Tag Archives: CAMHS

Light and Shade

IMG_1036I haven’t written anything for a while – too exhausted and unsure what to say. Jo is still at home but thinking seriously about going back to school tomorrow. It is a friend’s birthday, and she evidently feels that she is missing out on a good deal of social life. She can get quite disturbed at home and is very isolated. A couple of days ago Jo left empty sheet of paracetamol tablets ostentatiously on the kitchen table. I had no idea whether Jo had taken one for a headache, or the whole packet. We assumed that a serious suicide attempt would be more secretive, and she has long had a habit of self-medicating, as well as of threatening to kill herself, so I’m afraid we didn’t take all that much notice. I did mention this incident to the art therapist who came this morning, and he said he would have to report it. I also mentioned it to the woman from the LEA who phoned up to do a social assessment for Jo as part of the EHCP. She too was very concerned – although I assured her that Jo’s CAMHS counsellor was aware of her self-harming and state of mind. CAMHS can’t do much about it if Jo won’t engage with the service – I went on my own to her last appointment, as Jo wouldn’t leave the house. Jo wouldn’t engage with therapy at home either, barricading herself in her room when a lovely young woman came to do some drama with her. Jo has always engaged in risky behaviours, and our attitude since she was small was to ask ‘Is it life-threatening’? If the answer was ‘Probably not’ we would let her get on with whatever it was she was doing as supervising her was such extraordinarily hard work.

We had a good family day out visiting relatives a couple of weeks ago. The children are normally reluctant to join in our annual get-together and there have been occasions in previous years when having got them there they refused to get out of the car. Billy was the worst offender, but Jo would keep him company. This time his girlfriend Jane was invited along, which made all the difference. Billy behaved well in front of Jane, and Jane included Jo, making friends with her. Sunday morning we were discussing the success of the previous day when three CID officers turned up at the house. At first Billy assumeUnknownd that they had come to take Jo back to school, and told her as much. They were in plain clothes and an unmarked car, but unmistakably the police rather than Jehovah’s Witnesses (we had them today and they are always in twos rather than threes). To cut a long story short, Billy is in trouble over an incident that happened about fifteen months ago. The police had traced his address through his mobile phone number, which he had exchanged with someone else involved. They had a search warrant and took away Billy’s laptop and phone. He was shaken, as we all were, but resigned. He also had to tell Jane at least some of what it was about as she was in the house at the time and he could hardly conceal that he was in trouble. Billy’s biggest worry seemed to be the effect on Jane and their relationship. The police also made it clear that if he didn’t present himself at a police station for interview they would issue warrant for his arrest.

I had two days to try to find a suitable criminal solicitor, and last Tuesday evening Tony came from work and I picked him and Billy up, and we made our way to the police station where we met the solicitor. She didn’t think that it would be in the public interest to prosecute, but the investigations will take some time and he has evidently been engaged in risky, and often criminal, behaviour for some time. Although we were all in a state of shock, there was also a sense of relief that things were coming to the surface, especially as Billy is still a minor (under 18) and there is an opportunity to address the underlying issues when the legal process has run its course. Prosecution is a real possibility, especially if the police find more incriminating evidence on Billy’s laptop, which they hadn’t had time to go through at that point. Billy did a good job of explaining himself but it was far from evident to us that he understood what he had done, or why it was wrong. He clearly knew that he was in trouble, but seems to live in a world with different values. So far at least Jane and her family have stood by Billy – he was at their house last weekend. Its hard to know quite what she sees in him, although he can undoubtedly be kind and caring, and they seem very much in love. We will make the most of enjoying the positive influence Jane seems to have on him while it lasts.

On Thursday as well as attending Jo’s CAMHS appointment without her, I bought a cheap laptop for Billy so that he can do his college work, and Nokia pay-as-you-go phone so that we can contact him, and he can stay in touch with his friends and tutor. I also had to go to the Job Centre with his birth certificate, which the DWP needed for some reason. They haven’t paid Billy’s benefits this month or last, which makes it hard to pay his rent, but I haven’t had the time and energy to find out what’s going on as yet. As I walked through the front door I could see that all was not well. Although our house is messy and too full of stuff, most of the stuff seemed to be on the floor, along with smashed remote controls and debris. The first thing I saw entering the drawing room was damage to the plasterwork – and I later found a smashed up chicken coup on the decking. I was pretty annoyed, having spent another day running round after the kids while they smashed the place up. Billy had retreated to his room and Jo had calmed down by then. He knows exactly how to push Jo’s buttons by being incredibly rude to her, and she reacts but damaging things to deflect her aggression away from Billy. After the smashing episode she asked him how he would feel if Jane could see him, which touched a very raw nerve. He was sobbing but looked murderous. Tony remonstrated with Billy, who wanted us to simply blame Jo for the damage (and to call the police). His stated ambition has always been to make her so naughty that we get rid of her. He wasn’t in a mood to listen to Tony, but hopefully got the message that provoking Jo to get a result is just not on. It is a pattern repeated endlessly since they were very small, but no joke with two large teenagers.

Sprouting_nut_by_EaglewolfTony and I had a few sleepless nights feeling that we had reached another crisis, or at least turning point. Having both children at home with two parents is tough, but with one parent impossible. We agreed that Billy could only come home if he or Jo had a friend staying so that there is someone to act as a moderating influence on Billy’s behaviour (although this is not always effective) and both parents are at home. Logistically this might be difficult but we have been here before. It means cancelling other plans and commitments, which is annoying but can’t be helped. On the plus side, Billy did apparently attend a music therapy session that took place in college today. I just hope he finds a way to work through some of his anxieties and feelings in a way that enables some positive changes in his life. One of the images that came up in the art therapy this morning was that of a nut, like a conker, hard and brown but breaking open with the green shoots of new life. That is what I would wish for each of us.

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On trying not to over react

IMG_1082Jo was bored. Billy spent Friday night at a friend’s house, then phoned very early Saturday morning to ask how he should get home as there was snow on the ground. We checked the trains on-line, all running normally. He eventually made it home by early evening, but in the meantime he had invited another friend along as well, a refugee from building work on his house. That meant that Billy had company all weekend and didn’t need Jo. Jo was bored and stressed. I don’t know quite what happened but there was some incident on-line with one of her oldest local friends, who never wants to see her. Maybe with Billy occupied she had tried to find other company and was disappointed that it didn’t work out. It became apparent on Sunday that she had no intention of returning to school. By the time we took Billy to the station on Sunday evening to make his way back to college we found “my blood is on you all” smeared, in blood, all the way up the white wall of the staircase. On Billy’s bedroom door, along with more bloody finger marks, was the word “Die”. Very jolly! Tony and I were both tired and not in the mood for Jo’s drama-queen antics. We focused on getting Billy out of the house, and assured him that we were not ignoring Jo’s behaviour, we just weren’t sure how to deal with it. He suggested she needed an exorcist.

Part of me wanted to ring her CAMHS counsellor first thing Monday morning to say that we simply couldn’t cope with this sort of thing. Part of me just wanted to tell her off and get her to clean it up the mess, as it seemed indulgent and uncalled for. Billy and his friend had ordered a Domino’s Pizza takeaway after supper on Saturday evening, refusing to share any of it with Jo. On Sunday Jo refused to eat saying that she only wanted a Domino’s pizza. I don’t usually buy them as they strike me as overpriced and not particularly healthy, but Sunday afternoon I had made a special journey to get Jo a Domino’s pizza. This she had turned down on the grounds that it was too small. She had evidently boxed herself into a place where she felt she had to act out her frustrations, as happened so often when she was younger.

Fortunately Tony and I were too exhausted to do anything and Jo was hiding under her duvet, refusing to make contact with anyone. We decided that we would ignore her histrionics, calculating that she was not a suicide risk. I could see some blood on her sheet and broken glass on the floor, but nothing to cause too much alarm. We hadn’t the energy to try to get Jo back to school, and phoned to say she wouldn’t be in that evening. Her housemaster was relaxed about it so we did not feel under any great pressure from that direction. A couple of hours later Jo appeared in the kitchen and presented me with a dirty pink flannel, with which she had evidently wiped the blood off the wall (we have tough wipe-clean paint for good reason). I asked her to move the flannel from the kitchen table to the washing machine, which she did. She then found the remains of her breakfast sausages and the Dominos pizza still in the oven and disappeared upstairs with them. She didn’t say much until this evening (Monday) having slept all day. She is clearly stressed, and has cuts all down one arm, having broken something made of glass her friend had given her, in order to make the incisions.

Part of the problem seems to be Jo’s indecision about going ahead transitioning from male to female. She feels female and just wants people to treat her as a girl, but is finding it hard to accept that she needs medical intervention if people are not going to see her, at least partly, as male. We find it easier and easier to think of Jo as a girl as in personality, and the way she talks, thinks and acts she has always been far more female than male. But one can’t escape the facts of puberty. However she dresses and does her hair, Jo is in a male body. Hopefully taking about it, rather than just acting out her frustration and sense of isolation, will help Jo move forward. I’m glad we didn’t react to her message in blood, even if it was because we simply didn’t know what to do and were too tired to engage with it at the time. You could say it was a call for help, certainly a bid for attention, but not one we would wish to encourage. Being fourteen is never easy, and for Jo there is a lot more to work out than just who your best friend is and why she doesn’t like you.IMG_1084

Triumph!

imagesDyno-Rod came to unblock the blocked attic loo, which took about 30 seconds. The man then had a go at our washbasin, which was only draining very slowly, but somehow managed to make it worse. The water sat in the basin for a few hours until I decided to have another go with a plunger myself. After several minutes of vigorous plunging, having put in all other plugs and blocked up overflows, triumph, a little whirlpool appeared. A bit sluggish but the water started to drain out. I can cancel tomorrow’s plumber. Further investigations would have involved removing bathroom tiles and other fittings in the only room in the house we have redecorated recently, so glad to be spared that.

That wasn’t the only triumph. I had a planned visit this morning from two women working for the local authority. One is with the post-adoption team and the other works with adopted children via the Virtual School. There is at last some money available for post-adoption support. This meeting was to finalise an application for therapeutic support for Billy and Jo, and discuss what might or might not help. We quickly dismissed another parenting course. Don’t get me wrong, they can be very useful. I do understand that parents are the main resource for bringing up kids and that training the parents is therefore a worthwhile thing to do. There was a general feeling, however,  that there was not much more to be gained by this route. We have attended numerous courses, read a lot, go to support groups, use helplines, tried various therapeutic techniques, some with some success. What is needed now is more direct intervention with the children, especially as they have reached an age at which being a ‘happy family’ together is no longer our goal. We want to keep them apart as much as possible and equip them to go out into the world with basic skills and values. We decided that some sort if mindfulness training would help both children. CAMHS (child and adolescent mental health services) had recommended this for Jo to help deal with the need to self-harm, and to help her focus on school work. Unfortunately it was up to her to download an App and have a go herself, which she would not do. She is very resistant to letting her parents teach her anything, so nothing happened. The proposal is for the Virtual School worker to visit Jo’s school with me to discuss her lack of academic progress, and alternatives to GCSEs. This could include work experience. We also hope that the school might agree do some group work on mindfulness and meditation. They should jump at it, as the Virtual School would provide a person to teach and the funding.

Billy has a review meeting coming up at his College in a couple of week’s time when we can discuss the best way to deliver something similar for him. Mindfulness and meditation could help him deal with migraines and stress. We have also talked about EMD (eye movement desensitisation) for Billy, as it is supposed to help with trauma. If anyone has had experience of these forms of therapy with adolescents I’d love to hear about it. EMD might be simple enough that Billy would cooperate. Anything too demanding of time or energy is a non-starter. The last thorough two-day assessment that we managed to get him to participate in at Bibic in Somerset was very good at identifying his strengths and weaknesses, and probably helped him get his PIP (personal independence payment) but the suggested therapy was rejected. Bibic are heavily into Johannson Music Therapy, which Billy has tried before when younger after an earlier Bibic assessment, but it requires a high level of commitment on his part and he wasn’t prepared to give it a go. We didn’t push it as it would also have cost several hundred pounds and after paying for the assessment we had run out of money anyway. It was really good to talk to two women who understood what it is like to parent traumatised, troubled teens. It makes a refreshing change as so often we have either had “I don’t know how you cope”, “it must be terrible”, “I couldn’t do it” (not very helpful when you are looking for professional support) or suggestions that our parenting style was the main cause of their problems. We have also come to realise that there are no magic solutions. The kids just have to grow up and make their own way in the world. We can help them with baby steps and try to get as much appropriate support as possible. The rest really will be up to them.

IMG_1066Despite the dark, dreary winter drizzle the chickens are aware of the lengthening days. They are upping the laying and two Silkies have gone broody. I had seven eggs yesterday, and five today. Last year’s chicks are still a bit young to lay, and the little black Pekin bantam is definitely too old. Others like the Cotswold Cream Legbars are very seasonal layers. My little Silkies do, however, keep going throughout the year and only really stop when broody, which they are frequently. I don’t think my Bluebell or Burford Brown hens stopped laying either, nor the two rescued hybrids. They all slowed down a bit but we have never run out of eggs, or not had enough to share with the neighbours.

One of my sisters has sent me a DVD of the Coen brothers version of Fargo, which lasts about 90 minutes. This should just be long enough to make inroads into the ironing. I finally managed to clear the clothes off Jo’s floor, put away her decorations and remake her bed, so all-in-all not a bad day.

Moving On – From School to College

With huge bare feet, pyjama bottoms and a hoodie, 16 year old Billy returned to college last night, or to be more precise, to the family with whom he lodges in the town where he attends college. He is happier than we’v6th forme seen him for years, in fact since leaving primary school at the age of eleven. The five years he spent in, and sometimes out, of the private school we carefully chose for him because of its supposedly good pastoral care, small classes, and all-round non-selective education, were pretty miserable. He left before completing GCSEs with very little to show for a lot of effort (on our part and that of some of the staff), as well as considerable financial sacrifice. Whether he would have survived our local state secondary school we will never know, but given the complex nature of his problems it seems unlikely. His attendance at college is still patchy but he now has a good circle of support, which includes the college learning-support team, a one-to-one helper in Media Studies, a personal tutor, a post-adoption worker, and someone from the Virtual School with a brief to help adopted children, as well as his parents, and the host ‘mother’ who keeps an eye on him during the week. Billy also had a CAMHS (child and adolescent mental health service) counsellor as well, but they seem to have signed him off after their last meeting, despite my fears that Billy is approaching adulthood with unresolved issues, trauma and high levels of aggression, but on the positive side he is still in college with only one week of term left, and there have been many occasions when that possibility seemed a distant dream.

As Billy is undoubtedly bright and articulate, a million miles from being considered suitable for a Statement of Special Educational Needs, or its successor, his difficulties have largely gone unrecognised and unaddressed. Most adoptive parents will however recognise a familiar package of low self-esteem, poor processing and problem-solving skills, weak working memory, what’s called ‘executive functioning’ difficulties – which amounts to not coping well with everyday life, sensory integration problems, hyper-vigilance, and so on. Add to this, frequent stress-related migraines that migrated from his stomach to the classic visual migraine, and what looks like a pretty addictive personality and it is not surprising that formal education is a struggle. The current ‘pull-your-socks-up’, ‘just try-harder’ league-table, exam-based approach to education is a disaster for children like Billy. He won’t do well in exams, if he does them at all, and most schools and colleges are very quick to get rid of children like him who eat up resources with little to show for it, have patchy attendance and threaten their place in the league tables. Teachers can feel frustrated and de-skilled when their tried and tested methods don’t seem to work. From our perspective growing up and still leading a life not unlike that of his peers is success. We have been lucky to find some excellent teachers committed to Billy and their work, but they are fighting the systems they are in, whether in his private (public) or current state school.