F.E.A.S.T's Around The Dinner Table forum

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frazzledmum
Hello. It's been a while since I have posted on here but have been lurking. 
Anyway, D moved up from child services to adult services here in the UK last year, she started CBT which did not work for her and was put under the liaison team seeing a psychiatric nurse every two weeks, which was working very well,  until her nurse left for a few months (not sure why, doesn't matter). So, now she has a new nurse who she cannot stand and who argued with her at her last appointment. D said nurse was shouting louder than D and said that everything in her life is to do with her ED (not really true) and that D is not committed to her weekly appointments (bear in mind previous nurse said fortnightly appointments were fine). So, it ended with them both agreeing to have an appointment with the consultant with a view to discharging D. 

D has been eating well over the past few months and has put on a significant amount of weight, that has made her angry as her clothes don't fit, and she can't find clothes in shops that fit her as she would like etc. Her anxiety has increased (though am wondering if this is some kind of extinction burst?) I do not want this to go backwards at all and feel that this nurse is not the right person for D. D does not want me to attend any appointments, though I am going to phone nurse this week to find out more. D does acknowledge that she needs to see someone and mentioned that maybe a general therapist might be better than someone who expects that everything is related with ED (sometimes it's teenagers and hormones and life...). D has hardly spoken for a few days now and is very rude when she does, she stopped taking her medication a few weeks ago, which I flagged to new nurse who mentioned it to D at a previous appointment and they had a constructive discussion ending with nurse saying she would get D an appointment with consultant to review medication- which did not happen-this was before the disastrous nurse appointment last week.

So, where do I go from here? Is this a cynical ploy to rid their list of 'difficult' patients? Is it worth me trying to find a therapist privately? If so does anybody have any ideas as to how? What should I look for? Would every 3 weeks be ok as I can't afford weekly sessions?

I am sick of having all the negative stuff dumped on me and am panicking that I will be left to pick up the pieces of all the rubbish myself with no support. I am seeing my own therapist to try to save my own sanity.
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Foodsupport_AUS
It is hard to know exactly what went on in that appointment but it sounds disastrous. More to the point any therapeutic alliance sounds like it has been completely lost. Is there any possibility of instead of being discharged a new nurse can be assigned or a different therapist? It sounds very much like your D may accept she needs care and support if she doesn't have to see this particular nurse again. How does she want  you to support her in this? Is she able to express what she wants or needs for support? 
As for finding a new therapist privately hopefully someone who knows the UK system better will give you some ideas about the options. Frequency of visits can usually based on the degree of support needed, it really depends how she is going. 
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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Elibean1
Hi Frazzled, I think I’m your shoes and if you can I’d try to find a good therapist - who has a sound knowledge of ED but isn’t part of ED services, necessarily. I’d be very wary of a non ED aware therapist though, as ED plus clueless therapist (aka authority figure) could be disastrous.

Id need both me and D to feel good about the choice, ideally...therapeutic alliance is so important, this new nurse does sound disastrous in relational terms. 

Whereabouts in UK are you? X
Elibean
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tina72
My 2 cents:
First I think it should not be the nurse and your d decide about discharge but the consultant and your d. The nurse should be possibly changed if they cannot work together.
Then I would ask to have a contract before discharge with points what will happen if x or y happens (for example weight loss, refusing to eat etc).
Is she still living with you? Then I would add to that contract what you offer to do for her and what she needs to do for that.
Keep feeding. There is light at the end of the tunnel.
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frazzledmum
Thank you for the replies. I managed to speak to the nurse who agreed that there had been an argument and agreed with me that D is angry about something. She also reassured me that if D is discharged and needs to be referred again, she will be seen very quickly. She also said that some people need a break from therapy and then will realise that they need help and then go back, which all made me feel a bit better. She also said that D will not just be discharged and the appointment with the consultant really is a review, if D wants to be discharged then there will be another appointment with me involved as she still lives at home and her decision will affect us at home. If she wants to see a different therapist then that can be arranged, but D will have to commit to that (which I am not sure she will be happy about). This is a slightly different story from the one D told me on Saturday, which just goes to show that she will tell different stories according to who she wants to manipulate. 

I like your idea of a contract Tina, it will give me a bit more leverage rather than D just thinking she can have her own way all the time. 
Elibean: we are in London.
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tina72
frazzledmum wrote:
This is a slightly different story from the one D told me on Saturday, which just goes to show that she will tell different stories according to who she wants to manipulate


This is very common that they do that and they are often very good in it so please hear always both sides.

frazzledmum wrote:
I like your idea of a contract Tina, it will give me a bit more leverage rather than D just thinking she can have her own way all the time.


They often try to threaten us with "being adult" and to blackmail us. But in the end being 18 is just a number and they are as dependend as they were the day before. So as long as we pay the bills we can dare to set rules for that. And we need to do that because they need these boudaries to be able to stand up against ED. My d said later to us that all the rules and boundaries were "the best about FBT" (in her words) as it helped her so much to fight the ED thoughts and to tell ED that it is not her fault and she is not "guilty".
Keep feeding. There is light at the end of the tunnel.
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frazzledmum
Thanks Tina, you are right, it is so important to get both sides of the story and for reminding me that they need really strong boundaries, when you are in the middle of the battle is is sometimes easy to forget things like that.
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