I called the pdoc earlier this week to say, "hey, Sissy is having some serious issues." He bumped up her monthly appt to this morning.
We talked for some time. We went over therapy strategies. We reviewed the standards: hurting self, hurting others, seeing or hearing things, talking to people not there, hyper sexual or religious, want to die, sleeping, eating, toileting, school and then ... home life.
choices, choices, choices. pdoc agrees with us and the therapy team, it's a matter of choice, not medication or disability. There's no pill to fix this. It's up to Sissy. Pdoc said to her, "If you don't pull your stuff together and start making the good choices, I will send you back to the hospital. you can not behave this way at home. You can not treat your family like this."
Which is what the therapy team has told her. Which is what we've told her. Which she continues to pretend she's never heard. Therapist came this afternoon and we rehashed it all some more and Sissy still sitting at the table, tongue hanging out, staring into space, ignoring us all. I watched her therapist get completely exasperated with her and I just laughed. "Yep. Now you know why we're so put out with her. It's ridiculous. She simply doesn't care."
Therapist said, "I just don't even know what to do at this point! She has NO response to us telling her she'll go back to the hospital! NONE!"
and The Dad and I just nodded our head and said, "yep. we know."
So...
It's up to Sissy. We tweaked her lamictal a smidge and are changing when she doses her intuniv to help her sleep better (her sleep walking and talking is pretty bad right now) and the doc said if she gets worse in her rage or starts talking about suicide to call and he'll up the resperidal. Pdoc is also going to make some of the diagnoses official and fax the report to school in an attempt to nail down a medical IEP.
We're going to switch to CBTs to try to put it in her face that it's her choice to change and we're going to make her "rewards" be temporary. In other words, if she wants TV today, she must bathe properly TODAY. Tomorrow will start it all over. No TV if no proper hygiene. period. It's behavior modification with a short term, temporary reward. We'll also begin implementing a two tier consequence system. Consequence for the infraction and if she escalates or lies, then consequence that too. pdoc said to give her two choices (love and logic) make your bed by 8 am or get no computer time. you pick. He said to keep saying "the choice is up to you. only YOU can control the outcome."
but she's heard all of this and more in one way or another for four years worth of therapy. I'm not thinking it's going to have any affect. After that, there's nothing more that we need to do or change. It's up to Sissy now. I don't WANT her back at RTC but that's not a choice I get to make for her at this point. It's a choice SISSY will be making for herself, harsh words her therapist concluded today's session with.
5 comments:
I really want to believe sometimes that a few of my kids don't have the "choice" to behave properly - but they do. My son really liked the adolescent psych unit when he was there. Later bedtime, access to movies we thought he was too young for, access to bags of candy (LARGE bags, not those single serving things) he would win playing bingo, access to cans of pop that we would not allow since he won't brush his teeth. He claimed he showered there every day, but I guarantee he never used soap or shampoo - just got wet to re-activate the smell daily (and then got a reward). So, he caught on when the dr. would say things like Sissy was told and started asking to go to the hospital. How pathetic is that? Once, he cried (no tears) for almost an hour in the office, begging to go there because "he needs help". He can turn any time of deterrent into an "okay by me" deal. He turns every single restriction into way....more work for us than him too. He's real good at being bad.
My 17 yo daughter wants to do what she wants and then have me fix all the problems she causes by her terrible choices. I've gotten really good at saying, "Oh, that's too bad, what are you going to do about that?" Makes her furious but frees me from the responsibility of fixing everything - I'm usually wrong anyway - the 3 main things I hear from her when I make a suggestion is "I can't do that because...." "I won't do that because it's stupid" and "I don't know HOW!!". It's going to be one miserable life for our kids if they don't start choosing things to make their lives happier instead of fighting us all the time.
Argh. At least you'll know you've done everything even if Sissy chooses not to.
Suicide is a choice as well. But it's not one makes when they are mentally healthy.
She said nothing at all at the end of the session when the therapist said that to her?
@jules - she put her head down on the table, rolled her eyes back in her head and acted like she was going to sleep. So my hubby and the therapist, almost simultaneously said, "Sissy, are you tired?" trying to get her goat. And Sissy said "NO!" so both of them were like "Then what posture should you have when adults are speaking to you?" and she just grunted. So The Dad said, "OK, go get on your pajamas then" and she sat straight up and glared at us
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