Cutting the Healing

The emotional triage performed by therapists for the severely disabled is being eliminated by budget cutbacks

After four years operating as the only private psychotherapist in the county -- some say in the state -- to devote her entire practice to counseling poor and severely disabled clients, Savits closed her doors two weeks ago. She hopes her absence will be only temporary, while she searches for a location with cheaper rent. But even if she manages to find such a place, she may still be forced to give up some Medicaid clients to make room for others with better insurance or with private means.

Tucked away in the mazelike corridors of a Coral Springs office building on University Drive, the Wellness Counseling Center is for the most part indistinguishable from the dozens of other medical and psychological practices that rent space in the building. The outer office contains a chair and a small love seat and a spray of Newsweeks across a coffee table. The therapy room features a wicker couch, a teddy bear, and several flowery vases.

Appearances are where the resemblance ends. Unlike most other psychotherapists, Savits has never had much use for "the walking worried" -- yuppies with low self-esteem, midlevel managers with midlife crises, addictive personalities with AOL afflictions. She sees herself as performing emotional triage in a war zone, and she treats the worst-hurt first.

National studies have consistently shown that people with severe disabilities are three to four times more likely to suffer depression and other emotional problems in their lives than those who are able-bodied. No wonder, when you consider how their lives are dominated by their physical ailments.

Most have to rely on relative strangers to help take care of physical needs that many people would not choose to share with an outsider. "Their bodies are an open book," Savits says. "Where's the privacy? Where's the respect that most of us take for granted?"

Consider 32-year-old Donna Iavarone, who lost both parents within a year of each other and is just now, three years later, going through the grieving process. While dealing with that emotional trauma, she is also struggling to establish her independence in an apartment that she shares with another disabled woman, Debbie Price. Neither Iavarone nor Price can walk because of cerebral palsy, and they have set up their apartment so that everything they need can be reached while they sit on the ground. Their only alternative is to live in an institution.

Another client is a 50-year-old woman who has been confined to a wheelchair ever since she took her father's rifle and, under the spell of a teenage broken heart, shot away the part of her brain that controls her body movements below the neck. The woman has been a quadriplegic since the age of 14, and her parents, though living, do not visit or call.

Savits is not new to dealing with the needs of the disabled. If any moment can be identified as the beginning of Ellen Savits' mission, it would be the moment more than 30 years ago when a doctor told her that her young son Craig would never live to see his tenth birthday.

Craig had been born with severe mental retardation, and the doctor's advice to Savits was to have the boy institutionalized. Instead, she read everything she could find about mental retardation and then decided to embark on a controversial and incredibly rigorous program known as "patterning."

For the next five years, she put herself and Craig through a diligent daily schedule of mental and physical stimulation. The goal was to stimulate thought and activity and, by having the child mimic the body movements of an infant, return his brain to infancy so that he would have a chance to "relearn" different patterns of development. She doesn't know whether the program did any good, but the child who doctors predicted wouldn't live past the age of ten now lives in his own apartment and holds down a job in a fast-food restaurant.

Savits' husband, Mike, now says he doubts whether the patterning had anything to do with Craig's success. "I think the process itself has no validity, but that kind of attention given to anyone at that stage of life is bound to be productive."

Savits credits her work with her son with setting her on the path that led to her current occupation. At the time she didn't really know what she wanted to study. After her son was born, she changed her major to psychology. After graduating with a master's degree in social work from Dowling College in New York, she and her husband moved to Philadelphia, where she found work in a community hospital. Eventually, she rose to become director of the hospital's mental retardation center before moving to Florida in 1991.

Despite her background serving people with disabilities, she had no intention of creating a practice that concentrated solely on disabled clients when she opened the Wellness Counseling Center in 1994. However, she quickly began getting referrals from friends in the world of disability services, and soon there was no room for any clients except those with disabilities.

In retrospect this may not have been the wisest or safest way to structure her practice. "I think she dug her own grave, to an extent," says Joan Glickman, an aide to state Sen. Howard Forman (who voted for the legislation). Although Glickman says she sympathizes with Savits' plight, "when none of your clients has any money and all your income is based on government programs, you make yourself vulnerable."

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