Counseling isn’t working

When should I place my teen in a facility to get help?

So often it feels like an extreme measure to remove children from their homes and place them in a facility that might be in a completely different state.

There are no well-established guidelines for placing your teen in residential treatment. Generally speaking, teens enter residential treatment when their needs are too intense to be managed with outpatient counseling.

iStock 000007761349Small 200x300 Counseling isnt workingAfter talking with thousands of parents, what we hear most often is…

  1. “Outpatient counseling isn’t working.”

Parents frequently report that their teen seems to be spiraling out of control and increasing the intensity and/or the frequency of counseling has done nothing to stem the tide of distress and dysfunction. No matter how many opportunities they have given their teen to change, counseling, rewards, punishments have all failed to change the direction of their teen’s life.

  1. “Our family has had enough.”  “He was staying with his uncle, but he has worn out his welcome there too.”

All of the available emotional resources for support from friends and family have become depleted or drained.

  1. “I don’t understand it… he has a great life… I don’t understand why he is so depressed or angry or apathetic or lazy or failing….

Parents often experience confusion or ambiguity as to what the teen might be struggling with and are looking for greater insight and clarity.

  1. “We have to lock our bedroom door because he has stolen from us.” “We are afraid to leave her alone.” “She was grounded, but she just shoved me aside to run out the door.”

There are safety issues, such as escalating levels of substance misuse, self-injurious behaviors, or physical acting out that may be reduced in a controlled treatment milieu.

 

%name Counseling isnt workingAt Shelterwood Academy we can provide round the clock observation in a controlled environment. This level of stabilization helps clarify behaviors or emotions and allows parents to regain control of their homes. Reducing the impact of the teen in the home often protects siblings and enables parents to re-establish their relationships with one another. This renewed strength empowers parents and many families have reported to us that they felt the time out in a residential setting was critical in their own lives. The stress of worry, self doubt with regards to parenting skills, and the anxiety about their teen’s future were all greatly reduced while their teen was in residential care.

Change is a process

Screen Shot 2015 04 09 at 12.25.11 PM 300x199 Change is a processChange is a process, not an event

Do you ever say, “We have already dealt with this, why is he/she still struggling with this?” As parents we crave growth and change so deeply that once we see it displayed, even once, it is really hard to accept when it isn’t immediately repeated. Seeing behavioral growth might even tempt us to get caught up in the success and bring our teen home prematurely. After all, it is really tough to cover the costs of residential care and live so far away from our kids. It is natural to want them home, especially when we see good things happening. But teens that are required to attend treatment tend to demonstrate improved behavior before they have truly changed on the inside. Much like a cake when it is pulled prematurely out of the heat, it will always flop. Change isn’t about making one good choice when everyone is watching. The true mark of growth is when your teen makes the right choice when no one will know. This type of deep character growth that impacts all future decisions is what you should be seeking. So be patient and move through Shelterwood with purpose rather than with reaction. Your teen might return home with a depth that might surprise you.

Residential Therapy

SW Arch 92 Edit copy Residential TherapySome parents might be asking, “How do I know if my teen needs residential Therapy?”

I often tell parents that if they find themselves seriously concerned about their child’s behavior or emotional state more than once or twice a month, then they need to take action.   They know their child better than anyone else, and they need to pay attention to their “gut.”

The longer a parent waits to deal with serious emotional and behavioral issues in their teen, the more difficult it will be for a parent to address these issues themselves, and the greater the potential that residential therapy will be needed to assist the parents.

There are many specific warning signs: defiance, rebellion, lying, depression, isolation, suicidal communication, refusing to participate in family activities, being secretive, dramatic changes in behavior, friends, or academics, destructive habits such as drugs, alcohol, cutting, or eating disorders, choosing poorly in relationships.

When you get to this stage, you have probably already discussed your concerns with your child on multiple occasions with little success and have maybe consulted with a local therapist.  Unfortunately, outpatient counseling typically depends on some level of willing participation from the client.  Oppositional teens often struggle to make positive gains in the local counseling office for three specific reasons: First, because they have difficulty trusting a professional that they only see for brief weekly sessions.  It usually takes a great deal of time to build trust with a teen and they often doubt the motivations of people that they perceive as only caring because it is their ‘job.’  Second, teens often have difficulty expressing themselves through talk therapy and do much better when given an opportunity to express themselves through experiential therapy.  Some of the best counseling is done at Shelterwood while walking on the campus in the evening or sitting around the campus lounge with a cup of hot chocolate. Third, when left to their description of events or attitudes, teens find it to easy to mislead an outpatient counselor.  Outpatient counselors are put in a tough spot because they can only work with the information that they are being provided and oppositional teens find it easy to shift blame and avoid responsibility when they are the only ones in the office and the counselor has no other vantage point.

If your teen remains unmotivated and uninterested in changing his/her approach to life than residential care is the best option.  Residential therapy affords the counselor an opportunity to watch and interact with the teen throughout the day, seeing them at their best and worst while they interact with teachers, peers, and house staff.  Having been burned before, parents are often wary of a counselor’s ability to see through the manipulation of their teen.

Because of the 24/7 nature of residential therapy, it is really difficult for teens to mislead for very long.  But they certainly try, especially at first, enlisting one of three different approachesOne approach that usually only lasts a few days is to make attempts to act ‘good,’ trying to demonstrate that their placement was an overreaction by the parents and that they really don’t need to attend such a program.  A second strategy that they use is to try and create doubt within their parents.  They make assertions as to how bad the other kids are, or how horrible the food is, or maybe they will create elaborate stories about how the teachers don’t care about academics enough, or how the counselors just don’t understand.  After all, “You are right, Mom and Dad, I really do want help but just not here. It seems dangerous, unprofessional or not right for our unique family needs.”  The third technique is simply a power play, an effort to threaten parents with hurting themselves, hurting others, running away, or withholding future love and connection if they are left in the program.  Of course, I have also seen teens switch techniques when they are not achieving their desired results of getting removed from the program.

It usually takes a few weeks and maybe even a month or two to work through the teen’s resistance to change.  We use empathy and strength until teens slowly recognize the safety of their current surroundings and begin to let down their guard and become more honest.  By placing their teens at Shelterwood, parents are clearly communicating to their teen that there are consequences. And by keeping their teen at Shelterwood through graduation, those teens are learning that their mom and dad are serious about them learning these lessons before they return home.

It is important to remember that each teen is a free moral agent with his or her own will. Some teens act on what they are learning while they are still in the program.  For others, they might need to return and struggle again before what they learned can be solidified into lasting change.  Earlier this year, I heard from one young man who wrote to thank me and to tell me what he had learned at Shelterwood. The remarkable thing is that this young man did not finish our program; in fact, he had to be removed from the program. He described in some detail the things he learned in our program and the desire to come back and visit.

So, if you are dealing with a struggling teen right now, you are not alone, and you are not a bad parent. However, you are in a massive battle. You cannot focus on your past mistakes, and lose heart and give up. The Bible reminds us to “forget what lies behind and to press on.”  Seek the prayer and encouragement of others, and the wisdom and counsel of professionals.  And continue to believe that love never fails!

Signs of teenagers in crisis

depressed f med 150x150 Signs of teenagers in crisis

 

Families will normally be the first ones to notice changes in the teen’s behavior.

Signs of teenagers in crisis include the following:

  • becoming increasingly rebellious
  • withdrawing from family and friends
  • seeking new friends who exhibit questionable behavior
  • becoming violent
  • taking on compulsive obsessions
  • becoming sneaky
  • starting to lie about whereabouts
  • sudden drop in school performance
  • extreme mood swings
  • disappearance of items including money.

On noticing negative changes, parents and caregivers should take immediate steps to resolve the issue. Non-confrontational means of communicating with the teen should be implemented by parents and caregivers. If in doubt, seek professional help with the teen.

Does My Teen Need Help?

Teen Assessment

Read the list of 30 questions below to determine if your teen needs help.  This teen assessment is designed to be a first step and it might be critical for you to discuss the results with a therapist. Please refer to the scoring guide below to see which options are most suitable for your child, based upon the total number of questions that you checked as positive.

1. Does your teen struggle with basic family rules and expectations?
2. Has your teen ever been suspended, expelled, truant or had a drop in school grades?
3. Has your teen ever been verbally abusive?
4. In your opinion, does your teen associate with a bad peer group?
5. Has your teen lost interest in former productive activities, such as hobbies and sports?
6. Do you have difficulty getting your teen to do simple household chores or homework without a major fight?
7. Has your teen had problems with the law?
8. Do you find yourself picking your words carefully when speaking to your teen so as not to elicit a verbal attack or rage from them?
9. Are you worried that your teen may not finish high school?
10. Does your teen, at times, seem depressed and/or withdrawn?
11. Is your teen’s appearance or personal hygiene outside your family standards?
12. Has your teen ever displayed violent behavior?
13. Is your teen manipulative or deceitful?
14. Does your teen seem to lack motivation?
15. Do you suspect that your teen is telling lies or has been dishonest with you?
16. Are you concerned that your teen may be sexually promiscuous?
17. Have you seen any evidence of suicidal thoughts, such as statements that your teen wanted to be dead, etc?
18. Do you suspect that you have had money or other valuables missing from your home?
19. Are you concerned that your teen’s behavior is a threat to his safety and well-being?
20. Does your teen seem to lack self-esteem and self-worth?
21. Do you have a lack of trust with your teen?
22. Is your teen angry or displaying temper outbursts?
23. Does your teen have problems with authority?
24. Does your teen engage in activities you don’t approve of?
25. Do you think your teen is using or experimenting with drugs and/or alcohol?
26. Are you concerned about your teen’s well-being and future?
27. Does your teen seem to be in constant opposition to your family values?
28. No matter what rules and consequences are established, does your teen defy them?
29. Are you exhausted and worn out from your teen’s defiant or destructive behaviors and choices?
30. When dealing with your teen, do you often feel that you are powerless?

Your Total Score is: _______

18+ Checks = HIGH RISK!
– Get help! – Find a residential facility that you feel comfortable with.

9-17 Checks = BORDERLINE RISK

– The problems may be resolved by tightening up the Family Rules and Structure. However, a residential treatment facility may need to be considered if things don’t improve or if the situation worsens.

Up to 8 Checks = MODERATE RISK
– Tighten up family rules and be consistent with your monitoring. It is critical that you follow through. When you say something will happen, your teen must see it happen!

parents at computer 300x169 Does My Teen Need Help?Please call if you have any questions regarding this teen assessment.  We would love to visit with you and discuss these questions in greater depth if you have concerns.  (800) 584 5005

When is it time to place your teen?

Class under Tree copy 200x300 When is it time to place your teen?Teen placement is always a difficult question.  It can be very difficult to determine when and where to place your child in treatment.  A good place to start this evaluation is to simply make a subjective assessment of their general emotional health.  Mental or emotional health refers to ones overall psychological well-being.  It includes the way one feels about oneself, the quality of their relationships, and their ability to manage feelings and deal with difficulties.  Good emotional health isn’t just the absence of mental health problems.  Being mentally or emotionally healthy is much more than being free of depression, anxiety, or other psychological issues.  Rather than the absence of mental illness, mental and emotional health refers to the presence of positive characteristics.  Sometimes when considering outpatient treatment parents ask themselves, “is my teen ‘bad’ enough to warrant treatment”.  But maybe we should be asking, is our teen healthy enough to stay at home and deal with life as a young adult.  Here are some of the abilities that a teen needs to live a productive life.

People who are emotionally healthy have:

  • A sense of contentment.
  • A zest for living and the ability to laugh and have fun.
  • The ability to deal with stress and bounce back from adversity.
  • A sense of meaning and purpose, in both their activities and their relationships.
  • The flexibility to learn new things and adapt to change.
  • A balance between work and play, rest and activity, etc.
  • The ability to build and maintain fulfilling relationships.
  • Self-confidence and high self-esteem.

These positive characteristics of mental and emotional health allow you to participate in life to the fullest extent possible through productive, meaningful activities and strong relationships. These positive characteristics also help you cope when faced with life’s challenges and stresses.