Thanks LBJ - very much appreciated
The treatment facility can force continued treatment through a court order, but we are obviously hoping that she makes enough progress that would result in her staying voluntarily. I think we have settled on the residential care option as a next step. There will be a level of family involvement, albeit logistically a bit different as home and the treatment facility are in two different cities.
Regular family therapy over the phone, weekly phone calls, letter writing any time, family visits on campus (quarterly or more frequently), off campus visits with family, and home visits are all typical for RTC's here in the states. Parent's homework (reading assignments, skills learning (SET, Validation, DEARMAN, Mindfulness, Boundaries), are where we learn what our kids are learning, model them for our kids, and benefit from them personally.
There are a number of difficulties we are facing at present, and any assistance would be greatly appreciated.
1. To diagnose or not - there are different opinions on how to approach the BPD patient in terms of communicating whether they have BPD or not. What is your advice?
From personal experience I left this to the judgment of my daughter's therapist. He did not give her a diagnoses until she asked "what is wrong with me?"
2. Acceptance of a problem - how best should we approach the need for my daughter to accept that there is a mental disorder (whether BPD or not)
In my opinion it is far more important that she accepts responsibility for her thoughts, feelings, belief systems, and behaviors than a diagnoses.
3. How do we manage the balance of being supportive as parents and breaking the mindset of a parent/child co-dependent relationship.
It is important to allow individual thoughts and beliefs so that she can individuate from you. Allowing her to make choices gradually and not stepping in to save her from her choices is the best teacher there is. Offering support through validation and validating questions can help her feel heard/understood and cared about without telling her what to do and at the same time give her some guidance and things to think about.
4. What should we as a family be doing, apart from individual therapy to deal with the impact of my daughters actions, in readiness for the future?
Learn all you can about the disorder, how her belief systems, emotions, behaviors are interrelated and how to help her learn to meet her needs in healthier ways. Take good care of selves, live your value based boundaries, set limits, be steadfast in enforcing boundaries and limits, don't do for her what she is capable of doing for herself, and see #1
and most importantly, tell her you love her and the she is of the highest value just because she is HER!
It's a lot Dadx3!
Most all of this information is in the Tools and Lessons except these 2:
Validation and Teens The Power of Asking Validating QuestionsYou have some great questions, it will take an investment to learn all there is to learn and put it all into practice. We are here to help.
lbj