Kanga's safety plan

Discussion in 'General Parenting' started by JJJ, Jan 6, 2008.

  1. JJJ

    JJJ Active Member

    Well, Kanga has snowed another doctor. It looks like they are going to send her home at the end of the week. We are going to fight hard for her not to be sent home until Monday as weekends are the most difficult to supervise her. Her regular therapist and her therapist's supervisor are both coming to the meeting at the hospital with me tomorrow (on their own, unpaid time!!) to argue for a longer stay or at least an admission to the day-treatment partial-hospitalization program (PHP) pending Residential Treatment Center (RTC) placement. The hospital psychiatrist is very happy with her behavior since she started the Depakote. Um, hey there doctor, there is NO WAY that the Depakote is at therapeutic level in 7 days so it is a non-factor in her behavior.

    Based on the assumption that she is being sent home next Monday and enrolled in PHP, here is our safety plan.

    Current Home Modifications (in place before this psychiatric hospital stay:)

    All children sleep behind solid core doors and outdoor quality locks, impossible for Kanga to kick in.

    All sharps and medicine are locked in a cabinet.

    Additional Modifications:

    An alarm is being placed on Kanga's door so she can't open it without triggering the alarm.

    There will always be 2 adults home if Kanga is home (unless she is the only child home, then husband can be the sole adult).

    Fragile electronics will also go in locked cabinet when not in use (remotes, etc.)

    husband will take Kanga to work with him in the morning and the PHP bus will pick her up there. She will return to husband's work after PHP. This will ensure that the other children and I are never alone with her.

    Her normal weekday therapy will be moved to Saturday to ensure 6 days a week therapy. She will need to attend church with Piglet and I because I can't leave her home with the boys and just husband. There are 6 other adults from my family with us at church so I'll only be alone with her in the car for 1.5 miles of side streets.

    I will arrange playdates and other activities to keep the younger children out of the house on the weekend unless Kanga is at therapy or respite (hoping to arrange respite!)

    Here is the contract we are having her sign:

    Kanga’s Safety Plan

    <span style="color: #FF0000">The #1 Rule

    No violence!</span>

    Kanga agrees to follow these rules every day...

    1. Keep her hands to herself: no hitting, no throwing, no stealing.
    2. Speak nicely and appropriately, especially to Tigger.
    3. Do daily chores: clean room, clean upstairs hallway, and clean kids bathroom.
    4. Take medicine.
    5. Appropriately greet her family.
    6. Do her homework every day. If no school homework, then homeschool books and read for at least one hour.
    7. Stay in her room unless accompained by an adult.
    8. Go to bed when told.
    9. Comply with all directions from adults.
    10. Keep private issues private. DO NOT discuss issues with friends, teammates or others. DO discuss issues with therapists.

    Each day if Kanga has followed these rules she will be allowed to go to hockey. If there is no hockey, she will be allowed to call one friend from jr high or hockey and talk for 10 minutes. If after going to hockey or talking to a friend, Kanga breaks one of the rules, she will “owe” a day and must complete a good day before being allowed to earn hockey/phone again.

    Kanga understands that she is not to watch tv, listen to the radio or play video games. She understands that she is not to touch money. After 30 “good” days, she may earn limited amounts of these activities by doing extra chores or schoolwork as directed by a parent.

    Kanga understands that all of her things have been removed from her room and placed in storage along with her Christmas presents. She understands that the only thing in her room are some of her clothes, her bedding, her schoolwork and a journal. She understands that except for some garbage, all of her things are boxed away for her. A very limited number of items have been placed in Box A. She may begin earning things out of Box A after she has completed 30 good days. After another 60 good days, she may begin earning Box B and so on.

    Kanga understands that another act of violence will cause her to return to the hospital or to jail. Kanga understands that her parents will decide if it was violent. She will not get to decide.


    I did shorten the length of time that she has to be good to earn back her stuff and gave her something to earn each day (base on input from all of you!).

    I have to present this contract to her tomorrow, so please if you have any suggestions, offer them now!!
  2. klmno

    klmno Active Member

    Maybe I'm just too easy- and I don't know what she did to get herself where she is, but, is there anything (little) she can earn before 30 days are up? I have my difficult child earn his weekly allowance- I have a chart of what's expected of him each day and how much money he can earn for it. It's totaled at the end of each week. He doesn't get handed cash and he can't buy whatever he wants- it has to get my approval. If he doesn't spend it all, it gets carried over. Mind you, this is $1 a day for assigned homework, $1 per hour for chores, $0.50 per day for meeting schedule(getting up on time, coming home on time, going to bed on time). Obviously, he's not getting rich. But, this has helped him learn several lessons. I'm not saying this is the right answer in your situation- but little short-term goals and rewards can help a lot sometimes.

    Just a thought! Good Luck!
  3. JJJ

    JJJ Active Member

    Klmno - Her hockey and phone calls are very important to her which is why they are the daily rewards that she can earn. I know that without a daily reward, we will not get anywhere.

    As to what did she do, she tried to kill us by pulling the car off the road. She also tried to strangle her youngest brother, attacked her other brother and jumped out of a moving car and ran. She still refuses to accept responsibility for what she did, nor does she understand the severity of what she did. She says it was our fault that she tried to hurt us and that her brother's deserved to be hurt. If she was showing ANY remorse, I'd be more likely to be easier but she just doesn't care.

    We have tried allowances. However, she steals money and if she has some money of her own, we cannot always tell what was stolen v. what is hers. We have tried just having an "account" for her on paper but she consistently breaks things and has to pay for them. I think she owes us close to $1,000 at this point. At 13, she doesn't have the earning potential to pay the back. So, we are not doing allowance until after she returns from Residential Treatment Center (RTC).
  4. klmno

    klmno Active Member

    Gotcha! I understand better now- the stealing issue is why I don't give my difficult child cash- or rarely and it's small amounts. He goes through phases with it and it's actually a tell-tell sign now when I can see that he's getting "off-balance". Anyway, I'm glad you're trying to motivate her with something short-term. I don't think some of these difficult child's this age can see beyond tomorrow!! If it's any consolation, I have to pay about $4000 in restitution for my difficult child's crime spree, and that's not even mentioning attny fees, lost pay from work, etc. That's why I tell him he gets paid $1 an hour instead of more.

    Good Luck!
  5. smallworld

    smallworld Moderator

    JJJ, I'm not walking in your shoes, but I have lived through three kids experiencing manic reactions to SSRIs, and my kids can now articulate how truly out of control they felt at those times. Clearly, the psychiatrist thinks he's treating mania -- and Kanga's behavior certainly sounds manic -- or he wouldn't be prescribing Depakote. There's nothing rationale about mania so I think it's doubtful Kanga would be able to fully appreciate the severity of what she did or show appropriate remorse. But only you and your doctors can know that for sure.

    In the cases of my kids, we secured the environment so everyone was safe, but my kids weren't able to do homework or chores until they were stable on medications. Frankly, they were very ill until their medications took effect. In fact, my son is currently in a PHP, and as we work on his medications, we are not expecting him to do homework or household chores. We do expect him to take his medications, participate in therapy and accept consequences if he engages in unsafe behavior. Again, I speak from my own experience, and only you can know what Kanga can handle at this point.

    I wish you luck in finding Kanga appropriate help.

  6. meowbunny

    meowbunny New Member

    I think most of your list is reasonable. There are a couple of things I wonder about. Does she like to read? If not, an hour of reading is somewhere on this side of torture. I know it would be for my daughter. Could it be just a quiet activity like reading, drawing, etc.?

    The other thing is keeping private things private. I understand the desire by you (and any adult) to want family issues to stay within the family, but, at 13, that is so against the nature of a girl. This is the time that they tell EVERYTHING and if they have nothing to tell, they make it up. It seems to be in the nature of the beast. Honestly, I don't think there are many girls who could keep this one for a day, let alone 30 straight at her age. Is there a way to compromise it so that maybe it is specific things that cannot be discussed rather than being something as vague as "private?"

    I'm sorry you're being forced to go to such measures. I truly can't imagine having to protect myself and those I love to such an extent from another loved one. Hopefully, it is a manic reaction and the Depakote will help. Good luck on being able to keep her there for a longer period. It sounds like that wuld be the best for all at this time.
  7. mrscatinthehat

    mrscatinthehat Seussical

    Sending hugs. been there done that. Hope it works.

  8. susiestar

    susiestar Roll With It

    I am so very sorry you have to go to these measures simply to protect yourself and your other children from one of your children. It isn't supposed to be this way, and it hurts like HE&&. Sending hugs for your mommy heart.

    I disagree about the keeping private things private from casual friends and acquaintances. Kanga's problems are so complex that the acquaintance will simply think she is being abused. Just because teenage girls love to talk to each other does NOT mean that this is an unreasonable or inappropriate request. I think that this is the PERFECT time to have her work on this. It will protect the family.

    It might be handy to have alarms the boys can carry or wear around their necks, just in case. I know it gave Jessie a great sense of security when my difficult child was so out of control.

    Sending hugs to you and the family. So sorry she has snowed another doctor.



    ps. Will taking any documentation showing that depakote CANNOT be at a therapeautic level help with the meeting with the doctor? Just a thought.
  9. 1905

    1905 Well-Known Member

    Wow, I agree maybe you could give the others a whistle or something to keep on them at all times. You have to change your whole lives around, does the Residential Treatment Center (RTC) agree she goes back if there is violence? I wouldn't give any second chances.((((hugs)))to you.-Alyssa
  10. timer lady

    timer lady Queen of Hearts

    Triple J,

    How's the search for in home help going? Any responses? Keeping fingers for the day hospital program. by the way, I was ready to refuse discharge for kt unless she was discharged to that program - didn't need that as she was being discharged to the day program at the hospital.

    As to your behavior contract I can't think of anything you haven't covered or that I'd do different given your lack of Residential Treatment Center (RTC) placement or in home help. I hope that kanga can work her way out of the hole she's dug for herself - I truly do.

    I also know that your family will never be able to fully trust her again; you will always be on the alert. What an awful way to live. We lived that way for years with wm - it's exhausting.

    I'm so glad that therapist's are attending this meeting with you. You need an advocate with you.

    Please know we'll be sitting on your shoulder during the meeting watching your back.

    Keeping you & yours in my prayers daily.
  11. JJJ

    JJJ Active Member

    Thanks all. I'm leaving in an hour to go see Kanga for the first time in 3 weeks. The last time I saw her, she was being loaded onto the transport ambulance from ER to psychiatric hospital. I feel guilty, but I don't want to see her. I'm still scared and angry and sad.