Category: therapy

How to pick the ideal therapy pet for your child or teen

How to pick the ideal therapy pet for your child or teen

“A pet is an island of sanity in what appears to be an insane world. Whether a dog, cat, bird, fish, turtle, or what have you, one can rely upon the fact that one’s pet will always remain a faithful, intimate, non-competitive friend, regardless of the good or ill fortune life brings us.”
–Boris Levinson, PsyD, Child Psychologist

Any animal can be a therapy pet, but put thought into finding the ideal pet

It depends on your child’s individual needs and his or her innate appreciation of or connection with the creature.  Parents often think of furry animals like dogs or cats or “pocket pets” as the best therapy animals.  Dogs and cats are the most common, but they are not the only effective options.  (And some are problematic:  perhaps a family dog or cat is of no interest to your child, or is stressful because its behavior–easily agitated cats and chronically fussy dogs aren’t therapeutic!

What fascinates your child? What do they want–what creature(s) are they drawn to?  And are you willing to take care of this pet?  Your child’s therapy pet is not a lesson in responsibility… though that may be an outcome someday.  The pet is a therapist first, not a teaching tool.  Since you may be the responsible one, the pet must work for your needs and household too.

The right creature will reduce your child’s stress and continually delight them in some way.

Dogs and cats

Under the best circumstances, the right dog or cat will choose your child, calming them down or drawing them out of their shell. Dogs and cats are ideal for symptoms of anxiety, autism spectrum disorders, or depression. The right dog or cat is calm, loyal, and patient, and helps an insecure child or one who can’t handle emotional demands. Dogs also support physical exercise, and provide opportunities for significant life lessons.

True story – Some juvenile prison systems have dog programs, where the inmate is assigned a troubled shelter dog to train and teach appropriate dog behavior. Young inmates often empathize with a dog’s abuse history, and training the dog helps them learn patience, forbearance, and anger management.  The trained dogs are them adopted out to the community.  A program I personally know about has had very positive outcomes.

Pocket pets

Pocket pets help children who like touch, and bring out a child’s nurturing side. Small animals can also be playful and amusing–ferrets have especially silly antics.  It’s important the pet likes to be held, but it’s also important to prevent it from escaping and hiding. Their small size and habitat needs are better for small living spaces, and they can go anywhere with the child in a small carrier.  A concern may be their shorter lifespans. Is your child able to handle loss and learn from it?

Birds

Birds are smart ‘pocket pets’ and very loyal to the person they bond with.  A bird that’s purchased young or been hand-fed as a chick is tame and will readily perch on a child’s shoulder or finger… or happily hide out in a pocket.  Most birds can be taught words, whistles, or even songs in human language.  They are pretty, charming, highly interactive, and long-lived.  Birds are good for depressed children who need energy and stimulation, and children with ADHD who need attention and interaction.  Like a pocket pet, a bird can also travel with a child in a small carrier.

Reptiles

Reptiles aren’t often considered as therapy pets, but reptile lovers will tell you that they are indeed therapeutic and have inidividual personalities. Most are quite beautiful. Many like to be held and carried.

“She fell asleep in my shirt and nobody saw her. I noticed I was able to communicate with other people without problems. When I started to feel anxiety I put my hand over her and it calmed me downI was able to go in [a store], do what I needed to do and get out without a panic attack.”
–Teen with social anxiety disorder speaking about her Bearded Dragon.

Ask if a pet store will allow your child to hold one of their reptiles for sale.  Common pet store lizards that are good for children are:  leopard geckos, bearded dragons, and iguanas (which need lots of handling at first).  Like other small animals, reptiles can escape. Turtles are usually easy to find, but not lizards or snakes.  There are lizard leashes on the market for this reason.  Most snakes available on the market like to be held, or will accept it if handled often.

Fish

Beautiful calming aquariums are excellent sources of visual delight and serenity. There is a reason aquariums are placed in waiting rooms and in psychiatric hospital settings.  They provide gentle entrancing movement in a miniature natural world—they are healing like Nature is healing.  An aquarium is good for children with intense anxiety they can’t express, often with schizophrenic or autistic symptoms.  The soft bubbling sound can be calming because it is steady and hides noises that may overstimulate a child who’s grappling with a stream of upsetting thoughts.  Read more about “calming rooms” and how visual and audio environments help children with tantrums, “Calming room ideas to prevent tantrums in autism and other disorders.”

Insects (yes, insects)

I have two stories about therapy with insects

True story – A depressed 9-year-old boy was regularly teased at school, then came home to a single mother who was always too distracted by dating concerns to spend time with him. His father found a second wife and started a new family and showed little interest in him.  The boy was smart and very interested in science.  He befriended a neighbor who kept hissing cockroaches to feed her lizards, and he would visit often and ask to hold a roach and pet it to make it hiss.  The neighbor allowed the boy to borrow one to take to school for show-and-tell, which he brought along in a plastic container.  The students were both fearful and intensely curious about this giant roach.  Except for the squeamish, everyone wanted to pet it to make it hiss.  He became the coolest kid in class.  His teacher was impressed because he told the story about hissing cockroaches, where they were from, and how they were part of a forest ecosystem.  He stopped being teased, and his teacher gave him more attention with science studies… all thanks to a lowly roach.

True story – An 11–year-old boy with ADHD found a praying mantis in his backyard and picked it up. He knew from school it wouldn’t bite, and that it caught and ate other insects.  He wandered around nearby homes looking for bugs to feed it.  When he caught something, he enjoyed watching the mantis snatch the bug from his finger and eat it with gross crunching sounds and goo…. awesome for a kid like him. He was allowed to keep the mantis in an empty aquarium. As Nature has it, it died in the Fall. His parents, however, purchased mantis eggs from a nursery to populate the yard the next summer. When they hatched, the boy spent hours amusing himself by finding and feeding the baby mantis population,and watching them grow to adulthood.  It reduced the hours he’d spend indoors on video games,and connected him with nature outdoors.

 

–Margaret

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

Outlook for schizoaffective disorder and schizophrenia

Outlook for schizoaffective disorder and schizophrenia

How Schizoaffective Disorder compares to other disorders

There is little information about schizoaffective disorder in children, which usually starts around puberty.  As a parent, you know how seriously it affects your child, but how does it compare to depression and bipolar (manic and depressive states) and schizophrenia?  What is the course of schizoaffective disorder, and how can you help your child’s future?

Schizoaffective disorder is not as serious as schizophrenia,
but more serious than bipolar/depression.

Research conducted in Britain* studied young people who received typical treatment for schizoaffective disorder, schizophrenia, and bipolar/depression who were between the ages of 17 and 30 (average age was 22).  Over a 10 year period, those with schizoaffective disorder improved slightly, better than those with schizophrenia.

Outlook for schizoaffective disorderBehavioral functioning over time for schizoaffective disorder, schizophrenia and affective disorders (depression, bipolar) at four consecutive follow-ups.  (This scale goes from 2 (good) to 6 (poor). A “1” would be the level of a person with no symptoms and who is considered normal.)
*M. Harrow, L. Grossman, Herbener, E. Davies; The British Journal of PsychiatryNov 2000, 177 (5) 421-426

Behavioral functioning is measured by how well a person does in five areas:Russian brain diagram

  1. Work and social functioning
  2. Adjustment to typical life situations
  3. Capacity for self-care
  4. Appearance of major symptoms
  5. Number of relapses and re-hospitalizations.

Your child will struggle with these, but there’s good news according to a recent landmark study:
Family support improves a patient’s outcome.

Life with a schizoaffective teen,” tells my story, and what steps I discovered which worked to improve my daughter’s functioning and behavior.  This article also provides insights into how children with schizoaffective disorder think.

A new treatment program was developed that altered some well-established practices.  A set of schizophrenia patients received the following support and were later compared with those who had the usual medication approach.

  1. Dosages of antipsychotic medication were kept as low as possible
  2. Help with work or school such as assistance in deciding which classes or opportunities are most appropriate, given a person’s symptoms;
  3. Education for family members to increase their understanding of the disorder;
    (“Efforts to engage and collaborate with family members are often successful during an acute psychotic episode, whether it is the first episode or a relapse, and are strongly recommended.
    Family Involvement Strongly Recommended by the American Psychiatric Association)
  4. One-on-one talk therapy in which the person with the diagnosis learns tools to build social relationships, reduce substance use and help manage the symptoms.”

Patients who went through this for of treatment made greater strides in recovery over the first two years of treatment than patients who got the usual drug-focused care.  More here.
New Approach Advised to Treat Schizophrenia, Benedict Carey, New York Times, Oct. 20, 2015

“..if you look at the people who did the best—those we caught earliest after their first break with reality—their improvement by the end was easily noticeable by friends and family.”

beautifulbrainThe longer psychotic symptoms stay in an extreme phase,” in which patients become afraid and deeply suspicious,” the more likely the person will be vulnerable to recurring psychosis, and the more difficulty they will have coming out of it and adjusting to normal life.

How to help your child

Be very realistic about what your child can handle in school.  They may be extremely intelligent–but maybe can’t handle too much homework; or class disruptions; or lack of empathy from the teacher.  A parent or school counselor should help your child find low-stress classes or activities, and consider limiting the number of classes per day.  They can only hold it together for so long!  I found it helped my schizoaffective child to take later classes, starting at 10 or 11 am.

Get the whole family on board to make his or her life easier.  Your child might be stressful and a source of irritation for everyone, but family members can help reduce this by taking on the chores your troubled child would ordinarily do; avoid pressuring them about something, or anything; and allow your child to say oddball things without confronting them about how irrational they are or arguing with them.

DIY talk therapy – Here are some ways to guide your child out of their troubled states.

Anxiety

  •  psychosisSchizoaffective kids may express anxiety in a tangled web of seemingly unrelated things, and spike them with paranoia about what they mean. Listen carefully, and conduct a gentle interview to explore what truly is bothering them.  It may be as simple as the room being too cold.
  • Give them plenty of time (if you can). A venting session is sometimes all they need.
  • Diplomatically redirect a negative monologue with a comment about something else more positive. This is where it’s useful to hand them a cat or call over a dog, offer tea or juice, or briefly check email.  The point is to break the spell.

Run-on obsessive thoughts

  • Voices and thoughts can be angry, mean, and relentless. Your child may not tell you this is happening, or may simply assume you already know what’s in their head.  Ask him or her if thoughts or voices are pestering them.  If so, show indignation at how wrong it is for them to mistreat your child, “that’s not right that this is happening to you; this is so unfair to you; you deserve better; I want to help if I can…”
  • Encourage your child to ignore the voices/thoughts and they may go away, or encourage them to tell the voices/thoughts to leave them alone. “I refuse to listen to you anymore!”  “Quit pestering me!”   “Back off and leave me alone, you jerk!”  Negative thoughts and voices are just bullies.

Help your child stand up to thought/voice bullies the same as
as you would help any child dealing with a bully.  Seriously, this works.

Life with a schizoaffective teen,” tells my story, and what I discovered that worked to improve my daughter’s functioning and behavior.  It also provides insight into how people with this disorder think.

Take care and have hope.  You can do this.

Margaret

Mothers and Teenage Daughters: a School Counselor’s Story

Mothers and Teenage Daughters: a School Counselor’s Story

This article contributed by Benjamin Dancer.

I’m a high school counselor, which means I work with parents every day. Because I’ve made a career out of my work with adolescents, I see what a parent might be seeing for the first time. This includes a long list of unfortunate life events.

Back when we were teenagers, there wasn’t a massive network of servers positioned strategically across the globe to capture and record, forever, the embarrassment of our adolescent choices.

As a parent, I have a lot of empathy for other parents. It’s not easy, especially when you’re going through something for the first time. My life, on the other hand, is a little bit like Groundhog Day. In a sense, I’ve never left high school. Every school year I see the same things. Different kids, but the same behavior: alcohol, drugs, tobacco, bullying, kids running away from home, pregnancy and something new: sexting.

Take an adolescent boy with an underdeveloped prefrontal cortex, which by definition means he is incapable of fully contemplating notions such as consequence; take this teenager raging with sex hormones and give him a tiny device that he will carry with him everywhere, a device capable of sending messages instantly to anybody, anywhere in the world, and install a camera in that device. What do you imagine might go wrong?

facebook sextingWhen you and I were adolescents, we were no less reckless, no less idiotic with our choices, no less eager to use our bodies as grownups. The difference is that our stupidity has been forgotten by history. Back when we were teenagers, there wasn’t a massive network of servers positioned strategically across the globe to capture and record, forever, the embarrassment of our adolescent choices.  Sexting changes everything.

Over the last seventeen years in my work of mentoring adolescents and partnering with their parents, I’ve seen a lot of parenting styles. I’ve learned some important strategies in dealing with the situations teenagers present–strategies the average parent doesn’t have the time, through repetition, to learn. I feel confident telling you that there are some really good ideas out there. And some really bad ones, too.

Because I’m a writer, it occurred to me to write it down, what I’ve learned over the years. I’m a parent. I know it just as well as you do. We need a little grace in our lives.

Sexting book coverExcerpt from SEXTING AT SCHOOL:

The police called the sexting child pornography. So I understood Nicole’s concern: she wanted to talk to me about her daughter. Jessica was fourteen and three years younger than her boyfriend. He had been distributing images of Jessica through his phone. Nicole was worried; she was scared, and understandably so.

Jessica still thought she was in love.

“He calls her a bitch,” Nicole told me. “I read the texts. He says horrible things to her.”

“And she still wants to be with him,” I said.

The pain I felt for her was communicated in my voice. As a teacher, I see the scenario every year, but Nicole was experiencing this for the first time. Jessica was her daughter. Not long ago she was her baby. I could only begin to imagine the suffering the situation provoked. Nicole was in no position to hear how common this was.

Why do girls throw themselves at boys who treat them badly?

In Jessica’s circumstance there was a tremendous amount of grief. She had barely processed the loss of her dad. He was killed in an accident over the summer.

“I can’t stop her from being with him. I’ve tried. I took away her phone. I grounded her. She sneaks out of the house. I drop her off at school, and she ditches to be with him.” The mascara was now running beneath Nicole’s cheekbones, “Last night, she told me that she wished it was me who was dead. He was waiting for her out front. I saw her get into his car.”

sexting image“I can’t imagine what that’s like,” I told her. “I’m sorry.”

“Unless I physically restrain her, she will find a way to get back to him.”

I allowed for a long silence, as I thought there might be more Nicole needed to say.


“What did I do? What did I do wrong?”

I didn’t answer her question. And I didn’t dismiss it. I sat with her in it.

* * * * *

My role with Nicole is not all that different from my role with Jessica. It doesn’t matter whether you’re fourteen or forty, what you need is for someone to listen. What you need is for someone to understand.

Jessica and I talked later the same day.

“She went through my phone,” Jessica was angry. “She read my texts.”

I let her know that I understood her frustration.

“She won’t let me leave the house.”

“Why?”

“She’s trying to keep me from him.”

“Have you told her that you love him?”

“Yes.”

“And…?”

“She hates him. She doesn’t want me to see him.”

“Why does she hate him?”

At this Jessica paused. We had already talked about the pictures. She had told me stories about the boy. The way he had flaunted his sexual conquests. He was in my English class, and I had seen it firsthand: there were countless other girls.

After a long silence, she answered my question, “She thinks he’s not good for me. Is he?”mean boyfriend

It was ground we had already covered. In past conversations Jessica told me that she respects her mom for trying to protect her. I handed Jessica a box of tissues. She wiped the tears and told me, “No. He’s really, really mean.”

I listened to her cry for several minutes. I was thinking about her father. I knew the man well. I liked him. I was thinking about her mother. I was thinking about my own daughter.  It was true for all of us. What we need is empathy.

“I’m sorry,” I told her.  She questioned me with her eyes.

So I answered it, “I’m sorry you’re so alone.”

Jessica’s whole body shook when she sobbed.

* * * * *

no cell phoneThe last time Nicole was in my office she asked me if she should return Jessica’s phone. We had a similar conversation the day she asked me if she should call the police.

“What do you think?”

“I think Jessica needs to figure this out for herself. I’ve tried to protect her, but I can’t. I just can’t protect her from everything.”

“Does that mean you’ll give it back?”

“No. She’s not ready for that.”

“I don’t know the answers to the particulars,” I told Nicole, “but I know this. You’re a good mom. Jessica needs you right now. She needs you to be confident in your role.”

I saw the tears washing through the mascara, gave Nicole the box of tissues, and kept on going.

This is universal: the teenager wants desperately to have her independence, and she is terrified of it.

“Jessica loves you, and she knows that you love her.  Jessica is not aware of the fact that she is conflicted about this. She’s just a kid. As much as she pushes you away, she wants you to be strong, to love her.”

* * * * *

I talked to Jessica again a week later.

“Do you still see him?” I asked.

She was embarrassed, “Yeah.”

“Is he good to you?”

“Sometimes.”

“How about last night?”

She hesitated then said, “Last night he left me in a parking lot. I had to borrow a phone and call my mom to come pick me up.”

“Why’d he leave you?”

“To hook up with someone else.”

“Will you see him again?”

“Probably.”

“I have a vision for you,” I said.

Jessica smiled, like she had heard lines like that from me before.

But that didn’t deter me. I have an advantage over most parents of teenagers: I’ve made a career out of the adolescent. Their behavior can be alarming, infuriating and even demoralizing, but after seventeen years of guiding teenagers as they come of age, I have established proven routines.

I have a pretty good idea of how many repetitions it will take, of how many times I’ll have to say it before Jessica can even make sense of the words, of how many more times I’ll have to repeat it before she begins to adopt the language as her own.

So I told her again, “In my vision of your future, you will love yourself too much to let a boy treat you badly.”

* * * * *

BenjaminDancerThe story above is a composite of a dozen mothers and a dozen daughters I’ve work with over the years. In my FREE e-book, I analyze that narrative–elucidating what I believe to be the important parenting considerations.  

Find out more at: SEXTING AT SCHOOL, a FREE download at Goodreads.com, or if you’re feeling generous, you can buy it for $0.99 at Amazon.com.

About Benjamin Dancer:

Benjamin is a high school counselor at Jefferson County Open School where he has made a career out of mentoring young people as they come of age. He wrote the novels PATRIARCH RUN, IN SIGHT OF THE SUN and FIDELITY. He also writes about parenting and education. You can learn more at:

Website:      BenjaminDancer.com

Facebook:    https://www.facebook.com/benjamin.dancer

Twitter:        @BenjaminDancer1


Like this post or have a comment?  Please give it a rating (above) and share your thoughts. Your comments are helpful for other parents who read Benjamin’s article.  Thank you.

Margaret

Understanding and supporting a child with ADD or ADHD

Understanding and supporting a child with ADD or ADHD

Boy-with-ADD

This article contributed by the Diamond Ranch Academy.

Life with a child with ADD or ADHD can be trying and overwhelming. However, as a parent there are practical measures you can take to effectively control and minimize your child’s symptoms without controlling and monitoring their every move.

You help your child overcome daily challenges by redirecting his or her energy into positive activities. You start by having a dialogue with your child and family that honestly communicates the situation in a way that does not accuse them of being “bad”.  Their behavior needs improvement, but speak as if it’s a ‘normal’ problem that must be addressed.

Children with ADD or ADHD typically have shortcomings in executive function: the ability to think and plan ahead, organize, control impulses, and complete tasks. This means that you need to take over as the executive, providing extra direction while your child progressively obtains executive skills of his or her own. With tolerance, kindness, and plenty of family teamwork, you can help your child manage childhood ADD or ADHD and maintain a steady, happy home

You must to be able to master a combination of support and predictability.

Living in a home that provides love and lots of structure is the best thing for a child or teenager who is learning to manage ADD/ADHD. There are effective and simple changes you can make that are easy to implement; we offer four practical tips to help you understand and support your child with ADD or ADHD:

1.  Be honest with your child about ADD or ADHD
distracted girlIt is important not to avoid or ignore your child’s condition. ADD or ADHD is not your child’s fault, it is a brain disorder that causes young people to have trouble focusing, completing tasks, or planning the future. Most parents can reframe things, but don’t look at the negative. Your child should understand it is something they can and should manage. The rest of your family should do this too.

2.  Stay Positive
dad-and-sonWhen calm and focused, you are more likely to get your child’s attention and help him or her to be peaceful and attentive. And keep things in perspective. Your child’s behavior is related to a disorder, so most of the time it is not deliberate. Don’t sweat the small stuff; be willing to negotiate certain matters. For example, if one chore is left undone but your child has already completed two chores and their homework for the day, let it go and appreciate what they were able to complete. Staying positive also means believing and trusting your child. Trust that your child will learn, change, mature, and succeed.  Trust that your child wants to!

Taking care of yourself will allow you to take better care of your child.

It is vital to live a full, healthy life because you are the child’s role model and source of strength. Eat right, exercise, and find ways to reduce stress. Getting involved with organizations related to ADD or ADHD will also provide you with safe places to vent your frustrations and share experiences.

3.  Establish structure, enforce rules and consequences calmly

boy and garden

Help your child with ADD or ADHD to stay attentive and prepared by setting a strict routine. Set a time and place for everything to help your child with ADD or ADHD comprehend and meet expectations. Allow extra time for what your child needs to do, such as homework, chores, and getting ready in the morning.  Keep them busy but not too busy—a child with ADD or ADHD will become more distracted and act up if there are too many after-school activities going on.

Create structure in your home so your child knows what to expect and when.

Children with ADHD are more likely to succeed if they can complete tasks when the tasks occur in probable patterns and in foreseeable places. Children with ADHD need rules because it helps them track time and progress. Make the behavior rules simple and clear. Write down the rules and hang them up in a place where your child can read them. Children with ADD or ADHD respond exceptionally well to prearranged systems of rewards and consequences. It’s important to explain what will happen when the rules are obeyed and when they are broken. Finally, stick to your system by following through each and every time with a reward or a consequence.

4.  Encourage movement and sleep

teenstalkingChildren with ADD or ADHD often have a lot of energy to burn. Organized sports and other physical activities can help them get their energy out in healthy ways, and refine their focus while enjoying the development of new skills and abilities. Exercise leads to better sleep with children with ADD or ADHD, which also reduces symptoms of ADD or ADHD. Children with ADD or ADHD often find “white noise” to be calming when sleeping. You can create white noise by putting a radio on static or running an electric fan, for example.

Guest Post by: Diamond Ranch Academy
Diamond Ranch Academy is one of the premier youth residential treatment centers for struggling teens. Since 1999, the highly trained staff at this facility has provided guidance and support for teens with varying emotional and behavioral issues including; substance abuse, depression, ADHD, impulse control, peer pressure, anger management, oppositional defiance, self-esteem, grief/loss issues, family relationships, communication, and academic struggles.

Note from blog owner, I am not personally familiar with Diamond Ranch Academy and this post is not an endorsement, but this post offers good information for any parent of a child with ADD or ADHD.  For ideas on what to look for in a good residential program, see the post Residential treatment checklist

–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.

Calming room ideas to prevent tantrums, for kids with autism or other disorders

Calming room ideas to prevent tantrums, for kids with autism or other disorders

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This article was provided by Ryan Novas on behalf of National Autism Resources.

For those with an autistic child, it is a parent’s nightmare to face a tantrum with no way to calm them down.  That is why it is important to have a calming room or area set aside for your child that helps ease distress before a tantrum starts, or to send them to in order to ease the distress. Here are three versions of a calming room you can create to help when your child is about to have a tantrum.

The HUG room

calmroom6The hug room is popular for calming any child down, especially one on the spectrum. The hug room needs to have calming items that provide a sense of security and warmth, and a cocoon-like hug.  In this room, provide a weighted blanket or snug embracing vest (in case your child won’t lay down). Both of these are like bear hugs, which can be comforting and calming for children with autism.  Another great item to have in this space is a crash pad (used by many therapists and parents in combination with a weighted blanket), or a large or stuffed animal or pillow that the child can hold on to or hug.  You want to make sure the animal or pillow does not have parts that can be ripped off and chewed on or cause damage in another way.  You’ll also want all other items to be soft and safe to throw to protect the room or others in case your child does have a full-blown tantrum.

The SOOTHING SOUNDS & SCENTS room

calmroom4One thing that can work very well for some children, especially with tantrums brought on by overstimulation, is a room with soothing sensory experiences. In this room, block or mute outside sounds–TVs, stereos, and people walking or talking near the room so it’s as quiet as possible.  Once your child is in the soothing sounds room, you’ll need to have a place for them to relax or lay down.  You can use a bed, a crash mat, or something else they can fall asleep on or even just sit on with their eyes closed.  Silence or a soft gentle background ‘hum’  or soothing sound helps, such as  from meditation CDs, music or birds or flowing water.

calmroom3You can also try products like the Twilight Turtle which has soothing sounds and even includes a light show of constellations (also perfect for the 3rd room, below).  Noise blocking earmuffs and headphones make great additions for this room if your child needs to be removed from all noises.  These also provide a kind if ‘hug.’  You can combine them with a scent or scented toy or stuffed animals to calm your child.  Think about little pillows stuffed with lavender flowers, or an air freshener they like.

The VISUALLY CALMING room

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  • For a visually calming room, remove overly bright colors and small points like those from a static night-light that plugs into the wall.  Instead, find something like the Tranquil Turtle above or even liquid motion lamps or light projectors with calming colors and patterns. You can also try adding black out curtains on the windows to block bright sunlight–the point is to make light easy on their eyes. Darkness may help the lights do a better job.

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The most important thing when creating a calming room is to make sure it meets the needs of your child. Include features that are most effective for him or her. Don’t forget to exclude or remove anything that is easily thrown or could hurt your child or others or cause damage to your house.

 

Addendum:  I’ve seen these other things used to calm people to prevent overstimulation or anxiety.  The first two were in a psychiatric unit for calming mental patients.

  1. A bubbling aquarium, or a digital aquarium on a computer monitor
  2. A video image of a burning log in a fireplace or the rippling surface of water
  3. A small motion toy powered by a solar cell
  4. A pendulum clock

 

Have you discovered something that works for your child?  Please share.


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