I’ve posted before about choosing a therapist and our missteps in our choice of Amy’s first therapist.  The link below is a great introduction in what to expect from therapy.  Really, for Amy, we realized that she needed a coach-type therapist.  Her first therapist just lectured.  Her second, and still current, therapist is more the coach.  She helps guide Amy in understanding her thinking and pointing out unhealthy thoughts.

Depressed people have such a skewed view of the world and that just feeds the disease and the negative spiral.  The right therapist will help your child verbalize those views, explore why they may believe that, debunk the idea and then help them learn to replace the negative view with reality.

This article gives you a listing of what to look for and expect from a therapist.  I wish we had read it earlier in Amy’s treatment.  Maybe we wouldn’t have wasted that  year with the first therapist.
http://www.mentalhealthchannel.net/hot-topics/depression-anxiety.shtml#adjump

In the following article, MSN reports of a man who has saved at least 160 people from committing suicide at a tragically popular jumping spot in Australia.  As a result, Don Ritchie and his wife Mora have earned the 2010 Citizens of the Year award.

It’s interesting that Don merely starts his conversations with the potential jumpers with a simple, seven letter sentence: “would you like a cup of tea”?  This non-threatening, simple question has been effective 160 times!  The man is genius.

http://www.msnbc.msn.com/id/37670329/ns/world_news/from/ET

It got me thinking about how much easier it is for those not personally invested to approach our suicidal family members.  As Amy’s mood would drop, my fear increased.  I know she could hear it in my voice.  Maybe this is why her therapist can talk her down from the edge (figuratively) when I cannot.  Who knows?

One other random thought on this tea offer thing.  When my daughters were small, I would have them drink a glass of water to calm down after some trauma.  Skinned knee and crying uncontrollably always called for a glass of water from Dr Mom.  My kids joke that a glass of water will cure anything, including an amputation!  But really, I found that the act of drinking always got them to calm down, breathe more slowly and relax a little.  Maybe tea has the same effect…

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

Not all therapists are the same and each has a different approach to things.  One of the many mistakes we made for Amy during the first year was finding the wrong therapist.  In fact, Amy has shared with me recently that she always felt more guilty and worthless after her therapy sessions with her.

Amy’s suicide attempt came as a result of bullying.  She was really low in self esteem and felt victimized.  She needed a therapist who could be her ally and help her sort everything out.  Of course, this was easy to see one year into therapy but at the time we found her first therapist, we were just desperate for help.

I remember thinking that when we sent Amy to her first therapy appointment.  I felt like I was taking a kid with a broken arm to the doctor and saying “just fix it”.  We had chosen this therapist because she was referred to us by our family physician.  We didn’t do any pre-qualifying or asking any questions about her style.

Amy’s first therapist would have been great for a kid who had parents with weak parenting skills, for her approach was to become a “super-parent”.  She treated Amy’s symptoms of depression rather than getting to the root cause.  She gave Amy a laundry list of things to do – pick up her bedroom, turn in her homework, do her chores, etc.  Then, each week, she would grill Amy on her results and discuss any shortcomings.  Again, this would have been fine for a kid without discipline in the house but not what Amy needed.

My first clue that it wasn’t working out was after a year with this therapist.  We were disciplining Amy for something and she actually said,  in a begging tone of voice, “don’t tell Sally” (her therapist).

By that time we were much more savvy about what she needed and how to direct her care.  We started shopping for therapists, no small task!  We asked her psychiatrist and all of the caregivers in the hospital ward where she was being treated for recommendations.  Another place you can find them is on the website for your state department of mental health.

Working with a little more confidence and a lot less desperation, we started talking with potential therapists.  I had a list of questions which I asked them over the phone to try to do some pre-screening.  I asked them about their style and philosophy for treatment.  The questions were very open ended so I would get honest answers.

Some of the questions were:

1.  How do you establish your relationship with your clients?

2.  What are your thoughts on handling children with depression?

3.  Can you tell me about a client of yours who you successfully helped through their depression?

4.  What are your goals for treating children with depression?

5.  Where were you trained?

I recognize that each child is different and has different needs in a therapist.   However, you, as a parent, know what is best for your child.  You know how that child learns and grows, you’ve been helping them all of their life!  My focus was getting Amy to be happy and able to handle life by the time she becomes an adult.   I wanted someone to guide her along that path.

We found a new therapist, Jean, and the improvement was nearly immediate.  Jean was much more nurturing.  She made Amy feel safe and started to draw out Amy’s fears and worries and help her find ways to address them.  Amy has been with Jean for nearly two years now and it’s made all of the difference.

There is a downside to Jean, though.  Our insurance didn’t cover her appointments.  It’s been very much worth it though.  My advice to every parent is to remember that failure is not an option here.  You have to find the right fit for your child with every choice.  This means thinking outside of the box and considering other options, including a therapist who isn’t covered by the insurance.

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.