Reflections on Home-Based Care

by Molly Mayerson, LICSWVermont

I began my career in social work on a youth mobile crisis intervention team.  Our stated mission was to implement creative, community based stabilization services that addressed the needs of the whole family.  Sent out in pairs, we would go wherever the call came — from developing a safety plan on a house boat to assisting a parent in coaxing their teenager out of a bathroom.  No two days were ever the same.  During this time my belief in the efficacy of home-based care was strengthened.  Home-based care is, both literally and figuratively, meeting the client where they’re at.  By entering someone’s environment, we were able to assist in the provision of realistic and dynamic solutions in real time.  Clients often would say that with home-based care, they felt seen and heard in a way that differed from traditional treatment.  While we were on their turf, they felt in control of their treatment.

As my career developed and I transitioned to working with clients with eating disorders, I found myself frustrated by the lack of creative options for enhancing recovery.

Mobile crisis intervention.  Sober coaches.  Transitional living services.  Sponsors. All are possibilities for substance abuse and general mental health treatment.  Where were the options for eating disorder recovery?  Why did I see clients cycling in and out of traditional treatment centers without the progress many craved? Where was the in-between care?  I watched my clients become frustrated.  They were asking for more.

Remembering the powerful nature of my previous work in mobile crisis, I engaged a colleague and decided to do something.  We began to offer services such as in-home meal coaching, on-call family support, guided grocery shopping, and assisted meal preparation.  We encouraged clients, their families and their outpatient treatment teams to get creative in determining what would be most effective.  We created services to prevent need for admission to a hospital treatment center and services to successfully transition out of one.  Our clients were empowered by the multitude of options.  We tailored interventions to their environments and their specific needs.  We heard from clients that the often elusive road to recovery began to take on a more tangible form.  Clients and their families expressed a deep sense of gratitude for the services that complemented traditional eating disorder care.

As I write, I also feel an immense sense of gratitude.  Gratitude for the ways in which creativity can spark meaningful change.  Gratitude toward families for letting me into their homes and lives in a powerful way.  Gratitude that clients are believing in their hearts and minds that full recovery is possible.  And finally, gratitude to CNC360 for believing in the power of home-based care and working to expand and enhance these services!