SD13 now wants therapy

[kells76]

Almost exactly a year ago, SD13 (then 12) was struggling at our house one weekend; apparently Mom & Stepdad "were broke" around SD15's birthday so that's why SD12 wanted to go back to their place instead of staying with us for our weekend (sigh... feeling mom  stepdad's feelings for them)... during that conversation, where she asserted that DH and I weren't really listening to or hearing her, I suggested that if we were missing the mark so much, that maybe seeing a therapist could help her make sure that we really got what she was saying. She was pretty intensely against it (they never help, I've been before and it didn't work, blah blah blah).

For the last ~18 months or so SD13 and I have been doing a volunteer thing together EOW. It involves lots of sort of tedious lengthy tasks, but she is motivated, and we get time to talk. I have been working hard to just listen and validate, lots of "uh huh... yes... that makes sense... so you did X and then you were thinking, should I do Y or Z..." type stuff.

This past weekend, we were there, and we got to talking about autism, Temple Grandin, etc. She brought up that she has a lot of traits, quirks, and interests that make her wonder if she is autistic. She did finally get approved for SPED services last spring (though I am still not super happy with level of service) and has some supports and accommodations. She is also on social media way more than I would like, sigh, so there is part of me that wonders if she is watching too many TikTok videos of "autism influencers".

So I asked her if the SPED person at her school was someone she thought she could ask about that, and she said maybe, but then brought up something interesting: what if she did get assessed for autism "but it came back negative", then what would she do? So I commented that that seemed like a really good question to be asking herself, if she could be OK with who she is no matter what the label is. She thinks that she might "receive more support" if she did get diagnosed.

She then brought up that she wants to see a therapist to help her figure out who she is. I said that DH and I definitely think that is a great idea and are really supportive.

Then she said that she had already asked Stepdad, and he said "you're strong enough already, you don't need therapy" (according to SD13). I asked her how she felt about that and she said she felt not listened to/not really heard. She said it takes her a long time to bring up important stuff, and I agreed that she definitely had her own timeline for talking about things.

Anyway, DH and I are thinking it's a combo of his uNPD ego (my opinion is the only one you need and is correct, my greatness rubs off on you, if I say you're X then you're X, my amazing parenting has made you amazing) and a desire for there to be no challenges to his and Mom's narrative of "amazing parenting".

In our state, minors can consent to and receive MH services (among many, many, many other serious medical decisions) at 14 with no parental involvement. While I'm not happy about our state's law in general, in this particular case it could actually help SD13 -- she turns 14 in a few months.

I already called the practice where she used to see someone, but that therapist doesn't work there any more, so I left a message asking if I could meet a few practitioners and see if they'd be a good fit (SD said she wants "female, NOT old, with chill vibes -- like you, if you were a therapist" -- but I'm glad SD13 recognizes at some level that she needs someone outside the family for this).

DH and I talked last night and we are definitely on the same page -- to do whatever we can to make this happen. Willing to cover all transportation if Mom won't (she tends not to want to drive the kids around).

What I don't want to have happen is to create a new conflict where Mom and Stepdad double down on their indoctrination to the kids and hint that SD13 might lose their goodwill/acceptance/whatever if she reaches out for help. They could do that before SD13 builds a strong therapeutic relationship. I'm assuming we need to "go through the motions" of informing Mom about what's up. I'm not looking forward to it, but it is an interesting double bind -- she and Stepdad have built their parenting around "whatever you say you want is right" (because they've always been able to influence the kids to do what they want). SD15 was breaking out of it for a while but is back under the spell, mostly. Now SD13 is trying something new -- I don't want to inadvertently contribute to her getting "beaten down" by them.

Interested to know your thoughts on this.

[zaqsert]

Kells76, great that SD13 wants therapy.

Which of the factors are most worth avoiding with Mom, and which ones do you think may be ok to touch on? For example, best to try to keep Mom out of this as much as possible? Ok to ask her to share transportation, or best to keep her out of that too because she may use it to sabotage SD13's therapy? Any considerations of who will pay for therapy if not all of it is covered?

Depending on what you're comfortable touching on vs. avoiding, when you "go through the motions" of informing Mom, perhaps frame it as being something SD13 wants, and you and DH are willing to "put yourselves out" so Mom doesn't have to? Something like:

• SD13 wants to try therapy (SD13's idea, what she says she wants is right)
• You and DH will help with transportation (you know driving the kids around to yet another thing would be an imposition, so you're willing to help out)

I imagine you may feel that you and DH already do more than Mom and Stepdad do. Thought it may be worth it since you and DH want to do whatever you can to make this happen.

Does SD13 know that when she turns 14 in a few months, she will be able to consent to therapy with no parental involvement? This may help her realize that if for whatever reason therapy doesn't work out right now, she'll have another independent shot at it in a few months. Or if she were to start and then get shut down by her mom, she may be able to get back to it in a few months. Of course you'll have a far better idea of how she may respond.

If Mom were to ask what SD13 wants to talk about in therapy, you might avoid it by saying any conversation SD has with the therapist is confidential. While this could backfire if Mom must know everything, it may otherwise help to set her at ease knowing that you and DH won't know either (I'm purposely ignoring the conversation you and SD13 had).

Thoughts?

[ForeverDad]

I get it that you're pondering being the one to break the news to mom.  Instead, can you be there with SD13 when she talks to her mom on the phone, "I've been feeling for a long time..."  Then SD13 can invite you onto the call if needed for any smoothing over, where you could mention it's the child's right by state law at age 14 anyway.

That way you're there as a calming influence and support at the first interaction.  Does your D13 feel the need to disclose if she waits until 14?

[CoherentMoose]

Wow, great she's considering therapy.  Nice.  Challenging conundrum though.  One would hope her interest would come first, especially if you are paying for it.  So far, we've had zero luck working with an ex BPDh in the interest of the children.  He always turns it into something negative.
 It's amazing the word salads he creates.  Good luck with navigating those difficult waters.  CoMo

PS: Congrats too on being there for her and allowing her the space to communicate.  Really cool. 

[kells76]

Brief update:

I texted the kids' mom saying "hey, can you send me the kids' insurance info? We're updating our records."

She sent me a pic of SD16's insurance card only, and made sure I knew it was because we should already have SD13's card "because she gave it to DH years ago". Yeah... Definitely no way for you to ever request a replacement... Sigh...

So we sent that info to the therapy practice with the initial consult request. I think it should be good enough -- all they should need is group # etc. Now just waiting to hear back.

Haven't told Mom yet, or SD16 for that matter, just updating SD13 as we get info.

I asked SD13 the other day what she would do if "people" weren't supportive if her going to T or told her they thought she shouldn't do it. Interestingly she replied that "everyone at school would be pretty fine with it and mostly supportive". I wasn't ready to make it more specific by asking what she'd do if it were her mom. She does know that after she meets the T, I am sharing that with her mom, because it's important not to keep health info secret from parents.

No appt yet but hopefully soon.

No hint yet that Mom is suspicious of anything. DH thinks that it'll be a blowup when she finds out. Guess we'll see.

[formflier]

Hey..good thread but there is a question (or questions) which may not have been directly asked and answered.

Do you have to tell the other set of parents?

What is the wisdom (greater good) in not telling?

What is the wisdom in telling?

What is your (and DH's) "job" in this matter.  Perhaps "role" is better word to use.

And given the answer to above, who is your "customer"? 


I can see this going either way, even though I definitely have a preferred outcome.  I'm more interested in listening to how you work through this, than the particular outcome.

Best,

FF

[kells76]

SD13 is on Mom's insurance, so Mom gets the EOB, as far as I know. We can't afford out of pocket for this year. Believe me I'm tweaking the HSA contribution next year.

Also I'm not sure that SD13 could keep it under her hat. Maybe, maybe not.

Also, appointments would happen either during school -- so Mom would get an excused absence notification -- or during our time with kids, so SD16 would notice. Mom has already "played" things like "oh, you have a dr appt with me and you want to tell the dr you're transgender? I support you, and don't worry, we don't have to tell Dad, it's our secret". One of my values is to not normalize to the kids that one bio parent helps you keep medical secrets from the other parent.

So at this point it looks to me like a "when" does Mom find out versus "if". My thinking is I'd like to stay on top of the "when" versus getting a surprise rage email whenever Mom finds out. A way to help there be some predictability for SD13 -- "ok, heads up, I am letting mom know in 3 days that you are doing T, how about you talk through that with your T tomorrow".

That's how I'm seeing the if vs when question right now, if that answers your question...

[kells76]

SD13's mom texted me Sunday night saying that SD13 told her I'd been trying to set up T, but "Mom has already been looking into it and has inquiries into a few options that look good".

So on the one hand (a) I figured SD13 would "spill the beans" at some point and (b) it's good SD13 did not see this as something to keep secret.

On the other hand, I don't know how to reply, because I strongly suspect that Mom has done nothing of the sort, or, has "made inquiries" in the sense that anyone can look at a web page. Teen MH is REALLY full here; plus, SD13 wanted in person and not telehealth, plus she wanted a female therapist, plus not everywhere takes their insurance. Did Mom really find a female T covered by insurance with in-person openings in the next few weeks? Really?

I had set up a placeholder appt for this Friday at 12. Before Mom texted, DH told me he didn't think it was a good idea (the appt timing) because it'd mean picking SD13 up early from school, and apparently -- I did not know this -- SD13 "has to" wait with her little brother at school until Mom shows up (they're at the same school), and Mom is frequently late. So, if SD13 weren't there waiting (doing her role), then Mom would know something was up. Anyway, it's out in the open now.

I'm remembering when SD16 was doing "homeschooling" a year ago and hadn't started math yet, because "Mom was setting something up with an amazing friend who was an actual teacher". A week went by and I ended up just emailing worksheets to SD16. That same day Mom texted to say basically "how about you do math with SD16".

So I think it may be a similar scenario going on, where she is shamed/angry and wants to "be the real mom" and says she's doing stuff that she probably isn't.

The question is how to respond to her -- I don't think dropping the appt is good but I'm just so tired of all the BS and I don't really have a lot of energy to figure out what to say. All I can come up with is "Thanks, let me know if you want to be at SD13's initial meeting with Therapist as SD13 sees if she's a good fit"

...thoughts?

[formflier]

So...the decision is to delay therapy so she can "wait" with a younger sibling? 

Perhaps there is something I'm missing...it appears to me that "solving" the pickup for one day is easy and even if that is on a recurring basis...I don't know, just seems solvable.

Are you picking up a weird vibe here?  Maybe I'm "seeing" more than there is.

Best,

Allen

[kells76]

I'll try to untangle it...

Last week, when I had just set up the initial appt for SD13 (for this Fri at 12), and before I got the text from Mom, DH and I were talking about the appt and that's when he said he didn't think it was a good idea. That was because if we were still trying to get it rolling before alerting Mom, then SD13's "absence" from waiting with Brother would be noted. Mom's house is not a house where you can "do your thing" and not be grilled -- your business is everyone's business. So if we were to pick up SD13 early, that would "notify" Mom that "something was up" to ask about, and SD13 tends to "spill the beans" about a LOT.

More clear?

[mama-wolf]

SD13's mom texted me Sunday night saying that SD13 told her I'd been trying to set up T, but "Mom has already been looking into it and has inquiries into a few options that look good".

It sounds like while Mom may have some "options that look good" (which is questionable), you have an actual scheduled appointment already set up.  I wouldn't pass up on that, but it sounds like she may make an issue about little brother waiting at school.  Might not be an issue if SD13 goes back to school before it lets out, which seems entirely feasible if the appointment is at noon?  Sounds like the risk of alerting Mom beforehand is already moot...

Your proposed response sounds good.  And/or you could say something along the lines of "that's great that some other options may be available, since it might take a few tries to find a good fit"...

mw

[zachira]

Your stepdaughter may be old enough to sign for her own therapy depending on what the laws are where she lives. The therapy will likely help your stepdaughter to deal better with the difficult living situation with her mother and stepdad while building her self esteem and chances that she will have a rewarding life.

[kells76]

she may make an issue about little brother waiting at school.

He's 9, so I think it's more "one more way for Mom to insinuate into Dad's time" versus a real safety issue.

you could say something along the lines of "that's great that some other options may be available, since it might take a few tries to find a good fit"...

Yeah, I think I might.

Your stepdaughter may be old enough to sign for her own therapy depending on what the laws are where she lives.

In 6 weeks she will be, in our state... but I don't know if she knows that.

[ForeverDad]

Since the big worry was that bioMom might make a stink about finding out, well, she already found out.  Now that she knows, go forward with this appt.  You know she gets ruffled feathers, then settles down and returns to her comfortable level of minimal parenting.

Now that she knows some details, see how she wants to handle SD9 transportation.  Does school have afterschool arrangements for late pickups?

You may even add that this is "a bird in the hand is better than two birds in a bush", that other appointments would probably be hard to find and months away.

I would not offer to let bioMom attend the first session.  She might try to take over or stay for the entire session.  You know that when you take SD16 you may stay for the introduction and background depending on what SD16 wishes, then willing to wait in the lobby for the rest of the session.

[zachira]

The therapist's first legal duty is to protect the confidentiality of the minor child/teenager. In some cases and certainly with most teenagers, this means that the records of the child and teenager cannot be shared with the parent if there is a risk of harm to the child/teenager by doing so.

[Notwendy]

Play date for little brother?- arrange for him to go home with a friend after school that day?

BPD mom may not do this- I don't recall mine doing this- but as my kids grew up- I had a couple of friends with whom we'd trade off doing this. I know that the school has to have a name on file to allow this, but we were the "back up" person for school pick up. I'd say that most of the time we picked up our own kids but for times where there was an appointment or something like this, we could ask a friend to do the pick up. For the kids, it was fun to go home with a friend sometime.

[kells76]

It all kind of blew up. Not sure how much I'm up for describing, but basically it turned into Mom wanting to have a pissing contest about who really takes care of the kids. She sent the same text twice, once to me on my phone from her on her phone, and once to DH on his phone, but from the kids' phone. So, she's obviously wanting them to see her posturing about how she "doesn't appreciate not being informed" and "wants to make sure the T is LGBTQ friendly because that's what SD13 confided to her" and "she has always done 100% of the medical care for the kids" and "would appreciate open communication".

This is what I sent to her email with DH cc'ed:

Hi [Kids' Mom];

Thanks for reaching out about counseling for SD13. Sorry I didn't get back to your text sooner.

What SD13 shared with me many weeks ago was that SD13 had asked [Stepdad] for counseling, but was told "SD13 was strong enough already and did not need it". If what SD13 said isn't accurate, or if you heard something different, let me know -- that's the info I had to work with. I couldn't imagine you and [Stepdad]not being on the same page or not talking about that, and I knew how important the kids' health is to you, so I knew you would definitely tell us if you were going to set up counseling. Having not heard anything, and, like you, prioritizing the kids' health, I personally decided to research counselors. I'm glad you and I agree that supporting counseling for SD13 is a priority.

SD13 shared desired criteria with me as well: female, low-key, open to in-person meetings, and accommodating of SD13's desire to not make eye contact, among other requests. Finding practitioners in town who meet those criteria, plus specialize in teens, plus have availability is, as I know you know, a challenge! [Counselor Name] works with [City] Therapy and you can review her background here: [link]

Let me know if you want to keep that upcoming appointment, or if you have already made a different appointment. Looking forward to working together for SD13's health with your commitment to open communication!

Best;

[kells76]

and this is what I got back:

Hi [kells76],

Thank you for setting this up but after talking with SD13 they have decided to go with the other option. You can go ahead and cancel this appointment. They are set up to meet this [day] for an intake meeting with [other counselor] at [place] [link]

Thanks,

[Kids' Mom's Other Name]

So there is also this second layer of what to call SD13, so in addition to the pissing contest over "who really cares for the kids", there's this secondary contest of "who is really calling the kids the names and pronouns they tell me they want". In my email I used the initial letter for the nickname we all call SD13. None of us really use her given name and haven't regularly for years, and there's a nickname that she has told DH she's fine with and separately told me she's fine with. So in my email I use that letter, and in Mom's reply, so does she. But, DH and I say She but Mom says "They". At this point, that's fine; SD13 can talk to us about what she wants if she wants to.

We just had an IEP meeting for SD13 yesterday. Meeting got started with team members, me, DH, and Mom on Zoom (all different locations). SD13 wasn't there yet. Mom started calling SD13 by her "school name" -- SD13 goes by a totally different name, not given or usual nickname, at school. We've known about this for a few years. One teacher did ask DH and I about it, and we said that it was great that SD13 had a place where people could call her that, that we knew about it, and were totally flexible and supportive with people at school calling her that. We still call her by her nickname.

So anyway, meeting starts out, IEP lead calls SD13 by her given name, I describe what I see and use nickname and no pronouns (I'm getting good at never using pronouns), DH describes what he sees and uses nickname and "she", then Mom jumps in and says "out of respect I want everyone here to use [School Name] and "they them" pronouns". After that all the team members did. SD13 hadn't even shown up to the meeting yet. When she did (at Mom's house), she sat between Mom and Stepdad, hugging them, holding Stepdad's hand, and cuddling with him.

Meeting ended without any more comments from DH or myself.

...

It seems clear to me that Mom did all that "stuff" at the meeting to reestablish that "she is the real mom, she is the one who really knows SD13 deeply and is the most supportive". So it's just more of the same. It was kind of weird that it was out in the open, and almost intensely bullying.

It's also weird that Mom picked a counselor (well, she says that she and SD13 "spent a lot of time together picking a counselor") that insurance doesn't cover. The one I got is 100% covered. Mom says "their insurance will probably reimburse for it" but she's still having SD13 meet this person before finding that out. My guess is that this person seems to be the most aligned with Mom's worldview and goals, so again Mom is hoping for someone to "be on Mom's team" but have it look like supporting the kids.

Anyway, with all of that stewing around, two questions:

-do I get in touch with the counselor before the appointment? I'm thinking if I do, then there's less of a chance for Mom to "prime the pump" and "convince" SD13 that "SD13 doesn't feel safe with kells76 or DH knowing anything, so of course if SD13 wants it, Mom will protect her and make sure DH and kells76 aren't allowed to invade your privacy". But I'm also just really tired. Or would it "come across" as weird somehow if I got in touch beforehand?

-Mom also both demanded "open communication" and reiterated that "she has always done 100% of the kids medical care". Part of me wants to say "great, I totally agree with your idea for open communication... given that you want DH and I to do 0%, I look forward to your weekly updates about the kids' medical, dental, mental health, educational, etc information." But again, I'm tired, and it feels like just fighting on her level.

I think mostly my first question is the one I need help with -- if there's any downside to getting in touch with the T beforehand.

[ForeverDad]

Your stepdaughter may be old enough to sign for her own therapy depending on what the laws are where she lives.

In 6 weeks she will be, in our state... but I don't know if she knows that.

So in a month or so SD13 will be old enough to choose her own counselor.  Can she do that without informing all the parents and their spouses?  Legally, yes, but can she do it and stand up for herself?  She would surely face formidable pushback.  So... it's not 'over' quite yet.

Still, SD13 has a manipulated or influenced problem over at the other residence.  She's two different people depending on which parent she's with.  That must be tough for her to juggle back and forth.

[Notwendy]

Sounds like she's three different people with different names depending on where she is. No wonder this child is confused about her identity: gender and name.

I am so sorry. I don't have any advice. I just feel sorry for this situation you are in. You are doing your best to help and BPD mother is sabotaging your attempts.

I just hope this child is able to figure out who she is. Adolescents have a tough enough time doing that even without a disordered parent.

[zaqsert]

kells76, for the whole thing: 

I don't have a direct answer, but here's a thought in case it helps.

We recently did a few sessions of family therapy. The T had us do sessions in this order:

• uBPDw and me together, without our D11
• D11 on her own (two sessions, actually, but never mind that)
• Another session with just W and me
• A group session with all of us

So if there's any part of SD13's counseling that may be family therapy or something of the sort, then there may be a normal, reasonable place for the counselor to see you/DH separately from SD13.

In family therapy, it's because the parents and step parents all influence the child's environment. They're involved as part of the family system.

Someone recently half-jokingly compared it to dog training. In dog training, most of it has to do with training the dog's owners, much more so than the dog. I'm not calling anyone a dog here. I just thought the comparison was amusing.

[zachira]

Everything you say to SD13 mom seems to be an invitation for more drama. The more you tell her, the more problems she seems to cause for everybody. Would it be possible for the appointments with the therapist to be on days when SD13 is at your home? In some areas, there is free therapy at the school during school hours for all students. Do try to remember that SD13 asked for therapy for herself, not family therapy which would likely be all about SD13's mom making herself the center of attention and the victim.  

[zaqsert]

Do try to remember that SD13 asked for therapy for herself, not family therapy which would likely be all about SD13's mom making herself the center of attention and the victim.  

Good point. The family therapy comment I made above may not help then.

[ForeverDad]

I can just imagine this... A month or two from now SD14 walking into the room and sees your computer sitting on the page about your state's page for older teens regarding counseling privacy and rights.  You come in and offhandedly say, "Wow, maybe you know this but I read you don't need anyone's permission or approval or monitoring for counseling.  Does that change anything for you?"

Or maybe your state has a handout describing the details.

[kells76]

The appointment is today.

Mom set it up and I am fairly certain will not relinquish control of when appts happen and who takes SD13.

So in a month or so SD13 will be old enough to choose her own counselor.  Can she do that without informing all the parents and their spouses?  Legally, yes, but can she do it and stand up for herself?  She would surely face formidable pushback.  So... it's not 'over' quite yet.

SD13 it seems clear now does not have the internal strength to tell Mom "No, actually I do want to meet with this other person", even when SD13 turns 14. She will do and say to Mom stuff that makes Mom happy -- probably the vibe is like "yes Mom I totally want to see this T that you are showing me, not the one kells76 found, because you understand me better than kells76 does".

She's two different people depending on which parent she's with.  That must be tough for her to juggle back and forth.

I just hope this child is able to figure out who she is. Adolescents have a tough enough time doing that even without a disordered parent.

All I can do is pray that whoever Mom picked as seeming to share Mom's agenda will have the strength to actually help SD13 no matter what.

Or maybe your state has a handout describing the details.

I wish the issue was still that Mom opposed T but Dad and I supported. Now that "Mom supports it" it is more about Mom finding someone that she thinks will support her agenda, which is using the kids to get the kids to do and say stuff that Mom knows aren't values of DH and I. Mom wants to incite conflict and having the kids choose her as the "most accepting, most loving, best parent", and if she can get the kids to double down on "this is who I am, I know it for sure, and Mom and Stepdad are the only ones who really see the real me and support me, so I hate you and don't want to see you"... then she wins. If Mom can point to a professional who "supports" SD13 then she can be in a win win position: "It's not me making the kids say they're XYZ, look, this professional says the kids are XYZ, and if we don't 110% get with the program, it's not my fault if the kids don't want to see you".

That is my guess. So it won't matter if SD13 turns 14, any more.

[zachira]

What is likely to matter, is that the therapist cannot share case notes or what is discussed in child/teenage individual therapy with a parent if the child or teenager could be harmed by the disclosures. A competent caring therapist will let the child/teenager know that the therapist holds the privilege not the parent in ways that the child/teenager can understand and feel safe in being open with the therapist about their feelings and frustrations.

[livednlearned]

Hi kells76,

If SD13 is on the spectrum and happens to be (so-called) high-functioning (ASD 1), it could take years to sort out, especially if she's female. There will likely be many rodeos like this as people try and fail to sort out what's driving SD13's main complaint.

I guess the question is whether you want to pace yourself? What would happen if you let go and detached?

Mom's insecurity is kicked into high gear and it seems to be motivating her. It might not be what we consider good parenting but she is engaged. Sometimes this can help a T see more clearly what the dynamics are.

This happened to SD25.

Like you said, you can pray that the T is skilled.

And let go  (for now)