Category: bipolar disorder

Take this parenting skills test if you have a troubled child

Take this parenting skills test if you have a troubled child

So how are you doing in your difficult parenting job?  Score your parenting skills on a test designed for parents of children ages 11-15.  This is intended for parents of ‘normal’ children, so you may skip 5, 6, and 7. (If you are brave, have someone else score you too and compare results.)

Parenting Skills Test – printable form

Don’t be hard on yourself if you score low.  Only a “perfect” parent will have an excellent score… and they wouldn’t need to read this blog!

What did you learn?  What are the skills where you scored lowest?  Focus on them.  Troubled kids need to be parented differently.  What you’ve learned by watching skilled parents may not apply to you.  You might be thinking:  “I agree these are good parenting skills, but practicing them is impossible with my child. They hate/defy/scream/fill-in-the-blank constantly.” Suggestion:  Work on one skill at a time, and take the test again in few weeks to see if you’ve improved your score. 

Be and kind forgiving of yourself if you score low

When my child was young and I was stressed, I would have had a low score and fallen in the “Keep trying” group.  My child’s mental health so poor, and she was so at-risk, I could only focus on safety and live one day at a time.

Why 3 of the items don’t apply for parents with mentally ill children, IMHO

#5  “I let natural consequences do the teaching whenever feasible.”  In my case, natural consequences could always be serious and unsafe.  This would have been very unwise.
#6  “I am confident my child has everything she/he needs to make good decisions.”  No way.  They cannot make good decisions when they are irrational–that’s the problem.
#7  “I allow my child to do his/her chores without reminding.”  I gave up on chores.  It was one battle I didn’t have to fight.  It was much easier doing them myself and knowing they’d be done.

Please add a comment if you have found other skills to be effective,

–Margaret

What to know about psychiatric residential treatment

What to know about psychiatric residential treatment

residential centerHave you been searching for psychiatric residential treatment for your child?  Do all the programs sound wonderful?  Ads include quotes from happy parents, and lovely photos and fabulous-sounding activities.  But what’s behind the ads?  Residential treatment programs are diverse, but there are important elements they should all have.  Here’s how to avoid low quality residential treatment.

Psychiatric residential treatment is serious stuff–it’s difficult to do–especially when troubled children and teens are put together in one facility.

Should you ask other parents for their opinion of a program?  In my experience with a child in psychiatric residential care, and as a former employee of one, word-of-mouth is not a reliable way to assess quality or success rate.  There are too many variables: children’s disorders are different; acuity is different; parents’ attitudes and expectations are different; length of time in the facility is different; what happens once a child returns home is different…  It’s most helpful to ask questions of intake staff and doctors or psychologists on staff.  Quality psychiatric residential care facilities have important things in common.

What to ask about the staff:

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  • What is the training and licensure of staff?  Are there therapists with MSW degrees, registered nurses, psychiatrists and psychiatric nurse practitioners, and is a medical professional available on site 24/7?
  • There should be a high staff to patient ratio, and a physically comfortable environment with lots of emotional support.
  • Do the staff seem mature to you?  Do they support each other, are they a team? There is often heavy staff turnover at residential treatment centers because the work is emotionally draining, so staff cohesion is as important as the qualities of each individual.
  • Safety is paramount.  What are the safety and security plans in the facility?  Staff must be able to safely manage anything that can go wrong with troubled kids.  They should be trained in NCI (Nonviolent Crisis Intervention), “training that focuses on prevention and offers proven strategies for safely defusing anxious, hostile, or violent behavior at the earliest possible stage.”

What to ask about programs:

  • Does the program specifically identify parent/family involvement as part of treatment?  Does it emphasize parent partnership with staff?  Ask.  Whether you live close or far from the center, even out-of-state, you should be regularly included in conversations with staff about your child’s treatment.  You should also be included in a therapy session with your child periodically; some facilities can connect with you over Skype.  Your child’s success in psychiatric care depends on their family’s direct involvement.
  • The program should coach you in specific parenting approaches that work for child’s behavioral needs.  While your child is learning new things and working on their own changes, you must know what to establish back home when they return.
  • You should be informed why your child is getting the treatment or behavioral modifications he/she is receiving.
  • Last and most important: when your child leaves, there should be a discharge meeting and a discharge plan.  What this means:  all staff who worked with your child get together with you and discuss what treatment should continue once they go home.  Medication management and therapy is identified in advance, appropriate school accommodations are discussed, changes in the home environment are discussed if needed…  You should never leave without knowing what comes next in the months following care.

Body health is brain health, and vice versa.

  • residential programsMental health treatment will include medication and therapy, but must also include positive activities and an educational program.  The whole body needs care:  exercise, social activities, therapeutic activities (art, music, gardening), healthy food, restful sleep, etc.

Is your child emotionally safe as well as physically safe?

  • You should be able to visit the unit or cottage where your child will live, see their bedroom, and see how the other children interact with staff and how staff interact with each other.

What to ask about the business itself:

  • Can you take a tour ahead of time?  Can your child or teen visit too if appropriate?
  • Are emergency services nearby (hospital, law enforcement) that can arrive quickly?
  • Does the facility have a business license in their state?  Do they have grievance procedures?  Is the center accredited as a treatment facility, and by whom?  In the U.S., the main accreditation authority for healthcare facilities is The Joint Commission.

Psychiatric residential treatment works miracles, but it doesn’t work for all children.  Some need to go into treatment more than once to benefit. Some fall apart a few weeks or months after discharge.  These are common.  What’s important is that staff observations and advice help you and your child with insight and skills for managing his or her unique symptoms, and for communicating effectively.

Good luck.

 

What was your experience when your child was in residential care?  Please share your comment so others can learn.

Things that protect troubled girls from delinquency

Things that protect troubled girls from delinquency

 

Both boys and girls get in trouble with the law.  Boys are in the majority for arrests for crime, but statistics indicate that girls’ arrests are increasing:  “…between 1996 and 2005, girls’ arrest for simple assault increased 24%.”  Of 1528 girls studied over a period from 1992 and 2008, 22% committed serious property offenses and 17 % committed serious assaults.  (Girls Study Group, U.S. Department of Justice, 2008. www.ojp.usdoj.gov).

  

Troubled girls easily become criminal, but also risk being a victim

 

Girls who have behavioral disorders, from addictions or past trauma or emotional disorders, begin to have delinquent or criminal behaviors as early as middle school.  What makes a girl’s criminal activities different from boys is that girls put themselves at high risk of being victimized themselves.  How can a parent or caregiver prevent their daughter from engaging in criminal behavior, and trapping themselves in a social world where their stresses and disorders can worsen?

 

The Girls Study Group quoted above studied which factors protected girls from becoming criminal, or helped them stop and reengage in activities that improve and stabilize their lives.  Protective factors did not prevent all criminal activity however, yet the first one has been shown to be the most effective.

 

  • Support from a caring adult.  THIS IS THE SINGLE MOST IMPORTANT FACTOR in preventing girls from criminal activities of any kind.
  • Success in school helped prevent aggression against people, but not property crimes.
  • “Religiousity,” or how important religion was to troubled girls, meant they were less likely to be involved with drugs.

Risks to girls that are different from boys: 

    

Early puberty is a risk if the girl has a difficult family and comes from a disadvantaged neighborhood.  Biological maturity before social maturity causes more conflicts with parents and more negative associations with older boys or men.

 

Sexual abuse, which girls experience much more than boys, including sexual assault, rape, and harassment.  But abuse of any kind affects both boys and girls equally.

 

Depression and anxiety, which girls tend to suffer more from than boys.

 

Romantic partners.  Girls who commit less serious crimes are influenced by their boyfriends.  But for serious offenses, both boys and girls are equally influenced by a romantic partner.

 

Once she’s regularly breaking rules, it’s not easy to turn things around for a troubled girl.  It requires constant, persistent efforts to:

  • Keep her away from risky associates.
  • Keep her in school and up with studies. 
  • Keep telling her what’s great about her, what’s special, what’s powerful and good.

If you are a parent or caregiver, and you are lucky enough to have a strong mentoring relationship with your troubled daughter, keep it up despite any occasional law-breaking activities.  She’ll need consequences, but they should be obstacles to overcome rather than punishments—such as earning back privileges by having good behavior for a period of weeks or months.

 

If you don’t or can’t have a mentoring relationship, find out who can (or already does).  Admit you might not be the sole support for her success, and work in partnership with a caring adult.  Find out who believes in her already.  Find out who she asks for help if she’s feeling fearful or down about herself.  Listen to her if she talks about someone she’s grateful for for helping her through difficulties.  Girls respond really well to someone who believes in them.

 


Teen girls can be turned around and it’s always worth the effort.  She might be hard to take sometimes, but find something, anything, that’s good about her and let her know.  Over time, you’ll start noticing more and more great things about her, and then she’ll start noticing them too.

Gang Up on Your Kids: Network with Other Parents to Track Troubled Kids

Gang Up on Your Kids: Network with Other Parents to Track Troubled Kids

An article in the local paper told the story of a mother who desperately tried to get help for her at-risk son to keep him out of a gang.  Yet he became a victim of a drive-by shooting and was in intensive care for days, but he lived.  In the article, she said something I’m very familiar with; she said other parents never told her what they suspected, nor did anyone let her know if her son was at their house when he ran away.  Just knowing her son’s whereabouts could have helped her intercept dangerous activities.  Like her, I never got information from other parents who might have been (or should have been) concerned about my troubled child.  Why didn’t other parents stay in touch and help each other control their children?

 

At-risk kids hang out together, they know each other’s stories (true or not), and protect each other, and parents are out of the loop.  What if parents got together too, shared stories, and supported each other’s goal of protecting their child from making mistakes?  Kids’ unsafe plans and activities are no match for the many eyes and ears (and cleverness and wisdom) of all their parents combined.

 

How to track at-risk kids and join forces with other parents:

 

Go on the internet, check out Facebook and other social media, and look for your child’s page and the pages of his or her friends.  The police do this all the time; it’s one of their main investigative tools!  At-risk children share everything over the internet:  photos, favorite places and people, favorite activities (even illegal ones), and other incriminating information. It’s easy to identify kids who are at-risk.

 

Contact the parents or caregivers of your child’s friends, by phone or email anytime you find out that their child or teen was with your own child while doing unsafe activities.

 

I did this.  Some parents were thrilled to find support, but a couple were angry with me at first.  After all, I was delivering bad news.  They defended their child, or accused my child of telling stories.  I just said, “I thought you’d want to know.  My kid is in trouble, but you may want to know your child was also involved.”  It took some backbone to stay online, but they eventually calmed down and expressed disappointment in their child.  They often hadn’t suspected anything.  Then I asked if we could join-up and inform on each other’s kids to keep them safe.  Always, I received a strong yes.

 

Compare notes and share news about friends, friends of friends, which houses were dangerous (e.g. adult not at home, or adult provides drugs or alcohol), which places they hang out, and who might victimize them or be victimized by them.

 

Call a teacher and ask who your child hangs out with at school, or if they know another parent who is worried about their kid, call that parent and make a pact to keep each other informed.  Whether they help you or not, at least they know someone’s watching and paying attention.

 

True story – One mother I know recruited a “spy network” with her son’s friends’ parents and with employees of businesses he regularly frequented, such as a skateboard shop near his school and a coffee house.  She was able to keep track of where he was if he ignored her curfews, and inform the community police of adult associates (usually 18-24) who were known to provide drugs, alcohol, and cigarettes to youth.  Her information helped empower other parents who hadn’t known what to do, but were then able to restrict their teen’s activities away from home and make it uncomfortable for unsafe people to associate with them.

 

True story – A father I met took the “spy network” idea a step further and had contact cards, like business cards, which he gave away to police, teachers, other parents, and anyone he met who knew his daughter.  The contact cards basically said “Please help us keep Kari safe and call us, her parents, anytime she is at the following places [ … ] or doing something you believe is inappropriate.  Thank you very much for your help.  We will keep your calls confidential from our daughter.”  Then the card gave the parents’ names, number, and email address.  This greatly limited their daughter’s contact with unsafe or inappropriate friends and adults, because they knew they might be watched and reported if she was around.  Surprisingly, this attention improved the girl’s progress in family therapy, as she stated she felt more like her parents cared.

 

Word gets out quickly among the groups of at-risk kids and the adults who enable them.  If you let enough people know that they may be watched when at-risk kids are around, then they will avoid these kids and even ask them to leave their company.  Don’t forget:  you are smarter and more experienced than young people.  You, as a parent, are not alone with your concerns about your child.


Reach out to the other parents in your community.  You will be surprised how many will thank you.

–Margaret