Lancaster Physician Fall 2017 - 11

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Clinic for Special Children

A new partnership between WellSpan Philhaven and the Clinic for Special Children is
an example of how two established medical
organizations can come together to better
serve patients with complex medical and
behavioral health needs. For the past year,
Hailey has seen patients at the clinic twice a
month for therapy sessions. Her WellSpan
Philhaven colleague Dr. John Dolena, a
psychiatrist, has seen patients once a month,
prescribing and monitoring medications.
Hailey has learned to be comfortable in that
sometimes-crowded first visit with patients
and their families. She also has learned to
offer therapy that is culturally sensitive to the
Old Order Amish and Mennonite families.
She has learned to use appropriate language,
for example avoiding asking children what
makes them "proud," which is not a trait the
Plain community values.
"Instead, I might say, 'What made you
feel good about how hard you worked?'"
Hailey said.
Mental health services are just one specialty
service that the Clinic provides to its more
than 1,000 active patients, for which it serves
as a medical home. Adam Heaps, the Clinic's
executive director, said the organization has
built a coalition of specialty services, including
cardiology, audiology, orthopedic surgery,
ophthalmology, and nephrology, offering
them all under its roof. Plain community
families usually do not have traditional health
insurance and so often pay for services out
of their pockets. They don't drive cars and
may have to arrange for transportation to the
Clinic. The goal is to provide one-stop care
in an efficient manner.
The Clinic's partnership with WellSpan
Philhaven came about because some of the
genetic conditions the Clinic treats-including Maple Syrup Urine Disease, Fragile X,
and Prader-Willi syndrome-may cause
developmental delays and behavioral issues in
young patients. Other patients may experience
anxiety or depression while dealing with the
physical challenges of their conditions. The
children and their families have a need to
develop coping, social, problem-solving, and
communication skills.

I love that the Clinic is named the
Clinic for Special Children.

That is how these families
see their children.
"We recognized that mental health services
were a need for our patients," Heaps said.
"Pediatric mental health providers are few
and far between. Philhaven, as a prominent
mental health provider in the area, was the
obvious partner to help us with that."
WellSpan Philhaven works to integrate
behavioral health with physical health
services in local communities across a
five-county region. Its clinicians not only
work in behavioral health inpatient units
and outpatient therapy offices, but also in
homes, schools, and WellSpan's hospital
emergency departments and its primary
and specialty care physician offices. The
partnership with the Clinic is a continuation
of its work to improve mental wellness in
southcentral Pennsylvania.
At the Clinic, Hailey sees a range of
patients, from 2-year-olds to young adults.
Most of their families have never experienced
therapy and are sometimes a little nervous,
but they trust the staff at the Clinic and are
willing to try.
"As a therapist, I find it very encouraging
that multiple people are learning and working
with the children," Hailey said. "Most therapy
interventions work best when parents and
family members are heavily involved and
children have limits, structure, and a lot of
emotional warmth and support.
"A lot of these children have really strong,
stable family support systems and built-in support from their family and church network.
When they start to learn these specialized
skills-and everyone is learning them-they
work extremely well."
For example, Hailey worked with a little
boy who has Prader-Willi, a genetic condition
resulting in delayed development, behavioral

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PHYSICIAN

challenges, and an insatiable appetite, and that
can lead to obesity. With his family, Hailey
developed a stoplight system for foods, labeling them as red, yellow, and green. If the child
reaches for red-light foods, the family says
in a loving way, "Whoa! Put the brakes on!"
Hailey and Dolena worked with a little girl
with a congenital genetic issue, characterized
by loud outbursts and aggressive behavior,
offering behavior strategies and medication
management. The girl now can get along with
her siblings for prolonged periods, a "dream"
that her family had for the child.
With other families, Hailey offers coping
skills that are appropriate to their culture,
encouraging children to spend time with
animals on their family farms and to keep
a journal or scrapbook to help them handle
their emotions. Young women in Plain communities may reach out to others by writing
"circle letters," which travel from person to
person. Prayer is also a cherished way to cope
with feelings.
"Jen works with families to help them
understand the child and interact with the
child in a way that is helpful to everyone,"
Heaps said.
For her part, Hailey has been struck by
what she calls "the beauty of family" at
the Clinic.
"I love that the Clinic is named the Clinic
for Special Children," she said. "That is how
these families see their children. They see them
as truly gifts from God, and they wouldn't
have it any other way. They want them to
lead a happy and productive life. They see
their unique differences as special."

Table of Contents for the Digital Edition of Lancaster Physician Fall 2017