Chronic Illness

Sometimes children find it difficult to handle a lifelong disease, especially if they feel different from their friends. Young people who react with defiant, impulsive or depressive behaviors may be jeopardizing their health. Sometimes they adversely alter their eating habits or don’t take their medication as prescribed. As a result, the entire family feels the effects of the disease.

At Cumberland Hospital, we understand children whose chronic illnesses impact their emotional outlook and behaviors. Combining positive reinforcement with medical treatment, our experienced professionals help young people ages 2 to 22 heal physically and emotionally.

At Cumberland Hospital, young people – and their families – learn effective strategies to integrate successful management of their disease into their daily lives. And just as important, these young people can begin to enjoy life again.

Treatment Overview

Treatment starts with effective and individualized goal setting. Because different chronic illnesses require various interventions and intensities of medical services, Cumberland’s Chronic Illness Program offers a wide variety of therapies and activities designed to meet the individual needs of each patient’s medical, social and emotional health. After a patient’s initial evaluation, our clinical staff develops a Master Treatment Plan that takes into account the child’s unique, specialized needs. The length-of-stay at Cumberland varies according to the diagnosis and the individual child’s needs.

A pediatrician with training in adolescent medicine leads Cumberland’s clinical, interdisciplinary treatment team. The team includes a combination of pediatric-trained professionals: nurses, registered dietitian, occupational therapist, speech/language pathologist, physical therapist, psychotherapist, psychologist, behavior specialist or analyst, neuropsychologist, recreational specialist, behavioral counselor, teacher and case manager. The patient, family and involved professionals from the child’s home community are an integral part of the treatment team. The team meets regularly to set goals, develop treatment plans and review progress.

Cumberland’s clinical assessment and treatment often involve consultations with various pediatric specialists. Consulting specialists collaborate with the primary physician at Cumberland and provide input to the treatment plan. On-site specialists include an endocrinologist, physiatrist and psychiatrist. Other consultants include but are not limited to a neurologist, cardiologist, nephrologists, gastroenterologist, urologist and hematologist.

Most patients at Cumberland have serious medical conditions that have reached a critical stage largely due to medical non-compliance. A pediatrician directs their medical care, which is administered by nurses on-site 24 hours each day.

Medical Management: Teaching patients more about their illness and the importance of medical self-management is a major program focus. Patients may practice managing their unique medical needs, such as monitoring blood sugar levels or skin integrity to watch for signs of breakdown.

With varying levels of supervision, patients are responsible for making appropriate decisions concerning diet, exercise and self-medication. If appropriate, patients may be involved in medication trials. Patients with neurological involvement may benefit from bowel and bladder training.

Patients with diabetes may benefit from Cumberland’s insulin management program, advancing towards use of an insulin pump system. The plan allows patients the freedom to choose the amount of carbohydrates, protein and fat desired, and then take insulin based on planned food intake. This plan helps give patients control over their lives, while helping them understand body chemistry and ways in which food and exercise impact their bodies. Patients must demonstrate maturity, independence and responsibility to be eligible for this program component.

Depending on the type of chronic illness and the child’s specific needs, the following services may be included in treatment: individual and group nutritional instruction, activity therapy sessions to learn positive leisure choices, exercise groups, Eating Attitudes Training (EAT group) focusing on eating patterns and self-care cooking skills, individual and group diabetes instruction, cognitive retraining, physical or occupational therapy and speech/language therapy.

Treating the mind as well as the body, Cumberland’s staff teaches young people to recognize their emotional needs. Depression or other disorders may complicate a patient’s illness. Individuals may exhibit a specific pattern of self-destruction or behaviors that impede them from managing their chronic illness responsibly.

Intensive individual and group psychotherapies address each patient’s unique emotional and behavioral issues. Each patient participates in weekly Chronic Illness Group sessions to discuss the emotional affects and adjustment problems that can accompany an ongoing illness or injury. A major focus is to develop compensatory and coping skills. Topics include:

  • Anger management
  • Self-esteem
  • Body image
  • Assertiveness
  • Peer pressures
  • Healthy sexuality

Other groups may include Community Group, which involves discussions concerning interactions on the living unit; Process Group, which encourages acceptance of one’s disease; Experiential Group, which focuses on trust-building using positive successes on the outdoor ROPES course, and Stress and Relaxation Group.

Specific chronic illness educational groups focus on attitudes and individual cognitive problem-solving skills. For example, patients with spina bifida or other neurological challenges learn compensatory skills to assist with their memory and learning problems.

Diabetes, Morbid Obesity and Eating Disorders

Diabetes and eating disorders are serious medical conditions. When combined, these conditions can be dangerous. Some individuals have learned how to take only enough insulin to survive. Without enough insulin, calories consumed are not used by the body, but are carried out in the urine. Consequently, the person maintains a low body weight. Patients with both diabetes and an eating disorder (often referred to as diabulimia) participate in components of our specially designed Diabetes Program.

Adolescents with diabetes learn and practice healthy eating and exercise habits, as well as cooking skills and medication management.

Our Eating Disorders Program addresses issues such as body image, nutrition and positive attitudes and helps adolescents change their distorted thinking patterns. Patients in this program progress through a series of phases, each of which builds on the progress made in the previous phase. Levels-of-care and types of services vary depending on each patient’s need in any particular phase.

The family dynamic is a critical element in both the Diabetes and Eating Disorders Program. During family therapy, families learn healthy ways to help their child and all family members live with the child’s illness. Intensive individual and group psychotherapies address each patient’s unique emotional and behavioral issues.

Positive Behavioral Supports: Cumberland’s team uses an individualized behavior program throughout treatment to encourage acceptable behaviors rather than punishing negative behaviors. Patients earn privileges when exhibiting appropriate behaviors. This system facilitates positive feedback; patients see an immediate reward for appropriate behaviors.

Care and Goals

Helping adolescents learn responsible self-care extends to everyday situations. By learning practical life skills, patients get a sense of control in their lives and a taste of independence. All patients are taught and have opportunities to practice realistic, independent living skills such as money management, household chores, time management, problem-solving and employment readiness.

Cumberland’s reality-based, functional approach helps patients learn to integrate their chronic illness into a healthy lifestyle.

Cumberland’s Chronic Illness Program provides a structured environment for medical supervision and treatment of the underlying emotional, social and behavioral challenges preventing successful self-management. Our program helps patients learn healthy ways to live with their illness.

The admission criteria are as follows:

  • A chronic illness diagnosis
  • 2-22 years of age

Inability to function independently at an age-appropriate level in any of the following areas:

  • self-care
  • mood stability
  • school

Individuals may exhibit a specific pattern of self-destruction and behaviors inconsistent with responsible management of their chronic illness.