13 Year Old Daughter has gotten worse with normal treatment for OCD/MDD

[jjss]

Our 13 year old daughter has been completely normal up until 5 months ago.  Then she started worrying about school and started talking about feeling suicidal.  My sense from her is that the attention she received from teachers and counselors around the SI gave her the most amazing feeling that she's ever felt.  And it also helped her to get accommodations at school - and ultimately get out of school.  And that feeling is what she's been trying to get ever since.   

She's been to 2 PHP's and both times she started acquiring symptoms from the other kids in the program.  The last PHP (for OCD) she was in for 3 days and reported that her depression was gone.  But over the weekend after PHP started she created a suicidal plan with time/date, acquired the method (drinking cleaning solution), and wrote a suicide note.  She talked to a friend about this and that's how we ended up finding out about it. 

So the PHP said they could no longer deal with her and so residential was the only option.  So she is now in residential treatment for depression/ocd.

What we seem to be learning is that what she has been getting treatment for (depression/OCD) is not working because she's not being treated for what she actually has.  Those symptoms (depression/OCD)  just seem to have been acquired from others.  And those symptoms are what has allowed her to get what she's really looking for - which is feeling seen and being soothed. 

So, she's been in residential treatment for almost 3 weeks and it's paradise for her.  She gets to go out to Culvers, go to the bookstore, go on long walks with staff where she gets attention.  She's already talked to us about not wanting to come home because it's so great to be there.  And she's not really up for learning skills.  She's getting what she wants, so I completely understand why she wouldn't want to work on skills.  I can't imagine a world where she comes home and doesn't figure out how to go back to residential treatment within 1-2 weeks.  She's the kid of 2 therapists - so she's really proficient at knowing what to say to get her back into residential. 

Here are some questions:
1.  Have others been through this?  Of normal treatment causing the Suicidal behaviors to escalate? 
2.  We are thinking of moving her to a DBT residential program - which we hope would help to motivate her to learn skills for dealing with anxiety and obsessive thoughts.  Any thoughts on this?  The nice thing (theoretically) about DBT is that SI doesn't trump everything and wouldn't be reinforced in the same way as it is in the current program (and at at school)
3.  Anyone have experience with specific DBT residential programs?  I've found 2 I think might work - Nashotah Center (through Rogers Behavioral Health) and 3East DBT Program (through Mclean). 
4.  Any other advice? 

Thanks for any help you all can provide.

Non-critical information:
1.  Due to the sudden onset of these behaviors we have gone through an extensive process of ruling out almost all physical health causes of the behaviors.  The only 2 left are Cushings (which initial tests seem to eliminate) and PANDAS (she had a strep test and it was negative). 
2.  She was born at 24 weeks (1 lb 5 oz) and spent 100 days in the NICU.  She met all of the normal milestones (with slight delays). 
3.  She did have 3 surgeries from 18 mo. - 2.5 years to deal with kidney stones likely caused by the caffeine and other drugs doctors used to help her survive.  The whole process was quite traumatic for her.  She did 2 rounds of trauma therapy to deal with this (at age 11 and 12).  Therapy seemed to help. 

When I was trying to figure out how things have gotten so bad and continue getting worse - here are the 4 foundational problems we're struggling with:

1.  Being suicidal and sick works well to get her number 1 motivator - others caring and soothing her. Suicidal behavior works well to facilitate avoidance (school being difficult).  It’s working for her. 

2.  She’s not being treated for her accurate diagnosis.  The people helping are well intentioned but are treating her for conditions she does not have (e.g. depression, OCD). 

3.  Suicidal behaviors bypass normal limits and get results.  Suicidal behaviors get an incredibly powerful response from people and programs.  For instance, they put limits on her ability to attend programs and precludes her from dealing with the underlying problems by prioritizing dealing with suicidal behavior.     

4.  There are very few consequences to her behavior.  Most of those consequences are positive.  She experiences very little aversion around her behavior. 

Thanks again you all.
 
 

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders