Earlier this year at REM Iowa’s program in Coralville, the health of one of the residents was deteriorating. Although he was on a host of behavior modification medications, his behavioral episodes were increasing, and he was undergoing nearly 40 manual restraints a month. At 6’1, his size, strength and aggressive behavior presented treatment challenges that could lead to a new placement in an institutional setting. Beth Thompson, who had worked with the boy for more than three years, couldn’t stand the thought—Coralville had become his home. Beth suggested taking him off all of the behavioral medications that he’d been on since the age of eight. After all, they hadn’t helped him thus far—were they really making a difference in his life now? Not surprisingly, Beth’s proposal was met with significant scrutiny, and many were quick to disagree. But Beth believed in the solution, and working directly with the boy’s family, doctors and psychiatrist, as well as with the rest of the Coralville staff and her supervisors, Beth devised a medication reduction plan. The hospital was notified in case of emergency and Beth prepared the boy for what was to come. That was in January. In September, the young man started high school—free of any behavior-modifying medications.