Questioning the benefits of long term "talk therapy" with SS10. Need Suggestions

[mamachelle]

Yesterday we went to the pdoc for my SS10.

He is dx Emerging Bipolar and has many BPD personality traits.

His mother has BPD and Bipolar.

I have sent a series of 4 emails to all 3 of his therapists this month (neuropsych, psychologist, and pdoc) where I have been detailing his ever concerning behaviors and deteriorating ability to control his emotions.

Also, after a long talk with his neuropsych, who is a colleague and friend of the pdoc, the consensus is that SS10 is heading for a psychotic break.

It's bittersweet to feel validated in my concerns over something so serious but I did feel like I was being listened too finally.

I mentioned to the pdoc that SS10's regular therapist has continued to downplay his behaviors, calling them "drama".

I also mentioned that he has become so agitated this week that I asked the therapist to do "mindfulness" exercises with him before discussing his upcoming trip to see his Mom on Friday. SS10 mom lives in another state and so he only sees her on vacations usually these days.

So, the pdoc says... .  and I am paraphrasing.

"I don't think long term talk therapy is effective with kids like SS10 because it becomes just a routine. I am guilty of this too, but I do think "talk therapy" is better in a crisis or to work through short term problems. What is going on right now is that your child has a fever raging and you are sending him to a yoga class. Yes, you can still get benefits out of it, but I don't recommend having too much therapy"

Again, I felt validated that his "talk therapy" with the same T he has had since he was 4 is not really helping and not really hurting. But then I thought, maybe it is hurting if the T is not able to treat him and is ignoring his very serious issues. The pdoc was concerned if we did not add in abilify immediately we were heading for hospitalization.

So, I guess I can't just remove the talk therapy. I don't want to change therapists at the moment, but I am not sure what to do.

He is not able to get anything close to DBT at his age and with his dx as far as I can tell.

I just wonder if I should decrease his visits or what? I mean it seems so counter intuitive to decrease therapy when he is in crisis ... .  but why continue every 2 weeks when he leaves the appointments often agitated.

This last time with the mindfulness bit he did much better post therapy. So, do I insist the therapist work on mindfulness with him and continue to guide the therapy with no training ... .  ? I mean shouldn't a reputable phD Psychologist who knows my SS and the family, and the issues be able to figure this out... .  it's very concerning.   

I'm definitely open to hearing others experiences with non DBT talk therapy long term and any other talk therapy suggestions... .  

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]

Adding the antipsychotic is probably worth a try.

Have you considered any kind of therapy?  Maybe equine with an EAGALA certified t?

[mamachelle]

Yes, I am open to alternate therapies for sure at this point. I hope to have a behavior therapist coming back to the house which helps with the ODD component but I need to get an autism dx added (PDD-NOS) as that is the only way my insurance will cover it.

Hands on therapies seem to be best with my SS10 and also SS15 as they have  b/w thinking and have a hard time going from talking to doing... .  

I will look into the equine therapy, I know some of the therapy schools around here use it. I am in a pretty urban area but there are horses around as well.

((Thanks, and yes, hoping the Abilify helps. It seems to have stabilized his brother pretty well and also helped with the Depression he was having as well. BPD mom has also taken Abilify and she told me last summer she "loved it" --so on blood relatives alone-- without other drugs in the mix-- it looks like there is a good chance it might help.))