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TherapistMarryAnn, Therapist
Category: Mental Health
Satisfied Customers: 5785
Experience:  Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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My 15 year old son is in inpatient treatment for depression,

Resolved Question:

My 15 year old son is in inpatient treatment for depression, suicidal thoughts, and substance abuse. He has been enrolled 2 months with very little progress on the depression side. His father is diagnosed with Antisocial and Narcissistic Personality Disorders. What I need to know is what is that standard for care in such a contentious family situation with respect to advancement of family counseling? After 9 weeks, there is little progress and completing conflicting messages with respect to what my son is saying to therapists, vs me. There has not been one meaningful therapy session between myself, my son and the counselors. The repeated claim now is that he cannot make a statement for fear that it will be used in court. How can this be seen as an effective handling of the situation given that my son's family situation is out of his control? I expected that he would be given counseling on how to address his parents to relieve the stress he feels in a safe therapeutic environment. Instead, I feel the counselors are hiding behind the threat of suicidal thoughts and failing to address the needs of my son.
Submitted: 5 years ago.
Category: Mental Health
Expert:  TherapistMarryAnn replied 5 years ago.

Hi, I'd like to help you with your question.


If your son is in the facility voluntarily, then you may want to consider moving him elsewhere. When the facility is not meeting your family's needs and not addressing the issues at hand, then they either are not capable or they are avoiding it for some reason.


Is it possible that your son has expressed that he does not want family treatment? They may encourage him to have family involved but he may not want to. In that case, they cannot force him. Therapy depends very much on what the patient wants to do. The counselors can suggest but not force treatment beyond your son being held against his will and being required to attend sessions.


Any counseling someone receives is privileged information unless ordered by a court to be opened. If your son is in an incarceration type of treatment facility, then what he does may be open to the courts. In that case, the treatment he gets may not be condusive to him getting better as much as satisfying the court system that he has been exposed to treatment. The system can be somewhat frustrating because the rules change according to the situation and to the people involved.


If your son is suicidal, then treatment should focus on helping his depression. Safety of the patient always trumps anything else in counseling. Is he currently threatening to hurt himself? Has his suicidal ideation been evaluated? It needs to be determined if your son is suicidal with a plan or suicidal without a plan. Each indicates how serious the threat is. If he does have a plan, then the treatment he gets should focus on helping reduce the threat. Treatment may include medication and should always include intensive therapy sessions.


Can you request a meeting with the counselors or supervisors? You should have a voice in your son's treatment. If that is not possible or does not work, their should be a grievance system you can follow to get some answers. There are also patient advocates that can intervene and assist you in getting answers. You can contact your local United Way for resources or contact your local community mental health center for referrals.


I hope this has helped you,

Customer: replied 5 years ago.
This is actually very helpful and makes the most sense of anything I've heard in a long time. My son is not incarcerated although both of us feel like he is. Here is another twist, his father has medical decision making authority as left over by an old court ruling. I am paying for everything though. It is ridiculous. Can you tell me who the childrens rights advocates would be in the Los Angeles area? I heard that kids rights are very strong here, but don't know how to pursue this. I am meeting with the owner of the facility today and plan to tell him I want my son to leave. He was reported suicidal without a plan, but I believe strongly that he needs to get away from his father and live peacefully with his brother and me. There is very little understanding about the damage done by narcissistic parents, even among mental health people. Not sure why that is, but I have watched this man manipulate therapists, judges, GAL's, and this poor kid for years. There therapeutic environment is non-existant at this point, and it is clearly time to move on.
Expert:  TherapistMarryAnn replied 5 years ago.

I found this link to help you get started finding an advocate:


If they cannot help you, then they will be able to point you in the right direction. Also, consider contacting your local United Way. They have a lot of community information and can refer you to just about any resource you need.


Narcissists can do serious damage to a family and to others. And most people do not know when they are being manipulated because a narcissist is very good at what they do. The best thing you can do is learn what you can about narcissists so you have better ways of defending yourself and your children. The more you know, the less damaging he can be because you will know how to respond. Also, consider getting involved with support groups on line for narcissism and for the issues your son is coping with. Support is a great way to feel less alone and help your stress level. Here is a resource to help you get started:


It sounds like a good decision to move your son to a place you feel will offer more help.



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