Dear Original Poster,
I am glad that your daughter is seeing someone who is a specialist in treating PTSD. It may help you to educate yourself on this disorder as you are your daughter's primary support person and will be challenged for a long time about how to best support her recovery. I will include a link for the SIDRAN National trauma organization, a very good place to start.
We were in almost an identical situation as you. Things were so out of control and it seemed as if professionals in the community only lumped on another new diagnosis with no cohesive, coordinated plan while our child and family continued to spiral downward under the stress of dealing with a child in so much pain who was acting out self destructive impulses and having rages against us. There were occassions that we had to call the police to deal with these behaviors, but I would only recommend it as a last resort!!! School refusal and a sleep disorder were a part of the picture. Instead of trying to be suppportive or at least protecting the child's right to accomodations for the illness under Section 504 of the Rehabilitation Act of 1973-- a civil right's law-- the school was hostile to our requests for help and punitive toward a child who had previously been an exemplary student. Things continued to worsen, with increased suicide attempts and threats to run away. We especially had difficulty managing those acute episodes. Most of the time we were told that child wasn't disturbed enough for in-patient and would learn worse behaviors, no beds, etc. After a particulary nasty cutting episode that required medical treatment and observation for suicidal ideation child was hospitalized. The doc there was a zip them up on meds & discharge type. It seemed as if no one could give us a plan for dealing with the PTSD-- just a label and more labels leading to a life as a "career mental health patient".
At this point, we turned to a wilderness intervention program and an emotional growth boarding school. What allured us was the presence of a CLINICAL staff and slick promotional promises of an individualized educational approach with small teacher/student ratios that would be geared toward learning styles and strengths of child. The emotional growth part was presented as helping the child recover and build skills to cope in a more positive fashion. We were desperate and would make any sacrifice to see our child safe and recover. We NEVER approved of the negative, tear them down approach of BOOT CAMPS, and knew that this approach made children sicker. We were persuaded that EG was not like a boot camp approach.
WHAT WE EXPERIENCED:
Clinical staff were well-intentioned, but had no power in the system. The educational program plan was a "cookie cutter" plan that did not address any individual needs. In fact, it was humiliating to child. Program staff, who seemed to call the shots, were uneducated and seemed to believe that negative confrontations and harshness were legitimate treatment techniques that they were applying for the child's "OWN GOOD". The "program" was focused on negative behaviors and negative, punitive interventions-- a dressed-up, tear them down boot camp approach!!! Former positive, self-soothing coping mechanisims were denied the child. During a period when child was experiencing suicidal ideation and therapist had child on 15 minute bed checks, program staff subjected child to a scary, disorienting group punishment. Child became extremely agitated and was hospitalized near EG school. Psychiatric support refused to discuss PTSD & environmental triggers at the EG school and forcefully advised antipsychotic medication. At this point we had seen too much of this bizzare approach to "saving lives" and "pulled" our student.
We are of the opinion that the "treatment" child was receiving was pushing child into decompensation, or a psychotic break. Luckily, we had finally managed to connect with wrap around services in our community and a program where therapists/casemanagers/doctors came into the home not only to work with child, but to help us learn how to work with child and deescalate from the sleep-deprived crisis mode we had all been operating under for three years. We had a plan in place to bring the child home. (The best thing about having child gone for awhile was the opportunity to sleep so we could think clearly. This extra sleep probably helped us see through the EG BS!!!!!, -- despite the implicit message that we had screwed our child up so now we should step back and let the EG staff do their job. Very undermining to stresed-out parents who are in crisis themselves).
In wrong, undersupervised hands the approach is similar to the ritual abuse in cults where the self-system is further broken down. Maybe it works for some, but our child's program was very punitive & negative. Lots of restrictions, long periods of isolation, weeks in fact. During one week long table restriction, child was not allowed to laugh or smile.
In summary, we knew better than to subject a child with PTSD to a "boot camp" approach. We believed we were getting a positive, growth oriented program for our child. In our experience, this was not the case. The program made child worse. For months after coming home, child not only had nightmares about the original PTSD triggering event, but about the EG school!!!!!!!!! The time-out period away from child in crisis, which could be accomplished by respite service in the community, perhaps, helped us think more clearly.
With support from advocates, child did receive an IEP at public school, which is far from perfect but better than the no cooperation at all we had from ps before. Things are getting better, slowly for the past two years.... Still are times and areas that need work, but the intensity and frequency of these have improved. Our response to episodes makes a difference, as did diagnosis and treatment of the sleeping disorder. Also, IEP protects child from ps draconian attendance policy that gives a child with an A or B an "F" for too many absences or tardies. Public schools' response to emotional disturbance, or any disability, in fact, is another story.....
My heart goes out to you. There are no easy, quick answers, I know. But from our experience, a retricted EG placement that removes you from direct observation of your child, communication with your child, and the ability to exercise "due diligence" over your child's treatment is no way to go.
Here are the links to SIDRAN:
http://www.sidran.org/and
from the FDA Advisory Statement on PTSD
http://www.sidran.org/fda.htmlFDA Advisory Statement on PTSD
By Esther Giller and Elizabeth Vermilyea
The Sidran Foundation
?...Comorbidity
The moderating effects of PTSD can significantly complicate any other co-occurring disorder including developmental disorders. Persons with PTSD are likely to have at least one other mental health disorder. Even in the most conservative studies, people with PTSD were two to four times more likely than those without PTSD to have almost any other psychiatric diagnosis (Kessler et. al., 1995). Somatization was found to be 90 times more likely in those with PTSD than in those without PTSD. This shows an important but frequently overlooked connection between PTSD and physical complaints.
Many people with PTSD turn to alcohol or drugs in an attempt to escape their symptoms. Clients who are dually diagnosed with substance abuse and PTSD may benefit from trauma treatment instead of or in addition to traditional model substance abuse programs........
Misdiagnosis
Misdiagnosis and incorrect or inadequate treatment is not unusual for adults and children with PTSD. For example, refractory depression, substance abuse, and eating disorders, among others, often mask underlying but undiagnosed PTSD. Flashbacks and other dissociative episodes can frequently be mistaken for psychosis (especially schizophrenia), and unnecessary anti-psychotic medication can undermine treatment progress. Schools increasingly report disciplinary problems with no understanding that some children may be suffering from violence-related trauma disorders rather than ADHD or ADD. Consequently, they are improperly treated with Ritalin, while their real problems remain unaddressed.
Education
There is a dearth of treatment providers properly trained to recognize and treat PTSD, especially complex chronic types, and the topic is rarely addressed in universities and professional schools. Public education about PTSD is lacking as well, with lay people commonly associating PTSD with combat and little else.?
Good luck,
BEEN THERE, DONE THAT
P. S. Victim's Assistance Program was very supportive of us.
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Her diagnosis (given to us during her last hospitalization) are as follows : Border Line Personality, Major Depression with psychosis, Generalized Anxiety Disorder, Acute Psychotic break, PTSD & Schizoaffective traits.
Anonymous, I wish it were as easy as cleaning up my home environment...that would be welcomed & easy to do. This is serious mental illness & needs to be treated as such. We do not have a chaotic, sad, stressed, or depressed household. We are very regular people with no major issues surronding our home.We are not perfect by any means, just normal, down to earth people without a lot of chaos in our life.
We just recently found out about the sexual abuse (it is not ongoing), my daughter suffered this abuse for 2 years without our knowing anything about it. It always occurred at her friend's home & we never had ANY warning signs or clues this was happening. The abuse has stopped & we are getting her appropriate treatment with a mental health professional that specializes in PTSD related to sexual trauma.
My daughter (as well as the rest of us) also suffered the loss of a close family member to suicide. In addition to these 2 incredibly traumatizing events, she has had to undergo extensive medical testing for an endrocrine condition. She cannot take medication for this condition, as her psychosis gets worse with any hormonal treatments.
I am not discounting the idea that some kids are a product of their environment & if their home life could be stabilized, they too would be more stable...not the case here. Like I said, I wish it was that simple.
I am at a crossroads here...do I continue with the treatment she has been receiving (as it seems an act in futility at this point), or do I take it to the next level? That is something her doctor will have to help me walk through.
I originally posted this topic, because I wasn't sure if my daughter's behaviors & illness would warrant possible RTC placement or if you other survivors & parents knew of another way.
I have 2 other children & their home life needs to be safe guarded as well. Their mental health & quality of life is as important to me as my troubled daughters. My daughters behaviors have begun to have negative consequences for my other children. I have to consider everyone's wellbeing.
I am still very open to discussion, comments, questions & advice.
I have not decided what my next move will be....RTC (maybe), Acute Hospitalization (probably), Health & wellness for my entire family (definitely). :smile: "
