arghh! doing the right thing??

[tonime]

Ok- I will try to get this in short and sweet as possible.
difficult child--11yrs. diagnosis-adhd since 4
holding his own since 1st grade--no MAJOR issues--on medications had aide until 3rd grade --4th no aide
this year 5th grade--tried no medications first week of school/no good--put back on a week ago
Had major problem at school and soccer practice/ not on soccer team anymore-- was thrown off-- pretty major issues--being sexually inappropriate/threatening the kid--- I have posted this before
husband and I were in shock--but went to get help right away
through my niece -- who used to work for division of youth and family services--got the name of this place for counseling-- thought we were going to a "psychiatrist" today-- but now I realize he is only a psychologist-- with a phd
Here is the thing-- when I met him I had very good vibes-- liked him right away--he spoke with me first-- then he spoke with difficult child--but had me stay for first session-because he said kids are less anxious that way
difficult child really liked him-- the guy has over 20 years experience
there is someone in the center who can prescribe medications if needed- plus difficult child has nuerologist
do you think this is a good enough start with these issues? I mean this guy has over 20 years experience with adhd/aspergers/ anxiety issues etc. if he feels difficult child is something else-- would probably point me in the right direction?

 

[klmno]

This is tough- I'm kind of looking at this question too- do I let the psychologist be the "leader" of the treatment team or do I keep it the psychiatrist. In our case, I'm more comfortable with psychiatrist being the predominant one, at least right now. But that is based on my son's history and diagnosis. In your case, I can only suggest that you think about it- maybe also see apsychiatrist and see what they think before things get too far with this guy. My personal reluctance with psychologists is that if there is something chemical going awry, psychologist sometimes still see things from a learned behavior standpoint. They might recommend some medications, but they are dealing with things from a completely different angle. on the other hand, if it is a behavior issue that can be changed or re-directed, that needs to be dealt with and not medicated. With a lot of our difficult child's, I think there is both going on and it is difficult sometimes to find the right "team" between a psychiatrist and therapist to help them. That's just my 2 cents on it. Sorry I couldn't give a more difinitive answer.

I found my most comfortable answer by having a multi-disciplinary evaluation (MDE) done on my son. This is where several different types of professionals evaluate the difficult child collaboratively to determine what needs to be addressed from the various angles (therapy, educationally, psychiatric/medications, etc). And then they give you a written synopsis and recommendations for treatment.

 

[Lillyth]

It depends on the goal of the therapy. Why is he seeing the therapist in the first place?

If you really are concerned that difficult child may become someone who does sexually inappropriate things, and you wanted treatment for that, then you need someone who has experience doing that.

I would say that if you are comfortable with this guy, and he can get you the medications you need, or consult with someone who can & you and difficult child are both comfortable with him, then stay with him.

But remember that treating a juvenile who does sexually inappropriate things is a VERY specialized field, and if that is what you want him treated for, you need to make sure you go to a person who pretty much only does that.

BTB, most of the people I know who treat sex offenders do NOT prescribe medications. Meaning they are not psychiatrists. So just because someone cannot prescribe medications does not mean they are not the right guy for your difficult child.

Raport goes a long way in healing...

 

[Jena]

Ok my thoughts here and i'll be totally honest if you have a good vibe, if difficult child had one as well, also I liked the fact that difficult child was included in first session very common sense of him to lower the anxiety of the first session. I would say trust your gut just because he didn't go all the way finish necessary schooling to get the appropriate degree doesn't mean he isn't capable of truly helping.

plus you will know soon enough how the sessions are going. now here's a question would he be reviewing the file and difficult child's situation with the pyschiatrist with whom would write the medication at all?

i could totally see you being hesitant, yet for me coming off 4 pyschiatrists phd and all with no true diagnosis after years i'd say go with the guy you got the good vibe from with 20 years under his belt.

i wish you luck in your decision, it's not always easy to know the best thing to do for our little difficult child's.....

Jen

 

[Jena]

ok i type too fast, i meant the fact he included you in the first session with difficult child. sorry... to be quite honest i find alot of us here to be more informative than doctors that i've sat with for hours who look at me like a confused animal at the end of the meeting??? so scary..... trust your mom gut.

 

[tonime]

Well, I think my mom "gut" tells me that if difficult child likes him- he is more apt to open up to him
I am going to give this route a chance-- and hope that the psychologist is honest with me if he needs more
there are a team of specialists at this center--and there is a practitioner who can dispense medications
I don't want to overwhelm difficult child either with too many docs at once!
What I like is this guy has 20 years experience with ADHD kids--so one would figure if my difficult child is misdiagnosed-- this guy may have a clue

One day at a time...

 

[Wiped Out]

Is there a reason you can stay with-him and get a psychiatrist? With our difficult child we have a psychiatrist, two therapists (one is temporary), and a neuro-psychologist. I wouldn't trade any of them right now!

 

[TerryJ2]

If you get along well and he has that much experience, it sounds good so far. It can't hurt to try. Just remember that most psychologists are behaviorists and will work to study and change behavior. Most psychiatrists, will delve into the "whys" of what your son has done. If your son's issues are that he is impulsive and has no boundaries (I'm guessing that sexual issues aren't the only boundary issues he has) then the psychologist can surely deal with-that.
I'm sorry your son doesn't have a good diagnosis yet. Maybe this psychiatric can give you some insight into possible diagnosis's.

 

[smallworld]

Some parents have to put teams of medical professionals together for their difficult children. We happen to go to psychiatrists who do medication management and therapy for our kids (integrated care), but that is not the norm. Most parents have to find a psychiatrist (child psychiatrist) for medications and a therapist (psychologist, social worker or licensed counselor) for therapy.

Does this therapist have experience with kids who do sexually inappropriate things? It really doesn't matter if he has tons of experience with ADHD because your son could be misdxed.

 

[flutterbee]

I would stay with the therapist. It's hard to find psychiatrist's anymore that do actual therapy. They almost primarily do medication management these days.

We've had some wonderful tdocs that would have been very wonderful if difficult child not been so darn therapy resistant and we've had some tdocs that were a waste of time and let difficult child completely manipulate the sessions. If you like this guy, go with your gut.

 

[tonime]

Hmmm-- boundries--difficult child has had issues with them
let me tell you difficult child has and has had all symptoms of ADHD
hyper -- (little less now), couldn't focus, impulsive etc. etc. etc.
his peer relationships are what I worry about right now and his self image

anyway-- I also had an appointment -- at a hospital nearby for an evaluation--I will speak to psychiatrist to see if I should go through with it
husband thinks I should just stick to psychiatrist-
don't know if my insurance will cover both-- but I will call and find out

I don't mind taking difficult child to psychiatrist/hospital evaluation--but I don't want to make him clam up--he was not happy about going to psychiatrist and I was concerned that he wouldn't talk-- so I don't want to rock the boat since he likes this guy

hopefully, we won't have anymore incidents as we go

at least, I am feeling a little better about the situation-- still a little anxious (since I don't want anymore shocks to my system!) but I guess I feel better because we are on a road about doing something about it--work also helps--getting my mind off of stuff--helps me "detach" a little from difficult child and situation

 

[klmno]

I might have misunderstood. If you are trying to decide between an evaluation at a hospital with a child psychiatrist and seeing a psychologist, you can do bot. The psychologist would be ongoing therapy but the evaluation would probably just be 2-3 visits to confirm a diagnosis and recommended treatment.