Residential Treatment Center (RTC) ahead

Discussion in 'General Parenting' started by butterflydreams, Mar 13, 2008.

  1. Well, we had a treatment team meeting today. My daughter (15) wanted to go so she could share what she has observed and/or dealt with difficult child. Anyway, the doctor has said that he is getting worse, not better and is also regressing in age activities. He is "holding it together" this week during the day while there, but the doctor is not surprised that he is putting on a show for them. Anyway, he said he needs intensive help. He is having the nurse that works in the program (and handles all insurance and paperwork) to contact the insurance company about Residential Treatment Center (RTC) benefits. They are pretty sure there isn't, in which case I will have to go apply for Medicaid for him. We don't qualify as a family, but they said I can apply on his behalf for just him. I am not sure how this will work, or what will be involved. He receives social security survivor benefits from when his father died. I don't know whether or not this will affect anything, or if they will take this money or what. I guess I will find out. I don't even have a clue as to how long to expect him to stay in a Residential Treatment Center (RTC) (or where it would be located). I asked about the only one I had heard of here and the doctor assured me it wouldn't be that one, which I am glad because I haven't heard nice things about it. We may have to even go out of state, but he said one thing at a time, lets check on coverage first.

    I feel that this is the best situation for him. He needs more help that he is getting there. We haven't accomplished anything in the 3 weeks he has been there, except for the doctor to see really how difficult child is doing. My daughter and I are both suffering from all of this. My stress level, blood pressure, blood sugars (I am diabetic) and overall anxiety are WAY up. My daughter has had a real tough time, because he targets her so much of the time.

    The doctor also talked about adding a mood stabilizer. He said he would get back to me on that.

    For the time being he will stay in the outpatient program because there is no way he can go back to regular school at this point.

    There is no way I can afford our current rent without the addition of his social security that we receive now, I am stretched as it is. I am going to start looking at finding a different apartment that is cheaper, but not in a worse part of town.

    Hopefully I will hear tomorrow about the coverage since I haven't heard anything today. I just wonder if we have to apply for Medicaid for him, will it take awhile? or under the circumstances will it be fairly quick. I really don't know what to expect.

    I am just so drained right now. I know I am doing the right thing, but that knowledge doesn't make it any easier.

  2. ML

    ML Guest

    ((((Christy)))))) Thinking positive thoughts and visualizing good news for you. ML
  3. Steely

    Steely Active Member

    Just wondering, as I am not sure, if a mood stab should not be tried before Residential Treatment Center (RTC) - or maybe it has. What medications has he tried? What other interventions?

    Many, many people wanted my difficult child to go to a Residential Treatment Center (RTC), and I held out. Not sure whether long term this was the right decision - and there are many times I regretted it - but I also felt so confident that my difficult child who had already lost his bio-dad through abandonment, could not lose his other parental force, through long term placement. That was a very personal decision, and not one that is at all right for everyone - but I just thought I would share since our situations are a bit similar.

    Just know that you should not make your decision for your son's future based on one doctors, or even ten doctors opinions. I had one dr tell me that my son was so damaged he did not even think Residential Treatment Center (RTC) would help him - he is/was very very wrong. I knew it then, and I know it now. Go with your mommy instinct, and never let that be over-ruled by a doctors book knowledge.

    Sending hugs. I am sure this is a horribly difficult decision. We are here for you whatever you decide.
  4. timer lady

    timer lady Queen of Hearts


    First of all, let me say how sad it is that the treatment plan at outpatient isn't being effective. However, both kt & wm attended outpatient day hospital day treatment programs & medications could be & were changed there on a semi-regular basis. I'd also like to offer you that both of the tweedles have been in day treatment for 2 & 3 years respectively now.

    We are just beginning to see light with kt. wm is another story. It takes time for the maladaptive behaviors to be "unlearned" & replaced with healthy & safe skillsets & behaviors.

    This is a stretch for many states but have you looked into in home help before Residential Treatment Center (RTC)? Our state would rather & find it's cheaper to try this before Residential Treatment Center (RTC). I'm not saying psychiatrist is wrong but if you cannot get the funding this may be another route.

    My first step was to contact my local county mental health department for children. We were assigned a mental health case manager & things took off from there. Because of the level of needs that kt & wm displayed we were assigned a CADI manager (she's the lady who approves & pays for the services). I had to go before the state medical review team with the tweedles information & they have been designated as disabled. Because of that designation we have been able to tap into in home services, such as PCAs, regular respite, homemaking services (when available), in home therapy, occupational therapy, etc. We've utilized every one of these services at one time or another.

    Again - I have no idea what your state has to offer. I'm just mentioning this as a stop gap measure if the funding for Residential Treatment Center (RTC) isn't available. And this may not be available to you either. And I'd like to warn you some of this can be time consuming. Plan on finding other "survival" techniques in the meantime. Put a crisis plan in place, if you don't already have one. Ask psychiatrist if a PRN medication would be appropriate for difficult child. Utilize the hospital day treatment as long as possible. Utilize the staff at day treatment for ideas on redirection, self calming & any thing else you need at home in managing difficult child.

    In the meantime, you are stressed enough as it is. Please, if you can, take this one day at a time. Put it to bed at night & find an hour or two for yourself doing whatever it is you love best & is therapeutic & calming. Share time with your easy child - maybe the two of you can take up a nightly game of scrabble after difficult child is in bed.

    Most of all - be gentle with yourself. Take care of you. If you don't no one else will. :flower:

  5. janebrain

    janebrain New Member

    Hi Christy,
    just wanted to tell you that my kids also received social security benefits due to their dad's death and my difficult child 1 was court ordered to treatment at a dual diagnosis facility. The facility used her social security benefits for payment, in fact I think the check was sent directly to them. Previous to that she was in a private pay Residential Treatment Center (RTC) and we had to pay the total amount for that.

    Wishing you the best,
  6. smallworld

    smallworld Moderator


    I'm sorry if you've answered this before, but how much Prozac and Seroquel is your difficult child taking? Did he become worse once he started taking Prozac? Has he ever had any neurospychological testing to see if anything else is at play?

    If your son is getting worse and the psychiatrist is talking about a mood stabilizer, I'm guessing he's thinking mood disorder on the bipolar spectrum rather than unipolar depression. Prozac can induce a kind of bipolar mania that cannot be resolved unless the child is weaned from the medication. Before you go the next step to Residential Treatment Center (RTC), isn't it possible for the current program to wean your son from Prozac and start a mood stabilizer to see how he does?

    FWIW, my son had similar sx (including school refusal) and had manic reactions to both Prozac and Zoloft (SSRI antidepressants). In order to treat him appropriately, we had to wean him off of all antidepressants and have him take mood stabilizers (the first-line MS are Lithium, Lamictal, Depakote, Tegretol and Trileptal) and atypical antipsychotics (like Seroquel). He is now the best he's been in years on this medication combo (achieved by attending a day treatment program at a local psychiatric hospital for 6 weeks).

    I'm sorry things are so rough right now. I hope you get some answers soon.
  7. Thank you all so very much. With all the reading I have done here, I can really feel the support and caring from everyone.

    I just found out this morning (haven't heard from the hospital yet though) that there is Residential Treatment Center (RTC) benefits under my insurance through work. My son is on 40mg Prozac and 25mg a.m. and 50mg p.m. of Seroquel. My son actually did seem some improvement after being on Prozac. In fact there were some behaviors that were there before the Prozac that we are not seeing now. But others are worse now.

    As far as the mood stabilizer, I am not sure yet what the doctor is wanting to do, he said he would get back to me on that. I doubt under the circumstances that he would want to wean him while he is at home, but you never know.

    I am not taking the idea of putting difficult child in Residential Treatment Center (RTC) lightly at all. I am thinking not only the intensive help he can receive there (and needs), but also how all of this is affecting my daughter and me too.

    difficult child targets my daughter a lot of the time too. He has actually threatened her with a knife before. He has told her before that someday she would wake up dead. This was BEFORE he was on the Prozac. Now he hasn't threatened her physically, he has told her she should just die and get out of his life.

    There is no AFTER difficult child goes to bed. Like last night I told him it was bedtime and he proceeded to launch into a yelling fit that what was it to me whether he got any sleep or not and that he wasn't going to go to bed and that I had better stop getting after him or he was going to blow. This went on for little while with me ending up leaving him in his room (after telling him that yes he was going lay down even if he wasn't asleep), he was laying in bed. I went into my room to change into pj's and he left his room. Meantime, my daughter got tired of hearing what was going on and took out of the house. I called her cell and she was actually down the street (it was between 9:30 and 9:45pm). I told her that she had to come back, that it wasn't safe. If she wanted to stand on the porch or go on the patio that was fine, but she couldn't be down the street. She came back storming in saying how she couldn't handle this anymore and he is ruining her life and she just can't handle it anymore hearing us go back and forth.

    The stress that I am going through as you all know because you are dealing with difficult child's too is tremendous. It is affecting my health. I believe that if difficult child is getting the intensive help he needs outside of the home, then my daughter and I can work on ourselves as well.

    Ok, so it's time to actually get some work done here at work, as well as await the phone calls that I am waiting for.

    Again, thanks for all the support.

  8. janebrain

    janebrain New Member

    Hi Christy,
    I had to send my difficult child 1 to an Residential Treatment Center (RTC) when she was 16--I also had another child, 3 yrs younger, who ended up being diagnosed with dissociative disorder due to verbal and physical abuse by difficult child 1. I didn't even know anything was wrong til difficult child 1 was away for a few months. Then difficult child 2 felt safe enough to start expressing her emotions and over the next couple of years I realized the damage difficult child 1 had caused. I had been so wrapped up in trying to help difficult child 1 that I didn't realize difficult child 2 was suffering--she was a model student and child so I thought she was okay.

    Just wanted you to know I sympathize and empathize--sometimes residential treatment is necessary and not just for the difficult child who is going there but for the rest of the family who needs time to heal.

  9. Thank you so much Jane! That is exactly how I am feeling right now. I have to do something aggressive! I am afraid of what this is doing to my daughter.