Category: Tips to navigate “the System”

Christmas Gift List for kids in Residential Treatment Facilities (RTFs)

It can be challenging to Christmas shop for kids who are living in residential treatment facilities (PRTFs, RTFs, or group homes). There are almost always restrictive rules about personal items along with special rules for Christmas gifts. For example, in most facilities electronics, candy, and hardback books are not allowed.

So what can you give your child for Christmas? Below is a list curated from parents who have successfully navigated the holiday season while their child is living in an RTF.

But first, here are some tips.

  • Gifts deemed inappropriate or against policy will likely be thrown away and not returned to you.
  • Most facilities do not allow wrapped gifts because they need to approve the items.
  • Often gifts must be dropped off on a specific day.
  • You may not be allowed to open Christmas gifts with your child. If this is important to you, ask their therapist about doing so during a family therapy session or home visit.
  • Kids in higher level facilities aren’t allowed to have “dangerous” item which may include shoe laces, belts, hard back books, calendars with staples, etc.
  • Ask the facility if your child will be getting additional gifts from local charities or the facility. As you shop, it can be helpful to know if you are supplementing gifts or supplying all your child’s gifts.
  • Plan for the gifts you buy to be lost or destroyed. Shop at Walmart and don’t give expensive gifts. Label what you can with your child’s name.
  • To successfully navigate Christmas gift giving with the least amount of frustration and waste, email your child’s therapist your planned gift list ahead of time for approval.

Christmas Gift List
(For kids in RTF)

  • Clothes
  • Pillow
  • Stuffed animal
  • Pajamas
  • Markers and coloring books
  • Dot to Dot books
  • Playing cards
  • Family Pictures
  • Art Supplies
  • Basket ball
  • Soccer ball
  • Foot ball
  • Journal
  • Hygiene supplies
  • Hair bands
  • Stickers
  • Pillow case
  • Picture book of “happy” memories
  • Paperback books
  • Crayons
  • Teddy bear
  • Gloves
  • Hat
  • Shoes
  • Puzzles
  • Funky Socks
  • Magic 8 Ball
  • Comic books
  • MP3 Player/iPod Shuffle with no internet access
  • Stationary
  • Legos
  • Crazy Aaron’s thinking Putty
  • Blanket – burrito etc
  • Posters
  • Calendar (no staples)

Please let me know your additional ideas so I can add to this list!

A few thoughts about realistic expectations…

Kids with developmental trauma, especially those diagnosed with Reactive Attachment Disorder (RAD) are likely to turn any situation into a power struggle, including their Christmas gifts.

Even if you give them a gift they’ve been asking for – that you know they’ll love – you can expect them to:

  • Tell the therapist they know you aren’t planning to give them any gifts because you don’t love them.
  • Complain to staff about the gifts they do get, and say they don’t like them.
  • Destroy the gifts even if they love them and desperately wanted them.

It may feel personal, but it’s simply how your child relates to the world because of the lasting effects of early childhood neglect and abuse. Unfortunately, you may end up feeling manipulated, lied about, coerced, and judged. It can be tempting to withhold gifts because of these behaviors or because your child is not cooperating with treatment, but that’s not a good strategy.

First, keep in mind that it will be very difficult to execute. Staff will likely compensate by giving your child extra gifts creating an opportunity for triangulation.

Additionally, your child’s therapist will almost certainly see your lack of gifts as a sign you are a cold, and unloving parent – and the focus of your child’s treatment will be side tracked.

Most importantly, your child will internalize feelings of rejection and this will not be a learning lesson no matter how well-intentioned you are. Jessie Hogsett, who was diagnosed with RAD as a child, reminds us that our child’s actions aren’t necessarily reflective of what’s going on inside. He says “I remember being in an RTF during Christmas. So lonely. And I felt totally unwanted. Horrible times. A gift would have made me feel wanted, special, and thought about.”

So, plop on your Christmas hat, sip a peppermint latte, and go shopping.

Tips to work with your child’s school (includes free teacher handout)

I can’t tell you how many days I’ve navigated through carline with a drink holder full of steaming hot cups of coffee. Every school year I’d learn how my kid’s teachers took their coffee. On my way to drop the kids off at school in the mornings, I’d pick up a coffee for myself and one more to go. Especially when they were in elementary school, the kids loved their teacher’s reaction to the nice, fresh cup of coffee – and I loved the good will it built. In fact, when I found a teacher to be particularly challenging to work with, I’d throw in a muffin or cookie. That’s right – kill them with kindness and generosity and 9 times out of 10 it paid off in spades.

Working with teachers and school staff can be challenging for any parent, but more so for parents of children with special needs. Parent’s of kids with Developmental Trauma and/or RAD struggle even more because of the nature of these diagnoses. Few schools are truly trauma informed and our children are often adept at triangulating adults.

I have five children and we’ve got 504s and IEPs. We’ve navigated suspensions and expulsions. We’ve been to alternative schools and been in co-taught classrooms. Below is my hard-earned advice for how to navigate the system successfully.

Behind the scenes

Like any “system” we work with as parents, it’s important to pull back the curtain and understand how that system works and recognize its dysfunctions. Many of us have become so frustrated with a teacher, school administrator, or principal that we blow our top. We feel justified because they are being so unreasonable, causing our child undue hardship, or simply aren’t acting fairly. Unfortunately, our strongly worded emails and outbursts can have long-reaching negative impacts on our child’s school experience.

  • Teachers and school staff talk. Teachers and administrators talk about students, and even more often about their “cranky,” “unreasonable,” “mean” parents. The 6th grade English teacher vents her frustration to the 6th grade history and science teachers. The 8th grade teachers give the high school teachers and administration a heads up. If you are perceived as a difficult parent to deal with – everyone knows.
  • Parents are labeled and handled. Administrators and teachers will make a determination about what kind of parent you are based on even one interaction. While this may not be fair, it’s simply the reality. They’ll often meet ahead of time to strategize how to “handle” you in meetings and conferences which can lead to the incredibly frustration realization it’s the one of you against all of them. And once you’ve been labeled – it sticks
  • You won’t win (at least in the long-term). Sometimes a “strongly worded email” or conference can seem to be effective. But it’s important to realize your child will be in school for 13 years. Winning one battle at all costs can have serious long-term impacts. Once the school labels you as a “problem parent’ they’ll strategize how to best handle you in the future. A nasty email may win the battle – it won’t win the war.

While we all wish this wasn’t true, it’s human nature. For the sake of our children, we must understand the reality and become pragmatic. At least that’s been my strategy and more often than not it’s been successful.

Start off on the right foot

It’s so important to start the new school year in good faith and without a chip on your shoulder. Instead of assuming your child’s teacher is “going to be a problem,” start out by believing they’re going to be a partner. This means seeing the classroom through their eyes and empathizing with their needs. I have several teachers in my family and know it is a hard, often thankless job. Many teachers spend weekends and evenings grading papers and pay for supplies out of their own pockets. Most go into the job because it’s their passion, but can become discouraged and burnt out .

  • Be polite and act in good faith. A little genuine kindness and please and thank you can go a long way – especially with teachers who are overworked. Look for opportunities to compliment your child’s teacher. If called for, apologize and seek to make amends.
  • Be reasonable and solution oriented. It’s so important to recognize and respect the limitations of schools and teachers. Don’t lock yourself into one solution. Be an active listener and go into every meeting with a spirit of collaboration and mutual support.
  • Be ‘that’ parent. Reach out to your teacher in practical ways. Be the parent who they can count on as volunteer. Send in extra supplies when they’re requested – and when they aren’t. For example, all teachers always need extra pencils, tissues, and hand sanitizer.

Let’s not forget that as parents we find it incredibly challenging to care for our child, especially when their behaviors are extreme. Imagine a teacher trying to do that while teaching a full classroom of children. A bit of empathy and consideration can go far.

Work within the system

Fighting the system for reforms is a noble cause and one we all must support. However, the strategy for personal success is almost always learning how to work within the system. Thankfully, there are standard, legal processes to insure your child receives the educational supports they need and are entitled to. It can be a long process to obtain a 504 or IEP (Individual Education Plan), but well worth it because they are comprehensive plans with legal requirements. There are also many free or low-cost parenting advocates who are trained to assist parents in negotiations with their schools and setting up of 504s and IEPs.

  • 504s A 504 is a detailed plan for how the school will remove learning barriers for students with disabilities. Most commonly these include accommodations (how a student learns) like extended time for testing or priority seating. A 504 is easier to get than an IEP and usually the best stepping stone to an IEP.
  • IEPs An IEP is a legal agreement for a student to receive special education services. The IEP agreement can include both accommodations (how a student learns) and modifications (what a student learns). For example, it may include pull out educational services or classes co-taught by a traditional teacher and a special education teacher. An IEP requires an evaluation. Typically diagnoses like ADHD or RAD can qualify a student.

Resources

Be sure to check out this excellent resources on the ins and outs of navigating special education services for your child. From Emotions to Advocacy

Here’s a handout you are welcome to reproduce or email to your child’s teacher: Remember, approach is everything. You don’t want to come across like a patient being wheeled into surgery while handing the surgeon a diagram of the heart. Just offer this handout to teachers and school staff as “helpful information about my child’s diagnoses,” I find it’s always best delivered with a cup of coffee!

As parents of children with special needs, we’ve all had that sick feeling when we realize teachers and school staff have circled the wagons – and it’s “us” against “them.” Use the strategies in this article to make sure you are part of the team and that everyone – teachers, school counselors, principals, and you as the parent – are linking arms and circling your child with the supports they need.

2/3 of kids with RAD are first misdiagnosed with ADHD

It’s not ADHD!

Our recent Facebook poll showed that 67% of children first misdiagnosed with Reactive Attachment Disorder (RAD) and other developmental trauma diagnoses were first diagnosed with ADHD.

Survey by @RaisingDevon, March 2019

6 in 10 kids are being misdiagnosed with ADHD instead of RAD or other developmental trauma related disorders. Here’s what it matters:

  • Stimulant medications typically given for ADHD can exacerbate other symptoms the child is experiencing.
  • A misdiagnosis like this can cause significant delays in the child getting the treatment they need.

Keep in mind, kids with developmental trauma may have attention deficits and other symptoms of ADHD: inattentiveness, hyperactivity, impulsivity. However, the ADHD diagnosis doesn’t correctly point to the cause of those symptoms – the trauma. ADHD is a chemical imbalance often successfully addressed with stimulant medications. These same symptoms from developmental trauma are caused by a brain injury and stimulant medications can exacerbate other symptoms of developmental trauma. 

Here’s what parents are saying about how the misdiagnosis of ADHD impacted their child and family.

Our sons ADHD medicine amped him up causing extreme violent rages. He was arrested 3 times and faced felony assault charges from these rages. It wasnt until I was able to get a doctor to listen to me that he started to get better. His ADHD diagnosis and treatment made life hell at times. He is much better now and while we still have struggles, no one ends up arrested in the process.

S.H.

I parented my child so incorrectly..,we lost so many years. Letting go of the guilt was hard, so trust me I understand!

Katie

We went in completely unprepared for RAD [because of the initial ADHD misdiagnosis]. And it delayed getting a [correct] diagnosis and treatment by several years.

Jesi

We lost three precious years chasing the wrong problem.

Emily

Wrong medication for years, delayed us understanding how to cope with him. Still many professionals dont use the RAD diagnoses and always think ADHD when he can sit still and read for hours on end!

Katalina

Too many stimulants which caused aggression and chaos at home and in school. Terrible situation which makes me angry and bitter.

Karen

It’s how they minimized the problem, only mildly medicated him, and turned all the blame on us, because we apparently couldn’t manage basic behavior management. Mind you, this was social services AND a children’s hospital after an 11 day stay. Nor was it the last time. Still happening, only now he’s self-medicating with street drugs…

Sarah

Why kids with developmental trauma get diagnosed with ADHD

  • RAD and ADHD have many overlapping symptoms. With developmental trauma, kids can be hyperactive, have attention deficits, and other ADHD-type symptoms.
  • Most kids are getting this early misdiagnosis from pediatricians who are very familiar the ADHD diagnosis, but not as well versed in RAD or developmental trauma.
  • ADHD is a go-to diagnosis for kids who are struggling with hyperactivity and inattention school. It only requires diagnosis from a pediatrician and there are a number of medications that can be easily prescribed.

The difference between ADHD and RAD

While RAD and ADHD have overlapping symptoms, skilled clinicians can differentiate between the two. In a 2010 study by the University of Glasgow, researchers found these core items that point to a RAD diagnoses vs. ADHD.

Disinhibited items

  • Does s/he preferentially seek comfort from strangers over those s/he is close to?
  • Is s/he overly friendly with strangers?
  • If you are in a new place, does X tend to wander away from you?
  • How cuddly is s/he with people s/he does not know well?
  • Does s/he ask very personal questions of strangers?

Inhibited Items

  • Does s/he often stand or sit as if frozen?
  • Is s/he a jumpy child?
  • Is s/he wary or watchful even in the absence of literal threat?
  • When you have been separated for a while (e.g. after an overnight apart), is it difficult to tell whether s/he will be friendly or unfriendly?)

While not all children with RAD will exhibit all these symptoms, they are not symptoms of ADHD. Asking these diagnostic questions can enable clinicians to differentiate between the two disorders.

Full information on this research study can be found here:

How to get the right diagnosis

It’s critical that a child gets the correct diagnosis so they can receive the treatment and medications they need without delay. Here are some steps you can take to ensure this happens for your child.

  1. Inform your pediatrician (and any other clinicians) about developmental trauma your child may have suffered. Be sure to use the term “developmental trauma” and that you are concerned your child’s brain development may have been impaired.
  2. Ask your pediatrician for a referral to a psychologist for a full psychological evaluation. A referral may be necessary for your health insurance and also enable you to get into see a psychologist sooner. If the pediatrician suggests trying ADHD medications first, remind him/her of your child’s background and respectfully insist on the referral.
  3. Be cautious about accepting prescriptions for stimulants for ADHD. See a psychiatrist for medication recommendations. Once your chid is stable on mediations usually a pediatrician will take over dispersing them for your convenience.

What to do when CPS comes knocking…

An interview with Diane L. Redleaf, a family defense pioneer

Nationally-known leaders have called Diane L. Redleaf the “conscience of the child welfare system,” the driving force behind creating a “better, fairer child welfare system” and “the people’s lawyer.” Diane has played a leading role in hundreds of important cases on behalf of families, with over 60 published court opinions. She has also led legislative efforts that have benefited millions of children and families.  Her litigation and legislative advocacy has created due process remedies for wrongly accused family members and created social service and housing support models for families throughout the United States.


Child protective services (CPS) plays a vital role in keeping kids safe. For this reason, CPS investigators often err on the side of caution to ensure children aren’t exposed to harmful situations. Even when allegations are false, caregivers can face lengthy investigations. This unwarranted disruption and family upheaval is collateral damage, necessary to make sure children who really are abused get the justice and safety they deserve. 

For many parents of children with complex developmental trauma disorder (typically diagnosed as reactive attachment disorder or RAD) these interactions with child protective services are an unfortunate and challenging reality.

To legally advance the false allegations of a child with DTD is an unrecognized, innocent and unintended form of further harm to that child.

Children with RAD may make false allegations in their desperate attempt to control the people and situations around them. The resulting investigations disrupt the family, are tremendously stressful and in rare cases the outcome can be devastating.

Innocent parents and caregivers are often frightened and lack the resources and knowledge to defend themselves and protect the interest of their children. I recently had the opportunity to speak with Diane Redleaf, a leading civil rights lawyer for families in the child welfare system. She has extensive experience defending and advocating for parents who face false allegations of child abuse and neglect. She’s the founder of the Ascend Justice (formerly, Family Defense Center) where she served for many years as the Executive Director/Legal Director. With over 60 published court opinions, she’s played a leading role in hundreds of important cases and policy change efforts on behalf of families. Today she’s an advocate for families through her private legal practice Family Defense Consulting.

In our interview, I asked Diane how falsely accused parents and caregivers can successfully navigate the child protection system. While this cannot substitute for legal advice or address individual circumstances, I’m excited to share her invaluable guidance and tips.       

Keri: Kids like mine, who have RAD, sometimes make false allegations of abuse. As parents we’re afraid CPS investigations will be unfair and that we’ll lose our kids. Does that really happen? Are our fears justified?

Diane: It is a justified fear. You may assume the system will protect your rights and that justice will be done. That’s not always the case. There is a tendency to reinterpret everything as the parent’s fault. It may not happen the first time, but if the child makes allegations over and over, it’s possible they will finally get to an investigator who believes them.

Keri: CPS once knocked on my door at 1 a.m. because my son made a false allegation of abuse. What do you recommend a parent do in this situation?

Diane: Certainly be polite. In general, I never recommend you invite them in if you’re the only person around. You need a third party present. This will help ensure the investigator does not misrepresent what you say to them. You might suggest going into the office to discuss the situation at another time.

Keri: How can we protect ourselves during an investigative interview as parents? Is it a good idea to ask to record the interview?

Diane: In some states it’s perfectly permissible to record the interview, but that can get the investigators’ back up. Definitely have a third party present and keep your own notes. Put everything in writing.

You also need to be prepared for commonly asked questions. You can find a list in the Responding to Investigations manual found on the Family Defense Center website. For example, investigators will ask if you use drugs, have a domestic violence problem or have a history of mental health treatment yourself. If your answers to these questions could be problematic, you need to have thought through your responses because the information you give likely will be used against you. You don’t want to be provocative but you have the right to say, “Thank you very much, but I’m declining to answer any further questions.”

Keri: What if CPS wants to talk to our kids? Can they interview them without permission at school or similar locations?

Diane: It’s such a basic question but there isn’t a clear answer as a matter of law. They shouldn’t be able to speak to a child at school without the parent’s permission, especially if it’s not an emergency. They cannot speak to a child in the home without parental consent unless they have a court order or a dire (life-threatening) emergency. Children also have the right to not talk to investigators but of course they get intimidated easily. This is why it’s important to try to set up the interview in a therapeutic setting, especially if the child has a mental health issue. This will help make sure false statements aren’t repeated unchecked, that the situation doesn’t escalate unnecessarily and that the child doesn’t feel uncomfortable.

Keri: Many parents like myself keep daily documentation of our children’s behaviors. Some parents also use security cameras. Are those good strategies?

Diane: In general, keeping as much documentation as possible in terms of a diary is a very good idea. It’s really important for people to educate and work with their service providers. A lot of times they are your best allies. If there’s a history of false allegations, you need the service providers to document it. Having that documentation readily available will disarm the investigators because they’ll realize they may not have a strong case to go forward with.

Using security cameras depends on personal judgement and may sometimes be helpful. But I worry that cameras can be a double-edged sword—they may not show the full incident for example, or they may be used to show the parent was unreasonable even if all the parent is doing is defending herself. Video footage is more open to interpretation than parents may realize. And at the same time, video can capture the real out-of-control behavior of the child in a way that is otherwise hard to describe in words.

Keri: These investigations can be extremely frustrating and sometimes we get angry about how we’re being treated. Is it safe to vent on social media?

Diane: It’s a bad idea. I understand why parents do it but Facebook creates a written record. You worry that those communications will go straight to the state’s attorney or the judge who is going to interpret the child’s behavior as the result of the parent having a temper. It may not happen very often, but if a prosecutor wanted to access those communications, they absolutely could. And if they wanted to use them against the parent in court they almost certainly could. Remember only communications with your lawyer, and in some cases a therapist, are truly confidential.

Keri: So, what can we do if we feel the investigator or agency is targeting us or treating us unprofessionally?

Diane: You begin by going up the chain of command to register your concerns about how the matter is being treated. Start with the supervisor and go all the way up the line to the director. Unfortunately in some states you won’t get anywhere with that. At some point going to a legislator might be a good idea. If your concerns are legitimate, legislators can intervene and get a bad situation addressed. If there is an ombudsperson or inspector general in the agency then a call to them can be a good idea too.

Keri: When do we need a lawyer?

Diane: If you get the sense there is the possibility of legal action or you need advice on how to answer potentially problematic questions then getting legal counsel is a good idea. There are cases that get closed as unfounded right away. In those cases, getting a lawyer isn’t necessarily a good use of your funds and may make things worse. Unfortunately, you may be viewed as having something to hide if you get a lawyer. The investigators are often not sophisticated enough to understand that you can be innocent and still need or want a lawyer.

Keri: What type of lawyer handles these types of cases?

Diane: One of the reasons I founded the Family Defense Center in 2005 is that so many families truly didn’t know where to go or how to find help. The situation is better now than in 2005 — there is a much more organized family defense bar nationally and there are even well-coordinated networks of family defense attorneys in some states (Colorado, Illinois, Michigan, North Carolina and Washington state are the ones I know the most about). However, in many places, it is still extremely hard to find a knowledgeable and affordable lawyer. Lawyers who aren’t well versed in this area will oftentimes advise families to go along with what child protective services is asking. I don’t necessarily give that advice because I’m trying to protect people. Even unaffordable lawyers may not be knowledgeable so it is especially important to ask questions about the lawyer’s child protection defense experience. Lawyers who have represented families with mental health issues often have the experience needed for these cases so that can be a good place to start.  

 Keri: One of our big fears is that we’ll lose our children during an investigation. In my case, I’ve pre-arranged for my sister to take them. What can parents do proactively to ensure their children won’t go into foster care?

Diane: Exactly what you are suggesting is a good idea. Also, short term guardianships are a legal protection that can be developed as a plan. If it happens that the kids get taken, it’s really important for support people and family to go to court. Judges often see families who show up to court alone with no support or people willing to be a resource for the family. A big group of supporters showing up to court creates a whole different dynamic.

Keri: I understand you have a very limited practice these days and are focusing your efforts on advocacy. Are there other resources you can recommend to families?

Diane: When I was with the Family Defense Center I wrote the manual, “Responding to Investigations” which is posted on their website. It is used by both parents and lawyers who want to understand the questions and concerns that arise during a child protection investigation.

Keri: I’m really excited about your recent book, They Took the Kids Last Night: How the Child Protection System Puts Families at Risk. Tell me more.

Diane: The book is about how the system is not adequately protecting parents in wrongful allegation cases. I cover several cases where there is a medical misdiagnosis of abuse, usually with very young children who cannot say what happened. I focused on these types of cases in particular because they make it easy for the average person to understand how things could go wrong and the dynamics of these situations. I use these cases as a vehicle to talk about the challenges families face in proceedings where the presumption of innocence is not honored in practice. I discuss in detail what family defense is all about and make recommendations for some fundamental changes in the system to protect children by protecting their families. (Find more information about Diane’s book and request a discount code on her website here.)

The information in this article is intended to provide general guidance for “wrongly accused” parents who are involved in child protective investigations. It does not constitute specific legal advice.

Interview first published by IACD.

What Social Workers Need to Know When Working with Adoptive Families

By brave adoptive parent and advocate Pernell Meier

Social workers have been an ever-present part of my family. Over the course of 13 years, we have parented 7 children from foster care, 5 of whom we adopted. In that time, we have had countless social workers in and out of our lives. Some have been rock-stars and stepped-up for our family and kids, advocated and pulled strings. Others have been toxic and blatantly destructive to our well-being. And the vast majority have fallen somewhere in the middle – neither appreciably helpful, nor actively working against us. Though these workers were generally decent people with their hearts in the right place, I’ve been struck by how much even caring and well-meaning social workers can be unintentionally damaging…

This amazing post goes on to provide concrete ways social workers can support adoptive families:

#1 – We desperately need your help.  
Life with an emotionally disordered child, particularly one with attachment disorder, is profoundly hard…

#2 – We need to be believed.
Most of us present one way to the world and another way to those closest to us. They can turn on the charm and show their absolutely impressive best sides to you, while five minutes later becoming unimaginably cruel to us. I know that this is hard to believe…

#3 – You might be one of the only persons who we can talk to.
Most adoptive parents of high-needs kids have the same experience – friends and family fall away. The challenges are just too hard for people to process, so avoiding it is much easier. And venting to people can bring forth the inevitable, “You did this to yourself!” comments

#4 – We expect that you will be educated on these issues.
Over the years, we have found such an unimaginable lack of basic education on matters related to trauma, prenatal exposure and attachment that the process of trying to educate and explain becomes draining. We are turning to you as an expert…

#5 –  When we tell the truth about our lives and our children, this does not mean that we do not love them or lack commitment.
Telling social workers about what is really going on at home backfires and gets used as ammunition against us to further cement the workers’ original views of the family. This atmosphere creates self-censorship as the adoptive parents come to view most social workers as either not helpful or detrimental.

#6 – We don’t speak social work.
You have your own specific acronyms, and ways of speaking and understanding things, just as all professions do. But when you are talking to us, please consider that we are not always going to know what you mean…

#7 – No, we are not triggering them.  
Ok, let’s be real. Sometimes we do, just as any parent will occasionally handle a situation poorly.  But, these children do not turn into raging, mean, or out-of-control persons because we are in general doing something to them that makes them that way…

#8 – Yes, we have skills.  
We have read more than you could possibly know, called and talked with anyone we could, watched videos, taken trainings, and turned our values and our way of thinking inside out to try to make things better…

#9 – Your meetings can be painful and often feel like a waste of time.
Please know that we are likely dealing with quite a few different social workers, support persons, doctors, therapists, school officials, etc. and we have a lot of meetings that we need to attend…

#10 – You are not our child’s friend.
When you approach interactions with our children from the perspective that the most important thing is having a positive relationship between the two of you, you inadvertently damage our parental relationship because you put on those empathy blinders that do not allow you to even see, let alone confront deceit, poor behavior, manipulation and destructive dynamics…

#11 – You continually undermine us.
You set meetings with them without even bothering to tell us, thus keeping us out of the loop and making us play catch-up. You buy them things that we have said “no” to. When they have been behaving terribly and break the rules, you take them out for ice cream or fancy coffee…

#12 – You have enormous power over our lives and that is frustrating and scary.  
As the gatekeeper, you are the one who gets to decide if we “need” something or we do not. When you deny us what we’re asking, please understand that this is “just business” to you and to us it feels like a hot knife slicing through us…

#13 – You get to go home.
We don’t. This is our home. This is our life. At the end of your long, stressful work days trying to make the world a better place, you get to go home to a quiet house or to your attached children, where your pets and other vulnerable children are not being abused, put your purse or wallet and car keys down without thinking to lock them away, and shrug off the day’s worries. For us, our homes often feel like prisons…

#14 – You cannot imagine our grief and our guilt.
Often co-mingled with our grief is our intense guilt. Raising a child with special needs seems to inevitably bring this on as we often second-guess and agonize over so many of the decisions related to our children’s care. Often our lives are so impossible that absolutely nothing feels like the right thing…

#15 – We need you to be honest and acknowledge your mistakes.
We need to trust you because the repercussions of you either baldly lying, withholding essential information, or manipulating us to obfuscate the truth can be devastating. In this power imbalance, you hold the cards. We have little recourse when you do things that create harm…

#16 – You hurt the kids.
Social workers will come and go, but we will always be there. You are not their parent, we are, and the best thing you can do to help them is to help us with the excruciatingly hard task of standing by them…

Please be sure to read the full article here.

Why Residential Treatment is good (and not good) for kids with RAD

What’s your success been with Residential Treatment Facilities (RTF)? My son, Devon, has been in 2 group homes and 5 psychiatric residential facilities (PRTF).  They feel like ‘holding tanks’ that have actually made him worse. Unfortunately, they’ve been necessary to keep Devon and my other children safe.

Here’s a great pro and con analysis from IACD. Let me know your thoughts…

Most parents who are considering residential treatment for their children with reactive attachment disorder (RAD) feel depleted. After years of therapy and countless other measures, they often feel as though their children are worse off than before. These families are close to running out of money, time, and support. The people in their lives don’t recognize what truly goes on in their homes. They just don’t get it. The parents themselves know, however, that their entire household suffers as a result. They need help.

The decision to send a child to a residential treatment center (RTC) is difficult (although sometimes that decision is made for parents which is an entirely different topic). To add to the difficulty, most parents are struggling with secondary PTSD as a result of raising children with PTSD. They are in “survival mode” themselves. If you or someone you support is in the midst of making such a decision, consider the following.

Read the Pro’s and Con’s and the complete article here.

Be sure to checkout these op-eds I’ve published on this topic:

I’ve tried the system. It doesn’t work. (My take on the Parkland shooting published by the Sun Sentinel)

Don’t blame workers for psych center woes. (My take on some local RTF abuse published by the Charlotte Observer)

Open letter to a therapist from a mom of a child with RAD

Dear Therapist,

I am desperate for your help. I apologize ahead of time if I seem angry and defensive. I’m just burnt out and afraid you won’t understand. My son is completely out of control and nothing works.

I’ve tried to get help before from therapists and teachers, even police officers, but no one understands. They all think I’m exaggerating, or maybe even lying. My own mother says, “He’s just a kid,” and can’t understand what I’m dealing with is way beyond normal, way beyond safe, and way beyond what I can handle. My son went through trauma at a young age and has been diagnosed with reactive attachment disorder.

I’m not exaggerating when I say my son screams for hours. He’s torn his bedroom door off the hinges and put holes in his walls. His siblings are afraid of him. Sometimes I’m afraid he’ll burn down the house when I’m asleep.

When you meet my son, he’ll look like a very different child than he is with me. You’ll think I’m overreacting. I’m not. You see, my son is an expert at triangulating the adults around him. Due to his early trauma, he manages his surroundings and the people in them to feel safe. In doing so, he’s good at making everyone think I’m mean and crazy. Sometimes I start to believe it too.

I have a secret I should probably share with you—it’s true that I’m not perfect. I’m very aware of that fact. I’ve screamed at my son and lately I’m always angry and frustrated. I’m afraid to tell you this because you’ll think I’m a bad mom and blame me for everything. Most people blame me for my son’s problems. Yet, I’m the one person whose life has been turned inside out and upside down to try to help him.

Even though I’m not a perfect mom, I’m still a good mom trying my best. Click To Tweet

I’ve turned into an unhappy, negative, impatient person whom I don’t even recognize anymore. Sometimes I wonder if I have post-traumatic stress disorder, but feel stupid suggesting that dealing with a child could cause PTSD. It would be helpful for you to encourage me to get some therapy for myself.

Even though I’m not a perfect mom, I’m still a good mom trying my best. Before we get started, here’s what you need to know (because my son will tell you otherwise):

    • I feed my son three meals a day, plus snacks.
    • I don’t hurt my son.
    • I’m not the one who rips up his homework and throws it away.
    • He locks himself in the closet under the stairs. I don’t and wouldn’t ever do that to him.
  • Our house isn’t haunted, he’s not best friends with Justin Bieber, and he’s not going to live with his birth mom next week.

My son will tell you things in individual therapy that will take up all of our time to untangle.

In the meantime, we’ll be distracted from working on the really serious problems for which we need your help. This is why I’m going to insist on being present during all therapy sessions. Please understand it’s not because I have something to hide. I just want to keep things from getting worse than they already are.

Typical parenting strategies like sticker reward charts don’t work for my son. We’ve already tried all sorts of behavior modification strategies. I can’t ignore my son’s negative behavior either. I can’t just watch him hurt himself, his siblings, or destroy everything we own.

Please understand, our family is in crisis.

This is an emergency. We need help and we need it fast. That play therapy you do in the sand…I don’t know, maybe it works for some kids–but not for him. I’m not trying to be unreasonable; I just know what doesn’t work. If you don’t have experience working with trauma-exposed kids, please refer us to someone who does. I understand this is a very specific and serious issue that not all therapists have expertise in.

I’m willing to do whatever it takes to help my son heal and to fix our family. Please help us.

Sincerely,

Keri

Originally posted by the Institute for Attachment and Child Development.

Mental Health workers are burnt out

Mental health “workers” are chronically overworked, underpaid, and not appreciated. “Workers,” given a variety of job titles, are the day-to-day staff who work in group homes and residential treatment facilities, and provide some in-home services. Unlike licensed clinicians and supervisors they’re in the trenches with us and our kids. They’re often just as exhausted as we are.

It’s a sad truth we must face: even the most well-intentioned worker doesn’t have the capacity to give our child the quality care they otherwise would if they're burnt out. Click To Tweet

A few summers ago Natalie (not her real name) was one of our Intensive In-Home services workers. She was absolutely wonderful and dedicated to our success. She was on call 24-7 and when Devon flew into a rage she would hurry over, once rolling straight out of bed in her pajamas. “You go on and do your stuff,” she would say waving me away. “I’ll take care of him.” Natalie knew how much control Devon had over our family during his rages. It was debilitating, keeping me from my job and Devon’s siblings from soccer practice. Natalie was determined to put a stop to it. Day-after-day she spent hours shut in the garage or a back room with Devon while he screamed and raged.

While this respite breathed some life back into me, Natalie burnt out before my eyes. She was working 60+ hours a week plus taking paperwork home every night. Her employer was sometimes ‘late’ on her paychecks and she was over loaded with clients. 

It’s a sad truth we must face: even the most well-intentioned worker doesn’t have the capacity to give our child the quality care they otherwise would if they’re burnt out. 

Here are some ways you can counteract mental health worker burn out and make sure you child receives the highest quality of care possible.

Be Kind–Be polite. Often these workers can’t control the things that are upsetting you so it’s unfair to yell at them. Compliment them when you’re impressed with their work, or even just to tell them you like their new haircut. Offer the in-home workers a cool drink and snack. It is these in-the-field, on-the-ground workers that can make a huge difference in the quality of services your child receives so investing kindness is well worth it.

Do Your Research–Carefully research the agencies you receive services from. In most cases, the ones that can “get you in right away” are the ones to steer clear of. A long waiting list, or at least a few weeks wait for an intake appointment, bodes well for the quality of service you can expect. Ask for referrals from your pediatrician. It can be difficult to find people to ask for personal recommendations when you are first starting to get services, but once you’re “in the system” you’ll find yourself sitting in a lot of waiting rooms chatting with other parents. Take advantage of these opportunities to ask about their experience with various agencies even if you aren’t currently looking to switch services.

Demand Quality Service–Your first priority is your child. Don’t accept sub-standard services! When you first start services with any provider they hand you a stack of papers that outline your rights and the policy to file complaints. I used to dump those in the trash as I walked out of the building, but now I know how valuable they are. You need to know what you are entitled to and what procedures to follow if you need to escalate a complaint. If it becomes necessary, switch agencies or providers in order to get better services. Also check for a parent advocate organization in your area. They can refer you to services and will send an representative with you to meetings to advocate on your behalf.

Whenever you can, advocate for better working conditions for mental health workers. Our kids are only going to be safe if workers are qualified, well-trained, and fairly compensated. Not long ago, there was a riot in a psych facility in my area and the workers were blamed for not handling the situation better. I wrote an op-ed suggesting that we’re asking too much of these entry-level, hourly employees and that working conditions must be improved. You can read my full op-ed here: Charlotte Observer/Don’t blame workers for psych center woes

Assumptions: The deck is already stacked against you

Navigating the mental health system on behalf of our children, especially those with extreme behaviors, is like traversing hostile territory. The assumptions mental health professionals make about us and our families are quicksand sucking us into a quagmire of misunderstanding and bitterness.

Here are just a few assumptions that have been made about me:

  • You need basic parenting instruction and training; forget your idea of common sense, and trust the ‘professionals’
  • You’re being selfish and need to snap out of it; you’re not putting your child’s wellbeing above your own
  • You treat your birth kids better than your adopted child; that’s why he’s acting out
  • You don’t feel affectionate towards your adopted child because something is wrong with you emotionally and mentally

Of course, the worst, and most pervasive, assumption I’ve encountered is, “You’re mostly, if not entirely, to blame for your child’s behavior.”

Ouch. This one is perhaps the most difficult to grapple with–don’t we often secretly believe, or at least wonder, if it’s true?

As parents we must accept responsibility where appropriate, but with some perspective. Blaming the parent–especially an adoptive parent–is way too easy of a fall back position for a therapist. Lack of progress with your child can be blamed, not on their methods and approach, but on you. It also removes any agency and responsibility from your child.

Trust me, mental health professionals are making assumptions about you from the moment you walk through their door. The deck is already stacked against you. So, forget being charitable, assume the worst, and keep your guard up.

Blaming the parent–especially an adoptive parent–is way too easy of a fall back position for a therapist. Click To Tweet

Don’t overshare

Be very cautious about sharing sensitive information with your child’s therapist. It’s easy to think of them as objective. They’re not.  If it comes to taking sides, they are on your child’s side. Don’t do what I did and blurt out at your first appointment that you don’t feel maternal affection towards your child. If you do, that’s almost certainly the ONLY thing they’ll focus on going forward. They’ll immediately conclude this is the cause of your child’s extreme behaviors, not considering that it might be the extreme behaviors that has caused your lack of affection. I see a therapist myself now, and that’s where I blurt out everything and get the support I need.

Keep a journal

It is critical that you start keeping a journal. Start today. Every time you see a therapist or doctor–document the date, time, who you saw, and a summary of what was said. If your child’s teacher, foster parent, or caseworker calls you take out your journal and take notes. I once had a case worker insist my son hadn’t exhibited any behavioral problems in the last month to justify pulling his services. I was able to pull out my journal, flip it open and ask: “Well, what about last Wednesday when Juan called me to report that Devon was trying to stab a peer in the head with a pencil and had to be restrained?” I went on to list multiple incidents from the time period in question. His services were renewed.

Don’t believe it

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Your own feelings of inadequacy and guilt are likely to be your biggest weakness, especially when some of your most self-judgmental thoughts are affirmed by the assumptions underlying the advice mental health professionals give. You’ve been living under a great deal of stress and instability. You may be traumatized by what you’ve been through. 

Listen to the advice you are given and take what’s of value, but don’t automatically believe everything you are told. Just because they’re the “professionals” that doesn’t mean they speak gospel. You know your child and family best.

How have assumptions affected your ability to get help for your child?