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David Akiva
David Akiva, BA, MA,
Category: Mental Health
Satisfied Customers: 167
Experience:  Counselor; Behavioral Consultant
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My grandson is 17, lives with us, his grandparents, has been

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My grandson is 17, lives with us, his grandparents, has been under court order to do so for almost 2 years. He lies about everything with no emotion. He cuts school. He is charming, polite, caring, helpful (sometimes). I tell him all the dangers of lying and explain why his future is in his hands. What can I do?
He was totally disrespectful to his mother, our daughter, and had no supervision when living with his father before coming to us.
DuddyH :

Welcome, I'm a professional counselor and behavioral-consultant. I'd like to chat with you for a few moments to better understand your question.

DuddyH :

I see you are offline right now. I think my background as psychotherapist for kids in residential treatment may be helpful for this question. I'll check back in about 20 minutes for your response.


I have taken away the keys to his car at times. He gets a ride with a friend to leave school. He has only 15 weeks of school and will not get a diploma if he does not complete English and PE, which he does not like. I tell him how important it is to get a HS education and the consequences if he does not. He needs to simply complete something to prove to an employer that he is dependable (which I have not seen). He has always lied even to his mother, to whom he was verbally abusive.

DuddyH :

Thank you for the additional detail. I'm just going to read and respond...

DuddyH :

Would you mind telling more about the source of the court order? Has your grandson had any legal issues or this family related?

DuddyH :

We've had some site technical problems recently. Would you mind confirming that you're still there?

DuddyH :

I haven't seen a response from you in some time. You may be busy with another task right now. No problem. I'll check back for your response shortly.


Yes, while living with his father, he went into homes in the small town and took money from purses of these older ladies. One was home and caught him in the act. He tested positive for drug abuseHe was in juvenile detention until the hearing, after which the judge released him to our care under house arrest (we were the only alternative to foster care or jail). That went fine until the house arrest was lifted. He continued to take liberties with the rules, suffered the consequences, and started over with the same accumulative behavior. After testing positive for drugs and being caught stealing hydrocodone and other pain meds (my husband has Waldenstrom's Microglobulemia) he was sent to Clarinda Academy in Clarinda, Iowa. At his six-month hearing he was very articulate, polite, and penitent. The judge asked me if I felt he was ready to return to our home. Perhaps I should have said "NO" but felt after our visits to Clarinda and his testimony in court that he understood and would change his behavior once he was back with us. After only a few weeks, his father gave him a car (which we did not approve) because he worked with his father after school in the tiling business. As soon as the work was done in the late autumn, he went to school and did not return home until curfew which is 9pm weekdays and 11pm Friday and Saturday. He has broken curfew a few times. He was caught after curfew by the police when he was with some young men who were drinking and causing disturbance. His court appearance for that is 2/15. His schedules court appearance on the parole hearing is next Friday 2/10. I could tell you more, but ask me more direct questions and I will get back to you when I can. I will be leaving soon.

DuddyH :

Thank you for the detailed response again. I'm going to take a few minutes to read and then respond. Thank you for waiting. ...

DuddyH :

That was a great clarification thank you. Do you have about 10 minutes to complete this exchange? Or, would you like to set an approximate appointment to meet back again? I'd like to provide you some links as I interact with you here in chat to provide my answer.

DuddyH :

Alternatively, I could just develop an answer and post it for your later consideration.

DuddyH :

If I don't get a response from you in the next couple of minutes I'll develop a tailored answer for you. When you come back, you can review it and let me know if you think I've missed anything.

DuddyH :

Ok. I'm going to work on an answer for you. I'll post it in about an hour for you to look at.

DuddyH :

To start off, I’d like to say that I am very sorry to hear that you are going through this right now with your grandson. The additional details you provided speak to the fact that you are dealing with some serious issues and challenges. I hope this answer is genuinely helpful to you in terms of providing information and resources.

I need to start by letting you know that at we are not permitted to provide any kind of assessment or diagnosis. Besides, it’s really impossible to provide any serious case-specific clinical or counseling advice on this kind of online question and answer service.

What I can do is provide you an answer based on my work as both a program psychotherapist for kids with serious emotional and behavioral problems in residential treatment programs and treatment foster care. I’ve also worked as a school board wide behavior consultant.

The first thing that came to mind as I read your postings was home-based behavioral treatment and parenting support. For example there are 2 evidence-based programs for youth that have been shown to get excellent results in improving behavior in the home and community, and to improve academic performance at school.

These programs, which have also proven incredibly effective in the treatment of youth substance abuse problems, also get lasting results in keeping with follow up studies where the youth is checked up on years after the intervention.

These programs are heavily government funded and are very often provided free of charge to families who participate. They usually start to get positive results in a short period of time and last on average 3-9 months.

The programs I’m referring to are called Multisystemic Therapy or “MST” for short and Functional Family Therapy of “FFT” for short.

This is what I mean by MST:

This is what I mean by FFT:

Here are some excellent links that explain each of the programs in good clear language. Each of these websites also has a program location page:



Both of these programs are well respected by the youth criminal justice system because they are proven to drastically and lastingly reduce re-offense rates and substance abuse behavior. It may be very helpful to you to contact these programs directly, either through the websites or in your area specifically. If you don’t have an MST or FFT program in your area asking program managers or program psychotherapists about good “evidence-based” treatment/support resources in your area, may also be very helpful, time and cost saving to you.

As it turns out, any advice I would give to a family or client in my private practice about the kind of situation you have described, would necessarily involve the same basic assessment, treatment and behavioral parent training practices that are applied in these programs.

For example, it may be very helpful to set up a regular/daily home school communication process in order to get real time feedback on attendance and social and academic performance.

At home these programs would likely set up a positive discipline and behavior change program. One example of positive discipline is to start with a “clean slate” as far as access to privileges go. That means the youth starts with no privileges because of recent behavior problems, but quickly begins to earn them back by following through on specific behavior change goals.

These programs are also considered “evidence-based” ( ) because they tailor their interventions based on the youth’s actual behavior rather than on abstract or secondary clinical assessments, that are often based on opinion rather than on the facts of the youth’s behavior and its sources.

Also, every effort is taken to reduce unsupervised time with an anti-social peer group (kids who also have these kinds of problems and need specialized treatment/support themselves) – at home, in the school and in the community. In fact, behavior change is targeted in all 3 of those environments at the same time, for the best results.

I would strongly suggest talking to your grandson’s probation officer about these programs as well. Being in this kind of program (MST or FFT) can really help with minimizing harmful legal consequences, like incarceration or group treatment settings with other behaviorally troubled youth.

In cases like the one you’ve described, it’s so important to try and get professional help. I wish I could give you specific advice or a step by step plan to follow, but that could actually make things worse because I am not there to monitor behavior or assess intervention needs. Sometimes things you would never think of might be contributing to a behavior problem like dietary issues, environmental sensitivities or other medical aspects of a case.

There may also be more complex mental health needs in a given case that would not be apparent to the untrained observer. Here is a great online resource to help caregivers to identify signs and symptoms of mental illness. I’m not saying this is the case, but it is something that should be explored with mental health professional should you see any of these:

David Akiva and other Mental Health Specialists are ready to help you
The detailed answer I promised is in the last section I entered and begins with the words "to start of with".
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I wish you and your grandson the very best. Take care.
Customer: replied 5 years ago.
I will try to contact one or both of the services you recommend, but I doubt we have such services any where near. Iowa is in dire need of licensed psychiatrists.

Thank you for your help. I am running out of time. If he graduates, that will be in mid-May and he will be 18 on June 30. He plans to move out and find a room with his friend as soon as he is no longer under the juvenile court order.
I did check the FFT site - one of the pages has a map on it. There are programs running across Iowa:
• Four Oaks - Cedar Rapids
• Orchard Place Child Guidance Center - Des Moines
• Quakerdale - New Providence
• Four Oaks Waterloo - Waterloo
• Families, Inc. - West Branch
I would assume that there are MST programs across Iowa as well because it is an even larger, US wide program.
Customer: replied 5 years ago.
Wow!!! Thank you for your wonderful words. Reality is that nobody understands him and never will. You call yourself an expert and i call you a f**ked up excuse for a mental physician.
Sorry you feel that way. I did try my best to provide you with strong practical answer.