

of Addiction Medicine defines addiction

some people will experience setbacks or

so is not a sign of weakness. It takes

as a chronic disease of the brain

even relapses along the way. People who

courage to pick up the phone, or to walk

characterized by impairment in behavior

have never experienced addiction or

into that first meeting. But you can do it.

control and an inability to consistently

seen it up close sometimes struggle to

And when you do, know this: You will find

abstain from cravings. Along with these

understand this. “Why can’t you just

an entire community of professionals and

symptoms, addicts experience significant

stop?!” they ask.

recovering individuals there who

problems with interpersonal relationships and dysfunctional emotional responses.

If only the solution were that simple. Because the reality is more complicated,

using substances, ask for help — doing

understand you, support you, and are ready and willing to help you.

DENISE CONNELLY, LCSW-C, CAC-AD Denise Connelly is a licensed clinical social worker and certified addictions counselor at The Retreat at Sheppard Pratt. She holds bachelor’s and master’s degrees in social work from the University of Maryland.

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GERIATRIC PSYCHIATRY

Progress Report: Medication Management in the Dementia Population GERIATRIC SERVICES launched an

greatly improved communication among

initiative in 2013 to more safely and

staff deciphering records and created

effectively manage agitation on the

process efficiencies. An increased focus

Geriatric Neuropsychiatry Unit at

on documenting nonpharmacological

Sheppard Pratt. There is good

interventions — such as art, music, and

progress to report.

exercise therapies — also helped convey

During the course of an 11-month period, a 90 percent reduction in the frequency of agitation was shown in

the benefits of these activities, so they were used more often. The process improvements resulting

the rate of antipsychotic use for the

from this project continue to be in effect

management of behavioral and

at Sheppard Pratt.

psychological symptoms of dementia. How did we get there? Studies have

Ultimately, our hope is to advance findings and share them with the greater

During the course of an 11-month period, a 90 percent reduction in the rate of agitation was shown in the rate of antipsychotic use for the management of behavioral and psychological symptoms of dementia.

outpatient care, and off-site medical daycare services.

shown an increased risk of side effects

health care community to encourage

with uncertain benefits for some elderly

increased safety and effectiveness in

part of this project included myself,

patients with symptoms of dementia

managing medication among loved ones

Emily Draper, Rochel Friedman, Sheila

being treated with antipsychotic

in this elderly dementia population.

Harvey, Dr. Robert Roca, the late Dr. Rina

medication. In the face of that evidence,

Sheppard Pratt’s geriatric services

The staff members who were

Santos-Borja, Sheila Underwood, and

Centers for Medicare & Medicaid

serve older adults experiencing clinical

Susan Wolski-Vincenzes. This team was

Services launched a broad effort to

depression, anxiety, severe forgetfulness,

awarded a 2015 Minogue Award for

reduce the use of these medications

and other mental health problems. These

Patient Safety by the Maryland Patient

among this patient population.

services include two inpatient units,

Safety Center.

As part of our LEAN methodology program that focuses on continuously

Some of the staff from the Geriatric Neuropsychiatry Unit who participated in the project.

improving and eliminating waste, the geriatric services team at Sheppard Pratt first implemented a new process in the pharmacy order system calling for physicians and team members to re-evaluate the way they document behavioral symptoms and communicate with each other. For example, instead of recording a patient’s symptoms generally as “agitation,” the team began listing more specific symptoms such as exit-seeking, kicking, or insomnia. This

DR. JOSHANA GOGA Joshana Goga is a pharmacist and clinical specialist with Sheppard Pratt Health System. She is also an assistant professor at the University of Maryland School of Pharmacy.

sheppardpratt.org • heal.

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IN THE NEWS

Exemplary Physicians Honored THE SECOND RECIPIENTS of the Michael Edelstein, M.D., Physician Humanitarian Award were announced at Sheppard Pratt’s annual Doctor’s Day Luncheon on Thursday, April 2, 2015. More than Dr. Khizar Khan

Dr. Edward Zuzarte

80 nominations were received for

the award, which recognizes physicians who dedicate their time to fulfilling the needs of patients in a selfless and extraordinary way. Congratulations to Dr. Khizar

Please Join Us in Congratulating

Student Shows Poster at Annual Child and Adolescent Conference

• DR. STEVEN SHARFSTEIN, president and CEO of Sheppard Pratt Health System,

CONGRATULATIONS to Jenna Michelle

Khan and Dr. Edward Zuzarte for being recognized as this year’s winners.

for receiving a 2015 NAMI Exemplary Psychiatrist Award. • DR. HARRY BRANDT, co-director of The Center for Eating Disorders at Sheppard Pratt, for being selected by the readers of Chesapeake Family as one of their Family Favorite Doctors.

Jackson, a student at The Jefferson School at Finan Center, whose artwork was selected as the Maryland Coalition of Families for Children’s Mental Health Awareness Week poster for this year.

• BONNIE LINK, program coordinator and teacher at Hannah More School, and

The poster was unveiled at a reception

VERA ROTH, career and technology education director at The Forbush School at

on March 24 during the annual statewide

Glyndon, for being recognized as recipients of this year’s Unsung Hero Award

Child and Adolescent Conference.

by the Reisterstown/Owings Mills/Glyndon Chamber of Commerce.

Mark Your Calendar! For a complete listing of events, continuing education classes, and lectures, visit sheppardpratt.org/calendar-events.

Continuing Education: Wednesdays @ Sheppard Pratt A lecture series at The Conference Center at Sheppard Pratt most Wednesdays from noon to 1 p.m. to support continuing education of medical and mental health professionals. Visit sheppardpratt.org/education-training

EDUCATIONAL CLASSES

for more information.

PHILANTHROPIC EVENTS

Dick Prodey Lecture Series

2nd Annual Sheppard Pratt Stride

Sponsored jointly by The Kolmac Clinic,

Two Doctors, Two Generations: Medical Ethics Then and Now

Saturday, October 10, 2015

Sheppard Pratt Health System, and the

Save the date for this family-fun

National Council on Alcoholism and

event complete with music,

Drug Dependence of Maryland.

games, and more.

A FREE, eight-class series

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heal. • Sheppard Pratt Health System

held Wednesday evenings at The Conference Center at Sheppard Pratt from 7 p.m. to 9 p.m. Call 410.938.3900 for information.

July 8, 2015 Barron H. Lerner, M.D., Ph.D., professor, Department of Medicine and Population Health, Lagone Medical Center


IN THE NEWS

Sheppard Pratt Sponsors Art Exhibit to Promote Mental Health Awareness THIS MAY, Sheppard Pratt was a proud sponsor of the Maryland Coalition for Mental Health Awareness’s Third Annual Art Exhibit, which took place on May 7th at the American Visionary Art Museum. In addition to helping sponsor the event, which showcases artwork created by behavioral health consumers to eradicate stigma surrounding mental health, Sheppard Pratt also sponsored artwork created by a patient of The Neuropsychiatry Program at Sheppard Pratt.

The Mann Residential Treatment Center (RTC) Residents Lend Hands, Help the Hungry

Recognized Excellence

AS PART OF an initiative created by occupational therapy interns at Mann RTC,

SHEPPARD PRATT received

residents within this program have been spending time in the community helping

awards for both our logo

others. The girls units provided care packages

design and Heal magazine in the

to families at the Baltimore Ronald McDonald

2015 Aster Awards competition,

House, and the boys unit visited Moveable

which recognizes the nation’s

Feast, a local food pantry, and made more

most talented healthcare marketing

than 600 sandwiches for those in need. We are

professionals for outstanding

proud of the work this program is doing to give

excellence in advertising.

back and support our local community. Interns at Mann RTC.

Acceptance and Commitment Therapy July 22, 2015 Jesse M. Crosby, Ph.D., administrative director, Office of Clinical Assessment and Research, OCD Institute, McLean Hospital

Godfrey D. Pearlson, M.D., professor of psychiatry and neurobiology, Yale

NASW MD 10th Annual Clinical Conference

University School of Medicine

September 24-25, 2015 Linthicum Heights, Maryland

The Bad Mother in American Psychiatry: Where She Came From, Why Her Story Still Matters September 30, 2015

Diamonds in the Rough 2015 Conference for families, educators, and professionals working with students with special learning needs

Value in Mental Health Care: What Is It and Who Decides?

Anne Harrington, Ph.D., director of

August 5, 2015

of the History of Science,

Robert P. Roca, M.D., M.B.A., M.P.H.,

Harvard University

5th Biennial Trauma Conference Kennedy Krieger Institute

CONFERENCE EXHIBITING

October 1-2, 2015

Throughout the year, Sheppard Pratt

Timonium, Maryland

undergraduate studies, Department

vice president and medical director, Sheppard Pratt Health System How Can Biological Measures Help Guide Diagnostic Classification in Psychiatry? A Focus on Psychotic Illnesses September 9, 2015

Health System and its programs exhibit at a number of conferences and community events. Make sure to stop by our booth if you plan to be at any

September 26, 2015 Rockville, Maryland

ISTSS 31st Annual Meeting November 5-7, 2015 New Orleans, Louisiana

of these.

sheppardpratt.org • heal.

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SHEPPARD PRATT

Spray-painted mural by Juma Mkwela, Khayelitsha Township, South Africa.

at Sheppard Pratt. This was a chance to bring that knowledge someplace where they were willing to hear what we have to From left: David Pruitt, Tamara Maresky, Desmond Kaplan, Rene Nassen, Patti Prugh, and Eunice Dube.

out there, on a truly international level and show people what we stand for.

IN ORDER TO ADDRESS the mental health needs of those living in the underserved communities of the Western Cape of South Africa, a joint South African/U.S. child and adolescent mental health alliance was recently established among the University of Cape Town, Stellenbosch University, Columbia University, the University of Maryland, and Sheppard Pratt Health System. The inaugural project was a five-day child and adolescent mental health workshop that took place this past March, in which three Sheppard Pratt employees and two University of Maryland employees participated and led many of the lectures, workshops, and clinics. The workshop was free and open to all mental health and allied professionals. In their first debriefing with Sheppard Pratt since returning from the workshop, the participants reflect on their experiences in South Africa, the inspiration for this collaboration, and where they see it headed.

to South Africa? Desmond Kaplan: This trip was a further step in the work we’ve done with the Capetown community. We wanted to focus on what we felt were the real needs of the community. This wasn’t a

and international level. For the purposes of this project, we used our telemedicine equipment to video conference with those in South Africa, which helped us open the lines of communication and understand the needs of their community before we even arrived.

Eunice Dube: Having come from the region, and having worked there as a nurse, I have an idea of what health care services are like, so to be invited to participate in this really big, educational component of our health services, was inspiring. Desmond Kaplan: The issues in inner city Baltimore are not that different from what goes on in the shanty towns with drugs, alcoholism, and poverty. How is the mental health landscape different in South Africa from in the United States? Eunice Dube: There is a lack of enough qualified psychiatrists, and too many patients to care for. Desmond Kaplan: Just to give you some perspective, in South Africa there are

What inspired each of you to get

70 million people and approximately

conference that was sold out every day

involved with this project?

20 child psychiatrists. In the United

for five days.

Mark Rapaport: Look at it from the lens

States, we have 350 million people and

of what we do here. We forget how much

8,600 child psychiatrists. In South Africa

expertise we have in our own little world

they are producing just two child

fancy academic conference; it was a free

Telemedicine has allowed us to expand our reach on a local, national,

10

for us and the participants. And it was a chance to get the Sheppard Pratt name

Out of Africa

What was the purpose of the trip

say, and, in the end, it was very beneficial

heal. • Sheppard Pratt Health System


sophisticated and really

What is your biggest take away

targeted at what we felt

from the trip?

were the important topics for this community. And while that disconnect is there within their a back door for addressing

appreciation of the universality of the

the issues through the

issues that we’re dealing with. The recent

without having spent time going to the presentations

psychiatrists a year, and, in the United

for domestic violence that were going on

States, we are producing 800 a year.

directly in these little community

several schools for children with autism and related disabilities. There were 27 children in a classroom with one teacher and then a couple of people who were not trained. In contrast, in our schools, we put a lot of time into training, even for the noncertified and non-disciplined staff. On the units, the modality and delivery

meaningful for others. Laurel Kiser: I walked away with an

I wouldn’t have known that

Mark Rapaport: On the trip, I went to

much that I could give that would be

system, there’s been

para-professionals. Monica “Momma” Duda conducting a frontline domestic violence workshop in Khayelitsha Township, South Africa.

Patti Prugh: I did not know that I had so

organizations, in the shacks. What happens next? Desmond Kaplan: One of the nurses from South Africa is coming in June to Sheppard Pratt to visit, and I’m going to South Africa in August to work on a project in Johannesburg, and one of the focuses will be telepsychiatry.

protests in Baltimore have made these parallels all the more real. The magnitude of the issues and the problems and how we can intervene to help people is just so critical at this point. One of the things I heard in South Africa was that it’s not very often that someone from the United States comes over and talks about poverty here and draws those parallels. David Pruitt: I took away the relationships, both internally and once we were in Cape Town. I really did feel I learned more than I taught which is remarkable. Because of those relationships, I think it’s sustainable. Mark Rapaport: The relationships.

of services was lacking.

Patti Prugh: People are asking us

As much as I think we gave, we were

David Pruitt: Their public health thinking

for help with grants writing, how to

able to receive. It was not a one-way

formulate their concept into something

process. The need to go back and do

ours here in the United States, because

they can convey to a funder. Teaching

more is another take-away.

they have to look at the whole and find

this skill isn’t something that has to happen in South Africa; it can be done

Desmond Kaplan: This get-together

the issues they want to intervene on. But there is a large gap between the private,

long distance using telemedicine.

create an institute of international child

public, and academic centers; they’re

David Pruitt: I would hope that, whatever

mental health through Sheppard Pratt

much more siloed there because of the

we do, we layer on to the good work

and the University of Maryland. There’s

lack of resources.

that’s already been created. Telemedicine

an enormous amount of work to be

Patti Prugh: When I was really on

is a remarkable technology, and it can

the ground, I found that the frontline

help us, but I still think the group coming

workers who do not have formal training,

together and creating the experience

the work that they would do was so

we had was key.

was actually more sophisticated than

has made me dream big. I’d love to

done, and the world is getting smaller through technology.

From Sheppard Pratt: Desmond Kaplan, M.D., service chief of the Child and Adolescent Neuropsychiatry unit and medical director of the Telepsychiatry Program; Patti Prugh, senior art therapist and rehabilitation services coordinator; Mark Rapaport, M. Ed., principal/education director at The Forbush School at Prince George’s County and special education teacher on the Child and Adolescent Neuropsychiatry unit. From the University of Maryland School of Medicine: Laurel Kiser, Ph. D., M.B.A., psychologist and associate professor in the Department of Psychiatry, University of Maryland School of Medicine; David Pruitt, M.D., child and adolescent psychiatrist, director of the Division of Child and Adolescent Psychiatry, and director of Telepsychiatry, University of Maryland, Baltimore. From the VA Baltimore: Eunice Dube, R.N. Also participating in the collaboration: From Columbia University: Christina Hoven, Ph.D.; From Hershey Medical Center: Fauzia Mahr, M.D.; From the Psychiatric Institute of Washington: Michael Bogrov, M.D; From Tel Aviv University: Alan Apter, M.D.

sheppardpratt.org • heal.

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SHEPPARD PRATT HEALTH SYSTEM PHILANTHROPY

You give. They heal. You make great things happen when you give to the Sheppard Pratt Health System.

stride

SAVE THE DATE for the 2nd Annual Sheppard Pratt Stride Saturday, October 10, 2015 Sheppard Pratt Health System’s Towson Campus Join us for a family-fun day to raise awareness and funds to support Sheppard Pratt programs that help patients and students, their families, and those affected by serious mental illness.

RECORD-BREAKING BENEFIT SHEPPARD PRATT HEALTH SYSTEM hosted its 23rd Annual Care for Kids Benefit on March 21 at the Four Seasons Hotel Baltimore. More than 400 donors and community members gathered at the disco-themed gala, which raised money to provide essential supplies and therapeutically beneficial activities to our 20,000 pediatric patients and students. It was the most successful event to date and raised over $300,000! To see more photos from the Care for Kids Benefit, please visit facebook.com/ SheppardPratt. You do not need an account to view the pictures. Save the date for next year’s event on April 2! QUESTIONS regarding the Sheppard Pratt Stride or the Care for Kids Benefit can be directed to the Office of Philanthropy at give@sheppardpratt.org or 410.938.4020.

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heal. • Sheppard Pratt Health System


SPECIAL EDUCATION

they have both life and social skills is key to establishing their independence. The Cherrys have also learned not to feel guilty about actively finding respite for the entire family, however they have to go about accomplishing this. Often, the family would break apart mealtime, sometimes feeding Matthew at a different time to avoid conflict. According to Jason, the family “has not been afraid to take breaks and to operate atypically as a family. We’ve looked past the commotion and frustration inherent to Raising Autism™ to find the humor in life.” Matthew and Jason Cherry.

Raising Autism™ : A Family Affair THE CHERRY FAMILY knows autism.

their advice on navigating family life

In 1996, Cathy and Michael Cherry

with a child with special needs.

traveled to Russia to meet Matthew for the first time. They quickly found themselves interacting with a 3-year-old whose actions could only be described

Disability is a household event According to Cathy, one of the greatest challenges to life with a child on the

Parents have no frame of reference when their first born is a child with special needs When Matthew was about 13 years old, he became more physically aggressive and had very poor judgment, especially as it came to safety. Cathy understood that Matthew never wanted to intentionally harm other children, but he had such poor judgment that she had concerns for the safety of the whole

as chaotic. Once in the states and old

autism spectrum or any other special

enough for a diagnosis around age 3,

need, is realizing that it impacts

Matthew was shown to have autism

everyone in the house. Says Cathy,

spectrum disorder (ASD), bipolar disorder,

“You don’t just raise a child with autism;

attention deficit hyperactivity disorder

you raise a family through autism.”

(ADHD), obsessive compulsive disorder

By the time Matthew was in second and

(OCD), and fetal alcohol syndrome.

third grade, home life was tumultuous.

Later, with two other children in the

It was a highly structured environment in

household, Jason, the middle child, and

school, but not at home, and things only

Samantha, the youngest, the Cherry

got worse as Matthew hit puberty.

adolescence, and what was just being

family began a lifelong journey to

In sixth grade, Matthew began attending

a boy.” Not until her second son,

understand autism and to raise a family

The Hannah More School in Reisterstown,

Jason, was 8 did she finally gain a better

with compassion, patience, and, most

Md., part of the Sheppard Pratt Health

understanding of what was neurotypical

importantly, humor.

System, where he progressed and did

development. During these early years,

well in the school setting for about

as Cathy was learning how to manage

five years.

Matthew’s challenges, her younger two

We recently sat down with Cathy, principal of Purposeful Architecture and Purple Cherry Architects, and her middle

family. Then conflict started happening among the siblings. “As a parent, when your first-born child has special needs, you have no frame of reference for what behaviors and social skills may be typically developing,” says Cathy. “Without any prior parenting experience, I could not determine what was autism, what was

Through this process, the family has

children experienced events that were

son, Jason, now 18 and the exclusive

learned that you must look at home and

scary to them. When Matthew pulled a

professional race car driver of the Autism

school settings together. Children with

knife on his aide, it created a year-long

Society of America (ASA), to find out a bit

special needs require more time to

fear in Jason, then about 7, which

more about their journey and to share

transition to adulthood. Ensuring that

manifested as anger and defense.

sheppardpratt.org • heal.

13


SPECIAL EDUCATION

Samantha, who was much younger,

everything that they’re going through, the

to marry her expertise in architecture

would deflect her feelings in response

good and the bad, so that they can

with her experience working with

to the fear. Jason went to private

receive the maximum support they need.

individuals with special needs. She can

counseling to learn how to cope with his

When Matthew was 17, the family

truly understand goals and provide

anger. And Cathy learned that she

knew it was time to seek residential

compassionate solutions to impact these

needed to take Matthew’s audience

treatment for him. He would throw huge

environments. “It’s what’s important to

away when he was becoming aggressive.

fits, running across the room and

me now,” she says.

“Sometimes I turned off the lights in the

slamming his entire body into the

house and other times, I honestly had to

window. He’d throw himself into shower

as a race car driver as a springboard to

place him outside on the lawn to remove

doors. Cathy says, “We fixed the wall 10

support ASA. Says Jason, “When I was

Jason chose to use his career

growing up with Matt as my brother, I was

“Without any prior parenting experience, I could not determine what was autism, what was adolescence, and what was just being a boy.” — Cathy Cherry

embarrassed to have friends come over the house, and so I would ride my dirt bike a lot.” I then got into auto racing and began pro road racing. With 50,000 to 150,000 people in attendance at each race, and millions of viewers watching

him from a space where he could harm

times. He was hospitalized three times.

at home, Jason wondered, “What can

himself and others,” explains Cathy.

When it happens too much, you’re

I do with all of this attention? I saw an

overwhelmed.” And every member of

opportunity to speak as a sibling of

their support team needed to know what

autism, so I partnered with the Autism

was happening at home.

Society.” As the exclusive professional

Humor is the best remedy It took years for the younger siblings to get past their anger and resentment. But once they did, and once Matthew started

Now that Matthew is in a residential

its local affiliates to host families with

better and is more comfortable. He can

special needs at each of his races. He is

be home for two or three days at a time,

together. Matthew is usually the one

working to form an ASA sibling board for

and the family is able to enjoy that time

generating the humor, sometimes on

the next generation of leaders who will

together. According to Cathy, “When he

purpose and other times by accident.

eventually represent their autistic siblings.

got into residential treatment, it allowed

Cathy and Jason remember one time

the whole family time to begin healing.”

all three siblings is healed. A video on

because he picked it up. When they

Be proactive

Jason’s YouTube channel shows true

asked him why he would ever do

With the siblings now 15, 18, and 23, the

something like that, his response:

family, especially Cathy and Jason, has

“Because I wanted to see if I was

used the knowledge and patience

worthy of holding a bee.” Says Cathy,

they’ve learned from raising and growing

“Developing such a great sense of humor

up with Matthew, to help others with

has empowered all of us with a level

special needs. As principal of Purple

of patience that we would not have

Cherry Architects, Cathy started receiving

back on it, I can attribute a lot of my

developed otherwise.”

calls to work on special needs projects.

success to my brother and to dealing

She began creating living, learning, and

with the challenges and adversity.”

maturing, the family was left with humor to help piece the relationships back

when Matthew was stung by a bee

14

race car driver of ASA, Jason works with

environment, he composes himself

Today, the relationship among

love and friendship between the brothers. Jason’s best advice to other siblings is to “be patient, give it time, things will come full circle. In the moment, you don’t think anything will go right — I thought that for years. Looking

Full disclosure is vital

vocational environments locally, but

One of the biggest mistakes parents

knew she could do more. This led to the

make, in Cathy’s opinion, is to hide the

development of Purposeful Architecture,

realities of how difficult the situation is

a nonprofit arm of her firm dedicated to

Cherry’s Purposeful Architecture firm, visit

and to make it seem that everything is

creating spaces where children and

purposefularchitecture.com.

wonderful. For the Cherry family, it’s been

adults with special needs can thrive.

very important to fully disclose

Purposeful Architecture allows Cathy

heal. • Sheppard Pratt Health System

Jason Cherry can be reached through his website, jasoncherryracing.com, or through his Facebook page. To learn more about Cathy


MEET OUR TEAM

Get to Know Our Behavior Specialists CREATING POSITIVE BEHAVIORAL CHANGES IN OUR PATIENTS

Remy Chappell has worked since 2008 as a senior behavior specialist on 1H, the Child and Adolescent Neuropsychiatric Inpatient Unit. Her colleague, Thomas Flis, a 12-year veteran of Sheppard Pratt, serves as a senior behavior specialist on A7, the new Adult Neuropsychiatric Unit, having previously held the same position on 1H. The following are highlights from a conversation with these two professionals dedicated to achieving positive behavioral changes in our patients.

Q. What is a behavior specialist? A. Chappell: Behavior specialists look at behavior to determine why a person is doing what they are doing. There is a reason behind every behavior, and we try to figure that out by looking at environmental influences to determine the cause of the negative behaviors and to break the cycle and replace with and reinforce new, positive behaviors.

Flis: Remy and I are the only two behavior

in-home support, like an in-home

specialists at Sheppard Pratt. On A7,

therapist.

I work with adults with developmental disabilities, including ASD, genetic disorders, TBI, and intellectual disabilities. The adult population is different than the child population, because sometimes these adults have had problem behaviors for a long time, so it is much harder to break those behaviors.

Flis: For example, an individual who is

Q. How do you work with patients

unable to communicate verbally may be he has learned that every time he wants

once they leave to ensure they continue practicing the positive behaviors you have taught them?

or needs something, hitting himself in the

A. Chappell: Our biggest challenge

head has gotten the attention he wanted.

is our time limitations, as patients are

Our goal is to try to manage problem

only on our units for about two weeks,

behavior and to teach adaptive behaviors.

and we’re aiming to accomplish a lot

hitting his head against the wall because

in a short time.

Q. What types of patients do you work with?

Flis: Modifying behavior is a long-

A. Chappell: On 1H, we work with

our units. We perform numerous

children with neurodevelopmental issues,

assessments, work to create intensive

including autism spectrum disorder (ASD),

behavior plans, and determine

Down’s syndrome, traumatic brain

what works and what doesn’t

injury (TBI), and intellectual disabilities,

work for our patients.

among others. In addition to working with

It takes continuous

children, we also work with their families,

reinforcement to make

bringing them to team meetings, showing

a behavior stick.

them what has worked and what hasn’t;

Chappell: We also work

it’s the key to reinforcing the positive

to connect caretakers

behaviors once a child leaves the unit.

with outside resources for

CMYK / .eps

term process for people on and off

To learn more from our behavior specialists, visit our YouTube channel: youtube.com/user/SheppardPrattHealth

Q. What do you love most about your job? A. Flis: Many of our patients want to be able to express themselves, but because of their illness, they’re not able to. It’s amazingly rewarding when we’re able to manage a problem behavior and then teach a new, adaptive behavior that allows them to be more independent and express their feelings. Chappell: For me, it’s working with families who are really invested and want our help and accept our feedback. Those are the kids that get better and stay better and stay out of the hospital. That makes it all worth it.


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heal. Summer 2015  

A publication of the Sheppard Pratt Health System.

heal. Summer 2015  

A publication of the Sheppard Pratt Health System.