12months DBT, what next?

[wendydarling]

Hi 

My 28DD’s 12 months DBT comes to an end next week, she has been very fortunate to attend weekly group and therapy provided by UK NHS at no cost to us.  The treatment and care provided by the local mental health centre has been excellent, she sat on a waiting list for a year in the last few months of that they took the initiative to provide a weekly skills group to bridge and support those who had been on the waiting list for some time falling through crisis to crisis. Sadly these services are few and far in between for those who suffer mental illness in the UK. People go private if they can afford, like many others I’d happily pay more tax to ensure those in need have access to the care and services they desperately need. END.

DD’s on going support provided from next week is
- 6 telephone calls over the next 12 months to her therapist if in crisis;
- access to the 24/7 crisis team. DD eventually built up a trusting relationship with the CT, they were helpful when she was in crisis while waiting on the list at that point. They visited her at home and set up 3 meetings at the centre the same week, they listened and suggested ways to cope which at the time were hard for her to grasp as she’d not started DBT. She reached out to them on a number of occasions, with them she formed a crisis management plan;
- access to local Women's Crisis Home? Yet to be established if DD can directly self refer if she is in crisis, and that is dependent a bed is avaialable. DD was last hospitalised Feb 2016, she refused to be discharged on a Sunday  – ‘you’ll have to forcibly remove me’, the consultant escalated to the Head of Mental Health in our borough and Monday afternoon she was admitted to the local Women’s Crisis Home, where she stayed for a month and did well! DD stayed there again for a month in Nov 16, her therapist saw she was towards crisis and suggested, fortunately they had one of 12 rooms available.

When DD came home she shared she’d decided to stop work to focus on DBT, work was fuelling her anxiety, all too much to handle. DD lives at home, I supported her decision, health comes first.

A further meds change in January 17 seems to have helped DD’s deep depression, every day is a challenge DD’s anxiety remains high. It took DD 5 months to claim disability (60 pages of questions and evidence) with help of friends and me when she reached out for help. Her disability claim was validated by her therapist – the agency called her therapist for verification.  The disability award covers DD’s phone, travel to therapy, cat insurance and care, contact lenses, dental  etc, the bare minimum as DD lives at home.

I know DD has accomplished more than: 18months since last hospitalisation, 12 months since cutting, 14 months sobriety, external markers.

Today DD's ED is chronic having deteriorated since last summer, while she’s made the great strides above.

I’m searching private DBT and seeking ED advice as that may be the priority at this time. At 18 DD had 12 months therapy for ED treated in isolation was not successful at that time.
 
The next week is a further milestone in the journey, moving forwards, feels like a new dawn, more change, is good.

I’ve recently felt a bit stuck in my personal growth and learning, something feels good now, I can smell it in the air. I plan to stand back from some commitments late summer and give myself the space I need. I hope sharing where I'm a this point is helpful for you. Onwards I go, small and gentle steps, learning, growth and healing.

Many thanks to bpdfamily and all parents for your support, showing me the way.

Here I go, again, is good... .times like these

Hope and love, I'm here for you.

WDx 

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

[Lollypop]

Hi there WD

Thanks so much for the update. The NHS is fantastic in most areas, sadly not for mental health so it's wonderful to hear of your DD's care, support and treatment. Your daughter wouldn't be where she is without her determination and absolute refusal to be ignored. Also of course she's had you, effectively supporting her emotionally and financially and you've been her rock.

Her achievements are marvellous. Achievements bring confidence, the longer the period the stronger she becomes. Change is scary, particularly change in support and treatment. I wonder if she feels good to have the freedom or more that she doesn't feel quite ready? She's bound to be nervous.

You've mentioned critical ED. Is that depression? What kind of therapy did she have at 18? I got told last week that sometimes we deteriorate or lose momentum in one particular area while our attention and desires are focussed on something else. If there's a lot to do, it's not all worked on at once necessarily - there's building blocks to be laid and cemented in.

I can see that the end of DBT has been very much in your mind, perhaps holding your breath in a bit to see what happens. Remember to breath. You've both come so far and it's ok to rest, to reflect so you both can decide the next step.

Will her current therapist give an opinion as to whetherr or not they feel DBT should continue if possible on a private basis? 

I'm wondering about you WD. I'm thinking that you may need to take some of that advice you so brilliantly give to others. Are you taking good care of yourself? its not easy, life gets in the way. Time to replenish soon?

Hugs

LP

[Lollypop]

Hi WD

just logging back on and ED came to my mind immediately. DD's eating disorder - I guess it was always going to be the last thing to be conquered.  Has she ever been placed in a unit specifically for this? Or taken part in any ED group sessions?

LP

[wendydarling]

Thanks LP 

My understanding from DD, it’s like starting yet again, going back to all those many conversations that she went through with tons of people, explaining, re-explaining is exhausting. Yes, let’s see what they recommend on discharge, wonder if they’ll reassess her for BPD to give an onwards recommendation I’d have thought so. I’m lost on the eating disorder, I know they’ve latterly been working on this, DD is so thin, it was weekly one to one psychotherapy at 18 provided by a different hospital. Not been admitted though it's been on my mind if that's the direction she's going in

You’re right – building blocks, I’ve observed DD’s amazing progress in some areas, then others come to the fore eating disorder, disturbed sleep – not sleeping for days, picking her face and scalp - a replacement of cutting? Although still struggling I have seen a change recently, a bit more relaxed, engaged and happier in herself from time to time, socialising more. Summer always helps too.

DD is apprehensive, which is understandable when she considers the current treatment/people a great fit.  I googled DBT yesterday and the 3 certified practices I found 2 years ago came up. We have years ahead that’s for sure, slow and steady.

Yes, I’m looking forwards to dropping commitments in the autumn and having more time for me. Meanwhile I have 4 weeks leave to take. 

Breath as you say.

WDx