Walker arrived at The Dorm with a deep sense of hope that this would be the turning point he had longed for — in his own words, “my struggles with social isolation, executive functioning, and a lack of motivation made me unable to engage in life as I wanted.” His diagnoses of depression, anxiety, and Autism Spectrum Disorder (ASD) interfered in nearly every aspect of his daily life, such as his ability to maintain relationships, his career aspirations, and even the simplest daily tasks. He was also on a leave of absence from his university and hoped to return to school the following semester with The Dorm’s support.
Walker was also in the midst of exploring his identity as a transgender and gender nonbinary (TGNB) individual, a process that was both affirming and challenging. His growing passion for LGBTQ+ advocacy was intertwined with his own need for community—he was looking for a space where he could be seen, heard, and celebrated for who he truly was, and hoped he could find supportive peers at The Dorm.
Treatment and Life Goals
Walker hoped to achieve the following during his time at The Dorm:
- Practice life skills and return to a more functional way of living
- Learn ways to get over his social anxiety
- Return to school
Treatment Plan and Recovery Journey
Individual Therapy
In individual therapy sessions, Walker’s treatment team used the following modalities to work on his presenting problems and treatment goals:
- Dialectical Behavioral Therapy (DBT) and dialectics, or the idea that two opposing things can exist at the same time. This framework directly challenged the rigid, black-and-white thinking patterns often associated with his ASD, and over time, DBT helped Walker develop greater cognitive flexibility and engage in deeper introspection about his worldview.
- Cognitive Behavioral Therapy (CBT), specifically culturally competent and trauma-focused CBT, tailoring treatment to his TGNB identity. Walker explored the impact of stigma, discrimination, and other sociopolitical stressors on his mental health, while developing strategies to challenge negative thought patterns and build resilience.
- Family Systems Theory, or the perspective that families are interconnected units where each member’s behavior influences the whole system, to help Walker gain insight into family dynamics.
Clinical Coaching
Walker’s clinical coaching sessions consisted of these skill-building techniques:
- Executive Functioning Coaching (EFC), to assist with his depression and ASD-related struggles with daily activities. His coach provided both onsite and offsite support, helping him build practical skills in time management, organization, and task completion, which gradually improved his sense of structure and autonomy in everyday life.
- Behavioral Activation, a technique used in CBT rooted in the idea that by changing our behaviors, we can directly influence our mood and mental state. Behavioral Activation helped Walker engage in activities he was interested in to decrease his depression and anxiety symptoms and increase motivation.
- Walker also collaborated with his coach to identify a trans-affirming healthcare provider, an important step as he began exploring his medical transition.
Parent Coaching and Family Therapy
Walker experienced high family conflict rooted in the tension between parent expectations being at odds with his own beliefs. Through parent coaching and intermittent family therapy, his team worked together with the entire family system to explore family roles, patterns of under- and over-functioning, and the importance of healthy boundary setting. Walker’s coach also worked with the parents individually on managing their anxiety surrounding his transition back to school, which Walker was actively working on during his time at The Dorm.
Group Therapy
As described by his treatment team, Walker was a great contributor, respectful and gave insightful feedback — an overall “ideal client” in group therapy. Some groups he enjoyed included:
- Radically Open DBT (RO-DBT) Group, a branch of DBT geared toward individuals with rigid thinking and behaviors, where Walker practiced emotional openness, embracing flexibility, and building authentic social connections.
- Trauma Group, where he connected with many other peers who have experienced trauma and found a supportive community to help process his own experiences, allowing him to feel less alone in his healing process.
- Relationship Group, where Walker learned skills to better communicate with his family and friends, helping him gain insight into his relational patterns and learning strategies for setting boundaries and expressing needs.
Community Clubhouse
At The Dorm, Walker finally found a sense of belonging. Beyond the trust he built with his treatment team, he formed deep, meaningful connections with his peers, in both clinical and casual settings. The support system he cultivated with these peers was a lifeline, helping him overcome the social isolation he had struggled with for so long.
Walker Today: Outcomes
Today, Walker is back in school full time, fully immersed in his physics studies. The intensive care, individualized treatment, and group sessions he received at The Dorm played a crucial role in his transition, helping him rebuild the confidence to return to an environment that had previously been associated with stress. Walker now also has an improved relationship with his family and a close circle of friends, integrating a system of camaraderie and support into his daily life.
At The Dorm, Walker became fully involved in his passion for LGBTQ+ advocacy, volunteering with LGBTQ+ organizations and offering one-on-one support to others navigating similar challenges. This work brought him a sense of purpose, and allowed him to give back to a community so central to who he is. At discharge, Walker began working with a trans-affirming therapist and started his medical transition, marking an important step in his journey toward self-authenticity.
