Changing programs?

Discussion in 'Substance Abuse' started by Zardo, Feb 16, 2012.

  1. Zardo

    Zardo Member

    This is a long one....

    As some of you know, my son recently completed an IOP and is back at his boarding school for about one month. While there, he attends a nearby SA program run by a local agency once per week for "relapse prevention". In the month he has been with this agency, they have been continually questioning his drug screens. We were initially notified that his THC screen was questionable due to the faintness of the line. They watched it for a couple of weeks. During this time he was also told that there was a positive result for PCP, but they were dismissing that as a false positive as they considerred that highly unlikely with his profile. After 3 weeks of the line still being faint, they reccomended going for further testing at quest to determine levels, which he embraced as he had insisted all along that he was not doing anything. We went and the good news was that the THC and PCP were negative, but there was a postive for Opiates. He was absolutley adamant that there is no way that is possible, he has not done anything since the beginning of Nov. He asked for futher testing. He was so adamant that we believed him. So, to support him, we had a hair follicle test done to screen for EVERYTHING for the past 30 days. It came back all negative.

    During this time, my son's attitude at his SA program deteriorated. He tells me he doesn't trust them anymore. He questions why they keep saying THC positive with the faint line as I and he have been told in the past that ANY line is negative. He said he doesn't trust his counselor anymore and doesn't want to go there. When I deliverred the news about the negative follicle test to the counselor, she questionned it. She also seemed put off about my sons negative attitude in the past couple of sessions and says OK, maybe he's not using, but his overall attitude about rules and school give her great reason for concern and she doesn't know if this is the right program for him.

    I spoke to the gentleman that ran the follicle test. He tells me that he is VERY confident that his test is correct. He has been running his testing business for 5 years. He said there is no way around the follicle test. He said people try it, but it doesn't work. He also said he can tell when someone has tried because their hair gets very brittle. He saw no evidence of that with my son and I can't imagine when he would have done it as we agreed to it and had it done all within 36 hours. He had no access to any special store or products in that time.

    Putting all of this in context, he attends a highly structurred boarding school that has a very firm reward and consequence system and they have been working with him. I agree that his attitude about adults, school and rules is troubling at times, but it's he is staying sober and we need to keep working with him on behaviors. It seems to me that there has been a breakdown in the relationship between the SA counselor and him and I am wondering if I should just move him. I hate to "stop and start" again, but she is not seeing how painful this past month of "doubt" has been on him.

    In the time difficult child has been back at school - it's been up and down. He has not used, but he has good and bad weeks at school in terms of work completion and behavior. He thinks he doesn't have to follow the rules he doesn't agree with and he still blames some of what happenned to him over the past 2 years on his "overly strict" parents and "overly strict" school. He is not a fighter or a kid that talks back - it's more like, he is supposed to be in extra help for something after school and he doesn't go or he is late for morning medications. I am thinking the only cure for that is consistant consequences, time and maturity.

    So - I am asking for input - do you think I am "making excuses" for him or do you think that his claims of "not trusting" the SA program are valid. What would you do about it? he not only attends SA counceling here, she doesn one-on-one work with him. She mentioned his case being "more complex" than she is used to. Maybe I just move him to another individual counselor, but keep him in that SA program? Not sure what to do.....thoughts?
  2. Nancy

    Nancy Well-Known Member Staff Member

    If he has tested clean by all these tests including the hair follicle which I would trust, then it does sound like his counselor just has it in for him. I am usually very suspicious and don't ever believe an addict when they say there are clean until it is proved to me beyond doubt, but it's pretty much proven with your son and he should get credit for staying clean, not continually told he is lying.

    Since he is saying he does not want to continue with the program I would have his counselor changed if possible. It's more important that he stay in the program.

    Why does this counselor not want to believe the science?

  3. toughlovin

    toughlovin Guest

    I tend to agree with Nancy. I would trust the hair follicle test, that is one you really can't fake. (At least as far as I know). There are things that will falsly test positive on a urine test... poppy seed muffins for example I believe can show positive for opiates. So if he doesnt' like or trust the counselor he is not going to make progress with her. I think it is important to work with someone he trusts. To be honest I don't think if I was him I would trust her either... as she clearly is not showing any trust or faith in him.

    So at this point I would show your support in helping find another counselor... how does he feel about the program?

  4. Zardo

    Zardo Member

    He did like the counselor until the continual problems with the testing. He was even still pretty positive about it until the positive Opiate result. He said he cannot trust her or their tests. She initially said she is no longer willing for him to come only once per week for relapse prevention due to the positive tests. He was adamant that the tests are wrong which was shy he requested futher tests. I agree about the disbelief and he has lied in tha past, this time I believe him. While I don't think we're completely out of the woods, I think he is doing what he is supposed to do right now. So now with the proven negative, she is saying, well I want him to come more due to his other behavior issues. I guess I am more thinking maybe it's time to separate the two issues - she cannot be his individual counselor AND his SA counselor - conflict of interest. Our interest in him staying clean is separate from his progress in other areas, although related.
  5. exhausted

    exhausted Active Member

    The rest of his life will be these issues. There are always people we struggle with and trust issues will plague his relationships when he is not a "rule follower". He needs to face this and work it out. You double checked and have told him you believe him. That helps your relationship. I made the mistake of advocating for my daughter in both RTCs. I call it a mistake now, then I thought it was my job. She needed to take care of much of the struggles. This builds confidence and skills in kids. It also sends the message that you think they are competent. Most important (I did not get this until recently), they (my difficult child and yours), have made the choices that got them into these places. Perhaps some suffering in the world will make them want to be home and run by the rules. Also, to know that you will listen, but the action is up to them.

    Keep him there and encourage and empower him to work this out this time. Counselor doesn't trust him, she doesn't make him feel good right now. Instead of falling apart and being more defiant, he needs to figure out a better way to cope. What can he do to regain trust? It's unjust but this is the world. I would draw the line if it becomes abusive from the counselor. Right now it is just uncomfortable. Based on my own mistakes, I encourage you to be smarter and stronger than I was. :)
  6. Zardo

    Zardo Member

    Such a great point - OK - we believe him - he isn't using. Things have become strained with his counselor - make him work it out rather than changing programs- very thoughtful feedback. She, however may not agree to keep him because of his bahavior issues - I will keep you posted.
  7. Zardo

    Zardo Member

    Update - The woman at the program decided to refer him out. She said that difficult child has been through much SA counseling and he has been clean for quite a while now. (she now believes the follicle test). She said the larger issues to be addressed are behavioral and that's not really their thing. SO - I can appreciate that. Having said that, I am not happy with this outcome. I am fine with switching counselors to a more approapriate fit and there is another agency near the school where difficult child has worked with someone before that he likes and I do think that can be helpful, but she involved the psychiatrist who has been perscribing his ADD medications and Celexa and now there is a problem. For a couple of months, difficult child has been asking to stop taking Celexa. He feels he doesn't need it and he is doing better. Again, that OD attitude is still there, but it's much better than it was and he is making gains. I will admit that I and the psychiatrists had been blowing off his request. I never dealt with it or gave him a chance, I would just kind of blow him off when he tried to talk about it. When he met the psychiatrist this week, he told him that he is not willing to take it anymore and that he has already stopped on his own. I don't find that too unusual for a teen. In fact, I have many friends with teens who struggle within the normal range for teens and they have refused to take such medications at times or refused to take ADD medications. I will say that difficult child has been pretty cooperative with medications. He has been on the Celexa for about a year and when I spoke to him about it last night he said, I have been asking but no one woudl listen, "I'm doing much better and I don't want to be on anti-depressants forever." He does struggle with anxiety more than depression, so I told him this is where the concern is. He wants a chance. I don't really think that's all that unreasonable. I guess the psychiatrist said that he considers it "non-compliance" with medications and he is no longer willing to prescibe to him. This is a problem. I feel that the counselor does not know difficult child very well (only 1 month) and causing this type of disruption in his care is a problem. The same psychiatrist is the treating psychiatrist for this other agency. The counselor reccomended and in-home program where services come to your home 2-3 days per week. I think that would be great, but he's at boarding school. In the absence of that, she said there's a behavioral IOP nearby to the shool. I looked into it and don't find it appropriate. When I read up, the mission of this program is to provide services in an effort to intervene with kids that may otherwise be hospitalized. It's 3-5 days per week for 3 hours per day. I believe the school would say he cannot be gone that much and stay enrolled. He would have a real problem completing homework and they will not make accomidations. difficult child has made substantial progress this year. He has proven that he is committed to not using ( I know it's only a period of time, but it's significant progress), his demeanor at home has been MUCH better, I just got a progress report from school and the comments were surprisingly good. YES - he remains generally unmotivated, thinks unrealistically about the future and struggles with rules that he thinks are "stupid"; ie. bed time. Although this can be somewhat normal for teens, his conviction of being right about his beliefs are strong. So - am I crazy to say that I don't think he is bad enough right now to interuppt school AGAIN. Don't forget, I removed him from school for SA at the end of last year and he spent 90 days at Wilderness. I know the school would say that he's not perfect, but he is doing OK and they feel it's important for him to finish this year out. This is a school that is HIGHLY structurred and had consistant consequences that he is not spared from. I am thinking that weekly individual counseling along with participation in the on-campus SA program which includes weekly random drug testing is a better direction for now. We get through this school year and go from there. I am a believer that if the behaviors are more in the crisis range, he must be removed from his current setting. We did that last year as his use and defiance was spiraling out of control. That is not the case right now. Once he is home, there are in-home programs around our home. If he struggles, we register as CHINS and move forward with the in-home services. Truthfully, based on his current behavior and attitude, I would be surprised if that happens. Thoughts???
  8. DDD

    DDD Well-Known Member

    As I say fairly frequently, lol, one of the things that I love about our family is that we don't necessarily agree and feel free to share with one another. My point of view is alot different.

    Personally I don't see any reason to keep this counselor. In fact I think it could be detrimental to your son's maturity or development of conflict resolution skills. in my humble opinion, he has "earned" the right to make the choice himself. She is in a position of power and he is not. She has accused him of drug use many times and actually continues to defy the scientific evidence that he was truthful and she was wrong?? Nope..not my kind of professional and not a good role model either. Furthermore she actually is telling you that she "may" not continue as his Counselor because he has issues? Goodness Gracious! We're facing passive/aggressive behavior here.

    I don't even know why this struck a chord with me. In my mind (who knows why) I pictured your difficult child as similar to difficult child#2. He does not "mouth off", he has issues but there is a vulnerability about him. He has often been misread by school counselors and other adults. I wish I had taken opportunities to let him make choices instead of following directives. I don't know how the structure for change is set up at this school but "if" difficult child is allowed any input I sure would discuss it with him before making any changes. He is not there to be punished. He is there for help and guidance. Hugs DDD
  9. Nancy

    Nancy Well-Known Member Staff Member

    Zardo, first you have a counselor who refused to believe he is clean even with a follicle test and now you have a psychiatrist who refuses to work with him because he is non medication complient. My difficult child never took her medications by herself and I had to hand them to her. Your difficult child is doing well at school, has been clean for a good while now, and wants to get off medications that he feels are no longer helping. Wow I would say that's pretty mature. What am I missing?

    I think your plan is a good one and some of these people are to impressed with themselves.

  10. Zardo

    Zardo Member

    Nancy and DDD - thanks for your responses. I had tears in my eyes reading them. I feel like the situation with that counselor got out of hand and backed difficult child into a corner. My guess is that their last couple of sessions were pretty oppositional. Again, I am in no way saying that difficult child does not have some issues that he needs help with. I am going to talk to another counselor near the school that has worked with difficult child last year. I will see if he can fit him in for a few sessions and get another opinion. Just something in my stomach tells me that although I do feel that she is doing her best, something got personal here. I am upset that she has now sabbotaged the psychiatrist relationship - but maybe with a reevaluation from the other counselor, we can work that out.
  11. DDD

    DDD Well-Known Member

    Hugs. I know it's difficult to keep the right balance between being too attached and too detached. Sounds like you are comfortable with your next step as difficult child's advocate. DDD
  12. exhausted

    exhausted Active Member

    Zardo, I'm glad the counselor finially believes the scientific data! I'm glad she referred him out-it wasn't working. The fit isn't always great.

    I still encourage you to help him stand up to people and problem solve. My daughter was a doormat. We did too much of what she could have done. People in power should not have the right to run pell mell over kids who are there (they often do esp. the young"20 somethings" as I call them). Unfortuneltly, when they are in these places they have to develop skills above their years because their parents are not right there. My daughter has amazed me lately in how she has stood up to her boss in very appropriate ways-far beyond what we ever hoped for. Standing back and reassuring her that we trusted her and that she could do it has worked. She is proud of herself.

    I did not get that this was not part of the school setting- I though it was all part of the program and if he was out of the SA part he would be out of school as well. Sounds like you have a good plan. I agree that you should not move him when he is doing pretty good at school. I think these moves are very hard on kids. I hope you are able to rest-I am sure this has been very stressful.

    I think the doctor pulling out is very strange. I would not want him dealing with my kid. This can't be the first time a kid has refused a medication and asked to try to be without it. His job should be to monitor how that goes. I think its ok for him to tell your son he doesn't agree, but your boy deserves a chance to try to be off medications. We have allowed our daughter to be off Celexa for sometime now.(Did not like it at first) I don't know that it made a huge difference in her emotions anyway. The difference is that she is happy to be done with it.
  13. Zardo

    Zardo Member

    Exhausted - the one good thing is that he did advocate for himself on the medications, it's just that no one, including me, listenned. He has been saying for a couple of months that he doesn't want to take the Celexa anymore. When I told him the doctor won't see him anymore and the reason for it (medication non-compliance) he was angry. He said that he told the psychiatrist honestly that he doesn't want to take it and he doesn't feel he needs it. He said he was honest with him and he knows a lot of kids that just fake taking it. He said "I was honest, I don't feel I need it and I need a chance, if he won't see me now, then I don't want to work with him anymore." I told him that everyone's concerns are that these medications affect the brain and you have to work WITH your doctor to stop taking it, not just decide on your own. He said "well it's been 2 weeks, so it's too late for that, but no one listenned". That is true and whereas I will not take responsibility for his decision to stop on his own, he had been saying it and I should have listenned. My mistake here was not giving him credit for advocating and an opportunity. I did tell him that the major concern is not depression but rather anxiety, his response was that he really believes that the time he went on it was a horrible time in his life and he did need it. He feels better now and wants to see if he's OK without it. I told him that what's most important is to see if things start to go downhill and if they do, he should advocate to go back on it. He assurred me that he would, but you and I know that most likely difficult children cannot see when they are spiraling. IT's a work in progress.
  14. DDD

    DDD Well-Known Member

    Zardo I'm really impressed with your difficult child. He is a work in progress but he sure sounds like an adolescent who is morphing into a young adult. Sounds very positive to me and I'm glad he won't have the "downer" Couselor to deal with as he matures. Hugs DDD
  15. Nancy

    Nancy Well-Known Member Staff Member

    With all the prescription drug use/abuse going on today I am even more impressed that he is willing to explore going off them.

    I think we have to remember that it is very difficult for a 16 year old to stand up to an adult in that type of situation. My difficult child was as defiant as they come but she would never stand up to an adult in authority and try to convince them that they were wrong.

  16. Zardo

    Zardo Member

    "I think we have to remember that it is very difficult for a 16 year old to stand up to an adult in that type of situation. My difficult child was as defiant as they come but she would never stand up to an adult in authority and try to convince them that they were wrong."

    This is a tricky thing. Although sometimes mature, difficult child has a tencdency to ALWAYS stand up to adults. This is actually one of the things he needs to work on. He stands up and argues his point and will never back down. Again, not in your face, but to the extent where he is not open to 2 way communication, only getting his side across. This is one of the things that concernned her. There have been times that he has been better with trying to stay calm and understand a different perspective, especially when he was in IOP. So - although I think his advocacy for the Celexa was an example of using this skill in a positive way, this is a sticking point for him. I will talk to him today and tell him this this instance in an example of an appropriate use of that skill.
  17. DDD

    DDD Well-Known Member

    Zardo, is their any chance that he is as Aspie? Some of the characteristics sound a bit like it. DDD
  18. Zardo

    Zardo Member

    He does have some tendencies toward some larger diagnosis, but H and I do not wish to persue a route to put a label on his issues. I know many of you will disagree, but if he is classified anything, it would be on a light scale. For the most part, he functions within the norm, but with challenges. The counselor did suggest getting an evaluation, but we don't wish to pursue that. We feel that he has issues, and with support, time and maturity, he must learn to overcome them. He has a hard time "connecting" in a classroom, even with ADD medications, when upset he agrues his point without consideration of other people's needs/views, and he has a hard time accepting rules he does not agree with. Sometimes, when given a consequence, he will self sabbotage in an effort for self satisfaction. So, for example, if he is punished for missing an assignment, if he's upset about it, he may then not do the next assignment to make a point. IT's all on the table, we all know the tendencies and the therapeutic approach is to help him develop a better awareness of those tendencies and how they affect what then happens to him. So again, right now he seems to be doing OK. He still makes demands for what HE wants, but seems to be able to accept that he cannot always have HIS way better than the not so distant past. I do think helping him through these tendencies takes time. "The Unchanged Mind" presents the dilemma of kids who get all of these various diagnosis along with an interesting perspective, it's all related to the same thing - delayed maturity - it's an interesting read.
  19. exhausted

    exhausted Active Member

    It's always so tricky to advocate. Some will think it is enabling,when they don't agree with you. Some will think it is a disrespectful kid when it is a kid advocating for themselves.As an adult I have trouble doing this at times.

    Our difficult child tried and tried to advocate for herself(with our support and using the facilities procedures) to see a dermatologist while she was in state Residential Treatment Center (RTC). She had a precription which our dermatologist had given her, but they would not let her use the brush she needed to get to her back. She had huge cysts all over her back. We finially intervened. They still would not let her use a scrubber to reach her back so the medications would work. We filed a complaint-these cysts were painful,some on her bra-line, and have left terrible scars. Our compalint fell on deaf ears. It was used against us in court and we were called "enablers".. when the state ispection board finially got involved, JJs and my husband and I all filed formal complaints. They were punished. By this time difficult child had tried to committ suicide with pills they had left out (another issue they were in trouble for) and the judge released her from jjs to us.

    Nobody loves our kids like we do. Nobody knows their kid like we do. And trusting them to others in sometimes rigid situations and with rigid and often jaded people is tough. Finding that line of speaking up for yourself and opposition is tricky. He sounds like he is trying. I'm really glad he is willing to try being off medications and also willing to go back on if he needs to. :)
  20. DDD

    DDD Well-Known Member

    Interesting perspective. Obviousy we all know our children and make the decisions on what we believe is their best interests. I'm rooting for him. DDD