second-guessing our decision to bring our son home from Residential Treatment Center (RTC)

[recovering doormat]

Hi everyone, I haven't posted in some weeks since my son entered a diagnostic residential program at a facility in Pennsylvania on Jan. 2. Before he left, he was just a mess: smoking weed several times a day, refusing to attend high school, refusing to follow his dad's and my household rules, stealing, lying, you name it. Six weeks later, he is detoxed, unmedicated, and we have a clear diagnosis of Generalized Anxiety Disorder (GAD) and Dysthymia and recommendations from the treatment team (he had a particularly effective therapist) that he go directly to an Residential Treatment Center (RTC) for dual diagnosis treatment.

Initially, his dad and I agreed with the recommendation to find our son an Residential Treatment Center (RTC) that could tackle his dual diagnosis and would be academically challenging. The onus was on the two of us to find the ideal location and get him in ASAP. He could stay at the diagnostic facility as long as we needed him to even though he was done with the program. Problem was, our son knew that he was eligible to leave and that it was up to dad and I to decide when he left (his therapist told him that). He lobbied us nonstop while we visited and in phone calls, and he really got to his dad. I don't think either of us slept after we came home from the transition planning meeting last week.

After discussing the pros and cons, his dad and I elected to take him out of the diagnostic facility and bring him home to his dad's where we would enroll him in a private, college prep day school and set up supports (frequent psychotherapy, substance abuse counseling, family therapy, part time job, hobbies, recreation time, basically doing what an Residential Treatment Center (RTC) does at home) so that he could remain with us and still make progress in his recovery.

Needless to say, the therapy team was stunned that we changed our minds. They do not believe he can hack it at home, no matter how much structure and supervision we provide. I found myself sounding like I was rationalizing our decision when I spoke to his therapist.

He's been home 48 hours, and so far so good, but I have started second-guessing our decision. Not that it's necessarily a bad one, but because we made it based on our emotional response to our kid. Before our son even woke up his first morning at dad's, we had the behaviorist who has been working with us for the past year make a home visit to set up some ground rules for having our boy at home. In the past we have not provided the supervision our son needed to keep him from doing bad things and I'm already afraid we're going to fail. We do have Plan B, a list of Residential Treatment Center (RTC)'s within our state that we could get him into rather quickly if he starts to backslide despite our best efforts.

I just don't know if we are being selfish for wanting him home so badly. His sisters were really suffering with him so far away, and that was painful to watch. But some things were easier with him away, too, and no one wants to go back to the way things were just before he left.

Have any of you decided against placing a child inan Residential Treatment Center (RTC) in favor of doing it yourself? How did it work out?

 

[tracyf551]

I tried to do it myself for a long time. It didn't work. difficult child was sent to 2 placements. Did well at both while he was there. Beg and pleded to come home, "talk to someone, call this person and that person" I went to see him every 2 weeks at both placements, took the phone calls, wrote letters to him, etc. The 1st place was for 6 months the second was for 9 1/2 months.
Did I ever want to bring him home because I felt guilty??? Heck yes!!!!!!!!!
Everytime I talked to him. Did I do it? NO!!! We all missed him, we all cried, but we knew we had done everything we could.
Now difficult child is almost 19 and worse than ever. Drugs, drinking, current warrant for his arrest, steals anything not nailed down,etc. Did we do the right thing or the wrong thing with placements? I don't know. When he was away he loved us, he missed us, and he was sorry for everything. When he got home it was all different. he was good for about 2 months after returning home but soon went back his old ways.
I doubt I answered your question but this was my experience.
Good luck and keep us posted.

 

[compassion]

i ALSO TRIED DONG IT MYSELF AND NOW AM ADAMENT ABOUT KEEPING HER IN Residential Treatment Center (RTC) DEPSITE CONSTANT PLEADINGS AND INSIETENCE THAT EVERYONE SAYS SHE IS REDY TO COME HOME aPRIL 16 (16TH birthday). I am not getting hooked in the guilt. She is no way even beginnng recvoery. She is very unstable. From Nov.16 until mid Jan. she was getting semistable but it was next to impossible to really do it so this time she is styng in Residential Treatment Center (RTC) to get past actue phase. This takes time. She was also very manic, stealng, running way, doing drugs, acting out sexually. It was very scary wondering ehrn she would get itno crimina jsutice syatem. I am not going back to that. Compassion

 

[jbrain]

My dtr did great at her Residential Treatment Center (RTC), she was like a different person. Our educational consultant recommended she attend a step-down boarding school after that--he did not think she should come home. We could not afford a boarding school so we brought her home and she was great for about a month, then relapsed worse than ever. I had a nagging little thought that she would probably regress and in fact we were warned that she would regress but I didn't know she'd be worse than before the Residential Treatment Center (RTC).

She ended up living on the streets and had a warrant out for her arrest so we could get her put back in an Residential Treatment Center (RTC) (she was 17 at this time). She did go to a dual diagnosis facility in our state and did well there but went back to her wild life when she came out. By then she was nearly 18 and we had to let her go.

She is now 20 but greatly improved, is living on her own and we haven't supported her in over a year. She has changed greatly so I am hoping the Residential Treatment Center (RTC) experiences actually had an impact on her, just a delayed one!

Sorry to not be able to give you a positive experience but I have not heard of many kids coming home from an Residential Treatment Center (RTC) and doing well--we just don't have that bubble environment to keep them in and there are so many temptations and triggers at home. Also, I found myself very "watchful" and worried that she would relapse. It was very stressful--I wanted so much for her to be "cured" and any little lapse would upset me. I think I forgot that it was her responsibility to stay clean, not mine.

Jane

 

[recovering doormat]

I am so sorry to read your stories of how things didn't work out and how stressful it was on you. I am actually a bit more afraid of the additional stress on my ex and me of trying to duplicate the "bubble" rather than my son relapsing and being worse than he was before, although I would never say that won't happen as well.

I don't know how my son compares to your children on the conduct disorder "meter". His emotional disorder diagnosis is anxiety and mild depression, which led to his self-medicating with pot. The therapy team did not think that medication was indicated at the time of his discharge plan meeting. It's possible that we might want to revisit that if the therapist whom he will be dealing with at home thinks medications might take the edge off the anxiety. It just seemed to me that our son would have periods of relative stability, like he did at the beginning of the school year, where he blew all us adults away by actually doing well for the first 8 weeks in a huge, urban high school. Then, something happened, I don't know what, and he spiraled downhill. I don't know if he self-sabotages or worse, if his dad and I are so "fixed" in our responses, that we subconsciously pull him back just when he is about to make a breakthrough. Do you know what I'm talking about? Like we are afraid he will change for the better...sounds sick but that's what the behaviorist says we might think about.

Our kid knows that if he starts to backslide we won't tolerate the behavior that went before, an Residential Treatment Center (RTC) will be waiting for him.

I hope we haven't set him up for failure. Our behaviorist has been pushing so hard for us to give him a quality of life that will make him want to behave well enough to stay in our homes. So far we have been vigilant about keepign the stress level down (no switching between two homes, limit on visitors, no school today so he and his older sister are working in dad's office today, sticking to a predictable routine).

I take your experiences and advice to heart. I'm praying that we are able to help him, not hurt him more.

 

[C.J.]

My story is a little different - when my difficult child was facing placement in an Residential Treatment Center (RTC) - after a stealing $18.00 and a misdemeanor assault charge (I was the target), she spent three weeks in a juvenile detention facility. While there, she had a Level II psychological evaluation done by her private psychiatrist, and was seen by a county funded family counseling team. All recommended out of home placement to Residential Treatment Center (RTC).

I felt the "system" was being heavy-handed. Her mother, who assaulted a police officer, a felony charge, served no time. Her father owed over $24,000 in child support. Jail time - 24 hours. I successfully lobbied the judge to have her come home, and put her on house arrest for two months and intensive supervised probation (ISP) for a year.

N* was going to school, bringing her grades up, and then the lying started again. She met a boy - two years older than herself on the internet and tried to pass him off as someone she met while he was picking up somebody else at her school. Then she started to get sick EVERY DAY - more doctors, more medications. It was N* avoiding school. The ONE day she went to school in a six week period was the day HE graduated from his high school.

Fast forward to two weeks prior to N* being done with ISP, and her community service work isn't done (I did not remind her, though I was sick of the "system" by now.) ISP extended for six months and then she ran away again - with a new boy (two years older than herself) she met on the internet, and passed him off as someone she met at our church. When she returned home, I called the police to let them know she was home safe, and they came by and took her in for probation violation.

When I went to court after this, I only spoke to say I was present in the courtroom.

N* will say she learned a lot while in Residential Treatment Center (RTC) - I still doubt that - she still quit high school (now twice), got pregnant at 18 (sperm donor unknown - the possible number is staggering to my brain), no job, no money, no driver's license, no car. What she does have - a lot of ATTITUDE.

 

[susiestar]

My oldest child, Wiz, spent 4 months in a psychiatric hospital. it was not an Residential Treatment Center (RTC), exactly, but it was also not the typical "spend a few days and go home" psychiatric hospital. They kept him until he got over hiding his problems and showed the staff the problems (it took 6 weeks and the therapist and I conspiring to have me push all his buttons in a therapy session until he exploded - awful thing to have to do, but he had to show/tell what was going on to get help - and they could tell he was hiding behavior problems.).

He did well for a year at home. Then he started the downward spiral. He had two typical short "acute" psychiatric hospital stays in a different facility (our insurance changed), and then I couldn't handle him anymore.

He was beating me and I called the police to come and remove him. They took him to a youth shelter, and the judge told ME to find a placement. Just when I had found one, my father decided to retire from teaching and keep Wiz with him to "fix" him.

Not sure what my dad did other than drag Wiz out to trim trees and bushes every time they had a problem, but Wiz is thriving, planning for life after high school, getting good grades, and it did give Gpa something to do when he retired other than just driving my mom nuts.

I don't know if keeping your son home will work or not. Really, it is mostly up to your son. I wish you the best.

 

[recovering doormat]

Susiestar:

If I had a relative that could take our son to give him a break from the tension at home (volatile sisters, high-conflict divorce, father with-issues in denial) and get him away from the kids who helped bring him down, I'd choose that as my first option. Other adults who know our son think the world of him, that he's basically a good kid who can work hard and is smart. He has an open invitation to work for a local dockmaster and build his own boat with an expert's help. That's the reason behind having him come home instead of going directly to an Residential Treatment Center (RTC).

However, he's been home only three and a half days, and already the doubt is gnawing at me. His dad and I agreed that one of us has to be with him 24/7 for the time being so he doesn't backslide, and it's a lot harder to do, particularly when you have two other children and dad is a self-employed tax accountant during tax season! Yesterday our son finished working for a friend by 11 a.m and wanted to come home, so I stayed with him at his dad's house, all day until 6 p.m. The whole time, while son is showering, watching tv, chatting online with friends, I'm watching TV adn thinking about the laundry, bill paying, and tax preparation I should be doing at home. And wondering why I let my ex talk me into this.

Part of the problem is that we maintain a lot of contact with our son during the six weeks he was at the same type of place Susiestar's son was at. We missed him terribly, took his phone calls (3x a week) and phoned him on the days he couldn't call, at his insistence. Bad idea, in retrospect. all we did was fan the flames of homesickness, making it easier to justify bringing him home.

Compounding the frustration is that our public schools are on vacation this week, meaning there is nothing for the kids to do, and the administrative staff that I wold normally be calling to set up tutoring or an ed placement for our son are also on vacation until next week.

It's only Tuesday and I'm shot already!

 

[BusynMember]

All I can say is, I never put my daughter in an Residential Treatment Center (RTC). I didn't even realize it was an option back then (I hadn't found this board and nobody told me). It would have broken my heart, but I would have done it had I know, in retrospect. Even with homeschooling my daughter, I COULD NOT KEEP HER IN THE HOUSE AND AWAY FROM DRUGS & HER TOXIC FRIENDS. She found ways to get out, usually when we were sleeping. We tried hard, but we couldn't keep an eye on her 24/7. If I ran to the store and thought she was still asleep, she'd be gone when we came back. I have no opinion on what you should or shouldn't do. I just know that my daughter, like most drug users, was incredibly wily and clever and manipulative (she could pout and turn on the waterworks because she knew I was basically softhearted). I know I personally (along with my hub) couldn't keep her from self-destruction. Also, realize that when a child says "I'm smoking pot" (like mine did) likely he is doing MUCH more than smoking pot, no matter what he says or what you want to think. Pot doesn't cause one to put holes in the wall, steal money or get overly aggressive, if that's what was going on. My daughter, who is now clean, tells me the tricks of the trade and that "everyone always tells their moms they just use pot and usually the parents believe it." Don't. And never take your eyes off of him. He'll give you a honeymoon period to soften you up. He'll make you think he's learned his lesson to get his privileges back. Heck, if I were you I wouldn't give him phone or internet privledges unless you could check what he was texting or typing. He could be making sneaky plan. My pessimistic guess from experience is that after a period of perfect behavior in which you think he's ch anged, he'll finally strike, maybe harder, so you can't give him an inch, even when he seems to be on "yes ma'am" behavior. I think your ex is dreaming. Good luck!

 

[susiestar]

MWM has some excellent points. I know it is hard on you to be separated from your child. But sometimes what YOU want/need simply must be a lower priority than what your child NEEDS. If drugs are the issue, the child MUST be away from the situations and people he used with. So Residential Treatment Center (RTC) may be the way to go. I don't know.

I DO know that YOU need to go to Al Anon or Narc Anon. Drugs are a family disease. Parents simply MUST go to meetings so that they learn what is enabling and what is not and how to not enable.

Right now you have a 15yo and you are staying with him 24/7 to keep him from doing drugs? It won't work. He WILL find a way around you. Drug users and alcoholics are wily, clever and sneaky. Esp if getting off drugs was YOUR idea and not HIS idea.

I am sorry.

 

[janebrain]

I have to say that if you have to stay with him 24/7 in order to keep him from backsliding then he is not ready to be home. It sounds like your husband was thinking more of his own needs than difficult child's. Also, sounds like the Residential Treatment Center (RTC) was allowing way too much contact. My dtr's Residential Treatment Center (RTC) only allowed her to call home twice a week (except for family therapy which was once a week) and we were to cut the call short if she was using it to try to manipulate us into taking her home.

You two are going to be nervous wrecks if you have to stay vigilant every minute of the day and night to be sure he isn't relapsing. Also, this takes all the control away from him and he will likely rebel at some point. I just don't see how this can work if difficult child is not the one in charge of his own sobriety.

Sorry,
Jane

 

[recovering doormat]

It's only been a couple of days and you ladies are correct, if we have to be on him 24/7 then he's not ready. I am researching Residential Treatment Center (RTC)'s right now so that we can fix our mistake sooner, not later.

Today we brought him to the probation officer who drug tested him (he has been unable to access any drugs since Jan. 2, the day he went into diagnostic program) and gave him a curfew of 7 p.m. If he breaks curfew he goes back under house arrest. If he continues the b.s. he could very well go to juvenile detention before we're able to find an appropriate Residential Treatment Center (RTC).

I am very grateful to everyone who posted about their experiences. I think we made an emotional decision which is unfortunately not necessarily in our son's best interest. After we left the PO's office he promised that he would goto bed early tonight, to work tomorrow, would follow the rules, just so he could stay with us.

We'll see. The only thing I can be certain about is that neither my ex nor I want to return to the way we were living just prior to his going to rehab. It would be like asking us to stab ourselves.

 

[everywoman]

I have lived your life. As soon as my son got a chance to get away, he did. I wish I would have been able to find an Residential Treatment Center (RTC) to get him into when he was younger. He racked up a lot of charges between 17 and 19. He side-tracked himself. He is now working hard to get back on track, but he is 3 years behind his peers at this point. It is taking 5X the work it would have taken back then. Good luck and follow your gut. But I will tell you, you and ex living his consequences will only make the tensions worse.

 

[recovering doormat]

We are fortunate that we have a lot of help available to us if we want it, the problem has been that in the past my ex and I have not been on the same page, which causes problems of its own. I have been told by umpty-ump therapists adn social workers that we have to be unified, present a unified front to our kids, they shouldn't see daylight between us, and so on...but what do you do when one parent is a control freak in every aspect of the family life, and has their own unaddressed psycho-social problems, yet seems to never be held accountable by any of the outside entities helping our family? Several years ago we asked our state DCF (CPS in some states) for voluntary help and they issued a report for us that said that dad needed psychotherapy evaluation and counseling for his own issues. He's never seena shrink on his own, doesn't respect them, doesn't trust them...every time we deal with professionals, if he doesn't like what he's hearing, he discounts everything they say.

It's so frustrating. And it sounds so typical, angry exwife pointing the finger at her ex. But I've been the one to take our three kids to therapists, and each one has had something to say, in varying degrees, about their dad's detachment, lack of face time with kids, lack of respect for me, lack of tact with kids, and often inappropriate teasing behavior.

Our oldest is having her own problems adjusting to life as a young adult, and I can't help but wonder if I had really had a screaming fit and shamed him into digging into his wallet and placingher ina therapeutic boarding school, if she'd be doing better now (keeps taking herself off antidepressants, binge drinking, impulsive behavior).

I had to really pull up my socks yesterday and stay on top of our son despite my anger at his dad for insisting that we bring him home, then less than three days later, tell his P.O. that it looks like he has to go to an Residential Treatment Center (RTC). The capriciousness of dad's behavior, even though I think it's not meant to be malicious, is so cruel I could cry.

We are meeting with the behaviorist today, who is invested in helping us through this period. I'm hoping that she will follow through with including dad in the family counseling. He's been able to get out of it in the past because of his self-employment (he's a tax accountant) but I'm not willing to go back to the way things were two months ago. No way.

 

[BusynMember]

WE WERE a unified front and still couldn't stop daughter. Unless you are willing to do 24/7 sleep shifts, your son can easily get out while you're asleep (unless you get an alarm and he doesn't dismantle it). Our daughter climbed out her window and plain old walked out the door while we were sleeping. Before we homeschooled her, she did drugs inside the school and right outside of it too. She was a good faker and the school never suspected or called me. You literally have to watch them ALL THE TIME or they will find a way. Rules are for other people, not drug users. They don't care if you put up a united front or what you threaten to do to them. They need to get high and they will get high. That's why I say that I'd have put my daughter in an Residential Treatment Center (RTC) if I had known about them. At least she'd have been off the streets, unable to escape "out there", been away from her friends who only made things worse, and getting some sort of help. She finally quit after we had to throw her out. She ran to her brother's house. He lives in another state and is a straight arrow to the max. Knowing it was her last possible place to live other than the streets, she straightened up her act fast. On top of that, she had really WANTED to quit quite a few times, however her friends (ahem, I use the word loosely) would badger her and nag her and she'd always give in to them. Once she was out of their orbit she was able to quit without being pressured to go back to it. Druggies love company. They don't take kindly to one of their own kind changing. My daughter has often checked on her old "friends" to see how they're doing (she is now 24 and in college). Only one of her old gang besides her is on the straight road now. Everyone else is unemployed, in jail, just out of jail, etc. A few are even attempting to raise kids while they take drugs around them. Some have lost custody of their kids to social services.
It is very important to stop your child before it becomes a way of life. Once the kids are in their mid-20's and still doing drugs, well, I see the prognosis as much worse. My daughter took drugs from age 12 to age 19. Then she met her geeky boyfriend and he helped keep her honest too. Personally, I would not take on as heavy a burden as trying to keep my child off of drugs. There are too many ways they can trick you. As my daughter says, "Never trust a drug addict." They will do or say anything to win your trust and do their thing all over again, often with parents glowing that their kids are "doing so well" until the truth hits them again. I've been there too. Often the kids really need a totally new change of atmosphere and 24/7 controls. Lastly, my daughter hated therapists, didn't respect their opinions, didn't listen to them, barely talked to them, and they didn't help her one bit. I don't think therapy is enough. JMO.

 

[janebrain]

Hi Recovering,
I'm so sorry your husband is such a problem--you really have your hands full. I'm sorry it seems everything is your responsibility, you must be frustrated and exhausted! Just sending hugs for now--
Jane

 

[recovering doormat]

Tomorrow it will be one full week since difficult child 2 returned home from a diagnostic program where he also detoxed from marijuana use. I've been panicking and second-guessing myself for the past six days and resentful as he** toward my ex for insisting that this was better than letting him stay at the facility while we hunted for an appropriate Residential Treatment Center (RTC). Once again, I let myself be used by my ex since I don't work outside the home (waiting for kids to stabilize enough so I can focus on job hunting) as the "babysitter" for a 16 year old who should have been working all week at his dad's office. So why wasn't he? Because two mornings this week he was too tired to get out of bed at 7:30 when dad was ready to leave for his office. So junior stayed asleep while dad left as usual for work, leaving it up to me to go to dad's house four miles away to watch over him. Neither dad nor I can physically get him out of bed and into the car against his will. This was the situation we had before he left for the diagnostic program. He complained he couldn't fall asleep early enough to wake up on time for school/work/whatever, so dad would shrug his shoulders, make a passive aggressive phone call to me, then go off to work.

At the diagnostic facility bedtime was 9:30 (lights out) and wakeup was 7:40. He managed to abide by the rules because he wanted to keep whatever privileges he had earned, and he wanted to get out and come home. He had no medications to sleep and no psychiatric medications. Now that he's home he has all the fun distractions he's missed for the past six weeks: phone, computer, internet, cable tv, friends and family.

This morning he refused to get out of bed. I had told him that if he wanted to spend the night at my home tonight he had to go to work today and comply with dad and me. I figured okay, that's it, he's blown it, he can't do what we ask, he's lost privileges and time to contact the Residential Treatment Center (RTC)'s. Then dad called a little while ago and said difficult child 2 called him on his cell phone before he got five minutes from home and said he wanted to go work, would dad please pick him up. Dad agreed and he's at work until this afternoon. Im glad he decided to go with dad.

Next Monday I'm calling a couple of day schools around here to see if they are appropriate for him, and the school district is supposed to have tutoring set up in dad's office by Tuesday. Having him in school all day will be a big relief.