Trying to start medications

[idohope]

Well, husband is finally on board with medication for difficult child (Abilify). We developed a plan with help from psychiatrist and marriage therapist on how we would present taking medications to difficult child. Both PCs are out of the house for the week. If difficult child does not take the medication by a certain time each morning then she loses her special activity for that day. She is a multi-sport athlete and even over the summer she has 4 days with sports and a special clinic coming up next weekend. She does not lose tv or computer or have any other restrictions.

When we initially spoke with her about medications it triggered a 2 hour rage. She threw books and shoes at me. One nailed me on the head and brought tears to my eyes. I have a bruise on my arm from where a shoe hit me. husband remained calm and helped to stop the physical attacks.

We are a couple of days in and so far she has calmly (after the initial rage) given up her sports and refused to take the medication.

I have tried to speak to her about it a couple of times. During the rage she said something about why do we impose consequences instead of giving her a reward if she takes the medication. I told her I am willing to give her a reward but if she is not taking the medications then she can not have the "extras". I have tried to discuss rewards with her but she will not let me talk to her about it. She said the morning deadline for taking the medications was too early and we gave her an extra 1/2 hour.

I think at this point I need to say nothing and just ask her once each morning if she is taking the medication or if I am calling to say she is missing her practice today.

We have another psychiatrist appointment in two weeks and I guess will work out a new plan with him if she is still refusing at that point. The waiting is hard. 24 hours until the next possible time for her take the medications....

 

[idohope]

difficult child is still refusing the medications. Two hour tantrum last night. Mostly verbal and not physical. She hates us, she wants to die, she plans to stop eating. Why do we want to change her? It is all because we are bad parents. She finally fell asleep and was better this am. Would not take medications or eat breakfast but no crying, yelling or talk of dying. Agreed to go to her day camp. I am worn out.

 

[Josie]

I hate to say this, but I would probably sit down with her and tell her you are starting over. Give a reward for taking the medicine. Act as though she is going to go to her extra activities but when it is time to go, if she hasn't, tell her you will go as soon as she takes her medications. Otherwise, she isn't quite ready to go. You will go when she is.

Maybe the timing won't be exactly right at first, but hopefully, she will feel enough better that she will realize she needs them.

As it is now, you are locked in a battle of wills. The important thing is to get her take the medications.

My mother tells a story of my sister refusing to do homework. My sister loved TV so my mom told her that if she didn't do her homework, she couldn't watch TV. My sister gave up her TV and still didn't do her homework. Then, my mom told her she could watch TV if she did her homework. Just like that, my sister started doing it. The same idea and consequence, but a little different spin on it, and it made all the difference.

Have you talked to her about what the medications might do for her? make her feel less angry, less anxious, etc,, not just about how she will get in less trouble?

My daughters never totally refused their medications. They did sometimes say they weren't going to take them, but I left them there for them and disengaged and they eventually took them. If I tried to convince them, it would have been a long battle that I am not sure I would win. For the older one, I am sure I had to reward her with candy at first for taking them.

 

[Andy]

I am so sorry - these power struggles can get so intense and last so long. Hope is correct, time to talk to difficult child and see what can be done to stop the power struggle. At a time that she is calm, sit with her and start by saying something like, "You know, this is not working for either of us. I hate seeing you angry and loose out on these activities. Let's start over and see if together we can figure out something. Maybe if I explain the reason for the medications better you will see why they are important. These medications are not about changing who you are. They are to help you be able to be who you are without fears (or whatever the main issue is) taking over your decisions. I know sometimes you have hard days and these medications are suppose make those days easier for you. This medication also has to be taken the same time every day so we must decide when that will be. The doctor says they will work best in the morning. Having them at breakfast time will be easier to remember to take." "You are old enough to work with the doctor on this. The medication does not start working right away, sometimes it takes a few days or a few weeks. Also, when they make you feel better, you may not even see how they are helping but those around you will. Your friends will see that you are happier. You can tell us and the doctor how you feel when you take the medications so that we can make sure you are getting the right kind and the right dose." "Do you have any questions about the medications? What are your concerns over taking them?" (if you are unable to answer her questions or solve the concerns, let her know that you will call the doctor today and find the answers. If she wants to talk to the doctor directly, make up an appointment to do so.) "So, what do you say that we start over with this? You can start your activities again. I will help remind you to take the medication at breakfast so you have that over with before you start the day."

 

[Andy]

p.s. If one of her concerns is that she doesn't like to be reminded every day you can do non-verbal reminders (sometimes the kids don't want their siblings or others hearing that they are on medication). Put the dose in a 3 oz Dixie cup and place it with her breakfast. You can still keep an eye on if she is actually taking it but no verbal communication is exchanged with the other kids present. If it looks like she is walking away without taking it, you can then pick it up and quietly hand it to her, "You forgot this" or "Don't forget your cup".

 

[idohope]

Thank you for the replies. I agree that we are caught in a power struggle. There is so much that I would like to tell her/ask her about the medications and her feelings and concerns. difficult child will not allow any conversations about her behavior or medications. She immediately becomes physical. But perhaps over time I can work in some conversations a piece at a time. I tried to show her a pill today in a paper cup. She went after it and I grabbed the pill so that the pets would not get it and she shredded the paper cup in pieces yelling that she will not take it and then she started going thru the cabinets to finds the medications so she could destroy them. (I keep them somewhere else). She refuses to go to or speak with psychiatrist. (he saw her once briefly). She had a major tantrum stabbing food containers with scissors after her only visit with him to show us that she would never go back again). I will see what psychiatrist says next week.

Thank you again.

 

[ML]

I'm exhausted just reading about your struggle. Sigh.

 

[TerryJ2]

Whew.
Sounds familiar.
You're getting through it, though.
She's a tough one. Aren't they all?
Hugs.