moral delemma

[klmno]

Yesterday's meeting with intern was a complete disaster. It was the first time difficult child had been and was just there to meet him, we thought, but intern turned this into his own agenda to prove what he was going to do, I guess. It would have been really nice if he'd mentioned to me over the last month that he would not or could not provide what I was asking for and that he wasn't even going to try it. So, we won't be going back there. I'm left too livid over the whole thing and feel like it doesn't matter if I talk to them or not, they going to do the same ole same ole no matter what.

Funny, I was talking to difficult child tonight asking him how he felt, without expressing all my negativity about it. difficult child said the same things that I am feeling- he said whether I'm in the room or not, this is all they do. Now I'm not saying there aren't good ones out there. But the ones we've seen so far have been this way. They address adhd, behavior modification, or some typical concept of family therapy, which apparently means that you're supposed to perfect the family before addressing anything else, regardless of whether or not your family relationship is all that bad or casued any of the difficult child issues. (Maybe they just do things completely differently when a kid is involved)

I tried to stay positive while talking to difficult child and I mentioned again that there are good ones out there, we just haven't found the right fit, but if we see one who wants to focus on different areas as being the cause of the problem when we know it isn't and they won't focus on the real problems or they want to lead this into a "tattle- tale" situation between the two of us, then we need to remember not to create problems where there really aren't any. I reminded him that he is court-ordered to stay in counseling until a therapist says he doesn't need it anymore. difficult child said he wished he'd known all this before, because his individual therapist last year (the quack) told him that he would try to get him out of having to do therapy. He said the therapist told him he didn't think difficult child needed it so, then difficult child aksed me, "if I go back to him and asked him to write a letter saying I don't need counseling, does that mean the PO would have to let me off because I'd met the court order"? Well, yes.

See my delemma? That therapist is a quack and I know it. But then again, our current options are this or one who knows how to do family therapy, so he's going to turn it into that kind of problem regardless of everything else, or wasting time with one goes in circles and can't even get started on anything- it's like he's stuck on step 1 and 2. I'm seriously thinking about talking to the quack about this. I think he will see difficult child a few times then write a letter. I could keep looking for a psychiatrist who does counseling, or someone else to address what we need, but the PO and legal issues would be gone much sooner.

One big problem that I have with the quack is what he told difficult child about street drugs. Right now, difficult child is staying away from illegal drugs and turned someone in at school last spring for trying to sell a large amount and bringing them to school. But you know, I have to wonder what this guy could tell difficult child if he went back for a while and difficult child might not be able to maker a wiser decision. But, if difficult child only went a few times...???

SIGH, Again..

 

[Wiped Out]

Klmno,
Argh-you have had the hardest time finding a good t-doctor-I wished you live near me. I love difficult child's tdocs-both of them-soon he will be down to one. Many hugs.

 

[DammitJanet]

I realize that I am going to disagree with you here again and you are probably going to simply ignore me...lol...but oh well. It wont hurt my feelings any.

I think what you are "taking" from the sessions is simply what you dont want to hear because you want someone to hand you a sure fire cure which you think is in the TEC book. Very few therapists are going to work from that book. They simply dont work that way. They have their own methods that they work from that are based on long standing theories.

Basically they first get into the parent child dynamic and start to build a relationship of trust. This has nothing to do with if there is something wrong in the family unit itself or if anyone needs tattling on. Trust just has to be built if therapy is going to be successful. Next what you describe as them working on simple ADHD is most likely the therapist working on attentional skills and impulsiveness skills. He will tease out over time the wheres and whys of how come these skills are lacking and how to build better skills. This all takes time and that ever important trust. And no matter what type of therapy one goes to, behavior modification is an important component of therapy. You seem completely adverse to that term. If you are in therapy for anything, you are attempting to modify your behavior from some beginning behavior to a different more productive behavior. This doesnt have to mean sticker charts or reward systems.

 

[klmno]

Janet, I'm not ignoring your posts or opinions. I just think your "stuck" on believing that is the problem, just like you think I'm "stuck" in this step of the process. He has TEC book on his desk and they do use those methods there- that isn't the problem with the intern, at least it wasn't the other day.

Part of it is a trust issue, part of it is in what he was trying to focus on and the fact that I have lived through this before and each and every time, it makes things worse for us. Since he and I had discussed these things before-hand, I thought we were on the same page. If we weren't, he could have told me that. I would have held no grudge if he'd said "I do things such-a-such way and that won't change- like it or leave it"- I could have made an informed decision. That didn't happen, so I feel I could not trust him at this point. I specificly brought up things like this to discuss with him before and he acted like we were on the same page about these issues. I think he was just patronizing me.

 

[Christy]

Both a good therapist and a willing patient are necessary for therapy to be sucessful. Obviously difficult child is not interested in this aspect of his treatment and you know the old expression, "you can lead a horse to water but you can't make him drink." I know you are in a tough situation because you've had difficulting finding a therapist that is the right fit for difficult child and this just reinforces his thinking that therapy is a big waste of time. If you were not under the court order, I'd say take a break from traditional therapy and try to find another option but you don't want to do anything to upset the court. In this case, I guess the best thing to do is to tell difficult child that you will continue to look for a better therapist but for now, he must stick with the current intern. Ask difficult child to be polite and respectful and to go through the motions, so to speak. Who knows, after a few sessions they may ake more of a connection and might just get somewhere.

Good Luck
Christy

 

[klmno]

I had to stop to take difficult child to school but thought of an analogy while driving. This explains how I feel:

1) If I hire someone to replace a board in my porch steps and while discussing the project with the guy beforehand, he tells me that he also rebuilds chimneys, I'm going going to tell him that's great that he knows how to do that, but my priority is to get the steps repaired because I'm afraid of getting sued so that's what I'm interested in- not the chiimney, whether or not you could improve my chimney. If he says ok, he'll give it a shot (instead of sayiing he doesn't want the job or that he HAS to rebuild the chimney in order to fix the step), then I don't want to walk outside the next day and see a rebuilt chimney and nothing at all done to the step. But if that happens, I would not trust this guy again, I would be royally PO'd, feel completely disrespected, and would not hire him again.

2) I have a big problem turning the focus on the fact that I smoke cigarettes (outside my house), cook a roast and casserole every 4-6 weeks for dinner (one of difficult child's least favorites), etc., when I've been doing these things all difficult child's life and I am absolutely certain that these things did not make my son suddenly turn into a difficult child around the time he turned 11yo.

For one thing, I consider it a waste of time and money and a diversion from the real problems, for another, difficult child doesn't need to get any ideas or reinforcfement that these things caused him to break the law or have mood cycling or that me changing these things will make his problems go away. And I'm not changing things like that to bargain with difficult child (ie- I'll quit smoking if you quit breaking the law). I don't think it teaches a difficult child not to try to manipulate or to stay focused and take responsibility when a therapist sits right there in the middle of a converstaioon about different issues and looks at me and says "can you make roast less often". (This wasn't the intern- this was a previous therapist) difficult child has TOLD me that he sees how all that works, and I believe him- it would be obvious to anyone there in the room.

I made it a point to inform this intern of these things and how difficult child reacts to them and where it will lead to me and difficult child both being in chaos and that therapist's seem to like to get it to that point right about 45 mins into a session, then send us home. therapist TOLD me he was writing that down as a reminder to himself that he needed to go about things differently. Well, appareantly, he forgot to read that reminder.

So, 1) I didn't hire him to do the typical family therapy, 2) he delved into pushing difficult child into saying certain things (putting words in his mouth) and it almost seemed like he used his notes as a list of things to intentionally do. 3) It wasn't a problem with mine and difficult child's relationship that started all the issues with difficult child- we are all (including professionals) certain about that

He can use whatever method he wants, but it won't be on my dime or my time and not with me or my son again.

 

[Superpsy]

klmno, sorry that the tdocs don't seem to be listening to you. I just have two suggestions:
1. How about setting up a goal making session? It may help the therapist to get on the same page as you and see what you major concerns are right now. (I know you may have told him/her this in person during your sessions but it really does help to get it out on paper. It's also a good way to get difficult child involved in setting goals for the sessions).
2. There just doesn't seem to be a good fit between your needs and the therapists you see. It sounds like its based on theoretical orientation. i.e. therapist sounds like family dynamics kind of person (can be effective but takes time) and you sound like you'd prefer a behavioral or solution focused therapist to address critical needs now. Before you see a potential therapist it may be helpful to ask them about their orientation.

Hope this helps. Am I way off-base about this?

 

[janebrain]

Hi KLMNO,
I'm glad you explained what you mean, I think I get it now. My difficult child 1's outpatient therapist that we had for several years did this same stuff. All she ended up doing was reinforcing difficult child's sense of power over our whole family. One thing she recommended was that my husband change his work schedule so that he could drive difficult child to her middle school so she would be sure to get there on time. difficult child walked to school at that time and often was late or would not go. The therapist said it was of utmost importance that difficult child get to school. Okay, we tried it. Well, now difficult child really had some power. She could cause my husband to be late to work if she dawdled enough and she could cause him a great deal of stress and anxiety! That little experiment didn't last long!

The therapist also could not seem to focus on anything. She would get distracted and difficult child was an expert at deflecting her away from her issues. She also would make "contracts" with difficult child which difficult child would immediately violate as soon as she left the office.

If I had only had this group to come to back then I think I could have figured out what to do and I would have fired that therapist much sooner.

difficult child did have an outstanding therapist at her Residential Treatment Center (RTC) and my younger dtr has a great one here. He has taught me how to be a better parent and he is helping my dtr take control of her own life. He has taught me how to remain calm and get a handle on my own anger issues and how to keep from triggering her so she can feel safe enough to deal with her problems. He has given me permission to back off and allow her the freedom to make mistakes. He has taught me how to be a resource for her without taking over and trying to run her life for her and then getting angry when she doesn't do what I think she should do.

I guess the main thing is that my dtr and I have a much better relationship now thanks to her therapist. It seems to me that is what you are looking for--someone who will not make things worse but who will make things better.

Sorry for your frustration, I think I get it pretty well!

Jane

 

[klmno]

1. How about setting up a goal making session? It may help the therapist to get on the same page as you and see what you major concerns are right now. (I know you may have told him/her this in person during your sessions but it really does help to get it out on paper. It's also a good way to get difficult child involved in setting goals for the sessions).

We did talk about these things and after I asked him to tell me how he saw the "plan" and what strategies he planned, or something to try to find out the specific approach he inteneded and goals ( to make sure we were on the same page), he told me he couldn't. (I did leave that session a bit concerned- with eyebrows raised.)

There were a few things that happened in the fall of 2005 that had a major impact on difficult child. He had signs that these things were effecting him and he was having trouble dealing with them. Then, he became self-desstructive, started breaking the law, his personality changed, etc. Those things didn't have anything to do with our relationship being bad or anything I was doing or not doing. I took difficult child to a family therapist at thaat point though thinking that he could help difficult child or help me help him. He recommended that I take difficult child to a psychiatrist and said he thought this was a bigger issue than a family therapist could deal with. (Which I did)

Maybe the intern intentionally did go that route just to test me and see how I would react- to see if I was getting caught up into it and contributing to the escalation in difficult child (raging or mania). It seemed like a catch 22 because if I didn't say anything, I wasn't going along with the program. If I reacted, I would be contributing to the problem (it being just tattling or arguing or becoming emotional). Anyway, when it got to that point, I just said that I wasn't playing that game and that difficult child and I would discuss this at home and handle it a different way.

Maybe I'm just looking in the chimney section of the yellow pages!!

 

[klmno]

[All she ended up doing was reinforcing difficult child's sense of power over our whole family./I]

Right now, difficult child doesn't have that sense of power and I don't want him to get it- I'm a single mom with no emotional support or reinforcement regarding difficult child and I can't afford to add this problem on top of the ones we already have.

And while difficult child and I have a reasonable good relationship- not perfect but it works most of the time- turning therapy sessions into tattling sessions really does drive a wedge between us and focusing on issues that I feel have nothing to do with the real problems makes me come home angry and resentful, which doesn't help our home life much.

If I had only had this group to come to back then I think I could have figured out what to do and I would have fired that therapist much sooner

Yep- I got to this point the hard way too- I used to wait 4 - 5 mos before realizing that we were barking up the wrong tree- the whole time things were getting worse.

 

[klmno]

I think this intern is convinced that I am causing the erratic behavior and anger issues, instead of it being mania and raging. So, while I'm looking for help with mood cycling issues, intern is starting down the road of "well, if Mom changed, difficult child wouldn't have these issues". I think difficult child cannot learn to deal with mood cycling (whether to prevent it, cope with it, or treat it) if he is taught to blame someone else for it. Right now, difficult child is confused and needs to be taught and lead. Now that medications have difficult child relatively stable, difficult child even teeters on being in denial about all of it. I don't think he needs a therapist who doesn't acknowledge that difficult child cycles. (Intern told difficult child "forget BiPolar (BP)- I'm not here to deal with that stuff- tell me what bugs you about your mom" Then, after difficult child said a couple of things-typical teen things- intern says "see, you do have things you need to work on", like he just went thru all that to prove to me that we should be doing family therapy and forget what I had been telling him. I resent it- if he felt that way, this was an inappropriate way to get that point across, in my humble opinion. I felt he manipualted difficult child and hadn't leveled with me. I felt like he threw out my goals to try to prove his goals were more important. Neither psychiatrist's recommendations included this type of therapy, he had no reason to try to prove a different route with me. )

Or, at least he must convinced that I am triggering all this in difficult child and although, after learning about techniques, etc., I do see that changing some things can prevent or help de-escalate things. And, that is a therapuetic goal of mine- intern knows that as well. But, primary triggers are coming from other things- most of them outside our house- I'm pretty sure it isn't my cigarettes or roast. LOL!!

Intern did know about these things- that's why I went to him 5 times alone before taking difficult child in. Intern TOLD me he would give difficult child psychoeducation about mood cycling because one of my frustratioons with previous tdocs is that no one had done that and I would have thought it would be first on the list after getting a BiPolar (BP) diagnosis- or at least after identifying that mood cycling was going on. I had also told him that we'd had bad experiences with tdocs up to this point and I wanted to get straight whatever was going awry prior to bringing difficult child into the picture- so we discussed previous situations and I told him that if I'm viewing this wrong or misinterpreting, then I'd rather meet with him a few times alone to work through that first to make sure we were on the same page. He is the one that wanted to go ahead and meet difficult child.

PS the court order says "juvenile to continue in counseling until released by therapist". It doesn't order family therapy- the judge has been given written documentation from 2 highly respected psychiatrists of the things that happened in fall, 2005, and difficult child's diagnosis and medications and the documentaion includes the statement that difficult child is not diagnosis'd with conduct disorder. difficult child goes to counseling without a fuss and answers questions, talks, etc.

I've been trying to pursue what I have because I really believe it would help and make a difference in difficult child's life and future. But I can drop him off and let him chat with any therapist and it would meet the court order. I have not pursued that route because I wanted difficult child to have faith that we could find a therapist that could provide help in the areas that difficult child has problems with. I didn't want to do anything to teach difficult child to "play the system". But at this point, although I still have the same objectives, maybe we should do what it takes to meet the court order just to get that behind us, then, if we can meet the other objectives some other way it won't matterr.

This intern asked difficult child about 5 times "so, tell us what bugs you about your mom"- difficult child hadn't said his mom bugged him, but after being asked that 5 times, he came up with his list of stuff- which I had told therapist ahead of time that this is what it would be. LOL!

 

[klmno]

Janet, I keep reading your post and this keeps popping out at me:

Trust just has to be built if therapy is going to be successful.

My only reaction is that I can't see a single effort on their part to do that- especially this intern. I am not one to give blind trust and faith where my difficult child is concerned and given how critical his situation is right now and especially after going thru so many tdocs the past (almost) 3 years, I do need to see from a therapist that they respect that.

The poster who mentioned orientation- that might be onto something. One therapist always answered my questions with questions and that drove me nuts. Most make me feel like we're being manipulated into buying into their agenda. I don't trust anyone who makes me feel manipulated. And yes, a lot of this was the same type issue I went through when I was looking for a counselor for myself. I know it works for a lot of people- I don't question that, but if it was a magic cure, none of us would need to be here, right? The counselor I had (many moons ago) made me feel like we were just talking- she answered my questions with real answers, even if the answer was "I don't know", she still lead me through processes, but she did it by saying "I'd like for you to try XXX", not by manipulating me into doing something. So, if there is a name for that orientation, methodology or type of therapuetic approach, and someone can tell me what it is, I would love to know it so I can ask for that. I know to ask for CBT (cognitive behavioral therapy), which is pretty common- although not used as much with kids as with adults. This intern clearly has those skills and I was really starting to have some faith that this one might work because of it. So, I am assuming that leaving feeling manipulated instead of leveled with has nothing to do with methodology but lack of communication or just not being on the same page and having different expectations of what was going to transpire. But I could be wrong- I was shocked to learn "behavior contracts" are considered therapy by some.

I took a lot of things that you and others here brought up as points to discuss with this intern- one being that we already use rewards at home and of course, there are rules and consequences, and what is in place works fairly well most of the time. I just don't want the entire point and focus of the therapy to be a behavioral contract, like with that mst guy, because we have had a therapist in the past who focused only on behavior modification (that is actually one type of therapy in itself) and that was a disaster, too- even the sd people who know difficult child fairly well said they didn't think that was a good idea for difficult child and his issues.

I realize that any therapy is a process and it takes time that is dependent on the issues, those involved, etc., but I do have a real fear of still being there talking about casseroles or whether or not difficult child got an extended bedtime come January, when difficult child's cycling has started to kick in late winter for the past 3 years- so yes, I feel a sense of urgency to start discussing thses things and get off my cigarettes! LOL!

I know- I'm writing a book here. Sorry...

 

[flutterbee]

Here's my two cents. Do with it what you will.

The trust issue the therapist is worried about is not with you; it's with difficult child who is the patient. He has to build and establish trust with difficult child so that any therapy will be helpful. That includes hearing difficult child saying that mom smokes and makes casseroles.

My response to that is, so what? Tdocs hear that from kids ALL the time. Mom yelled at me, mom made me go to bed early, mom doesn't cook every night, mom works, mom goes out with her friends sometimes. All kids complain about their parents. I hear it from my kids' friends all the time. Tdocs do, too. He needs to hear this to 1) establish trust and 2) see where difficult child is coming from. I can't believe for one second that the therapist is going to say, oh, yeah...now I can see why you got into trouble. If my mom smoked and made casseroles I would have started a fire, too. It just doesn't work that way.

But, after that trust is established, the goal of therapy is to realize that these aren't the problems, that each person is responsible for his or her own actions, how to recognize when he is escalating and tools to use to calm, cope, maintain.

Further, my daughter started therapy the first time when she was 5. My son did therapy for about a year when he was 10. I was never in with them during their therapy session unless the therapist asked me to be. I usually saw the therapist for the last 10 minutes of the appointment with the my child in with me. If I needed to talk to the therapist or s/he needed to talk to me away from my child, we scheduled another appointment.

They have to get to know the kid - the patient - personally before they can begin to work on anything. If they just jump right in, it's going to blow up in their face because it's going to turn the kid completely off.

We've gone through a few therapist's, too. There was only one that I felt was really a waste of time. The other ones pushed too far, too fast and difficult child was completely p*ssed and would not go back. Even if I forced her, she would just sit there and glare without saying a word. The entire reason this happened was because they didn't take the time to build the trust.

 

[klmno]

Thanks, Heather! All responses help me work through this. I'm only going to address the things that are still giving me food for thought- the things I'm not addressing, I don't have a concern about. Except that I think the parent needs to trust the therapist, too, but I see that the therapist is going to start with trying to get the kid's trust. So, no issue with therapist getting difficult child's trust. Issue was that I felt therapist plowed right into something we discussed and I thought he wasn't going to do. (See below for clarification.)

Further, my daughter started therapy the first time when she was 5. My son did therapy for about a year when he was 10. I was never in with them during their therapy session unless the therapist asked me to be. I usually saw the therapist for the last 10 minutes of the appointment with the my child in with me. If I needed to talk to the therapist or s/he needed to talk to me away from my child, we scheduled another appointment

I think that is typical for individual therapy with a child, and primarily, that is what we discussed for this situation. But, since there are some things that I wanted to address with the therapist (like learning more tecniques to help difficult child de-escalate, for instance), we discussed format and I asked him how he thought we should go about this last week - the last meeting before bringing difficult child in. We got to a certain point in that converstaion but then time was up. He mentioned maybe we needed to talk again privately before going further, to make sure we were on the same page, but he did already know that I wasn't there seeking family therapy, unless he saw some compelling reason to do that later on, then we'd discuss it. Due to what had already been scheduled, I had to go ahead and take difficult child with me this Tues. When we got there, therapist said he'd like to meet with both of us together first, then me by myself, then difficult child by himself. Given that it's only a 45-50 min appointment., I figured he was just using this initial meeting to help difficult child feel comfortable with him and touch base with me about any further thoughts on format.

Instead, we weren't in his office for 5 mins before he starts on the typical family therapy approach and doing it in such a way that it appeared obvious (I could be wrong but is sure looked this way) that he was trying to prove this is what we needed. That really bugs me, still. Not only did that move too fast, but if he for some reason decided we needed this more than anything, I think he should have told me that first- there would have been no reason that he couldn't have met with difficult child to get to know him a little then used a little time with me privately to say "I really think the best way to accomplish things is through family therapy, I'm not willing or comfortable to pursue anything elses with you right now", or whatever. This approach made me concerned, then, when he started going into mania issues with us, I tried to send him gestures that would remind him that this is a very sensitive subject with difficult child and he had told me he would take that slow, then when he got to the other stuff, plowing ahead more, I just shut down. The time limit was up, it didn't matter, so we just left.

What could be done differently? I guess I should have made sure he and I met without difficult child again. I had previously explored different tdocs, an individual one with format as you describe above for difficult child, and a different one for family therapy or both of us or just as an individual therapist for myself. However, for a number of reasons, both psychiatrists involved, and actually even the tdocs that we tried this with, said that is a bad idea in this situation- use one therapist only for all of it. So, this is still up in the air, I'm not mad aboout it being up in the air. I'm mad because I don't think he should have plowed down that road with this being up in the air. And even if we had decided on family therapy as the solution, he plowed to faast and didn't lead the session in a way that left a stopping point at end of session time. He didn't stop after a certain time to meet with either of us individually like he said he was going to and he just kept "plowing" until 45 mins was up- no "stop plowing at 40 mins" so we can reel things back in to a good, calm stopping point. It was more of a peel back layers then open the door, like I told him already, this was a concern I'd seen in a therapist before. Some tdocs are pretty good about making sure this doesn't happen- or at least they try to prevent it.

They have to get to know the kid - the patient - personally before they can begin to work on anything. If they just jump right in, it's going to blow up in their face because it's going to turn the kid completely off.

As said above, he jumped right in with typical family therapy instead of sticking to 15 mins each- meeting together, then individually, just since this was the first time difficult child had been there, like he himself said is what he wanted to do.

The other ones pushed too far, too fast and difficult child was completely p*ssed and would not go back. Even if I forced her, she would just sit there and glare without saying a word. The entire reason this happened was because they didn't take the time to build the trust.

That happened when difficult child first started going to counseling- but now it only happens if he really doesn't like the counselor. So, I do give weight to difficult child's opinion on whether or not he's comfortable with the therapist.

I had a lot of hope in this one- it became obvious through our 5 meetings alone that he is skilled and used to using CBT with kids, he's at the psychiatric hospital (teaching hospital) and they are using more current methods than other places, he seemed like he wasn't to one extreme or the other, personality-wise, so I thought difficult child would like him, etc. You know how it is- the more you have your hopes built up, the more disappointing it is. That has a lot to do with why I got so upset over this. And, I do have the access baggage from previous bad experiences that I have to fight with to try to stay objective. Between psychiatrists who sincerely did make things worse or were a complete waste of time because all they ever heard was difficult child saying things were going great and all that we've gone through with legal issues this past year, it's like having PTSD that is triggered when I get concerned about a therapist or when legal authorities are not happy.

I think maybe part of this happened because we weren't on the same page as much as I'd thought and additionally, maybe this is where his lack of experience does come in. The first 2-3 meetings I had with him, he was answering the phone when it rang, answering the door, etc, like we were just chatting and anyone else could interrupt whenever they wanted- it happened 4 times in one session. I kept looking at him funny about it, then it came to an abrupt stop and never happened again. I assume he's discussing things with some sort of supervisor at later times and learning some things. I hope he learned something out of this situation. Maybe I'm wrong, but I don't think this was all my doing that caused this problem.

Anyway, previous therapist (Mr. go in circles) called yesterday and left a message- I left a message back about scheduling another appointment with him.

The other thing I forgot to mention- the intern seemed to put words in our mouths a lot. If they'd really conveyed what we were thinking, I would view it as "oh, he really clicks with difficult child" or "wow, he really understnads where I'm coming from", but instead, they were more reflective of stereotypes or his wrong assumptions. Maybe it's me not communicating things well but this leaves me having to decide how much time, if any, I want to spend seeing if I can undo his pre-conceived ideas, which I think Marg or someone brought up in a previous thread. Also, he wasn't very good about reading my or difficult child's body language correctly either. I'm not sure if that's his lack of experience, not knowing us, or just that we're that "different" from other people. LOL!

 

[Shari]

You wrote "Maybe the intern intentionally did go that route just to test me..."

I don't recall the specifics, I'm sure its on the board here somewhere from way back when, but I felt the same way with difficult child 2's in-home at first. And so did difficult child's babysitter. But that's what he was doing - testing difficult child's caregivers. I ended up really, really liking him. Not saying that's the case here, just my experience.

 

[klmno]

That might be it, Shari, as Janet or Heather one pointed out- maybe he was checking into the family dynamics.

I think part of what gets to me, too, in regards to this is that therapist brought up things to difficult child that I had told him might be a good idea to wait a bit before bringing up because I had told him how sensitive difficult child was to discussing certain things and that difficult child always either has an emotional upheaval at home after a session when they are brought up because no therapist to date has brought them up at a time when they are ready to actually deal with the issue in a session, so it gets brought up, and difficult child holds in how upset he is until he gets home and I'm left trying to dealing with what really should be dealt with by a therapist.

Anyway, if that isn't what happens, then difficult child takes it like I just have been in there tattling all his faults or past mistakes, so difficult child has told me that then he'll just tattle all mine, and that is exactly what he'll do. So 1) therapist knew all this up front and still plowed down that road the first time he meets difficult child and 2) it leaves me afraid that therapist is only seeing me as a horrid mom and when PO calls to check in to verify difficult child's therapist and get an update, (here's where my paranoia starts) therapist might not think these things are a big deal so he might tell PO, who sometimes goes out of her way to make me look bad to the judge and GAL (that part has actually happened before and isn't paranoia), so we might have to go back to dealing with judge, social services, custody case, mst instead of private therapy, etc, etc. Things got so chaotic last year when they never should have- just way too much got blown out of proportion so quickly and cost me so much- not just financially, but emotionally for difficult child and me both. People sometimes don't realize how one sentence can turn into a nightmare- one sentence from psychiatrist that someone else made an assumption that they knew he meanst XX instead of YY; one sentence from a vindictive half-bro who had ulterior motives, one sentence from a B****y PO, one sentence from a gal who made way too many assumptions and told the judge things before checking out the facts, etc. So, I'm trying to work through that. But, I am extremely cautious about a therapist who has preconceived notions that aren't entirely accurate and then hears difficult child make me sound like a horrid mom.

Example- one therapist last spring, difficult child goes into and told him that I put beer in the car and drove off and left him at home alone one night. That sounds pretty horrid and neglectful doesn't it? Do you have any idea how the judge would react to that? Doesn't that leave therapist's thinking the mom is the problem?

Would you like to know what really happened? difficult child was raging, to the point that I was afraid he was going to get violent with me or our dogs. I tried everything I knew to get him to calm down. I knew if I called cops, they would put him in detention right away, even though I felt he might need psychiatric hospital, he was on probation. Then, difficult child hid phones and started throwing things at the house and windows. It kept escalating, I took what beer there was in the house and put it in the car (to make sure difficult child did not go that route of drinking any), I put dogs in the car and told difficult child that I was leaving to go find a phone to call the cops. I drove around the neighborhood for about 5 mins and then returned home. I did not call cops. I knew that so far, my difficult child can de-escalate from a rage if he can take a mental time-out, so to speak, but I couldn't get him to do that on that night until I just took the dogs and left. Oh- and as I was leaving the driveway, difficult child tried to jump at the car. When I got back, he was calm.

Now, if we had a therapist who was already on board with all issues, I would have contacted them. I want a therapist who can help me learn better how to help difficult child, and of course, help difficult child learn better about helping himself. But it does take trust from both of us for me to tell a therapist this- if I don't know them from Adam, they could have my son removed or thrown in detention or psychiatric hospital that day. I don't think it was a life or death situation and many of us here have had times like that with our difficult child's. But not all tdocs are used to hearing about these things. And not all tdocs know techniques to teach a parent. And, being that the therapist didn't know us so well, he was left trying to figure out who was lieing on who- me or difficult child. How did it get to that point- the good ole "tattling" sessions. That's why I hate them. I've had tdocs tell me "call police" on every issue- much calmer issues than this incident. Then, one had him tdo'd for doing less then this.

Do tdocs need to know that situations like this are happening at home- of course. But when you start the way this therapy started, with a therapist who apparently feels that mania and raging are in the control of the kid, I'm not so sure this is the way to start. Of course- this is how they check those family dynamics. LOL! And, that is how the ole' behavior contract gets slapped down. Which is where we were 18 mos ago and that kept making things worse. Until psychiatrists figured out that difficult child is cycling and becoming manic- this isn't something a behavioral contract can fix. In other words, as tried and true as their method might be, I think they need to get to know us before hearing the horror stories like this or they will more than likely assume the worst. That has just been our experience.

Fortunatley difficult child didn't go this far with the intern this week. I have never told difficult child not to tell a therapist something, but I have told him (after my example situation) to either tell the whole story or none at all and that he should be careful about telling anyone, even a therapist, the worst things before they know him, unless it is a situation where someone could get or has been hurt.

I personally, feel that if we found a therapist who was used to dealing with mania and raging in kids, they wouldn't be so shocked about these stories and would be concentrating on techniques rather than who's lieing, call cops, or tdo- unless it really is a life or death situation. But, I also think that a lot of tdocs are not used to dealing with mania, or at least they don't acknowledge it as such. If a therapist really is used to dealing with kids who are BiPolar (BP), I tend to think they don't need to hear a bunch of stories like that- they know kids who get manic do things like this. They know the kid's thinking gets skewed. They know the kid more than likely has raging episodes.

I got off-topic- this didn't actually happpen with this intern- it has happened in the past and I am afraid it could happen with this intern because of the way things transpired on Tues. It's more than fear- it's like I could see just where this was leading. The more I think about it- that might be more the root of the problem. Intern really didn't even acknowledge mood cycling exists in difficult child- maybe he's one who doesn't believe it can. Inearlier discussions, he was quick to respond to questions in ways that proved he had experience doing CBT with kids and working on certain issues. But, when I brought up the topic of techniques to help kids de-escalate, he seemed a little at a loss. It happens to be my personal opinion- right or wrong- that if anyone (parents or tdocs) knew a way to de-escalate a situation before it got too out of control, they would use that technique rather than letting it get out of control then calling cops or tdo-ing.

 

[klmno]

Intern just called- I just spent about 1/2 hr on phone with him. He apologized for not sticking to what he said he was going to do onTues. but said he couldn't do his job if he felt like he was always having to audition. I discussed some of my concerns. (I have more that we didn't even get to- I brought up strategies for helping de-escalate again and what about school- he held back again when that came up and started saying well, he didn't know how much he could do about everything- that concerns me.) Anmyway, we made an appointment for Mon. He said he'll meet with- us both, then difficult child, then me.

SIGH... do you think I should go thru with this or let it go?

I'm glad he called so we could talk about some of this, but right now, my gut feeling is that i still don't think I could ever be comfortable with this. I don't think I should pursue it any further.

 

[flutterbee]

Ok. I'm going to admit right off that I haven't felt well all week so my cognitive issues are more pronounced and I'm having trouble keeping up with everything you've said. But your last post really stood out.

I am not trying to be offensive or put you on the defensive, but I've never known of anyone to meet with the therapist so many times (I think you said 5) before the therapist meets the child. I understand your concerns...you have had some bad experiences and some completely worthless experiences and you don't want that to happen again. But, the therapist can meet with you 20 times and until he has met the child and see how he reacts/responds, he is only theorizing as to what will or won't work. Yes, there are certain therapies that are better for BiPolar (BP) or depression or ptsd or what have you, but they all have to be tailored to the specific patient.

His statement that he can't fix everything is, in my opinion, true. The thing is, if he can get difficult child to the point of de-escalating on his own, helping him to recognize triggers and when he is escalating and teaches him tools to cope then the other stuff falls into place. That's what I always have to explain to my daughter. She wants specific help with XYZ (for example, she always says they aren't going to be able to make me go to someone's house that I don't know and ask the girl to play). No, they won't. But, they can help her learn tools, help build her confidence, etc so that she can do that on her own. Does that make any sense?

I really like that he called you. He is obviously concerned about how it went and concerned about how you feel about it. And he aplogized. Wow. That jerk of a therapist that I just saw not only didn't call when I was obviously upset when I left, but when I called to cancel and told them that I did not want to reschedule, he didn't call then either. In my book, your therapist earns bonus points for calling.

I would say to give him another chance.

 

[klmno]

His statement that he can't fix everything is, in my opinion, true. The thing is, if he can get difficult child to the point of de-escalating on his own, helping him to recognize triggers and when he is escalating and teaches him tools to cope then the other stuff falls into place. That's what I always have to explain to my daughter. She wants specific help with XYZ (for example, she always says they aren't going to be able to make me go to someone's house that I don't know and ask the girl to play). No, they won't. But, they can help her learn tools, help build her confidence, etc so that she can do that on her own. Does that make any sense?

Yes, that makes sense, thanks! Although- that does require therapist acknowledging that these things are going on with difficult child and not just intentional bad behavior.

Another thing he said on the phone- I mentioned something about "why are we doing family therapy- I know our household isn't perfect, but we have bigger problems and we aren't there for family therapy." And, I discussed having a psychiatrist involved more- as far as helping me with strategies and difficult child with understanding what is going on with him. I was trying, politely, to say that if his method of teaching us this aspect was family therapy, then maybe this was an issue. I mentioned that some parents get this from counseling with a psychiatrist, but that difficult child's regular psychiatrist wouldn't do this. He said "Oh, so you're frustrated about that" me- "Yes, and this is where I feel the gap is, but I don't think that discussing my casseroles and whether or not difficult child likes them is going to fill that gap". He said "I see your point- so regular psychiatrist has only met with difficult child 15 mins at a time and never covered these issues- then I will talk with psychiatrist here and see if we can come up with something". That is my best hope- then difficult child could see this guy (intern) for indivudual therapy, and I, or we, could meet with psychiatrist for what I'm looking for, but there is no conflict between therapists and psychiatrist could help intern understand a little more about cycling (I really don't think he gets that concept so well-I think many people don't until they see it first-hand). Well- that's my dream- we'll see if it can happen. Maybe- I still have such negative feelings about all this that I can't say for sure that anything he does would be enough for me right now- I was way too ticked about the whole thing Tues. that I don't know that I can wipe that slate clean. I still feel like he has pre-conceived ideas, etc., that I don't know that I want to deal with. I'm going to give it the weekend and we'll see how I feel Mon. morning. If I can't get past feeling like this, I might have to cancel- no sense going through more if I have reached a point where I can never be comfortable with him- Know what I mean??

If I do go thru this Monday and he pulls another 45 min family therapy session after what he told me on the phone, I can't begin to tell you how I'd feel. But it wouldn't be good. I do think that could happen because he said the same thing on the phone that he said Tues.- let's start with both, then difficult child, then me.

But thanks, Heather, you've helped me a lot. Sorry if I've been defensive- my anger was with these tdocs and the situation, not with anyone here.

I'm sorry you don't feel well- and thanks again for trying to keep up- I know I've written a book. And something does appear to be wrong if I need to go through all this to deal with a therapist.

 

[amazeofgrace]

I can relate to your frustration. I will not move out of this county because I finally have 2 in home therapist (one for each difficult child) that are awesome! If I move to a new county I might lose them, and I am not risking that, not in a zillion years. I also finally found a psychiatrist, well she's actually a Psychiatric Nurse praticioner, but she is so thorough and actually listens, again I am not going to anything to jeapordize losing her! Now if only I could fine a Behavioral Assistant of such a caliber, and I'd be set, sadly that's a frustrating ordeal, of them sending me BA's that are qualified but don't show up, or they aren't qualified and show up late. If I am going to have someone at my house 6 hours a week, they'd best be qualified and show up!

Sorry I am rambling, but I can relate to your frustrations. It seems to be a never ending battle.