Please help - do you have any opinion about therapeutic school?

[hibiscus]

Hi, I used to check baby bargain board often when my DS was little. I did not know where/who I can consult, and thought about this board. I am seeking some advice on how to proceed with DS's nervous breakdown. Here is a brief summary (sorry it is long).

DS is in 8th grade at gifted school. He has been straight A student so far, but he had emotional/social issues in the past and had some counseling and medication for his anxiety/depression since 5th grade (he weaned off med summer after 6th grade). For that, he has 504 plan. He is a perfectionist. He tends to be extreme with his emotions and keeps them to himself till it explodes. Even we keep telling him getting B is fine and important thing is to put your effort to what you are passionate about (and it is ok to do so-so sometimes), he thinks anything less than A is a failure.

DS had very hard time with one big project recently. His teammate (I call him Y) constantly tried to control the project by demanding DS more work than the project asks after he has done his part, by insisting to take on a critical segment and brings in incomplete (and not so great) work, and by yelling/cursing at DS when he and other teammate offerred Y to help improve the work. There were 3 milestones and in each time Y dropped the bomb a few days before the turn-in date and DS ended up taking over to finish by doing all nighter. Because of this DS did not have time to do other assignments when this happened and he was extremely upset for turning in lower quality work than he wished--due to finishing 1 months worth work in 1-2 nights. We talked to the teacher. She gave Y some talk and one referral for cursing, but that did not help much. DS refused to go to school the day of the presentation because he was shocked to see the final project shown to the teacher the day before--all DS's work was deleted. DS was crushed. Y ended up putting DS's work back after teacher intervened. The final result (B) was disaster for him. We told DS that he did what he could and even DS is not happy about the outcome, we are proud of him handling the difficult situation.
But it did not help. It was like he just lost control of his emotions and he has series of anger outbursts at home. He was not able to go to school since. We first thought this was just a real world experience for him and did not know it was this serious till he lost. It was too much for him.

We brought him to psychiatrist last Tuesday to start meds again. The Dr. told us he is suicidal. Though he does not think DS actually takes action, he could harm others (Y) as well because DS is in very dark place now. The Dr. also told us to take DS to partial hospital program. We followed the suggestion thinking the most important thing for DS now is to get a grip of his emotions and equipped with skills to deal with stressful situation.

We told the whole situation to school. School district suggests DS to go to therapeutic school after completing the hospital program and be observed there for a few months, and then district decides A. DS stays the therapeutic school, B. DS transfers to other school with therapeutic classroom or C. DS get back to his gifted school. We feel sending DS to therapeutic school would kill him--he loves his current school. Only reason he keeps attending partial hospital is he thinks he can get back to his school once he finishes the program. We have not told DS what the school district wants.

Finally, (thank you for reading till this point) I would like to hear about your opinion about therapeutic school. Also any suggestions for us to do at this point? I want to cry, but I have to think what we can do to help DS first and I do whatever it takes to help him.

[123LuckyMom]

I really don't have any BTDT experience to share, but I didn't want to read this and not respond. I'm so sorry you and your family, and especially your DS are going through this! I hope you get some good advice. Hugs to you!


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[basilicali]

Hi! This sounds so difficult! I have no experience with this myself, but I would recommend talking with the therapists or psychologist at the hospital program. Since they are spending so much time with your DS, they may have some good suggestions and discuss options with the school district. Is the hospital program just a short term stay, or will he be there for a while? There may be also the option of home hospital school where they send teachers to your home. I am a general pediatrician and a few of my patients with severe anxietyor concussion have done this, then gradually transitioned back to regular school.

[hibiscus]

123LuckyMom:

Thank you for your message - means a lot to me.

hibiscus

[hibiscus]

Basilicali:

Thank you for your resonse.

>Is the hospital program just a short term stay, or will he be there for a while?
We were told it usually takes 2 to 4 weeks. It is partial, from 8 to 3.

>There may be also the option of home hospital school where they send teachers to your home.
I will look into that and ask to the school district if we find it more suitable to his case.

Thanks again for your input.
-hibiscus

[hillview]

I am so sorry. As a parent with an 8 year old with challenges I feel for you. I'd ask the psychiatrist for an opinion on the schools (he/she may know more about the therapy school as well). You could ask to go visit the therapy school as well to get a better sense of it and fit for your son. The school may be in CYA mode. It does sound like getting your son more intensive help through school and doctors is a top priority and if the current school really does not have these supports it may not be the best place for him right now.

Finally it is ok to cry. It is so hard. You could consider if a therapist for you (and DH) during this time would be helpful.

Good luck.

[jren]

My gut would tell me not to put him back in the same environment at the gifted school. I would prefer homeschool or in-home school mentioned above. My DD is on anti-anxiety meds for anxiety and possible bi-polar. The only difference is that she doesn't care if she makes failing grades. But we do try to avoid highly stressful situations, and it seems that school is one of his triggers. I would think a gifted school would be even more pressure on top of his already pressuring himself. So sorry that you're dealing with this! We just had an incident in our neighborhood with a teen and I would take the suicide risk seriously and take all precautions despite what your DS wants to happen.

[annex]

I agree with others that at least for the rest of this school year I would focus on finding the right medication and therapist match, with a plan to either homeschool yourself, transfer DS into a virtual school, and/or ask the school district for an IEP so their homebound teacher can support your child outside the gifted school. Sometime during the summer, you can reassess where DS is emotionally to see if going back to the gifted school makes sense. An entirely therapeutic school means no peers without emotional issues in the environment, less access to extracurriculars/sports, etc. typically. They can be great schools with good routines and structures, but they are generally a last resort for students who are too volatile to handle the larger class sizes, larger buildings, etc. of a typical school. Option B would be preferable if the gifted school is too high pressure to go back to - the therapeutic classroom could end up being more of a support room with a special ed teacher that your student will have access to when they are struggling. Plus there would be a full IEP team that would provide more services such as a social worker, psychologist, etc who can support your student and guide their general education teachers in accommodations to use to prevent his anxieties from spiraling out of control.

[mmsmom]

I am so sorry you are going through this. I agree with those that say focus on getting DS the help and medication he needs for now. Explore homeschooling, virtual school, homebound teacher etc whatever will help him complete 8th grade. Is 9th grade high school in your area? If so it may be a good time to move on from the gifted school. It does seem the gifted school may be playing too much into his need for perfection and maybe he would do better in a less competitive environment. I would reevaluate options with his psychiatrist and the school district over the summer once he is more stable.

[hbridge]

I PM'ed you....

[StantonHyde]

We have a partial hospitalization program where I work. The stay is usually around 2 weeks for kids coming from the outside (e.g. not transitioning from inpatient). The program should have a school, where your DS can do his work so he doesn't lose ground--the work is individualized to the student. They have education specialists who work with the child's school. Sometimes that stay may be 4 weeks--depends on how things are going. It is a great option for kids who need some intense help, structure, medication management, close monitoring. They will get to know your child and then they can make a recommendation for school after the program. Some kids go back to their schools, many kids don't--it was a bad fit for them/triggered their issues. School avoidance is a SERIOUS issue for your son. It can be symptomatic of bigger issues--as the doctor explained to you.

I would get your DS into the partial program ASAP and then take it from there. Good luck!!!

[hibiscus]

hillview:

Thank you for your input. We arranged a visit with the therapeutic school this Friday. Also, we will have a family session with the partial hospitalization program on Thursday to find their findings. I will ask the caseworker about the school option at the session

>The school may be in CYA mode.
What does CYA mean?

Thank you,
-hibiscus

[hibiscus]

jren and annex:

Thank you for your message.
My DH and I talked tonight about the therapeutic school, and now lean towards the option. Will find more about it this Friday when we visit there. We thought some sort of transitioning phase would be helpful for our son once he completes PHP. We were wondering though, DS could be able to handle being gifted school since he was fine doing assignments/going to school till that big project. We have to see how much he recovers from current state....

-hibiscus

[hibiscus]

mmsmon:

Thank you for the comment.
Yes, high school starts in 9th grade. It could be a chance for DS to start fresh...Both DH and I started to think the rest of this school year would be transitional and we want focus on finding a counselor who DS can click. We did not have luck in the past, so we started interviewing counselors who are out of network, too.

-hibiscus

[hibiscus]

hbridge:

I read the message. Thank you very much! I PM'ed to you as well, but in case you have not seen it, I hope the best to you and your family.

-hibiscus

[hibiscus]

StantonHyde:

Thank you for telling your insight. I forgot to mention in the initial post that DS started PHP last Thursday. Will find how he stands now on coming Thursday at family session. We started see him trying the skills he leaned, but understand he could stay PHP for a while for severity of his state and how he keeps his feelings.

-hibiscus

[hillview]

hillview:

Thank you for your input. We arranged a visit with the therapeutic school this Friday. Also, we will have a family session with the partial hospitalization program on Thursday to find their findings. I will ask the caseworker about the school option at the session

>The school may be in CYA mode.
What does CYA mean?

Thank you,
-hibiscus

CYA mode = Cover Your A$$ mode meaning they may not be willing to take a child back that they are concerned is a liability for them. I defer to some of the other posters here and think you've gotten some good advice. Great that you are going to visit the school.

[StantonHyde]

Please note that while your son may be smart enough to handle the work load, he may not be able to handle the emotional stress of a G&T program. And behaving appropriately and being healthy are just as important, if not more so, than academic functioning. Good luck!!

[hbridge]

Hi, I did not get the PM....

Hugs.

[KpbS]

I am so sorry you are going through this. I agree with those that say focus on getting DS the help and medication he needs for now. Explore homeschooling, virtual school, homebound teacher etc whatever will help him complete 8th grade. Is 9th grade high school in your area? If so it may be a good time to move on from the gifted school. It does seem the gifted school may be playing too much into his need for perfection and maybe he would do better in a less competitive environment. I would reevaluate options with his psychiatrist and the school district over the summer once he is more stable.

This is exactly what I would do as well. Big, big, :hug:, OP.

[hibiscus]

hillview:

I see. Thanks for the explanation!
There were some pros/cons we thought after the school visit. Student/teacher ratio is 5:1, there is a math tutor to give individual instruction based on each kid's level. Therapeutic sessions are core part of the day at school. But the environment is depressing. We found there are some kids who actually harmed other kids at their base school before attending there (there are several monitor staff in hallways and gym). We are torn, but this could benefit DS who still needs to work with his emotions.

StantonHyde:

Absolutely agree. We feel we should give DS ample of transition time and access if he is capable of going back to his school during summer...

-hibiscus

[hibiscus]

hbridge:

Thank you. I sent the message again to your hotmail account (the other one did not work)

-hibiscus

[hibiscus]

Thank you, KpbS.
-hibiscus

[hibiscus]

We had family session at Thursday. The caseworker hinted DS could be discharged soon and told us we need to tell him about the therapeutic school as part of discharge plan. When we talked to him about it, he just broke down. It was a mess, but eventually he started trying to accept the outcome. He feels he is punished, but we told him this is not a punishment, this is a consequeence of his action/thoughts, and he needs more therapeutic time to transition.
So, he showed regression at PHP due to the school news and his stay was extended.

School visit was OK. We found pros/cons. They do offer a lot of therapeutic session time during the day and there is a math tutor to fit individual needs. Felt comfortable with 5 to 1 student-teacher ratio. The facility was not well kept and depressing. When asked they said some kids there actually harmed other student at their base school. I was not sure how this impact on DS's psyche, but we think he needs more time to transition/recover to the level he can handle normal daily routine without having meltdown....

I started interviewing therapists to start DS's counseling after PHP completion. One place suggested us go through a full scale of neuropsychological evaluation at Washington DC. The cost is $4,000 plus airfare/hotel for us. Is this pricing within normal range? I appreciate your input.


-hibiscus

[StantonHyde]

Regressing after being told about discharge plans --happens quite often, so I wouldn't feel defeated by this. Did you ask the PHP for recommendations regarding testing etc? Because $4K seems like way too much money to me. Should be more like half that--but I don't live in a HCOLA. The PHP might be able to do the testing for you and they should certainly be able to recommend someone who can do the testing. They should also set you up with a counselor for after care--or did they give you a list of therapists?

[hbridge]

I started interviewing therapists to start DS's counseling after PHP completion. One place suggested us go through a full scale of neuropsychological evaluation at Washington DC. The cost is $4,000 plus airfare/hotel for us. Is this pricing within normal range? I appreciate your input.


-hibiscus

The $4000 price seems reasonable (we live in a HCOL area). Check with insurance, they may cover a portion of this. The neuropsych will give you quite a bit of information that might help you decide on "next steps" and help you learn how to best help your son. That being said, depending on where you are located, you may be able to find someone closer so you wouldn't have to travel...

[hillview]

The $4000 price seems reasonable (we live in a HCOL area). Check with insurance, they may cover a portion of this. The neuropsych will give you quite a bit of information that might help you decide on "next steps" and help you learn how to best help your son. That being said, depending on where you are located, you may be able to find someone closer so you wouldn't have to travel...
Agree that is what we pay locally