Does my daughter need Residential Treatment Center (RTC)?

Discussion in 'General Parenting' started by ShesMakingMeCrazy, May 4, 2016.

  1. ShesMakingMeCrazy

    ShesMakingMeCrazy New Member

    Hi, I'm new to this forum. I came here, as I'm sure others have, to find solace among people in similar circumstances. My BD is 15. She is an only child. She has been high maintenance since the age of 3, very moody and prone to raging tantrums of surprising duration. While she was still in diapers, she was put in timeout in her room. She pulled all her books on the floor, pulled off her diaper and urinated on the books. Her solid wood bedroom door has cracks in it from where she threw heavy items against it as a small child. Things really started getting difficult around age 11, when she was hitting puberty. She became very depressed, anxious, irritable, angry, demanding, impulsive and needy, and it has only gotten worse since then. She started cutting around age 12 and this has continued to a greater and lesser extent. She has never cut herself seriously enough to need stitches. She overdosed at 12, but told me about it immediately thereafter. I gave her ipecac, and she was not hospitalized since it appeared to be a gesture. She has been under the care of a psychiatrist, multiple counselors, intensive in-home treatment. She was in a residential treatment center for 3 weeks one year ago. This did more to help us than her. We desperately needed the break this allowed. When she returned home we instituted a point system, and things improved for a short while. We have had her in the local public school, but removed her in 7th grade when she was complaining of being bullied. We put her in online school for the remainder of the grade, and she wound up failing. She repeated 7th grade the following year in a different online school and passed. Having her at home all the time was problematic and stressful. I managed to get her into a really good charter school this year, but her complete lack of effort and general PIA behavior necessitated pulling her out once again. She has been homeschooled for the past month. She has disliked school since 2nd grade and it has been progressively harder for us to get her there and get her to do the work. Since it appears that she will be failing 8th grade as well, we decided to give her the opportunity to spend a year doing GED prep, then allow her to take the GED when she is 16. Initially, she stepped up to the plate, got herself up in the morning and starting work without any nagging. Unfortunately her initiative waned and she started falling behind. This led to an increase in argumentative and angry behavior, loss of privileges, family conflict. 6 days ago she overdosed on Zofran and was taken to the ER. She was kept there until today, and as we speak, she is being transported by the Sheriff's office to an inpatient psychiatric hospital 3 hours away.

    Compared to many of the kids on this forum, her behavior is less extreme. She is not generally physically aggressive. She is not using drugs (that I know of). She has not committed any crimes. She is lazy, self-involved, entitled, mean, verbally abusive, impulsive, self-injurious. She is like many teen girls, but to a higher degree. I'm sure we have contributed to her development. We have the best intention of being firm and having rigid boundaries, but her incessant bargaining, wheedling, arguing, demanding wears us down to the point that we will do almost anything to buy some peace. We both realize that this is not effective parenting, but there is a limit to what we can endure. She does have periods of niceness, when she acts "normal" and is pleasant to be around. Her father and I are always on guard, waiting for the other shoe to drop. She can go from 0 to 90 in half a breath. The word "no" tends to have an extremely negative effect on her mood and behavior. I fear my husband will stroke out, and I'm ready to have a nervous breakdown. Neither of us are weak people, nor are we pushovers.

    I wish I knew the proper path to take. I don't want her shelved. I do want her to get the help she needs to be a well-adjusted adult. Our lofty goals of years gone by have fallen and now we want to keep her alive, not pregnant, not on drugs, not in jail until her 18th birthday. Beyond that we will have no control, and only hope that we would have been able to instill in her some coping skills and real-world know-how to be able to survive on her own.

    Any input from the community will be appreciated.
  2. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Gosh, sorry for the chaos. Obviously there is a glitch in your daughters processing. Any diagnosis? Any mental or neurological differences on either side of her DNA tree. Much can be inherited. Did she have chaotic early years? Any chance a friend or neighbor abused her?

    Has she ever been to a neuropsychologist?
  3. ShesMakingMeCrazy

    ShesMakingMeCrazy New Member

    She's had numerous diagnoses over the years, including depression, anxiety, Obsessive Compulsive Disorder (OCD), ODD, ADD. She has been on a variety of medications, including Prozac, Celexa, Zoloft, Lamictal, Abilify, metformin, birth control. We recently stopped the birth control since you seem to be making her more emotionally labile. She wanted to try decreasing the Abilify since it was causing a significant hand tremor, but this seemed to worsen her mood lability. She's now on 5 mg of Abilify daily, along with 200 mg of Zoloft. She was on metformin to decreas the weight gain potential of the Abilify, but this prescription ran out and has not been reordered.

    Her father and I have been married all her life. We have lived in the same home the entire time. I am the breadwinner, my husband stays home with her (he has back problems). I have wondered many times whether she was molested as a child, but when asked by numerous people in a variety of ways, this has never been supported. I have no reason to believe my husband has been inappropriate with her. About a year ago she made a very bad decision by calling a "friend" to pick her up. She went to his home, where she was raped. He then returned her to where he picked her up and we knew nothing about it for 6 months, when she finally broke down and told me. She has never told us his name and does not want to press charges. She has a long history of manipulative behavior, so there was some question of the reality of this event, but I do believe that it happened.

    She has depression scattered all over for pedigree on both sides. Her paternal great aunt has some psychotic symptoms now and has been "just not right" for years. As far as I know, she has no psychiatric diagnoses. The child has never seen a neuropsychiatrist/psychologist. She is very intelligent, which makes her all the more troublesome. She is very creative and musical. She has always had difficulty reading, and seems like classic ADD. She relies heavily on her technological gadgets.
  4. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    You may want to have her get a neuropsychological evaluation. This has nothing to do with intelligence and is more diagnostic...and very thorough. It is not a neurological exam, it is a psychologist with extra training in the brain. My sons neuropychogical testing was ten hours long and answered questions others missed. Therapists, teachers and counselors are not really trained to diagnose psychiatric or neurological disorders and they dont do much treatment other than talking, which rarely works with our differently wired kids. medications arent the entire answer either. Sometimes certain ones make them worse.

    I hope things get better and you can find answers. This is clearly not your fault. Your daighter was likely born with differerent wiring and if you find out what is wrong it is easier to accept it and get appropriate interventions. If dhe was raped that probable added to everything tenfold. Take her tona place that hrlelps with sexual abuse.
    This horror happened to my oldest when she was a child and she.didnt tell us until she was fourteen "becsuse he said he'd find me and all if I told." Im not surprised she used drugs for a while. This needs to be addressed. Now.
    Not trying to scare you, but to me, her problems do sound quite severe with even more problems in the future if they are not taken care of now.
    Last edited: May 4, 2016
  5. InsaneCdn

    InsaneCdn Well-Known Member

    School is brutal for kids who are differently wired. I wish I had better answers - but I know what my two went through (and only one is actually a difficult child).
    The medications she is on don't really match the diagnoses given.

    A really thorough psychiatric evaluation would be of benefit - IF you can get one who is willing to provide labels. Too many in the child-and-youth system will NOT give the appropriate diagnosis. We didn't get accurate diagnoses until adulthood. It makes a world of difference when you know what she - and you - are dealing with.

    I suspect you're dealing with both a developmental difference AND some form of mental illness.
  6. ShesMakingMeCrazy

    ShesMakingMeCrazy New Member

    Well, right now she's in a psychiatric hospital. I kinda doubt she will be thoroughly evaluated there, but who knows.
  7. FrustratedMomma

    FrustratedMomma New Member

    Dear ShesMakingMeCrazy,
    Unbelievable! You are describing my daughter almost to a T. She will be 17 in a few months and we have been dealing with issues since she was 12. She has been hospitalized 4 times for suicide attempts. When she comes home she is calm, happy and cooperative. She was also in a day program a year and a half ago for 3 weeks. And has just completed a IOP drug and alcohol treatment. We discovered she was taking Benzodiazopines on a fairly regular basis. While she was self medicating she was absolutely horrific. She was defiant (as she is most of the time), slept way too much and could be very aggressive. she has also been self harming since she was 12. My husband and I were contacted by Child Protective Services investigating our treatment of her 3 separate times. Which was VERY upsetting as we only want the best for our daughter and try to do whatever we can to aid in her treatment. She has been diagnosed with Major Depressive Disorder, Anxiety and suffers from Panic Attacks. Although I tend to think the Benzos (depressants) contributed to her moods. We have also caught her drinking - another depressant. She is currently taking Zoloft and Trazodone to help her sleep. I am not confident the medications are working for her.

    I should also point out that she can be very loving and compassionate at times. Which makes it more difficult to deal with. We also have a 23 year old son in college who is very close to her - but he is frustrated with her as well.

    She has always been headstrong, which I too thought would be a good trait for her as she got older. Wrong. She was more mature and level headed when she was 10! When she was small she was literally stuck to me. She either wanted me to hold her or had to sit on my lap or next to me touching me. Maybe I miss that as she grows older. I love my daughter with all my heart - but right now I really do not like her!

    Anyway, I could go on and on. I just wanted to mirror your frustration and maybe see if there may be someone out there that could offer suggestions.

    I am certainly one FrustratedMomma!
  8. Copabanana

    Copabanana Well-Known Member

    I agree with everybody else about the neuro-psychiatric evaluation. Any Children's Hospital will have a neuropsychologist who will do a comprehensive in depth evaluation.

    I think there is hope.
    Her creativity will be something to build upon. Here she will find her meaning and her solace too. From this she can build an identity to be proud of. I know I sound unbelievably optimistic or naive. But I believe many if most creative people began living chaotic and confused lives. It is her task to learn to master her genius which now is mastering her.

    Not everything is psychopathology in this world. Sometimes it is brilliance and creativity that has not yet been tamed.

    I believe the school district is legally obligated to help you, up to and including placement in residential treatment. You may need to find a disability rights attorney or advocate.That is what we did. For free. They go with you to IEPs and force the school district to accept responsibility. I would look for a phone number for Disability Rights Advocates, an agency that helped us about 15 years ago. Even talking to them in another city would give you a place to begin.

    I would not accept her back at home unless there is a proper school situation for her. That does not mean home schooling. By you are doing that you are taking over the responsibility of the school district to educate her in the proper setting. Do not do this. You are hurting her, yourselves and really, even other parents and children, by allowing the schools to be bullies.

    They are abusive. They victimize children and parents by abrogating their legally mandated responsibilities. Theirs is the responsibility to educate every child not only the ones who are pliable and easy.

    No more of this:
    This will give you a break:
    There must be a plan in place before you accept her home. A plan for her to be transported (free) to a proper school where she is safe and able to learn. They must pay for taxi to transport her if a school bus is unavailable.

    If such a school cannot be found, the school district is legally responsible to pay for her to be housed in a treatment setting and schooled there.

    If I were you I would look for Art or Music Therapy programs, and I would support any creative endeavor it was within my means to support. In most large cities there will be Art therapy programs where teens and adults to go who have been traumatized.

    There are workbooks on how to apply art to dealing with trauma. Nowadays there are new treatments for trauma that are somatic, not verbal. Like walking, even. There is the belief now that traumatic emotions are retained in the body/mind and can be discharged. Any physical activity will be good for her.

    There are books like those by Peter Levine (the name Tiger is in the title) that talk about age-old somatic based ways to discharge trauma. You might enlist your daughter's adaptive energy to learn herself how to help herself.

    That person who can be enlisted to help herself is there. I would try to engage that person and be clear that you will no longer welcoming that other side of her. No child should be allowed to bully her parents, even through emotional dis-control. Insist at the hospital where she is that you be given the tools to manage her behavior and the training to do so.

    She will have a discharge plan. Google on the internet applicable discharge plans for kids with your daughter's kinds of problems. Like training in behavior modification. Or respite. I do not know.

    I am glad you are here. There is no way that any parent could do this alone. Our problems were less, but still I do not know how I did it.

    Take care.
  9. Copabanana

    Copabanana Well-Known Member


    I went on an on and did not answer your question about Residential Treatment Center (RTC). I believe your daughter needs a setting where her self-destructive and destructive behaviors are contained, and her adaptive and growth potential can be harnessed. I believe that once she settles down, a dialog with her and you and professionals will arrive at the proper next step. It may will be Residential Treatment Center (RTC). She may well get what she needs there. You may, too. I would not allow her to be schooled at home. Legally, she is entitled to a school placement. She deserves that. You do too.
  10. You need to have her evaluated properly. We never did and the result has been no contact for some years due to our choices of treatment approach. Also there is a risk that the Residential Treatment Center might diagnose her so they can keep her until you are out of money.
  11. MommaK

    MommaK Member

    You have described my life with the exception of being hospitalized, home schooling and over dosing. My daughter has just been diagnosed bipolar with-anxiety and depression. It's been such a hard struggle for our family. We are praying that the intensive partial inpatient program she starts on the 16th will help us all.
  12. ShesMakingMeCrazy

    ShesMakingMeCrazy New Member

    Well, my husband is on his way to pick up the little darling after spending a week in the hospital. She has hated it there. According to her, she has learned numerous coping skills that have helped her while she was there. In her absence, I have been rabidly reading "The Explosive Child", and listening to radio shows posted on Lives in the Balance website. I feel that Dr. Green's approach is valid, and the program has the potential to be helpful. Obviously, I have not had the opportunity to use his techniques, and I still have a lot of questions as to implementation, but I am eager to try it.
  13. MommaK

    MommaK Member

    Mine found out yesterday the program she starts next week is 4 hours a day 5 days a week for at least 8 weeks. It's group and individual counseling, a weekly meeting with psychiatrist and medication monitoring. She is not happy and told us yesterday she may go and she may not. Now 3 days ago she was all about it and ready to start the program. That is when she thought she would do the program on her terms and it would be once a week. My husband leaves in the morning for a 3 week cross country and international motorcycle trip so I'm bracing for a fight.
  14. InsaneCdn

    InsaneCdn Well-Known Member

    Maybe hubby needs to cancel his trip.
    Yes, I'm serious. This isn't just about your challenging child - you have another child in the picture, plus you. And HE gets to walk out the door for THREE WEEKS?
  15. MommaK

    MommaK Member

    Yes, I agree, however, hubby is also bipolar with-depression. He is not as severe and is much more stable. His presence actually makes things more difficult because I'm then dealing with both him and my daughter and trying to balance everything else and not have my son feel left out.
  16. InsaneCdn

    InsaneCdn Well-Known Member

    Double Ugh!
    It's not unusual for a parent to have some of the same challenges as their child... sometimes it's a benefit and sometimes it's not.

    While he is gone, please find ways to look after yourself - and your son.
  17. MommaK

    MommaK Member

    I will. She will spend the night with my mother in law some to give me and DS a chance to hang out and not be so stressed. My son and I both also take jiu-jitsu. It has become my lifeline right now. When I'm training I can only focus on training so it's my sanity saver. For my son it means twice a week he gets my undivided attention for a minimum of 2 hours. We look forward to jiu-jitsu.
  18. ShesMakingMeCrazy

    ShesMakingMeCrazy New Member

    I'm beginning to think that diagnoses are overrated. To an extent they help, such as when you know a person is Bipolar or ADHD, you can use specific medications to combat the problems. But with vague catch-all terms like ODD, it is all about learning management techniques for challenging children. For the most part these techniques seem pretty consistent. We know that "Plan A" parenting (reward/punishment) does not work with these kids or they wouldn't be "difficult" in the first place.

    My daughter and I have been taking Tae Kwon Do since Oct. I started this because I read that this type of activity is especially helpful with ADD. It turns out I have ADD too, I just didn't know it until now. Anyway, we have found the classes very helpful for stress reduction, bonding, discipline, focus, etc. I told the instructor about what was going on and he suggested bringing her to class 5 nights a week. I don't know if this is possible logistically, but I'll try.

    MommaK, have you tried to get your dtr into Jiu jitsu, or some other martial art?
  19. MommaK

    MommaK Member

    I have tried that and she is really really naturally good at it, but doesn't care for it.
  20. ShesMakingMeCrazy

    ShesMakingMeCrazy New Member

    Bummer. What about a different type? Does she have any friends? maybe they would like to take the class with her.