Treatment facilities

Discussion in 'General Parenting' started by notafolksinger, Apr 1, 2008.

  1. This is my first time to post. I really need advice and support.

    My son, who will be 16 in two weeks, has been diagnosed with conduct disorder, early onset, and that is his only diagnosis. No medications.

    He is currently in juvenile detention for vandalism, misuse of a computer, and calling in a bomb threat to his school. He has also been threatening and bullying peers. He's been suspended from school every year since first grade. But his conduct is worse now.

    The court will not pay for treatment but will let me place him. I have narrowed down the search. But I am not sure which type of facility. I was surprised that most places turned him down for their "level of care."

    I want the best intervention possible. His psychologist is not much help--he's all smiles and little substance.

    Basically I'm wondering what type of luck people have had with the following:

    • There's school number one with an enrollment cap of 10 boys. It focuses on behavior modification and social, emotional, and academic needs. High credentials for staff. Also treats sexual offenders. That's the part that scares me.
    • There's school number two with an enrollment of 30. It's behavior modification but uses positive peer culture. I'm afraid my son will walk all over these people.
    • Military school
  2. I should reply to my own message. School number one does not currently have sex offenders but does accept them. In terms of clinical treatment, I prefer it.

    School number two represents the norm that I've found--I'm worried that counseling is only once a week (hasn't worked in a year) and that positive peer culture is not enough.

    I'm worried that military school will not focus on emotional issues.
  3. smallworld

    smallworld Moderator

    Welcome! I'm glad you found us.

    I'll let someone with more experience with treatment facilities jump in to answer your questions, but I hope you won't mind if I pose some questions to you. Your answers will help us help you.

    What kind of doctor diagnosed your son with Conduct Disorder?
    When was his last evaluation?
    Has your son ever been on any medications? If so, what?
    Any mental health issues or substance abuse in the family tree?

    Again, welcome. You will find a lot of support here.
  4. My son was diagnosed by psychologists. He meets criteria for oppositonal defiance and conduct disorder but nothing else. He's never been on medications. He had a complete evaluation this summer and his current psychologist did an evaluation with the same findings. Really it's low self esteem, identity, attention seeking, and social skills that he struggles with in addition to chronic conduct disorder.

    Punishments do not work. He has never been successful in school with behavior but does well academically except for in math.

    In my family, we have some history of anxiety and depression. And bad tempers. Last year I was diagnosed for the first time with generalized anxiety and major depression. I am currently anxious but not depressed. No substance abuse.

    No one can tell me the best intervention for his increasingly antisocial behavior. Weekly counseling is a joke.
  5. smallworld

    smallworld Moderator

    I strongly believe that you need to rule out ALL medical (such as seizures), psychiatriatric (such as anxiety and depression) and developmental (such as Autism Spectrum Disorders (ASD)) disorders before settling on a diagnosis of ODD/CD. There is far too much overlap of symptoms among childhood disorders. It is very important to separate out the adolescent with a disorder whose maladaptive coping mechanism is oppositional/defiant/antisocial behaviors and the adolescent with a primary diagnosis of ODD/CD.

    To that end, I would recommend new evaluations with both a child/adolescent psychiatrist and a neuropsychologist to figure out exactly what you're dealing with. We on the board have found that regular psychologists tend to focus on the behavior and not the underlying cause behind it. You need to figure out if there is an underlying disorder fueling your son's ODD/CD behaviors. Only with an accurate diagnosis will you be able to put the appropriate interventions into place.

    If you were to go the treatment facility route at this point, I would recommend that it have a diagnostic as well as therapeutic component. It should also have a psychiatrist on staff in the event medications are needed. I'm not sure the facilities you described have those components as part of the treatment.
  6. meowbunny

    meowbunny New Member

    It is rare for ODD and CD to stand alone (not impossible but rare), so I definitely would try to see if there is something hidden.

    As to choice of schools, I would definitely rule out military school. There is discipline there but that's it, no work for behavior mod or therapy. Pretty useless for most kids who have serious problems. How well supervised are the kids in the facility that accepts sex offenders? If you think he would truly be safe, that is the one I would select.

    I wish you luck. Having a child so out of control is hard for everyone, especially the mother. You wonder where you failed, you wonder what you could have done to stop this earlier ... so many questions, so many fears, so few answers. When you do start questioning (do you ever really stop?), remember that you've been a good enough mother to fight for him, to try to find some answers and get him help. You haven't let him flounder or totally suffer the consequences on his own. You have truly done the best job you can.

  7. Fran

    Fran Former desparate mom

    Hello and welcome. I know you only asked advice about treatment facilities but I had a few questions.

    How does he do academically?
    Does he have any hobbies or interests?
    Does he have friends?
    What does he do when he is out of school?
    What sort of behavior do you see at home?

    I'm not anti military type school since I think it would have been a big positive for someone like me. I thrive best in structure and clear rules but you have to be careful that it is a safe place and not he** on earth. The best schools have checks and balances. Having said that, I would not place my difficult child in that environment. It is not a place where he would function and would probably cause a total breakdown.

    Either one or two sounds pretty good. Don't discount the effect of peer pressure. My difficult child went to emotional growth boarding school. There was a very strong emphasis on peer support and criticism with staff backing. Morning and evenings they met as a group to talk about the good things that someone observed a peer doing and the negatives someone saw a peer doing. It was quite effective.
    In terms of sexual offenders, your question to the staff should be "what safeguards does the program have in place to protect your child?"

    Anyhow, that's my .02
    Hope it's a help.
  8. DammitJanet

    DammitJanet Well-Known Member

    Hi and welcome to the board.

    I have a kid who has/had CD and now has a personality disorder. Its a tough road. There is a type of therapy called MST that has shown much better results than even inpatient care. Just do a google on MST and see what you can find. If you cant find anything PM me and I will search.

    Basically its like being on intensive probation but with some therapy and home/community supports thrown in. Its also a whole family deal and, parents, law enforcement, family, medical establishment....has to be completely on the same page.
  9. Star*

    Star* call 911


    Welcome to the family.

    Have you considered a Therapeutic Foster Family? Look for a local chapter of Mentor in your area. Call them. You may find it more suitable for your son to just get out of YOUR house and into a house with highly trained people with kid to adult lowered ratios. If I had it to do all over again - I'd do just what I've done - but I don't have too many good things to say about group homes or Residential Treatment Center (RTC)'s. Your son has to be the one that is willing to do the work - and most are so crowded - they (kids like ours) don't get the one on one attention they need. And as far as superior staff - Yeah - prove that one to me. PLEASE - I've asked for vitae, class courses, dates of hire and have gladly been given all - much to my chagrin later at these "wonderful" staff members.

    Unless the courts deem he has to be in a locked facility these types of placements are usually cheaper/more one on one attention/better knowledge of your sons situation and problems/more time/and more care.

  10. Thank you so much for the feedback. I have been touring facilities in neighboring states for the past few days and just now returned home. I saw a total of four facilities.

    The good news is I found placement for my son. It's the small program with 8 teens at a time with a possibility for 10. It's family-style living and has a psychiatrist who will also do an evaluation. It is a lot like a Therapeutic Foster Family. This place also does positive peer culture but not as its sole strategy. I was lied to by a competing facility about this place accepting murderers and rapists--some admissions staff work on commission, and some are more ethical than others.

    I saw one very scary residential treatment facility (the one that lied to me). That place was a circus and had no credentials for staff or counselors. It relies solely on positive peer culture, which looked a lot like loitering or a day at a circus to me. I bet over half their enrollment is sight unseen. It would have to be. They lied about enrollment being 30--I saw 60 kids.

    I've asked multiple times about diagnosis, and he does not meet criteria for any of them. We've had him evaulated for ADD or ADHD and Learning Disability (LD) several times since second grade. The answer is always no. Maybe an MD will have an alternative diagnosis.

    My son can't live at home. Either I place him, or the state puts him in juvenile detention for 12 months. Since he called in a bomb threat, the whole town wants his blood. The kids in the gym at school did not hear the announcement, and now it's local news.

    My son has been out of control lately and has been very mouthy and defiant with me in the past few months. Before that was reserved for peers at school and teachers. Now I see it at home.

    He makes good grades in English and history, B or C in science, and lower and sometimes failing grades in math. He likes video games and anime. He isn't successful in sports because he does not compete and quits everything. If he's unhappy in any group activity, he makes my life a living hell. He had a paper route--what a total nightmare that was. He's been asked to leave a social group lately because his behavior problems in the community lately.

    He's established an identity for himself as a pain in the ass. He gets negative reinforcement. He "knows" right from wrong but seems to think his approach to life isn't a problem. He's not sexually active or taking drugs.

    I don't know the answer.

    His dad and I are divorced, and he won't help me pay for treatment. He wants our son to serve a jail sentence. I've never known anyone to come out of juvie "better." His dad just doesn't want to pay, and he says that our son needs consequences. I think he needs treatment and also natural consequences he's already experiencing. Punshment and consequences only work in the short term with him and always have...
  11. Star*

    Star* call 911

    Folksy -

    I HIGHLY encourage you to call the Department of Social services AND the licensing board for group homes/facilities AND the Disability and Special needs Advocacy people in that state and report what you saw.

    I did - they shut him down.

    Not to worry - a fresh coat of paint and a few new beds, empty the septic and he's back in business - but at least the boys that were THERE are in a better place.

  12. Marguerite

    Marguerite Active Member

    It sounds like you've found a really good place and it fits with the recommendations.

    You're on the money with consequences - natural works best, adding in other consequences make it hard to distinguish punishment from vengeance. Our kids tend to resent vengeance and will dish it out in return if it's used on them. But natural consequences - it's hard to get angry when there's nobody to blame but yourself.