After all this treatment ... all this time

[timer lady]

My tweedles have had significant therapy, inpatient stays, Residential Treatment Center (RTC) stays & the like.

Reading thru kt's quarterly Residential Treatment Center (RTC) review & her psychiatrist's assessment kt's GAF is still only 38.

Unbelievable - friggin unbelievable. I shouldn't read these things - makes me nuts. Makes me scared as kt is heading quickly toward becoming an adult.

Unbelievable.

 

[klmno]

I'm sorry- I know from reading your threads the past couple of years that you have tried so hard to get them both the best care and treatment possible. There's only so much you can do though, as you know. I am wondering if the GAF is staying constantly low or varying through the year- did the write something for "Highest GAF this past year"? Was it low, too? It may be that she will just need extra supports all her life. Still, you know that without the care that you made sure she had, she would have ended up in a lot worse situation.

 

[JJJ]

Not at all what we expected when we adopted, is it?

((((Hugs))))

 

[crazymama30]

Hugs. I have found that when I see things on paper it makes more real, more permanent. When husband's psychiatrist filled out the fmla paperwork for me it really threw me for a loop. It was like reality smacked me upside the head hard.

If I were you I might not read stuff like that, I know for me it would make everything harder.

 

[DaisyFace]

Reading thru kt's quarterly Residential Treatment Center (RTC) review & her psychiatrist's assessment kt's GAF is still only 38.

I don't mean to be dumb....but what's a GAF? And what does a 38 mean?

What would healthy GAF be?

 

[DaisyFace]

I don't mean to be dumb....but what's a GAF? And what does a 38 mean?

What would healthy GAF be?

OK--I found it "Global Assessment of Functioning"....

Scored on a scale of 1 to 100 with 100 being no problems and 0 being completely incapable of even getting through the remainder of the day.

Sorry for the dumb question...

 

[Jeppy]

I didn't know what GAF meant either. Thanks for explaining.

 

[Fran]

Not all of our children improve enough regardless of the interventions that are in place.
JJJ, not what I was expecting when planning my pregnancy either. No one gets guarantee's. This is also not in the "Expecting a baby" books is it.

I'm sorry Linda that kt isn't making better progress.

 

[Shari]

So sorry, Linda. Its so hard to work your tail off with minimal progress.

 

[timer lady]

I'm sorry I didn't explain GAF scores.

Fran, JJJ ~ nope not what I expected when husband & I adopted the twins. Not at all.

I've been looking into long term adult homes for wm; keeping my fingers crossed that kt can become more functional.

Be that as it may, I met with kt's psychiatrist today. Discussing her progress in this stay. Discussing discharge date (end of January 2010). AND making kt aware that if she gets to the point where she is physically aggressive with me again she will not be able to live here. I think those words, delivered very gently by myself, really hit kt between the eyes.

psychiatrist supported & helped kt understand both her bipolar & her mood disregulation; the impact it has on her & others around her. He also said that she is learning skills at a rate that is impressive to him. He cautioned her that she needs to be hyper aware of her body, her emotions & such.

kt is motivated to come home & is working hard after her last run from Residential Treatment Center (RTC). AND she is reading college level books; currently she's reading Ernest Hemingway's A Call to Arms.

Thank you for listening to my rambles & concerns.

 

[gcvmom]

She may just need more time. Eighteen is such an arbitrary number for declaring someone an adult. Better to shift expectations than hold them to some unreasonable, pre-ordained number. Maybe 25 is more realistic for her. And then one has to ask, what is a reasonable GAF for her to reach? Has anyone offered a guess at what's truly attainable for her, given what she's up against? Just wondering out loud here.

I'm sorry she's not progressing like you'd hoped.

(((Hugs)))

 

[moonglow]

Sounds like where the youngest of the three my sister adopted could be at. I recently found out his 15 yr old bio-mom had been doing drugs when she was pregnant with him..and was caught abusing him as an infant in the home for pregnant teens too which resulted in her losing him...hence my sister adopting. The dr that did some recent testing said some parts of his brain might not have developed correctly. Severe Learning Disability (LD)..AS..can't seem to process spoken language very well...gets information all mixed up..yet can read on a college level AND understand what he read. Very strange stuff. The scary thing is his IQ was dropping with each test and my sister was wanting to know why! He is just above borderline IQ now. We all think he needs to be living in a group home with supervision. Sister kicked him out at the end of the school year...he is 18 but has another year of high school to go. Got him set up in an apartment..things are not going well. He was getting more and more abusive towards her to the point it was about to turn into physical abuse and with him so much bigger then her now...she had a enough and for her safety he needed to move out.

I guess what I am trying to say here is that we never know what might not be working right with difficult child that they truly cannot help. Things under developed, not connecting right...who knows...and who knows how much can be genetic or a wild card too! you can only do the best you can and nothing more. And work with what you have. Its still hard...crushing in fact giving so much and then nothing. But you never know either...studies show the brain is still developing up to the age of twenty five! And for some..things suddenly click into place later...

Hang in there.

 

[Wiped Out]

(((Hugs))))

 

[Steely]

Hugs Linda.........many, many hugs. I know exactly how you feel, as I am experiencing the same exact thing with Matt. Sigh.

 

[Penta]

How fortunate your children are and have been to have to advocate for them, even though this was not what you signed up for as an adoptive parent. You are even planning for the future looking at long term adult placement. I think the quality of kt and wm's lives have been so greatly enhanced by you being their Mom.

 

[KTMom91]

Hugs...

 

[DammitJanet]

Linda...I know that 38 number scares you to death but I just wanted to let you know that it doesnt have to be so scary. My GAF is consistently only 10 points higher and you have met me, I am ok right? The only reason I am not lower is that I have a very good family unit around me who keeps me from having to go inpatient on a constant basis. If I didnt have that support, I would not be able to function as well. It is sad to say but what we have to hope for with our kids is that they can meet and marry/live with, very good and supportive spouses.

 

[DaisyFace]

Linda...I know that 38 number scares you to death but I just wanted to let you know that it doesnt have to be so scary. My GAF is consistently only 10 points higher and you have met me, I am ok right? The only reason I am not lower is that I have a very good family unit around me who keeps me from having to go inpatient on a constant basis. If I didnt have that support, I would not be able to function as well. It is sad to say but what we have to hope for with our kids is that they can meet and marry/live with, very good and supportive spouses.

Linda--

I have been thinking along the same lines as Janet--it is, after all, just a number. It's not a predictor of the future....and with the right supports and a loving family, she could be fine.

It also seems to me that my difficult child was assigned a GAF of 38 when she was admitted to psychiatric hospital last week. At the time, I didn't understand what they meant when they were talking about the numbers....but there had been a comment made that the number was sufficient for hospitalization.

Perhaps your daughter's progress MUST be noted in a certain way to justify continued in-patient treatment? Maybe it has to do more with billing and insurance purposes than an actual measure of progress?

Hope you are feeling more hopeful today....

--DaisyFace

 

[busywend]

I never use the tests to evaluate my child. Sometimes she would be doing great and tests or scores would be low. Other times when she was at her worst they would show her doing well.
I figured I knew her better than any test could relay to me.

You know what KT has shown you she is capable of and not capable of. I think with time she will continue to add to the 'capable' column.

 

[Fran]

From what I see the GAF upon hospitalization is usually low. It's part of the reason for hospitalization. Hopefully with treatment the GAF will improve on discharge as stabilization takes place and a difficult child learns new life skills. It's just a measurement of progress and where someone is compared to the average. One's progress to a higher level of functioning tends whether great or small tends to hint at what the future level of improvement may be. It's not in stone of course, but it's a concern.
Obviously, difficult child isn't a number. It's just a way to measure change. Just as none of us are our weight but if we don't learn how to improve our eating and exercise, the future doesn't look positive that change will happen.