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Hallowsgate Hospital,
1507 Slaughters Creek,
Cabin Creek, WV



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 Joleen MacMahon

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Joleen MacMahon

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Join date : 2012-10-29
Age : 22

PostSubject: Joleen MacMahon   Mon Oct 29, 2012 7:13 pm



MacMahon, Joleen "Joey"


This transfer form will be completed by Dr. Adkinson from the Wilfred Institution

      D.O.B: 22/09/1994
      AGE: 18
      GENDER: Female
      STREET ADDRESS: Wilfred Insitution, 6574 Wilfred Way
      TOWN/CITY: New York City
      STATE: NY
      HEIGHT: 4'10
      WEIGHT: 90
      ETHNICITY: Caucasian
      DISTINGUISHING MARKS: 5 inch scar on left side of abdomen, brown pear shaped birthmark on right thigh midway up outer edge.


_____________________________________
Medical History

Do you have any ongoing medical issues for which you require treatment or medication?:

Joleen has genital Herpes Simplex Virus type 2.

Are you aware of any allergies? If so, please list allergy, age of onset and any medications or treatments you require or receive:

Patient is allergic to strawberries and fish.

Have you had any surgeries or invasive procedures in the past? If yes, please list reason and approximate age of procedure:

D&C, miscarriage of pregnancy, age 15.

Do you take any medications or supplements daily? Do you follow any treatment plans? Please list medications or treatments, and reasons below:

20 mg of Lexapro once daily
1 mg of Klonopin before bed.
therapy 3 times a day.
Valtrex administered when herpes outbreaks occur.


Do you use tobacco, consume alcohol, or use any other drugs including street drugs and/or prescription medications not prescribed to you? If yes, please list number of packs a day, number of drinks a day, and/or drugs consumed below:

Before committed was hesitant to admit to frequent abuse of alcohol and narcotics. Must be monitored with klonopin as patient has tried to hoard before.


_____________________________________
Psychiatric Screening

Please describe, to the best of your ability, your emotional and mental state of well-being:

Patient refuses to believe that abuse happened, acts out in ways of extreme sexual deviance or aggression. Her outward attitude and personality often come off as brash and overwhelming. She is still in extreme denial of abuse by her foster father.

Have you been diagnosed with any psychiatric or psychological ailments? Please list any diagnoses below, and the treatments or medications prescribed to you. Please include name of medications, dosage, and number of doses per day:

Joleen still has problems accepting there is anything wrong with her behavior. She has been diagnosed with Stockholm's syndrome/hyper-sexuality. Patient was severely abused by foster father over a course of 4 years. She does not feel that anything that happened was wrong and often feels we are lying to her about things. Suffers extreme night terrors more than 5 times a week, assumed to be trauma related.

Have you ever been hospitalized or referred to regular outpatient care due to these ailments or associated incidents? If so, please note where, and at roughly what age:

Joleen was admitted after a failed suicide attempt in reference to being removed from a sexually abusive home. Patient overdosed on Vicodin and stabbed herself in the abdomen. She was never had a stable home and Wilfred Institution was the first stable environment she has been in. She was 16 years old at date of admission.

How have these ailments affected you and your life? Are there any major life instances you feel have been directly affected by these ailments, such as suicide attempts, criminal activities, etc?:

Joleen's state file is thick with instances of minor juvenile offenses, most of which stemming from activities such as shop lifting or public sex acts. Once she was removed from the care of her foster father and placed in a medical hospital for care she stole a bottle of Vicodin and a knife. She ingested the bottle before stabbing herself in the abdomen. Since then she has been institutionalized to try to rationalize her thinking.

What is your social life like? Do you have many friends or relationships? How are your family relationships?:

Joleen, who goes by Joey or Mac at our facility, has a very infectious personality and is often seen interacting with other patients. We do however have to monitor her closely with males. Often her behavior with them is inappropriate and she must be reminded to "know her boundaries." She has no known family and was raised in the foster system of New York City.

Do you believe your life circumstances have contributed to any ailments? If so, what circumstances, and why do you feel they have contributed?:

Joey's life of being bounced from foster home to foster home and back to the orphanage has giving her a deep rooted need to be loved. Obviously she has responded to this by searching for it in the wrong places. Rejection or refusal of her "love" seems to trigger her self defense of anger or violence. She has never had a normal relationship, friend or otherwise, in her life. We have been working on teaching her boundaries for different types of people she will meet in her life (Friends, employers, doctors, and eventually romantic relationships). I fully believe the patient's past has directly attributed towards her current situation.

If you could change one past event that has happened to you, what would it be, and why?:

Joleen has often stated that she has wished she could have known her biological mother or father.

Do you wish to rehabilitate from your ailment(s)? If so, how do you feel this would best be accomplished?:

We are working on making Joleen a functioning member of society as of now we feel that she is possibly a threat to herself or others based on her past actions. This, however, would require her to come to terms with her abuse.

_____________________________________
Environmental History

Where did you grow up? Please list the location(s) and describe what it was like growing up there:

Patient was a ward of New York State since birth. Bounced from foster home to foster home and often had extended stays in the orphanage, until being places with Dale and Melanie Dornth. Joleen was places in their care at 11 years old and was removed from care at age 16 when it came to light that Dale Dornth had sexually abused her from age 12 on. Though both Dale and Joleen claim the relationship was mutual, it has thoroughly effected her ability to function as a normal member of society.

What was your family life like? Did you spend much time with your parents? Do you have any siblings? If so, what are your relationships like?:

Joleen was shuffled from home to home, most of the time because she was found to be having inappropriate relations with the male children in the home.This lead to her being placed with Mr. and Mrs. Dornth, where the pattern of inappropriate contact continued with Mr. Dornth. She has never had any communication with her biological mother or family being that they are unknown.

What was school like? Did you have any problems? Did you enjoy school? What were your grades like?:

Joleen's grades were above average and she has continued to excel in our education program at the institution. She has received her diploma through our program three months ago.

Did you engage in any extracurricular activities, such as academic, artistic, or sporting clubs?:

Patient did not participate in any out of school activities.

What was work like? Did you have any problems? Did you enjoy your work? What were your coworker relationships like?:

Not Applicable for this Patient.

Have you ever been convicted of a crime or misdemeanor? If yes, please explain, list conviction, and list any sentences associated with convictions:

Joleen was on probation for one year after a shop lifting charge. She was caught stealing makeup and clothes from the local mall. She has had many run ins with security and charges are normally dropped.

Lastly, please tell us about yourself. How do you feel about yourself and what you have done with your life? If you have committed crimes, how do you feel about those now? What are your hopes for the future?:

We have tried hard and with some success to break through with Joleen about the trauma of her past. We are hoping that your facility can continue with success to help restore her to a working member of society. On a personal note, Joleen is a good girl, she has just been handed a hard card and is doing the best she can to get by. I will be sad to see her leave our care for another facility but hope she will flourish under your care.

_____________________________________
Out of Character Section

What are they not telling us? What secrets do they have to hide? What back story are we not hearing? This is where you can tell us all the things your character wouldn't put on an application, or others don't know.:

Joleen (Joey or Mac) is a girl who has just been dealt a rough deck. She is manipulative and conniving to the point most do not know its happening, She should be monitored closely with her interactions with other patients being she will try to use them all to her benefit. She fully believes that nothing that happened between her and her foster father was wrong and that he loves her dearly. (Even though he kept her cut off from society)

Your Nickname: Charity
Your Chatango Screen Name: ThisIsCharity
Your Character's Playby: India Eisley


Last edited by Joleen MacMahon on Tue Oct 30, 2012 6:45 pm; edited 5 times in total
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Nebby
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Posts : 114
RP Reward Points : 14
Join date : 2011-07-14
Age : 30

PostSubject: Re: Joleen MacMahon   Tue Oct 30, 2012 5:53 pm

THIS APPLICATION IS PENDING

This application is currently pending. Below, you'll find the reasons for this pending notice. If you wish to continue the application process, please follow the points laid out below by a member of Hallowsgate's staff.
_____________________________________________________________

  • Hello there! This is a very light pend so fear not! Joleen will be ready for the haunted halls of Hallowsgate very soon. So let's move right along!
  • Joleen needs a little clean up. There are a number of typos and misspellings throughout the application, as well as spacing errors and broken code. A proof read and a run through spell check will make a world of difference. In addition, the title of the application is incorrect and will need to be corrected.

_____________________________________________________________

Please reply to this thread once you have edited your application, to let us know, and a member of Hallowsgate's staff will review your application again at our next possible convenience.

This app was reviewed by: Nebby and Ghost.
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Joleen MacMahon

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Age : 22

PostSubject: Re: Joleen MacMahon   Tue Oct 30, 2012 6:49 pm

Okay! I proof read her again and ran her through spell check (I'm so sorry I forgot!) and changed the title. If you need me to do anything else just let me know!

_____________________________________________________

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PostSubject: Re: Joleen MacMahon   Tue Oct 30, 2012 7:05 pm


________________________________________________________________________

MACMAHON, JOLEEN


    DIAGNOSIS(ES): Stockholm Syndrome, Hypersexuality
    WARD: Female
    DORMITORY: 06
    BED: 01
    THERAPIST: Dr. Finn McAlister


________________________________________________________________________

OOC - BEFORE YOU BEGIN PLAY

Before you begin play, you must complete the few steps listed below:

  • Sign up for the Hallowsgate Patient membergroup HERE.
  • Sign up for the who plays who list HERE.
  • Sign up your play-by on the face claim HERE.


Don't forget to familiarise yourself with the pertinent patient handbooks and other in character information that you'll need to reference for play, and have fun!
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Dr. Anita Forrester

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PostSubject: Re: Joleen MacMahon   Tue Dec 04, 2012 12:44 am

THERAPY NOTES
_____________________________________

    Date: 12/01/12
    Attending: Dr. Anita Forrester
    Session With: Dr. Anita Forrester
    Session: Group Therapy


Therapy Notes: In today's session, the topic was positive and negative emotions, and the patient's experience with each. I had them write down both the most positive and negative emotion they experience and mix them in with a few emotions I added myself. They were then asked to draw out a slip, and describe their experience with whatever was written on the slip. Rather than have them draw one positive and one negative, I left it to chance what they would get, as I am interested in hearing about all emotions they feel and how they affect them.

Joleen was an interesting case to have in group, as she was very different depending on who was speaking. She greeted one of the other patients, Quincy, although she called him Paris, and greeted me, using the prefix Ms. rather than Dr. Since she is my patient, I didn't mind that she address me in such a way if it makes her more comfortable when talking to me. She introduced herself, pointing out that her accent would give away that she was from New York. Initially, Joleen seemed pleasant she would chime in with Tallulah every time she was disrupted the session, and both girls were warned to stop. Joleen first chose the word empty, and said that Hallowsgate makes her feel empty. She also said that she feels like it is sucking the out everything she liked about herself. I told Joleen that we would be discussing her feelings of emptiness later, as she is my patient. I believe that if Joleen can find self worth beyond the traits her disorders cause, she might feel better about herself and see Hallowsgate as a place where she can heal.

Joleen's second word was excitement, and she expressed excitement in the upcoming holiday, asking if we celebrate Christmas at Hallowsgate. I told her that we did, and it gave me an idea for meeting one on one with her later on.

Additional: It was fairly clear to me that Joleen is influenced by those around her, and will attempt to keep pace with some of the nastier members of the group. Each time Tallulah spoke out, as previously stated, Joleen would join in, but toward the end when Tallulah was quieter, so was Joleen. I feel that it will be important to keep Joleen separate from Tallulah as much as possible, and to stop side conversations if they are in the same group. Reinforcing good behavior, and punishing bad will be effective with Joleen, who still very much behaves like a child.

Follow-Up: In addition to individual therapy, I will be contacting the occupational therapist to join us. I feel that by giving Joleen some adult responsibilities and teaching her how to manage personal affects it will help her mature, and also to heal.


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Dr. Benjamin Graham

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PostSubject: Re: Joleen MacMahon   Tue Dec 04, 2012 7:47 am

Dr. Benjamin Graham wrote:


Nov 29, 2012

    Group Participants:
    Thaddeus Salant - Schizophrenia (Catatonic Subtype)
    Moira Hanley - APD/(Suspected OCD)
    Quincy Randall - Sexual Paraphilia (Vampirism)/Obsessive Love
    Joleen MacMahon - Stockholm Syndrome/Hypersexuality
    Harlow Jacobs - GAD/MDD/Hypersomnia


Therapy Plan: Today's therapy will be an exercise in sharing and relationship building, utilising the light-hearted nature of a game to foster communication about the self with others. The aim of the game (a customised jenga block game) is to encourage patients to talk about themselves openly, build rapport with others, and foster trust with others. The game functions in such a way that each block has a therapeutic question pertaining to the self written upon it. Patients (and therapist) play the game of jenga as usual, only players must answer the questions on the blocks they pull. At the end of the game, whoever knocks over the tower will have to answer an (appropriate) question from each of the other members of the group.


Group Observations: New patient, Quincy Randall, was in attendance for today's session after a morning arrival. He was first into the group room and displayed appropriate greeting behaviour and vocalisation. He did appear a little dazed, as to be expected for new arrivals, but was otherwise pleasant. Next to arrive to our session today was Joleen MacMahon. Her face was still bruised from a recent fight with roommate Jamie Gibbs, but she seemed in relatively well spirits despite this. However, her body language and tone of voice bordered on the inappropriate. Harlow Jacobs arrived shortly afterwards, seeming a little anxious though he nodded in greeting and took a seat without prompting. Thaddeus Salant seemed much unnerved, as his behaviour might be best described as skittish and evasive upon entering the group therapy room. Regardless, he also took a seat without having to be prompted. Moira Hanley was the last patient to arrive to the session, with little enthusiasm, but also was seated without being prompted.

Before introductions could be made Joleen MacMahon and Quiny Randall struck up an introductory conversation between themselves. Given Joleen's injuries and diagnoses, and Quincy's condition, I intervened and disrupted this private conversation by encouraging Quincy to turn his attention to the rest of the group and introduce himself. He was polite and compliant with this request. Thaddeus Salant continued to exhibit distancing behaviour and anxious body language during the introductory part of our session, which remained throughout, though he was supplied with some note cards and a pen, in order to doodle. Clearly having some activity eases some of his anxiety, though I will be discussing paying more attention to group activities with him in future individual therapy sessions.

Our group session went largely according to plan today, though I encountered some oppositional and defiant behaviour from Moira Hanley whenever it was her turn to select a block from the tower. Moira Hanley and Joleen MacMahon also engaged in a short-lived verbal altercation towards the end of our session, the precursor of which came towards the beginning, when Joleen seemed to attempt to defend me from one of Moira's outbursts.

In the middle of our group session, Joleen made inappropriate sexual contact with myself underneath the table, my reaction to which disrupted the game momentarily as I put distance between us. I did not verbally raise the issue during the group, in the interest of not derailing our activity, but this behaviour is entirely inappropriate and should be made special note of, with Miss MacMahon's primary therapist.


Session Report: I started our session today by choosing the first block, and answering the question upon it in very impersonal and general terms.

Moira Hanley was next, drawing a block which asked her to say what motivates her. She disputed that she had any motivations. When I questioned why she got out of bed in the morning, she eventually answered that going out to smoke a cigarette was her motivation for getting up. More on this in later individual therapy notes. It is my belief that Moira witnessed Miss MacMahon's inappropriate contact, and she attempted to bait me with suggestive questions after the fact, before she was derailed by the continuation of the game. Moira's second block was one that she refused to answer, and which I kept for a later session. It asked her to talk about a time when someone made her uncomfortable. She refused to answer and put the block back on the tower. Moira was kept after the session for an impromptu individual session, following her poor behaviour throughout the group. During this individual session, her cigarettes and personal affects were confiscated, only to be earned back by cooperation with her therapist and the other staff, and evidence of her behaviour and self control improving towards others.

Quincy Randall was relatively calm and polite in our session today. he did not make trouble, though I am cautious of allowing him to associate with Joleen MacMahon, given her diagnoses and Randall's susceptibility to romantic and inappropriate advances. he answered both of his questions from the game eloquently, beginning with being asked: How often do you incorporate what people think into what you do?[ He admitted that he didn't often give much thought to what other people thought, but that it did matter to him on some level. Though he admitted trying to give consideration to it, he also noted that sometimes the things that he wanted overrode this consideration. Individual therapy could focus on impulse control, and on healthy outlets for thoughts and frustrations, as well as healthy relationship constructs and interpersonal communication and listening skills. Mr. Randall's second block from the game asked: What are your plans for the future, and how do you hope to achieve them? He admitted to wanting to go back to Paris, and acknowledged that it would only be possible if he got out of Hallowsgate, further conceding that his discharge depended upon honestly and a willingness to cooperate. Efforts should be made to reinforce these thoughts for Mr. Randall, but also to build upon other things that will have to be addressed in therapy.

Joleen MacMahon was willing and compliant with the group activity throughout our session, despite her obvious inappropriate conduct towards myself. She was upset by Moira Hanley's outbursts towards me, but responded favourably to attention during the group. Given her conduct towards me, I can assume that she harbours a sexual attraction towards me, which influenced her behaviour during our session. Regardless, she answered the questions she received from the game, beginning with being asked to list five things that made her happy. While largely inappropriate, she answered with the following, and was allowed to let it rest at that for the first round: "Well you make me happy Ben. Very happy. [...] And I like bright colors, like purple and pink and aqua. Singing makes me happy too. I liked going to the movies that was always fun...and sex. Sex makes me very happy." Joleens second block asked her If you were an animal, what would you be and why?' She answered that she would be a unicorn, because then she would be so special that everyone would have to care about her. Obviously, given her history and diagnoses, attachment issues can be guessed at throughout. I would recommend that therapy focus on creating appropriate and reliable relationships with others, and on boosting real self confidence and responsibility. Her sexual promiscuity may be compensating for a lack of real attachment in her interpersonal relationships. I would recommend exploring the possibility of a buddy system, with another female patient unlikely to give in to sexual advances, or even a female member of staff.

Harlow Jacobs was quite withdrawn and appeared anxious for a lot of our session. He seemed perturbed that he would have to answer questions at random from the jenga tower block, but he did manage to put forth some effort to do so, for the most part. He started off with a block which asked: Where do you want to be? How do you think you can get there? He struggled with this question, and answered that he didn't want to be anywhere, his tone unsure and anxious. Looking to me for a prompt, I asked Harlow if he would like to be outside of Hallowsgate one day. He conceded that he did want to, but that he didn't have any clear goals as to where he wanted to be so long as he was useful. Future therapies should focus on realistic goal building and self confidence, encouraging small steps towards small goals at first, and then building up to larger ones, as I expect he may be easily overwhelmed. Perhaps some activities involving personal responsibility and rewards for effort may help. Harlow did not have a chance to answer a second question, after Moira Hanley's conduct and Joleen MacMahon's reaction to her meant that our session needed to be cut short to avoid more conflict.

Thaddeus Salant was anxious and evasive throughout the group. She shows fear of his peers and hospital staff, and prefers distraction by way of drawing. I think that art therapy could be very good for him so long as it is fully monitored and the art work is actually guided and discussed. he should not just be left to his own devices, but should be eased into more social contact and communication instead. Though he struggled with comfort levels throughout the group, he was coaxed into participating in the game, wherein he drew a block which asked: What realistic alternatives are there to your current lifestyle? Thaddeus answered that he didn't know, and that he believes that being 'in here' [Hallowsgate] is better than being 'out there' sometimes. He lack any real self confidence, and is easily startled. Outside of guided art therapy, his treatment plan should focus heavily on safe socialisation and on self confidence building, as well as learning coping skills for his emotions, and working with medications more closely to find the best treatment for him.

Additional Notes: Socialising activities should be pursued for Thaddeus Salant, after individual sessions discussing social and life goals and considering medication options to control the symptoms of anxiety he is subject to. Guided art therapy should also be explored, as well as confidence boosting activities and communication skills, executive managing, and personal nutrition and hygeine skills.

Moira Hanley was kept behind after our session for an individual meeting which will be documented further in supplemental notes.

I will be filing an incident report concerning Joleen MacMahon's conduct and feelings towards me, in order to assure that this matter is entirely transparent and handled accordingly.




_____________________________________________________



Forty-Nine | Divorced & Single | Smoker | Psychiatrist | Stubborn | Damaged Goods
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Dr. Benjamin Graham

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PostSubject: Re: Joleen MacMahon   Tue Dec 04, 2012 7:58 am

INCIDENT REPORT
_____________________________________

    Date: Nov 29, 2012
    Attending: Dr. Anita Forrester
    Nature of Incident: Inappropriate Conduct/Inappropriate Contact


Incident report: During our group therapy session, patient JM conducted herself in a flirtatious manner towards myself for much of our time. Our session consisted of a game meant to foster talking about the self and building trust and rapport with peers. One of JM's questions was to list five things which make her happy. Her first answer was to relay that I, Dr. Graham make her 'very happy.' Following continued flirting and this answer, JM made inappropriate sexual contact with me underneath the table, using her foot. I removed myself to a distance, but I did not bring up the behaviour with her in the interests of maintaining tenuous group control. Additionally, JM displayed protective behaviour towards me when I was confronted in session by an oppositional patient, causing a verbal altercation between the two. When the other patient, MH, once again engaged in verbal altercation at the end of our session, JM had an emotional outburst and lashed out at the game pieces we had been using, before storming out of the room, visibly agitated and upset.

Additional: JMs behaviour towards me is disquieting. Any procedural advice from head of dept. would be greatly appreciated.


_____________________________________________________



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Dr. Benjamin Graham

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PostSubject: Re: Joleen MacMahon   Tue Dec 04, 2012 8:02 am

INCIDENT REPORT
_____________________________________

    Date: Nov 30, 2012
    Attending: Dr. Anita Forrester
    Nature of Incident: Inappropriate Communication


Incident report: I received the following note in my staff mail box this morning.

Joleen MacMahon wrote:
Stuffed in Dr. Ben’s mail slot is a quickly jotted note on crinkled paper:
Ben, Thought about you last night. Sorry if I made you mad. J

Additional: I have taken no further actions on this incident and continued behaviour, pending meeting with head of dept. regarding how to proceed.


_____________________________________________________



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Faith McCoy

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PostSubject: Re: Joleen MacMahon   Fri Dec 07, 2012 2:44 pm

Incident Report
_______________________________



Who Was Involved: Jamie Gibbs and Joleen McMahon
Staff That Responded: Nurse Faith McCoy

Incident Notes: I was doing my round through the Second Floor Female Wing, when I heard someone desperately screaming. I ran to the site of the screaming, which was Acute Dorm 6, and saw Jamie Gibbs's hand wrapped solidly around Joleen McMahon's throat with no signs of letting go. I promptly called for Orderlies, while wrapping my arm under Jamie's and across to her other shoulder, safely and quickly pulling her away from Joleen. It was clear this was not going to be enough, so I reminded Jamie that if she killed another patient the chances of her seeing her children again were slim to none. I realize this may not have been in the best technique, but it got through to Jamie who promptly let go of Joleen's throat, right as the younger woman was beginning to pass out from lack of oxygen and most likely die.

Afterwards, Jamie proceeded to repeat that she was not crazy, at least twice, to which I responded that I did not believe her to be crazy. I place myself between the two to ensure that if another fight broke out, neither patient would come to harm, while assessing Joleen was okay for the moment though it was clear the two had been fighting for quiet awhile before a staff member arrived.

Additional Notes: It should be noted that once I arrived at the scene, Joleen was the losing party in the altercation, but upon looking at Jamie Gibb's injuries it is easy to see the younger patient was not 100% innocent in the matter. She did not speak much at the end, due to her throat injuries, but once Isolation was suggested by another patient, Joleen began to panic. I placed my hand on her shoulder, in a comforting and professional manner, and explained to both patients that I would not be placing them in Isolation, but in separate rooms in the Medical Wing, and then their psychiatrists would be called down.

Follow-Up: The thought at being completely alone clearly had a tremendous affect on the young patient, whether that should be explored further is not my call to make. I do suggest questioning the woman and getting to the root of the altercation, but in the mean time, I have suggested Jamie Gibbs be relocated to her own Chronic Dormitory.

_____________________________________________________


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Dr. Anita Forrester

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PostSubject: Re: Joleen MacMahon   Tue Dec 11, 2012 8:52 pm

THERAPY NOTES
_____________________________________

    Date: 11/12/2012
    Attending: Dr. Anita Forrester
    Session: Individual Therapy


Therapy Notes: The purpose of today's session with Joleen is to discuss her behaviors toward Dr. Graham, her fight with the patient Jamie Gibbs, and her loss Christmas privileges.

Joey seemed nervous, but otherwise pleasant when she entered my office, greeting me once again as Ms. Anita. Again, I have not corrected her as it seems to make her more comfortable when talking to me. During our group therapy session she said that Christmas excited her, and I asked if she was looking forward to the holidays. She said she was, but was sad to have missed some of the decorating. I reassured her that there would be more to come, and explained that the hospital was setting up the play and skating outing. She was very pleased with the new, but did not make the connection when I said that only patients who have shown good behavior would be going. She expressed more concern over her lack of town appropriate clothing than anything else. I found this to be troubling and it set the tone for the remained of the session. Joey didn't believe her behavior to be a problem, and it took some further questioning to get her to admit to any thing.

When asked if she believed she'd earned the trips to Charleston and skating, she asked if it had anything to do with the fight with Jamie and was quick to blame the other girl for the incident. She began to cry as she explained that she'd asked to see Jamie's pictures, and that the other woman became confrontational. Joey said that she'd threatened to call for help if Jamie came at her, and then she was attacked and the blows she exchanged were in self defense. I do not believe Joey to be a violent case and she was likely provoked into the fight, but her first response should have been get find a staff member instead of only saying she would. Joey went on to add that she didn't have a chance to get out before Jamie attacked. Because of the circumstances and because I have not spoken to Jamie yet, I moved on from this topic to address the issue of her behavior with Dr. Graham.

I ask Joey if there was anything else that we should discuss, and she asked if it had anything to do with her visit to the old children's ward. I was unaware that she'd ever been there as there is no notation of this in her file. I warned her of the dangers of the ward, but then asked her to tell me about the group therapy with Dr. Graham. She mentioned the verbal altercation with Moira, how she'd called her out because of her pick of a unicorn, and that she smacked the game off the table when she became angry. She mentioned the apology letter written to Dr. Graham, but that was all she said she needed to apologize for. After a reminder that she wouldn't be able to attend any of the outings if she wasn't honest, she said she didn't do "it" to upset anyone. She believes Dr. Graham to be flirting with her, and watching her. I suspect that Joleen is transferring the affections she received from her step father onto Dr. Graham as a way of coping with being separated from him, and that she is imagining a connection where there isn't one. She referred to him as "dreamy" and said that he wasn't upset when she touched him.

Additional: Joey has been asked to write another apology to Dr. Graham. In this letter she is to explain why what she did was wrong, and apologize for her behavior. She has been allowed to write this letter on her own time and is to bring to me for review before I pass it on. Joey will be asked to write the letter again if she is inappropriate, or fails to grasp why her behavior wasn't appropriate. In addition, if the letter is not returned to me in a timely fashion she will not be permitted to attend any of the Christmas festivities that she has made it clear she wants to take part in. I feel that making her responsible for the letter will help illustrate that her actions have consequences, and that she has the power to make her situation better or worse for herself.

In addition, her behavior is to be monitored over the next couple weeks. If she repeated any of the above, or acts out in any way, she will stay behind with the other patients who do not have the privilege of going out.

Follow-Up: Joey is to be reprimanded immediately should she behave inappropriately with staff or other patients, as she currently views a lack of response as a positive one. She is to be removed from group and sent to seclusion or my office should she act out. If Joey attempts to hand off her letter to Dr. Graham or to anyone else, it is to be placed into her file immediately and not delivered to him.

Joey has mentioned she went to the children's ward but I do not see any notations in her file. Please, if anyone is aware of this or knows if a staff member was involved, make a note of it.



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Dr. Rose Lewis

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PostSubject: Re: Joleen MacMahon   Tue Dec 18, 2012 12:18 am

THERAPY NOTES
_____________________________________

    Date: 12/13/12
    Attending: Dr. Anita Forrester
    Session With: Dr. Rose Lewis
    Session: Group Therapy


Therapy Notes: As we began the session, it was obvious that some people were not keen on participating. I explained that we would be listening to different songs in effort to elicit responses and measure our emotions. I wanted to make a connection between the types of memories that could be triggered and the emotions that they feel in an effort to help them understand their control. Some were nonplussed, though Luce stated that he would give it a chance. With “Make someone happy” Joey explained she thought of her father. Moira interjected that it “explained a lot” and we discussed why the song made Joey feel this way. Upon playing “Home”, I asked Elijah about his response. He resisted and then had an emotional outburst, commenting on the death of his wife. He then refused to participate and left the room. “Shake it out” was played next, and I chose Adriana to answer. She had a positive memory of the song, thinking of when she was first promoted. “Last Night I heard Everything in Slow Motion” was the song for Luce, and he explained that it reminded him of “Well, there was this lovely young lady I knew in Tampa who liked music like that. One of the more pleasant times in my life. A real woman, that one - never hit me for trying to be decent.” This elicited a negative response from Eva, as the two had come to blows outside of the session. “Glory Days” was for Eva, and she stated she did not “dwell on the past” and that she didn’t have any such glory days. Moira was last, but refused to participate stating “Because I think this is pretty fucking stupid.” I dismissed the rest of the group and spoke with her one-on-one.

Additional: Joey was overall a positive influence on today’s group. She participated well and did not engage in the verbal sparring that occurred during the group.

Follow-Up: I believe that Joey is making progress, and that she seems to do well in group situations. I think group activities might be better for her, as she has more stimuli to interact with (and more distractions from behavior that might get her into trouble).
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Dr. Anita Forrester

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PostSubject: Re: Joleen MacMahon   Thu Dec 20, 2012 12:46 am

THERAPY NOTES
_____________________________________

    Date: 09/12/2012
    Attending: Dr. Anita Forrester
    Session: Individual Therapy


Therapy Notes: Joey has written her apology letter to Dr. Graham and turned it into me. However, it is unacceptable, and she has been asked to write it again. The note has been attached below.

Additional: This note will be edited when her revision is handed back.




Joleen MacMahon wrote:


Dear Dr. Ben,

I’m sorry I touched your penis with my foot. I thought you were enjoying it, but I guess I was wrong. I won’t do it again.

Your friend,
Joleen.



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Dominic Santos

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PostSubject: Re: Joleen MacMahon   Mon Dec 24, 2012 7:52 pm

INCIDENT REPORT
_____________________________________

    Patient(s) Involved: Joleen MacMahon
    Responding Staff: Officer Dominic Santos


Incident Notes: Ms. MacMahon was in the recreation room as scheduled when another patient began screaming and hitting himself in the face. As I responded to this individual, Ms. MacMahon bolted out of the room and I chased her to the abandoned children's wards. She was out of my line of vision for no more than one minute as I followed her into the decayed ruins. I found her cursing in panic as she grasped her hand, which she had cut against the wall. After examining the wound, I told her that she would need to come with me to the medical wing to get it cleaned and bandaged.

Ms. MacMahon then asked me if we could sit together and look at the murals on the wall- I believe from this reaction that the pictures were comforting to her, perhaps reminding her of her earlier placement. I told her firmly that I could not allow that, given her injury.

Additional: Ms. MacMahon appeared extremely distressed, and so I placed a hand on her shoulder. I also turned her injured hand palm up. I realize physical contact of any sort may have been the wrong thing to do, because Ms. MacMahon responded by wrapping her arms around my neck and whispering, quite seductively, in my ear. I pulled away and told her that was 'enough', thus indicating that such behavior was not appropriate. I then escorted her to the medical wing where she was treated for her wound.

Follow-Up: In future therapy sessions, Ms. MacMahon should probably be coached on reading social cues and which behavior may or may not be appropriate. On my part, I admit to underestimating her reaction to the sense of touch or a lowered guard. Placing a hand on her shoulder was only meant to calm her and to make sure that she wouldn't try to run again, and was unfortunately taken for sexual advances that were not there.

(THREAD: http://www.hallowsgate.com/t717-some-place-like-home-dom )

_____________________________________________________


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Dr. Virgil S. Hennessey

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PostSubject: Re: Joleen MacMahon   Mon Jan 21, 2013 1:34 am


Group Therapy Report
_____________________________________________

    Patient: Joleen MacMahon
    Attending Clinician: Dr. A. Forrester
    Session With: Dr. Virgil S. Hennessey
    Patients in Session: Joleen MacMahon, Thaddeus Salant, Adriana Clarkson, Evangeline Baker


Session Plan: Session to focus on the topic of self image in correlation to self confidence. Patients will be discussing their own self image, what has caused this perspective, how they feel it has impacted their self confidence, and then patients will discuss as a group ways in which they can improve their self image and thus their confidence, addressing each case individually and sharing ideas.

Session Observations: Miss MacMahon seemed in fair spirits upon entering the session, and happily took a seat nearest to staff. Much of her body language in the earlier half of the session could be best described as solicitous towards staff. As the session progressed and we focused on Miss MacMahon's lack of self image, she became visibly upset and evasive.

Therapy Notes: Miss Macmahon was forthcoming with her introduction, and in describing Hallowsgate in one word, she chose the word 'lonely'. Miss Macmahon was then asked first, to describe to the group how she sees herself. She replied that she was not sure what staff meant, and asked if staff was referring to personal appearance. Miss Macmahon then went on to list a number of physical features she thought were nice, including her hair and her breasts, but added that she used to like the way that her body looks, but now would like to lose some weight. Her mannerisms were solicitous as she spoke. She added that she also considers herself smart but that she does not show it. Staff elaborated that the question refers not just to what is on the outside, but what is on the inside, and how she feels about herself as a person. Miss MacMahon elaborated on her answer, stating that she thinks that she is nice. However, as she continued on, she largely focused on remarking about how other people see her, and noted that she believes others do not give her a chance as they see her as a child. Miss MacMahon was largely quiet while others were sharing, but she did briefly exhibit an outbursts in defence of Mr. Salant, when he described himself as worthless. She disputed his belief. Later in the session, staff opened the floor up to suggestions on how Miss MacMahon could establish a real sense of self, after it was suggested to her by staff that she exhibited a lack of one at this time. Miss MacMahon agreed that this was an accurate description. The rest of the group suggested that Miss MacMahon spend less time trying to please others, and more time focusing on herself. At this, Miss MacMahon became emotionally upset, defending her focus on others and lack of focus on herself as her being 'nice'. She did not grasp the point of the suggestion, and at this time, staff moved on to focus on another member of the group.

Additional: Miss Macmahon's initial propensity to describe only her appearance, when asked how she sees herself, suggests a level of superficiality in her self-directed thought processing. Clinicians might work on establishing a more thorough sense of self with Miss Macmahon, beyond physical appearance and sexual attractiveness. She appears largely focused on how other people see her rather than exploring how she views herself as a person, and this should be addressed before progress can be made with her habits toward compensating through sexually deviant behaviour. Establishing a real self worth may be the best course for therapy. Trying to establish understanding with Miss MacMahon on the topic of her won self worth is a difficult matter, as she refuses to think past the surface at this time. It is suggested that all individual therapy be largely focused on rectifying this before clinicians can move on to other trouble areas.





Dr. Virgil S. Hennessey



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Dr. Anita Forrester

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PostSubject: Re: Joleen MacMahon   Sat Jan 26, 2013 10:58 pm

INCIDENT REPORT
_____________________________________

    Date: 19/1/13
    Patient(s) Involved: Joleen MacMahon, Clarence Hoffman
    Responding Staff: Dr. Anita Forrester


Incident Notes: Joleen MacMahon and Clarence Hoffman were discovered in the hayloft of the stables in a compromising position, stripped of their clothing from the waist up. They were told to separate and redress, and both did without complaint. Clarence began explaining that the incident was all his fault, but I did not discuss the matter with them, and they were instructed to climb down the ladder. Joleen first, then myself, followed by Clarence. They were then escorted back to the hospital, and Clarence was taken on ahead by an orderly to isolation. Joleen waited with me until I received word that Clarence was in his room, at which point Joleen was also taken to isolation.

Both patients are to remain in seclusion until lights out, at which point they are to be escorted to their dormitories separately. Under no circumstances are they to see each other.

Additional: Despite the repeated attempts made by the staff, Joleen does not seem to understand that her actions have consequences. As a result, Joleen will be accompanied by a female orderly escort during the day, and extra bed checks will be made during lights out. She is prohibited from borrowing clothing from other patients, and will be restricted to hospital scrubs until she can demonstrate control over herself, and show some initiative and interest in her recovery. Joleen will begin daily chores around the hospital, and will be scheduled to meet with the occupational therapist to help in learning responsibility.

Joleen and Clarence are to be separated immediately should they be found together and taken to seclusion. In group therapies, if they happen to be in the same one, they are not permitted to sit beside one another. Interaction between them is to be discouraged, and all conversations should be noted and placed in their files.

Follow-Up: I will be having an individual therapy session with Joleen in the future to discuss the privileges removed and how she will be able to earn them back.

Additionally, any patient found to be giving Joleen clothing or other items she is currently prohibited shall receive one warning. If they continue, their privileges shall be revoked as well.


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PostSubject: Re: Joleen MacMahon   Sun Jan 27, 2013 3:22 pm

PATIENT OBSERVATION
_____________________________________

    Patient(s) Involved: Joleen MacMahon
    Responding Staff: Officer Dominic Santos


Incident Notes: As I was directing patients into the library during the blackout, I struck up a conversation with Ms. MacMahon- the details of his conversation may be useful to her attending psychiatrist to possibly discuss in future sessions. Ms. MacMahon floated over towards me to the edge of the crowd where I was, and I noticed that she was not quite ‘herself’- at least not in the confident, bubbly air that she normally presents herself with. Her hair was unkempt and down, and she was exhibiting many nervous habits such as biting her lip and fumbling with her hands. I asked if she was alright, and she admitted that she didn’t like the dark and was distressed because she was separated from Ms. Tallulah Tansy. I shined my flashlight directly in front of us so she could concentrate on that.

Without warning, she became extremely anxious and begged me to go check on Mr. Jasper Harmon. I told her that I had to stay where I was needed but promised to assist Mr. Harmon if I were called to do so, and assured her that there were other staff around to help him. Noticing that nearly all of what she told me had to do with other people, I suggested to her to perhaps focus on herself and her own treatment.

She then became a bit defensive and asked me why ‘everyone says that’. I told her that I thought it was good that she cared about others, but remarked that if that was all she did, she would lose herself that way. I then said that she had a good heart- I was speaking the truth, but the comment was also meant to assure her that what I was saying wasn’t an attack.

She then said: “I’ll get better when people understand that…caring for people isn’t wrong. Wanting to make people happy isn’t bad.” – I told her I agreed with her, but said that sometimes a person can do this in unhealthy ways.

Ms. MacMahon then asked me if I could deliver a message to Mr. Clarence Hoffman and I firmly declined. The message was benign enough- she wanted me to tell him that she was sorry that she got him into trouble. She didn't seem upset at all when I told her this, and reacted to the news in a mature fashion.

I watched her walk to another part of the library after she told me that I didn’t understand and that the message to Mr. Hoffman wouldn’t hurt anyone. I then resumed my other duties.

Additional: Her expression was curiously blank in her last few sentences. She also remarked: “I’d be nice to you to you know.” – I’m not sure what exactly this means, but should perhaps be discussed in future sessions.

Follow-Up: I would suggest for Ms. MacMahon’s therapist to discuss with her about the amount that she gives to others, and her failed attempt at contact with Mr. Hoffman. I will continue to block any messages between these two until I am instructed not to.

_____________________________________________________


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