Yesterday I got an e-mail from the mother of an out-of-control 13-year-old boy. A mother who had read my blog and was writing me for advice on how to help her son.
I get a lot of these e-mails, and they all begin with some version of “I thought I was the only one…”
The only one with a divorce from hell. The only one with a kid who’s tearing up the house. The only one pinballing from one ineffectual mental health professional to another, in the hope of finding SOMEONE who will tell her how to fix her kid.
None of this is to diminish this mother’s pain. The details of her story are unique to her AND they echo the narratives of so many other mothers who feel freakishly alone.
I exchanged a few e-mails with this mother, trying to answer her questions about how to help her son — particularly whether or not she should send him to residential treatment. And when I read what I’d written, I decided to turn it into a blog post.
This is for all the mothers of out-of-control kids who write me. This is for all the people who google “how do i find a good residential treatment facility for my kid” and end up on my site. This is for all the parents who have sent their children to every therapist and psychiatrist in a 100-mile radius and still find themselves living in a war zone.
This is for every exhausted, terrified mother who has ever crouched in the corner of the shower wishing the water would wash her and her troubles away.
This is for any parent wondering what to do for a kid on the highway to hell when everything that has been tried has failed.
Note: For the sake of reading ease, I refer to “sons” but this advice also applies to daughters.
An Open Letter to Parents of Out-of-Control Kids
1. Get your son into a good residential program ASAP, while he’s young. The longer he goes without real help the more likely it is that his problems will get worse. The older he gets, and the more failures he has (drugs, problems with the law, school failure) the more his self-esteem will suffer and the more problems he will create. If a kid is 17 and acting out, he is essentially gone (because he’s almost a legal adult) and you will have lost the window to help him.
2. If you have other kids, your son’s behavior is impacting them (it certainly affected my daughter). You are probably not giving them the attention they need because you are too busy putting out your son’s fires. They deserve not to grow up in Afghanistan.
3. Most outpatient therapists do not understand how inpatient facilities work. I’m sorry, Joe Outpatient Therapist, but it’s true. Some will tell you you can’t send your kid to residential because he will be traumatized/tortured by boot camp sadists/hate you forever. Some will tell you your only option is to get your kid put on Probation. Trust me: You do NOT want to get Probation involved! Juvenile detention is a BAD, BAD place for a kid to be and should only be a last resort. Once your kid is on Probation, you forfeit what little parenting control you have to the whims of juvenile court .
4. If you can afford it, hire a school placement specialist. There are residential treatment facilities all over the country and an educational consultant can help you pick the right one for your kid. Yes, there are bad treatment centers but there are a lot of good ones too. You need help knowing which is which. I would avoid military schools, as they tend to be more punitive than therapeutic.
5. My son had multiple diagnoses and multiple med trials. He is currently on NO meds and is doing well. In hindsight, I’m not sure any of the diagnoses was accurate. What he needed was the scaffolding of a residential program, which offers 24/7 therapy and structure. No regular home, no outpatient therapist, no meds in and of themselves, can provide the support that a good residential program can.
6. Do NOT listen to people who haven’t been through what you’ve been through. Your friends don’t get it. Neither do your relatives (unless they’ve had a kid like yours). And any therapist or psychiatrist who dissuades you from sending your kid-with-a-death-wish to residential is clueless. If you choose to send your child to residential, do NOT waver. See it through. Do not be stymied by guilt or other people’s perceptions that you are “abandoning” your kid. You are doing the opposite — you are saving him.
As HuffPost Parents editor Lisa Belkin pointed out in her excellent piece on this development, this asinine mentality that working in an office is the only way to be productive, is dubious. It is dubious, it is a morale-killer, it sucks for kids, and it is a lousy, Orwellian reality navigated by parents who require two incomes.
And it becomes a truly surreal Orwellian reality for those of us who are single parents and must cling to their jobs like rockclimbers scaling Mt. Everest.
And the more I thought of all this, the more panic descended on my shoulders, and the more hamster-on-the-wheelish I felt, with the mantra nothing-you-do-is-good-enough ping-ponging wildly in my head.
I slunk out of the office early, drove home and found Luca post-mac-n-cheese, sprawled on the couch with his iPad. I practically begged him to let me fix him dinner — “What about potstickers? Cornmeal-crust pizza?”
“Nah,” he said. “I’m not hungry now.”
I poured myself a glass of wine, steamed some potstickers for myself, and stuffed the laundry in the washer.
Later, Luca asked me to get him some ice cream, which I scooped into a bowl and presented to him like a wise king offering frankincense to the Baby Jesus.
He wanted to watch Breaking Bad with me, so we sat on my bed, watching it on his laptop.
“Your bed is really comfortable, Mom,” he said.
I sighed and smiled at him and savored this thin slice of family time, and for a moment, all was right in my impossible, 21st century single-mom-working life.
EJ says
Nice. Thanks.
Lucy Pritzker says
THANK YOU! I will be sharing this with my clients! “Residential” is so scary to hear, but, in the words of another mother who was once trembling from her out of control son, “it was the last resort- but I wish it had been our first.”
Keep on writing!
Best,
Lucy
Pauline says
Thanks, Lucy!
Christina Simon says
By sharing your advice, you are helping many, many parents. Very happy to hear your son is going well! Here’s to a great summer!
Pauline says
Thanks, C — I’m very grateful to be able to share a positive outcome to a scary story.
Olivia says
Wonderful… another resource I’ll print out and share with my clients with, um… challenging children
Jan Wilberg says
Pauline — You are absolutely, completely 100% right on in your advice. Residential treatment is the key. A once a week outpatient visit doesn’t change the day to day. It’s a little tiny hour in time. Residential treatment fundamentally re-orders a kid’s thought process, re-builds him, if you will. Moms think it’s draconian – the worst possible, rejecting thing you can do. Maybe it is – but it’s the price that has to be paid sometimes in order to save a kid. I know this firsthand.
Pauline says
Thanks, Jan — it’s important to hear from other mothers who have made ths same choice.
Erinia says
As someone who does quality assurance checks for residential facilities and therapeutic boarding schools, as well as acute facilities, it is important to note that MOST RTC programs want the child to have at least 2 acute stays in the hospital in the last 6 months, as well as outpatient therapy/medication management. If it’s a therapeutic boarding school, then they want to see that the child has gone to a Wilderness Program like Luca.
Many programs also want to see a referral from that outpatient therapist/psychiatrist. So definitely talk to them about your concerns. Quite frankly, if you can’t handle it in the home and you see no improvement, or even escalation in the behaviors, then residential can be such a great gift.
Also note, that if you are relying on insurance, most insurance companies also want to see the above. However, once the child is out of the home for 30 days, then the child may become eligible for Medicaid to help with the cost.
I want to give a brief shoutout to Kidlink Treatment Services. A parent can call Kidlink to have their child evaluated for placement at multiple facilities at the same time. They also hook you up with a placement specialist to help with the process. If you want the number, I can provide it.
Pauline says
Thank you so much for your input, Erinia! And yes, please leave the Kidlink number. What a great resource!
Erinia says
Yay! I was briefly useful!
The number to Kidlink Treatment Services is 1-800-726-4032. They work with facilities in multiple states and can find one that best fits your insurance, and the child’s presenting problem.
Pauline says
Awesome! Thank you, Erinia!
Pauline says
Awesome! Thank you, Erinia!
Mia says
Most studies have actually shown that the success rate of even good RTC’s is at best 50%, and most gains are undone within a year of returning home. Best practice is to utilize the least restrictive environment. If you have access to intensive in-home services, the success rate is much higher if you can treat the child in the community, addressing both family dynamics and the child’s behaviors.
Pauline says
There are so many factors…so much depends on the individual kid and family. And yes, if the kid returns to a chaotic or permissive household, he will probably go back to the way he was before. That’s why family therapy and parent education is a crucial part of RTC therapeutic programs.
Most of the families I know had tried EVERYTHING before sending their kids to residential. And intensive in-home services can be a fortune. Kids end up in residential because the least restrictive environments haven’t worked.
Melinda McGruder says
I know you’re going to hate me for this and call me a troll but I have to be a little skeptical of your parenting style if you are watching Breaking Bad with your child. I know I’m old fashioned, but just saying…