Danielle was in her late 20’s with two young children when she experienced her first on-set of psychosis. She was hearing voices that would not stop, including occasional command voices, telling her to do things she did not want to do. Being out in public resulted in feelings of paranoia and intrusive thoughts relating to trauma she had experienced would result in daily flashbacks. Eventually, two months after her on-set of psychosis, the resulting functional impairments caused Danielle to lose her job. She was subsequently hospitalized twice with severe depression and feelings of extreme overwhelm associated with her symptoms.

Patty, case manager with Buckelew Programs’ Independent Living Program in Sonoma County, first met Danielle in June of 2019. “She was pretty shut down, with a flat presentation and minimal verbiage,” says Patty. “And because the voices she was hearing made her afraid to wash her hair, for the first two years of our meetings, Danielle would come to appointments wearing a beanie which she wouldn’t take off.”

As debilitating as her illness was, Danielle was very fortunate to have strong family support and a solid work history. Her on-set of psychosis came at a time in her life when she had already been successful at work; knew her capabilities and had mastered many life tasks. She remembered what that felt like – to be independent and a contributing member of society – and that was a place she wanted to inhabit again.

When Danielle first connected with Buckelew Programs, she was living with her parents but wanted to learn how to live independently and be successful. She wanted employment and to possibly pursue a college degree. Her treatment plan involved learning new skills that would diminish anxiety responses and build self-confidence regarding her intent to return to work and school. Organizational skills and routines would provide structural support to reduce feelings of overwhelm and fear as she worked towards achieving her goals.

“Patty helped me relearn how to live my life,” says Danielle. “How to stay organized, practice good hygiene and keep my house clean. All skills that I had prior to my breakdown that I needed to master all over again.”

Two years into her treatment, Danielle worked with Patty to help guide her through the application process to get her own apartment. Through that process and interviewing with the property manager, she secured a lease and began to gain confidence that she could live independently.

“I encourage my clients to use effective communication skills to advocate for themselves, especially when talking to their doctors,” said Patty. “Over Zoom, it’s can be very challenging for a physician to properly assess a patient, unless they are giving input. Through these skills learned from her case manager, Danielle’s dialogue with her psychiatrist became more articulate and helped him to understand her challenges.

Although Danielle was hearing voices almost constantly, they weren’t menacing and in fact had become her everyday companions. But she also knew that if she kept interacting with them, the likelihood of achieving her goals and improving her social skills would be compromised. Patty explained that Danielle wanted to let go of the voices but wasn’t able to tolerate high doses of the medication. “Many people who experience psychosis learn to live with their voices to balance a lower dose of medication side-effects,” said Patty. Danielle found that what also provided her solace and supported her recovery was her creativity and love of writing.

Danielle started attending a local peer-run Wellness Center that offered social skills classes and opportunities to practice being out in public and successfully interacting. She enrolled and excelled in the Peer Education and Training Program, a 15-week program focusing on successfully interacting with peers and helping them with their social skills, goal achievement and recovery.

The training concludes with assistance in securing an internship within the community, where employment skills as well as social skills can be further developed. Danielle felt ready for that next step. “The gradual change in her medication also worked to lessen the internal stimuli to the point where she practices routine personal hygiene,” says Patty, “Which eases her social anxiety and promotes community integration.”

Danielle was successful in securing an internship with Buckelew Programs in Santa Rosa, which involves continued training (180 hours) to eventually become a certified peer mental health counselor. She is also enrolled at the junior college and is taking a class, a first step in possibly pursuing a degree. Danielle sees her family and children often (her parents and the father’s parents share custody), is enjoying living independently and being back in the workforce.

“Buckelew Programs provided guidance, support and encouragement so Danielle could pursue her goals and continue with her recovery and growth,” says Patty. “Her progress has been inspiring to watch. Now she wants to help others and pay if forward.”

“Having Patty and Buckelew Programs in my life has meant a great deal to me,” says Danielle.