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!

Saturday, February 6, 2010

Parent with Hope

Bear is 16 and has been diagnosed with C-PTSD, RAD, bipolar disorder, ADD and cerebral dysrhythmia. He openly admits that he is sneaky and manipulative. In December he transitioned out of his last two classes at a special school for emotionally disturbed youth and is now at the public high school full time. All last semester he was "flying under the radar" at his mainstream high school, but apparently they are starting to get wise to him or his behavior is degrading to the point that they can't help but notice.

At home Bear has long since lost most freedoms and privileges. He needs, and feels safest when he has, lots of structure and supervision from someone he respects and that cares about him. Every time we "lighten up" he does things like - skipping school, doing drugs, having sex, smoking, lying, stealing, and hanging out with kids with major issues.

As Bear has moved to full-time regular high school I've been more and more involved at the school because I do not trust the public school to be able to take care of his special needs. They have been fairly cooperative.

I've been more and more upset with Bear's therapist because there is so little communication and I want/need specific advice and support on how to handle Bear and his issues. This is what I have come to expect after 3 years of attachment therapy with Kitty. Since we originally approached Bear's therapist as an attachment therapist (didn't work out - insurance problems), when we finally started seeing him about 6 months ago, I had certain expectations. I think Bear is too old for true attachment therapy, but I still expected the same relationship with his therapist.

The following is my last e-mail I sent to the therapist. He admitted at Bear's next appointment that he never even read it.

The more people I talk to at Bear’s school, the more worried I get.

His English teacher sees him as paranoid and feeling unsafe. She’s talking to Bear about Bear not getting along with Hubby and I, about his issues with the In School Behavior Program (ISBP) staff, about all sorts of personal stuff. He appears to be confiding in many people. Most of whom are not qualified to help him.

I just talked to the Crisis Counselor at the school as well. She doesn’t want to share too much about what Bear talks to her about, but she said he recently came in in crisis mode about his relationship with Hubby. Bear told me this morning that he talked to her about the staff at ISBP. He said one day he went into the ISBP room because he was upset about something, but an ISBP teacher started yelling at him about how he needed to be doing what he was supposed to be doing. Something about when he walked into the ISBP room (or maybe school in general) that he had "no rights" at all. That they could tell him what to do and he had no rights. (Obviously NOT something Bear likes to hear). Bear’s case manager, who works in the ISBP room, was according to Bear, “just standing there listening.” Since she works in the ISBP room and didn’t stand up for him, he refuses to deal with her anymore either. He said the male ISBP teacher was also spying on him and against him. Bear stated that if he sees anyone from ISBP in the hallway, he turns and walks away. These are supposed to be one of his main supports at school.

I have a meeting with the Crisis Counselor on Monday, who called because she wants to sign him up for something called LifeSteps - which is during class and is supposed to help kids with life and relationship skills (I’m going to talk to the person running it to see if it’s appropriate) and I just signed him up for something called New Horizons – which has after school field trips to help kids figure out career and school choices.
The Crisis Counselor is an experienced Social Worker who was a foster parent, but doesn’t really know a lot about Bear’s background. She is "backing us up” from what she said ("Parents give tough love and discipline because they care about you.").

I believe that Bear's C-PTSD is in crisis mode and getting worse. I know he has lots of reasons to be this upset and terrified (the girls getting cell phones and he didn’t, no longer having the support of the special school, the boy who threatened to beat him up last semester just got back to school, med changes, finding out the military is not
an option after graduation, school staff knowing about his stealing and lying, worried about having to move out this Summer – he didn’t have to of course, and now knows he can’t, but I know this still upset him…). There are probably other issues I’m just not aware of like talking to birth family or possibly drugs. I’m really afraid that this spiraling is going to force him to continue downward and pick up even more speed.

I don’t know what to do. Please return my call so we can meet. I don’t want to take up Bear’s therapy time if we don’t have to. I need some advice on how to handle this, and need your opinion on how Bear is doing in therapy. I need your honest opinion on whether or not he’s progressing or if this is part of the problem (maybe dredging up old issues he can’t handle). To me it sounds like he’s stuck and repeating the same concerns/issues over and over to different people. People who don’t know how to advise him. He has a psychiatrist appointment this evening (5:30pm) so if you have time to talk before that, that would be great. I know meds won’t help PTSD, but I think he’s refusing to tell anyone about issues that can be helped with meds if
necessary (like sleeping – I’m pretty sure he’s having nightmares/flashbacks,
although he’s said nothing about it).
Monday I met with the Crisis Counselor and she called in the case manager. We talked about the issues with ISBP, and my concerns that because no one is keeping a close eye on Bear, he is manipulating the system and we may not be catching the fact that he might be getting worse. Also, he obviously feels unsafe and is probably not learning if he's under such stress. We decided that we needed to have one person gather information from all his teachers and the counselors on a regular basis. The case manager made the most sense, and she e-mailed all Bear's teachers asking for info on any time he left the classroom or was acting unusually.

Yesterday Hubby and I met with Bear's therapist without Bear (Bear was on a church retreat). Bear's therapist basically told me to back off. He said he had asked me at the beginning to "parent with hope," and that was my job.

The therapist also said he doesn't think we should be treating Bear for RAD. That Bear is a little attached to Hubby and I, but that what Bear needs most is a loving relationship with me if we ever expect him to have a relationship with a female in the future. That I need to "parent with hope" and talk to Bear about my feelings and values, but gently and not directly.

The therapist told me to let the school handle what happened at school because I was too involved. I tried to explain that I was trying to back off by having the case manager take over, but that it took some effort to get it set up. I also tried to explain why I felt I couldn't rely on the school to deal with Bear and catch him doing what he shouldn't be doing. That I felt that when Bear gets away with stuff it makes his issues worse. Hubby agreed with the therapist, but this is because Hubby is worried about me doing too much and being over stressed.

The therapist also said that he did not answer my e-mails or want to share anything that had happened in individual therapy because he knew I would ask more questions. After a lot of hemming and hawing he said he felt that by answering my questions he was being asked to "mentor or intern" me as a therapist! Totally not what I want from him!

I tried to explain that I just wanted advice on how to handle Bear and be a better parent. A therapeutic parent, not a therapist. Obviously feeling pushed, he grudgingly said he would schedule to see me on Mondays and gave me a "homework" assignment (called Making progress rather than pursuing perfection) and all the new patient paperwork! Somehow I went from strongly considering firing this guy to being his newest patient?!

The therapist then said that he felt Bear's biggest problem is personality disorders (Narcissitic, Borderline... and something else I can't remember). I get the feeling that he feels that my RAD parenting style (structure and responsibility) is all wrong or unnecessary or something. He wants to work with Bear to first, get Bear to acknowledge that he has a problem, and then try to help him develop things like empathy and compassion.

The therapist talked about key ages in kids' lives 5, 13(puberty) and 15. Bear of course is older than these. We got Bear at 13, but obviously didn't do what we should have done? The therapist never said this of course.

I left the session furious and feeling like I'd been told everything I was doing and believed about parenting Bear was wrong. That the therapist thought his job was to help Bear and my job was to just back off and love Bear and that nothing I do would make any difference.

I spoke to a friend at ACT while I was pretty upset. He pointed out that there are lots of parents of RAD kids and the way we parent is effective. There are few parents of kids with personality disorders because these are adult diagnoses - so there is no way to find out more or better ways to parent them, because technically they don't exist.

I think that the way I'm parenting is mostly right. I've tried to back off and be more of a coach since Bear's unable to reciprocate (as suggested by Katharine Leslie), and now I'm being accused of not being loving enough (by the therapist). I know Bear doesn't feel safe (Beyond Consequences) so I'm providing structure and supervision so he'll feel safe - and I'm being told that I'm too involved and too strict. Normally I'm ooth a nurturing and overly protective parent. It probably appears that I am too focused on discipline with Bear because he makes it so hard to get emotionally close to him, and I acknowledge that that is an area I need to work on.

Hubby doesn't want to change therapists and thinks he's seen some improvements in Bear (but he admits that could be from other things). I don't really trust this therapist and he's definitely not a good match for me, but maybe that doesn't matter if he's really helping Bear? Can I stand to trust my son to someone I dislike and distrust. Despite his appearance, Bear is still a child.

Hubby doesn't think Bear has RAD, but Hubby admits he doesn't really know that much about it. I do think that Bear has or will have a personality disorder (probably Borderline Personality Disorder. I don't know enough about Narcissistic.

I still don't know what the therapist means by parenting with hope. I think I do that.


Miz Kizzle said...

From what you've blogged it certainly sounds like you parent with hope. You haven't given up on him and you want him to succeed but you're realistic in your expectation that he will have a difficult time in the future.
"Parenting with Hope" is one of those vague terms that therapists like to throw around. They love jargon but if you dissect some of their favorite phrases they make little or no sense.
Bear lives with you and the therapist sees him for what? an hour every month? You and your husband are the real experts on Bear. The therapist can give you suggestions and tell you what he observes about your interactions with Bear but you're the one with the experience.

Anonymous said...

I've been worried about you and wondering where you've been.

Think hard about whether or not you want to go to that appt. on Monday (and the following Mondays.) That could be a waste of time and money if you don't really trust or respect this guy. And if Bear sees you going as a patient it could reduce his view of you and put you on a par with him, somehow undermining your authority.

Just some thoughts off the top of my head. (((Mary)))

marythemom said...

"the therapist sees him for what? an hour every month? You and your husband are the real experts on Bear. The therapist can give you suggestions and tell you what he observes about your interactions with Bear but you're the one with the experience."

The therapist seems him weekly. My biggest complaint about this therapist is that he doesn't give me suggestions or talk about what he observes! He's basically telling me it's none of my business and to quit trying to do his job.

Purple, I'll post soon about why I've been incommunicado the last week (involves Bear of course), and I'd already decided to cancel the Monday appointment. The therapist made it perfectly clear that he is not going to change his views and he is patronizing me. I know he thinks I'm interfering and questioning his decisions. I think he should have to convince us that he is the right person for the job. Honestly I really want to just fire him, but Hubby disagrees. *sigh*

"I don't know what to do. I don't know what to do." I wish I had a pop-up book that would tell me.


Sheri said...

This made me sick to my stomach and sad! I am so sorry this is so hard. We have been there with therapists who think we are crazy. . . I want them to spend 48 hours being the parent to my son! Trust me, they would change their tune!

It has to be difficult when you and hubby are not on the same page. Thankfully mine does what I tell him! :)

marythemom said...

The hard part is deciding if the therapist is right, partially right, or an idiot (he does not make this easy). Bear really has most likely got several personality disorders, but there is not really anyone out there giving good parenting advice for this.

My husband usually just goes along with whatever I say, but in this case he agrees with the therapist's intent - for me to back off, just not for the same reasons. Hubby wants me to have less stress.

Mary in TX

GB's Mom said...

One thing I have learned in parenting special needs children for almost thirty years is to listen to my gut. If you distrust and dislike the therapist, you have a reason even if you don't know what it is. Trust yourself.

Jennie said...

DUMP THE THERAPIST! OMG. if there is anything that makes it worse for me as the mom is not being able to connect with my children's doctors or therapists. Since they are minors and I am their biggest advocate, it is imperative that I see eye-to-eye or at least that I speak in tones concise enough to let the therapist know that I

dump the therapist!!! tirangulation at it's best is happening here.

oh, and that's my unprofessional, totally subjective opinion that you have the right to completely ignore! lol

Anonymous said...

My gut told me that my son had bipolar. His therapists said "No, you are just seeing ADHD and drug use." The therapists seemed to do some crisis management, but never work that would get to the heart of my son's anger. A lot of that was because my son wanted the therapist as a father figure, but no more than that. ... I believe in trusting your gut, even 'though I often don't have the nerve to carry through with the change.

Was any of his time inpatient good for him? Do those docs have any local recommendations?

There are so many problems to try to solve, and at the least the therapist and you have prioritized them differently and he's not trying to speak your language so you can see why he thinks his priorities are better ones.

At the very least, the two of you need to come up with clear goals for therapy so you both know and agree on the path you are taking! Written goals!

But not reading the email? That, to me, is the deal-breaker. That means he thinks he knows everything he needs to know already. (And who is the narcissist?)

Ask your husband if he would keep an employee who didn't read emails from the person who pays him. Or one who won't tell you what he's trying to do until he is finished.

Mom 4 Kids said...

If your taking votes I vote to dump the therapist. He sounds defensive (to me) perhaps because he doesn't know how to advise you on how to parent Bear.

I am no expert but my #1 rule if a professional or anyone wants to give me advise on my kids is has that person parented a child or children with my child's issues? If so how'd that go? How'd that kid turn out/progress?

You do love your son if you didn't give a hoot why would you put so much effort in?

Hugs to you (((Mary))), you are doing a bang up job!!!