advice requested re out of control teen

Parent Cafe
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<p>I have a daughter (lives with her mother in another state) who is almost 17 that had a bit of a breakdown last year and was diagnosed with ADD and trouble controlling her emotions. Everything has been pretty good up until the last month. She has her first boyfriend and not to put the blame on him but things have gotten out of control. She is incredibly disrespectful to her mom, has emotional outbursts if she does not get her way, is staying out all night, sneaking the boy into her room and smoking a lot of marijuana it seems. Last week she skipped school the entire week and said she was going to drop out of school.The dr changed her prescription a few days ago and today she is doing her homework and says she is going to school tomorrow.</p>

<p>My daughter is physically stronger than her mom so I am being asked to go help get her to the hospital which I can do but I feel this is not going to really solve anything as she is not being a danger to herself physically (making awful choices though…) or anyone else. Her mom indicated her room reeks of marijuana so I am reluctant to call the police to take her as they will surely find the drug before I could flush it and she may end up with a record that haunts her for a long time.</p>

<p>The dr wants to hospitalize her but I think that is only to be sure she is taking her meds which control her moods.Are there places we can send her to sort things out? If we put her in the hospital, in a few days she will be on her meds for certain and be released, it does nothing to sort out the bad decision making…</p>

<p>I want her alive first of all and secondly it would be great to get her through high school. She is an above avg student and has a bright future if we can get her through this…</p>

<p>just looking for some advice or experience…thanks</p>

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<p>Wilderness program. Second Nature is a good one and is unusual in that it has programs for kids over 18, which yours will be fairly soon: snwp.com</p>

<p>Residential treatment center.</p>

<p>Therapeutic boarding school.</p>

<p>Most kids at RTCs and therapeutic boarding schools went to a wilderness program first. Some of them specifically require that. The path would usually be to start with a wilderness program for 6-12 weeks or so. At that point the next step becomes clearer with input from the program’s therapist, plus an ed consultant.</p>

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<p>I believe family therapy is the only thing that will have long-term impact. If there has been a confrontational, or punishment-based, or avoidance-based dynamic, the anchor that she believes her boyfriend adds will give her a place to stand to defy these tactics. Parent and child need to change tactics and dynamics. If your daughter goes away, when she returns the dynamics will be the same unless her mother changes. I wish this were not the case, but my experience is that it is.</p>

<p>There are actually some places (expensive) that can help. You may want to look for an educational counselor or educational consultant (to me this is a misnomer, but that is what it is) to help with a placement. These people, if they are good, will be able to match your child’s issues with excellent resources. Many programs are peer-mediated with a cohort of similar kids working through these issues together, and some have a wilderness component to build confidence and self-reliance and break dependency and blame. The emphasis is also on parent education for some of these so that while the child learns new tools, so does the rest of the family.</p>

<p>There are programs with the right fit (i.e. not all hardened gang-types or heavily-addicted drug abusers), rest assured. I may not be the best resource. I am sure you will get lots of support from this community.</p>

<p>I may be wrong though. If you are floundering a few days from now, PM me and I will dig around.</p>

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<p>When you say “Dr” do you mean an MD - a psychiatrist? IS she also seeing some sort of therapist? IMHO it is not good to just have someone writing a Rx without having a therapist to help the teen understand the ramifications of her behavior. </p>

<p>There are steps in between full hospitalization and doing nothing. She can up her visits to the therapist to 2-3 x week. There are intensive outpatient programs, where she would go once or twice a week for 3 hours at a time in a group setting. There are partial hospitalization and day programs. Usually inpatient is for seriously suicidal or psychotic/schizophrenic patients who need to be hospitalized for their own safety. </p>

<p>It sounds to me like an intensive outpatient program would be better. And finally, is SHE on board with any of this treatment?</p>

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<p>One thing to note (apropos of the later post): wilderness programs and RTCs typically have a family-counseling component. As a generalization, that’s probably a lighter element at a therapeutic boarding school, but different institutions are different.</p>

<p>An interesting book, aimed directly at the parent, is “The Parallel Process.” It was written by a former Second Nature therapist, but it’s addressed to parents of troubled kids generally.</p>

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<p>thanks for the replies. perhaps her boyfriend fills the void I have caused…not sure about that. we have had a difficult relationship to say the least. her mom has always been very accomodating to her but impossible to say if things would be different if she had not been. my daughter has also been given a lot more freedoms than I liked but partly it was due to necessity.</p>

<p>she has been going to a psychiatrist. I thought we were going to hospitalize her last week and I drove up to assist. I spent time with her mom and talked her out of doing so as I felt the issue was more to do with rebelling than anything mental. I met the psychiatrist and he is ok but he is the first one I have ever had a conversation with so difficult to say.</p>

<p>It seems awfully cold for any wilderness based programs…but I think that is something more in line with what may be needed. she is not on board with anything that infringes upon her freedoms but that is going to have to change.</p>

<p>I was scheduled to leave tomorrow morning but her mom called and said she is taking med, doing homework tonight and will go to school tomorrow and also indicated she would go visit the dr tomorrow, so we will hold-off for a day or so it seems. I just think the hospital is not going to help much…</p>

<p>thanks again for your comments!! I will try to google some of the programs/schools mentioned, before I go</p>

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<p>Just a note on the time-of-year issue: at least one of the people involved in running a wilderness program has said that he thinks winter is the best time to go to one.</p>

<p>On a semi-related note: there’s one (Pacific Quest) that’s located in Hawaii. I know, sending a troubled kid to Hawaii sounds crazy to me too, but I’ve met two sets of parents in the last year who spoke highly of Pacific Quest.</p>

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<p>The islands are known for having lots of pot farms. I wouldn’t send her their. She needs tough love with experienced counselors and a psych team that knows what they are doing.</p>

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<p>there.</p>

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<p>Again, is there any sort of behavior treatment going on or just Rx? </p>

<p>What diagnosis does the MD give and what is his reason for hospitalizing her? It’s a pretty big step if it’s just for rebelling. I’d look into some intensive therapy first. The hospital will be m</p>

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<p>Oops silly phone. </p>

<p>The hospital will be mostly suicidal, psychotic and probably substance abuse patients. Could backfire on you. </p>

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<p>To date, no behavior treatment. She initially refused her meds, but seems to be taking them the last 3 days so I am also not sure what basis we have to hospitalize her. She had an outburst last week at the dr and her mom and said no meds, no more office visits but seems she is agreeable to all now.</p>

<p>I think it is more behavioral and drugs than mental and my fear is they will see this after 2-3 days in the hospital and release her and then what…I think her mom is just wanting an immediate fix and last time she was hospitalized it worked for quite a while but the problems were not drugs and a boy…</p>

<p>thanks again.</p>

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<p>You do not give a diagnosis or what meds she is on. Has she been diagnosed with bipolar disorder? Is the MD a psychiatrist?</p>

<p>There seems to be some misunderstanding on this forum, if your daughter does indeed have such a diagnosis. Parent-blaming is irrelevant and not helpful: true psychiatric disorders are not caused by bad parenting or bad relationships. Nor is any kind of therapy important: many kids dealing with bipolar disorder, and their parents, are hostile to therapy, and rightly so.</p>

<p>If her diagnosis is borderline personality disorder or adjustment disorder, then CBT and DBT (therapies) can help, and these can be accessed through regular therapy or through a partial hospital program.</p>

<p>In any case, I doubt this is simple “rebelling.”</p>

<p>You mention she has been hospitalized before. How was that possible? Normally, for insurance to pay, there has to be danger to self or others. There is a lot of history missing here.</p>

<p>If she cannot stay in school, there are many options. Tell your ex-wife to read “The Film Club” about a son who dropped out of school. There are many ways to do high school these days, online for instance. She could get a GED at some point. Check out North Atlantic Regional High School. National Outdoor Leadership School is a wilderness program that is not formally therapeutic: highly regarded and may point to some future interests. I think it is not necessary to stigmatize her yet with the more highly “therapeutic” programs.</p>

<p>It is possible that offering to your daughter that she can leave school if there is another plan, might improve things- she may feel better about staying in school if it is her choice. Is the school aware of what is going on, and have they offered any help? Has anyone suggested CHINS? School can provie structure but it is not for everyone all the time.</p>

<p>What does your daughter like to do? Are there healthy interests she can pick up on?</p>

<p>If she has bipolar disorder and maybe she doesn’t, meds can do wonders. It is normal to resist them at times, even for years. It is also hard sometimes to find the right med or meds. Have her read “An Unquiet Mind” by Kay Jamison. If there is a different diagnosis, get your daughter a book that can help her educate herself. I also think that therapists who use meditation, going to yoga or Nia, taking an art class, playing music and so on can really help.</p>

<p>Calling the police is rarely a good idea. If she is suicidal or extremely violent, of course she will be hospitalized and pink-slipped. Otherwise, make sure she has the right meds, is educated about her problem, and has several options that she can “own” for dealing with it. The school issue will matter less than you think over time and she can make her way through high school and onto the next step in many ways.</p>

<p>Feel free to PM me.</p>

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<p>I would start with the hospital…Often parents think that is such a very big step…but they don’t have the tools themselves to help with the teen. I know two friends who have had to take that step and after a hospitalization or two they have gotten on track. Hospitalization helps show the teen that Yes, this is a Big Deal and also takes the teen out of the home which helps them focus on themselves and allows the doctors to figure out the medication. Usually the parents will get therapy/training/counseling as well.</p>

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<p>If you can afford a good therapeutic boarding school, some have excellent track records and can change families for the long term. Here’s one with an excellent reputation that has helped several people I know of: <a href=“Montanaacademy.com”>Montanaacademy.com;

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<p>Just a few notes, mostly related to some other posts:</p>

<ul>
<li><p>While it presumably depends on the hospital, I’ll agree with surfcity - at least based on anecdotal experience - that psych wards can do more harm than good.</p></li>
<li><p>I don’t know all the ins and outs of various insurance schemes, but exchange plans cover residential behavioral care. There is a requirement of medical necessity of course, but it’s short of the full-on “danger to self and others” that justifies civil commitment.</p></li>
<li><p>Another financial source is the public school district. The prospects for success depend on the district and the facts, but some will pay for out-of-state residential placements. You need to talk to a local lawyer who practices special education law to get the scoop. Most special-ed cases involve learning disabilities (or other disabilities, like deafness), but diagnosed personality disorders are disabilities too.</p></li>
<li><p>On the diagnosis: many psychiatrists and psychologist seem to hand out bipolar diagnoses like they’re handing out business cards. Diagnoses in general are surprisingly flexible. They’ll change bipolar to dysthemic disorder, swing between BPD and adjustment disorder, and of course there’s always oppositional-defiant disorder for good measure.</p></li>
<li><p>Montana Academy does have a good reputation, based on what I’ve heard. I believe it would generally be one of the ones that would be appropriate for a kid who should be a good student, but for the behavioral issues. Another is Carlbrook, in Virginia, which leans particularly heavily to the academic side. There are bunches of others, with various focuses, histories and approaches. Researching them can be a bit tricky, because some have gone through various changes in recent years. Also, there’s a rather shrill anti-everything faction that you just have to learn to disregard.</p></li>
<li><p>As mentioned, police aren’t really the right resource for ordinary care and handling (so to speak). They’re for more pressing things, like runaways and the like. FWIW, they generally seem remarkably uninterested in charging middle class kids from nice families with drug offenses, or really anything at all (which may be a fit subject for some kind of policy discussion, but here I’m just throwing it out as a practical note). If you need them - which you may not - there are transporters or “escorts” (different kind of escort from the more lurid ones) that are sometimes enlisted as necessary.</p></li>
</ul>

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<p>If a medical doctor thinks she is worthy of hospitalization then I am worried you don’t know the whole story. </p>

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<p>I agree that bipolar disorder is over-diagnosed, but bipolar 1 is very specifically defined and Lithium is a life-saver. A diagnosis from a good psychiatrist is immensely important to get the right meds on board- and avoid the wrong ones. Antidepressants can be disastrous for bipolar disorders. That is why I asked.</p>

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<p>When was she hospitalized before and what was the diagnosis?</p>

<p>I had been going to say that it sounded to me like you and her mom were way overreacting and that all this talk of meds and hospitalization was likely to do more harm than good. But if a qualified professional previously considered that she needed to be hospitalized, I’m realizing that there’s more to this story that you’re not explaining here.</p>

<p>It also makes me think that you should NOT be taking advice from strangers on the internet based on a few incomplete paragraphs that you’ve typed up here. None of us are fit to offer advice in a situation as serious as what yours seems to be – even if we were all psychiatrists or crisis counselors or whatever, we don’t have nearly enough information and we’ve never met you or your daughter.</p>

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<p>Llamas- You and I are on the same page. I think winter wilderness, particularly Second Nature, is a great recommendation. After that, someplace like Carlbrook or Montana Academy could be considered. This is very, very expensive. I think the Second Nature m odel is the best in the emotional growth business. Check out <a href=“http://www.strugglingteens.com”>www.strugglingteens.com</a> There is a lot of information and Lon Woodbury is an excellent educational consultant. </p>