Suggestions please...

[butterflydreams]

So difficult child is making alot of progress at Residential Treatment Center (RTC). The way their program is set up, they earn passes every week, the passes range from 4 hours to a weekend. The week goes from Wednesday through Tuesday of the next week and then treatment team is held every Wednesday with passes earned issued after that. So week after last difficult child lost points and lost a level so instead of the weekend pass he was supposed to get, he got a 12 hour pass. I will find out tonight when I visit him what he gets for this weekend, I am anticipating a overnight pass which means 8am Saturday to 8pm Sunday.

Here is my situation. Towards the end of every pass - it doesn't matter how long the pass is - the last hour or 2, difficult child gets depressed and mopey and even sometimes has a little attitude, because he knows its almost time to go back and he doesn't want to. Some of the times it has been grief issues too, talking about missing his dad - which is good because they are really working on this. It makes it really hard for easy child and I. I understand he doesn't want to be there and he knows ultimately he has to go back, but it is soooo draining for the last hour or 2 of his pass.

I know he misses being at home, I understand that. I try to remind him that he gets a pass every weekend, and that I visit him during the week usually once. I also point out to him, just like his therapist did, that wouldn't he rather be there now and get better and hopefully not have to go back, then coming home too soon and ending up in there even longer. I remind him how good he is doing and that I am really proud of the hard work he is doing and so is everyone else.

I am hoping maybe someone has some suggestions on how better to handle this time during the ending of his visits that is so draining. We do have a routine of stopping at a McDonald's which is down the street from the facility to get a ice cream cone on our way back.

Other than this time towards the end of the visits, the visits have been going really good for the most part.

I plan on talking to his therapist about this too when I meet with her next week. I also write about it on his reports that I have to fill out at the end of the visit.

Thanks for any suggestions.

 

[gcvmom]

What about shifting the conversation to what he's going to do later that day after you've gone? Try to find something positive for him to focus his mind on, and then get him to carry that train of thought to discuss the next day and positives he can focus on about that time. Maybe if you get him to get his mind out of the present moment that he's in, where he's anxious about you leaving and sad about the fact that he won't be with you until your next meeting. Something like, "What are your plans for the rest of today? What are you doing tomorrow? When we meet on Xday, I'd like you to have one story of something fun/cool/enjoyable you did/learned (whatever fits) that you can tell me!

My husband would get stuck in depressive or anxious thoughts that were almost of an Obsessive Compulsive Disorder (OCD) nature. It overshadowed everything in his life. But in his case, it was more negative thoughts of what the future held and he was often missing out on the joys of the moment he was in. That got much better after he started Lamictal. It's not totally gone, but the feeling around here is as if a lead weight has been removed. I don't think any therapy before husband started medications would have made any difference. But if he were to see a therapist now, I think he'd actually be able to process and utilize whatever suggestions or skills he'd be taught.

Does your psychiatrist feel the current medication regimine to be effective for your difficult child?

 

[butterflydreams]

Thanks GVCMom. I will try shifting his focus. It can just be so draining.

As far as medications, we don't know yet. He has been on this medication combo now for 1 month this week. I do think it is a better combo than what he was on before. difficult child even says he doesn't feel "on edge" all the time like he did.

 

[meowbunny]

With my daughter, we'd come back early, anywhere from 3 hours to 30 minutes. That way, the last hour or two would be with her and her friends at the Residential Treatment Center (RTC). It took the focus away from me leaving and her staying. It also gave me a chance to see some of what was going on in her life, how she was relating, etc., rather than just what I was hearing from staff and her. It did make the transition a little easier for both of us.

 

[butterflydreams]

Thanks Meowbunny, unfortunately, when I bring difficult child back, I am met at the door. No one is allowed on the unit unless it is visiting time. When you pick up for passes or bring them back, a staff member meets me at the front door of the facility.

 

[Andy]

Maybe take that as a cue to talk about progress and serious stuff that difficult child is going through. Maybe there is something he wants to share but doesn't know how to bring up? "I know you miss home and I hope you are able to come home soon. I know there are certain things the doctor wants you to be able to do first and though I don't know all of them, the most important one is that your medications are right for you. You may be feeling better, however, the doctor can tell best if they are the ones you really need now or not. What are you learning while at the hospital? Continue to work on following the rules and keeping calm." Go ahead and ask him what the hardest part is - he may just need to vent also.

As Gvcmom suggested, talk about what is coming up. Do you also make plans for the next pass? Something special to look forward to?

I also liked MeowBunny's suggestion but since that won't work ask him if we would like to go back early. If it means free time with others he may, however, the others may be in programming so that would just mean he is alone on the unit. However, you can ask if he is missing out on anything he was looking forward to.

That will be your serious talk moment. Then do something fun, "That was a good discussion. What should we do for the next 1/2 hour before heading back?" Toss a ball back and forth, tell jokes, go for a bike ride, whatever.

Does he have an opportunity to talk with you one on one when easy child comes to the pass with you? If not, is that an obstacle you may want to address?

 

[mrscatinthehat]

Well, when this would happen on occaision our difficult children new they would head back at the time things started to go down hill. We made it clear that visit time was for visiting and if things got in the way then plans and times would get changed. But for them it was a control thing. They wanted to do what they could to control the situation and the like. Not sure if making it known that uncooperative or what have you means he goes back. Of course it also depends on what is being worked on. But that is one thing that worked temporarily for us.

beth

 

[butterflydreams]

Thanks!

Adrianne, we do sometimes discuss the next pass as well as when I will visit him next. As far as talking one on one, yes and no. easy child isn't always around during the pass, but almost always goes with to take him back.

Beth, I haven't really considered what he has been going through towards the end of the pass being uncooperative - it's more of a letting loose of feelings. Usually this has just been him being quiet and mopey and crying. This last weekend was the first time that he did anything more. We had gotten to McDonald's to get our ice cream and he was crying, I talked with him and so did easy child reassuring him and telling him he was doing good, etc. At first he didn't want an ice cream, and then he said he would. We sat down at a table to eat our ice cream and he sat at a different table next to ours. You could tell he was still upset. He ate the ice cream and then set the cone on the table. He was sitting there with his arms folded and then reached out and crushed the cone with his hand. I asked him why he did that and he said he was mad. He then moved over a little more and just started staring out the window and wiping his eyes. easy child and I finished our ice cream and I said lets go to Walmart and look for the slippers that difficult child wanted - we had just enough time to run down the street, run in and grab them and get him back in time. By the time we got to the checkout, he was fine. We got back, I walked him to the door, he gave me a big hug, said I love you and said see you Wednesday.

 

[Wiped Out]

The others have given good ideas, just wanted to send some hugs your way. It's great to hear that you are seeing improvement and I'm sorry the last part of the visits is so difficult.

 

[timer lady]

We had this at the end of every pass for both kt & wm. The feelings let loose - every sad thought in the world came to the forefront. In my mind, it "deleted" the entire pass.

Sometimes, I think, wm especially, would have to remind himself why he was at Residential Treatment Center (RTC); why he needed the extra help. No one could talk him out of his blues (now he never did have a overnight pass from Residential Treatment Center (RTC) ~ couldn't earn that).

We, like meowbunny, would take the tweedles back early & get them back in the flow of Residential Treatment Center (RTC) life. husband & I would stay & visit with staff while wm would settle back in & get in to play time with friends.

It it a real change in mindset for our difficult children to go from home life to Residential Treatment Center (RTC) life. Home life isn't set up to give the level of structure that Residential Treatment Center (RTC) is....wm needed that level. I think for wm, he knew it & got very sad.

I wish I could offer you a simple answer for this...our kids can be so complex.

 

[butterflydreams]

Thank Wiped Out for the Hugs, I needed them!

Timer Lady, thank you. I really believe difficult child needs the structure of the Residential Treatment Center (RTC) too. He seems to thrive in the really controlled structure of when he was inpatient and now at the Residential Treatment Center (RTC), even when he was in the partial psychiatric hospital program. There is no way that kind of structure can be achieved at home.

I will take everyones suggestions in hand.