Building an Ecology of Support: A Case Study of One Young Woman with Severe Problem Behaviors Living in the Community

Abstract

This case study describes 30 months in the life of a young woman with a history of life-threatening self-injurious behaviors (SIB) who moved from a large public institution to her community. Quantitative and qualitative research methods were employed to provide a nonexperimental description of her behavior and lifestyle in the community. Quantitative measurements included: (a) activity patterns, (b) social network, (c) self-injurious behaviors, (d) aggression against others, and (e) staff changes. Qualitative results emerged from semistructured interviews and participant observations conducted over a 6-month period. Together, these data revealed a young woman actively involved in a lifestyle characterized by an increase in the frequency and diversity of activities performed in the community. Problem behaviors occurred at low levels for extended periods, yet there continued to be times with major regression. Qualitative results also indicate a general reduction in the intensity of self-injurious behaviors. Results are discussed in terms of the importance of multicomponent positive interventions, the need to design environments that promote lifestyle changes, and the value of collaboratively employing quantitative and qualitative research methods.