BPDFamily.com

my nearly 19 yo D is living at home after having dropped out of freshman school in a dramatic fashion (of course!) she has had a very rocky relationship she's wanted to break up many times. about a month ago, she committed to sticking with it and working things out. unfortunately, i fear this move has driven her true feelings even deeper and she is now engaging in risky sexual behavior (beyond the steady relationship) that is worrying me to death. nevermind how i know... .i know. she's in therapy 3x a week and i've planted the seed of the thought of residential because i really think she needs to be out of this area and have the chance to fully engage with therapy. as it stands now, she may have a good session here and there but NOTHING sticks... .she lacks follow through. she has been honest with her therapist recently but, again, she wavers in her commitment and follow through.

i don't know how or if to bring this up directly with her or detach and just let chaos ensue and deal with the aftermath... .i worry she could get hurt physically, though, too in any of the encounters she engages in.

i love her so much... .

this illness started as an eating disorder, depression and has been a rocky ride of unpredictable behavior for the last five years... .though not officially diagnosed, BPD really seems to fit... .any insights appreciated.

At 18+ years old she can refuse to go to rtc.  Does she want intense help and is willing to stay inpatient?

Are you hoping that if you find a place that appeals to her she will agree to go and agree to stay long enough to get the help she needs, work the program, and not front?

lbj

@lbjnltx

I know she can refuse. That is the difficult part. She is not willing at this point. There is a crisis brewing and I'm trying to figure out whether circumventing it -- by out-ting the current situation -- might prompt her to get the help she needs. Wishful thinking. She has been hospitalized before in crisis situations and these times only served to stabilize. They did not treat the deeper underlying issues. She was resistant but did IOP PHP... .felt everyone else was sicker... .also those programs focused on ED which is really a subordinate issue for her at this point.

Any input on good residential treatment for BPD appreciated.

Hi again thora,

I don't have any recommendations for adult inpatient RTC except by reputation:

McLean

Menningers

I have found that it's most important to understand the needs of your daughter and what you believe will work for her.  That is how I chose an adolescent program for my daughter.  Looking through all the options of the 100's of programs gave me an understanding of the different therapeutic environments, treatment approaches, peer support styles (group aspects), and family involvement (this is important even for adults).  From this understanding I was able to develop a search criteria to narrow it down to a handful.  From there I was able to narrow it to 2 facilities by talking to other families who had been through the programs.  Once I had it down to 2 I was able to narrow it to 1 by visiting them both and meeting the staff and talking to the girls currently in the program.

There are factors outside of our control (location, financial) that unfortunately also play a part in the decision. 

Whether or not she wants to go at this time, it is advisable to work through the process and choose a place so that when the time is right you can move swiftly and with as much certainty as is possible to get her help.

It took me a month, full time, to work through this process of choosing. There are probably not as many options for adult women as there are for adolescents so it may go much quicker for you. 

lbj