This blog is my place to vent and share resources with other parents of children of trauma. I try to be open and honest about my feelings in order to help others know they are not alone. Therapeutic parenting of adopted teenagers with RAD and other severe mental illnesses and issues (plus "neurotypical" teens) , is not easy, and there are time when I say what I feel... at the moment. We're all human!

Thursday, May 29, 2014

Adult FAIR Club

So Kitty, (now 19yo - diagnosed with RAD, bipolar, complex PTSD, borderline personality disorder, brain injury, borderline IQ,...) graduates high school this weekend. This has been causing a LOT of stress for a kid who has a low tolerance for change and stress. We've always provided a lot of structure and support, which she needs, but with her distorted perception of reality, she doesn't agree with us --especially because she believes we don't treat her the same way as our younger, neurotypical bio kids, Bob - 17 and also graduating, and Ponito -15.  She thinks this is because we love them more, but of course that's not true. 

She hides her issues from everyone (but us) and gets lots of validation from the school and her friends that she's being treated badly.  Mostly because she tells them how unfair her life is - and that it's all our fault.  I do realize this is because her expectations aren't based in reality.

So for the last few months she's been surly, isolating, and missing a ton of school (2 or 3 times a week!  She says it's because she's not sleeping, vomiting at night and has migraines.  We've ruled out physical reasons.  It's all stress and anxiety.). 

We've talked often in therapy about Kitty becoming an adult and making the transitions to adulthood. She's told us straight out that she wanted adult privileges, but was not going to act like a respectful, responsible adult. She said if she lived with anyone else she would be respectful, but refused to do so with us. She doesn't quite meet the qualifications for group home, but is not able or willing to do what needs to be done to live outside the home. So she will be living with us, but will be nasty and resentful about it. We understand that she's not really capable of a lot of the normal adult responsibilities, and will probably never be able to live completely on her own, but we are hating that we're going to have to live with this crap.

Sunday night she informs us that she's going to stay late at work (Hubby was supposed to pick her up at 10pm) and she'd get a ride home. She didn't come home at all. Monday morning (a holiday) she asks Bob to bring her her meds (to wherever she was), but her sister didn't want to - so she missed both her evening and morning meds.  Not the first time she's missed her meds in the last 7 days.

Monday evening, after weeks of being "too sick" to help out around the house or do pretty much anything but go to work and school (sometimes), she informs us that she's going to Subway with friends and walks out. She didn't show up for hours, and her only response to my texts was that she wasn't dead and she'd be home "Later." She didn't come home until 2:30am.

Tuesday she overslept and missed a final exam, but she's special ed so no one at school cares. I warned her there would be consequences (FAIR Club). When I went to pick her up after school for therapy she wasn't there. She refused to answer my texts, but told her sister she was with her new boyfriend. I have no idea where she spent the night, and honestly was convinced she'd decided to try to live on her own (well, mooching off friends).

Wednesday afternoon she had a meeting with a state agency that helps with employment and she showed up just in time for me to take her to the meeting. The guy told her she needed to start acting like an adult (paying rent and bills, writing checks, and reminded her that her parents loved and cared for her. She came home like all was forgotten. She did semi apologize for taking off, but blamed it on her friends' influence and us being controlling. She was not happy when I told her there would still be consequences.  She did the crime, she'll do the time.

So I told you this long story, because I need some ideas for consequences:


Dear _Kitty_,

Welcome to the “Adult” FAIR Club!  The FAIR Club is designed to give you boundaries and additional support while you practice and gain (or regain) the ability to be Respectful, Responsible, Honest, and Fun To Be Around, Loving and Learning Adult (RRHAFTBALL). First, we, your parents, want to apologize to you for not making you feel safe enough to be part of this loving, healthy family.  We are making a commitment to you to help you become a RRHAFTBALL adult.  
Transportation – You will be given transportation to approved suitable events arranged prior to the actual event.  This can include therapy, doctor appointments, appointments with service providers, job interviews, work and school. This is to keep you safe and remind you to be aware of the welfare of others.  
Curfew - You will have eaten, taken your meds, fed the dogs, and be in your room by 9pm.  You will be up, taken meds and have eaten breakfast by 10am.  This is to help you get the rest you need (learning to be RRHAFTBALL is hard work!).  Wandering the house, getting a drink of water or something to eat, shows me you still need more time to learn to be RRHAFTBALL.  Do these things BEFORE room time!  
Electronics – Viewing electronics an hour or less before trying to sleep causes great difficulty with sleep.   TV, computer, phone will be stored outside of your room at night.  A radio alarm clock is acceptable
Family Time - You will need to hang around the family a LOT so we can show you by example how to be RRHAFTBALL.  You will need to make lots of eye contact and use a pleasant tone of voice when speaking with others.  If you need any help, hugs, or just someone to talk to – ASK!  That’s what we are here for.
Chores - You will be expected to do all of your chores (including cleaning the bathrooms you use on a regular basis), laundry, and to pickup after yourself.  

If you no longer wish to be part of the FAIR Club, you must SHOW us that you are ready to rejoin us a full member of this loving, healthy family by:
1. Being RRHAFTBALL!  And following the FAIR club and family rules without complaint, reminders, whining or argument.
2. Complete your writing assignment (listed at the bottom of this page).  Use neat handwriting, complete sentences and good spelling and grammar.  You can ask a parent for help and use a dictionary.
3. Sincerely apologize to all parties involved (including both parents).
4. Sincerely offer restitution to all parties involved (how can you make it right?)
Writing Assignment: _ Review and sign the Boarder Agreement.  Write a 1 page essay about what the responsibilities and common courtesies of an adult living at home should be, and what the consequences ought to be when you don’t act like an adult.   Ex. Letting people know where you are and when you’re going to be home.
Extra Chore:  Work with parent to finish laying the flooring in your old and new room.  Deep cleaning of kids’ bath and both ½  baths.
Mom and Dad

Wednesday, May 14, 2014

Adult Function Report

To apply for SSI, Kitty has to fill out an Adult Function Report - Form SSA-3373-BK.  Of course she had a huge meltdown over the first real question which was:

"How do your illnesses, injuries or conditions limit your ability to work?"

Honestly, I couldn't blame her.  This is not an easy question on the best of days, especially for someone who has limited understanding of her diagnoses, let alone acceptance.  After talking about it in therapy, Hubby was extremely frustrated by the time we got through the session (she was very triggered and dysregulated, causing her to be disrespectful and verbally abusive) and wanted to let her deal with the natural consequences - having her fill it out herself.  The therapist strongly suggested that I fill out the form for her.  I proposed that someone else go over the results with her in the hopes that she would accept it better.

So here's the answer I wrote:

How do your illnesses, injuries or conditions limit your ability to work?Extreme issues with executive functioning, memory, hearing, understanding language, organization, sequencing, planning, task completion, focusing, impulse control, reasoning, prioritizing, follow through, cause and effect, understanding directions, inability to make quick decisions, problem solving, emotional instability…
Being in large noisy groups is stressful and anxiety provoking, and easily causes feeling overwhelmed and drained.  The ability to handle stressful and/or new situations is low, particularly when aggravated by loud, chaotic environment.  Low frustration tolerance causes shut down, great upset, and/or the feeling of being overwhelmed.   Recovery time can be considerable before emotional regulation and composure returns.  There is a strong tendency to develop physical symptoms or fears when under stress or feeling anxious.  History of suicidal ideation and multiple psychiatric hospitalizations and residential inpatient psychiatric treatment.
During academic career, required a sheltered, highly structured academic program offering maximum support (particularly emotional support) to complete a special education program.  Needs constant reassurance and frequent prompting when working, along with frequent and immediate feedback.   All information must be presented shortly (in small chunks), simply, orally and concretely in a calm, quiet, environment to have maximum comprehension (processing speed is in the lower extreme range – 1st percentile - 65).  There is great difficulty multi-tasking and following multiple step directions (working memory is well below average – 3rd percentile – 71).
When presented with an emergency situation or the need to choose between multiple options and/or make quick decisions, is easily flustered, often freezes, is prone to making impulsive decisions.  Recurrently sees obstacles as insurmountable and often unable to make well-thought out, rational choices.  Often preoccupied by emotional difficulties which inhibits learning and completing tasks.  A highly structured, supervised environment with established routine, minimal distractions, and emotional support and regulation is needed for optimal success.
Exhibits great difficulty staying on task and completing tasks quickly.  Requires periodic review of already mastered concepts and active involvement (versus passive activities or unstructured downtime) is needed.  Assistance with maintaining attention and alertness during group interactions is required, as well as frequent prompts to redirect attention back to a task or speaker.
Significant social and emotional delays lead to great difficulty in making appropriate decisions and exhibition of recurrent displays of inappropriate emotions and feelings during interpersonal interactions.  Misperceptions and overreactions to the behavior of or interactions with others are common.  A concrete, black and white sense of right and wrong cause frequent upsets.  Great difficulties regarding: accepting personal responsibility for actions; accepting correction; lack of self-confidence; limited empathy and understanding of others; judging other’s motivation, capabilities, and social interactions; poor social skills; trouble judging appropriate interactions and other’s motivations; communication issues…
Chronic insomnia and non-restful sleep cause excessive absences (due to difficulty with getting up in the morning) and issues with focus and multi-tasking.  Being tired often triggers frequent headaches and esophoria (which causes double vision, nausea, and dizziness).  Possesses limited physical stamina and strength.
Numerous medications and changes in said medications often cause side effects including lethargy, confusion, trouble concentrating, memory problems, feeling unsteady/ dizziness, suicidal ideation, self-harming, headaches, fainting, insomnia, drowsiness, blurred vision...  
An inability to drive, due to not meeting many of the criteria, medications, and esophoria -- combined with living in an area with no public transportation, greatly limits ability to get to and from a workplace.
Learning disabilities cause issues with basic math (including understanding money, budgets, paychecks, value of property, insurance, benefits, deductions, making change, working a cash register, calculating discounts and percentages…), learning new processes and computer programs…   Language disabilities cause great difficulty filling out forms and applications, basic reading, spelling, decoding multi-syllable words, limited vocabulary, written expression including composing anything beyond simple sentences….

The rest of the 8! pages of questions, which had a tiny little line on which to answer were things like:

6.  Describe what you do from the time you wake up until going to bed.

It repeatedly asked questions like:
What changes in ____________ have you experienced since the illnesses, injuries, or conditions began?
Of course the standard answer was, "Disabilities began in early childhood."

14 a.  List household chores, both indoors and outdoors, that you are able to do.
b.  How much time does it take you, and how often do you do each of these things.
c.  Do you need help or encouragement doing these things?
If "YES," what help is needed?
d.  If you don't do house or yard work, explain why not.

20 d.  For how long can you pay attention?
e.  Do you finish what you start?
f.  How well do you follow written instructions?
g.  How well do you follow spoken instructions?
h.  How well do you get along with authority figures?