Second meeting with the Licensed Clinical Social Worker (LCSW)

[needprayers]

Met today for the second time with the Licensed Clinical Social Worker (LCSW).

She still does not paint a pretty picture. Says the son has so much rage and anger, and is definitely ODD with depression. She said if things do not change for him, by the time he reaches adulthood there is no doubt he will end up in jail from assault or murder (scary) .

We are to continue to be firm but calm.

She is going to get with the pediatrician and start him on an antidepressant (zoloft/lexapro/?) to get him out of this depression and hopefully relieve some anger. Also getting him a full physical with bloodwork to rule out any thyroid problems.

If the antidepressant doesn't work, she is going to send him to a psychiatrist with a recommendation of mood stabilizers. What are mood stabilizers ?

Next step is to try hospitalization for a while.

Please pray the antidepressants work.

 

[smallworld]

How old is your difficult child?

I recommend not starting any psychiatric medications without seeing a child psychiatrist first. That way you can figure out what class of medications should be started first. FYI, mood stabilizers are typically prescribed for bipolar disorder. They include Depakote, Lamictal, Lithium, Trileptal and Tegretol.

ODD is not a helpful diagnosis. It typically describes a set of behaviors for which there is an underlying cause. When the underlying cause is identified and treated, the oppositional behaviors subside and improve.

I personally would ditch this social worker. She's too much of a downer.

 

[slsh]

I agree with smallworld on all counts. A psychiatrist should be managing antidepressants, and if there's a possibility that a mood stabilizer is needed, you want to have that onboard first, before an antidepressant.

No one has a crystal ball and quite frankly, I'm really irritated at the arrogance of this SW to predict such a dire future. Ridiculous. Your son is 12.... he's still a baby in the grand scheme of things. There is no telling what maturity may bring for him in the future, along with- appropriate treatment now. I wonder if she's trying to scare you to ensure he will get treated - but you're already seeking treatment for him, so not sure why she would resort to such doom and gloom.

I have to tell you - while my kid is most definitely not the poster child for a successful adult difficult child, if you compared him today to the child he was at 12, it's night and day. He's not violent anymore, he's actually not been arrested as an adult. I can't say he's functioning terribly well, but he certainly is doing so much better than we would have thought possible when he was 12.

*Nothing* is carved in stone. Your son has so much emotional growth ahead of him. It is way too early for anyone to predict how he will do as an adult.

So sorry you had to hear that from a "professional". in my humble opinion, time to find someone else to help you guys.

 

[needprayers]

i think she is trying to scare us too. although I have my concerns about her, i still like the strictness she has with my child, and for whatever reason, my wife seems to like her. this is just our second visit and our first Licensed Clinical Social Worker (LCSW), so i'll see how things progress from here for a month or so. should i be worried about the antidepressants ? he does seem terribly depressed a lot of the times, and she is hoping that it will pick his spirits up enough to get him to not be so angry with us all the time.

this afternoon has been wonderful with the difficult child. he's been in a good mood, i think mostly because the Licensed Clinical Social Worker (LCSW) suggested to him that if he was good this week i should give him his playstation back for an hour or so this weekend.

about the psychiatrist, Licensed Clinical Social Worker (LCSW) said she would send the difficult child to him to evaluate after 6 months or so, to test him and "possibly" put him on mood stabilizers if the antidepressants didn't do anything.

she is correct about where my son is heading. if he doesn't change his attitude about authority and choose right over wrong, he is headed down a dreary path. thats why we are seeking help now ..

again, thanks for all your comments, it really helps knowing others go through similar heartaches.

 

[susiestar]

It is WAY WAAAAYYY too soon to start predicting jail, esp as medications have never been tried. At 12 my son was a monster. I am NOT joking. We learned that year that he had been attacking Jess viciously, even choking her into blacking out. She never said a word and hid all of the marks because he said he would kill thank you if she told. We put a panic alarm on Jess for all the time he was in the home for the week that it took to get him admitted to a long term psychiatric hospital. If she was home she had the alarm. We only found out about it because the cat led me into the room late one night and I found him choking her.

After he broke down and spewed ALL of the horrible things he had done to her I was totally confident that he would end up raping some girl and possibly killing her, if he didn't kill me first. It was THAT bad.

At 14 he had to leave our home because he decided to beat me. I will NOT be anyone's battered woman. I wouldn't tolerate it in a husband, and I dang sure wouldn't tolerate it in my son. The last time he headbutted me back into the bar so I had a couple of bruised ribs, a bruised sternum and a giant bruise across my back where I hit the bar. Of course it bruised so deep it took four days to show up - my body is strange about revealing bruises.

Within about 6 weeks we agreed to let my parents have a chance to turn him around. My dad taught jr high and had just retired, and Wiz was in jr high at the time. Wiz and Gpa went head to head about a zillion times. Right at first he backed my mom into a wall with threats to hit her - she told him if he did he would not only leave, he would leave in an ambulance or body bag because she would wait until he was asleep and beat the sh** out of him, so he better think about it before he EVER did it again.

None of us are quite sure what happened, but by 16 he had repaired relationships with all of us and is an awesome big bro and a great son!! A big part of this is largely because my dad is far more Aspie than Wiz is, and anytime Wiz got into trouble my dad made him go out and do heavy yard work (they have an acre of land that a prior owner landscaped the living daylights out of by planting all the stock from a nursery that went out of business - and it hadn't been really tended in ten years!). The yard work was done with Gpa working next to Wiz. Gpa out waited, outfoxes and out-Aspied Wiz until Wiz figured out it was easier and more pleasant to behave and not spend all his free time doing yard work.

Your son mmay turn things around too.

As for the medications, I would insist on seeing a child and adolescent psychiatrist before he takes anything. Antidepressants (esp the SSRIs that are commonly used now) can trigger mania and/or cause suicidal ideation. If your son has a mood disorder you need to rule out bipolar BEFORE you monkey around with other medications. Insist on the mood stabilizers FIRST.

If he is on medications other than mood stabilizers it can trigger mood cycling that can take a LONG time to stop - even after the medications are stopped. There is even a type of bipolar that is CAUSED by antidepressants. They are NOT something that should be dispensed by a Licensed Clinical Social Worker (LCSW) - IN NO WAY SHOULD THIS Licensed Clinical Social Worker (LCSW) BE RECOMMENDING medications!!! (Sorry to shout at you, but this is important!). The Licensed Clinical Social Worker (LCSW) is NOT trained in psychopharmacology and is an amateur tinkering with your child's brain chemistry.

Do you REALLY want an amateur who has NOT studied the medications the way a psychiatrist has to tinker around with your child's brain chemistry??

We were ignorant and let the pediatrician rx prozac and then zoloft for Jessie after we learned about the attacks. She was having panic attacks and severe anxiety. Jessie was ALWAYS the kid the teacher could count on to behave well, have the right answers, be nice to the kid the others were mean to, etc... She NEVER disrupted a class with-o a VERY good reason (like the kid next to her sticking a pencil into his arm and squirting blood everywhere - he liked Jess so he didn't get any on her!) but on prozac she seemed drunk and was not cooperative at ALL. Then the third day on zoloft she got up and led the class in a conga line (or bunny hop, whatever you call it) when the teacher tried to get everyone to calm down after lunch and recess!!!!! Thankfully the teacher knew the whole situation and understood it was the medications!!

We then insisted on a psychiatrist to do medications. It was scary and I will NEVER again let anyone rx psychiatric medications unless they are a psychiatrist!

If you truly think bipolar is a possibility, even a remote one, please read "The Bipolar Child" by Papalous (sp?) ASAP. Especially the part about medications and what they do.

This is NOT something that an Licensed Clinical Social Worker (LCSW) should be doing. NOT NOT NOT NOT NOT.

This Licensed Clinical Social Worker (LCSW) needs to find another line of work - she is way too sure that kids are destined to a bad adulthood. The strictness is good, but her doom and gloom prophecies are out of line.

 

[needprayers]

thank you .. I will have a talk with my wife about this. From what I have read/know about bipolar symptoms, he is not bipolar. I do think I make the Licensed Clinical Social Worker (LCSW) sound worse than she is, but I am concerned about the zoloft/lexapro suggestion.

 

[CrazyinVA]

about the psychiatrist, Licensed Clinical Social Worker (LCSW) said she would send the difficult child to him to evaluate after 6 months or so, to test him and "possibly" put him on mood stabilizers if the antidepressants didn't do anything.

With all due respect, this is not up to her, it is up to you. If you want your difficult child to see a psychiatrist now, find a reputable one and make an appointment. I agree with the above that a pediatrician should NOT be prescribing psychiatric medications, it's too risky, they simply don't have the specialized training.

I do believe an Licensed Clinical Social Worker (LCSW) can make suggesetions as to what they think might be going on, but that's it ... they shouldn't diagnose or recommend specific medications. For instance, when my Youngest became quite manic while on Zoloft, the Licensed Clinical Social Worker (LCSW) she was seeing mentioned that sometimes anti-depressants trigger mania in bipolar patients. She didn't presume to tell me to put Youngest on mood stabilizers, she simply said, it's time to go back to the psychiatrist and re-evaluate, see what the psychiatrist thinks about the possibility of bipolar. The psychiatrist concurred, and then we tried mood stabilizers. I think counselors/Tdocs/LCSWs are helpful in offering perspectives of possible diagnoses, and working with a psychiatrist to discuss what they've seen in the patient in a clinical setting, but they shouldn't be the front line of a diagnosis in any child. They're just part of the treatment team, along with the psychiatrist, and you, the parent.

If she has a good rapport with your difficult child, and you find therapeutic value in her sessions with him, by all means, hang on to her. But I'd take her medication/diagnosis advice with a grain of salt.

 

[Shari]

Helen Keller and Temple Grandin had bleak futures as children. Someone believed in them, and look what they achieved?

I'd take my child and find someone who believed in him to help him. And someone with an appropriate degree.

This is the second Licensed Clinical Social Worker (LCSW) in as many days to be ready to toss a kid out with yesterday's trash. That just does not make me a happy person. These people are supposed to help our kids!

 

[smallworld]

I agree with everything that has been said.

We go to a top-notch pediatrician in a major metropolitan city on the East Coast. I've been taking my kids to him for 17 years. He refuses to prescribe psychiatric medications because he KNOWS that he's not trained to prescribe them. He always refers kids to child psychiatrists when there's a mental health issue involved. That's the way it should be.

 

[BusynMember]

JMO. A LSW is not taught how to diagnose and I doubt this one knows how to do it any more than the rest of us here or you. in my opinion you aren't taking him to the right professional. The last think a Licensed Clinical Social Worker (LCSW) should be doing is diagnosing AND prescribing the kind of medications he needs. It's not just arrogant, it's dangrous. I hope you decide to seek out a neuropsychologist or a Psychiatrist on your own. Fortunately a Psychiatrist will likely not listen to a social worker, at least not if he is a good psychiatrist. I have been in the mental health care system (as a patient and then for my son) since I was 23 and now I'm 57. No social worker ever tried to diagnose me or suggest medication. My son is on the autitism spectrum. How do you know (or the social worker) that your son has a mood disorder and not high functioning Autism Spectrum Disorders (ASD)? Or something else? You need to have testing done, and not just for IQ. Your wife may like her, but I'd try to encourage her to see somebody else. It's not who she likes, it's who is competent to help your child. And I agree that it's insane to predict jail for a child that age. What a downer!!! Good luck, whatever you decide to do.