BPD Life Coach

[Kesata]

We are in that, "What to do when our BPDdaughter returns from treatment at a residential center?" phase. The center has been treating her ED and also her BPD. The problem is we live in a BPD treatment wasteland. In short, there is 1 DBT-light (they screen patients carefully, offer individual therapy and limited group options, zero phone support and there are only two therapists), and no one treating both BPD and ED. Those therapists who say they work with BPD, the majority use CBT and some use MBCT or they don't specifiy what treatment model they use. Our BPDdaughter, who will be 20 in January, is one who easily relapses without support. Her psychiatrist has indicated as there is inadequte support for her here, returning to her home town will be a disaster. The nearest full on DBT clinic is about 220 miles RT. We tried that for awhile, and although excellent support, they stopped seeing her because her ED became so acute. I don't know if resuming that will be enough for her.

The other evening I watched John Oliver's show about mental illness. There was a segment on Assertive Community Treatment. While it primarily benefits schizophrenics, I started thinking about what form community support for BPD would be most effective in helping them function semi independently in their local community. For my BPDdaughter, access to DBT full-on, and then someone familar with BPD and DBT who becomes her Life Coach. Checks in every day/weekly, helps the BPD set  goals, checks in again at the end of the day/week to see how the goal work is going, helps them navigate life skills within the community, is part of the treatment team, communicates to the team how the client is doing and handles some of the phone support for issues stemming from managing day to day issues, but maintains contact within agreed upon boundaries. The Life Coach's role ebbs and flows as the client progresses or relapses. Perhaps they meet frequently at first, less as the client progresses, frequently during times of crises.

But in the real world, or at least in my everyday world, BPD is not on anyone's radar screen. Maybe in urban areas, but if you live in rural areas with smaller towns, there is so little. I'm guessing BPD people move to the bigger cities and the treatment options there. I don't want my daughter to roam from one in-patient treatment program to another, but I'm getting the idea that may be the only way to keep her from jail, drugs, alcohol, sex trafficking, abortions, or suicide.

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

[ReclaimingMyLife]

Hey Kesata, you make great points about getting your daughter the support so critical to her ongoing success.  I was a job coach for several years working with women transitioning from welfare to work and did much of what you described.  Because all of the women were mothers, my job involved MUCH more than just dealing with "work."  Indeed, successful work involved childcare, transportation, mental and physical health, and daily life skills (budgeting, hygiene, planning), etc.  

Regarding your idea of a life coach, MUCH life coaching happens over the phone and/or computer.  There are even life coaches who are/were also therapists.  Possibly you could find someone - even if they are far away - who really knows what they are doing with BPD who could support your daughter as you imagine.  While in-person support would probably be ideal, good support from a distance is could be much better than no support or bad in-person support.  

I also found this online DBT support group a while back. I haven't heard anything about this one way or the other, but she is a young woman who has recovered so she might be particularly resonant with your daughter.  The group is affordable and accessible since it is online.  Might be worth a look:  www.emotionallysensitive.com/about/.  Just an idea. 

I applaud you for thinking outside the box.  In my job coach position, the woman started the company because she thought people with disabilities should be able to work (they were institutionalized at the time).  Her bosses said the residents weren't capable of working.  She decided to get them jobs anyway.  And she did.  That was prob 25 years ago and she started with just a couple of residents.  That same company now does supported employment for approx 400+.  Amazing what she was able to do with her vision.

Your vision for your daughter is equally bold, desperately needed and, I believe, very possible.  Who knows just where you might take this!

Speaking of job coaching, you might also look into what resources are available to her through Vocational Rehabilitation and any supported employment programs they contract with.  Here is an article on the benefits of supported employment:  www2.nami.org/template.cfm?template=/contentManagement/contentDisplay.cfm&contentID=8364

If you could email me your state and city, I could try to find out what resources (fingers crossed) might be nearby. 

Good luck!  You are fighting the good fight!

[lbjnltx]

In my own family's journey thinking outside the box was multi layered and good results from it came our way.  We were also in a very rural setting which had it's benefits and did cause obstacles for treatment.

There are recovered BPD's doing Life Coaching, like Tammy Green.  The key to the success of your plan is A. How invested the Life Coach will be.  B. If your d accepts the help and support and  C. Will the psychiatrist and/or personal therapist work with the Life Coach (and vice versa).

If your d's eating disorder is acute inpatient care may be needed for a time. 

You are doing a great job of being an advocate for your daughter.



lbj

[bpdmom1]

I've been worried about the same.  We live in the city, but still struggle to find resources.  I found out just the other day that my daughters RTC does provide phone support after she returns home. 

We worked with a consultant to place her in the RTC she is currently in.  They might also be able to help find support for your daughter when she returns home.  www.strugglingteens.com/ec/