Is an RTC right for our well-behaved Borderline 17 yr old daughter?

[anirab]

Our 17 year old daughter surprised us 2 years ago with a request for psychological counseling for sadness. While she had some very odd and irrational behaviors, we thought she was simply being a moody teen. Our daughter was adopted at birth and was raised in a 'family oriented' environment with a mom, dad and brother.  No divorces, no trauma.  She'd sing in the shower, laugh, was a decent student and a member of marching band etc.  Within a few months of therapy, the therapist mentioned that she had BPD.  I researched this, and learned of DBT, so we started her on that particular kind of therapy.  I bought every book under the son, and responded in the home as a child with BPD requires.  We no longer let her engage us in her circular thinking and out of control arguments. Soon after the local diagnoses, I learned that she was superficially cutting herself on her upper thigh.  This was a very upsetting finding and we decided it was time for a psychiatric diagnoses so we brought her to Menninger to help us with the correct treatment protocol. She was very cooperative because she was very aware of her problems.  At Menninger, she was diagnosed with major depressions, generalized anxiety and emerging borderline.  They suggested an RTC for follow up treatment.  Now she is entering her 5th month at an RTC and has developed knowledge of the skills needed to stay under control although she can't always use them at the appropriate time.  She has refused to work her therapy for over 3 weeks and can't explain why.

I joined this message board to ask advice on whether an RTC is an appropriate environment for a well-behaved Borderline (no drugs, no promiscuity etc).  She also deeply misses the family and always expresses her love.  Our thoughts are to bring her to McLean for 30 days, then home to finish up her high-school senior year at the school she attended since she's 5.  Is every borderline right for an RTC? Lots of self-doubt about keeping her at an RTC at this stage.

All feedback would be appreciated.

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

[ForHannah]

Hi  Hi!  It sounds like we are in similar situations except that my 17 yr old did eventually become defiant, truant and involved with drugs... .so she is a bit "worse" than your daughter, but still not the classic (sometimes horrific) BPD symptoms we read so much about here.  My daughter also went to Menninger and emerged with the exact same diagnosis as yours.  She's consistently been in treatment for a year and the last 3.5 months in an RTC.  My daughter IS making progress and seems to get better and better all the time.  The only time she really stumbles in her treatment is around the time of her period... .has always had terrible PMS.

If you can offer McClean and Menninger to your daughter, she is one lucky girl in that regard. 

I certainly would never tell you what to do, but I only share that there have been many times when I second-guessed my decisions about her treatment but in the end I always rely on the opinions of the professionals who care for her.  I am just a mom and am ruled by my emotions where she is concerned.  They are professionals who are trained and have many years experience treating hundreds of clients. We have been very blessed with some amazing therapists.   I've trusted them and they have not steered us wrong yet.   

Sorry I can't offer you more, but you most certainly have my empathy.  ((Hugs))

[lbjnltx]

Now she is entering her 5th month at an RTC and has developed knowledge of the skills needed to stay under control although she can't always use them at the appropriate time. 

developing knowledge of skills doesn't equal change... .i can know what i need to do without doing it. ;p

it is the desire to learn, the desire to achieve, the desire to have a healthy life, the desire to love self that is important... .without these desires the skills are not helpful.  :'(

I joined this message board to ask advice on whether an RTC is an appropriate environment for a well-behaved Borderline (no drugs, no promiscuity etc).

yes, it is an appropriate environment... .if she was placed at an rtc recommended by menningers then it most likely has a program beneficial to an adolescent w/BPD... .then we as the parent and knowing our child and the kinds of treatment that will most likely get their attention and be a catalyst for change must make choices. 

with full knowledge that dbt is the premier therapy model for people w/BPD, i made the choice, based on knowledge of my daughter's interests, chose an rtc that practiced dbt w/the individual therapist but not group dbt... .the group therapy model is ppc, equine is the main focus of the program... .i did not believe that dbt was the sole key to my d's potential success... .in other words, i did not want to put all my eggs in the same therapy basket.

what do you believe will be the key to your d's success?

Our thoughts are to bring her to McLean for 30 days, then home to finish up her high-school senior year at the school she attended since she's 5. 

what do you hope will be accomplished by taking her out of the rtc and to meclean for a month?

lbjnltx