Help / Advice Needed for Upcoming Meeting...

Discussion in 'General Parenting' started by DaisyFace, Jan 18, 2011.

  1. DaisyFace

    DaisyFace Love me...Love me not

    We have a meeting scheduled next week to determine a "Total Service Plan" for difficult child.

    Having been "burned" in the past by not knowing what to say/do/expect/ask for - I am VERY nervous. I have never been through a TSP meeting before. I have no idea what to expect.

    Our caseworker is pretty new to the job, too. When we first met her, she described how her last two cases were helped by getting the child a mentor. The mentor would take the child out into the community for some one-on-one time, get an ice cream...something like that - and give the child a chance to develop a positive relationship with an adult role model and discuss issues that were going on at home and at school.

    I think it's gonna take a lot more than a weekly trip for ice cream to solve our issues with difficult child...

    The caseworker already has a MOUNTAIN of information (from me) going back several years in her file, as do the therapist and psychiatrist. This is difficult child's first year in this school - so they haven't seen a lot. All they know is that teachers are complaining that difficult child is not doing homework....thus earning Cs andDs instead of As and Bs.

    My worry is that all these folks have so much information in front of them - they are going to lose sight of the "big picture"....and/or focus on the stuff that is easy to fix.

    I'm worried that they will focus on the weekly ice cream and tutoring after school because it is simple, easy and inexpensive (and has nice, easily attainable goals) - as opposed to considering an expensive Residential Treatment Center (RTC) placement for the scarier issues and less attainable goals.

    How should I prepare?

    Should I go in with a goal in mind? Like "SAFETY for difficult child and the family".

    Or is my role just to listen to the experts and see what they recommend?

    How do these meetings typically work?

    Thank you for any insight...
  2. DammitJanet

    DammitJanet Well-Known Member Staff Member

    DF...have you completed a parent report yet? If not, get one done before this meeting. Make nice copies for everyone. There is a format in the archives or somewhere. I know its either in the FAQ's or Susiestar's signature.

    Then...make a nice one page bullet-ted note for yourself. Call it your concerns/issues and requests paper.

    Put down all the things that you know about your daughter. What she has done and what you are worried about but in short blurbs.

    Put down in short blurbs what you think would help.

    I dont think a mentor is going to help either. A community support technician might but that would have to be someone who came out a whole lot more than one time a week for an hour. Someone who met with her every day from the time school lets out...say picks her up at school and works with her until 5 or 6 pm on therapeutic issues and community/family issues would be good. Thats if they dont want to jump head first into Residential Treatment Center (RTC).

    Personally, I would want Residential Treatment Center (RTC) but most times they want LRE first so I would request a full time support person with her 8 or more hours a day with her. Cory had this up until he was 15. Actually I think he had one after that if Im not mistaken...could have been one more at one of the group homes.

    This would be a person who is assigned to your daughter to shadow her wherever she goes. School, home and community. They are there to help her, redirect her, help her with therapeutic goals, get her to therapy, work on skills, all that good stuff. Basically a junior therapist that can be with her most of her waking moments except nights and weekends. Some can even get weekends but that is rarer.

    I would also ask for individual therapy for her with a therapist well versed in teens who are starting to show symptoms of borderline. This means they know how to work on DBT. Also ask if there are any group therapy sessions near you that she could attend. Also ask about getting her into programs to work on her self-esteem and keeping her away from drugs and the dangers of teen sex.

    Just rattling off some things off the top of my head.
  3. DaisyFace

    DaisyFace Love me...Love me not


    That is just off the top of your head? Wow!

    I didn't even know those types of things could be done for a person!

    Yes, Residential Treatment Center (RTC) is my first choice too - but I'm willing to bet they don't want to go that route straight out of the chute.

    I didn't know I could request a full time support person. That's good to know!

    OK - full time support person
    DBT therapy
    group therapy
    anti-drug / anti-teen sex programs

    As far as a parent report goes - I've got a folder about two inches thick with all the copies of everything in it...reports from docs, hospitals, school incident reports, grades, attendance reports, police reports, etc. The caseworker already has a copy. The psychiatrist and therapist should already have most of it.
    My worry is - it's so much paperwork people's eyes just begin to glaze over.

    Would it be appropriate to make a summary with bullets for everyone at the meeting? That way I could highlight the top concerns right up front...

    Or would that be a little too "pushy"....?
  4. DammitJanet

    DammitJanet Well-Known Member Staff Member

    A parent report summarizes all those reports. It is basically like a life history of your daughter. I even put a picture of Cory on the front of the report so they knew who they were talking about...and the picture I used was his Head Start graduation picture which was just so cute you couldnt help loving

    I wish I still had my parent report but I lost it in one of my computer transfers. I think I had it on a floppy disk if you can

    Its basically...difficult child born on blah blah blah birth info.

    Family history and family genetic history.

    difficult child from toddler through preschool.

    Maybe significant things about her at different ages that you noticed or this is the time to put in any times you have had her tested...such as...In June of 1999, difficult child was hospitalized at XXX and Dr P dxd her with ADHD and ODD and placed her on YYY.

    On NNN, BBB school reported that difficult child did kkk and she was suspended for 5 days.

    You get the drift. Put it into short things for each year. Hit the highlights.

    I think Cory's parent report went everywhere with him for years. I started his at 12 after I landed here. It went with me to his first psychiatric hospital, to court (his case manager, therapist, PD, DA and the judge all had a, to every IEP meeting, to every team meeting to secure services even those I didnt attend when just his case manager went trying to attain higher levels of care. I was told without that report we would never have gotten him into a locked facility because you have to provide so much evidence and its just so hard to do that. I had it all down in one very neat package for them with incidents, dates and times.
  5. susiestar

    susiestar Roll With It

    The outline for the Parent Report is in the link in my sig. I got tired of having to go find it in the archives. It is FAR more useful than the pile of paperwork you have, though you need that paperwork to make the report. Read the explanation and outline. The picture is an excellent thing. I went further because I know the docs we worked with didn't read all of it. Or if they did they had so many distractions they forgot which kid was which partway through. I copied a picture of Wiz onto the front, and onto the first page of each section (smaller picture on the first of each section). That way they not only saw his name, they saw the FACE. If you have any video of her rages, pics of damage she has done to the house, etc... put it on a disc. Print the pics and copy them into the report. MANY of us have found that NO ONE believes the rages are what we say until they see them in person or on video. It is one reason that nannycams and surveillance are so helpful if you can afford them.

    If you can, use those reports to make a timeline. sort of like in history classes, that arrow divided into years with points marked where things happened. It can be very illuminating to show either how things are just staying the same or how they are getting so much worse, depending on what is happening. OR getting better if that is happening (not in difficult child world very often, sadly).

    When you go in have your list of dream supports. If you had this difficult child and all the $$ and cooperation in the world, what would you want? Include RESPITE, crisis services so that you can call when she goes off at home, someone to shadow her 8+ hrs a day INCLUDING TIME AT HOME - NOT NOT NOT just at school.

    You need something to work on her bizarre thinking. I don't know if it is grandiose or delusional or magical or what, just that she often seems to have no concept of reality based on waht you describe. Go back through your posts and note what you have written. Include the internet stuff and her high risk of becoming a victim of sexual violence.

    The anti drug/teen sex programs are good to add in though they will have to be extreme to make any difference to her. in my opinion the shadow needs to have the job of keeping her from making plans to meet boys for sex, esp if they are not boys like her last internet plans. Her safety MUST be included in this person's job.

    A metnor is NOT going to work. If it is a guy then it will be someone she tries to hook up with or he will have friends/kids/etc... that she will set her eyes on. If it is female she will either use her as an excuse to get out of the house or to meet males. she is really good at manipulating poeple at first, so this needs to be a thought.

    She also needs someone to work with her on personal hygeine and appropriate behavior. Chances are it is part of self esteem issues and DBT may help, so go for that help (therapy).

    Does she have any learning disabilities and are there any assistive technologies that would help? Toss those in (like the Alphasmart NEO2, a word processing tool for kids/schools. Very durable, one piece, no internet access so she can type assignments and NOT go online.

    As she will be 16 in less than a year, you are going to need to start thinking about transitional services. Those will help with whatever she will need to function as an "adult" after age 18. I am not terribly familiar with what is involved, but others here should be able to hel with that. Not sure you need this NOW, but you need to start thinking about what is going to be needed to help her become an adult (will she be able to stay at home after age 18? What will the rules be? Rent? Job? School? etc...).

    Given the desire to get into trouble with drugs and sex, you may want to ask for as much intensive help as possible. The more you push for the more they will start to think Residential Treatment Center (RTC) is more able to provide what she needs. Looks at how her choices and behaviors impact your son. Is she a danger to him? You have been afraid that she is trying to find someone to come and kill you or help her kill you. Do NOT leave that out or forget to push this fear into the mix. THis means she is a danger to her brother as well as to you and husband. A lot of focus needs to be placed on how to keep him safe from her, esp after school while you are at work. This total service person NEEDS to think about this too, as do the tdocs and psychiatrists - though my experience is that MANY people don't want to think about i t and won't unless you force it into their laps. We even had a JUDGE who didn't want to hear about how Wiz hurt his sibs until I got insistent. I thought I was going to get a contempt of court fine at one point but the CPS people stood up and said if I wasn't insistent then they couldn't leave the sibs with us because he was too dangerous. Of course THEY (cps) didn't want to DO anything, but they did say that to get the judge to listen.

    Anyway, work on the parent report and timeline. As you go through all that stuff, think about what would help. Integrated Listening Systems (ILS) (Independent living skils) therapy? In home therapy? Shadow to keep her safe because she is determined to be unsafe? Training/supervision of personal hygeine? Anti drugs/sex/gangs programs? (Not sure if she is aware of/interested in gangs, but they often attract kids who want to use drugs and have sex, so it is something to think about) DBT therapy? Respite for the rest of the family? Programs to help your son deal with the stress of living with difficult child?

    When yo go into the meeting, have the parent report, your bullet lists, and a summary of the parent report (think of it like an executive summary written for a boss), the timeline, etc...

    Timerlady might be a good person to ask about what all can be offered as her kids have had a LOT. Just as a thought, if Residential Treatment Center (RTC) is not available, would a therapeutic foster family be helpful if they were truly therapeutic and she was the only one or was in a house with up to 2 other girls like her? I don't know if it is a good idea or not as it would depend on the training of the family - I have heard some are not trained at all and some are trained very very little.

    I hope this helps.
  6. timer lady

    timer lady Queen of Hearts

    DF, are you getting a waiver for services? That would dictate the dollar amount being spent annually. Once we knew that amount our team broke down the services available for the tweedles.

    Our number one item was respite; husband & I knew we could handle anything if we knew that respite was coming. At first we had 2 respite weekends a month. We were given PCA (now it's home respite), Integrated Listening Systems (ILS) (independent living skills training) & in home therapy. Keep in mind this is extremely intrusive so I would ask for anything that would take difficult child out in the community.

    Saying the above, this all depends on what the team recommends & how the services are alloted. Some services are more costly than others.

    Definitely be prepared for this meeting with a parent report. Have any & all documentation for all crisis calls, hospitalizations, school behaviors issues, etc. If you can have a letter from psychiatrist & therapist explaining the need for this or that service. I know there is a thread somewhere in the archives about how I requested & rec'd services & setting them up.

    Each staffing meeting I attend I also focus on the positives; it's real important for me & I think the team appreciates that not everything is negative.

    Good luck & keep us updated.
  7. DammitJanet

    DammitJanet Well-Known Member Staff Member

    I only know what is available locally so keep that in mind. Here respite is very hard to find. You have better luck finding a person to be with her 8 hours a day home, school and community. Im not exactly sure what they call them now but when Cory had them it was called either High Risk technician or Community based technician. When he first started the program they were called day friends and that was what we always called them. I will be honest here and say that I thought they were well trained baby sitters for problem kids. often do you see a 14 year old with an adult following them around in the classroom, then to lunch, then to gym, then taking them home? How does that kid explain it..oh..this is my I often wondered how Cory dealt with that.
  8. DaisyFace

    DaisyFace Love me...Love me not

    The therapist will be at the meeting.

    The original referral to get us to this agency came from the psychiatric hospital.

    psychiatrist, school counselor, and another party I don't recognize have all been invited to the meeting. The invitation letter states that an array or services will be discussed, including possible placement and "if you or your representative does not attend....we will assume that [your agency] is willing to participate in any cost share agreement [for treatment]."

    psychiatric hospital recommended Residential Treatment Center (RTC) "off the record"...meaning they thought it would be a good option if we the parents would find a private placement and pay for it 100%. Short of that, they no longer refer children to RTCs. So no "official" letter from them.

    therapist will recommend Residential Treatment Center (RTC) - but cannot commit to funding.

    psychiatrist may or may not recommend Residential Treatment Center (RTC) - but will also not commit to funding. I'm kinda hoping he won't show up...he is elderly and sometimes has "off" days. He might just tell them everything is fine with difficult child!

    The school will definitely object to any funding commitment on their part....and will most likely recommend a "study skills group" and similar services that are already offered at the school.

    I think the funding is going to be a HUGE factor. The services the caseworker mentioned are the "mentor" program and occassional respite with a foster family. The caseworker says they sometimes do Integrated Listening Systems (ILS) - but it's very expensive so that's not always available.
  9. DaisyFace

    DaisyFace Love me...Love me not


    Would it make sense to bring an abbreviated parent report? You know, basically a one-page summary of all the issues that are happening now?

    My feeling is that they should see that difficult child needs help in all these different areas simultaneaously.

    Whereas the files everyone already has - especially due to their size - are divided into sections like "Problems at home", "Problems at school", "Problems with peers"

    I don't want to give them the opportunity to say "Well, let's just start with this problem and worry about one thing at a time..."

    I want them all to look at it and say "Well, rather than hiring a different specialist for each thing - it makes more sense to get her into one program that can deal with all of this."
  10. susiestar

    susiestar Roll With It

    That makes sense, but you need the full report to make the abbreviated one or else it will likely miss things. On eof the benefits of the parent report is that it shows all of the things you have tried. That is what we mean when we say to bring the parent report and a bulletted list of the problems and interventions/solutions. They do need to see al the problems that are going on at once in outline form or bullets. If you have it in paragraph form it will NOT get read and understood.

    The timeline I suggested can also show how a few problems grew and grew into a large number of complex problems because they threw fingertip bandaid solutions at severed artery problems.
  11. DaisyFace

    DaisyFace Love me...Love me not

    That's a good point. In documenting all of the troubles - I have not documented the solutions that were tried and failed....
  12. DaisyFace

    DaisyFace Love me...Love me not

    And I just found out--

    The name that I did not recognize on the invitee list is an administrator from the psychiatric hospital.

    Should be an interesting meeting...
  13. susiestar

    susiestar Roll With It

    Maybe they are investigating whether some time in the psychiatric hospital would help her?? Could be a good thing?