By Rachel Petterson, contributor
April Hepler has known that she wanted to be a psychotherapist since she was in middle school and had imagined creating a retreat center since she was in college. Then, when her son was born with disabilities, her professional and personal experiences intersected and led her to found the nonprofit organization Adagio House in September 2019.
Hepler, who serves as the organization’s executive director, started Adagio House with the idea of providing psychotherapy services to caregivers while those they cared for could spend time with another staff member on-site during the therapy session.
Quickly, Hepler and her team saw wider opportunities for the organization to not only offer a break for caregivers but vital support services. To properly care for them during these respites, she said, caregivers would need to be confident their loved ones were safe and happy. From there, the concept behind Adagio House began to grow. Last month, Adagio House opened its new community center on Blackberry Lane, near EMU in northern Harrisonburg, to help expand its services.
Hepler said she wants to fill in gaps that day and residential services cannot fulfill–including serving as a “drop off” for when someone needs to go to the grocery store or take a moment for themselves at home.
Sandi and Robert Silvers have used numerous Adagio House services over the last three years. Robert is an adult with autism and paranoid schizophrenia, and he has lived with his mother since leaving a residential care program.
Sandi started using the respite services soon after her son returned home, and since then they have both attended psychotherapy there. Sandi also attends the caregiver support group when she can (sometimes, she said, respite services haven’t been available at the same time as those meetings). And Robert attended recreational activities at Adagio House last summer, which included going to a farm and interacting with music. Adagio House started a full summer day-camp last year, with plans to host it again this year.
Sandi first used the 90-minute respite periods to return home and get some sleep. The Silvers’ home is close by, which is fortunate because caregivers must stay within a 10-minute radius for safety. Now, she uses that time to do something special for herself or to run errands or sometimes to make important phone calls.
She’s said she’s not sure how they would have found respite services without Adagio House. Before Robert entered the residential program a couple of decades ago, she relied on connections she had as a special education teacher. Now retired, she initially went without any respite at all once her son started living with her again.
In an interview, Robert offered enthusiastic responses about his time at Adagio House. He’d done artwork and crafts, and he has gardened outside, which is related to his favorite topic: farming. His mother said on days they go to Adagio House, her son wakes up excited.
Each drop-off respite session costs $20-$40 on a sliding scale. In addition, if a caregiver uses therapeutic services at Adagio House, on-site respite is available for $10-$20 during that session. Adagio House offers all of its services on a sliding scale and participants can also apply for assistance from a Compassion Fund.
Adagio House’s counseling and occupational therapy services accept insurance, including Medicaid, with the aim to provide maximum financial accessibility while still paying their employees what organization leaders consider to be a living wage.
Hepler told The Citizen that, along with difficulty affording services like those at Adagio House, caregivers often have trouble finding attendants if they are using the Medicaid’s Consumer Directed Services. Adagio House helps facilitate attendant matching, aiming to put feelers out to those who might be interested in being attendants, using connections to local colleges to provide lists of interested people to families looking for attendants. The attendant program is entirely separate from Adagio House’s services and staff. Their role is only as a connector between parties.
In addition to respite and therapy/support services, the organization also offers massages, individual life-coaching for those who want strategic help with specific challenges, a support group for adults with ADHD, and a journaling group for women in leadership.
‘Reverse inclusion’
Hepler knows firsthand the importance of validation and connecting with a community in the face of the uncertainty and challenges that come with caring for someone with disabilities.
After she had her son, she sensed his behavior was atypical, although it wouldn’t be for another decade that he received an accurate diagnosis. In the meantime, Hepler struggled with others not taking her concerns seriously. She felt isolated.
“I needed a place where there were other people who validated and believed and trusted and walked alongside, even into the hard places,” she said.
This experience informed her vision for Adagio House.
“I started to think about: how do I create that? That space where we can walk alongside and it doesn’t have to be perfect, because it never is,” she said.
Hepler said she and her team recognize that their services are relevant to all kinds of people, not just those connected to someone with a disability. What makes them different is that, unlike most of the rest of the world, they center those with disabilities and their loved ones first and all others can join in and adapt to their world– a sort of “reverse inclusion,” as Hepler put it.
“What I know to be true is that the things that we do to make human beings living with disabilities and caregivers feel safe and secure here works really, really well for everyone else too,” Hepler said.
Hepler said she also aims for Adagio House to be welcoming to all. For example, she trained herself and her staff in vocabulary relevant to the LGBTQ+ community to ensure the organization is as inclusive as possible.
The organization is founded on principles of attachment theory, and this applies to both the programs they run for the public and the way they internally operate.
She wants Adagio House to be a place where people can come as they are, even if that means going outside and throwing ice from the ice machine or finding other safe ways to express sensory and emotional needs.
“We’re here to support, not here to fix things,” she said.
After all, she said, that’s what is needed for an environment conducive to secure attachment.
“When we think about attachment, we think about a balance between going out into the world to accomplish things, to have a life of meaning and purpose and feel confident and capable, and then coming in to get internal needs met, to be close to another person in more vulnerable, emotional ways,” she said. “That balance is really the key to secure attachment.”
This philosophy starts internally within the organization, with the aim to create a secure environment for the employees, who then work to give that to caregivers and others who use Adagio Houses’s services.
“To create a space where it’s okay for it to be all the things all at once, even if it doesn’t always make sense why it’s all the things all at once, creates a space of healing,” she said.
Room to grow
The opening of the new community center last month allows for more flexibility in the organization’s services.
The new space has a large kitchen and “sensory gym,” complete with a large swing, for the occupational therapist to use, as well as large spaces for meetings and movement and smaller rooms for quiet activities attached throughout.
The building was previously an event space, and Adagio House will continue to offer the large conference room upstairs to the public to rent out for events, providing another income source.
Adagio House maintains its original Chicago Avenue office for individual and group psychotherapy/counseling.
Looking to the future, Hepler says she has dreams of opening an inn for caregivers to stay overnight. She also said she imagines hosting field trips to the community center for special education classes at local schools and boarding facilities. And she envisions hiring additional staff, such as a speech therapist, psychologist and psychiatrist. Right now, the organization works with their clients’ personal psychiatrists as needed.
Adagio House also plans to use grant money or other income to make the community center more physically accessible, including the addition of motorized doors and an elevator. The second level of the community center is already accessible to those in wheelchairs but only from the outside.
‘Meet me where I need to be met’
In the meantime, the Adagio House’s services function as a way to open a pressure valve for caregivers.
Sandi Silvers said one of the benefits she found from therapy was finding relief from a sense of isolation.
“I started there just as venting, and it was absolutely wonderful,” she said.
Robert Silvers also goes to therapy, and he’s recognized the benefit for his mom. At the mention of his mother going to therapy, Robert chimed in—“for your coping skils.”
Sandi said she’s grateful for the acceptance she and Robert have found there.
“They appreciate [my son’s] humor and they are just really willing to work with him and meet him where he needs to be met,” she said, “and meet me where I need to be met.”
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