Please Help

[amyrow]

Dear Dr. Bradley,
My husband and I have both read your book several times as we have tried to shepherd our eldest daughter safely through some difficult years, and at times its been the only thing that's kept us sane. Although we have personally met many therapists throughout this time, your voice is the only one that we truly have come to trust. We respect your wisdom, experience, and calming attitude. We are at a crossroads now, and really need your advice.

Our gifted 17-year-old daughter has struggled for the past four years with a variety of issues and acting-out behaviors. She was diagnosed with an eating disorder at 13, received out-patient treatment and therapy, and seems to have overcome that. Next, she moved on to an inappropriate boyfriend and regular pot-smoking as well as cigarette smoking, alcohol use, and some cutting. She has been under the care of a therapist for all this time, and while her pot smoking seems to have abated, her drinking is getting worse (hard liquor now, and much more frequent -- it seems to be all she and her friends do when they go out together). We are at our wits end as to how to help her and are painfully aware that we are only her legal guardians for one more year. We've been thinking about an outpatient substance-abuse program, but I know that our daughter doesn't think she has a problem. She would probably attend and go through the motions, but she is very bright and adept at deflection. I'm not optimistic that it would have any effect.

Some friends of ours recommended an educational consultant who had helped place their depressed son in a program, and we met her this week and described our situation. Though for she met Liz for only 10 minutes and us for about 2 hours, she recommended that we immediately place our daughter in a wilderness program likely followed by a residential treatment center or a therapeutic boarding school. The consultant highly recommends wilderness first, because she said the experience "marinates" the kids and can help them get to the phase where they admit they have a problem before they enter any program for longer-term treatment. But she also said that if money is too much of an issue, we could skip wilderness and send our daughter straight into a residential treatment program

We are grappling now with this life- and family-altering decision. We are frightened to send our daughter away, although this consultant seems experienced and knowledgeable (she and her partner visit programs, follow up with kids and parents, and know many of the therapists well). We are looking at investing all the money we've saved for our daughters college education in this, her last year of high school. We are afraid she will hate us forever for sending her away. We are afraid we are overreacting. This is a milieu we are profoundly uncomfortable in, and we want so much to do the right thing -- neither over or underreact.

Dr. Bradley, although we know you cannot offer us specific therapeutic advice about our daughter, we desperately need your help for ourselves. Should we and how can we get comfortable with this dramatic course of action which will put great financial strain on our family, possibly alienate our daughter forever, and has no guarantee of positive benefit?
We appreciate any insights you can give us as we move forward and try to do what's best for our daughter.

[Mike Bradley]

Dear "Mom",
Yes, I do need to defer to your therapist on this call but I have a few questions/thoughts that you likely have covered already.
First, has your daughter been evaluated for medication? She likely has a psychiatric (as in needs medication) disorder. Not much will get better until this has been addressed.
Second, where does her therapist see her in terms of addiction risk? If you don't know, ask for a joint session where this can be addressed.
Third, as crazy as this possibility sounds, might your kid agree that she needs a residential treatment program? These work best if done voluntarily, and maybe a voice inside of her is whispering that she needs help.
Fourth, if she refuses to go, what are the laws regarding forced placement in your state? Some programs offer to essentially kidnap your child, a process which is not only traumatic but might be considered a felony. At 17 she is in that terrible legal status where she gets to choose her treatments and yet you are forced to not throw her out if she refuses.
Fifth, has there been any legal involvement? If she is on probation (or could be put there) many courts can compel treatment for kids like her.
If some of those thoughts give you a pause, consider trying some outpatient treatment before you go to the terrible costs of residential treatment. Your decision really depends upon the "dangerousness" of your child, a decision that is best made with everyone (daughter, therapist and you guys) at the table. By the way, if her shrink says that she can't discuss this with you consider getting some coaching from another shrink who specializes in adolescence.
Let us know how you make out, and good luck.

[Esprit]

Amyrow,

I want to answer you as a mom and as someone who stood just at the same crossroads as you not long ago. And just as you, I was horrified over a ton of scary choices and felt paralyzed in trying to decide which road to take. You just mull it over and over and no matter how much you think about it, you can't forsee where it'll all end or what path is *right*.

After killing myself with the decisions, circumstances escalated to a point where my son was willing to go to an in-patient rehab. for "an assessment" which included packing his suitcase as he was most likely going to be admitted. The assessment was very well done and he just sort of went along with the admission since he had huge consequences with the court hanging over him, although this was NOT court mandated. What followed was the turning point in his life. Being away from the outside world/influences and being forced through intensive and sometimes confrontational groups, plus daily individual sessions, NA/AA and education, structured day, eating well, ALL of it, came together to help him to admit the most critical thing......that he DID have a problem. I later came to understand from this program that almost no one goes in thinking that they do and that it is a misconception that they have to go there seeking help and admitting to a problem. The couselors in this program saw their job as getting them to that point AFTER they come in. I think even those who say they see they have a problem don't really get it until afterwards. My son told me that he went there with no intention of stopping drug use/drinking. But after 2 weeks it was like a light went off, aided by being in an environment where he COULDN'T use and allowing enough time for his drug adled thinking to clear.

I think the most important thing is to get her into an environment that is intensive and pulls her from her crowd. In -Pt. rehab. is covered by insurance. I debated Wilderness programs and I think they serve a purpose but am very glad we went the in-pt. rehab. route. I don't think she can be physically forced there, but if there is any way to coax her for going for an assessment with the possibility of admission...even if it involves bribery or telling her how she'll have time off from school to do this, anything that can work it could be a turning point for her. However, I totally agree with Dr. Bradley that if she needs medication, that should be addressed first and the in-pt rehabs. all have dual diagnosis specialties. There develops in a good place a comraderie and an atmosphere that really can help the healing and recovering. The place my son went was a great atmosphere and strange as this sounds I found myself wishing that I could retreat to this place myself for a month!

I also want to respond to your statement about needing support for yourselves. The weight and fears of this kind of crisis take a devastating toll. I waited to get support until I felt like I was disintegrating to where I might never be able to pull together and yet kept going and kept fighting for my son with every breath I took. Sounds dramatic, but it was how it felt. I'm still struggling with post traumatic stress related to the time period and thankfully have found a counselor who understands all of it and has helped me through, both in helping to guiding my decisions with my teen through thick and thin and in helping ME to recover when things settled. It truly kept me going and was essential to healing after he pulled through this terrible time. Any help and support you receive for yourselves translates into additional help for your daughter.

Whatever path you take, your daughter has involved parents behind her who understand what's at stake and that will serve her beyond any choice.
Good luck....my heart aches for you in these difficult decisions.

[Jesse]

I agree with Esprit and Doctor Bradley

[France47BERRY]

I agree with Esprit and Doctor Bradley

After reading this confession.. I would also agree with Esprit and Dr Bradley... pretty much reasonable rationalization of the situation... well, at the end of the day it's her decision...still...

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