Residential Treatment

Discussion in 'General Parenting' started by Amelia G, Nov 2, 2012.

  1. Amelia G

    Amelia G New Member

    This thread is for discussion of all the various issues that come up regarding placing a child in a residential treatment center or group home, their experience there, and transitions to and from home.
  2. Amelia G

    Amelia G New Member

    First I have to rant/vent.....
    So we have been doing our darndest to help our nephew whom we adopted. We offered to take him in when he was 3 months old, but the state wouldn't hear of it. In the mean time, he had over 5 placements, including 2 with birthmom during which he was subject to neglect and verbal, physical, and sexual abuse. He was addicted to meth at birth. He went through more in those two and a half years than most of us ever have to. End result is that by the time we got him, he was pretty damaged. He has fairly severe reactive attachment disorder (Reactive Attachment Disorder (RAD)). He was originally delayed in speech and coordination. We gave him lots of love and encouragement and enrichment. As he got older, it became clear that he would have to have medication in order to stay in control. So first Sertraline for PTSD, then Concerta for ADHD. As his behavior worsened, added Abilify, Tenex, and Depakote. Behavior continued worsening, with increasingly risky behavior, ODD veering towards Conduct Disorder. Ended up in the psychiatric ward of a hospital at the beginning of last month, after running away 12 times to different places (and he is only 8, barefoot, even at night!), and then peeing and pooping in the time out room at school, followed by throwing feces at the teacher. That was it. We couldn't keep him safe at night when he was clearly able to sneak out so quietly after being put to bed. He doesn't seem to care what effect his behavior has on others. No remorse, not clearly a conscience, little empathy (even though he is social, and can be very sweet and charming when he wants to be). So we did the unthinkable, we took him to the county psychiatric unit. They found him a child psychiatric placement a day later. There, they took him off of all his medications. Surprise, surprise, he was totally out of control. Instead of reintroducing his medications, they put him on totally different medications. At one point, he was a bit sedated and showed some possibly psychotic behavior. They diagnosed him with bipolar disorder (we had been wondering for years about that). Only with pressure did they add back some stimulant and some SSRI. Long story short, we wanted him in residential care because we didn't feel we could keep him safe anymore. Boy, was arranging that a nightmare. He was denied at a Level 12 and also at our local Level 14 Residential Treatment Center (RTC)! Finally, a social worker found a Level 14 (ie locked) placement about and hour and a half from our home. So we picked him up from the hospital. Even though he had been their two weeks, he still wasn't really stabilized. And drove him up to his current Residential Treatment Center (RTC). It is so scary to drop one's child off at a center where you have no idea how well they will be treated! At least, they have 24hr supervision, and claim to do treatment/therapy. Not sure yet what that actually entails (play therapy at his age). He had no school for three weeks. Finally, they found a way to get him into the on-site NPS, even though his current IEP didn't call for that. Residential is being paid by county of origin; treatment by MediCal; schooling by his new local district. I feel like I have been doing paperwork and crisis management for, um, 2 months! Almost forgot to do the one piece of paperwork for my easy child daughter's college apps. Yikes! So I'm trying to piece together what is happening to him, and am hoping to God that his time in residential doesn't ruin what attachment he had been developing to us... These places are staffed by interns, some probably without pay, even teacher interns without credentials. I worry about all the small stuff and the big stuff. (Mind you, I have my own PTSD from dealing with difficult child's abusive behavior.)
    When he was in the hospital, I asked difficult child which living option he would like best. His first choice was to stay in the hospital, his second choice was the group home/residental treatment center, and his last choice was home. :(
    It is so hard to put out so much love and care for a child that doesn't clearly appreciate the love!
    Anyway, he says he likes it there. When we call or visit, he only has time for a quick hello/goodbye. He wants to be doing what all the other kids are doing. The good news is that the day is highly structured for him. In his first few days, he flew out of control often, and needed restraint. Now, he's more settled in, and finally eating something.
    So, I'm a little nervous; this weekend will be the first time that we bring him home for an overnight. He is a totally different child since all his medications were changed, and we don't really know who this new difficult child is! I'm glad the bipolar was diagnosed, and I'm OK with the new medications, but worry that some of his medications may need to be adjusted upwards for real stability. When my husband visited last weekend, difficult child could only tolerate about 10 minutes of time with him, then wanted to be back with the group.
    Have any of you dealt with placing a child in residential treatment and trying to keep the relationship alive?
    How do you figure out if they are giving appropriate care?
    How often do we need to visit to keep the relationship alive and meaningful?
    They say he could be there two years... What does this all mean?
    I could use support, advice, and more than anything, some reassurance!
    I know I'm supposed to be feeling some relief that we don't now have the daily hassle of dealing with him, but I worry, and I've been well-trained in guilt. I worry about him. I really want him to develop attachments and improve. I don't want to inadvertently become the mother of a psychopath.... We are trying so hard to STOP the cycle of abuse, and provide opportunity for some HEALING. In the meantime, I probably need some healing, too.
  3. buddy

    buddy New Member

    Hi and welcome. My son was adopted at age 2. He has many neuro-developmental disability issues but also has attachment issues. He was in the psychiatric hospital last year and acted up to stay there. He loved it and talked for months about wanting to go back. I.drove an hour to see him daily and he'd often kick and hit and verbally attack me when I showed up. I have belonged to groups and talked to Reactive Attachment Disorder (RAD) specialists. Sometimes Reactive Attachment Disorder (RAD) kids do much better without the pressure of the traditional attachment /family. The picture needs to change for them.

    Just mho, You can let him know you'll always be there for him but do not take it personally that he is liking that structure and life there. As you stick with him he will see how committed you are. My son now says he hates the hospital and doesn't want to go. I imagine he will need to at some point again and though I don't want it, he could need a residential placement.
    As things go on, (again jmho) you will be able to see if he at least could handle a group home situation or other supports but just look at options over time. No need to decide this early on.
    It's heartbreaking to think our kids may never be able to fully feel that secure unconditional love of parents. So, we do all we can to at least help them to function in the world and to not hurt themselves or others and hope above all that they'll be happy and fulfilled.
  4. recoveringenabler

    recoveringenabler Well-Known Member Staff Member

    Amelia, welcome. I am so very sorry to read your post, you are certainly in need of support and lots of hugs. I really applaud you for doing your very best for this child, trying to break the cycle of abuse, your love and concern for him shines through your post. It's a sad story. I wish I had some sage advice for you, I want you to know I read your post and would encourage you to get as much support as you can. You've been doing a wonderful job all along making difficult decisions. I don't have any experience in the areas you need support in, other parents will be along to weigh in. I am sending prayers for you to find the information you need, the support you need and the peace and healing you need...............(((HUGS)))