Lara’s history

Lara* struggled with obsessive compulsive disorder (OCD) for years and had input from specialist provision in the community and a previous admission at another adolescent inpatient unit. Lara’s day would be dominated by OCD rituals that she would struggle to manage. She engaged in evidence based treatment for OCD called exposure and response prevention with some success, although she still struggled with her OCD.

She hadn’t properly talked about it, but Lara also experienced significant trauma in her life and would later go on to talk about three distinct traumatic memories that she had between the ages of 7 and 11 years old. These traumatic memories were all of a sexual nature and unfortunately as Lara’s brain was trying to process these, her OCD was getting worse.

Lara developed beliefs that she was a bad person and that, in her mind, was likely to cause other people sexual harm. Nothing could be further from the truth, but this was how she saw herself at that time. The shame associated with these thoughts prevented Lara from discussing this properly with anyone and her negative beliefs about herself intensified to the point where she started to self-harm and have suicidal thoughts. A crisis admission was arranged to an adolescent unit but unfortunately this planned short term admission ended up being longer than anticipated due to her risk escalating quickly within an inpatient setting.

When Lara came to us

Lara arrived on Unicorn Ward, a psychiatric intensive care unit at Cygnet Hospital Sheffield, due to her risks escalating whilst at another hospital. Lara was intent on harming herself and ultimately ending her life. When Lara came to us it was clear that she was struggling, but it was unclear what it was that was driving her risk i.e. why was Lara so intent on causing herself harm.

Lara’s care

Lara worked well with the multi-disciplinary team on Unicorn Ward on risk management strategies and coping skills so that she was able to manage her self-harm urges more effectively, and increase the amount of time between incidents of self-harm.

The road was not a linear one and there were times when Lara felt hopeless, and times when she was placed on continuous observations for her own safety. However she was also able to build up some positive therapeutic relationships with some of the support workers and psychology team which allowed Lara to begin to give some initial details of the traumatic experiences she had gone through.

“It’s been a hard journey to get to where I am now but things are coming together and feeling positive. I’ve been seeing all my friends and family and going on holidays that I never thought I would be able to go on. In my spare time I volunteer at the blue cross animals centre and spend time with the cats and dogs which always puts a smile on my face.”

It was not until Lara stepped down to Pegasus Ward, our general adolescent unit, at Cygnet Hospital Sheffield, that Lara discussed the full extent of her traumatic experiences and a full understanding of the interaction between her OCD and traumatic experiences was able to be realised. Lara engaged well with family therapy and worked towards being able to share how she felt with her parents who responded in exactly the way she needed them to, offering love support and reassurance.

Lara continued to work with the nursing team in order to reduce her level of observations and other restrictions that had previously been in place due to heightened risk. She would often create her own care plans and come to ward rounds with her own ideas about how she wanted her care to progress. Lara also contributed to the development of the service by contributing to the reducing restrictive practice initiatives.

Lara today

Lara is now living back home with her mum and dad and working with her community team who have given her lots of support. She has recently started trauma therapy and is receiving lots of help with this. Lara has a good therapeutic relationship with her Care Co-ordinator and says that talking to people is becoming easier every day.

“The best experience I have had so far in recovery is becoming independent again. For ages, I was unable to do what I want and when I want , but the feeling when I can get out of bed in the morning and decide what I want to do without too much worries is so amazing. I just want to keep moving forward and plan for the future.”

Lara has recently enrolled in college and is starting her nursing access course soon which she hopes will lead to a place at university, which she is very excited about! We are delighted to see the progress Lara has made and would like to wish her all the best with her studies and for the future.

^{*Name has been changed to protect their identity.}