My first experience at the Buffalo Psychiatric Center was for my orientation. When I first arrived, I was met at the door by Marcy who is the secretary in the volunteer office. I handed in my paper work that was required and had my picture taken for my ID badge. I was then mandated to watch a video that was created by BPC. One of the main focuses of the video was that recovery is the number one goal at BPC. In fact, their mission statement is “partnerships in hope and recovery.” It is their main belief that all patients can recover from mental illness with the proper treatment and guidance. Another large issue that the video discussed was confidentiality and HIPPA (the Health Insurance Portability and Accountability Act). It is a very important issue at BPS that all patient’s records and information are protected and private. The video gave an overview of mental illness and discussed the three main illnesses that patients at BPC suffer from which are depression, bipolar disorder, and schizophrenia. Finally, the video gave a tour of the campus. After finishing the video which took approximately an hour, I met with Sue Joffe who is the director of Public Information and Volunteering at BPC. After she reviewed the paperwork that I handed in and asked me some questions about myself, she explained to me that she was finalizing some of the details about where I was going to be placed so she would be in touch with me later in the week about when my official start date. I had a very informative first experience at BPC!

My first official day at BPC was as fascinating as I had hoped it would be. I arrived early to the Strozzi Center which is the main building at BPC where patients live and treatment is done. I signed in and received my ID card and set of volunteer keys that were to be turned in at the end of my day. As I had always heard, there was one extra large key on my key ring that unlocked every door at BPC. My supervisor, Linda, was there to introduce herself and explain my placement. I was told that I would be volunteering in the Treatment Malls. These areas are located on 2 North and 3 North and can be either co-ed or just one specific gender depending on the session. These sessions are meant to guide patients towards recovery and range in lessons from cooking to spirituality. My job would be to help patients finish their task during these sessions if their group was one that required completion of a specific assignment. Or, if the group was more aimed at discussion, my job was to get encourage the patients to join in and to actively participate myself. On average, I would be attending and aiding in four sessions per day.

My first group experience was with Mary who is a Recreation Therapist. This group was called “Wellness 101.” In it we discussed the importance of friendship and what to look for in good friends.

My second group was also with Mary and was known as a “Shaping” group. In this group, we took the patients outside into the courtyard. If they kept busy (i.e. walking, playing cards, etc.), they would receive a prize at the end of the session which was normally candy.

After lunch, I had my first experience with a community meeting. This meeting was being run by Dr. Reynolds who is a Psychologist at BPC. A community meeting is a group meeting with the patients on a specific unit that is meant to discuss issues with in the unit, upcoming events in the unit, and issues going on in the world which is meant to keep the patients in touch with society. Any questions that patients have are also addressed. The community meeting that I attended was for Ward 75 which is an all female unit.

My final group of the day was with Elizabeth who is a Level Two Certified Occupational Therapy Aid. This group was titled “Humor Me” and was meant to show the patients how to find humor and laughter in their daily lives. Patient’s favorite funny movies and TV shows were discussed and a time for jokes to be told was done at the end.

During my first day at BPC, I noticed several illnesses present in different patients. In the “Humor Me” session, I noticed several patients that most likely suffered from depression. My number one clue to this was that many suffered from flat affect. No matter what jokes Elizabeth and I told or how we tried to engage them in the group, they showed no emotional reactivity. While playing cards during the shaping group, one of the male patients seemed to suffer from schizophrenia. I arrived at this conclusion because he seemed to have trouble focusing on the task at hand, seemed to be responding to internal stimuli and was constantly babbling. Elizabeth referred to him as a “true” schizophrenic.

One interesting fact that I was told about the patients is that they normally have a very difficult time getting going in the morning. Many of them fall asleep for the majority of the first session. Furthermore, another side effect (besides trouble getting started in the morning) of the patient’s medication is that they have a drooling problem.

I again arrived bright and early at BPC, ready for a new week’s challenges. Upon first arriving, I always have to buzz up to Mary or Elizabeth because Linda does not want me on the wards alone. After meeting and chatting with Elizabeth for a bit, it was time to begin the day’s rehab sessions.

I started the first session with Elizabeth which was titled “Wellness 101.” The patients seem to have this session everyday but because it is so early, most are always sleeping through it. Today, the topic of dry mouth was discussed which apparently is another side effect of specific medications. We discussed ways to prevent it or to lessen it. The dentist that the patients see gives out a product to help dry mouth which was confirmed by one of the patients who had just come back from the dentist.

For my second session, I decided to go do yoga with Mary. We did many different poses and stretching which seemed to help the stiff backs of the girls. There were two female patients in this group and it was decided that we would set up a yoga booth at the Activities Fair on the 28th. I am really looking forward to helping the girls put this together! After yoga, Mary and I made sure that the girls sanitized their mats for the next group and then we rehydrated them with fruit juice. One thing I have noticed is that all patients are on a very strict diet and if they are rewarded with candy after a session (like this one), they are only allowed one piece even though many try to take two. Furthermore, another thing that I noticed in this session was that one of the ladies seemed to suffer from bipolar disorder. Although this was never confirmed for me, I came to this conclusion from my experiences with her. On my first day at BPC I had met her and she was as sweet as can be but today she was very low and experienced concern that she did not want me watching her during anything that she did. At the end of the yoga session, however, she wanted to make sure that she served me some fruit juice. This patient seemed to suffer many highs and lows.

“Leisure Exploration” was my third group with Mary after our lunch break. This group was very compliant and somewhat uneventful. Everyone seemed to be very satisfied from lunch (discussing the tuna sandwiches quite often) and enjoyed listening to music that each patient had the chance to pick out which reminded them of a specific time in their lives. A few patients even got up to dance with one another. It was nice to see everyone get along.

My final group of the day was very eventful. It was again with Mary and called “Recreation Exploration.” The idea for the day was seasonal bingo and everyone was to make their own board with summer words. We had a bunch of different people piled into this class. Several of the patients were able to complete the task on their own with no help needed. One gentleman, though, needed me to completely set up his board for him because he could not figure out how many rows he needed for the number of words we had. He was able to play the actual game on this own, however. Another lady needed help both with setting up her board and with playing the actual game. It appeared that she was greatly concentrating at her task at hand but grew visibly upset and frustrated when she could not figure it out. The final woman that I want to discuss suffered from severe schizophrenia and she seemed to be having a bad day. She could not sit still and constantly was getting up and down to leave the room. She was also having a conversation with someone who was not there named “Charlie.” Because she is mainly deaf, she just about yells at the top of her lungs so she can try and hear herself speak. Interestingly enough, if I sat next to her and really just focused on her and trying to get her to pay attention to the game, she was able to play and even got bingo on the last game.

I was very excited to come in today because before groups started, Mary took me on a tour of one of the women’s floors. Some rooms are doubles and others are singles. Each patient gets a bed and dresser, as well as other small necessities such as a hamper. Showers and bathrooms are in a different area. Patients have to ask to use specific things such as hair rollers. There are also special eating times and designated time to give out medication.

My two morning groups were with Mary today. Our first group was called “Recreation Exploration.” This group, Mary explained to me, involves each patient finding a certain leisure activity that they enjoy doing both inside and outside of the hospital. These activities included reading the paper or magazines, doing crossword puzzles or word searches, coloring or drawing and doing an exercise video. The activity that I participated in was cards, specifically war, with one of the men in the group. It was a very pleasant surprise playing with him because he was very much with it and seemed to be having a good day. He knew how to play the game and followed the rules very well. I specifically enjoyed this rehab session because it seems that I am getting more responsibilities the longer I am there. Now that I am beginning to know many of the patients and their names, I take attendance and make sure that all of the patients are where they should be.

For my second session, Mary and I traveled to one of the wards instead of the patients normally coming to us. We travel to these patients because they are on the geriatric unit and only leave the unit in the afternoons because it is difficult to transport them. Mary and I brought the craft cart up to them and engaged them in many different activities such as painting, drawing, coloring and word searches. It seems that every patient loves music so we always put the radio on for them or CDs. One of the patients drew a free hand portrait of me! Her artistic skills were incredible!

After lunch, I partnered up with someone new named Deeana who holds the same title as Elizabeth. Her session was called “Music Appreciation.” In this group, we pick a specific artist to discuss and go on Wikipedia to get information about their life. After we discuss, we play a CD of their music so the patients can get a taste of what the artist sounds like. Today’s artist was Peter Tosh who specializes in reggae.

My final group of the day was called “Staying Well” and in it we discussed vending machines. Deeana ran the group. There are many vending machines at BPC that the patients have access to. Recently, these vending machines have undergone changes to make them somewhat healthier. We handed out a sheet that discussed the better options to pick in vending machines and everyday life. Patients were encouraged to eat healthy so they would feel good about themselves.

The last thing that I want to discuss in this entry is another patient that I was introduced to today who absolutely fascinated me. Upon admittance, it was thought that this patient suffered from some sort of mental illness. When his treatment team examined him further (especially the gray matter in his brain), they realized that his problems stemmed from years of massive drug use. This was only recently discovered during the last couple of weeks. This patient is also is the early stages of dementia. He requires constant supervision because he often falls and also gets very confused by his daily activities and the locations of his rehab sessions. Furthermore, he rarely speaks, shows very little emotion and sometimes it does not seem as though he is comprehending much of what is going on. This all stems from the massive damage to his brain.

Writing about this day still makes me incredibly happy because when I first arrived, I met Elizabeth and we headed up to one of the men’s wards. Elizabeth had to review a few charts before groups started for the day. When we arrived on the ward, Elizabeth told me that it was okay if I go through a few of the charts to look at the patient’s medical history. I found it absolutely fascinating to find out why the person first came to BPC and how long they had actually been there. It was nice to delve a little deeper into the patient’s lives.

Once groups started I was informed that groups are repeated on a weekly basis so I was going to participate in the same groups that I had been in on the prior Thursday. My first group was again “Wellness 101” with Mary. In this group, we discussed ways to cope in everyday life. I especially enjoyed this lesson because the hand out that Mary provided was based on the letters of the alphabet and each letter provided three ways to cope in everyday life. One patient in this group appeared to suffer from an advanced case of schizophrenia. Not only did she continue to walk in and out of class, as well as constantly fidget but she also decided that she wanted to act like a chicken because she was told to (not by anyone present in the room). Right in the middle of the class, she began clucking very loudly and then resumed fidgeting.

My class after “Wellness 101” was again the “Shaping” group. Mary and I decided to go outside again since it was such a gorgeous day out. We provided word searches having to do with baseball and ice cream flavors so the patients could keep busy and earn their reward (again candy). Several patients played rummy and we also put on music of their choice. It was very interesting to me how many songs and artists they know and remember. Many patients were able to sing along word for word. This time I was asked to dance with one of the patients and I had a very good time doing so.

Today was a very special day in the afternoon because it was decided that we would hold an ice cream social for every patient at BPC. We wanted to reward them for their good behavior these past couple of weeks when it has been so hot. Apparently, a side effect of many patients’ meds is that they overheat and can suffer from heat stroke. Furthermore, the heat can sometimes make them (like many other people) very irritable. This has not really happened, though, so the ice cream social was a treat. We provided individual skippy cups that were chocolate and strawberry marbled. Toppings included: chocolate syrup, strawberry syrup, butterscotch, caramel, rainbow sprinkles, chocolate sprinkles, cool whip and cherries. I was in charge of putting the cherry on top and handing the ice cream sundae to the patient. Some patients were not able to have ice cream because they needed to be on thickened liquids so we have them butterscotch pudding with their choice of toppings. I can not even begin to count how many patients we served but we had enough ice cream left over for staff to indulge in (although the cherries were long gone)! We held the social in the courtyard and many patients were again dancing to the music provided. Many played basketball or walked around the courtyard but most just enjoyed sitting or napping in the warm sun and being able to talk with other patients and staff outside of the rehab sessions. It was so nice to see all the smiles and looks of happiness on the patient’s faces! It truly made me feel incredible about being involved at BPC!

As always at BPC, today was another interesting day. I arrived at 9:00 and met with Elizabeth on the 6th floor. Before groups started today, Elizabeth allowed me the opportunity to read through the e-mails on how the patients did on Friday, Saturday, and Sunday while I was gone. An e-mail is sent out for each day which details if the patient did not take their medication, if they are on suicide watch, or if they seem agitated among other things. I really enjoyed receiving this privilege because it felt like I was gaining more trust at BPC and that I was allowed to be a part of the patients’ treatment process.

My first group was with Elizabeth and was “Wellness 101.” This group seems to take place everyday which is good because it gives the patients ways to maximize their health while at BPC. Today we discussed smoking cessation which was very relevant because although BPC is 100% smoke-free, many patients sneak off to have a cigarette in a place like the bathroom. We discussed the new rule beginning in 2012 by the FDA in which a graphic picture needs to be placed on the packaging of cigarettes. These pictures range from lifeless bodies to lungs destroyed from smoking. The patients seemed to really take to this lesson because it hit home for so many of them. For the most part, they remained calm and quiet throughout the entire lesson.

My second class was again with Elizabeth and was entitled “Morning Wakeup.” In this class, we played lively music to get everyone going for the morning since it is sometimes very difficult for the patients to get moving in the morning. We did many dance steps and exercises such as raising our arms high above our heads almost like a sun rising during the song “Here Comes the Sun” by the Beatles. We walked and marched around the room and tossed a beach ball back and forth to everyone. I really loved this class because I felt that it got everyone’s blood pumping from the catchy music beats and put a smile on many patients’ faces. As always, many patients began grooving and dancing without any of us staff telling them to participate. Everyone loves to dance at BPC! One patient in our group, though, seemed to suffer from borderline personality disorder. I noticed this because of how this patient treated me personally. At times she seemed to enjoy interacting with me but other times she would quickly move away from me, roll her eyes at me and spit in my direction. Furthermore, she would sometimes leave the room yelling about her dislike for our class, only to come back a few minutes later. She appeared to be very unstable and her little tantrums happened very often. I later found put that she often swallows whatever is in her reach and has required extensive surgeries. She is also on suicide watch lately and frequently tries to leave the building.

After lunch, my first rehab session was with Deeana and was titled “Common Thinking Errors.” In this group, we discussed what to do when you are faced with people that you do not like. Doing things such as thinking of something you enjoy when you are around them or trying to think of one positive thing about them are just a few of the things we discussed during this session. I really enjoyed this session because I again felt that the lesson focused on another daily problem at BPC. Because patients are together all day everyday, there are bound to be people that do not get along well. This rehab session tried to help patients with a part of their life that must be dealt with daily.

For my final session of the day, Deeana and I combined with two other groups and took them down to the basement area which was nice and cool. There were many activities for the patients to participate in. First of all, there is a fenced in area filled with tables and chairs if patients choose to sit outside and read, draw or just enjoy the fresh air. There are pool tables, a ping pong table, a Wii, a small machine for shooting baskets, as well as other tables and chairs inside for card playing. There is a TV but it is not turned on during group sessions. Finally, bingo is held on special evenings and they even have a large board that lights up the numbers once they are called. The patients seemed to really enjoy their time in the basement.

When I first arrived at BPC this morning, I again got to review some patient’s histories with Elizabeth. I am enjoying this more and more because I am getting to know the patients really well by now so it is nice to know even more about their life than what is on the surface. Plus, sometimes the patients try and discuss their history and this is not always accurate so it is nice to know what is true and what is not.

My first group today was with Mary and was titled “Recreation Exploration.” The group was very low key today. For the first ten minutes, we went around and told the room what we each enjoyed doing during our leisure time. I told the room that I enjoyed playing tennis and spending time with the ones I love. Some group members said they enjoyed listening to music or gardening while others enjoyed shopping for antiques or watching sports. After this was completed we broke off and began quiet activities such as reading the newspaper and magazines or playing solitaire. It appears that the patients enjoy this quiet time in the morning since it is so difficult for them to get moving that early in the day.

My next group was one that I have never been to before called “This Emotional Life.” Elizabeth runs this group. Elizabeth and I discussed how this group pertained to the patients before everyone arrived. She told me that emotions and tensions always run high here and the patients enjoy knowing that they are not the only ones suffering from raging emotions. Elizabeth tried to instill in them certain lessons about feelings and emotions that they can carry with them. In this group, we read two separate stories and discussed the feelings of the characters in them and what the lesson to be learned was. For example, one lesson discussed loving people despite their imperfections. We really encouraged participation in this group, for things like recognizing the feelings and many patients did very well with this. The interesting part about this group was that many patients seemed to be feeling overly emotional today so the group was very fitting. I would like to talk about one woman in particular who seemed to be suffering from schizophrenia. Throughout the entirety of the group, she responded to internal stimuli. She screamed, cried, made nasty faces and said things such as calling the stimuli “a jerk who she told thousands of times to go away because he was bothering her.” We eventually had to ask her to leave the room to go to the quiet room because she was too much of a distraction to the other patients in the group.

After lunch, my next group was also a new one for me and was called “Recovery Happens.” Elizabeth ran this group and it was mainly a group for those suffering from co-occurring disorders. These patients have some sort of mental illness, as well as an addiction to drugs or alcohol that they are also fighting. In this group, we focused on personal strengths. Every member of the group had to tell us what they thought their personal strength was and we then told them what we felt their personal strength was. We provided them with a checklist of different strengths that they could either say they had or wanted to develop. I feel as though this was a very good lesson because it allowed the patients to think positive thoughts about themselves and the qualities they possess. Hopefully the group allowed them to remain in a good state of mind.

My final group today was “Creative Arts and Music” with Mary. This group was again very low key with us putting on music for the patients (today the choice was the Beatles). We also provided them with large summer fun posters that contained crossword puzzles, word searches, word scramblers, and plenty of coloring. Many patients were happy that they had something to take back to their room and work on.

Today was again a very different day for me at BPC. When I first arrived, I got the okay to head over to the Gertrude Butler Rehabilitation Center. This is a place where patients with privileges (which are earned) are able to go. More groups are held at the Butler Center, as well as a gym, a bowling alley and a swimming pool. Patients must display good behavior and progress toward recovery to get this unescorted privilege. Good behavior includes going to and participating in rehab sessions, showing respect to staff and taking medication among other things. Patients seem to enjoy the privileges of coming to the Butler Center because it breaks them of their normal routine.

Upon arriving at the Butler Center, I first went to the Wellness section in which I attended a class known as “Healthy Living.” In this class, we discussed several ways to maximize your life by living in a healthy manner. These ways were simple such as remembering to wear a coat when it gets cold out to more complex such as what vitamins to take and what specific problems they help. As always, I truly feel these classes are beneficial to the patients because I feel that many people do not take into consideration these issues because they are so concerned with the probability of being discharged. When we bring these health problems to light, the patients remember that they are still important and could lead to discharge.

My next class was in the New Beginnings section and was called “Self-Determination.” We discussed optimism in this class, what it meant to everyone and how it differed from pessimism. I enjoyed this class because it was taught by a younger woman who just began her career in social work which is something that I am considering.

After attending these two classes, I noticed many differences between the Strozzi Center and the Butler Center. First, there are many more patients in the Strozzi Center for treatment groups. Furthermore, the people in the Strozzi Center are much sicker than those in the Butler Center. The patients in the Butler Center seem to be much more stabilized and closer to discharge than those in the Strozzi Center. This is why they have many privileges. Finally, the groups in the Butler Center seem to be much more advanced and the patients participate much more. Again, this is mainly because they are further along their road to recovery. I would also like to discuss one of the patients that I came across at the Butler Center who appeared to suffer from paranoid schizophrenia. I arrived at this conclusion because she constantly discussed a microchip that was implanted in her head. This microchip knew and controlled all of her thoughts. She seemed so preoccupied about this microchip and what it would force her to do next.

For my afternoon session, I was back in the Strozzi Center with Mary and Elizabeth. My first group was with Mary and was called “Wellness Self Management.” We brought the work books out so we could discuss that there are many ways to recover from a mental illness and that recovery is in the hands of the patient. It is important for the patient to understand that they are the keepers of their destiny and not Therapists, Psychiatrists or any other staff member that they may come in contact with. The patient needs to take the steps necessary to begin their road to recovery and they must believe that it’s possible.

My final group of the day was “Humor Me” with Elizabeth. In this group, we watched two episodes of “Everybody Loves Raymond” which the patients truly seemed to enjoy. We gave them a print out of the background of the show and of the specific characters. They seemed to be very happy watching this. Maybe laughter is the best medicine!

Today at BPC seemed rather repetitive since I have done these specific groups before but it was none the less interesting. When I first arrived, I worked out my schedule for August with my supervisor, Linda. I’m hoping to be able to finish all of my hours by the time school starts at the end of August. After this meeting, I headed to my first group with Mary.

The first group of the day was “Recreation Exploration.” This group was really enjoyable today because we put on an exercise video for the patients that involved tai chi exercises. It was a slower tape but really relaxed the patients and allowed them to stretch out all of their kinks. Normally some patients do not get involved in some things that go on during groups but everyone participated today when they realized that it may help their aches and pains go away for a short amount of time. After it was over, some patients even complained about how out of shape they were! The tape finished a little early and after that, we had every patient write down their name and hobby on a sheet of paper for the upcoming hobbies fair that is taking place on Thursday.

My next group was called “This Emotional Life” and was run by Elizabeth. In last week’s group, we focused on heart-wrenching stories that brought tears to many patients’ eyes and even to mine. This week we took a different approach and discussed several Buddhist stories that all had a moral to them. All of these morals were then applied to the patient’s lives. We really wanted to focus on Zen in the group today. For example, we discussed a story about Buddhist monks who are not allowed to touch women based on their religion. In the story, one of the monks carries a woman across a street because she could not cross on her own with all of the water that was on the street. The other monk in the story calls him on this and says that he is not able to touch women so he should not have carried her. The first monk’s reply is that “you are the one still carrying her” meaning that he is still dwelling on a point that he should not be. When relating it to the patients, we discussed how they should not dwell on past events that could not be changed. Instead, they should learn from these events and focus on the future that lies ahead. I truly enjoyed this specific group session because of the lesson that Elizabeth had planned for it.

After lunch, my next group was “Recovery Happens” which was again with Elizabeth. This group is normally taught by a peer mentor but he is receiving training so Elizabeth has taken over the group. AS she said, she doe not have experience with mental illness or addiction because she herself has never suffered from either so she chooses to take a different approach which Is to focus on recovery and coping. Today, she planned a lesson on different situations, what to do in them, and how to cope with them. We used made up examples and then had each patient discuss a real situation that happened to them and what they should have done differently. I think this was a good lesson because it shows the patients where they went wrong and how they could act differently if ever faced with that situation again. Furthermore, by showing the patients that they have the power to make their own right decisions, it gives them confidence for the future.

In my last group of the day with Deeana, we decided to take our group outside to the courtyard because it was a nice day out. Some patients played basketball and some just sat and seemed to be deep in thought or maybe just enjoying being outside. I spent my time painting a few patients’ nails and singing and dancing to the music that we brought.

In this last section, of my journal, I want to discuss one of the patients who suffers from chronic schizophrenia. At first, this patient seemed to like me and was being friendly while mistaking me for Madonna. After I caught him, throwing basketballs over the courtyard fence and corrected him, he became very nasty and claimed that “Fred” told him to do it. He proceeded to tell me that he could not stand me and did not like me. For the remainder of our time outside, he sat in a corner and has a conversation with “Fred.” Another problem that I noticed he suffers from is echolalia in which he is always repeating himself.

Today was a very exciting day at BPC for a few reasons! The first reason being that it was my first day starting at 8:00 instead of 9:00 and the second reason being that it was the day of the Hobbies Fair. Because I now arrive an hour earlier, my first hour involves sitting in on the morning meeting. These meetings are held every morning at 8:00 and discuss the day’s groups, any changes taking place at BPC and specific patients or floors. These meetings are meant to get the day going and keep everyone up to date.

My first group of the day was with Mary and was called “Wellness 101.” We had somewhat of a rowdy group today but we made the best of it and discussed an article entitled, “Did You Get Your Dose of Wellness?.” This article listed several different aspects of life and examples of how to find wellness in each. For example, some of the areas were intellectual, spiritual and environmental. For the intellectual area, one could practice deep breathing that could connect the mind and body. I believe that this was a useful lesson because it gave the patients ideas on where to begin their journey towards wellness. I think that it is always good to start the patients with small steps so that they do not get easily discouraged.

My second group of the day was the “Shaping” group which I have come to find out can also be called “Building Social Skills.” This group was with Mary. This is the group in which we like to keep the patients busy so that at the end of the group they receive a reward of candy. In today’s group, we went with the topic of the upcoming Hobbies Fair and went around the room so that every patient could tell us their hobby. It was very interesting to hear the hobbies that the patients had before they entered into the hospital and some that they try to keep up with while in the hospital. Some of the patient’s hobbies included writing lyrics, collecting coins, collecting stamps and gardening. After discussing their hobbies, we allowed them to keep themselves busy for the remainder of the time left in the group. Several patients played rummy together, others listened to music and others talked with Mary and I. Everyone was rewarded with candy at the end of the group.

Mary, Elizabeth, Deeana, and I all had lunch together after our groups and before the Hobbies Fair. Lunch was quick, though, because Mary and I wanted to head down to the cafeteria to get our tables set up and ready for the Hobbies Fair.

When we first began discussing hobbies a few weeks before, Mary had asked me what my hobbies were. I told her that I have always enjoyed playing tennis and that I have been playing since I was five years old. Mary then asked me if I would like to have my own table at the Hobbies Fair that could be dedicated to tennis. I gladly agreed! For my table, I brought in a tennis racket and tennis balls, as well as articles on how to hit a forehand, backhand and serve. I also brought in articles on the history of tennis and the health benefits of tennis. Also, because I have participated in yoga with Mary in the past, I had a few videos and articles on yoga and yoga positions. Mary’s table was next to mine and involved pet therapy. One of the secretaries at BPC even brought in her own Golden Retriever named Bentley! The patients loved him! There were many other tables at the Hobbies Fair including camping, jewelry making, fencing, biking and crocheting. Many of the patients made their way down to see the Hobbies Fair. I saw a lot of familiar faces who came up and asked me about my hobby which was nice that they were so interested. Popsicles were also handed out to those patients who visited to thank them for coming.

The final thing that I would like to talk about is one of the patients who visited the Hobbies Fair. This patient showed characteristic signs of Borderline Personality Disorder in the sense that she seemed rather childlike and easily threw tantrums if she did not get her way. Furthermore, although she was born a girl, she was not sure if she wanted to be a girl or a boy. She routinely switches back and forth in her decision. Finally, she dressed as though she was once in the military, saluted to everyone and even used military lingo even though she was never in any branch of the service.

Today was another new day for me because it was the first day that I stayed until 6:00 on a Tuesday. I hope to finish my hours by the time school starts so for this Tuesday and the next two, I will be working until 6:00 with Mary. As always, when I first arrived at 8:00, we met for our daily update meeting.

At 9:00 when the meeting was done, I again participated in something new. I have discussed Dr. Reynolds, a Psychologist, in one of my first posts. He is in charge of Ward 75 and on this morning he ran a goals group. This involves every lady on Ward 75 discussing a goal or goals that they have for either the day or for the long term. They announce these goals to everyone in the room and this entire session takes approximately a half hour. Some of the ladies were very forthcoming about their goals while others had to be asked what their goals were. The goals included anything from participating in every group of the day or taking all medicine for the day to going to live in an outpatient treatment center or earning more privileges around BPC. It was incredible to see how much hope so many of the women had for themselves and that many realized recovery was in their own hands!

After attending goals group with Mary, I had my first group with Mary called “Recreation Exploration.” Mary explained to me today that patients are placed in this group when they are motivated enough to keep busy for thirty minutes. Sometimes we allow them to keep busy on their own while other times we plan an activity for them to take part in. Today Mary brought in an article about fitting fitness into one’s busy schedule and all the ways that this is possible. Some examples include taking the long way to the bathroom and if one hasn’t seen a friend, scheduling a walk with them to catch up. After we went over this lesson, we put on a walking tape for the group that involved certain walking in place exercises and types of aerobics to do while walking. The patients seemed to enjoy the exercise!

My next group of the day was with Elizabeth and called “This Emotional Life.” We started off the group by asking every patient to describe how they feel today in one word. Some patients said hopeful while others said tired or discouraged. I even participated and said that I was excited because today is the first day that I would be staying at BPC until 6:00. After this activity, Elizabeth wanted to discuss friends. Her first handout had two questions: describe your first meeting with your best friend and the other being if a friend did you wrong but showed up at your door at a future time, what would you do?. Many patients participated and came up with a variety of answers. The final activity that we did in this group was read over a page of quotes by different famous people on friends. An example of one of these quotes is: “A friend is a single soul dwelling in two bodies.” This quote is by Aristotle. We also discussed the meaning behind every quote.

I kept busy during my lunch today and continued to read patient histories or the daily reports on patient’s activities. I truly enjoy doing this because not only does it give me a background on patients but it allows me to form a more personal relationship with them and cater to their specific needs.

At 1:00 when groups started again, Elizabeth and I took our “Recovery Happens” group outside for some fresh air. I spent my time talking to two patients close in age to myself. We discussed how long each has been at BPC, when discharge may be coming and what they’re personal discharge plan is. Talking to these two men made one realize that mental illness is not something that just affects the older population. These men had been showing signs of their illness from their teens doing things such as stopping forms of hygiene like showering and moving between different addresses or living on the streets. Both of them would later be diagnosed with schizophrenia.

My 2:00 group was with Deanna today and was called “Staying Well.” The topic of today’s group was resilience. Deanna passed out a sheet that detailed ten ways to improve one’s resilience. Some of these ways included making connections, accepting that change is a part of living and moving toward goals. What was nice about this particular lesson and sheet was that these were all examples that patients could do while at BPC> Some lessons focus on life outside of BPC but Deanna prepared this lesson to practice in BPC so that the patients could begin moving toward recovery. The patients seemed to enjoy this lesson with many of them participating by reading part of the handout.

Normally I leave right after groups but as previously stated, today I was staying until 6:00. It was very different staying at BPC this late because things very much calm down between 3:00 and 5:00 while patients have some down time before their evening groups. During these two hours, I began navigating my way through the computer system at BPC with Mary’s help. One of the programs that is on staff computers allows the staff to access their programs that they taught for the day, what patients were in them and it also gives a rating scale so each patient can get a score from that group. For attending programs and doing things such as participating and cooperating, patients get reports that aid in their recovery by letting everyone know how they are progressing toward discharge. In other words, the more a patient is on good behavior, the quicker they will be discharged. Whenever a staff member runs a group, they give each patient a score from zero to four and record how much time that patient spent in the group. These reports are then passed along to the treatment team. Since I had two hours to kill before going to the 5:00 group, Mary taught me how to work my way through the program and enter the information. I got all this done somewhat before 5:00 so I read up on more patient histories.

At 5:00, Mary and I headed up to Ward 75 (all women) to take the girls outside. While outside we walked around the courtyard, listened and danced to music and discussed many of the patient’s lives and their families. The patients seem to really enjoy discussing their life and families outside of BPC! They are very open to sharing information which also allows me to get to know them better!

Today I was back to my normal schedule at BPC. After attending the morning meeting, I went to my first group with Mary called “Wellness 101.” We had somewhat of a large group this morning with many patients coming from other groups to join ours. This morning, Mary prepared an article from the newspaper entitled “Dealing with Stress can be so Stressful.” The article was from the Buffalo News and discussed how trying to cope with stress and reducing stress level can consequently cause even more stress. After reading this article and discussing it, we asked every patient to come up with one way to cope with their stress. Answers we received were, for example: eat, sleep, music, poetry, martial arts, walking, and reading. Once we finished this task, we played some non-stressful music for the patients that you could hear in classes such as yoga. Several patients commented that they felt much more relaxed after this group.

My next group of the day was the “Shaping” group with Mary. We decided to take the all male group outside to enjoy the nice weather. After a small fall my one of the patients which resulted in Mary and I having to go back inside to fill out an incident report, we finally made it outside. I spent my time with one specific patient playing cards and walking the courtyard. This patient suffers from schizophrenia but has been doing well so his privileges are being reinstated. He is a card shark whose favorite game is rummy. I learned about his family and that they were coming to visit this weekend and bringing him his favorite food, chicken wings. It was nice to have 1:1 time with a patient who I have seen in many of my groups at BPC. He seemed to enjoy the time as well!

My first group after lunch was “Wellness Self-Management” with Mary. Normally, we get out the wellness books that discuss mental illness and are written by people who have suffered from it. Today, though, not many patients showed up for a variety of reasons such as their ward had a community meeting. So, Mary and I decided to let the patients who came pick their own activity. Mary ended up playing Scrabble with one of the male patients while I did beading with the two female patients. One patient in particular had trouble finding the exact color beads that she wanted to I rifled through the bead bucket and found the color while she actually beaded the necklace. This patient appears to suffer from schizophrenia with internal stimuli telling her to go after political figures such as the Clintons. Every time she is let out of BPC, she does not comply with her treatment plan and goes after the political figures. Furthermore, she often expresses thoughts about harming her family members.

My last group of the day was with Elizabeth and called “Humor Me.” We are still focusing on the show “Everybody Loves Raymond” but now we are centering on a specific character. Today’s character was Ray’s brother Robbie. We watched an episode in which Robbie is in bad economic shape so Ray and his wife loan him money. Instead of putting the money to good use, Robbie uses it to go to Vegas. We related this back to the patients at BPC by telling them that if family or friends bring them money, they should not go right down to the vending machine and spend it all on junk food. Instead they should save it for discharge.

Today at BPC, I was going to stay through lunch and read up on a few more patient histories since I enjoy doing this. I again attended the morning meeting and planned to spend the entire day with Elizabeth since Mary was off today and normally is every Friday. This is the first Friday that I have been here so I was very much looking forward to experiencing the groups that are ran today.

My first group was called “Quality Health and Wellness.” In the group we discussed the crisis that has hit the news in the past couple of days. The crisis that I am speaking about is the salmonella poisoning that has hit twenty-six states including New York. The salmonella is breaking out in ground turkey. Salmonella, I found out, comes from food that is exposed to animal feces. We discussed the signs and symptoms of it, as well as what the treatment process is and how it can be fatal in people such as children, the elderly, and those who have an immune disease. I was very interested in one of the men who participated in today’s group. Once a professor at the University at Buffalo, he now appears to suffer from paranoid schizophrenia. When discussing the salmonella crisis in the group, he told the group that he believes all of the food at BPC is poisoned on purpose. Furthermore, he will not sign any written documents or contracts at BPC because his delusions tell him that there are underlying things in the contract that he does not know about. He does not trust the wellness books we read and always is very suspicious of his fellow patients and staff.

My second group was “Problem Solving” or another “Shaping” group. We took the all male group outside and had everyone walk the courtyard since it was a nice day out. While walking, Elizabeth explained to me that these types of groups were for patients with a low level of activity and many of them have been here for quite some time. Because of the chance of a reward at the end of the group, it is supposed to stimulate them to participate in the activity. We do not want them sleeping on the grass or just sitting there. We want to stimulate them to keep busy. Almost every group member either walked with us or kept bust by talking to a staff member. Everyone was rewarded at the end.

My first group after staying through lunch was “Current Health.” Because we had a different group of patients, Elizabeth decided that she wanted to do the lesson on salmonella again since it is very big topic in the current health world right now. After discussing the article and highlighting the main points from it, Elizabeth had a food trivia game prepared. Questions were things such as “what fruit fell out of a tree onto Sir Isaac Newton’s head?.” Everybody said out loud what they thought the answer choice was. This was a fun way to get everyone’s brains working and to get every patient participating.

My last group of the day was “Recreation Exploration.” We again took our group outside. I spent part of my time discussing music with one of the patients and finding out that he adores the Beatles and has been playing the drums and the saxophone since he was younger. My other half of the time was spent walking with several patients around the courtyard while discussing the food at BPC.

Today was a fairly normal and uneventful day at BPC. As always I arrived at 8:00 to attend the morning meeting at 8:15. Besides going over the normal group schedule, the only other interesting event was that one of the patients had been granted a day pass to go and visit his mother but once he arrived home, he bolted. He has made several calls to his parents about his whereabouts but has no plans to return to BPC or even to Buffalo. He had already begun his trip across country. This patient suffers from paranoid schizophrenia that is worsened and brought on by drug use. Every time he came back from a home visit, it was necessary for him to give a urine tox to make sure that he had not been using drugs. He always seemed very guarded and suspicious but had hopes for a discharge so I can only hope that he tries to stay well because he is so young (twenty-five or twenty-six). I always enjoyed seeing and talking to him because he was so close to my age.

After the morning meeting, I attended my first group with Elizabeth called “Wellness.” The topic today was bee stings as we learned from the incident report that morning that one of the patients had been stung by a bee and that we had to take every precaution because many patients are allergic to bee stings. The article discussed the symptoms of bee stings, how a bee stings, how to remove the stinger and treatment for a bee sting. The primary way to remove a stinger is with tweezers but a credit card scraped toward the stinger or long finger nails can also be used. It is vital to get the stinger out quickly, especially if one is allergic so venom is not continuously released into the bloodstream. Treatment includes removing the stinger, applying ice, cleaning the area and using anti-histamines. Many patients paid close attention to this lesson and took it very seriously because they themselves were allergic to bee stings. One patient who normally just sits and listens even took out her glasses to actually read the article herself because she was allergic.

My next group was “Yoga and Relaxation” with Mary. We had our normal couple of girls this morning and we introduced some new poses such as “cobra pose.” It is very interesting to see the week to week improvement from the girls. Not only do they practice in their rooms in the morning when they wake up and are stiff but just watching them in the group, one can notice how much more balanced and relaxed they appear. After a half hour of yoga, we cleaned our mats, rearranged the chairs and went to rehydrate with some Kool Aid.

My first group after lunch was “Leisure Exploration” with Mary. We had quite a big group today but we did our best to appeal to everyone. We first passed out a sheet of paper that discussed leisure attitudes. An example of a question was: “My leisure time is my most enjoyable time.” The patients had a one to five scale ranging from strongly disagree to strongly agree. We wanted to stress to the patients about the importance of leisure time and how to balance the proper amount of both work and leisure time. After spending about a half hour with this, we allowed everyone some leisure time. Some listened to music, some read the Bible and others colored. I spent my time 1:1 with another patient who seems to do so well with individual attention. We began a big poster that was about her life. She had to write down information about her mother and father’s names and where she was born among other things. Apparently I was not giving her enough time between questions, though, because she looked at me and said “that she could just not be rushed!!!.”

My last group of the day was “Staying Well” with Elizabeth. We had a completely different group so we again discussed the packet on bee stings.

Today was another long day for me at BPC as I was there from 8:00 – 6:00 again. Even though this is somewhat of a long day, I really enjoy it because it is extra time with the patients and I get to see what goes on after 3:00 when I normally leave. We had our normal 8:15 meeting today which went by rather quickly because the daily groups were the only things that needed to be addressed today. After the meeting was done and before my groups started, I took some time to pick my groups for the day and to read the progress notes and movement summaries from yesterday. These summaries discuss meds being taken or not being taken, if any patient fell or was having pain and if there were any codes among other things. I like reading these summaries because it lets me know what to look out for with the patients. For example, if they have not taken their meds, we need to be extra careful.

When groups began, my first group of the day was “Recreation Exploration” with Mary. Part of my time was spent testing out our huge box of markers to see which ones were still good to use and which ones were too dried out to use. Mary is hoping to put in an order for new supplies so we wanted to see what we already had to work with and what we may need to order. After that, I helped one of the patients color signs for his room that had sayings on them such as “VIP – Very Important Patient.” He wanted to finish the signs during this group so I helped him along.

My next group of the day was “This Emotional Life” with Deeana. We decided to take it easy today since it was a gloomy day and everyone seemed to be down in the dumps. So, Deeana brought down cards, different pictures to color with crayons and colored pencils and some items to challenge the mind such as crossword puzzles and rubix cubes. Although we did not have a structured lesson planned, we wanted to keep the patients busy so they would not just sit there or sleep. I spent my time playing war with one of the patients. Another patient in the group seemed to suffer from schizophrenia of the paranoid type. She discussed with me how she could not go over to the Butler Building because she was scared that someone who controlled her feet would make her have a serious fall on the way over and she would be badly injured. Staff had to buy her new sneakers because she would not wear her old ones. She appeared to have many different habits because she was so terrified of being injured. For example, she moved a chair constantly so that she could see everyone around her and they would not injure her. Coloring seemed to relax her greatly as she was always carrying around a coloring book and crayons.

I chose to stay through lunch today and read through some more patient histories, as well as punched holes in many sheets that I had to go down and file in Ward 75’s charts later on. These papers were any changes to their daily schedules that they and staff had to be aware of. My supervisor wanted to put all of my time spent at BPC on Tuesdays to good use so I have started filing paperwork and Ward 75 was the first one to do.

After lunch, from 1:00 – 3:00, I had my first experience with a Treatment Team Meeting. In these meetings, different staff members that are part of the patient’s daily lives, get together and discuss how the treatment of specific patients is going. They discuss whether the goals the patients made for themselves and that the staff has made for them are being met, if a different course of treatment needs to start and when another review or discharge date should be set. We discussed four different patients today from the women’s ward or Ward 75. Staff included was the Psychiatrist, the Psychologist, the Treatment Team Leader, the Social Worker, the Nurse from the unit and Mary and I. After discussing each patient at length, we then brought that specific patient in to ask any questions they may have and they were then told about their treatment plans and if there were any changes to them. The team tries to stay completely positive with the patient and encourage them to work toward all of their goals.

I think that being a part of this meeting was one of my favorite things about BPC thus far because it allowed me to get a glimpse of the background work for a patient. There is such a process and a combined effort that goes toward working for every patient to get discharged and it was so nice to see this going into action. Everyone contributed during the meeting and bounced ideas back and forth off one another so each patient would have the best plan possible for them. The saying “two heads are better than one” definitely worked and applied to this Treatment Team Meeting!

After we finished discussing the four specific patients, a quick update was given about every other person on Ward 75. There was also a plan put into place for who would be reviewed at the next meeting. Meetings for Ward 75 occur every Tuesday at 1:00 and different patients are discussed every time.

After the meeting, I had time from about 3:15 – 5:00 to do some work for Mary. As I talked about before, I punched holes in schedules during my lunch hour. During this break, I went down to file the schedules in the chart. Mary showed me the exact place for them. After filing the schedules, I completed some more TSRs for Mary like I had last Tuesday when I was there late. The TSRs are the rating scale for group participation. After doing both of these tasks, I took a small break and then it was time to head down to Ward 75 with Mary for our 5:00 group.

For my last group of the day, Mary and I decided to take the ladies down to the basement. We met Elizabeth down there with her group as well. We put on the radio for everyone to listen to. Most of the guys played pool while the ladies played cards or read magazines. I played ping pong with one of the patients. This group was fairly low key which was a nice end to a long day.

Today at BPC, I was back to my normal hours. After the morning meeting and reading the progress notes and movement summaries, I attended my first group with Mary known as “Wellness 101.” This group is by far my favorite group of the week because we always have a very rowdy crew. Today was no different. Mary prepared a lesson about how safe one is outside the home. It was a total points questionnaire that asked questions such as: “Do you trust your instincts? Do you carry keys in your hands? Do you try not to walk alone?.” Points were added up at the end and one was rated as things such as “safety alert” or “bravo, keep up the good work.” Although the lesson began well, the crew eventually became very riled up. One patient in particular who appears to suffer from schizophrenia seemed to be having a very off day. He continued to walk in and out of the classroom screaming profanities and nasty things to no one in particular. He would calm down after a few minutes but would begin screaming again soon after. No one was provoking him but he truly was a distraction to the group. Although I do not get shaken up easily and have not since I have been at BPC, today was somewhat nerve-racking for me because the patient just continued to scream and yell and eventually he directed his anger at Mary and I when we started telling him to calm down or leave the room. Although I knew that I would no be harmed, I still felt very tense in the situation. But as our supervisor likes to say, “We did not sign up to work with girl scouts!”

My next group of the day was again with Mary and was the “Shaping” group. Since it was a nice day out, we decided to take everyone outside to the courtyard. We had a bit of a younger crew today so many of the guys got some of the basketballs out and either started a pick up game or just shot around. I really like to walk the courtyard with a certain patient at a time so I can try and get to know them better so this is exactly what I did. I walked the courtyard with three different patients throughout the entirety of the group.

After lunch, my next group was also with Mary and was called “Wellness Self- Management.” I have a favorite patient who comes to this group who always likes to do beading. Last week we made a green necklace so this week she decided that she wanted a pink one so we spent our time beading a pink necklace. Sometimes during this group, Mary and I bring out the wellness books that I have previously talked about and discuss them with the group. Many of the patients are not fans of the books so Mary and I put our heads together, after the urging of a patient for a composition notebook, and decided that maybe BPC should look into buying composition notebooks so patients can write their own recovery story and path to wellness. The patient seemed to really enjoy this idea so Mary was going to look into it.

My last group of the day was with Deeana and was my first time going to this group. It was known as “Life Roles and Goals.” We read and discussed a story titled “Tonya’s Story” which came directly from a previous patient at BPC who wrote her story in a “Goals” group. The story discussed her co-occurring disorders and how she finally decided to take control of her life and her destiny and get herself well again. I believe that this was a great story for the patients to hear because many do not realize that they are in control of their recovery so to hear that a fellow peer did it, can only motivate them to do it themselves.

I am becoming somewhat saddened because this is my second to last week at BPC. I am going to miss all the people I met and the experiences I was so lucky to accumulate. After attending the morning meeting and deciding which groups I would go to today, I went down to Ward 75 to finish filing the women’s schedules in the charts like Linda had asked me to do. I have gotten pretty good at navigating through the charts and figuring out what paperwork goes where.

My first group of the day was “Recreation Exploration” with Mary. Mary prepared a handout that was titled “Personal Leisure Activities Evaluation.” This worksheet asked patients questions such as: “list five activities you enjoy indoors, list five activities you enjoy outdoors, list five activities you enjoy that can be done both indoors and outdoors, list an activity you enjoy doing alone and list an activity you enjoy doing to relax.” I believe that the patients particularly enjoyed this because it allowed them to think outside of BPC and what they enjoyed doing before they were admitted to BPC and what they would again enjoy doing after discharge. I particularly enjoyed this group because one of the patients who is normally in the group. This patient spears to suffer from schizophrenia and often has grandiose thoughts about college at Harvard, as well as delusions of babies, angels and devils. She often stares off into space as if seeing some sort of internal stimuli. Today, though, this patient was very pleasant and a true joy to be around. She enjoyed talking about her family and her heritage and tried to engage the rest of the group members to discuss these topics as well. She especially wanted to know everyone’s name so she could address them as such. Although it was a pleasure to have her in my group today, she is proof about how much these patients cycle through good days and bad.

My next group was “This Emotional Life” with Elizabeth. I attend this group every week because the patients who are scheduled for it are always so animated. I guess the title is truly fitting for the group! Today is the anniversary of the death of Elvis so Elizabeth decided to dedicate the group to him. We first asked all of the group members if they knew what day it was and some of them did guess correct about Elvis. Elizabeth passed out copies from Wikipedia about his life and every time she discussed one of his songs, she would play a snippet of it from her CD collection. She truly loves Elvis! Being that this group is made up of older patients, they all seemed to know Elvis’ music. Many sang along to it, some hummed and other danced. Almost all made specific requests for songs. We really had a nice cooperative group in which most people participated.

I took a lunch break today because Mary was leaving early so I was not going to stay until 6:00 like I normally do on Tuesdays. I plan on staying until 6:00 next week on my last Tuesday at BPC. After lunch, my first group was “Recovery Happens” with Elizabeth. We continued on with the Elvis theme but since this group is for patients suffering from a mental illness AND a substance abuse problem (co-occurring disorders), we focused on the controversy surrounding Elvis’ death. This controversy was that Elvis died of a drug overdose. Elizabeth printed off several articles from the Internet that discussed the death of Elvis. We read and discussed these articles as a group and patients weighed in on how they believed Elvis died. We then discussed a bit about his early life as a famous star. Finally, for the last five or ten minutes of the group, we played some more hits by Elvis at random or we took requests from the patients.

For my last group of the day, Deeana and I decided to take our group outside. It was a gorgeous day out and many of the other groups were planning to go outside. I spent my time outside doing two activities with the patients. First, I walked around the perimeter of the courtyard with a few of the patients and then I played a few games of checkers with a different patient. Unfortunately, I got my butt kicked and lost all three games! I guess I did not realize how rusty I was!

Today was another fairly normal day at BPC for me. After the morning meeting and reading the movement summaries from the last two days, I went to my first group with Mary. This group was “Wellness 101.” In today’s group, we watched a video on stress. The video gave tips on how to relax and live a stress free life. One of the biggest tips to do that was to do something for someone else because this makes anyone feel good about themselves. I believe that many of the patients here would benefit from this because almost all of them could use a positive boost. The video also have tips on activities to reduce stress such as meditation and things to cut out of your life for less stress such as alcohol or coffee. I think that the patients benefitted from this video because they all need to learn how to manage or greatly reduce their stress level so they can begin the steps toward discharge.

My next group of the day was “Shaping” with Mary. It was another beautiful day in Buffalo so we decided to take the guys outside to enjoy it. All the patients seem to love going outside and many of them beg for us to take them with if they are in a different group that is not going outside. Once we got out there, many patients stayed very active by walking or playing basketball. Others preferred to sit quietly and read a magazine or bob their head to the music we played. Since all of them, with a little urging, kept busy for the full time, they were rewarded with a piece of candy upon coming back inside.

After my lunch break, my first group was “Wellness Self-Management” with Mary. Like I have for the last three weeks, I pretty much worked 1:1 with one of the patients doing beading. I have been told that this patient does much better in this type of setting so I really enjoy doing this. Although this patient strung most of the beads on her own while I picked out the exact color she was looking for, she said that her hands got tired toward the end so I finished the necklace for her while we chatted. There were a few other patients in this group who either read the paper or a magazine.

My last group of the day was titled “Living with Respect” and it was being run by Mary because she had been asked to pick it up for someone who was out sick. Since this was last minute, though, we had nothing planned and decided to again take the patients outside to enjoy the nice weather. This group appeared to be much less active and many of them just sat and one of the picnic tables not doing much of anything. I think, though, that they may have been enjoying the sun. Some patients danced around and sang to the music and other enjoyed the magazines. I spent my time walking around the courtyard with two of the patients.

Today was my last long day at BPC. As with the other two Tuesdays that I stayed until 6:00 on, I planned on staying through my lunch and keeping myself busy. I always enjoy Tuesdays here because after the morning meeting, at 9:00 a “Goals” group is run on Ward 75 that I always like attending to see what type of progress the ladies are making toward their goals. When I arrived down there with Mary I found out that one of the ladies had been discharged to family care which was absolutely great to see that recovery is within reach for so many of these patients if they stay positive and work toward the goals they set for themselves and the goals their treatment team sets for them. Almost every patient participated in the goals group today whether they did on their own accord or with some coaxing from Dr. Reynolds. Some goals that I heard included going to all programs, participating in programs, and the ever popular, getting discharged.

After “Goals” group, my first group of the day was “Recreation Exploration” with Mary. As always, the goal for the group was to find a leisure activity for thirty minutes to keep yourself busy. The patients in this group all seemed to choose different activities. One female patient chose to do crossword puzzles and word searches about summer, one of the male patients read the paper and a different male patient played five hundred rummy. I chose to share the paper with the patient because I did not have any idea how to play rummy. One patient in particular seemed to be having a lot of trouble with her medication today. Apparently she was given a new shot of medication this morning because her doctor is seeing if something different will work for her. At first she was constantly drooling and falling asleep. Once we tried to wake her up, she said she felt nauseous and began whining. Toward the end of the group, she could not sit still and was moving from chair to chair and hitting everything she passed by. This just proves that any little tweak in medication can have such drastic changes on a patient.

My next group of the morning was “This Emotional Life” with Elizabeth and Deeana joined in. Elizabeth prepared an article titled “How to Find Your Emotional Balance” that came from the Oprah Magazine. The article discussed several different areas, the first being that every person has a different level of emotional balance. Much of happiness, more than half to be exact, is genetic but the rest can be learned. People need to learn how to navigate life’s emotions without losing their mind. An analogy for this is that emotional balance is like mastering a surfboard. One needs to learn how to hone life’s gnarliest waves without wiping out and also catch the good waves and ride them to shore. The next section of the article discussed the keys to this emotional balance. Several mood-steadying strategies were listed such as daydreaming and listening to music. The last part of the article discussed techniques to practice if one suffers from mild depression or anxiety. Some of these recommendations were yoga and reorganizing. I think that the patients really enjoyed this article because balance is something that they always struggle with. There is a happy medium for every person and it is just a matter of finding it for each person. Hopefully this article aids in that.

During my lunch today, I caught up on some movement summaries that I had missed from last week. I also read a few more patient histories that I had been interested in reading. I have enjoyed staying through my lunch at times because it gives me a chance to catch up on these types of things that I often do not have time to do before or between groups.

After lunch, I made the decision to attend another Treatment Team Meeting with Mary. I specifically wanted to go to this one because a certain patient was being discussed and I wanted to hear about her discharge plan and what the treatment team thought of her. This patient was the first one discussed and it was fascinating to find out about her life before BPC. Although she is fairly young, she has been at BPC for most of her life. When she is in the deepest part of her illness, she often discusses angels, devils and babies. I learned in this Treatment Team Meeting that she is always discussing these things because as a child she suffered sexual abuse at the hands of many different family members. She believes that her life ended at this point and that she has went to heaven (angels) or hell (devils). Furthermore, because she was so young at this point, she identifies herself with babies.

A few other patients’ treatment plans were discussed but nothing was as interesting as what I just discussed. Also like the last Treatment Team Meeting that I went to, we either confirmed or denied patients requests for increased privileges and gave a shorter summary of every patient on Ward 75.

After the Treatment Team Meeting, I had two hours to kill before going down to Ward 75 for a group. Because this was my second last day at BPC, Mary decided that she wanted to take me on a tour of some of the outpatient homes for prior patients at BPC. We decided today that we would head over to RCCA and make a few other stops during our lunch break on Thursday. RCCA is on the grounds of BPC and houses approximately one hundred people. Rooms at PCCA are mostly doubles with a few singles mixed in for those who get lucky enough to get one. There seemed to be more male patients there than female because one whole floor of the three floor building was dedicated solely to males. RCCA appeared to be very nice with all aspects being neat and clean. They put in ping pong tables and pool tables, as well as many TVs to amuse the patients. The lady who gave us our tour told Mary and I that many of the patients who make the transition from the Strozzi Center to RCCA have a very difficult time because there is no where near the amount of structure. Patients at RCCA have their whole day to themselves unlike those at Strozzi who attend programming or other activities to keep them busy. At RCCA, staff wakes patients up at 9:00 and patients have all day to do whatever they like whether that be bowling at New Beginnings or attending programs at the Butler Center. I think that many patients balk at the idea of going to RCCA because it is still on BPC grounds and they want to get as far away as possible once discharged but it is such a nice option for patients to begin rebuilding their lives.

From 5:00 – 6:00, Mary and I kept it real simple with the ladies from Ward 75 and just took them down to the basement. One of the male wards was down there as well so it was nice for everyone to interact by talking, playing pool or watching TV while we played music for them.

Today was a very sad day for me because it was my last day at BPC. I have had such an incredible experience and it is sad to see it come to an end. At the morning meeting today, several members of the staff brought in beverages, doughnuts and bagels because it was my last day. It was so nice to see that people remembered that it was my last day. We all ate breakfast together and then headed to our first group.

My first group of the day was “Wellness 101” with Mary. When I first came into the group, one of my favorite patients had a goodbye card for me that she made, as well as a stuffed animal lamb she named “Sam.” It was especially hard to say goodbye to this patient because I had formed a close bond with her. She was the same patient that I did beading with every Thursday. In today’s group, Mary prepared a handout on what a person would do with two ten million dollar gifts. One gift was restricted for personal use only and the other gift had to be given away. Each person was given time to think of an answer and then had to share it with the class. Many different answers were shared such as putting the money in the bank, traveling, buying a house and going to Las Vegas to gamble it all away. Giving it to charity was also a very popular answer. After we finished this exercise, we had some time left to just talk as a group.

After this group, I had the “Shaping” group that we decided to take outside since it was another nice day. Although some of the patients complain that they always go outside (the majority love to), time is winding down and pretty soon the weather will not be conducive enough to go out to the courtyard. Most of the patients today just wanted to sit and talk and ask me what I would be doing when I finished up at BPC. It was nice to have a relaxing group and everyone was given candy at the end for participating.

I decided to stay through my lunch today since it was my last day. Mary decided that she would take me to another outpatient residence. This one was called SOCR (State Operated Community Residence) Olmstead and was located farther from the Strozzi Center than RCCA was. This residence was a bit different from RCCA that I saw on Tuesday. The motto of this residence was: “Ask not what SOCR Olmstead can do for you but what you can do for yourself.” Their goal is to help patients realize that their recovery is in their own hands and if they want to get better, they need to focus on that goal. An example of how they do this is that they set up certain medication times in which patients need to come to a small window to get their meds instead of staff bringing them to the patients. This outs much more responsibility on the patients. SOCR Olmstead is only a twenty-four bed housing with mostly doubles but again a few singles. It is two floors that are co-ed but males and females have separate bathrooms. There are sitting areas with TVs and computers on both floors and the basement has a ping pong table and a Wii gaming system among other things. Just like RCCA, though, patients find ways to amuse themselves throughout the day. I really enjoyed seeing another outpatient housing option and on our walk back to the Strozzi Center, Mary and I walked completely around the Richardson Complex which was the original housing at BPC. Back then it was known as the Buffalo State Asylum for the Insane and housed thousands of patients.

After lunch, I was very surprised to find out that Mary had planned an ice cream social for the rest of my afternoon there as a thank you and goodbye. Many of the patients who were free to come joined us and we spent the rest of the afternoon chatting about my experience and my future. I am very sad to leave BPC and hope that one day I will be back to visit or even work there like I told many people when I said my goodbyes!

I have absolutely no regrets from my experince at the Buffalo Psychiatric Center. I was placed in an area where I would have a daily interaction with patients like I had requested and hoped for. I was given the opportunity to see mental illness first hand and have realized that this is an area that I would love to work in for the rest of my life!

In regards to how my course work at Canisius related to my experiences as BPC, I believe that the first way this could be shown is a class that I took my sophomore year. In the spring of 2010, I took Abnormal Psychology with Dr. Sanders. In this class, we learned about several different disorders that ranged from obsessive compulsive disorder to schizophrenia to borderline personality disorder. We were taught the symptoms that a person affected with a specific disorder might show based on the information in the Diagnostic and Statistical Manual of Mental Disorders and how to react around these patients. Because of this information that I received in Abnormal Psychology, I felt that I was very prepared for my experiences at BPC. When reading patient histories, I was able to the axis criteria that was mentioned and why it was placed in a specific axis. Furthermore, when meeting with a patient for the first few times, I was able to form a hypothesis about what disorder they might suffer from based on their behavior, personality, or the symptoms they showed.

The next way that I feel my course work related to my experiences at BPC was when I took Biopsychology of Stress with Dr. Putnam in fall of 2010. As I discussed in many previous entries, stress plays a major role in the lives of many patients at BPC. Patients are taken away from homes and families and put on a very strict treatment schedule with the hopes of helping all patients to heal. Many classes in the treatment malls were dedicated to stress and how to recognize what stressors one might have, as well as activities one might be able to partake in to cope with stress and eventually be rid of it. Dr. Putnam’s class prepared me in the area of stress by teaching me what outward and inward physiological reactions one might suffer from when under great amounts of stress. Also, Dr. Putnam’s class taught me the history behind stress which was interesting and informative to share with patients.

Another class that I felt could be integrated into my experiences at BPC is a class that I completed in the fall of 2010. Bio-medical ethics discussed many of the ongoing ethical problems in healthcare today. Arguments were presented for both pro and con sides with the hopes that one could make a decision about how they felt on certain topics. While working at BPC, many ethical topics came up such as electric shock therapy and straitjackets. At one point in time, both of these treatment forms were widely used for patients placed in psychiatric care. Today at BPC, though, other healthier forms of treatment are used with the hopes that they show a better outcome for the patients in the end.

The final class that I feel relates to my experience at BPC, is the class that I am enrolled in right now known as Cultural Psychology. In this class, one of the goals was to discuss how psychological concepts can be transferred throughout all cultures. It is very important throughout all aspects of life today to be sensitive to other cultures and their beliefs, values, and morals. This could easily be applied to my experiences at BPC because many patients at BPC were not from the United States. For example, one patient was from Jamaica while another man was from Russia. Although they spoke some English, it was very limited and often a translator was needed to intervene. These patients had many different ideas about life from where to sit in a room to how to address a newcomer. It was very important at BPC to remember to respect different cultures and ideas.