I met intern psychiatric (therapist)

[klmno]

Some things seem great about him- I still have concerns. I'm going to meet with him alone next week, but I wanted to get opinions from here, too. I know some of this is "me" being untrustworthy, so I need an objective viewpoint.

1) He says that the standard format with counseling a kid this age is for therapist to meet with difficult child or difficult child and parent, but not with parent alone. He explained why and it makes sense. i have no problem with that if he is supposed to be difficult child's individual counselor- but, when he is supposed to be helping me with strategies to de-escalate difficult child, I don't see how this can work. When we've tried that in the past, it seems like it has only served to pit difficult child and me against each other. Or, more likely, I am just not going to sit there in front of difficult child and say "if I deal with him this way, I get better results than dealing with him that way". Maybe I'm just viewing it wrong, but we aren't a couple in marriage counseling and it seemed to me that perenting strategies shouldn't all be discussed in front of the kid. Anyway, therapist suggested coming in to talk to him without difficult child if I had things like that to discuss (this sounded like a compromise solution for him).

2) This vision he portrayed of what counseling difficult child would be like seems fine- if difficult child were 2 years ahead of where he is now. But difficult child isn't- I mentioned a couple of times that he would need to back WAY up with difficult child. Just because he's been in counseling off and on for almost 3 years doesn't mean anything- it was useless. difficult child hasn't even had the first conversation from a therapist about what is going on with him- in terms of this diagnosis doesn't mean he's a freak. difficult child doesn't open up to anyone but me (and I'm sure I'm not getting it all). I can't tell you the times that therapist's have thought everything was going along smoothly while I'm being questioned by others about why therapist doesn't know about all that has happened. therapist doesn't know because therapist only hears what difficult child says.

3) We still have legal issues to contend with. Regardless of how things should be or are in other places, here if a therapist even mentions "maybe this would help" it will result in a court order for me and difficult child. So, this intern (the first time I meet him) says "maybe I'll recommend this; maybe I'll recommend that". And, I sit and cringe. And can think only of "I don't have time to do that, I can't afford that, that's a bad idea for us- now how much will it cost me in attny's fees and time off work to prove it in court".

There's more- I'll save it, LOL! So, can you get PTSD from custody issues, difficult child's legal issues, and tdocs, oon top of the stress of raising a difficult child while trying to keep a job and medication insurance? He noticed my anxiety and commented on it. Well, I'm sitting there thinking, tdocs have caused a lot of it.

 

[Andy]

I don't know what to tell you - follow your instincts - what feels right?

I can share how our therapist appts work:

1. Before the appointment, I fill out a form and write any issues I think need to be addressed.

2. difficult child visits with therapist for the majority of the visit. He goes over my form to see what is going on from my view point.

3. I am called in. therapist reviews with me what they have discussed and gives some suggestions. Usually reminding difficult child about coping skills and reminding difficult child that he HAS TO LISTEN TO MOM! (I love that!) He then asks if there is anything I wanted to bring up.

4. therapist dismisses and always tells difficult child how he looks forward to their visit. "You are a great kid. Every time I see your name on the appointment calendar I think Great, I get to see difficult child today."

So, watch for how he uplifts difficult child - Does he instill in difficult child that difficult child can improve and can be in control of his behavior? Does he convey that difficult child is a good person?

One day we had a very intense issue so when therapist came to get difficult child, I handed him the form and said, "I wish we could have 2 hours today!" He then asked if I wanted to go back right away. It was great to be able to have that appointment with difficult child and therapist.

Another time, difficult child wanted to talk about something but did not know how (wasn't really comfortable) to bring it up. So, I went in 1st (alone) and discussed with therapist what difficult child wanted to talk about.

So, it sounds like your intern will operate the same as my therapist. Let's see if anyone has a different experience.

My opinion is that a therapist should be able to work with you on whatever your difficult child needs most. We do have to follow the structure of the therapist's office, however, there also needs to be flexibility on the therapist's part to do what is best for difficult child. So, sometimes you will need to be able to meet in person with therapist and express concerns without difficult child knowing the details.

 

[flutterbee]

I think you meeting privately with difficult child at a separate appointment where difficult child doesn't come is wise. difficult child has to have trust with the therapist and if he's worried about what you guys are talking about, trust is harder to come by. I would make separate appointments with difficult child's therapist and just tell her I had a doctor appointment...didn't tell her with who.

I think it's good that he has ideas. If he's competent he'll realize quickly with difficult child where the starting point is.

I think the maybe's will become more concrete as he gets to know difficult child. I would let him know your concern with the maybe's and what that will entail for you.

You need to let the therapist know what hasn't worked in the past and what is cost prohibitive. He may be able to find resources for you for the latter.

I hope this helps.

 

[DammitJanet]

I went in with my son when he was younger but by the time he was your sons age it was hit and miss. It was more of a Meet and greet type thing. therapist met us at the door and asked if there was anything I wanted to discuss that week, if there was, I gave a few highlights, they went in...at the end, therapist wrapped it up for me and off we went.

You could ask if you could have email contact with this therapist to keep him apprised of any problems or questions you have regarding your son. But really...this is your sons therapist. He is there for him to work on his therapy. Not so much your parenting skills. It might be a better idea for you to get your own therapist to work on those areas for you.

I dont understand why anything that the therapist works on inside their sessions should impact the court. Its work product and legally really cant be released. All the therapist can release to anyone is certain things and his notes from sessions are not one of the things he can release. I found that out when I requested my notes be released to a court hearing.

 

[timer lady]

klmno, as kt has gotten older she is asking for & receiving more alone time with therapist. Before that ever became a reality I set up my expectations of therapist meeting alone with kt.

I always email or call with concerns before an appointment. I expect that concern to be addressed in one way or another. kt has had to learn to trust that even though we "are talking about her" it isn't to her detriment ~ she's begun to understand that nothing I bring up to therapist is critical/mean in nature.

The last time I spent time with therapist & kt complained that I needed to quit talking about her I replied that she needs to enjoy this ~ this time it really is all about her!

I'd also like to offer that your difficult child has matured in some ways. Even though he's been in therapy for X number of years & hasn't made progess, you'd be amazed at how much has actually sunk in....how much your difficult child may have processed.

Good luck in the new endeavor for your difficult child. I hope it all works out in a positive way for both of you.

 

[Christy]

Initially, I would try to meet with both difficult child and you together so that you can establish a relationship and get a feel for this therapist before either of you meet individually.

Speak up if you don't think something will work. You have been living this situation and this therapist just met the kid!

Hope things go well,
Christy

 

[Josie]

When we had a therapist, I usually went in first to tell what was going on. Then difficult child 1 would go in and then we would all meet together at the end to summarize and agree to the next step. She was a defiant child so I don't see how it would have worked if she had just gone in. She would have said everything was fine. If I went in by myself, I could tell it like it was without having to word everything carefully since difficult child was right there. Also, like you said, it isn't always a good idea for them to hear parenting strategies or if the therapist thinks you could have handled something differently.

Sometimes, I even had my own appointment if there was a lot going on. It was listening to me that the therapist realized how bad things really were.

My daughter was younger than your son is now, but if she was still defiant, I would want it to be set up the same way. I don't think it would work to have a separate therapist for me to deal with the ODD behaviour.

 

[klmno]

Thanks, all! It helps to hear how others have handled this.

He is there for him to work on his therapy. Not so much your parenting skills. It might be a better idea for you to get your own therapist to work on those areas for you.

Well, here is where I think things have gone awry in the past- and I'm sure a lot of it is terminology. According to both psychiatrists involved (regular and the one I've used as a consultant), we are supposed to have one therapist to work with difficult child and deal with family issues both. Twice, I have tried this having two tdocs and everyone involved frowned upon it. Since they weren't helping anymore than anyone else, I have given up on that approach.

The terminology part- ok, some people refer to it as family therapy- which makes me visualize us working on our relationship, like getting along better. But, what is described (and I agree is needed), is the same type of therapy that I hear others descsribe when they have larger families than ours. Which includes, how to cope at home with rages, how to manage difficult child better, some working on our relationship, therapist being involved in IEP if needed, etc. I have discussed the possibility of me having a separate therapist just for myself that difficult child doesn't see, but I have been told by several profs that it needs to be someone who also communicates with and knows difficult child. Now, if my anxiety or worry interferes with my ability to deal with difficult child issues, then I would need a separate therapist. But right now, the focus is on one who is going to help him individually and help us as a "family" (even though we are only 2 people) in a way that helps me maintain and supports his treatment goals.

Sooooo, the only part about that that confuses me, is the part about how to accomplish that if the therapist never sees anyone in the "family" alone except for difficult child. Think about it- when difficult child is in the psychiatric hospital, he has a psychiatrist there assigned to him. It is his psychiatrist, not mine, BUT, psychiatrist and parent do talk alone on occassion.

This is probably something I just need to discuss with this new guy again. He said there was usually only a problem with this approach when it's a young teenager because they are so sensitive at that age about therapist and parent discussing them without them around. I understand that, completely. It sounded like we might be able to find some compromise solution. I don't think I would need to talk to therapist individually on most occassions.

The issue with the courts- they might not have to turn over notes, but I was court ordered to sign release forms (which I didn't even know the judge could legally order me to do). Since the GAL called every prof involved and started talking about more than just getting updates on difficult child (which I specifically wrote on the release forms), and PO will be calling now, I'm just a little cautious about making sure tdocs/psychiatrist know that I think they should have limits on what they are discussing with others.

The way people here (our jurisdiction) make assumptions is unbelievable. psychiatrist had recommended in home help for me last year and GAL assumed that meant MST (since that is all our jurisdiction offers- however- psychiatrist doesn't work in our jurisdiction and probably had no idea of that)- so GAL asks judge to order MST, and it was ordered. Now, had psychiatrist discussed this with me first, or GAL checked/verified, etc., it could have saved me about $1000, and a couple of days off work, but instead, I took it back to court to get the order changed. This is only one example of why I'm gun shy about them. (I should clarify- this MST guy was not here to do anything other than put difficult child on a behavioral contract and get everyone in his life to buy into it, and it is their policy to discourage any other treatment for the kid going through this. That didn't exactly encompass the recommended treatment for him, which is what I had to show in court to get the order changed.)

I know how therapist means it when he says "well maybe such and such could help". But I've seen first hand how that goes through attny., PO, etc and the judge ends up ordering whatever the attny's have interpreted this to mean.

FOP- fortunately, difficult child isn't defiant with tdocs/psychiatrist. He is extremely sself-conscious and has a hard time "spilling his guts" with them, although he is much better with psychiatrist because he's been seeing the same one for 2 1/2 years. He normally confides in me (if he confides in anyone about something) so the times I'm in there with him help prompt him to open up. This gets better after time and he loosens up more.

 

[TerryJ2]

Klmno, I understand, and my difficult child has simlilarities, where he is rarely defiant with-the dr. He's very self conscious and sometimes totally clams up. We've wasted many sessions that way.
So sorry this is so frustrating. I am reading this whole thread to learn from it because you're way ahead of me.
Take care.

 

[klmno]

Thanks, Terry! I don't know that I'm ahead of you, or anyone else for that matter. All I know is that when difficult child started exhibiting signs of self-destruction 2 1/2 yrs ago, and it kept getting worse the more I tried to follow the advice of those tdocs, I had to stop it and try to "tune in" to what was going on with difficult child because I thought for sure I was going to lose him. And, I honestly could understand him getting upset if therapist appts are us going in and me just telling whatever bad he'd done the previous week while he's just sitting there imploding. Then, a year ago, when his behavior was more extreme in different ways, I couldn't sleep until I had a more thorough second opinion - by someone (people) who hadn't been involved but who would look at the entire picture.

 

[Josie]

klmno,

My difficult child wasn't defiant with the therapist or psychiatrist but the reason she was there is that she was very defiant with me. Giving consequences for defiance resulted in meltdowns and/or violence. She was also violent with her sister.

Outside of the home, she appeared to be the perfect child. On rare occasions, she would be defiant with me in front of someone else but it appeared within the range of normal for the most part.

If she had gone in by herself, the therapist probably would have thought there was no problem. It was me going in by myself that convinced her there really was a problem.

 

[klmno]

Oh- thanks for clarifying. I understand your post better now. I'm thinking it would help if I give therapist some specific examples of what I think might warrant a private conversation with him. This way, if he has another suggestion or idea, at least I'll know it pertains to something that actually fits our situation.