scared....first therapy appointment for my son is today

[ktgrok]

With all my son's behavior issues we have a therapist visit scheduled for today. I met with her about a month ago to discuss things, but then things were going well so I hadn't brought in my son. When things deteriorated I knew I had to bring him. But I'm so scared!!

 

My son has said many times he will not go. He doesn't know yet he has an appt today as I didn't want to ruin halloween for him or I. I am letting him get his schoolwork done first before I tell him. Otherwise it won't get done. I hate springing it on him, but telling him ahead of time would have made him miserable for days. I'm scared of his reaction. I'm a bit frightened that I won't physically be able to make him go.

 

I'm also scared of what will come out. There have been parenting moments I'm not proud of. He has gotten violent several times (hitting and punching walls) and I've had to restrain him to keep him from hurting himself or breaking things. That led to him screaming that i was hurting him, him physically wrestling me, etc.....also, twice I have hit him (slapped with an open hand) which I am NOT proud of....I'm scared i'm going to end up investigated by child services or something if this is presented or interpreted wrong. Is this a valid fear??

 

And I'm worried none of this will help, or that I will be told something awful, or I don't even know.

 

Please please pray for us. Our appt is at 4:30pm Eastern time.

[dirty ethel rackham]

I am praying for you today. I pray that you have the strength to follow through on what he needs and to weather the storms to come.

[Sun]

I think most therapists that have experience working with children who have violent outbursts understand the need to restrain them physically sometimes. In fact, when I attended a conference on anger in children, one of the topics presented was how to safely restrain someone (safely for the child - AND for the adult). Also, most therapists will understand the extreme frustration that comes with parenting in general and even more so sometimes with kids who are more challenging. I highly doubt a slap would warrant a call for CPS. I know it's way easier said than done, but try not to worry about that. Just focus on your son and your family and doing what's best for them.

 

I'll be thinking of you today and hoping it goes well.

[ktgrok]

Thank you, I do hope they understand. One of my son's issues is that he will purposely push buttons, to try to instigate things. Sometimes it still works on me. I regret what I've done..and have apologized. I thank God for the attachment we have from when he was little, to help cushion our relationship during this time of tribulation.

 

And thanks for the reminder that he NEEDS this. It's hard to admit I can't fix this myself. REALLY hard. And today he was being so sweet i wanted to cancel. Then he started getting angry and upset about the fact I make him wear a helmet and no other kids have to. Mind you, this is in the middle of the morning, no bike riding is taking place. I even asked, why are you getting so upset (he was stabbing a piece of paper) and he said "i don't know." sigh.

 

And last night when he was trading candy with friends at the house, after trick or treat, he got upset that no one would trade him for his favorite. (he can't eat milk, so his options are very limited, which IS frustrating). But his reaction was so over the top, he actually curled up in a ball in the corner of the room away from everyone, huddled around himself. His friends thought it was ridiculous..he was SOOOOOO upset and his reaction so NOT age appropriate. I would have expected that from a 4 year old or younger, at the oldest. Not an 11 year old. Something needs to be done.

[thescrappyhomeschooler]

:grouphug: I'm pretty sure they will understand the frustration level of a parent dealing with those kinds of outbursts. You are caring enough about your son to try to get help in dealing with his problems. I hope it goes well for you today.

[ktgrok]

I told him.

 

We had 15 minutes of him venting rage. I stayed out of it, honestly. I had the baby and didn't want to expose her. He thankfully limited almost all of it to his punching bag (although he did kick the bag across the room and into the hall...a professional heavy bag! he weighs less than the bag I think). He trashed his room a bit, but less than I've seen in the past and didn't break or destroy anything other than a soda can, which he crushed. He is basically not speaking to me, and spending time cuddling the cats. All in all it could be much worse. Oh, and he said he wished he could kill himself...yeah....that sends chills up a parent's spine.

 

I do think I can get him there though, as he said he's not going to talk, rather than not going to go. That is ok, i figure once he's there that is her problem to figure out, right?

[Elizabeth in WA]

I do think I can get him there though, as he said he's not going to talk, rather than not going to go. That is ok, i figure once he's there that is her problem to figure out, right?

 

Yes, but ... Be prepared that he might not talk. My ds14 was diagnosed with Aspergers at that age. He did not talk at all in his first three visits with the child psychiatrist. It was a couple years later before the "selective mutism" became an official part of his diagnosis, but... it was extremely stressful to deal with at the time.

 

:grouphug: I hope things go well and your son clicks with the therapist quickly!

[ktgrok]

I can handle that I think...I assume she is used to it?

 

Yes, but ... Be prepared that he might not talk. My ds14 was diagnosed with Aspergers at that age. He did not talk at all in his first three visits with the child psychiatrist. It was a couple years later before the "selective mutism" became an official part of his diagnosis, but... it was extremely stressful to deal with at the time.

 

:grouphug: I hope things go well and your son clicks with the therapist quickly!

[gingersmom]

Good luck with the appointment.

 

I noticed you said it was a "she". Would he be more comfortable with a man?

 

If this therapist does not work out do not give up. My daughter saw more than 1 therapist before clicking with hers.

[ktgrok]

I chose a woman because I thought she would be less threatening....and he is close with my best friend and my midwife, both women. If this doesn't work out maybe I will try a man next. We are leaving soon...please pray!

 

Good luck with the appointment.

 

I noticed you said it was a "she". Would he be more comfortable with a man?

 

If this therapist does not work out do not give up. My daughter saw more than 1 therapist before clicking with hers.

[Chris in VA]

just saw this--praying for you and your son.

There are few things, ime, that can make you feel more inadequate than not being able to handle your children. It's so incredibly humbling to ask for help. I commend you for being willing to do so. I've been there with both my boys, and it really does make you grow.

[tex-mex]

just saw this--praying for you and your son.

There are few things, ime, that can make you feel more inadequate than not being able to handle your children. It's so incredibly humbling to ask for help. I commend you for being willing to do so.

:iagree: :grouphug::grouphug::grouphug:

[Celia]

You're in my thoughts, and I just want to say congratulations for doing what you know is best for your son, even though it scares you to do so.

 

That is love, and you're a great mom.

 

Hope it goes well. Keep us posted.

[Tabrett]

:grouphug:

How did it go? Did he talk?

[ktgrok]

he did talk!!! He refused to talk about the incident last night, where he curled in a ball in the corner, but talked about hitting walls a bit. Honestly, I think he was giving us the middle finger at one point, but it might have been an accident. Either way, I'm not sure what I think. I left with us having agreed to give him more control over what his room looks like. But I really think she is talking more "behavior" and I'm talking more "not normal, maybe depressed or diagnosable with something". I told her how he hid in the bathroom and wouldn't talk to anyone when we took the carpet out of his room, and his anger over us changing to laminate. (this is a health issue, we all have allergies and we have multiple animals). she says "well, what about a throw rug". Um, I tried that already. I didn't schedule a therapy appointment only to be told "try a throw rug". How about the fact that in front of his grandparents he curled up in a ball, then ran and hid in the bathroom, then refused to speak to anyone, all at 11 years old???

What about the fact that he punches walls and objects?

 

Maybe it is just like this in the beginning, to build trust with him?

 

Katie

[Suzanne in ABQ]

 

Maybe it is just like this in the beginning, to build trust with him?

 

Katie

 

 

Yes. It's a process. She needs to build a relationship with him in order to get him to share enough to figure out what's going on, and to have any chance of him doing what she asks him to do.

 

He's probably kicking himself for speaking about the walls, after promising himself not to talk at all. ;)

 

Give it time. She managed to get him to talk a little. And, she let him know she heard him. If she had just blasted him from your point of view (which is how it would have appeared to him if she had addressed all your concerns without hearing any of his), he would have clammed up. Give her some time. Maybe talk to her on the phone or via e-mail to get her thoughts.

[Sun]

I can completely understand why you're rather taken aback by what the therapist said today. I would be too. That being said, I think you may have to give it a few sessions before she'll be able to have a decent feel for what's going on. Also, was your son in the room the whole time or did you have a chance to talk without him present? If he was there, she may not have wanted to say anything about the extremity of some of his reactions.

 

:grouphug: Remember that you are trying to help him. If this therapist turns out to be the wrong person for him and you for whatever reason, then try someone else. It can take a few tries (different therapists) to find one that really gets the situation and with whom you can work. Good luck!

[Laurie4b]

he did talk!!! He refused to talk about the incident last night, where he curled in a ball in the corner, but talked about hitting walls a bit. Honestly, I think he was giving us the middle finger at one point, but it might have been an accident. Either way, I'm not sure what I think. I left with us having agreed to give him more control over what his room looks like. But I really think she is talking more "behavior" and I'm talking more "not normal, maybe depressed or diagnosable with something". I told her how he hid in the bathroom and wouldn't talk to anyone when we took the carpet out of his room, and his anger over us changing to laminate. (this is a health issue, we all have allergies and we have multiple animals). she says "well, what about a throw rug". Um, I tried that already. I didn't schedule a therapy appointment only to be told "try a throw rug". How about the fact that in front of his grandparents he curled up in a ball, then ran and hid in the bathroom, then refused to speak to anyone, all at 11 years old???

What about the fact that he punches walls and objects?

 

Maybe it is just like this in the beginning, to build trust with him?

 

Katie

 

I worked in kids' mental health for a number of years. What you got today sounds very appropriate. She may back off on easy suggestions though (like the throw rug) as she gains more info. But no, punching walls and objects is not all that uncommon at his age. The curling up in a ball is more so. However, it can simply indicate that he needs coping skills when his feelings get really intense and/or that he's getting secondary gains out of the behavior (control, a feeling of power, attention, revenge--any of these kinds of things can act as a reinforcer of the behavior and keep it going.

 

There are different ways to approach mental health. One is with a big emphasis on diagnosis. That can be helpful if there is a physiological issue that meds will help. Other than that, you'll find that diagnosis in mental health is not as cut-and-dried as you might hope; it's not real likely that any three therapists will agree! And unless there are meds involved, the treatment for that kind of acting out will be pretty much the same, no matter what the label is. And teenaged boys can be like PMS on testosterone for months at a time.

 

Research wise, behavioral and cognitive-behavioral approaches have a lot going for them. Unless he absolutely cannot control his behavior, teaching him to do so is warranted whatever the diagnosis.

 

Things that would be reasonable:

 

She may be wondering about the extent to which this is an interpersonal conflict (hence the suggestion of a compromise on the throw rug. It was a mistake to offer a suggestion for compromise without first asking you what you had tried in terms of compromise, but one mistake isn't enough to call off the game. I'd give it a couple more sessions.) She may also have been seeing what kind of reaction there was to a suggestion of a compromise. Would the parent be flexible? Would the kid be flexible? Without assigning any blame to you, by this point, most parents and kids have developed some negative cycles of dealing with conflict that both will have to step back from and learn something new.

 

She may teach him how to relax, help him to identify things that happen when he is at the beginning of a state of anger before he loses control, and teach him how to assess and use coping mechanisms (such as relaxation, self-talk, etc.) rather than escalate.

 

It is not the sign of a poor therapist that they start with seeing if they can affect the problem through changing the environment, teaching coping skills, etc. Wouldn't it be wonderful if with a neutral but skilled outside party involved, that his behavior turns around? It's like trying the "do no harm" thing first. Personally, I'd rather have that for my kid first, rather than have a "explosive behavior disorder" label and medication from my first visit.

 

If after 3 visits, you don't have a clear idea what she's doing or where she's going, call her to ask about the treatment plan. If it makes no sense, then you can go elsewhere.

 

Warning: When using behavioral approaches, behavior will sometimes worsen when you are on the right track. An analogy: suppose you liken the "bad" behavior to putting quarters in a coke machine. Suppose you liken whatever reward there is for the behavior to getting the coke. What does the average person do when the coke doesn't come out? Usually we escalate our behavior. We might push the button several times, shake the machine, pound on it, try to reach up inside, say a few choice words. It's because the expected reward isn't forthcoming. We might give up that day and try again the next. The same thing will result when there is no coke. However, there will come a point at which a person will stop going to that machine. Back to the situation with the kid, when they don't get whatever it is they are looking for, they will try harder to get it (the behavior often gets worse); however, shortly, the behavior should drop off precipitously.

 

Hope this helps

[ktgrok]

LOL Laurie, I've used the coke machine with my dog training students when describing extinction bursts, it was funny to see someone else using it!

 

You made me feel a lot better. You are right, diagnoses doesn't matter if behavior or cognitive therapy works. And medication is a last resort as far as I'm concerned. And after reading your take on it I definitely think she was feeling out our relationship and my way of dealing with problems. She suggested a compromise on how clean his room needs to be and I suggested we write down a definition of how clean it needs to be. She thought that was a good suggestion, and said we should try to implement that in the next 2 weeks and then see how well it worked. I thought that was kind of a small point but I see now it will also show how well compromise works in general, how our relationship works, how well I can implement things, etc. Thanks for explaining that!!!

 

I'll give it a few more tries and see what happens.

 

I worked in kids' mental health for a number of years. What you got today sounds very appropriate. She may back off on easy suggestions though (like the throw rug) as she gains more info. But no, punching walls and objects is not all that uncommon at his age. The curling up in a ball is more so. However, it can simply indicate that he needs coping skills when his feelings get really intense and/or that he's getting secondary gains out of the behavior (control, a feeling of power, attention, revenge--any of these kinds of things can act as a reinforcer of the behavior and keep it going.

 

There are different ways to approach mental health. One is with a big emphasis on diagnosis. That can be helpful if there is a physiological issue that meds will help. Other than that, you'll find that diagnosis in mental health is not as cut-and-dried as you might hope; it's not real likely that any three therapists will agree! And unless there are meds involved, the treatment for that kind of acting out will be pretty much the same, no matter what the label is. And teenaged boys can be like PMS on testosterone for months at a time.

 

Research wise, behavioral and cognitive-behavioral approaches have a lot going for them. Unless he absolutely cannot control his behavior, teaching him to do so is warranted whatever the diagnosis.

 

Things that would be reasonable:

 

She may be wondering about the extent to which this is an interpersonal conflict (hence the suggestion of a compromise on the throw rug. It was a mistake to offer a suggestion for compromise without first asking you what you had tried in terms of compromise, but one mistake isn't enough to call off the game. I'd give it a couple more sessions.) She may also have been seeing what kind of reaction there was to a suggestion of a compromise. Would the parent be flexible? Would the kid be flexible? Without assigning any blame to you, by this point, most parents and kids have developed some negative cycles of dealing with conflict that both will have to step back from and learn something new.

 

She may teach him how to relax, help him to identify things that happen when he is at the beginning of a state of anger before he loses control, and teach him how to assess and use coping mechanisms (such as relaxation, self-talk, etc.) rather than escalate.

 

It is not the sign of a poor therapist that they start with seeing if they can affect the problem through changing the environment, teaching coping skills, etc. Wouldn't it be wonderful if with a neutral but skilled outside party involved, that his behavior turns around? It's like trying the "do no harm" thing first. Personally, I'd rather have that for my kid first, rather than have a "explosive behavior disorder" label and medication from my first visit.

 

If after 3 visits, you don't have a clear idea what she's doing or where she's going, call her to ask about the treatment plan. If it makes no sense, then you can go elsewhere.

 

Warning: When using behavioral approaches, behavior will sometimes worsen when you are on the right track. An analogy: suppose you liken the "bad" behavior to putting quarters in a coke machine. Suppose you liken whatever reward there is for the behavior to getting the coke. What does the average person do when the coke doesn't come out? Usually we escalate our behavior. We might push the button several times, shake the machine, pound on it, try to reach up inside, say a few choice words. It's because the expected reward isn't forthcoming. We might give up that day and try again the next. The same thing will result when there is no coke. However, there will come a point at which a person will stop going to that machine. Back to the situation with the kid, when they don't get whatever it is they are looking for, they will try harder to get it (the behavior often gets worse); however, shortly, the behavior should drop off precipitously.

 

Hope this helps