Tag: PRTF

Most Popular, We need to do better

Parents in crisis can’t parent therapeutically – so stop expecting us to.

My teenaged son called this evening to explain that he’d cursed his teacher out and thrown his desk across the classroom. He was upset because he’d lost his school issued Chrome book because he’d taken it home (not allowed, and not his first time) and had pornography on it. I listened patiently without judgement. He explained how his elopement from school ended in an entanglement in a pricker bush and contact with a concrete culvert which scratched up his arms and legs. He was covered with bloody scratches and scrapes. I expressed empathy as I sipped my coffee. I offered encouragement when he said he was going to try to earn back the Chromebook and even said I’d talk to the school to ask for a clear plan to work towards that goal. I told him I was proud of this choice to make tomorrow a new day.

Today I was a therapeutic parent superstar and here’s why:

Had this situation happened when my son was still living at home, I would have gone nuts. I would have been throwing out consequences and yelling. My anxiety would have been through the roof. I would have been angry, embarrassed, frustrated, and overwhelmed.

Back when my son was living at home, our family was in crisis. The situation had grown toxic. It took several years of his being in treatment programs, and my being in therapy and educating myself, to begin to find a positive way forward.

Unfortunately, this is not uncommon. Adoptive and foster parents aren’t prepared for the early childhood trauma most kids coming into our families have experienced. We usually reach a crisis point before we learn about therapeutic parenting. By that time, we’ve become desperate and demoralized. Our mental and physical health is so degraded that we are barely surviving. Our kids are out of control. Our life is out of control. We can’t even manage to brush our hair in the morning much less use a calm and kind voice after our child spits in our face.

No doubt, our children need us to be that calm and steady, therapeutic parent, but at that point, we simply don’t have the capacity to do it. And given the our current relationship with our kids, it’s likely we aren’t even the best person to do it. Though few dare tell the shameful truth – we likely have come to a point where we really don’t like our kid. It’s a struggle to be nice to them. It’s difficult to not feel adversarial towards them. If we’re really being honest, some days we’re as out of control as our kids.

Unfortunately, few therapists understand this. They usually underestimate our child’s extreme behaviors and the level of crisis our family is in. They assume we have the ability to parent therapeutically and shame us if we don’t. For our families to heal and thrive, this is something that must be recognized and addressed.

The only clinician I know who is talking about this and teaching other clinicians about this is Forrest Lien of Lifespan Trauma Consulting. (If you are a parent, please follow him on social media to support his efforts on our behalf.)

Families in crisis do not have the capacity to parent therapeutically. This is why we must:

1) Get help to families before they are in crisis (this means pre-adoption training and post-adoption support),

2) Support parents and families in a holistic way. Help us get to a place where we can parent therapeutically.

3) Surround families who are in crisis with supports. Stop shaming us for being broken and demoralized. Give us a hand up.

Parents must be healthy and educated to parent therapeutically.

A note about therapeutic parenting:

There are no perfect treatments for developmental trauma. My son hasn’t been able to access the highly specialized treatment he needs. My response to his phone call today doesn’t solve the problem – I realize that. However, consequences, though perhaps “deserved” won’t work, and will only further escalate my son. What I must do is choose the response that is most likely to move the ball forward. My goal is for him to remain in school and to not get kicked out of the group home. My goal is to de-escalate the situation. I highly recommend A to Z Therapeutic Parenting for practical information on therapeutic parenting.

Resources, 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.

Most Popular, We need to do better

The Boy Who Cried Abuse: When kids are abused in residential treatment facilities

Devon was a boy who cried wolf. On several occasions, he claimed workers had purposely hurt him. When he mumbled about Mr. Myron beating him up. My stomach churned not knowing what was true, what was exaggeration, and what was an outright lie. It was hard to imagine a worker beating Devon, but not hard at all to imagine Devon accidentally hitting his head during a restraint. I was pretty sure this was somehow Devon’s own fault, and that the investigation would bear that out, but were those fingermarks on his neck? How could that be an accident?

Read the full story here.

Tips to navigate "the System"

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)

In the News, We need to do better

I’ve tried the system. It doesn’t work.

Here’s my op-ed on the Parkland shooting printed by the Sun-Sentinel (Feb 2018)

When my son, Devon, was nine he pushed his four-year-old brother down the stairs. It was one big shove that launched Brandon through the air and left him sprawled on the tile floor below. At 10, he punched his teacher and several classmates. At 11, he attacked a woman and dislocated her thumb.

Told a man had fresh dental work, Devon (for the purposes of this oped, I’ll call him Devon) promptly slugged him in the jaw. He was 12. At 13, he punched a young girl in the back of the head, unprovoked, and used his pencil to stab classmates. He still does. At 14, he grabbed a woman’s breasts and genitals threatening to rape her; using a jagged piece of plastic he stabbed a man in the cornea. At 15, he bit a man, breaking the skin and drawing blood; he did $3000 worth of property damage in mere minutes.

Devon, now 16, has verbalized detailed plans to torch the group home he lives in. He routinely threatens to kill himself, me, his siblings, his teachers, and other students.

Nikolas Cruz, the Parkland high school shooter, is a troubled kid, too. While I don’t presume to know Nikolas’ history or diagnoses, Devon and Nikolas are both teenagers, adopted males with behavioral and mental health issues. I adopted Devon from foster care in Broward County when he was four. Like Nikolas, his disturbing record of deviant behavior telegraphs worse to come.

The media is calling the Parkland massacre “preventable” and pointing to missed warning signs. But, I’ve heeded the warning signs. Devon’s received comprehensive mental health services for years. Running the gamut — outpatient therapy, day treatment, therapeutic foster care, group homes, psychiatric residential facilities, mental health hospitalizations — he’s received thousands of hours of therapy. He’s been dealt diagnoses like a hand of Go Fish and is on a cocktail of anti-psychotic drugs.

All these mental health services, like water and sunshine, have unwittingly nurtured Devon’s proclivity for violence. He’s only gotten bigger, stronger, smarter, and more dangerous. I fear he could be the next teen paraded across the headlines in handcuffs.

When Republicans call for greater access to mental health services as a remedy to school shootings, they fail to recognize the mental health system has no meaningful solutions for violent kids like Devon and Nikolas.

Take a walk. Talk to staff. Hug your pillow. These are the coping skills therapists give angry teens to reel in their extreme emotions. The absurdity comes into focus when a teen like Nikolas opens fire on hundreds of innocent victims, taking 17 lives. Would tragedy have been averted if Nikolas knew to pull off his gas mask and take some deep breaths? To put down his AR-15 and hug his pillow?

Psychiatric treatment facilities are virtual incubators for violent kids. They focus on underlying mental health issues promising the negative behaviors will diminish. In these programs, Devon has no consequences for truancy, vandalism, criminal threats, and assault. Not even a time-out. Protected from criminal charges, he’s become desensitized to his own violence and indifferent to social boundaries. It’s normalized his violent responses to even the smallest triggers: waiting his turn, a snarky look from a peer, being served breakfast he doesn’t like.

It’s unlikely Nikolas’ trajectory would have changed even if he’d received the years of intensive mental health treatment Devon has. Mental health facilities are little more than holding pens for kids who are too dangerous to live at home.

I’ve tried the system. It doesn’t work.

Funding to offer these same ineffectual services to more would-be-shooters won’t stop tragedies like the Parkland shooting, especially since Trump nixed the Obama-era regulations making it easier, not harder, for mentally ill people to buy guns. I don’t pretend to know the answers, but I do know a bad idea when I see one: giving these kids access to guns. If we’re not going to do something as basic as keeping deadly weapons out of the hands of mentally disturbed teens, what mental health interventions can possibly keep us safe?

Keri Williams, a former resident of Broward County, lives with her family in Charlotte, N.C., and is working on a memoir about raising her adopted son.

In the News, We need to do better

Don’t blame workers for psych center woes

Here in Charlotte, NC we’ve recently had a lot of news about Strategic Behavioral Center, a Psychiatric Residential Treatment Facility (PRTF). You can read the full story from the Charlotte Observer here describing a disturbing riot on January 1st. Here’s an excerpt:

Patients at Strategic Behavioral Center — some wielding wooden boards — attacked one worker, barricaded themselves in a room and escaped through a broken window. Others fought with each other or vandalized the building.

Amid the mayhem, some hospital staff watched in fear and did not try to control the situation. They initially delayed calling for help because a former executive had erroneously told them to not call the police for trouble with patients.

Having dealt with workers at PRTFs and other mental health facilities, this article bothered me–or rather people’s response to it bothered me. I saw calls for the workers to be fired, and disgust by their behavior. What this article didn’t convey is the untenable position workers like this are in.

Here’s my op-ed response published by the Charlotte Observer:

Stripping naked is just one way my teenage son, Devon, thwarts workers at psych centers. Afraid of sexual misconduct allegations, they’re unlikely to physically restrain him despite the mayhem he causes. This trick has worked for Devon (an alias to protect his privacy) at multiple psych centers in Charlotte and throughout the state including at the Strategic facility in Garner.

The recent investigation into the Strategic facility in South Charlotte paints a picture of workers, afraid for their lives, standing by watching a riot unfold without trying to control the situation. While the workers’ actions are shocking to many, as the parent of a child who has been a resident of five different psysh centers, I understand why and really don’t blame the workers. Continue reading here.

What do you think?