wrap around services?

Discussion in 'General Parenting' started by crazymama30, Jul 20, 2011.

  1. crazymama30

    crazymama30 Active Member

    So therapist is going to look into this for difficult child son. I have heard of it many times, but really do not know what they are. I am guessing (hoping) it would be helpful. difficult child is better on the increased abilify, we will look into other medications next week after the neuropsychologist testing, but is still very volatile and impulsive and hyper. I came home from work to take him to therapist, and he was raging yelling at me because his dad said (read between the lines difficult child heard) that his therapist appointment was at 4:30 instead of they would leave about 4:30.

    Tomorrow he has social skills group from 9am to 10:15 (I have a friend picking him up to take him and I will take him home) and then neuropsychologist from 1pm to 4pm. Friday I am going to have to stay home with him as husband is too sedated from the clozaril to be much help.

    I hope wrap around services are as good as they sound!
  2. gcvmom

    gcvmom Here we go again!

    CM, I've heard of this before but didn't know exactly what it encompassed either. So I googled it :) Here's a link for what's offered in one area of my state:


    I imagine it must be similar in other states.

    I hope they determine that he qualifies. You sure could use the support right now.

  3. crazymama30

    crazymama30 Active Member

    I hope it helps and he qualifies, he blew up yesterday because he did not get to go with grandma to take his cousin home. He had that wild feral look in his eyes. I don't know what I will do tomorrow.......i may have to work part of the day and spend part of it home as I don't think he should be unsupervised all day. psychiatrist is out of town (i have her cell number but hate to use it) so I would like to wait until monday to call and see about adding another mood stabilizer. We will see how today and tomorrow go.
    Last edited: Jul 21, 2011
  4. gcvmom

    gcvmom Here we go again!

    I remember when my husband would get that "look" in his eyes when he got mad. And difficult child 1 would go there, too. It's very unnerving to witness the "switch" being flipped in their head -- makes me think of Dr. Jekyl/Mr. Hyde.
  5. crazymama30

    crazymama30 Active Member

    I think what I find eerie is that for my difficult child out stops as quick as it starts and once it is over he really does not seem to get why people are upset with him
  6. gcvmom

    gcvmom Here we go again!

    Yes, there is a big disconnect in their awareness of others. My husband has gotten better (not perfect, though) about this since he's been on his seizure medication and Paxil. It's almost as if something in their emotional regulation gets in the way of their perception of who/what's going on around them.
  7. seriously

    seriously New Member

    wrap around services vary hugely from one place to another. it usually refers to a more intensive level of service/intervention than you get as an outpatient or even if your child is in partial hospitalization. it often focuses on the family as a whole using a systems approach.

    here in our region, that means that you see a family therapist once a week at home and maybe some additional time at home trying to improve family function/communication.

    and, here, unless you are in the juvenile justice treatment diversion program that has a grant, you can only get wrap around services if you have full service MediCal (California's version of Medicaid)

    the agencies that provide this kind of intervention simply don't offer it to private pay or to those with insurance despite the fact that these services are generally not offered by anyone else or insurance will not cover them because they don't fit into the outpatient/inpatient categories.

    If the psychiatrist gave you her cell, it was because she wanted you to use it.

    So call her. The sooner he starts on an additional mood stabilizer the sooner you will know if it's going to help.
  8. compassion

    compassion Member

    I had this for nearly 2 years with my daughter until she turned 18 in April. The first, like you said is stabiliztion via medications, can't really reinforce behaviors if very unstablle, manic, etc. For us, I kept insisting after daughter was hopitalized for 3.5 months and still very unstable. I got 3 hours of week of in home therapist. She was an applied behavorial analyst and it helped a lot. We are in the process of getting a new one as we will be relocating. Our private insurance does cover it.THe wrap around was covered by community mental health, SAMH. I had a casemanager through the behviorial health center. I was thinking Residential Treatment Center (RTC) and she had to fail at lower level of care first. Wht worked for us was meeting in the community (grocery store) weekly. My hope is as she starts community college this fall, the BA will work with her for on half hour a week on the pro-social behaviorsw needed, then work with me. This helped with medication adherence, schoolwork (she grduated last month! and making progress on threats, blackmailing, hostage taking, and extoriton behavior. Compassion
  9. crazymama30

    crazymama30 Active Member

    Seriously, I am one state up from you. difficult child has OHP Plus, which is full medicaid but my private insurance is primary, medicaid is secondary. therapist did not think that would be a problem. I called her earlier this afternoon, but have not heard back yet. It is worth a try, we could certainly use something that would involve the whole family.

    There have been so many budget cuts that I just don't know what is still available. Hopefully I will hear from therapist tomorrow.

    psychiatrist will be back in town Monday, and difficult child is getting a bit better. He still has explosive moments, but overall is getting much more rational. I would like to taper him down on the abilify and add a mood stabilizer, maybe trileptal or depakote? I know when we first started with psychiatrist she said she did not use Lithium or Tegretol in kids as she though the side effect profile was too harsh, which is fine with me as I don't want to have to worry about his water intake for Lithium in the summer, and while Tegretol works great for husband, there really does not seem to be much of a link between what works for him and what works for difficult child. Lamictal did nothing for husband, and abilify gave him tardive. difficult child does well (when he does well) on the combo, and has never shown any side effects from either medication and has not had much of a weight gain from the abilify either.
  10. seriously

    seriously New Member

    your sig must not be up to date. it shows difficult child taking lamictal and abilify.

    the best atypical antipsychotic that has worked for my difficult child 2 has been geodon.

    it's interesting that she thinks lithium's side effects are worse than depakote. I would have said they are the same or the opposite.

    glad he seems a little better.

    hope the wrap around services materialize and are helpful.

    right now I am mostly feeling like we are being told to do a bunch of stuff that we can't do like wife and I go out to dinner, me leave difficult child 2 and his twin sister home alone so I can go do "social" things - something I don't feel safe doing since she's afraid he'll hurt her.
  11. crazymama30

    crazymama30 Active Member

    Seriously, I must have mispoken somwhere. difficult child takes abilify, lamictal and vyvanse and I would like to maybe add Trileptal.

    difficult child has actually already tried Lithium and Depakote years ago, when he was in 3rd or 4th grade, and experienced increased aggression. Hindsight being 20/20, he probably should have trialed the medications longer, as we stopped after a week or two and I remember psychiatrist checking the blood level (different psychiatrist) and he was at theraputic levels.