Residential treatment?

[taaudyli]

Has anyone had success with this?  She spent two 5 day stints in the inpatient at the local psyciatric center and was very compliant there but then came home and had a meltdown within 3 days.  They sent her to another residential place out of town but then we found out it would be $1750 for 6 days (that's after insurance).  Huh?  My other children are terrified of her and don't want her back in the house.  I really don't want her here if she's going to threaten us with knives everytime I try to enforce  a rule.  I'm about to have a newborn in 3 weeks and don't have the physical or emotional energy to handle her right now.  People have been recommending the Teen CHallenge program.  I'm just not sure.  My dh doesn't want us to go into the poor house but what's our alternative?  Options?  THere is a hospital that has the dialectial therapy for borderlines and I don't know much about cost/time factors. 

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

[lbjnltx]

from what i know about teen challenge, it is mostly a program to address addiction.  i don't know if they would even take a child who is violent or suicidal.  some rtc's won't either.  for instance some will not take a child dx w/conduct disorder.

rtc's are very expensive.  250 per day at falcon ridge where my BPD13 is.  insurance won't pay anything as they are "out of network" and we only have 15 days coverage... .they threw it all under the 6700.00 out of network deductible. 

please don't take offense, but the serious nature of your daughters behaviors would most likely have to be addressed in a clinical rtc.  set up more like a hospital than a residence.  some clinical rtcs have step down programs like a regular rtc once they are stable.  check into menningers in houston, texas... .mclean in massachusetts... .get references from them if they can't help you.

we have a state hospital an hour away that uses dbt... .640.00/day.  i hope you have better insurance than i do!   

when we first considered an rtc my BPD13's pdoc told me "don't mortgage the farm for a 90 day program"... .in other words... .if you can't commit to a long term rtc... .don't bother.  most 90 day programs are wilderness therapy/behavior modification type programs... .not going to get  you the desired results of new coping skills, changing their ideas/thoughts about themselves and their world... .behavior mod won't do that... .intense, long term, controlled environment may.  there are no guarantees.

there are companies that make loans specifically for therapeutic schools/rtcs.  the interest rates are fairly low.  some parents use college funds, some get 2nd mortgages... .

i hope  you can find help for your daughter... .and yourself.

take care as best you can... .;p

x

lbjnltx

[ErikaB]

I had to get my daughter into the court system by begging dhs and proving we had exhausted all other resources.  She had even been in a PMIC for one year and was still failing "outside".  This opened doors to treatment that kids can only get with court-order plus the state funds it.  I think these facilities are also held more accountable because they are state/fede funded.  My daughter is almost 16 and in shelter (again).  She will be going to a residential called Forest Ridge in Iowa, about 3 hrs away from me.  I have heard very good things from professionals all over.  I know they get kids from other states too, but I don't know how that works.  I think there is voluntary admissions too, but I'm sure it's expensive.  But it's in the middle of the sticks, so good for runners like my girl.  At one time the website listed DBT as a therapy- I couldn't find that recently, but that is incorporated in the program.  It is to help with thinking patterns, behaviors, underlying emotional problems, gaining trust, self-awareness.  It's also all-female.  I'm very cautious, because I've heard sad stories, like my niece who got kicked out of bootcamp and her parents paid $27,000 anyway in a private program.  Bootcamp wouldn't work for my daughter.  She gets defensive w/that in-your-face confrontation, as she has shown by assaulting police officers who were just there to transport her but cornered her.  I don't know if this was at all helpful.  I say RESEARCH well. 

[ErikaB]

OOps. I wanted to say also that I encourage calling agencies or treatment facilities that you have trust in and are reputable - even if out of state, to get recommendations.  If you get the right people, they can lead you to resources.  The good ones are usually very knowledgable about reputable options. Maybe you have already done so! It just helped me out, because there is no "front door" to find this info  

Erika

[taaudyli]

Ericka,

I'm sorry but what's PMIC?  I'm not used to the lingo.  Do you just let her run and then call the cops?  That's what the last confrontation was about.  She wanted to leave and my husband stood between her and the doorway and she ran around looking for weapons.  We've only been at this for three months and already exhausted.  I don't know how you guys have been doing this for years.

[ErikaB]

Sorry, PMIC stands for Psychiatric Medical Institute for Children.  It was a nice campus with 5 "houses", a main building, parks and 2 schools- for 104 kids.  I was able to voluntarily refer my daughter (when she was 13) and needed 2 doctors (her psychiatrist and family dr signed) to recommend.  She fit the criteria so she was admitted and medicaid paid for it- they didn't go on our income (luckily) but my daughter's which was child support only.  I had to pay part of the first month ($800) then I just paid them my monthy child support (well, I got to keep $50).  The PMIC was federally and state and donation funded.  I like to share this, because at one time I thought about selling my home, moving in w/parents to send her to a therapeutic boarding school (was researching on internet).  It was our 3rd or 4th psychiatrist who introduced me to the facility.  My Dad was a VP for another non-profit care facility for children (developmental/physical) in the community which was funded similarly so he knew the board of directors, etc. and had been impressed.  Before that I had a stigma about "state" facilities which I have now changed my mind about!  At least in our state (IA).  My daughter did well w/the structure and had positive med changes and diagnoses but just was unable to transition home- we've had nothing but problems since.  So now looking at different res.trt that will hopefully address her thinking patterns/behaviors.

[ErikaB]

My daughter has run off blatantly and by sneaking out.  I set my boundaries and occasionally she will be deterred by that, but not usually.  So, I will just call police once she is gone, after I have stated that she is leaving without my consent.  Often, she would stay around and argue about that, trying to convince my to give her permission.  I gave up battling with her and I think she actually did too.  Her impulses are so strong and out of her control or mine.  I hate having to use the police, but often it is the only thing left and/or the only plan B. 

[tapestry strings]

I don't have "answers" really, but can just tell you what stage of the game we are in.

Our BPD daughter is turning 17 in a few days.  In January of 2010 we discovered she was cutting... .about 6 weeks after she started the behavior.  She spent 7 months either inpatient (IP) or outpatient (PHP) with a psychiatric hospital that was about an hour away.  She went thru multiple med adjustments, and they could not get her stabilized.  We even tried ECT (shock therapy) while there at the hospital, as a last ditch attempt to get the depression under control.  Not much effect.  During those 7 months, she was only "home" (full discharged) about 6 weeks total.  The rest of the time she was either fully admitted to their facility (IP), or was there outpatient from 8:45am to 3pm five days a week.  It was a roller coaster for us.  Her shortest time "home" was 3 hours, where she was so emotionally distraught that we had to take her back.  With her longest discharge being that one 6 week block of time.

With exhausting all resources that a psychiatric hospital could offer, they recommended an RTC (residential treatment center).  We were referred by the psychiatric hospital to a State funding resources, that in the state of Georgia is called GCAL.  There was paperwork involved, with lots and lots of documentation that was needed as to what had already been tried for treatment, what we were experiencing at home, stresses on other children in the house, etc.  I was amazed when we qualified for 100% coverage for an RTC.  My husband's income puts us in "upper middle class", so my assumption was that they would simply provide a discount on the $480/day that the RTC charges.  But we are "fully funded".

Our daughter has been in this RTC facility three weeks today.  She is still in the E&S until (evaluation and stabilization)... .which is normally a 2 week "stay" before being placed in a less restrictive environment.  Just yesterday, our daughter called to stay that she had had her first day of "school" at the RTC, and that the art teacher hated her, and was showing scapels and other tools used in art... .and that she began to obsess about cutting.  She was getting quite graphic and euphoric in what she was telling my husband over the phone about her obsession... .And she has had no "honeymoon" during her stay there.  Our fear was that she would be compliant and sweet and innocently repeat that she no longer had urges to cut, and was "fine".  She has kept them hopping during her 3 weeks there.  So our fears of her having an early discharge (she has the ability to "give the right answers" can be pushed to the background for now.

There is work to be done.  The funding is there.  The treatment plan is planning for her to be there for 8-10 months.  And life at home is stabilizing, so that I can focus on the other three teenagers that I am raising... .ages 15, 14, and 12-3/4.