Posted 17th November 2011
We are very pleased to announce that Sian Gouldstone of Harrison Associates won this year's award.
Sian Gouldstone from Harrison Associates won the award this year for her outstanding work. The other finalists were Emma Baker from Proclaim Care, and Claire Morris from Corpore.
Here is the Case Study which supported Sian's nomination;
For Harrison Associates, Sian Gouldstone specialises in neurological cases although she has a wide experience. In this case she helped a man whose pre-existing psychological difficulties were exacerbated by a brain injury.
Sian has been working with Alex* a man in his early 30s who has a brain injury following a road accident. He had a troubled family background and had been in prison for assault. When Sian first met Alex he routinely slept with a large knife by his bed, had a CCTV camera installed covering the street and only went outside early to walk the dog and visit his sister. Social Service personnel refused to visit him. His anxiety was realistic (he had been attacked by his ex-girlfriends’ family) but his injury gave him paranoia and inability to control his violence.
After Alex’s injury he underwent rehabilitation, from which he absconded to return to his mother’s house. He was discharged from the service and received no input for over a year. Alex’s behaviour became increasingly aggressive. He had been assessed by a social worker/psychiatrist and had been given a brain injury nurse but his needs were not being met.
Sian decided, with the aid of supervision, that she should work with Alex: ‘I was worried he would murder someone in the community unless we got him some help. Alex’s solicitor had organised an interim payment, but I found him difficult to assess and engage.’
Sian did manage to build a constructive relationship with Alex and he did respond. However, one Saturday morning his sister rang Sian to say that her brother had attacked her. ‘The police weren’t able to section Alex but I spoke to him and he agreed to be admitted to a psychiatric unit. However he fell between agencies and no one wanted to take him.’ Sian spent the whole day on the phone and finally got him admitted to a local unit.
Gradually, week after week, trust was built. Alex trusted his solicitor, and was able to start trusting Sian: ‘It’s because I’m not “treating him”. He sees me as an advocate for him.’ Sian organised interviews with two psychiatric neurological specialists and helped Alex to choose the less authoritarian one. She accompanied him to meetings.
Meanwhile the ‘honeymoon period’ with the unit came to an end. Sian dealt with daily phone calls from Alex complaining about the staff. After a few months Sian and Alex had one ‘turning point’ phone call. He felt an OT at the unit had been sneering at him. Sian asked him whether it was possible that ‘People smile when they’re frightened’. He apologised to the member of staff and they now have a great relationship.
Alex is still in the unit. There are worries that if he re-enters the community, even supported, he will pose a risk to others. But he is making progress. He can go to local shops on his own, he has started to ride his bicycle. ‘He is a character,’ says Sian. ‘People either adore him or simply can’t work with him. Initially I took a reactive approach and once a relationship was established it was possible to be pro-active. It’s all about empowering him as an individual.’
*Not his real name
This year's conference was our biggest and best to date. We had over 70 more delegates attending than last year. This newsletter provides a summary of the speakers, information on the Case Manager of the Year Award, and details of our sponsors, without whom we would not...