Ideas for help with 16 y/o (started in new member intros)

[crumblingdad]

So at the urging of PhoenixRising and vivankananda figured I'd bring this over here... . some of this is from my intro post and some more recent information relating to our daughter HH.

Have read most of the info on the boards and lurking for some time but recently things have escalated with our daughter.  New to the board - have lurked from time to time.  Our 16 year old daughter (HH) has no official diagnosis but we came to the conclusion approximately 2 months ago that she clearly has BPD and meets most of the symptoms. 

HH has been in and out of 5 different group homes in the last 2 years which began after a failed suicide attempt which had us put her into the state mental hospital.  She then was hospitalized in a private hospital by us after she made threats of suicide a few months later.  She was sexually assaulted and raped when she was 13 by a peer and has been diagnosed with PTSD as well as anxiety disorders but never given the BPD diagnosis - a counselor she has been working with suggested it could be it a few months ago and our research into it following that couldn't have made it more clear she was right.

Shes been home since early spring and lives with both her mom and myself as we are divorced.  Thurs-Sun with me and Sun-thurs with mom as I travel during week for work until thurs night.

Most of her group home placements were a result in us voluntarily getting her placed into the State's CHINS program as a threat to herself.  They discharged her after almost two years in CHINS saying they feel their is nothing more they can do to help as nothing has been successful and they've exhausted their resources.

She took off from her mom's just three weeks ago and brought friends into my home while I was away and partied there.  Ended up being "talked into" driving them to the store at 3am because she was the least drunk and got pulled over for DWI (she's unlicensed driver and blew a .04 in a zero tolerance state).

Since the arrest HH has started dabbling in heroin over the last two weeks.  Used for 5 straight days with a "friend" and when we found out I was able to keep her home and she stayed clean 2-3 days then ranaway and used again last sunday night.  She returned after using and to the best of our knowledge hasn't used since Sunday night.  She doesn't want to go into any rehab programs and most require she be a willing volunteer despite her age.  Currently working with McLean and her therapist to see if they will take her into a 14 day program which is more an adolescent residential mental health program then rehab.  She is now wavering whether she'll consider it - HH's thoughts on not doing the opiates anymore is now "I'm not interested in any drugs or alcohol anymore other then heroin - I don't want to be an addict but I don't think I want to stop getting high and I don't want to be in another placement or inpatient program as school starts in 12 days and I want to go to school and I think it'll keep me occupied if I can stay clean till then."  Trying not to argue with her much and using validating statements with some of her recent irrational arguments and comments over the Heroin while somehow finding a solution and finding an appropriate inpatient facility that will address the addiction and the BPD issues.  Very few facilities (even straight rehabs that will take an adolescent let alone anything to assist effectively dealing with BPD here in New England).

Certainly open to any suggestions on what we should do next or facilities in New England that might be helpful.

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

[crumblingdad]

Quick update from today on DD16:

We attended court today for arraignment on her DWI charges.  Prosecutor was tremendous and spoke with us prior to arraignment.  He asked if we'd had substance abuse issues with her and if this was an event that was escalation of her troubles or a one time incident.  We were honest and said it's an escalation and she has serious substance abuse issues that are escalating as well.  He had a long talk with DD and explained he hates to see a DWI on her record at 16 and how serious it is but the only one that can help is her, not her parents, him, or any law enforcement.  He asked if she wanted to get some help and the whole process terrified her with the courts and she began crying hysterically about her future hopes to join the peace corps or any other career she might choose and how this would ruin everything. 

She agreed she wanted help and we told him we were hoping she'd get inpatient treatment at McLean and were working on that.  He recommended to her that she plead not-guilty and if she takes steps between now and trial date of Oct 29th that when she comes back end of October he'd lower charges to a reckless driving and drop the driving without a valid license charge completely.  So now waiting on an open bed to get her some help as she's agreed and praying no set backs between now and beginning of next week while we wait.

[pessim-optimist]

 

Welcome to the Parents' board, crumblingdad!

I am glad you found us. And it is wonderful to hear about this change in events. Your story sounds scary. I can see how you chose your name. It looks like there might be a bit of light at the end of a tunel for your dd. I am glad that in this case the system seems to have helped so far... .

It seems to have bought you some time to do more research on possible placements for your dd in the future if it is needed. She is 16, and I am not sure about all the rules, but I think that there are some facilities that take in teens even if it isn't voluntary (I am not sure). Hopefully some veteran parents in these situations will give their advice/experience.

I read your story, and I have to say that I do not have experience with situations such as yours, but I wanted to welcome you here, and tell you that there are people here with children in similar trouble (you probably already know that, since you say, you have been lurking, right?

Hang in there, crumblingdad, and stay in touch!   

[vivekananda]

Hi crumbling dad   welcome to our parents board 

I was pleased to hear your update which sounds positive. There are a number of parents currently discussing residential care, in a variety of forms. Here is a link to the successful treatment of a young woman now 16, she was 14 at the time. You may find this experience helpful to read about:

A Case Study of Residential Treatment

I expect what would be helpful would be a dual diagnosis program. I do hope your dd can take advantage of this opportunity.

Let us know how it goes, ok? And if we can help in any other ways... .

Vivek  

[Phoenix.Rising]

crumblingdad,

I'm glad to hear your daughter agreed to wanting help.  That sounds positive.  One step at a time.

[singlemom]

I see some positives in your situation, and since it can all seem overwhelming, I thought I'd point those out. 

First, it sounds like you and your ex are able to co-parent without undue animosity or blame, and that is terrific.  And since, if we are being honest, having a BPD child can be exhausting, it's actually nice that you can get some breaks from the intensity.

Second, the fact that she is concerned about herself and her future are good signs.  One of the biggest struggles that I have with my daughter is that while she came to the conclusion that she has BPD on her own, she is utterly opposed to therapy or help of any kind. 

And third, it does sound the the prosecutor doesn't want to nail her to the wall.  My experience with the court system here has been much less positive.

I'm new here too, so I don't have as much to offer in the way of advice as some of the old-timers might, but I do offer you my well wishes and a   or two.

[crumblingdad]

Good news is it took some work end of last week thru today with getting forms from her therapist to McLean and the admission process but they have said they have a bed and will accept DD16 tomorrow.  It's their 14 day inpatient dual diagnosis acute treatment program for adolescents (14 day ATR they call it).

To the best of our knowledge we don't "think" she has done anymore heroin since a week ago Sunday but hardly confident in that - she snuck out of her mom's in middle of night last night and we don't know where she went but she returned voluntarily this morning.  She's decided she MUST attend her first day of school tomorrow and is willing to go to McLean for the 14 day inpatient program but ONLY after she goes to her first day of school.  McLean is requiring a tox screen and psych eval at an E.R. before we take her since they don't have detox and they want to be sure she's not going to end up with physical withdrawals if she has been actively using. 

Being a voluntary program she must be willing to go and trying to talk her into this somewhat irrational need to attend first day of school would be futile. Her mom and I spoke and I'm traveling till Thursday so mom's idea was she's going to negotiate going to school for half day and dismissing her and heading to an ER then taking her to McLean and seeing if DD16 will agree to the compromise of getting in part of her "first day of school."  We think she primarily wants to see some teachers she likes from last year and being part of that so she's not coming in 2 weeks without having seen anyone or met any new teachers or students (she attends an alternative program school) so hoping that compromise gets her on her way voluntarily before the open bed isn't available any longer.

We shall now see how she reacts to this as well as hopefully see a clean tox screen tomorrow (although I'm worried she may have used again if she snuck out most of last night and who knows if mom can keep her home throughout this evening and overnight without her running off again).

Thanks again to all for some of the ideas and support. 

[vivekananda]

I got my fingers and legs crossed for you! a dual diagnosis at McLean sounds wonderful.

I'm waiting to hear how it went... .

Vivek    

[pessim-optimist]

I got my fingers and legs crossed for you! a dual diagnosis at McLean sounds wonderful.

I'm waiting to hear how it went... .

Me too!   

[qcarolr]

Will be keeping you  and your D in my prayers that she will be getting this admission while she is still feeling in need of help. Our BPD kids can change their moods so quickly sometimes. I hope the tox screens come out negative so there are no additional delays.

qcr  

[ConflictedxAMillion]

I am so thinking and hoping for you.  The progress sounds positive and I hope that you and your family are able to seize the opportunity with McLean now. 

I remember what it was like for our ddBPD(now 21) at 16.  If only we had known, heard of, even suspected BPD, things may have been a little different.

We too are from New England (VERMONT) and basically there is no specific support related to BPD here.  Vermont is still in the dark ages and the basic definition of stigma.

I ended up taking my daughter to McLean for diagnosis about 6 months ago.  My daughter also became involved with heroin to the point where she was addicted.  My daughter will practically do any drug she can get her hands on.  She has been unable to hold a job. 

Now at 21 though, it seems so much harder to try to persuade her, get her help because she will not advocate for herself and doesn't really think she's BPD (even though she meets all nine criteria).  I worry every day if she will have a roof over her head and food in her belly.

I think if we were back at 16, her stepdad and I would have a little more influence to help get her the counseling, the support, agreement to a residential facility.  I'm hoping for you and your family it works out for you and that your daughter can gather the courage and strength and determination to make her life better for herself as well as her parents.

Good luck and keep us posted.  I would love to hear about how the 14 days works out at McLean.

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

[qcarolr]

Conflicted -- my DD27 was not dx BPD until family court ordered psych and neurophych evals as part of a custody case when she was 23. She heard this dx as a way to justify her blaming me for causing all her probelms.

As I have learned so many skills here to make changes in myself, things are slowly getting better for her. She too self-medicates with street drugs, though not heroin as she is fearful of needles. She may have a dependency on meth right now, though not a daily user during days she is at our house. She has survived being homeless, and this is her current peer group. Kind of toxic, yet better for her than the extreme lonliness without any peers.

lbj, currently a moderator, gave me strength several years ago with this quote that I keep by my home desk:

It is not within your power to orchestrate the outcome... .

You can only try to create opportunities... .

This is about Radical Acceptance that can be gained with daily practice of mindfulness activities (mine is meditative prayer and breathing breathing all day long).

So keep putting those opportunites in front of your kids - keep the line in the water and they will not drown. Learn as much as you can about gaining courage and strength for yourself (self-care and knowing your values), values-based boundaries (protecting those values), and validation (growing healthier communication with your pwBPD. The other integral part is building a support network - we cannot do this alone. Both here and in our community. Search this out. This has been a struggle for me - took lots of courage to reach out and ask for help that builds me up (instead of capturing me in my rescuer/victim roles).

This has gotten really long. There is always hope. Our kids need our love most of all - without any strings attached -no matter what they do to themselves or others in their overwhemed emotional states.

qcr  

[Phoenix.Rising]

crumblingdad,

I see you have some good support here.  I echo what has been said about you having the ability to 'create an opportunity' for her with McLean.  Whether your daughter realizes it or not, some seeds will be planted while she is there.  That can only be a positive, in my opinion.  Someone also mentioned radical acceptance, and I think that is great advice.  If you haven't already, it couldn't hurt to get some advice from senior members on the Staying Board as well.  Hang in there!

Workshop on Radical Acceptance:

Radical Acceptance for family members

[vivekananda]

lbj's advice to me was "do you want to be right or do you want to be happy?" ouch   that hit home to me! But it took a long time to get through   I put it here again apropos of nothing but just to remind myself 

Vivek    

[crumblingdad]

Oops I updated what was happening over in my intros rather then here by mistake.

Last week our dd16 did go to ER for tox screen and eval and got a bed and approval for mclean.

Unfortunately in the 5 hours it took to get all that done she changed her mind and refused to be admitted.

Been a rough time since - she mostly has refused school and the two days she went she left early or skipped half the day.  She's been using heroin off and on the last week. 

Today we finally had enough and at the urging of her school counselor and nurse who feel she's suicidal they convinced us to do an involuntary commitment and that's in process to a private hospital she was in for a suicide attempt 2 years ago.  I don't believe this will be very helpful but should give us a week or two reprieve and keep her alive for a few weeks.  We are also hoping maybe she will agree to mclean again and can perhaps get her a transfer into their dual diagnosis program once she stabilizes in a few days.

[vivekananda]

crumblingdad,

I am so sorry. For you, your dd and for her mom. It is so sad and you must be so hurt.

You are in my prayers,

Vivek      

[Phoenix.Rising]

Hi Crumblingdad,

That sounds really rough.  At least she will be in a safe place, and that is important.  Your family will be in my prayers as well.  One foot in front of the other, one day at a time.

[Rapt Reader]

We are also hoping maybe she will agree to mclean again and can perhaps get her a transfer into their dual diagnosis program once she stabilizes in a few days.

Yes, yes, yes, yes, yes... . I will ask the Universe to help you! This would be a great outcome. Please see if there is a way to make this happen.

My son was also a heroin addict; 2 regular rehabs didn't work, and in February of this year he had suicidal ideations, and ended up in the Psych Ward of our local hospital. His Out Patient Therapist and I worked it out with the Psychiatrist at the hospital: He would not be released from the hospital's Psych Ward unless he agreed to admit himself into the Dual Diagnosis Program that he went to, and he is today 6 months clean and sober and doing great!

And, he is 36 years old, and has diagnosed (by the DD Program!) BPD. You can get this done. Godspeed   

[qcarolr]

crumblingdad - keeping you all in my thoughts a prayers. qcr  

[MammaMia]

crumblingdad

Welcome to the family!

I am sorry.  Sounds like you have had quite a week!  The one thing you can rely on with pwBPD is that they are unreliable... . their decisions change almost as quickly as their moods. 

I am glad to hear you were able to get your dd hospitalized, despite her resistance.  She is where she needs to be.  You did the right thing. 

Please keep us posted.  We understand your dilemma more than you could ever know, and we want to help.  In the meantime, we will be praying for you and yours.   Stay strong.

[crumblingdad]

Thanks all for your support.  Met with the social worker at the hospital today and our DD16 made it clear to the psychologist there that she is only there because we were going to force her into it anyway so she agreed to stay.  She has expressed that yes she's doing heroin and intends to continue doing so but she's fine doing what she's doing and doesn't need help and can handle it on her own.

Fingers are crossed - going to stay positive as it's only been 24 hours and perhaps she will stabilize and have some rational epiphany for the good (since they do come and go like the wind as we all know).  Was told she has about 5-7 days window before they'll discharge her although she thinks she will be discharged by Monday based on the "deal" she made to go there with her mom which wasn't quite what was stated by mom.

Staff there are pretty concerned yet the psychiatrist and the psychologist "couldn't make our meeting today" and the only suggestion her social worker/case manager made is that we use her looming DWI court date as a boundary to tell her we'll recommend to the judge that the sentence involve a court ordered substance abuse program. 

Since that court date is end of October I looked at the social worker and asked if he was saying that her treatment and transition plan upon discharge should be merely a threat of a hypothetical court order that's 7 weeks post-discharge? Yeah throwing threats and ultimatums of something weeks away with pwBPD usually work tremendously and that should work well.     

Not impressed at fact he seemed to understand how dire the circumstances are but had only that to offer.

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

[Phoenix.Rising]

Again, I'm glad she is in a safe place.   Today is what matters most.  In other words, we don't know what the future will bring, nor do we really have much control over it. 

I do hope you are able to talk with the psychiatrist/psychologist soon.  I'm sorry you didn't get a chance to converse with him/her.  I would think they might have a better plan of action than the social worker.

[vivekananda]

Since that court date is end of October I looked at the social worker and asked if he was saying that her treatment and transition plan upon discharge should be merely a threat of a hypothetical court order that's 7 weeks post-discharge? Yeah throwing threats and ultimatums of something weeks away with pwBPD usually work tremendously and that should work well.     

You would be enormously frustrated c-dad. I am reassured however that you 1) have the language that shows you understand the system and 2) that you understand who BPD works. so within it all you have a good balanced handle on how to manage everything. That can only be good for your dd.

Doesn't stop the pain though, eh?

Cheers,

Vivek       

[qcarolr]

crumblingdad - this is so frustrating. That the system, limited by overload of cases and limits to resources and the 'due process' built into the system, does not get that our BPDkids need to get put into supportive care immediately. I am in a similar place with my D27 and her DWAI. In her case the does not comply with the court ordered alcohol/drug classes, treatments, drug/alcohol monitoring anyway. She ends up with violations of probation, back in court, short jail as sanction then back on probation. Hoping for her to get into a dual-dx program this time so the mental health piece gets treatment. Then it is up to DD to participate.

Keep working for the mental health piece to be addressed. THe courts have limits to what they can offer, and there is always a longer delay. Maybe you can focus your efforts on getting her into a dual-dx program to meet the drug use head on with mental health support. That seems to be a key with others here.

qcr  

[crumblingdad]

We have been trying desperately to get her into Dual dx but most programs are voluntary and/or $7000-10000 a month which is just not feasible.

The success we've had has been now twice getting approval for a bed at McLean and both times she's refused to go which makes her ineligible.

The hospital we put her in had no real transition or discharge plan and essentially discharged her a few days ago back home with an appt with her therapist and psych and said they'd get her into a family outreach counseling with the state Child and Family Services who is coming today (and we've done this before with no success).  So she was essentially discharged home with a discharge plan to do what she was doing before we put her in there.

Our protests that this wasn't sufficient fell upon deaf ears - they were disorganized and completely muffed an opportunity to get her into McLeans dual dx program.  They originally got her a bed at McLean again and she agreed to go but hospital called her mom and said she could leave to go there and to come get her but hadn't gotten insurance approval.  When mom arrived that morning they said "oh wait it won't be till this afternoon we didn't get insurance approval yet."  This triggered our DD16 who believed she was leaving right then and wanted to leave then and changed her mind yet again on McLean and said no way not going if I have to stay here till this afternoon.


She's home again with her mom, refusing to come to my house now and snuck out again already last night although we've located her and got her back home.  No signs she's used heroin again quite yet but she's already said she's "fine" and will probably use again and therapist called us saying she's very concerned.

[bpdteensmom]

crumblingdad

Glad to see your story (not glad you have such a harrowing one however!). It sounds like you are on the 'right' path for your daughter.  My dh read about a program at McLean for Teen GIRLS with BPD... is this the same program you are trying to get her in?  If so, it seems like it would be the best benefit to her... If I remember correctly though, it was also private pay as it was considered experimental? I'm not sure of all the details... .maybe you already know about it, but if not, you should definitely look into it.  I can see if I can find more info if you'd like. Hard to have something that is potentially so helpful right there in your backyard and not be able to access it...

I'm glad you posted the info about the CHINS... we've had much talk about this item lately.  Our family therapist says that she has had a few clients on them, and in the end, the kids ended up dropping out of school.  Not the ideal outcome at all... and I don't believe those were even necessarily pwBPD. It can be so frustrating trying to navigate the system and find some outside help.  Also, I'm told the law changed a bit and the police can no longer file a CHINS... and the school can only file if they are under 16... so it's right back on the parents.

I'm hoping your daughters outcome is a positive one and that you remember to take some time for yourself...

[crumblingdad]

BPDteensmom,

Their are two adolescent programs for BPD at McLean.  The first one is a 14 day acute dual diagnosis program (ART) and this does accept insurances and requires the necessary referrals etc.  It is a voluntary program though so requires the kid be invested as it is not a secure facility so they can walk if they choose.

The second, also voluntary, is a minimum 28 day adolescent BPD program which is a "self-pay only" program (and very expensive - I believe somewhere around $50K for the 28 days) designed for BPD and focuses a lot on DBT therapy.  Great program for those families that can afford it - again though, requires the child to be interested and willing to go.

Chins programs vary from state to state as to what they allow and what they don't and how to get a kid into it.  We live in NH and program was stripped two years ago, much funding was restored this last year but not all.  We were able to petition under the auspices at that time that our child was a danger to herself and it was right after the funding got stripped (most everyone was amazed we got the approval since it was the first parental petition approved after the cuts and they were only allowing funding for 80 kids in the entire state).  I wouldn't say it was useless as it did provide some much needed stabilization at the time but their were a lot of negatives to it and I don't know if we were to do it over again that we would go that route. This year they've restored some funding but in speaking with her former JPPO who has since been promoted he really feels they exhausted what resources they did on her to no avail and can't see how the program would benefit her.  NH has some weird legal issues too, any criminal activity once 17 is almost automatically tried as an adult so they try to discharge kids from chins once they are 17 yet parental responsibility doesn't label them as an adult until 18 which truly mucks up the waters.  Since our DD16 will be 17 in just 2-1/2 months we are riding into that grey area where her next mis-steps will become adult charges.

[bpdteensmom]

crumblingdad

This must be so frustrating when you are doing everything and then some in your power to help your daughter only to run up against the systems brick wall. 

Thanks for clarifying the McLean programs... 50k for 28 days and your kid can walk out after 2 days.  Boy oh boy I don't know if I'd be able to put much faith in that.  Maybe someday though, it will be covered and some other kids will be able to benefit from it.  Is the ART program a female only program too?  We are in MA and it sounds like the CHINS laws are a little different, but they also seem a little counter productive from what we've read and been told. Working in Human Services I know that NH was always behind the times when it came to services for people with Developmental Disabilities (MR) but I'm not sure how they are with MH services.  Of course being on this side of things is always different!

Hang in there... Hopefully she will see the light.

[Phoenix.Rising]

  crumblingdad,

Thank you for the updates.  As fast as our loved one's moods can change, I wouldn't give up on the McLean option.  You mentioned she has a counselor.  I was thinking if your daughter found a local therapist that she felt somewhat comfortable with (one that is versed in BPD and recovery methodologies like DBT) that might eventually find some success.

Also, there are some great books written by women with BPD who are in recovery.  I read one called "Get Me Out of Here: My Recovery from Borderline Personality Disorder" by Rachel Reiland that was very good.  Another book I've heard can be helpful is "The Buddha and the Borderline: My Recovery from Borderline Personality Disorder through Dialectical Behavior Therapy" by Kiera Van Gelder.  I believe the second book was written by a younger woman.  Maybe if your daughter could start one of these books and find that she identifies it could possible encourage her to get better?  I have a feeling the second book could possibly catch her attention because the author struggled with drug addiction as well.

And like another poster mentioned, make sure to take time for yourself in all of this.

Phoenix.Rising

[LynnieRe]

I am finding out that BPD is just makes parenting incredibly difficult. 

All I get in feedback is that "its the age" and she'll grow out of it. 

I think you do what you can, provide support that you can, but if the situation is not safe for her or YOU and other family members, then you have to provide a safe place for her to go.  However, like it was quoted, you provide the opportunity. 

The result is up to you. 

My BPDd is 16, and we are working with family/friends to provide a place for her to be on weekends etc.  As it as become obvious that we are not safe together for the time being.  Her father has signed off on her, and I have other stressors I'm dealing with, and with no support for myself I am "crumbling"  She has been hospitalized before for suicide attempts, she is currently not suicidal or self harming, but she has created an atmosphere in this house of such anger and distrust, then I am medicated for anxiety and I am not able to function.  So that is the situation we have come up with.  She will live with others during the weekends, with me on schooldays.