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.

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.

Aging out of RTF into the real world – a dangerous proposition

J.D. spent his teenage years growing up in a residential treatment facilities. He celebrated his 18th birthday by walking out through those doors – free to make his own decisions and live life his way. Within days, J.D. was causing a public disturbance. Police were called. They told him to put his hands in the air. He laughed. He mimed a gun with his fingers. The officers open fire.

J.D. fell to the ground – dead.


For those of us who’s kids have spent years in residential treatment facilities (RTFs) – growing only more dangerous and violent – this story strikes like a death bell in our chest.

My son Devon has been bounced trampoline-style from facility to facility since he was 10. He’s been in these facilities because he cannot live safely at home. He poses a threat to himself and to his younger siblings. However, instead of getting better in these therapeutic settings, his behavior has become worse. 

Because of the polices of these facilities, Devon has committed assaults and serious vandalism with no consequences. 

  • He’s created thousands of dollars of property damage –  no consequence.
  • He’s made false allegations of abuse – no consequence
  • He broke a woman’s thumb – no consequence.
  • He stabbed a kid in the back with a pencil – no consequence.
  • He punched a girl in the back of the head – no consequence.

Unfortunately, this is how treatment facilities work. The underlying idea is if you consequence kids, that’s all you’ll ever do and they won’t be able to receive therapy. This is true, but on the flip side, what if the “therapy” the kid is receiving in leu of consequences does not help? What have they learned?

My son will turn 18 in a handful of months. He’s itching to leave and at one-minute past midnight he’ll bolt. He won’t have a high school diploma or have any job skills. Worse, he won’t understand that there are consequences in the real world. He’s come to believe that, with a bit of fast talking, he can turn any situation into a ‘therapeutic incident’ and deflect consequences. 

I’m sure that’s what J.D. thought too – before he was shot and killed by police. He expected them to beg him to calm down, offer him coping skills, and at worse drop him to the ground in a physical restraint. I have no doubt that J.D. did not understand the danger of his behavior.

For the safety of our kids, who will someday age-out of residential treatment and into the real world we must find a balance. I don’t pretend to know the answer and there are no quick and easy solutions to this problem. But here’s what I do know: Our kids must have effective treatment AND understand that their choices have consequences. 

My kids’ pediatrician told me this story. He personally knew this young man and the incident happened several years ago. 

RTF: A bad option, that’s sometimes the best option

My son Devon was 10-years-old when I dropped him off at a residential treatment facility (RTF) for the first time. I knew almost instantly it wasn’t going to work. They didn’t believe in consequences. School work was optional. With unlimited dessert and no rules, it was more like a summer camp than a program for kids with severe behavioral problems.

I called my sister for advice and my words came out with a sob, “He’ll see this as a reward.”

“I don’t care if it’s Disney World,” she said, without hesitation. “You have to get him out of your house. Nothing else matters right now.”

“But he’s going to get worse here–“

“We’ll deal with that later. Leave him,” she said. 

And I did.

Devon’s behavior had been growing increasingly unmanageable and dangerous over the previous 18 months. He was having violent outburst every day and the stress level in our house was toxic for everyone. My youngest son, who was 4, was especially frightened and would tremble with fear when he sensed Devon’s anger mounting. I was suffering from PTSD—even though I didn’t realize it at the time.

I’d been trying to get help for Devon for years. We’d tried outpatient therapy, intensive in-home therapy and partial hospitalization. He wasn’t getting better and I had no idea how to help him. I only knew what I was doing wasn’t working. 

As I’d predicted, Devon’s behaviors did become dramatically worse from the RTF. However, my sister had recognized what I could not – it was still the best option available to us. Unfortunately, if you’ve exhausted outpatient options and your child is becoming unsafe, it may be your only option too. 

Why RTFs don’t work

While an RTF may be the best – or only – option available, it’s important to have realistic expectations. These facilities are rarely effective for kids with developmental trauma disorder. In fact, they can exacerbate the symptoms, and here’s why:

1. The treatment is not specialized for developmental trauma. Your child will be placed with kids who have a variety of issues including anxiety disorders, eating disorders and PTSD. The coping skills they will learn – like taking deep breaths, playing with a stress ball and counting to ten – are not enough to heal the brain injury caused by developmental trauma.

2. The workers are under-trained, overworked and underpaid. Your child will work with a licensed clinician for therapy. Yet, the general supervision is typically provided by workers who have a high school diploma and on-the-job training. Our kids are very challenging to deal and the chronic understaffing and inadequate training results in inconsistent quality of care.

3. The staffing structure lends itself to triangulation. Because workers are rotated (and have high turnover) they are easily triangulated – especially against the therapist and parents. Unfortunately, your child is likely to gain a sense of control by behaving this way – a feeling they unconsciously crave – and will continue even when it sabotages their treatment.

4. The kids become institutionalized. In these facilities, your child will be exposed to and influenced by kids with sexualized behaviors, horrific language and physical violence. They’ll quickly learn the ropes and how to work the system to their advantage, for example, by making false allegations to retaliate against staff or peers. This is knowledge they’ll ultimately use to manipulate the staff and you as well.

RTFs are intended to teach your child how to cope and let them “practice” good behavior for when they return home. Yet, the artificial environment and behavior-based modification techniques do not help them to truly heal. 

“Kids with DTD learn to work within the external structure of residential treatment facilities. It doesn’t get internalized for them though,” said Institute for Attachment and Child Development Executive Director Forrest Lien. “Ultimately, most kids go back into their families and fall apart. Sadly, it’s oftentimes the only option for parents.” 

Sadly, unless you are able to send your child to a program that is highly specialized for developmental trauma, your child is unlikely to get better. 

When to consider an RTF anyway

Parents who are considering sending their children to an RTF often ask for my advice. It is a very personal decision and every child and family is different. However, the following are a few words of hard-earned wisdom I often share. 

1. Consider an RTF if your child is unsafe to himself or others. Remember to consider not only the physical, but also psychological well-being, of other children in the home.

2. Consider an RTF if you are at your breaking point. You cannot help your child when you are unstable yourself. An RTF may be the breather you need to regain perspective.

3. Consider an RTF if your child  engages in unlawful behavior. An RTF is likely a better option that juvenile detention where your child will get a criminal record and receive little treatment.

The decision to send your child to an RTF should be a last resort but you may be at that point now. You alone are not able to heal developmental trauma any more than you can set your child’s arm or cure his leukemia. The best you can do is access the best possible treatments available and support and love your child through the process. 

For us, an RTF was the best choice because Devon had become unsafe to himself and his siblings. And after years of giving it my all, I had nothing left to give. He’s now 17 and in his ninth RTF. It’s not the forever family I’d hoped for and not what any parents wants. Yet, it is often the best of the limited choices families like mine have. It is the best choice for us. And while my son doesn’t live at home, he’ll always be a part of our family.

First published by Institute for Attachment and Child Development here.

Out Of Options, Parents Of Children With Mental Illness Trade Custody For Treatment

Illinois NewsroomJul 31, 2018

When Toni and Jim Hoy adopted their son Daniel as a toddler, they did not plan to give him back to the state of Illinois 10 years later.

“Danny was this cute, lovable little blonde-haired, blue-eyed baby,” Jim said. There were times Daniel would reach over, put his hands on Toni’s face and squish her cheeks.

“And he would go, ‘You pretty mom,’” Toni said. “Oh my gosh, he just melted my heart when he would say these very loving, endearing things to me.”

But as Daniel grew older, he began to show signs of serious mental illness that manifested in violent outbursts. When his parents exhausted all other options, they decided to relinquish custody to the state to get Daniel the treatment he needed.

Listen here as the Hoys tell about how they gave up custody of their son to get him needed mental healthcare.

“To this day it’s the most gut-wrenching thing I’ve ever had to do in my life,” Jim said. “But it was the only way we figured we could keep the family safe.

[bctt tweet=”To this day it’s the most gut-wrenching thing I’ve ever had to do in my life. But it was the only way we figured we could keep the family safe.” username=”RaisingDevon”]

Across the U.S., children encounter many barriers to mental health treatment, including a shortage of psychiatric beds and coverage denials from insurance companies. In a desperate attempt to get their child treatment, some parents have discovered a last resort workaround: they trade custody for treatment.

Known as a psychiatric lockout, a parent brings a child to a hospital and refuses to pick them up. The child then enters foster care, and the state is obligated to pay for their care.

This happened to Daniel in 2008, and has happened to thousands of other children before him, according to a report from the Government Accountability Office.

Today, despite a 2015 Illinois law that states families should never have to trade custody for mental health treatment, at least four children a month enter state custody this way, according to data obtained by Side Effects.

Out of options

Daniel grew up as the youngest of four children in Ingleside, just north of Chicago. As a baby, he’d been severely neglected — starving and left for dead — and the early trauma Daniel experienced affected his brain development.

At around age 10, his post-traumatic stress disorder manifested in violent outbursts.

“You could almost tell the stories that would describe him like a monster,” Toni said.

“He held knives to people’s throats. He tried putting his fingers and his tongue in the light sockets. He broke almost every door in the house.”

In the car, there were times when he’d reach over and grab the wheel while Toni was driving to try and force the car into oncoming traffic. Other times, he would lash out at his siblings.

“At the same time, he’s a little boy,” she said. “He didn’t want to be that way. He didn’t like being that way.”

Despite Toni and Jim’s efforts to help their son with therapy, the violence escalated. Daniel was hospitalized almost a dozen times over a period of two years.

His doctors said he needed more intensive mental health services than he could get while living at home. He needed 24/7 residential treatment, but both Daniel’s private health insurance, and the secondary Medicaid coverage he received as an adoptee, denied coverage.

So the Hoys applied for a state grant meant for children with severe emotional disorders. They also asked for help from Daniel’s school district, which is supposed to cover a portion of the costs when students need residential care. They were denied both.

“We were told we had to pay out of pocket for it,” Toni said. The treatment could cost up to $150,000 a year, and that was money they didn’t have.

Then, during Daniel’s 11th hospitalization, the Illinois Department of Children and Family Services, or DCFS, gave the Hoys an ultimatum.

“[They] basically said, ‘If you bring him home, we’re going to charge you with child endangerment for failure to protect your other kids,’” Toni said. “‘And if you leave him at the hospital, we’ll charge you with neglect.’”

Out of options, the Hoys chose the latter option as a last-ditch workaround to get treatment.

Once the DCFS steps in to take custody, the agency will place the child in residential treatment and pay for it, said attorney Robert Farley, Jr., who is based in Naperville.

“So you get residential services, but then you’ve given up custody of your child,” he said. “Which is, you know, barbaric. You have to give up your child to get something necessary.”

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Get Toni’s book here.

Taking it to the courts

The Hoys were investigated by DCFS and charged with neglect. They appealed in court and the charge was later amended to a “no-fault dependency,” meaning the child entered state custody at no fault of the parents.

Losing custody meant Toni and Jim could visit Daniel and maintain contact with him, but they could not make decisions regarding his care.

Toni spent months reading up on federal Medicaid law and she learned the state-federal health insurance program is supposed to cover all medically necessary treatments for eligible children.

The Hoys hired a lawyer, and two years after giving Daniel up, they sued the state.

Less than a year later, in 2011, they settled out of court, regained custody of Daniel, who was 15, and got the funding for his care.

Around the same time, Farley decided to take on the lack of access to mental health care on behalf of all Medicaid-eligible children in the state. He filed a class-action lawsuit, claiming Illinois illegally withheld services from children with severe mental health disorders.

“There [are] great federal laws,” Farley said. “But someone’s not out there enforcing them.”

In the lawsuit, Farley cited the state’s own data that shows 18,000 children in Illinois have a severe emotional or behavioral disorder, yet only about 200 of them receive intensive mental health treatment.

In a settlement in January, a judge ruled the state must make reforms to comply with Medicaid law. The state has until October to come up with a plan to ensure all Medicaid-eligible children in the state have access to in-home and community-based mental health services.

A law that didn’t fix the problem

While these legal battles were taking place, lawmakers began their own work to ensure parents no longer have to give up custody to get their children access to mental health services.

In Illinois, six state agencies interact with at-risk children in some form. But Democratic state Rep. Sara Feigenholtz said they operate in silos, which causes many children to slip through the cracks and end up in state custody.

“It’s almost like these there’s a vacuum, and the kids are just being sucked into DCFS,” she said.

Feigenholtz worked to get a bill passed in 2014. The Custody Relinquishment Prevention Act, which became law in 2015, orders those six agencies to work together to help families that are considering a lockout to find care for their child and keep them out of state custody.

So the agencies developed a program together that launched in 2017 — years after the deadline set by the law. It aims to connect children to services.

But Feigenholtz said the fact lockouts still happen shows a lack of commitment on behalf of the agencies.

“I think the question is: Shouldn’t government be stepping in and doing their job? And they’re not,” she said. “We just want them to do their job.”

B.J. Walker, head of DCFS, said the reasons lockouts happen are complex. “If law could fix problems, we’d have a different world,” she said.

Walker said many children in need of residential treatment for mental illness have such severe or unique conditions that it can be a struggle to find a facility that’s willing and able to take them.

Even for families that get state funding to pay for the care, families Side Effects Public Media spoke to said the waiting lists can run six months or longer. When parents are unable to arrange a placement, the child may enter state custody, and as ProPublica Illinois reports, they could languish for months in emergency rooms that are ill-equipped to provide long-term care. Some out-of-state facilities are not willing to accept Illinois children, citing concerns over severe delays in payments that stem from a recent two-year budget crisis in Illinois.

The program to prevent lockouts requires families take children home from the hospital after medical providers have done everything they can. But many parents say it’s not an option for them because their child remains too violent for home.

For these reasons, children continue to enter state custody as a final effort by their families to help them.

A spokesman for DCFS said in an email that, when the agency gets blamed for this problem, it’s like when a pitcher comes in at the end of a losing game to save the day and gets tagged with the loss.

What it will take to prevent lockouts

Lockouts can happen anywhere, but Heather O’Donnell, a lawyer with a Chicago-based mental health treatment provider, Thresholds, said the situation is particularly bad in Illinois.

She said a big part of the problem is that society sweeps mental health conditions under the rug until there’s a crisis.

“We don’t have a very good system in Illinois for children or adolescent or young adults with significant mental health conditions,” O’Donnell said. “What Illinois needs to put into place is a system that helps these families early on so that these kids never get hospitalized.”

That’s what the state is trying to fix now.

The consent decree issued as part of the class-action lawsuit settlement requires the state to propose a plan by October to ensure all Medicaid-eligible children in the state have access to mental health services in their communities, with changes slated to begin in 2019. Farley estimates the changes will cost the state several hundred thousand dollars, based on what it cost other states like Massachusetts to implement similar reforms.

The difference treatment and family can make

Daniel Hoy is now 23 and has been out of residential treatment — and stable — for five years. He has a 2-year-old daughter, works nights for a shipping company in Rantoul, in central Illinois, where he recently moved to be closer to his parents.

Daniel said treatment was tough, and he would not have gotten better without his parents’ love and support.

“Sometimes it’s so hard to do it for yourself,” he said. “It almost helps to know that I’m doing it for myself, but I’m also doing it for my family and for our relationship.”

Toni’s thankful that despite losing Daniel while trying to help him, they ultimately made it through intact. She’s in touch with other families that have gone through lockouts too and most, she said, are not as lucky.

That’s why Toni said she will continue to speak out about this issue. “Kids do need services,” she said. “But they also need the support of their families. And when they have both, a lot of kids can be a lot more successful.”

Get Toni’s book Second Time Foster Child: How One Family Adopted a Fight Against the State for their Son’s Mental Healthcare while Preserving their Family

Republished with permission. This story was produced by Side Effects Public Media, a news collaborative covering public health.

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The Boy Who Cried Abuse

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.

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)

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.

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?

I’ve tried the system, it doesn’t work

Read my original Op-ed on the Sun Sentinel website here.

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?

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