I'm so mentally exhausted about the

[DammitJanet]

You might not like exactly what I am going to say either. It seems like you want to go in for a very quick fix and have someone tell you what you want to hear kind of like a yes man. You only want a therapist if they follow your exact protocol. Maybe that is just the way it comes across through the printed word...dont know.

Im not entirely sure exactly how long your son has been in therapy or how many therapist he has seen but how long has he actually stuck with any one therapist for a given time?

There are a ton of different forms of therapy out there to try that can help no matter what the diagnosis. Just because you are using the exceptional child at home doesnt mean that the rest of the world is going to accommodate your son using those methods for the rest of his life. He needs to learn other methods to deal with whatever problems he has. Therapy can give him more tools for his toolbox. You might use one method at home, school might be using behavior charts and incentives with some success, and therapy could be using a combo of talk therapy along with CBT. It it all works out to make difficult child into a productive child, then it is working. So much with therapy is the relationship between the client (difficult child) and the therapist. If difficult child can become comfortable enough to open up and talk to the therapist then progress can be made no matter what method the therapist uses.

 

[klmno]

We've had nightmare situations with tdocs before- ok, some were nightmares, some were just a complete waste of time. He has seen the longest for about 5 mos, I think (that would be twice on 2 different occasions). I understand what you are saying, but it really isn't the situation here. There has been no therapist with the same outlook to begin with. I tried, sincerely tried, to work with the behavior modification approach and my son kept getting progressively worse. I have sat and listened through 3 tdocs go on and on about how they can help for 3-4 mos, on different occasions, only to hear them end up saying that they don't know what to do. This isn't a situation where they are saying to me "I strongly recommend XXX" and I'm sitting there saying "no, it has to be this way". It's a situation, usually, where they are syaing "so, this is your therapuetic goal" and I'm saying "no, that isn't my therapuetic goal". Yes, we're looking for more than an individual therapist for difficult child, based on recommendations from 2 psychiatrists. I didn't write the treatment plan- I'm trying to find a provider for the treatment plan that a psychiatrist wrote. The therapuetic goals are spelled out in the treatment plan.

I just don't think all tdocs are competent and I don't agree that any therapist can help any person with any method, if the person can be comfortable with them. I have seen it do more damage than good at times. I get the point that maybe that hasn't been your experience but it has been ours.

Janet, this might be a "different strokes for different folks" sort of thing with us. I started out like a desparate female looking for any answer available 2 1/2 years ago. When I realized that I was pickier about a painter or plumber for my house and had been interviewing them more than tdocs who I expected to help "shape" my son, I changed that tactic. I think I have every right to set goals for treatment, along with what goals my son might have (that he wants to set for himself- not that I'm setting his goals for him). I don't think the goals should change to meet what a therapist is most familiar with. And, I think if I asked them what their approach and/or plan would be to meet those goals, they should tell me. If they can't tell me, I've learned to cut my losses- If things are getting worse after several mos., I won't continue on with some illusion that someday this will make them better.

 

[susiestar]

I found the psychiatrist who did therapy as well as medications pretty much by accident. We had just been dropped by the developmental pediatrician because he stopped taking the medicare we had, and then when we got private insurance a month later he didn't take that company because they have a terrible reputation (but we have great coverage with them). So I called around and got into a large psychiatric hospital's intake dept and they set us up with the doctor who had the first availability. We met him and talked with him because we really NEEDED someone to do the medications. He started out the talk therapy with asking how things were going. Then he had them schedule longer appts because it was clear that we had a LOT going on at the time. We stopped after having several young ladies that Wiz was in teh psychiatric hospital with tell ME (not tell Wiz, but tell ME) that he was inappropriate with them when they were in the psychiatric hospital. I really really don't EVER want to support someone who is inappropriate with a teen - I had enough of this when I was a teen. It was a shame, because he was reallly firm with Wiz and while Wiz resented what the psychiatrist said, he also seemed to act on the directives adn guidance given. I didn't stop seeing him based on what the teens said, it did play a role, but I did speak with a nurse who worked for an agency - she filled in at the psychiatric hospital and a number of other places. She had stopped working at the psychiatric hospital based on what the doctor did. We had becoem friendly and met for coffee a few times. That is when she told me that the girls were being truthful - she had walked in on him with one of the girls. When she complained to the agency she worked for the psychiatric hospital made compalints about her in return. But the psychiatric hospital made complaints AFTER several written reports of her service that were glowing, so the complaints were not taken seriously against her.

I am not sure what method he used, just that he would insist on accountability by Wiz. I havent' really looked for a therapist who used a specific technique, other than finding that the various reward systems rarely worked.

I don't think it is unrealistic to expect the therapist to work toward goals you and your difficult child set. I also think that it is reasonable to interview the tdocs before bringing your child in UNLESS the child wants to be part of the interview process. Jess has helped me interview a number of tdocs for her. I want her input. BUT with the way some tdocs ahve insisted that your relationship with difficult child and your family dynamic are the reason for his problems, rather than focusing on the problems that the bipolar cause, I can see wanting to get a feel for the therapist before you bring difficult child in to meet him.

I guess what I see you asking is for a therapist to be realistic and to give you the tools suggested by the CABF forum and the Bipolar Child book. And a therapist who is not versed in the illness your son has will not be able to cope with the problems the illness causes. The therapist will also not be able to help YOU modify your relationship with difficult child in ways that your difficult child needs so that HE can cope with his illness. I can see why traditional therapy that focuses the responsibility for all problems on the family dynamic would not help your situation. Mostly because the problems are more accurately caused by the illness. And difficult child needs to learn to take responsibility for doing things that cause him to cycle, for his behavior when cycling, and to learn to pay attention to cues that he may be manic or depressed or heading into mania or depression.

I think that when you find the right therapist he will be able to make a lot of headway. I also think it is totally ridiculous for a therapist to not know what the problems are after several weeks or months of therapy. To keep asking you what the problems are seems idiotic. It gives the impression that the man can't bother to keep his patients and their problems straight. That would make me incredibly uncomfortable.

I do think that there are many kinds of therapy that can be helpful in a person who is stable. In a person who is unstable there is going to be soemthing specific needed, and most likely until they are stable not much will be accomplished in talk therapy. BUT that is my opinion and impression of the needs of someone with bipolar. so it might be totally wrong.

Anyway, the therapist you saw who said he was well versed in therapy for BiPolar (BP), yet didn't remember your son's problems and family situation after several months seemed to be a waste of time. And for some people it takes a LOT to find the person they can be comfortable enough with to open up.

I am sorry you had therapists who drove wedges between you and difficult child. That is an irresponsible thing for a therapist to do, in my opinion.

 

[klmno]

Thanks, Susie! That means a lot to me! I;ve been reading on the juvenile BiPolar (BP) forum for a break and now I'm going to go to bed!

by the way- difficult child didn't want to go through this intial process with todoc. difficult child says he's tired of the meetings where all that happens is review history, diagnosis, etc. I can't blame him! And, we were still seeing another one- the one who spent 4 mos alternating between asking diagnosis and goals and promising he could help- until 2 weeks ago (right before we went on vacation). So, for insurance payment purposes, I can't take difficult child to more than one therapist in one week. I kept that one going hoping he would actually get to the point (or SOME point) while I checked out this intern. If he'd gotten somewhere, I could have quit pursuing the intern. Anyway, I think a lot of it has to do with what they are familiar with and I'm just not looking for it. They have told me (several of them, not all) that in almost all cases, parents are coming in asking for behavior modification. So, that is what they're used to doing.

I'm waffling a lot about this intern- I would like to see if we can get the psychiatrist more involved and maybe use both. For one thing, the intern said "has anyone given difficult child psychoeducation to explain to him about BiPolar (BP) more in depth than what the psychiatrist and I explained"- NO- "has anyone worked with difficult child on stress reduction" - NO- "has anyone worked with difficult child on relaxation techniques" - NO. So, I think he understands some of my frustrations. Just not the "buzz words" he said that made me doubt how much he really understood and what kind of attitude did he really have underneath it all.

Anyway- thanks a lot for your support. And that psychiatrist you said was messing with teens at the psychiatric hospital- what a perv- I hope he ended up getting his due and that the girls came out allright. That is disgusting.

 

[TerryJ2]

klmno, this does sound exhausting.
It's obvious that certain people are experts at certain things. If you pick up a brochure at any dr's ofc, it will have a bio of the dr and talk about their training and specialty. Sigh.
I bookmarked the therapists here in VA. Thank you.