Amy learned during her first hospitalization to try doing enjoyable activities as a distraction when she started feeling overwhelmed.  These activities were called “copers” – something to help her cope with her anxiety.  She made a lengthy list which she would bring out and review as needed.  She would then choose one to do.  If that one didn’t work, she’d bring out the list and choose another until she found one to calm her down.

Some copers were typical – reading, singing to music, drawing, etc.  Some were just plain weird, like letting rice run through her fingers.  Yes, we honestly had a bag of “coper rice” which she would play with.  The tactile sensation was soothing to her.  The coper list went with her to school in her pencil bag, too, ready for when she needed it.  Of course, the coper rice had to stay home but there were plenty of other things on the list that she could do at school.

My point here is that if it works (and is legal, ethical, not destructive  and moral) then let them do it.  Whatever it takes.  Yes, it involves some getting used to but let them do it.  They need to find how to control their emotions on their own.

It kind of reminds me of Amy’s imaginary friends when she was three.  She had half a dozen of them.  We followed the drill; indulge them and eventually she’ll give them up.  So, when her imaginary friend Dorothy was staying for dinner, we set a place for her.

We did have to draw the line a few times, though.  I remember her older sister coming to me complaining that she couldn’t watch TV because all of Amy’s imaginary friends were sitting in the chairs.  We  told Amy that her friends had to go home at that point.  She smiled at me  and I started to suspect that the friends were becoming a matter of convenience.  Or in her sister’s case, inconvenience!

Who knew our kids could have their own month?  Anyway, here are some helpful links for support:

• National Federation of Families for Children’s Mental Health at http://www.ffcmh.org
• National Alliance on Mental lllness at www.nami.org
• Substance Abuse and Mental Health Services Administration (SAMSHA), US Department of Health and Human Services, at  http://www.samhsa.gov/children/index.aspx

Treatment facilities have different approaches in their treatment of child and adolescent psych patients.  Of course, upon Amy’s first admission, we had no clue about this.  This was one of the many first mistakes we made during her first year of treatment

The treatment facility we first sent Amy for treatment had the reputation for being the best so that’s where we went.  We were frantic – we just wanted to get her the best help.  She had attempted suicide and was deeply depressed.   We were also brand new to psychiatric treatment.

This treatment facility was very rigid in their approach.  Parents were only allowed to visit every other day for just one hour.   They told us we had to sign a blanket consent/treatment order allowing them to treat her any way they deemed fit – including electroshock.  Hank and I both got the feeling that we were suspected as being the source of Amy’s problems.

We did question their methods.  Their responses were condescending, as if we were questioning their experience and training. At the time, we had grave reservations about their style of treatment but we assumed that this was just the way psychiatric patients were treated and we should comply in order get her help.

Amy said that they were very strict in their discipline, too.  She later told us that she just did whatever they instructed and gave the appearance of getting better just to get released quickly.  She was released after a week and then went into the day program, which she participated in for another couple of months.

In retrospect, that treatment facility was probably very effective for adolescents who had a history of acting out.  During family group therapy, we learned that was the case with the other kids there.  It was, however, completely inappropriate for a scared, depressed 12 year old.

A year later, when Amy needed to be hospitalized again, we were more savvy.  We decided to shop around for her treatment facility treatment.  There were two other treatment facilities in our area that provided treatment and we decided to check them out.  We found a completely different program from the first.

We interviewed the program manager about their facility and treatment methodology.  We found that it was a better fit for Amy.  They were more nurturing in their approach.  They recognized that any treatment facility setting was stressful and the kids were already stressed before they were admitted.  They didn’t require a blanket consent form – we would have to consent to any treatment that was a deviation from what she was currently receiving, including any change in medication or dosage.  He stated that parents can be a contributing force in the child’s problems but it wasn’t just assumed that they were.  Visiting hours for parents were for two hours every day with the hours being accommodating to working parents. The staff was caring and treated the children as individuals.  The kids in the ward seemed calm.  I observed a nurse give a kid a hug and heard staff encouraging the kids.

Parents need to understand that each treatment facility is different and you need to do some comparative shopping to find the right fit.  Although you’re confused, trust your gut.  If we had, we never would have admitted Amy to that first treatment facility.

I get so frustrated by Amy’s treatment sometimes. Why is it so hard to get a mental health professional to provide advice? After all, isn’t that why we take her there? During the early months of her treatment, we had so many questions and ideas but could not get advice.

After about a year, we discovered that we had to take control of the situation. We had to act as “case managers” for her treatment. I’m a manager by profession and I finally figured out that we had compartmentalized systems all affecting her. I called them the Spheres of Influence.
Amy’s Spheres were 1) her psychiatrist, 2) her therapist, 3) her school and 4) her family. All four had influence over her and her perception of reality. (If Amy weren’t depressed, there probably would have been another, 5) friends).

As Amy’s case managers, we had to make sure each Sphere was contributing to her improvement. Because I’m such a management geek, my husband and I had a brain storming session in front of an old blackboard at home to do this. We wrote each Sphere on the board and listed our thoughts on it.