He's Home

Discussion in 'General Parenting' started by WSM, May 26, 2009.

  1. WSM

    WSM New Member

    Discharge plan: individual and family therapy, monitor medications.

    difficult child didn't want to come home, husband said, "I tried to talk to him but he's not being nice to me and I was starting to get mad. Nothing's going to change."

    He's going to school tomorrow. There was another kid from his school in the psychiatric hospital with him. Wonder if difficult child's worried about walking into that school now that everyone knows he stole a nintendo DS from one of them.

    We had to do a sweep before he got home to make sure that all our valuables and sharp objects were secured. What a drag.

    psychiatrist tomorrow, therapist the day after, then we'll see what has to be done. I already know, call DCF, call the judge. DCF will think he's not bad enough for them to pay to put him in residential. The judge will say: we aren't a babysitting service (I heard him say that abt a 16 year old girl who had no place to go pre trial. Her family refused her and several facilities refused to have her back too. They finally found a place 7 hours away.

    He was diagnosis'd with "MDD severe" along with ODD and b/pd. What's MDD?

    It cost $700 for a 7-day stay. We read the hospital notes: it sounds like his stay wasn't as peaceful as the therapist on Saturday made out. "Guarded. "I'm fine" minimizing outbursts, seems unable to understand consequences, aggressive @ home, compulsive lying, stealing, easily agitated and angered, poor inpulse control, SI/HI, alert, anxious mood/affect, limited insight/judgment/impulse control, irritable at times, easily agitated, sleeping well, hyperventilate at times. "

    Hyperventilate at times? Irritable? Easily agitated and angered? Those are things we haven't seen.


    We are back where we started and $700 poorer.
    Last edited: May 26, 2009
  2. smallworld

    smallworld Moderator

    MDD = Major Depressive Disorder
  3. busywend

    busywend Well-Known Member Staff Member

    But, you have started a paper trail that I think prove very valuable to you in the future. I am sorry it is so difficult to get the help these kids need.
  4. Wiped Out

    Wiped Out Well-Known Member Staff Member

    I'm sorry the hospital stay didn't help but like busywend said you did start a paper trail. Sending hugs your way.
  5. CrazyinVA

    CrazyinVA Well-Known Member Staff Member

    Add me to the "paper trail" comment list. It may take awhile to secure DCF funding, they will probably want to see an escalation of events. I'd defintely give them your log. Does your insurance have an out-of-pocket maximum per year? With copays like that, the good news is you may hit the maximum sooner! (yeah, that's me, silver lining gal)
  6. lizanne2

    lizanne2 New Member

    Sending you support and an extra guardian angel.

    Sorry that there is a slow start to him receiving the help he needs. As everyone has said, you have started the work.....

    Hang in there.
  7. WSM

    WSM New Member

    We didn't have a good night. He snuck a steak knife upstairs from the dinner table and tore the stuffing out of a stuffed animal.


    He and husband are at the psychiatrist right now.
  8. Jungleland

    Jungleland Welcome to my jungle!

    I suggest not allowing him near ANY sharp objects. Cut up his meal for him, or better yet, serve him Oatmeal. It is healthy, filling and NO knives needed. Or sandwiches, etc. I know, you probably are already doing that and I am being reduntant, but just in case...

    What else does he have to do for DCF to step in? Sneaking knives into his room is a MAJOR danger to himself and others. OMGoodness, let the judge take him home for a few days!!!

    Big, gentle hugs and praying things will calm down. You don't need this!!

    Hugs, Vickie

    P.S. I get nervous when I find my difficult child with a thumb tack! Yikes, couldn't imagine if she snuck knives!!
  9. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Lock up the knives, scissors, etc. and use little plastic for silverware and paper plates (so he can't break the plate and use it as a weapon). As a bonus, you won't have to wash dishes.
  10. GoingNorth

    GoingNorth Crazy Cat Lady

    Be careful with the plastic-ware. It can be broken and used as a weapon. I have a friend who worked in corrections warn me about this.

    I have also cut myself twice on plastic-ware. .One of those cuts required a couple of stitches!
  11. WSM

    WSM New Member

    Just talked to husband on the phone. The psychiatrist appointment was a disaster. She yelled at him. She said she didn't understand why he was hospitalized, she thought that depakote was dangerous, particularly for children, it causes irreversible liver damage and the risks are too high, and she gave him an rx for riperdal.

    husband told her about the knife and the torn up lamb and difficult child said someone else did it and she sort of believed him. Said that husband had to consider that someone else was doing these things to make him look bad (that's difficult child's promotion). husband said straight out he would not be considering it (after all this has been going on for over 2 years, it happens when only husband and difficult child are in the house, it happens when there are any random assortment people in the house, and it happens when he's in the house alone). She said she didn't think he was innocent of all of it (after all difficult child admits to some of it) but husband should consider that someone else is doing this.

    She also said that depakote wouldn't stop his impulse control problems but risperdal would.

    She wouldn't support residential, thinks that he's a rejected child and no wonder he doesn't want to live with us and said husband has to advocate for difficult child. She said going to residential wouldn't do him any good, he'd come back the same as he went in. husband said, "But we'd all get a break, it'd make him happy, it'd let the rest of us relax." She was angry at that answer. And said he had to support his son.

    husband feels beat up and difficult child is pleased. Tomorrow is therapist, the one who said he needs immediate hospitalization. husband and I will talk to him and see if he can give us a reason to stay with the psychiatrist. Then he's going to find someone else. He doesn't see any reason to fight the psychiatrist as well as everyone else.

  12. CrazyinVA

    CrazyinVA Well-Known Member Staff Member

    Run, do not walk, to a new psychiatrist.. if you can convince husband of this. If you like the therapist and he is supportive, maybe he can give a recommendatin of another psychiatrist that he's worked wtih before. I found that it was imperative that the psychiatrist and therapist were on the same page and worked well togehter.

    I'm so sorry.. did she say all this in front of difficult child?? Talk about undermining you and your husband. Absolutely infuriating.
  13. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Ok, fire this psychiatrist and head for the hills. I'm not a doctor, of course, but even I know the doctor is clueless. Depakote is routinely given to kids for epilepsy. Is she NUTS???? It's not always effective as a mood stablizer, but it IS a safe one. As for believing his silly lies, does she think a stranger climbed through his bedroom window to set him up? Or does she believe it's one of his well-behaved siblings.
    If you stay with this crazy doctor, expect this kid to get worse, not better. I'd have walked out of that meeting with a phone book in my hand because even picking a doctor out of the phone book has to be a better risk than continuing to go to her.
    I'm flabbergasted. What on earth can therapist say to convince you that this doctor is competent?
    Get thee to a brand new psychiatrist...STAT!!!! Never see this one again.
  14. WSM

    WSM New Member

    I don't know if she said this in front of difficult child or not.

    I think the therapist is going to have to be very persuasive for husband to go back to the psychiatrist again.

    I have no problems with him being on depakote or risperdal, I have no loyalty to one drug or the other. He seems to have no side effects with depakote, but he also never struck me as having real problems with mania or seizures. Risperdal sounds like it has some success with- schizophrenia which my uneducated self thinks is closer to what difficult child's real problem is. That and perhaps some personality disorder.

    Interesting that she acknowledges that he has impulse control problems but thinks he might not be doing the things he gets caught doing.

    Interesting also that she didn't say he doesn't need anything but the lexapro she originally rx'd him.

    I doubt we'll see her again. We will take criticism, but we are not going to tolerate willful blindness.

    by the way, daughter age 9 cried when she saw what happened to the lamb this morning. husband got her calmed down. Yesterday when difficult child came home she said she wasn't really glad he was home.
  15. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    To me, the point is, psychiatrist doesn't even know about the medications. What else doesn't she know about?
    She just sounds really awful. I wouldn't put up with her and wouldn't believe she sould help. JMO.
  16. gcvmom

    gcvmom Here we go again!

    I am just flabbergasted at the psychiatrist's comments. Ditto to what the others said to run, not walk, to a different psychiatrist. That's just mind boggling for her to suggest someone else might be doing these "things" to make him look bad! What kind of fantasyland is she living in?

    I agree that Risperdal would be a good choice for difficult child, based on what you've described. Not sure why they put him on Depakote -- it's typically for manic symptoms, which is why my difficult child is on it. If they truly think he is depressed, then Lamictal would be a better mood stabilizer choice because of its antidepressant qualities. It worked very well for my husband when he was on it. But I'm certainly not a psychiatrist. And I sure don't understand that one!

    Good luck!
  17. recovering doormat

    recovering doormat Lapsed CDer

    You poor thing! That doctor is incompetent and dangerous. I'm praying she didn't say all of that stuff in front of your stepson.

    Everything you have told us about this child screams that he needs a good, long-term (12 to 18 month) placement in a facility that can confirm his diagnosis, make sure the medications are right, and help him work on his problems. and the rest of you surely need a break before you all collapse.

    I could smack that doctor for talking to your husband that way.

    Risperadal was given to my son in a small dose after his first hospitalization (zoloft and risperadal). His diagnosis was Generalized Anxiety Disorder (GAD) and ODD and the risperadal was for impulse control. The only issue was that it tended to make him sluggish in the morning, and that affected his school work.

    This incident with the knife jolted me back to the first time our son was hospitalized at age 9. He was there for seven days, discharged (reluctantly by the therapist, who felt that she didn't get to see the real kid) on a Friday afternoon, and by Sunday night, I was calling 911 to get help to take him back to the psychiatric hospital. He went crazy adn was running around the house, tried to push a second floor window screen out to jump out the window. He went back to the psychiatric hospital that night and stayed for two weeks. When we brought him back to the hospital the social worker on duty at the nurses' station said he wasn't surprised, that he had predicted we would be back. These short stays just don't cut it with disturbed kids.

    As it turned out, my son had his fifth inpatient hospital stay this past January; the good news is that he is no longer violent toward people or property.
  18. WSM

    WSM New Member

    Went to therapist tonight (he's a pediatric neuropsychologist who worked 7 years in a Residential Treatment Facility (RTF)). He gave the name of another psychiatrist if we wanted to change and suggested we finish out the month with the depakote and see what happens. In short, he didn't give much direction or opinion one way or another. husband is going to research depakote and decide about which medication to go with.

    He didn't seem to think much this time about or feel urgent about difficult child going into residential except that maybe we as a family are all burned out. Last time he was saying: "He's very disturbed, very very disturbed, and needs immediate treatment" and pushed us into the psychiatric hospital (and $700). This week he proposed the dread behavior modification plan.

    God I hate behavior modification plans. EVERY SINGLE SOLITARY therapist want to 'start over' and try a behavior modification plan.

    And they never work. And they cause trouble between husband and me.

    So now we have to come up with three levels of responsibility and rewards, and if difficult child performs well at 80%, he gets his reward.

    So there should be five behaviors, telling the truth, being where he's supposed to be, respecting property, saying please and thank you (never an issue-ever), and putting his plate in the sink after dinner (never ever was this a problem).

    Of course I asked 'how do we know if he's telling the truth? How can we quantify it to decide whether he gets his reward?'. Well, you ask questions you know the answer to: did you go to school today, did you have dinner, etc... Great: this is where husband and I are going to have problems: husband will ask "Are you holding a fork? Are you eating potatoes, are you wearing shoes, do you have red hair?" and I'll ask, "Did you stab that stuffed animal?" He'll tell the truth 4 times and lie about the stuffed animal once and his score will be 80% and he'll get his reward, although his behavior changed not one bit.

    There'll be: well today he didn't throw away his shoes, he didn't break his lamp, he didn't rip a book, he didn't cut his clothing, he didn't throw syrup all over his room, but he did spray paint his wall." Again, 80% and he gets a reward. (even tho other professionals have said you don't reward for not doing bad things...should every kid get a reward for not throwing away their shoes?)

    ANd if after three or four weeks, he keeps failing, that means his tasks are too hard, so they will be rewritten to make it possible for him to be rewarded.

    Also, it gives great scope to husband and me to argue over what is a lie and just a misunderstanding or a difference of perspective or what might really be true, give him the benefit of the doubt. And did he really wander the neighborhood or not. Or steal the money or not. I want to cry.

    And then it will be once again, "You're just the stepmother, I'LL decide" of course, then when real trouble comes, it's "I want us to be a team" (and did I mention the therapist at the psychiatric hospital said I was essential to helping fix the problems and perhaps even more crucial than husband?).

    husband is salivating at giving difficult child rewards at any pretext. He believes in bribing difficult child to behave even though he won't admit that's what it is and knows it has never worked in the past--not ever. But it makes difficult child like him better.


    The other problem is this business of 'starting over'. No. I will not. I will not roll over and expose my belly to this kid. We have safe guards in place that help reduce stress a bit, I will not dismantle them to 'give difficult child a chance'. A fact of life that everyone, even difficult children who can't help it and didn't ask for these problems in their lives have to live with is if you screw someone over often enough they will not trust you and that will have unpleasant consequences for you. If you screw someone over enough, they will learn to protect themselves from you and it might not make you happy how they do it.

    It's unfair and I will not consent to giving up lessons learned. And I've learned difficult child cannot be trusted AT ALL and must have his hands watched every single solitary moment. Sorry, it's an unpleasant reality, but it's something we've learned the hard way and at great cost. We aren't going to pretend it doesn't exist. No, I refuse to 'start over'. Any behavior modification plan is going to have to take into consideration the need of EVERYONE in the family to be comfortable with it.

    I am so discouraged.

    I hate behavior modification plans. One thing I know, is if we persist, difficult child will sabotage the effort and it's likely this therapist will give it up, like most of the others have. Then maybe we can get real help.

    Except probably we can't because it doesn't exist and difficult child isn't yet dangerous enough to get the government involved.

    I'm very depressed about the whole thing.
  19. gcvmom

    gcvmom Here we go again!

    I'm curious what the therapist sees that's changed since his last recommendation for hospitalization and his assessment that difficult child was very very disturbed? What's different that he thinks behavior mods will now work? Did any one come straight out and ask him to explain his new approach?

    husband is going to play this little game with difficult child and nothing is going to change.

    Continue to speak your truth and hold firm to what you know will keep you safe. I'm so sorry things seem to be in limbo.
  20. WSM

    WSM New Member

    No. The session seemed unfocused and unfinished. The therapist also didn't want to talk about anything negative about difficult child--no discussion of the stealing the nintendo DS, no discussion of riding the bike around the neighborhood and abandonning it in someone's yard, no discussion of stealing a steak knife and tearing apart a stuffed animal, no discussion about the lies. therapist kept saying: that's in the past, we're starting over.

    (I wish credit card companies had that philosophy).

    We've been told before the difficult child needs cognitive therapy, it's so hard to find someone who will do it. Does it even exist? Behavior therapy just doesn't work with him.

    I feel myself just shutting down.