As usual, I'm the last to know...

[spudsnsalsa]

Thought I'd try to document our journey here as a way to offer light to one who may be behind us on the journey since all I've been reading here the past week has been soo helpful to me!

I came to this site because we were in crisis with BPDD16. In patient for the 5th time in 3.5years and the 2nd time in 30 days. She is definitely ramping up her threats AND follow through on using suicide to control us and her friends with the last attempt landing her in the ICU for 2 days. We are so spun out trying to find "the right" psychiatrists, therapists, counselors, and therapeutic schools and finding that none of them really had a grasp on her actual diagnosis or if they did they were in the whole "she's not 18" so let's not mention anything to the family for fear of labeling her schools of thought. Her current psychiatrist, of only the past month, has done more for us than all the other 5 put together in the previous 3.5 especially as he directly told me to educated my self on BPD and "do it NOW"!

Since she is an adopted child who was 3yo at the time of adoption, we always worked on the anxiety component because she clearly did have Anxious Attachment! But unbeknownst to us, the YEARS of handling the attachment issues poorly have been contributory to her BPD. Our school district has always been proactive and she has been on an IEP for 3 years which allowed for us to try the therapeutic day school route when her repeated suicide hospitalizations caused them worry. Unfortunately NO ONE at the therapeutic day schools ever once said anything about or suggested I read up on BPD and they all tunnel visioned on the depression meaning a whole school year now wasted since they naturally did NOTHING effective and besides the limited success in schooling [therapy came first so she spent more time in 'therapy' than in class because of her anxiety/depression] and the ZERO success in 'therapy' we tragically had to have the closest call with losing her to suicide to FINALLY meet a psychiatrist who clearly saw the big picture.

When the first therapeutic school placement failed I asked the school district about residential schooling. They seemed somewhat supportive but as at that time we were still focused on the adoption trauma/attachment as the driver behind the issues the only one they "approved" was, upon touring, not something we felt at all comfortable with and we [mostly me] went back to a position that residential needs to be the decision of LAST RESORT. Fast forward to this week and I am faced with a psychiatrist confronting me on just how much more LAST RESORT is 2 days in ICU? Then an IEP revision meeting of less than 20 minutes in length when all the team members lean in and express relief that I have finally asked for residential as they have been concerned for her safety and unanimously voted that it was what they ALL felt was the best place for her to get therapy and education for a while now. So, here I sit waiting for the list of schools I submitted to be checked against the State Approved list and then a check of which of those have impending openings. Relieved that the expense of the school is now not a concern but stressing over how to afford traveling to the far flung locations to tour... . and then the expense of traveling there for visits/family weekends and such!

Have talked with her current DBT therapist [of only 1 months duration] to see if she will take me on in my daughter's place as my PTSD and grief regarding this process have taken their toll. We start tomorrow 

As soon as I have the list of "State Approved" residential programs I will post as it may be a comfort for others looking around Dr. Google to see which ones have been pre-cleared in some way by 'the powers that be'. Also hope to continue posting the progress through touring, how we decide which program to choose, and her progression. First field of landmines to navigate will be selecting without her getting too involved in the process! Currently she too is not only in favor of residential but is BEGGING for it but given what we all know with BPD she will soon start the splitting and sabotaging to either try and get the program she sees as the 'best' [already campaigning for Timberline Knolls because that is where the Disney stars went?] or to change her mind and fight going [hasn't dawned on her that we have tickets for 1D at the end of August that will be missed if she is in residential but as soon as she remembers that the game playing will begin in earnest I'm sure!] Plan to lean HEAVILY on the phrases "they don't have any openings" or "they weren't on the approved list" during the next month or two... . or however long it takes to get an opening in one we are comfortable can be a success!

Thank you to all who have posted on here before as you have brought me a large measure of peace over this decision. Hope to pay it forward myself!

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

[jellibeans]

Dear spudsnsalsa

Please keep us posted and I would like to see the list when you get it. Not sure where you are located but hope one of the places is with driving range. This is a tough time and really you are doing well to get through it. I am glad you are going to see a T so you can recover and heal from this ordeal. I am feeling optimistic going forward and hope your dd is open to change. Hang in there... . things will get better. Try to put that into perspective. One day you will look back on this time and it will be a faint memory... . your dd will be on her own and doing well... . you won't feel the deep hurt and pain you feel now and either will your dd... . she has a long life ahead of her and this is just a bump in the road.

[spudsnsalsa]

Latest on our journey is that local school district checked the list of programs we submitted that featured DBT in their therapeutic modality for consideration against the list of programs approved by our state and found only Falcon Ridge was 'approved'. Seeing as how we are located in Illinois where Timberline Knolls is located I am quite surprised to find it is NOT approved by the state for a residential placement of a high school student? So, asked for her files to be sent to Falcon Ridge for consideration and also asked if there was a 'comprehensive' list of approved programs so I could check to see if there were any on the list that did feature DBT that I had not been aware of when compiling the original list?

Have talked with the administration contact with the group that run Falcon Ridge and they are suggesting Red Rock Canyon as an option as well. As much as she assured me that the boys and girls NEVER mix at any time, I am not feeling that suggestion especially given the size of the program and some personal considerations given past experiences with other therapeutic day school populations and how being in group with them adversely affected my daughter.

So, unless we win the lottery or there turns up to be other viable options on the state approved list... . it is looking like we are not actually going to have much choice in the matter

[jellibeans]

Dear spudsnsalsa

I do think falcon ridge is a good place and there a lot of people on this site that have sent their kids their with good results. I am not sure I understand but did the admin at Falcon not think it was a good place for your dd? I have talked to the people there and I have found them very helpful. I would see this as a real positive even though it is some distance away. Will insurance be covering the whole cost or is school district covering only school part. This place is not cheap and if you are getting it paid for I would be very happy. When will all this take place? You have to fly into Vegas and then drive... . maybe you could take a couple of days for yourself and stay an extra day to relax. take care

[spudsnsalsa]

They want to review everything in the files from the school and mental health team before they say for sure but they were thinking Red Rock Canyon program might be a better fit for the following reasons... .

1] Her latest suicide attempt landed her in ICU and it gives them pause given their rural location and distance from nearest ER. Would be more comfortable to have her nearer an ER which of course gives me pause wondering if their staffing is as they advertise how she would be able to attempt another time and in a way that may lead to needing an ER? I mean the whole REASON the school and mental health team suggested residential is to have a 'safer' environment?

2] Since BPD is the driving diagnosis with the adoption trauma/anxious attachment underlying, they felt their 'best' DBT therapist & program is at the Red Rock Canyon location.

My concerns include the difference in size of the two location populations and the inclusion of boys in the RRC location... . even though they 'claim' that at NO TIME do the boys and girls EVER mix... . her most recent suicide attempt was driven by boys in her therapeutic day schools who verbally and cyber bullied her [told her she was too ugly and full of drama and save their eyes and ears the pain of being in class with her by just going ahead and committing suicide please!]  and the fact that MOST of the boys in treatment are externalizers with major behaviors that drive her anxiety.

Then the petty complaint... . finding it hard to understand how sending a child who has ZERO skills or history of a successful peer interaction into a living situation with 3 girls to a bedroom when she is coming from her own plush room seems to be placing a hurdle in her path before she even learns any skills to handle being in such close quarters? Sigh, knew this would be hard... . just didn't realize I'd be left with such few options and hate feeling like I am being railroaded :'(

The school district approved the placement in her IEP so they will be paying.

[jellibeans]

I just wanted to caution you about assuming the school will pay the whole amount. It is my undersatnding that the school pays for the school part and not the medical and therapy part. I am not sure they will pay for the room and board either. I am not sure if you have confirmed this or not but because the cost is very expensive I just wanted to bring this up.

As far as going the the Red Rock location I think it is time you put your trust in the system and give up control. Do not concern yourself with your dd abilities to share a room etc... . they have a lot of experience and let them be the ones responsible for making your dd comfortable in her new surroundings. Try to get your anxiety in check and embrace the help you are receiving. forget about the worry and the what if's... . the sooner your dd gets the help she needs the better.

I know it is hard and I am sure you are stressed that is to be expected but don't talk yourself out of it because of your fear of the unknown. Hang in there... . this is a good step forward.

[spudsnsalsa]

The reason it has to be 'approved' by our state is because the school district has approved it in her IEP and ARE covering the costs. They will be covering everything except medications and pdoc.

After another conversation with the C.A.R.E. representative ... . and another night with ':)r. Google'... . I am relieved to have found another few options with ISBE approval so less sense of being 'rail-roaded' BUT the number of lawsuits and reading the minutes from Virgin, Utah city council meeting... . and learning they are trying to expand Falcon Ridge by double AND add boys in at least a day student component... . gives me great PAUSE as to whether the C.A.R.E. schools are a good fit. Need to tour and get an IRL vibe to compare with the on-line presence. Also learned that DBT is no longer a featured therapy at Falcon Ridge... . and is only one of the options offered at Red Rock Canyon... . and since that is one of the stated goals of the IEP it may complicate things?

Anyone out there with comments or experiences they would care to share here or in a PM about Heartland Behavioral Health Services in Nevada, Missouri?

[spudsnsalsa]

Sorry for having gone silent for so long after promising to keep everyone updated :'(

In the end we felt that since the adoption trauma was the driving source to her BPD we would  go with a RTC that addressed the RAD/Anxious Attachment primarily. While this RTC does not specifically use DBT they do incorporate quite a few of the components but it became my opinion, after talking with LOADS of facilities and her therapeutic team here, that no amount of talk therapy of any kind was going to be effective until the underlying attachment issues were stabilized! So, we did not choose Falcon Ridge and this RTC for now with DBT as the transition/follow up is our working plan.

She entered the RTC the first of August and it has been a very HARD thing for all parties! I have anxiety that I am working through over the sense that I am adding yet another huge traumatic experience to her load and should this place NOT be all that their PR and referrals report that I maybe left with a permanently damaged soul! This coupled with the fact that the vast majority of the girls are HUGE externalizers with their BPD behaviors and the near constant state of turmoil that my daughter reports [it is a given she'll exaggerate] but a lot of which is confirmed to us by her personal therapist has driven her to a very, very dark place with her urges of self-harm and suicide. Her therapist seems competent compared to many we have had in the past... .I just feel that the 'formula' employed by the facility is so very targeted to the fighter/drug abuser profile. Her therapist begs to differ and proffers that the fighting/drug abuse behaviors are driven by the same emotions as my daughter's isolating/self-harming and will respond eventually to the same therapeutic programs and trots out the old "it often gets worse before it gets better" line. I remind him that we have already had an ICU experience and that worse to me means death so don't even go there as the VERY REASON we chose RTC was for her safety and to end the suicide attempts! Soo, here's where we are at currently... .since my daughter is still showing the other pathological behaviors including poor peer interactions, insists on hiding behind her perpetual victimhood, and refuses to "trust" any of the different therapy departments [this has canine therapy, adventure therapy, group therapy, and individual therapy] we are giving this placement some time to demonstrate how their therapeutic template can work for DD.

We are allowed to visit whenever we wish with a weeks notice given to the RTC of our intent. Where the visit occurs is dependent on her therapist's evaluation of where she is emotionally. The past two visits have been "on campus" and with how well the first one went the second one [while also 'on campus'] included a couple of hours unsupervised with DH, DD, and myself sitting out by the lake under their gazebo Skyping with friends and family she hadn't seen for the past month. We head there again tomorrow and if when we arrive she is still the same as this mornings evaluation by her therapist then we are trying our first off campus with plans for pedicures and dinner. No fears of her harming or being suicidal as it will be all about her... .and hopefully we are establishing a sense of how if she would dig in and work that she could be spending quiet evenings with us rather than in a home with 7 other raging teens! Not saying that of course , but hoping it becomes obvious But one of the things I have wrapped my head and heart around... .it is not going to be the 8-9 month optimistic quote given as seeing how stubbornly she clings to wanting to be the one in control and not 'trusting' her therapists I now know we are looking more like 14 months... .maybe even longer, sigh.

Now, off to bed as I have an 8 hour drive ahead of me! I will try to continue updating... .but now I see why others drop off as this is not the stress free break one assumes will come once the source of the stress is away 24/7!