new to site--to take dd to inpatient or IOP or residential

[butterflyjjgirl]

Hello everybody,

I'm new to the site and am thankful to have found it. I'll try to keep the history and question as brief as possible.

Last year in May, our 13 yo dd informed her school counselor that she wanted to commit suicide and that she'd been cutting herself for several years. We had NO idea that this was happening.

After 3 rounds of IOP over a period of 5 months, we went back to the ER and she was finally admitted to the child psych unit at a large university hospital. The attending physician stated that she did have BPD, but the official dx would be depression and anxiety because insurance would cover that dx. She stayed for 9 days and discharge recommendation was to place her in a residential facility in another state. It wasn't too far away--4 hrs. She was admitted to the RTC and stayed for 32 days which was all that our insurance would pay.

Discharge recommendation was IOP specializing in DBT skills, but there isn't a facility that specifically utilizes DBT. As a result, we found a center that specializes in DBT and scheduled indiv. treatment and group sessions that occur 1x/wk. Over the past 8 months, we have seen minimal progress and would attribute that mostly to medication management. My husband and I feel that we have received minimal support as parents.

She started cutting herself a few days before the start of school. The day before school started, she asked to go to the ER with the intent to be admitted to the psych unit. She states that she doesn't feel safe at home, although we have now required that she be visible at most all times at home. Plus, all sharps, meds, and alcohol are securely locked. My husband and I are concerned that she is asking this in order to avoid school, which has been very difficult. For most of last year, she did not attend full-days. School is definitely a "trigger" for her. We have asked her to try to make it through this first week and then we would re-visit going to the ER on Friday. We definitely don't want to invalidate her feelings or request. We just know that when she falls behind in school work, she begins to show more anxiety and problems escalate (e.g., she asks to go home, she lies about completion of work, her moods become much more erratic).

I guess these are my questions: did we make the correct decision or should we go straight to the ER? Should we look into another IOP or a RTC at this point? She has stated that she wants to learn how to use DBT skills and has recently been cooperative in treatment (the past 2 mo).
 
We are so lost. Any suggestions would be appreciated!

Thanks!

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

[Feeling Better]

Hello butterflyjjgirl 

I would like to welcome you here to bpdfamily and to say how sorry I am to hear of what brought you here.

I live in the UK and I’m sorry I don’t have any experience with IOP or RTCs, but it sounds to me that you are doing the very best that you can for your daughter.

It is extremely positive that your daughter wants to learn DBT skills and that she is co-operating so I would urge you to learn as much as you can also so that you can support and encourage her along the way x 

[Merlot]

Hi butterflyjjgirl

Along with Feeling better, I welcome you here too.

This all sounds incredibly intense and frightening for you. Mamy parents here will be able to relate as they come here in crisis, including me, searching for the right answers.

Ive recently read "I Hate you, Dont Leave Me". There is great insight in there regarding treatment options. There is no one size fits all and I think from my learning its about consistency in treatment and approach, noting some approaches may work better than others for your daughter.

I applaud you in trying to retain her at school by setting a small boundary for going to the ER. Her schooling is important and this must have been very hard for you when Suicide Ideation and self harm is involved.

I hope you have good support for yourself. We are alwyas here to talk with you and support yoi through this crisis and beyond.

We're glad youre here and we look forward to talking again soon.

Merlot

[SkellyII]

My husband and I are concerned that she is asking this in order to avoid school, which has been very difficult. For most of last year, she did not attend full-days. School is definitely a "trigger" for her. We have asked her to try to make it through this first week and then we would re-visit going to the ER on Friday. We definitely don't want to invalidate her feelings or request. We just know that when she falls behind in school work, she begins to show more anxiety and problems escalate (e.g., she asks to go home, she lies about completion of work, her moods become much more erratic).

I guess these are my questions: did we make the correct decision or should we go straight to the ER? Should we look into another IOP or a RTC at this point? She has stated that she wants to learn how to use DBT skills and has recently been cooperative in treatment (the past 2 mo).
 
We are so lost. Any suggestions would be appreciated!

Thanks!

Hi butterflyjjgirl,

Your situation sounds familiar. School is a MAJOR trigger for my 15yr old daughter as well, he behaviour is very similar to your daughters.

I highly recommend the IOP specializing in DBT skills if you can find one, that's really helped my daughter since her last suicide attempt. And getting on the proper meds can't be overlooked as well. Both have helped my daughter immensely over the past year. She's not out of the woods yet, but there's been a big improvement.

I'm impressed that your medical would cover 32 days of RTC just for cutting. My daughter is a cutter, has had two suicide attempts, and the insurance company would only cover a 9 day RTC.

Some centers have a family DBT skills group,we did that for a year, and it's helped both my daughter and I.

[wendydarling]

Hi butterflyjjgirl

I'm sorry you and your young daughter going through this.  

School/work can be triggers, my daughter gave up work to concentrate on DBT. I believe the advice is treatment in the community where possible, engage day to day life.

I'd go with your daughter, if she's stated she's willing to keep with DBT she's taking on her responsibility and this is important. If your daughter is in crisis can she call her DBT therapist 24/7? Instead of ER. My DD rang her therapist a few times and that helped deescalate the crisis, she was reminded of the skills she was learning. One thing early on that helped my daughter (30yr) is finding ways to self sooth, is your daughter familiar?

How did this week go?

WDx