Case Study 2

Julie, mid 40’s

Behaviours of concern: Regularly taking things from people, blaming others

Background: Julie is a woman in her mid-forties who has Down Syndrome. She is a friendly, artistic, sensitive, and gentle natured person who is very connected to her large family. She still grieves for her mother who passed away several years ago. Julie is employed and catches the train to and from work independently. She has various interests including cooking, drawing, and getting dressed up and going out to community events. Julie lives in supported independent living accommodation.

Julie has a diagnosis of kleptomania; she takes things that do not belong to her from others and sometimes from shops or work. Julie will often throw these items away or give them to someone else. She also may blame others for taking the items. This behaviour occurs about 3-4 times per week.

Assessment: Positive Behaviour Support was introduced to investigate opportunities to address Julie’s behaviours of concern by developing her strengths, promoting positive environmental change strategies, and supporting her network to meet her social needs. Following data collection and analysis (talking with Julie and her support network, observations and analysis of behaviour recording charts and incident reports), it was found that Julie’s kleptomania is triggered when she is experiencing symptoms of depression. The behaviour is often opportunistic when Julie is unsupervised or when she is experiencing anxiety or if her feelings are hurt. The behaviour causes Julie distress after the event and can upset others, whose items she has taken. Julie is less likely to take things that do not belong to her when she is socially engaged, her emotional needs are met and when she is supported in the community by staff that know her well.

Strategies to improve quality of life: Emotional regulation is important to reduce Julie’s behaviours in relation to kleptomania and staff have increased understanding of the need to encourage Julie to talk about how she is feeling. It is important to validate Julie’s emotions and to reassure her and to always interact in a positive and authentic manner. She also needs high levels of social interaction and so staff engage her in daily activities. Routine and structure are important for Julie so visual tools and schedules were developed to help Julie and staff plan the day and schedule meaningful social engagement. Her health and wellbeing are also highly important to maintain and increase Julie’s quality of life. Staff have been trained in how to detect and respond to changes in Julie’s mental health and presentation, which reduces the frequency and the severity of Julie’s depressive symptoms.