Ask a Psychiatrist and Get Answers to Mental Health Questions ASAP
Welcome, I am a professional counselor and behavioral-consultant. I've worked as a treatment program developer and psychotherapist for high behavioral and emotional needs children and youth.
Do you mind if we chat for a few minutes so that I can better understand the situation and problem you're describing before providing an answer?
What do you mean more specifically by "out of control"? For example, what are her top 2 or 3 behaviors of concern?
running away, using drugs and alcohol, defiant, poor grades,
I'm very sorry to hear that. How are you doing right now?
Not good, don't feel like we have any control in our house
we have 3 other kids here
Has your daughter had any formal diagnosis? What have counselors/therapists said is her problem most recently?
oppositional defiant and and a couple Dr's have said she seems narcissistic
Does she have a serious drug or drinking problem? What kind of drugs does she use; how often does she drink and/or use?
She has no fear about her safety, which makes it a full time job for me. We try and keep a close watch on her, so it is not daily, but whenever she gets a chance, she will drink, take pills, or smoke (spice, cigarettes, and marijuana).
I think it became serious/daily while she was living with her dad, which was probation's doing, because there was no supervision.
She also becomes physical with us during arguments.
Was there ever a time when she was well behaved at home and/or at school? Was she ever a good or average student?
She used to get all A's until middle school. I think she decided it wasn't cool or something. She may actually believe she will get all she needs out of life with her looks. The outside is much prettier than the inside. We used to all get along fine, but she did always have the worst temper tantrums I had ever seen. They started around three, but by nine she was really bad.
She was also well behaved at school until about 6th grade when she started hanging with the wrong crowd.
She has been suspended many times and does not think the rules apply to her. She is also very rude to the staff.
What kind of counseling has she had? Did it have a name like behavioral counseling or cognitive behavioral counseling? Was it talk based?
Most importantly, what kind of home based counseling has she had? What was it's basic goals and methods?
I'm not exactly sure what kind, but mostly talking. The outpatient was group, where she just learned more bad behaviors from the other kids. I am assuming it was behavioral.
We have been through a few diff counselors over the years.
We have had home-based, too.
What kind of home based counseling did she have? What was it's basic goals and methods?
Did it have a weekly behavioral parent training/family counseling component?
While probation had her placed in a therapeutic foster home, we started the home-based. The counselor visited Nadia at her foster home, came to my home, then we also met out in public. They also continued when she was transitioned back into our home. It just ended 2 wks ago. While my husband and I did learn some good ways of handling her, we don't believe she learned from the experience.
Was she in group foster care (more than 1 foster child)?
No, just a single family. Actually, in the first home she got into a physical fight with the foster mother's granddaughter. Then, they moved her to another one where there was another 6 yr old boy.
Thank you for all the detailed information...
you are welcome
I also want to add that she has been running away nonstop and DCS wants us to let them start home based all over again. We are reluctant to completely start over with something that didn't help.
I think that what Nadia (and you) could really benefit from in a serious way is an "Evidence-Based" intervention like functional family therapy or multisystemic therapy. These are home based programs that systematically teach behavioral parenting, provide proven family and individual counseling support and intervene simultaneously in the home, school and community settings. They've been proven to get lasting positive behavioral change results in as little as a few months. This includes "academic normalization" or doing good in school again....
FFT and MST are both usually fully government funded and free by the way.....
These approaches all so target reduced interaction with an "anti-social peer group" and systematically counter "peer deviancy training" problems....
Let me get you some links. Back in a few seconds....
MST - http://mstservices.com/
FFT - http://www.fftinc.com/
If you ever consider treatment foster care again, I would recommend that you do everything you can to get Nadia into an MTFC program. MTFC applies the same proven treatment approach that both MST and FFT apply. But they focus on getting the child or teen back home with the new behavior changes too.....
Group residential treatment most often makes problems worse as you seem to understand in your response related to group counseling...
Let me get you an MTFC link...
I don't think we will do foster care, that was the probation's doing.
So do I let DCS get involved, or do I do this on my own?
They said it was up to me.
I have to tell them tomorrow
If I were in your position, I don't think it can hurt to do both. The DCS may have connection to an area MST or FFT program and help you get in faster. I would also contact the program managers in your area (MST/FFT) and find out about what programs they are running and how you can get involved......
I would also ask about evidence-based behavioral parent training programs that you can take as a parent. The more connected these are to MST/FFT or MTFC the better, because they teach what works and not what someone thinks works or doesn't work.
Ok. Thanks for your advice. It's nice to have some third party input here.
For example, they teach how to use a point and level system, how to set up home school communication that works and how to reduce negative peer effects (bad peer pressure etc).
You are very welcome. I wish you and Nadia the best in all of this.
Please don't forget to press the green "Accept" button so that I am recognized and paid for my work with you today. If you feel that I have not answered your question satisfactorily please let me know so that I can try and improve my answer.