Thursday, May 6, 2010

Request for advice

I started a different post yesterday, trying to catch up on the day by day roller coaster we've been on with Penelope lately. But things have taken a turn for the worse. Penelope is currently in attachment therapy with her Papaw. I'm currently sitting at work and am completely pre-occupied with what is going on with her. There is too much sh*t going on in both our lives and I'm trying to get my head around it all.


I haven't really spoken about it much on here because I gave the counselor my blog address in order for her to get Penelope's history and a better understanding of what we have been doing over the recent 1 1/2 years. So I didn't want to say anything negative on here, but just keep it between us. When Penelope abused her cousins, it was very apparent, regardless of what CPS or the police would want, that Penelope needed additional services. We had discussed it with her therapists and they agreed. When CPS came out and evaluated our situation to ensure Penelope was safe and being cared for to their standards, we met those requirements. But I asked for a referral. Who could help Penelope with her own abuse so she isn't compelled or whatever the right term is, to do this or anything like this again? The police wanted Penelope to get extra help too but they had their own agenda we have recently found out. We were referred to a place that does evaluation to determine services needed and then they find places to refer you to. Then I got a call out of the blue from this place, I'll call the Purple Place.


I met with the Program Supervisor who came to my house and met Penelope and I. She talked about having in-home intensive therapy up to 3 times a week. This person would work with Penelope in the home and work with both of us to help me help Penelope. She would also go and observe Penelope at school. And then if I was interested, a Trauma Therapist. I liked it all. I was concerned because of the fact they do not do attachment therapy but she said almost all of their patients have RAD. Okay, well than this is where we need to be I think. A new frontier in Penelope's healing. She tells me who she is thinking of assigning to us and says that she is her best home-based counselor.


The problem is, the counselor that she assigned doesn't seem to get it. I told her from the beginning about dependability being essential for trust. If she says she is going to be at the school to observe Penelope at 1pm, then she better be at the school at 1pm. The counselor's first visit to the school, she was late and I had gotten a report from the teacher about Penelope's inability to focus and participate because she was watching for her new counselor. I told her what I've learned to do is, whenever possible, just don't tell her and just show up. Then there is no expectation set so if she is on time then great, if she is late, not a problem. But when you say "I'm going to do this" you better do it. She said she understood and was used to that with her other kids. But she is usually late to our house too, either traffic or her prior appointment. Always sorry. Always apologizing. She has been late picking up Penelope for her truama therapy from school. She forgot she promised Penelope she was going to get her cookies as a treat the next time she came, one time. But when she called to let us know she was late, Penelope said "Did you bring the cookies?" to which she responded to me, "Oh shoot I forgot. I'll stop and get them right now." But I covered for her with Penelope. But "I forgot" is a common phrase too. "I forgot." "I'm sorry." And it's not just Penelope, she does it to me as well. She forgot my Medicaid application, she forgot to have me sign some forms that we had to date retroactively for her purposes. I don't care about the forms, but I do need Penelope's Medicaid. But that's not happening either. I tell her I haven't heard anything and it's "You'll get something in the mail." I was told she knew people and has helped people get this done in the past. Her boss should go in sales. Maybe that is her position and I read into it as a mental health professional. Anyway, I spoke to her about our concerns, and the schools about Penelope's ability to function, fears about her cracking and ending up back in the hospital and just Penelope's overall decline. Her answer was to observe her in the classroom last Friday and call me afterward. No call. I was told by the school she came at the end of the day after class was over. That would explain why there was nothing to report. A couple weeks prior I had a conversation with her about how when Penelope was physically mature enough I am going to have her put on birth control. Even though I told her that her ATs and her Psychiatrist all agree that is an excellent idea, she felt that is overboard. That her sister wants to put her niece on birth control and you have to let your children make those decisions without that umbrella. The reason I bring that up is I feel it speaks to her approach to Penelope's issues. This is Penelope, who has been abused a good portion of her life, became sexualized at a very early age and has 4 counts of rape against her at the age of12. This is not a regular turn-of-th-mill child. So, during this conversation about Penelope's decline, I find out that last week Penelope was trying her hand at manipulation and splitting and told this counselor "My mommy won't let me buy her a mother's day present. We aren't going to celebrate mother's day." Not how the conversation went down with Penelope but even after my explanation that we were going to just spend the day together but not celebrate it - keep it low key, she felt that wasn't fair to Penelope and a cause to her decline. That she should be able to celebrate mother's day for me. Like I'm not acknowledging our relationship as mother/daughter. I reminded her of what happened last year - Penelope drawing her stabbing me to death with a dagger multiple times with an evil grin on her face. I also explained the hardships of the years before as well. It's common knowledge in the RAD world that Mother's Day is a day that is very hard for these children. A day to celebrate a woman that has hurt or abandoned them, or someone they have mixed feelings about. A person that they thought was perfect and have since been disenchanted with. A person that every one else in the world has except them. (At least that is how they feel sometimes.) A day that brings out strong emotions they struggle coping with. And us Mothers do what we can to help them and us survive these days without permenant scars.

Over the next few days this conversation rubbed me wrong. I felt like it needed to be addressed because Penelope needed to see the counselor and I on the same page about the issue and we needed to address any possible feelings she may have like I didn't want to acknowledge her as my daughter. Which I already know is not the issue. People, she is splitting! So when Wednesday came around, our regular scheduled home visit she was a no show. She was suppose to be there at 6:30 but after 7pm I called her. Usually by now she has called to let me know she is running late again. She answered it like I woke her or something. Then it dawned on her that we had an appointment. She said she went home sick so she's at home and forgot. It was hot today and she got overheated and went home. She forgot to call us and she was sorry. I didn't know what to say. It had been a horrible day with Penelope and once again, it's "I forgot, I'm sorry." I really don't know what I was expecting anyway. I hadn't yet seen her value. It's just the disappointment of an empty promise. Promise of additional support in the home. Whenever I talk to her, it's always "Plan to go see Penelope at school today/tomorrow.." but what about here? What about home stuff? I had brought up a couple weeks ago more frequent home visits because things were getting worse but I got a "umm..hmmm." It's easier for her to see Penelope at school because she can drop in when it fits her schedule and I'm only home in the evenings.

So all these thoughts come down on me with this, and I needed to accept that this is just who this counselor is and what she brings to the table. It's not what I'm looking for for Penelope and I. It's hurting not helping. I became emotional and just said "I can't do this anymore..... " and hung up. My dad was there and he felt that this was the final straw. I was feeling the same way. But I don't like to make decisions when I'm emotional. I don't think straight. Shortly later she sent a text saying that she would start coming every Wednesday instead of every other Wednesday. Then later she left a message saying she was planning on going to see Penelope at school and to call to discuss what was going on. I had told her that it had been an extremely difficult day. But after talking to my dad about it and put some thought into it, around 10:30pm I sent her a polite email terminating her services. I asked her to mail me the copy and receipt of the Medicaid application so we can continue to follow up with it - she had told me she always gets a reciept. I also told her I would follow up with the trauma therapist about finding a better appointment time now that Girls on the Run is over and Penelope isn't particpating anymore. I had asked her on Friday to talk to the therapist about a better time and I hadn't heard back on that issue yet either.

She left a message around 10am the next day saying she was planning on seeing Penelope at school around noon. I left for an early lunch hour to run some errands and to call her supervisor so I could get a new counselor for Penelope when I found the message. I called her right away and ended up leaving her a message stating that she must not have received my email and that I had made the decision to discontinue services with her and that I'd prefer she'd not go to school and I wished her luck. I hadn't talked to her supervisor yet but after my lunch break I got ANOTHER call from the counselor. She was disappointed in how I felt and that it can't be worked out but informed me that if I terminated her services, Penelope can't continue with the trauma therapist either. That wasn't my intention as I wanted someone else - someone that is a better fit, who is actually supportive anyway, but to not be able to continue therapy? What the heck!

So I called the supervisor and requested an immediate call as soon as possible. She called about an hour later but had obviously already talked to the counselor. The supervisor defended everything that the counselor did - except the lateness. She said she'd talk to her about the lateness. But it's the whole thing that is the problem. The lackadaisical approach and the message it sends. Like Penelope is just some regular kid and I'm just some whacked out helicopter mom. Like when Penelope went into a rage fit in her room barricading herself in the closet banging her head and fists on the way but she continued to talk about court stuff in the living room ignoring her fit. Then when Penelope comes out full of piss and vinegar, it is time for the counselor to leave. She talks to Penelope for like two minutes and leaves. Where is the support in that situation? She said "We believe in focusing on their strengths not their weaknesses. We take the strength-based approach." I'm like, "So, what? You ignore the weaknesses? So when she is struggling, you just act like the problems aren't there?" Well, I can see you are struggling, but hey, at least you didn't off yourself. Thanks for being strong enough not to do that today. Seriously! She says "That's when she goes and observes Penelope in the school." So I talked about that. How I've told the counselor that Penelope has been on a spiral decline and there are serious concerns by her teachers and myself that she is going to end up in the hospital and all she comes up with is she will observe her in the classroom so she can see for herself and call me to let me know how it goes - which she didn't. But that the counselor had said that she hadn't been observing Penelope, just pulling her out so this time she will observe her. But even with that, what is she suppose to do with that information? Because she hasn't done anything. She didn't say anything. I said "What would you do if you went to school and saw Penelope not able to focus enough to read, or to write on her paper, or be present? What would you do." She said "Well, I'd take her out of the class and ask her what is going on?" I said "Then what do you do with that information?" She said "I...would...talk... to.. her about it." Like I'm crazy to think there is anything more to do. Hmm.. maybe investigate it a little more with the teachers and the parent and see how long a situation has been going on, if it hadn't already been reported. Maybe do some problem solving and figure out some ways to help her cope with whatever is going on. Maybe educate Penelope on what to do when she is emotionally shutting down and withdrawing. Maybe educate the teachers on what can be done. You know, in a 5-10 min. conversation over the phone at a later time or something. Problem Solving. Progress. Support. HELP! I mean seriously I didn't sign up for this to give people something to do.
I talked about how it doesn't seem she takes anyone's opinion into consideration and if she does, she takes the opposite stance. She treats Penelope's situation like she is a regular kid with regular problems. I talked about the conversation about birth control and how she compared Penelope to her niece. She said "You have to treat them regular or they feed into it and they get worse." I said "You sound just like her Uncle before he left her alone with his 3 and 5 year old." These kids do not have the same instinctual boundaries that normal kids have.

I just feel like it's another example of a mental health system that is failing these children! But I don't know what to do to help her. Do I look for something similar and just "learn from my mistakes" with these people or is there something out there that truly understands the nature of reactive attachment disorder but can focus on helping her with her abuse? I am lost.

7 comments:

Anonymous said...

Hi, I've had similar situations with therapists, especially in-home. Don't waste your time, she either doesn't get it, or she is just saying things to make it look like she's doing something. Its frustrating because they don't take responsibility and can just leave when time is up. My theory is that the people who are really good are either booked up, very expensive, definitely are past the stage in their career where they are making house calls... So its hard to get someone qualified. All the in-home visit people I found were young, had no kids, and little experience. Who else is free to work nights?
We still see a therapist who is ok but not great, but I find more answers by reading books, blogs, and from parent groups.

I've thought about doing counseling over the phone, I haven't tried it yet, but some of the big writers/speakers about attachment therapy offer it if you want to try, here are some I've found:

http://www.nancythomasparenting.com/pages_parents_consultations.php

http://www.theadoptioncounselor.com/online_coaching.html
This one also has a blog to get a feel for her.

http://www.beyondconsequences.com/phonecoaching.html

I've followed your blog, I'm a single mom too, adopted a child with some severe issues, attachment and other things.

marythemom said...

My children were never offered in home therapy, but we did have a caseworker who was mandated to come to our home weekly. It was allegedly to help us handle our son (who at the time was very violent and was on the waitlist for residential treatment). She silently stepped over him pouting on the porch (about to run... again). She completely ignored the screaming meltdowns of our daughter. She sat silently, judging. The only advice we got was, "Don't let him escalate." He was undiagnosed and unmedicated bipolar and RAD who'd only been with us 4 months! Saying "No," even breathing set him off! She was young, single, no kids, no experience. She was worse than useless.

I think you were totally right to fire the counselor. She doesn't understand your child's needs and was making things worse. Keep fighting to keep the trauma counselor if that's what you want!

Mary in TX

RADMomINohio said...

Thank you for your comments. It sounds like I did the right thing. I still need to figure out something on the trauma therapy area because the supervisor did confirm that they will not allow Penelope to continue with their therapist either. You can't have one without the other. And she doesn't have anyone else to replace this counselor, she's her only one. Lie. Either then or in the beginning because she said she was her best which implies there is someone to compare her to. But regardless, based on what she said about their approach, someone else there probably wouldn't have worked either.

marythemom said...

So it wasn't necessarily true that the supervisor agreed with the counselor, more that she had no choice because she had no alternatives to send you anyway. Either way that stinks!

We're currently without a good therapist who "gets it" too (for our son anyway. Our daughter's therapist is great, but wouldn't work for our son.)

Hugs and prayers,
Mary in TX

RADMomINohio said...

Mary - That stinks that there isn't a good therapist for your son. It's so hard to find ones that get it. That was a hard pill to swallow in the beginning of our journey - in that there isn't services readily available for this disorder, like other disorders out there. "You know what's wrong with her but you don't have anyone who can help her?" The attachment therapists that we have now have been our saving grace. I just wish they could also help her with her trauma. They do talk about it, but her trauma is so complex, coming from different people, different areas over such a long period of her life. Some she remembers, some only subconsciously. But the AT had to come first. You have to have a child who can bond/attach and start to care, before they will even work on themselves. At least that how it seems when it comes to Penelope. But her walls still go up and her RAD defenses come out. It's a tough road these kids have to take to retrain their brain.
About the supervisor, I don't know what to believe. I do know that she agreed and supported the counselor's statement that Penelope couldn't continue with the trauma therapist if I didn't continue with her as Penelope's counselor. But whether or not there was another counselor that we could have instead, is another topic. When I first met with the supervisor she said things like "I think I will assign . She is my best counselor." That implies there is more than one. But now she claims the've only have one. Which honestly doesn't make sense when you think about this woman is the supervisor of the home-based services if their home-based services consist of one employee.
It doesn't matter at this point. It's just is so frustrating to not only find out the services provided aren't what you were told but that they have to be act like it's all in your head and deceitful about it when we are talking about helping children here.

marythemom said...

That's Sales 101. Make them think you're giving them the best person for the job, hand-picked just for them. It's supposed to be comforting and keep them from looking for things to go wrong. People who feel that things are going to go well, tend to where "rose-colored glasses." If you say, "I hope this works because it's all we've got," the person tends to expect things to go wrong and be looking for the flaws.

Of course for us, when we started we didn't know what was wrong, let alone what services were out there. Now we've got a pretty good idea (bipolar, RAD, ADD, C-PTSD traits of BPD...), and he's "too old," "too resistant," and "too damaged" to even try to reach.

One thing that we've found helps with complex trauma is EMDR (by an expert trauma specialist of course)... assuming the child is willing to cooperate (which my son wasn't, and my daughter wasn't far enough along in AT to be able to handle). We might try again with my daughter this Summer. I found a good one that takes Medicaid.

Mary in TX

RADMomINohio said...

I have heard of EMDR but I haven't looked into it much.Your comment is the third time I've heard of it. I'm going to look to find local resources. THank you! What changes have you noticed from it?