Counseling/Therapy appt's missed...

[pblsn2]

Newbie here - tried to find relevant discussion thread w/o starting a new one but not able to.

Any pointers on getting your child to make their appts?  Our newly diagnosed daughter has already missed two this week - "Just didn't want to" was the reason as well as ":)on't see it helping."  My response was basically it's the only thing that's going to help.  The cost is one issue but what are good motivators?  Thanks, 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

[lbjnltx]

Hello pblsn2,

Do you and your daughter go to therapy together?  My d and I did.  If she would refuse to go sometimes, I would go by myself and use the time to learn and get feedback from the therapist (t).

Sometimes to encourage her to go I would plan an outing to the mall together.  I did not say "If you go to therapy I will take you to the mall.  It was more like "I thought after therapy we could go to the mall since we will be nearby" (we had to travel an hour to get to therapy and the nearest mall).  This will work if you are her source of transportation or if you attend together.

If she goes alone is her attending therapy attached to any rewards?  Some may think of this as bribery... .others will see it as positive reinforcement.

Have you tried anything similar to this?

lbjnltx

[Rapt Reader]

Hi, pblsn2 & 

I agree with lbjnltx... .Is there any way to attach some sort of reward or positive reinforcement to making her appointments? She still lives with you, right? I know she is 18, but actually my own adult son (36) used to balk at his appointments, and at times I have had to be pretty creative to just get him roused from bed in order to even leave the house for the appointments. I admit that it got easier once his car was totaled, and he had to rely on me to get him to his appointments. I basically don't take "No" for an answer (but, at this time he's in recovery and doesn't balk anymore).

I used to offer him his favorite cup of hot tea, or latte, when reminding him that he needed to get moving for the appointment. Not, "You need to wake up" but "What would you like this morning, tea or latte?" And, like lbjnltx, I'd casually mention "After the appointment I need to head on over to the mall; maybe you'd like to browse the Best Buy... ." or something else enticing to him. Maybe food, instead, like "I'd like to check out that new diner down the road from the Therapist, after the appointment... ."

It's tough when our child needs help, but isn't motivated or interested enough to actually get it. As parents, it seems we need to be pretty optimistic, radically accepting, and creative to keep them going sometimes... .Here are some links that could help:

Helping a loved one with BPD seek treatment

What can a parent do? (for parents of pwBPD)

Radical Acceptance for family members

If you've been reading about Communication using validation, maybe using the TOOLS: S.E.T. - Support, Empathy and Truth technique can help when talking to her about the need to go to her appointments. A sample of something I've used:

"I know you don't feel like getting up and going to see the Therapist today; it's a chilly grey day, and I can totally understand how much more inviting it is to stay curled up in a warm bed. To be honest with you, I didn't feel like getting out of bed today, myself! However, the appointment is in an hour, and I can make you either a cup of blackberry tea, or some mocha latte... .which would you like today? It'd be great to get moving now so there's time for you to drink it... ."

Just an idea; you know your daughter better than anyone, but maybe reading through the links I've posted above will give you some ideas that are better for you? Good luck!

[pblsn2]

thanks for the ideas and material.  she does live with us and drives herself (or would) but maybe that privilege needs to be pulled.  i guess the irony we all face w/ this disorder is the 'self destructive' nature of it removing the desire to get better and the abandonment issue if they do.  i'm still very early in the learning and understanding of this.

[pessim-optimist]

thanks for the ideas and material.  she does live with us and drives herself (or would) but maybe that privilege needs to be pulled.

Hello pblsn2,

You have gotten some very good advice here. I just want to add one small, but important detail about positive reinforcement and privileges.

To a person with BPD, any negative consequence is likely to feel as punishment, which they do not react well to. So, if we remove a privilege, or try to apply positive reinforcement, it is really helpful if we can present it in a positive light - as a motivator.

Example of negative versus positive (same end result, very different environment):

'If you don't go to your appointments, we will take the car away' - sets up a power-struggle, and feels like punishment

':)riving a car requires a high level of responsibility. You can show us that you are responsible by keeping your appointments. As long as you can do that, we will trust you are responsible, and you will keep your privilege to drive the car.' (Puts it in a positive light, and if she doesn't go, and you do need to take the car away - she has an opportunity to earn her privilege again, if she improves her behavior = goes to appointments)

Does that make sense?