Where to Begin? <---LONG - Sorry

[gizbywife]

Hi. I am going through the roof with my difficult child's situation. He's 13 and we don't know what to do or where to go next.
He is currently in an alternative education (partial) program offered by an area school district where he is doing "all right" but still having bouts of depression, lying, stealing, etc. etc. ad nauseum. Since October we have experienced the following:

• 2 physical fights resulting in In School Suspensions
• 3 instances of stealing - cell phone, money, jewelry
  (the police were involved in 2 of the instances, so he is in a first offenders' program and needs to do 10 hours of community service a month as well as check in weekly with a pseudo-parole officer which I have to fight with him to get him to do)
• Nightly screaming matches = him screaming at us. Us not knowing what to do and trying desperately to stay calm.
• 1 report made to Children & Youth services (by difficult child who was angry we wouldn't take him to a movie at 9 pm on a Sunday night) resulting in our being investigated for child abuse - found to be unsubstantiated and dismissed
• 2 reports of unwanted physical contact with a girl
• Assignment of a TSS who was removed after he threatened her
• Refusal to do homework
• Refusal to participate in family outings, then crying and screaming that we don't want to ever do anything with him.
• Several threats of suicide (mostly to get out of trouble, as indicated to us by therapists and crisis counselors)
• Medication Merry-go-round

I could go on and on, but I think you all have been there, done that and received the torn t-shirt, eh?

My questions for you all:
- How long before we start to consider out of home placement?
- How do we save our marriage - the stress is phenomenal!
- Should I quit my part time job to focus on him? I stayed home until he was 10.
- How does one afford out of home placement? How do you find a good place?
- If we decide to go the Residential Treatment Facility (RTF) route, how do we explain to friends and family where he is?
- How do we deal with PPs who we seemed to be surrounded by and who all have FABULOUS advice!

OK, that's a start. If this was the wrong place to put this, please let me know. I am getting desperate.

Thanks!
- How do we keep our 2 easy child from hating difficult child and blaming him for everything?
-

 

[DaisyFace]

Hello--

I am sorry that I don't have any good advice on this--my difficult child is the same age as yours...and she is still living in our home.

I just wanted to welcome you and send support your way.

--DaisyF

 

[Sagegrad]

I can only answer some of your questions regarting Residential Treatment Facility (RTF)'s. We were lucky that after 2 emergency PHospital stays (a total of 30 days), our insurance company saw the value in paying for Residential Treatment Facility (RTF) ($300/day) vs Emergency psychiatric hospital stays (+/- $1000/day).

As far as what we say to family and friends is that it is the best thing for our daughter and hopefully will result in her getting to a turning point. Our close friends know all about what we've gone through and they understand the situation. When other people ask, I just say "shes great".

We did alot of reasearch before we found a place - and as a matter of fact the Residential Treatment Facility (RTF) we chose was out of network for our insurance but got insurance to cover it because the in-network places were full. Get input from the proffesionals in your area (psychiatrists,therapists, etc and make visits)

Im wishing you the best of luck and you've found a great place for support. The people on this board are truly amazing parents and even if you dont contribute, it's worth reading and learning from the posts.

Sage

 

[smallworld]

Welcome! I'm glad you found us.

Before I answer your questions, I have to ask a few questions of my own:

What kind of professional diagnosed and is currently treating him?
Has he ever had a neuropsychological evaluation?
What medications is he currently taking? At what doses? What medications haven't worked and what was his reaction?

I'm sorry you're struggling so. With the right interventions, things can get better. With some more information from you, I hope we can point you in the right direction for help.

 

[TerryJ2]

Hi Gizbywife,
nice to meet you.
You do sound like you're up to your eyeballs.

I can only comment on a few things.
First, I don't think ADHD is enough of a diagnosis. You've got to find the smoking gun. Until then, you will continue to have problems.
Second, I would not quit my PT job. It's my only sanity. And $.
Third, go on a date night with-your husband once a wk. You are not allowed to talk about your difficult child during this time.

Some of his issues are age-related. Teenagers can be drama queens and kings. But with-a difficult child, everything is magnifed. I had a student from S. America living here for a while, and she used to cry and yell and hate our food, and sleep late, and then she'd complain that by the time she got up, the food was put away and no one had time for her. See what I mean?
Exaggerate that 100 X and you've got a difficult child.

I don't know what kind of rules you have in your household but you've got to be consistent. To. The. Letter.
Expect tantrums when you lay down the law. Where a regular kid would whine, "That's not fair!", a difficult child will break out a window.

 

[DDD]

Welcome aboard. Glad you found us. Sorry you had to.

I'll be reading to learn more about professional input. Meanwhile, I just want to say "vent all you want", we all have done it and may do it again! Also wanted to send you a hug! DDD

 

[gizbywife]

Wow. Thanks! You guys really are the best source! I appreciate the support and just hearing that you all have been doing it too. In answer to a couple questions you all asked:

He's been being treated since age 6 with various and changing diagnoses based on behaviors. The common denominator is impulsivity. He has also been diagnosed with Anxiety, ODD, and possible Bi-Polar.
He's been helped in varying degrees by:

• Pediatrician
• Licensed Clinical Social Worker (LCSW) (Licensed Clinical Social Workers)
• TSS
• Emotional Support staff from the school
• Psychologists
• Psychiatrists
• Clergy (counseling)
• School Counselors

We have changed psychiatrists twice. Once because the office staff was inept and the other time because when he was seen by the doctor he was referred to as "the boy" and it seemed like it was the first time we'd ever seen this guy (even after a year).

He has been treated with almost any medication you name - Zoloft, Strattera, Abilify, Adderal, Concerta, Cymbalta, Tenex, and I'm sure more that I'm forgetting. His current "cocktail" is Cymbalta - 54 mg and Geodon - 20 mg working up based on his tolerance and Vyvanse - strongest dose (70mg?). He's being "weaned" off Abilify, as it didn't seem to be doing much for him.

As far as psychological testing goes, he's not had anything concrete other than those done on paperwork.

Currently, he's been physically violent with our 15 y/o daughter to the point where she's afraid to be left home alone with him. Are there places to send him where he'll be safe and we (husband & I) can go out for a dinner or movie? Our other easy child get along fine & daughter is willing and eager to babysit DS. We're actually planning a Valentine's Day date while he's doing his community service, but that won't be very long.

Thanks again for the love, hugs & support. I really can feel it! When husband gets home I'll be putting him on here as well.

Oh, also, is there any kind of support group out there for siblings of difficult children? I know my 2 easy child are very frustrated and, at times, frightened of what's going on at our home.

 

[compassion]

Welcome!!! My difficult child has mood dissorder (bipoloar I) with many of the symptoms you mentioned. I am learning it is ilness not badness.
After struggling iwth all you cited for 7 months , we admitted her last week.
I am in porcess of gettign SSI for her as our insurance does not cover any Residential Treatment Center (RTC). They cover acute care and out patient. I found an adolscent psychiatrist that had much experince with bipolar. My daughter is in a dual diagnois inpatient unit for substance abuse and bipolar and conduct disorder. It is close enough we can vist multiple times weekly, have family therapy weekly,etc.
As far as the PCs, I think they need to see you model comassion and underatading but firmness. It is not OK to stel, be vioenet etc.
Nami (National Association of Mental Ilness) has helped much.
Al-anon is also a huge help.
This site is great.
Read about mood disorders (biploar ) in teens.
My expereince is it is very difficult to stbilize in home when the behaviors have escalated to be of danger for themselves and others. We reached our bottom when she kept flying into biploar rages, thraating to kill us iswth a screwdrevier, traking drugs, runnning away mulitple times and putting herslf in grat danger. Shfe stole our cars, wrexcked them, stole thousands of dollars. Shfe is very ill.
Compasson

 

[klmno]

Hi! I'd recommend reading The Explosive Child- it will help calm your nerves a bit!! You can tweak the concept a bit for your son's age and specific concerns. Did a psychologist do neuropsychological testing? This would be a good idea to have done- not through the school, but privately. Also, you could try contacting a nearby Children's Hospital or teaching hospital and asking for a multi-disciplinary evaluation (MDE). The best scenario, in my humble opinion, would be to get the neuropsychologist testing done, then once you have the results in hand, get an MDE. That's your best hope of honing in on an accurate diagnosis when a mood disorder is involved. Then, you will have written recommendations for treatment.

If it turns out the Residential Treatment Facility (RTF) is the best option for your child, check with your insurance company- some pay for it (with time limitations), but some don't pay for any. If the school feels he needs it, they will pay for the educational component. Other than that, then it takes getting a local agency to fund it. That process and agreement depends on your local and state laws and policies. You could start by doing a google search for your state "youth at risk" or something like that. Also, you can try calling your state board of mental health and asking them. You might be able to get a little info from your dept of social services (not the child protection services people- don't call them).

I'd try google searches and state dept of mental health first. If you are comfortable, you could let us know what state you are in and someone from that state could probably offer more specific advice.

 

[C.J.]

Gizbywife,

Welcome. Your story doesn't surprise or scare us. We don't think you're a bad parent because you've got a child with problems.

Check into the neuropsychologist evaluation if you haven't already tried that. You said all the tests have been done on paper. If insurance is not cooperative, contact a local university or children's hospital for referrals. After you've got more information and input, you'll have a better idea when/if you son needs Residential Treatment Center (RTC).

How to pay for Residential Treatment Center (RTC)? In my case, my difficult child was sentenced there after multiple probation violations. They billed my insurance company, and charged me for child support " sliding scale, since insurance did not cover all the costs. The rest was picked up by the state. Your son already has had police/court involvement. If you found just one of the people you encountered in the 'system' who seemed to be helpful, ask for their input " which Residential Treatment Center (RTC) would they recommend if it were their child? Check with your insurance company about what program(s) they would pay for, what they require from your son's doctors, etc.

I don't have advice for your marriage " I'm single. I have advice for your sanity. Make time to be away from your children to do something you want to do. Attend someone's home spa party (or co-host one with a friend/neighbor), go to a bookstore and spend time reading there, if you live in a city with a museum, go on the free night, take a drive for an hour listening to the music YOU love most, or listen to nothing at all, take a walk. If the part time job is something you enjoy, stay there. If you don't look for something else.

How to talk to well meaning friends and family " that's tough. I explained my struggles. I shared my concerns with those who I trusted not to gossip. Finally when the going got very tough, and I'd reached the end of my rope, whenever I got the 'Well have you tried&#8230;..?' or 'If it were my child, I would&#8230;..' I would then invite well meaning friend/family to come to my home, spend an entire 24 hours with N*, and try it themselves. Nobody ever took me up on it.

When N* was in juvenile detention and then the Residential Treatment Center (RTC), I told the school administrators and her case manager the truth. I told my adult friends and family the truth. I struggled mightily with what to tell N*'s friends when she was away. I didn't want to trash what little was probably left of her reputation by feeding into teenage gossip. When N*'s friends called, I said she was away for awhile and when she returned, I'd let her know the friend called. After a week or so, the friends stopped calling. Strange, when N* returned home, she was mad that I didn't tell her friends exactly where she was. She was somewhat proud of being arrested, prosecuted, and sentenced. Maybe it heightened her 'street cred' with the other difficult children she knows.

If your 13 y/o does go into Residential Treatment Center (RTC), you and your family are going to have to come to an agreement on what to tell others.

Most importantly, what you tell your other two children is you love your difficult child no more or no less than the other two. There is nothing your difficult child can do to diminish your love for him. While his illness and/or behaviors may have to be addressed, that remains to be seen, but you and your husband will be taking steps to take care of the entire family. If you don't already do it, have a one parent/one kid fun outing each week/each pay day. The kids would take turns doing something on a day one of you can spend 3-4 hours with them. They need to feel like you're paying attention to them too.

 

[compassion]

Gizbywife, in my expereince, this takes full time effort and time so if you can quit your outsie job, that would be helpfula nd realistic.
Another great suport is CABF-Child and Adolscent Bipolar Foundation.
Get your child on the list now for yur county funded adolescent alcohol treatment center. I was told to do this bakc in September but kept hoping it would get better and Residential Treatment Center (RTC) would not be necessary (did not happen/only got worse) We dhould be able to get reimbursed once Medicaid kicks in but wish I had started process earlier.
Start the medical documentation immediately.
Compassion

 

[lkmcd]

I am new to site. Have a 16yr old daughter who is bipolar/ADHD/Pervasive Developmental Disorder (PDD)/ EXTREME ODD. She was constantly running away. Passing herself off as homeless (along with other children with even more extreme issues. When she is on task she is fabulous & fun to be around but she is a full-time job just by herself. She stole my car several times in Oct.,the 1st time of which the police picked her up. Now we are dealing with the charges and all the additional fallout. Looking for a residential program for her. Preferably in northern Cal. Does anyone know of any programs???? I do not know if I am posting in the correct spot.....please direct me if I am not!

 

[BusynMember]

Your child has only been put on ADHD drugs and anti-depressants, yet the child could have something that would be made WORSE by those medications. Are there any mood disorders on the family tree? She could have early onset bipolar or something similiar. The medications s he's been put on would make THAT worse. I'm all for the neuropsychologist evaluation. They do actual testing. I have had lots of experience (unfortunately) with mental health people and I think NeuroPsychs are most accurate and most helpful, even moreso than psychiatrists. I would get that testing done.

 

[susiestar]

Hi and Welcome! The others have great advice. I STRONGLY suggest the neuropsychologist evaluation, the book "The Explosive Child" and making a parent report to help you communicate with all the professionals involved. I will put a parent report link at the bottom of this post.

I think mood disorders need to be looked into, and agree with MWM that the medications he is on/has been on would make those worse instead of better.

NONE of us think you are a bad parent because he has problems. Not at ALL!

As for your marriage, marriage counselling is almost a must. Or at least some time each week to talk in peace. It is hard to get, but very important.

Anyway, the parent report - here is a link that talks about it: http://www.conductdisorders.com/forum/showthread.php?t=10

This is, in my opinion, CRUCIAL to write. Do it in several chunks of time, not all at once. You don't have to give copies to each doctor/expert/school/etc... but you may want to share parts or all of it with some or all of them.

I found it IMMENSELY helpful to put small photos of my difficult child at the beginning of each section, or in the middle of large sections, so that the docs remembered exactly which child this talked about.

Stick around, you can't bring much of anything here someone hasn't experienced. This is a very supportive, loving and helpful group. Glad to have you join us (but very sorry you NEED to join us!)

Gentle hugs!

 

[gizbywife]

Thanks so much for the information - I have picked up The Explosive Child and wonder how they got our permission to write a biography of our lives over the past 6 months +. I'm going to get husband to read it, too, so he can see that we're not alone!

I also broached the subject of the neuropsychologist evaluation with difficult child's counselor - she pointed me in some right directions and was pretty surprised we hadn't done it already. Does anyone know why the MH community of professionals shy away from this test? It seems to be a great way to get answers, but I've not had it recommended by any of them until I brought it up.

I'll keep y'all posted - You have been a bright light in a very dreary place!

 

[TerryJ2]

Gizbymom, LOL about the Explosive Child bio. Yup, they've spied on us all! Where are our royalties?
I have no idea why the MH community shies away from neuropsychologist referrals except that no one these days wants to do more than they have to b4 they can punch the timeclock at 5.
Sorry, I don't mean to be cynical.
But I really don't know the answer to that one.

 

[TerryJ2]

Welcome, Lkmcd.
If you go up to the top, to General, and look at the top left side where it says "New Thread," that is how you start your own topic. Hardly anyone will see you buried down here.