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Approaching Age-Appropriate Rehabilitation with Adolescents

Each year more than 100 adolescents, ages 12 to 21, come to Shepherd Center from all over the country. They or their families choose Shepherd for its specialized treatment teams, age-appropriate therapy and expertise in treating teens and young adults with spinal cord injuries. The adolescent rehabilitation program follows Shepherd Center's philosophy of returning patients to the highest possible level of functioning and independence, while addressing adolescents' needs for autonomy, privacy and control. Cheryl Linden discusses the Adolescent Rehabilitation Programs available at Shepherd Center.
Approaching Age-Appropriate Rehabilitation with Adolescents
Featured Speaker:
Cheryl Linden, MA, LPC; MS OT/L
Cheryl Linden has been part of the Shepherd Center family since 1988. She spent 13 years as an occupational therapist before becoming a staff counselor in 2001. Linden works as counselor on the Adolescent Team in Shepherd Center’s Spinal Cord Injury (SCI) Program and in the SCI Day Program. She received her M.S. in Occupational Therapy from Western Michigan University, her M.A. in Psychology from Georgia Professional School of Psychology, and her B.S. in Social Work from Manchester College.
Transcription:

Melanie Cole, MS (Host): The adolescent rehabilitation program at Shepherd’s Center follows the philosophy of returning patients to the highest possible level of functioning and independence while addressing adolescents’ special needs for autonomy, privacy, and control. My guest today is Cheryl Linden. She’s a licensed professional counsellor and occupational therapist at Shepherd’s Center. Cheryl, let’s start by talking about the prevalence of adolescents that need specialized treatment for brain and spinal cord injuries. What do you see most commonly?

Cheryl Linden MA, LPC; MS OT/L (Guest): Well, Melanie, it’s a variety of reasons why kids end up here. Often time you'll see an increase in the summertime with outdoor sports, extreme sports that kids participate in. Often times car accidents, kids pushing the limit which brings kids into the Shepherd Center with brain and spinal cord injury.

Host: Then tell us a little bit about the adolescent program and some of the hallmarks of it. What do you feel are really special parts of it that can help adolescents going through this?

Cheryl: Melanie, I think one of the big things is that we keep all of the adolescents together. They're all generally housed on the same wing on the same floor. So they get to hang out with their peers and have that all important peer interaction. We also participate every Friday in something called Fun Friday where we drift away from the mundane everyday rehab and do something specific for adolescents. We might go to the movies or we might go on an outing somewhere, like to the aquarium. If there is filming in town, we often get invited to go on the set. So something that’s a little bit different.

Also because they're in school, we take into consideration that they need to stay up on their schoolwork as well. So as long as it’s not in the summertime, they're participating in school while they're doing therapy. They're often in class with other adolescents in school. So they have that same kind of peer interaction. Also when they go back to school, we have one of the therapists go with them on the first day and have a program called No Obstacles where we talk about that transition back to school. The kids can decide for themselves; do I want my friend to come to that meeting? Do I want the whole school there? Do I want just my class? And get that sort of awkwardness out of the way so that they can jump right back into school.

Host: What a wonderful way to reintegrate them. So while we’re talking along those lines, speak about that psychosocial aspect. So that first day they go there with a counselor. As you said, it can be so awkward. They want to learn, and they want to get back involved in schools and activities. How hard is that for them to remake friends? Keep some of their friends after a traumatic injury, such as brain and spinal cord. Tell us about how that all works for them.

Cheryl: Well, I do think the advantage that we have with social media these days is that they're always staying in contact with friends back home differently than before we had social media. So they're not so foreign to their friends when they go back. When they make that transition back to this school, we have a full time schoolteacher here who has been in contact with their school all along. They’ve been working either on assignments that the teacher sends or via the internet. So they’ve had interaction with their friends and the school. So when they make that transition back, it’s generally either the physical therapist, the occupational therapist, the speech therapist, or the rec therapist that goes with them. There's a whole presentation that they set up together and decide, “What do I want to tell these people? How much of my personal information do I want them to know in terms of my spinal cord injury?” So not only does the student themselves get sort of an easier transition back to school, but the other friends at school can ask their questions and get all of that sort of social awkwardness out of the way the first day so that people can more easily transition and get back in to not only the academics, but back with their friends and doing things that they used to do.

Host: Along those lines, are you seeing their friends feeling awkward to them? Are you seeing their friends responding well, offering to help or hangout? What do you see as far as that part?

Cheryl: I think friends, for the most part, are very accepting. If the adolescent has a very high level of injury and may be on ventilation or in a power wheelchair, sometimes that’s a little more awkward for people because they're not sure what to say and what to do. Oftentimes, the friends come here and visit. Those that do that really quickly learn that, “Hey, my friend is still the same. They’re just sitting down now.” And, “Oh, there might be a different way that we play basketball or there might be a different way that we go hangout, but it doesn’t mean that we can't.” I think having some of that education and seeing that it’s okay to have questions and they ask their questions of their friends, and their friends can take charge of their life at that point. I think that makes that transition much easier. But it is, at times, awkward because this might be their first experience with somebody with a disability.

Host: How interesting. What about the comradery among the teens that are experiencing this together. Tell us a little bit more about the program and some of the teen outings that our offer.

Cheryl: Well, the program is very, very pro-developmental. What I mean by that is we try to get the kids back involved with things that they did prior to their injury. So the Shepherd Center is a pretty laid back kind of environment. As the counselor, I'm not typically in my office with the kids. We may go out to lunch to together. I may go on the outings with them as well where we’re participating in the Atlanta Braves games or we might be going to the soccer games. So that’s a time for them to be out and about with the other teenagers where they maybe don’t feel so conspicuous because they have other kids with them.

We are always up for pranks around the hospital. As a matter of fact, we have a 14-year-old in here now who has already started pranking the CEO and other people in the office. So we encourage those activities that kids do anyways. I think that helps them with the transition back into their life where their spinal cord injury or their brain injury doesn’t have to take the number one place all the time, if that makes sense.

Host: It totally does because when you just described it, it normalizes it for them. If they're able to even do things like that to the CEO, then they feel like they are now a part of the community and they're not going to get reprimanded. It’s fun. It normalizes it. So how do the families and siblings play a role? How are they involved?

Cheryl: Well, when you work with an adolescent you automatically work with the parents. So oftentimes we’re spending as much time with the parents as we are with the kids. We do have a policy where parents do not come to therapy because we want the kids to be able to establish a relationship with the therapist separate from their parents on their own. As a counselor, I meet with the families all together as well. Oftentimes when siblings come up over the weekend, if I know ahead of time they're here, I will spend time with the siblings because the injury may have happened to their brother or sister, but it does impact the whole family. So if you think about this as a cog wheel, every person in the family is a piece of that cog. So everybody is impacted. So we do try to pull in family and friends, extended family when they're here so that we can help the whole family adjust to this type of injury.

Host: You seem so passionate and wonderful in your job. Cheryl, tell us a little bit about how developed the particular approach that you have that helps you connect with younger patients that are going through so much.

Cheryl: Well, I started out here in 1988 as an occupational therapist. I think what helped me as that transition from an OT into counseling was I had the physical part of the brain injury and the spinal cord injury pieced down from working in the gym on the floors with patients. So I think that brought to me a little bit more knowledge about what everybody is going through on a day to day activity. That as a counselor I was able to pull those pieces in.

It also helps that there are some things I can do as an occupational therapist that I wouldn’t be able to do had I not had that degree. By that I mean some of the kids who are on ventilators, I can take them outside. I can take them places because I know how to manage their vent care. Whereas if I didn’t have that background, I couldn’t, and I wouldn’t be as involved I don’t think with the kids. So this is my 31 year here. I am very much a kid myself. If you would see my office, you would kind of see. A lot of the kid’s schools have fundraisers and they sell t-shirts and I have all their shirts and they're all framed hanging in my office. It’s really kind of a low key place.

I think the other thing is I made sure that I continued to participate in the fun activities. For example, we’re having a fashion show this Friday. It’s our seventh annual fashion show. It’s for the adolescents to really showcase themselves as they move through their injury level. It’s turned into kind of a big deal. That’s an event that I MC. Certainly we bring a comedic aspect to it. We have a haunted house we do every year. I participate in that. I try not to be oh, you're going to see the counselor in the office. Much of my work is done with the kids outside of here.

Host: How great is that? As we wrap up, tell the listeners what you would like them to know not only about the adolescent rehabilitation program at Shepherd, but adolescents going through brain and spinal cord injury. How tough it is for the family, for those kids, for everyone around them, but yet what you see as far as hope and light and how they are really developing their own new normal.

Cheryl: Well, I would say this Melanie. A lot of people ask me outside of here, “Isn’t Shepherd a depressing place to work?” I said absolutely not. Do people sometimes get depression? Do people sometimes have anxiety? Absolutely. These are events that happened in their lives that are unplanned, that happened in a matter of seconds. I think when you spend most of your time trying to normalize something and most of your time working with a kid where the injury is not the thing that defines them, it is a part of their life. They got to be a member of a club they never wanted to be a member of. However, it doesn’t have to be the only thing that’s in their life. When you open people’s eyes up and you help family work through you still have your son, you still have your daughter. We can still do so many things.

As they see progress in their child, I think that helps people move through. Plus with peer support and kids coming back to visit, you see where somebody can actually go to and you see where they’ve been. It’s like you know what? I didn’t ask for this. I didn’t deserve this. I got it, but am I going to let the injury run me? Or am I going to run it? I think when you empower people to say, “I'm going to run it and it is not going to run or define me.” That’s where you see the hope and the light and the success.

Host: Wow. What a great description and I can see why you are so good at your job. Cheryl, thank you so much for coming on and sharing your expertise and telling us all about what these adolescents are going through and how you're helping them at Shepherd’s Center. It’s just amazing. Thank you again. That warps up this episode of Shepherd’s Center Radio. Head on over to our website at shepherd.org for more information and to get connected with one of our providers. If you found this podcast as cool as I did, please share with your friends on social media and be sure to check out all the other fascinating podcasts in our library. I'm Melanie Cole.