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

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isoharmony
So following our latest inpatient admission for suicidality, it was recommended that my d follow-up with a psychiatrist and start a DBT class at a community mental health center. The mh center is refusing to let her take the DBT class as she is "not a client" there and would require her to stop seeing her ED therapist and see one of theirs. (My d is autistic and switching therapists would be a bad idea) I have spent weeks making phone calls and I am unable to find a child/adolescent psychiatrist to manage her meds.

I am feeling left out to dry here and I am in a bit of a panic with no solution in the near future. She was put on olanzapine in the hospital as a short term solution for the voices and mood regulation, but everyone told us she should not be on it long term for fear that rapid weight gain (she has been wr since last spring- even beyond wr through this fall) would cause her to return to binge/purge and restriction. She has gained an alarming amount of weight in just over a month. I can't say how much as she won't be weighed, even a blind weight at the doctor's office. As a result, she is even more depressed, will not remove her jacket, wears the same clothes over and over and has been going back to binging and purging. Everyday is a battle over food, but for the opposite reasons as when we started this trip. I did buy her some new clothes, but she is struggling with it big time. It is looking like she'll have to quit dancing as well, as she can't face putting any of that stuff on.

Our last hope is a developmental/autism clinic that is over a hour from us. I am told they will be able to manage her medications, but I think it may be a long time before they can fit her in. She is still in the intake process, which is quite lengthy.

I am trying to not fear what ED fears and I know this weight gain is temporary. (Right? Will she stabilize when transitioned off the olanzapine?) My husband is in even higher panic mode. I think our fear is where this is all leading if we don't find help soon. Any advice on how to manage the day to day with this?
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Torie
isoharmony wrote:
So following our latest inpatient admission for suicidality, it was recommended that my d follow-up with a psychiatrist and start a DBT class at a community mental health center. The mh center is refusing to let her take the DBT class as she is "not a client" there and would require her to stop seeing her ED therapist and see one of theirs. (My d is autistic and switching therapists would be a bad idea)


Oh my. What a difficult time for you, your d, and the whole family. I wish I had some good advice to offer, but instead all I have is a question: Might it be possible that your d keep seeing her current t and add in whatever the DBT center requires? 

Hang in there. You will help your d through this. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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isoharmony
Thankfully, we have a therapist who is lobbying the mh center to make an exception to their policy for my d. They have told me unequivocally that she'd have to "stop seeing" her current therapist and switch to one of theirs. Her ED therapist tells me they have made exceptions in the past, so she is hoping they will in this case as well. I just struggle with how any community mh center would not want the best care for each patient. It has taken her so long to connect to her current therapist.

I do think DBT would be a great thing for her. Emotional regulation is tough for her as is distress tolerance. These would be wonderful tools for moving forward.

Thanks for the encouragement, Torie.
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Psycho_Mom
Hi,

As I understand it, DBT is supposed to include an individual therapist, as well as the DBT speicalist/team. And of course, a community mhc is spupposed to be for the community... IS this really a good DBT program, and is there any other in your area? Have you checked the Linehan certification website:

https://dbt-lbc.org/index.php?page=101163

If the mhc class doesn't work out, perhaps you could work with an individual DBT person?

In the meantime, are you doing Magic Plate? If not, read about it on this site and ask lots of questions; sounds like your d might benefit from you making all decisions about food for the moment. 

best wishes,
D diagnosed with EDNOS May 2013 at age 15, refed at home Aug 2013, since then symptoms gradually lessened and we retaught her how to feed and care for herself, including individual therapy, family skills DBT class, SSRI medication and relapse-prevention strategies. Anxiety was pre-existing and I believe she was sporadically restricting since about age 9. She now eats and behaves like any normal older teen, and is enjoying school, friends, sports, music and thinking about the future.
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isoharmony
Thanks for the link PsychoMom. The one clinician they list is over an hour from us. I have been told by two people that this class would be a good fit for her. Her ED therapist has introduced some of these skills but she feels the class would move her along in her skill set. She would still be working w/her therapist to work these skills into her life. Still looking to see if there is any thing else available.

I have heard Magic Plate referenced here, but I need to read up on it. We have used the meal plan they sent her home with from inpatient treatment a year ago, but her diet has changed a lot since then due to chronic GI issues. We are trying to make all the decisions, but she fights us on that since she is perpetually hungry.

She bravely decided she needs to stop dance for now. She is just too stressed about it right now. She is sad about it, but she realizes that she may need to let go of some things until she is better. I think she made the right call, as she made it through the day without purging.
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mjkz
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So following our latest inpatient admission for suicidality, it was recommended that my d follow-up with a psychiatrist and start a DBT class at a community mental health center. The mh center is refusing to let her take the DBT class as she is "not a client" there and would require her to stop seeing her ED therapist and see one of theirs. (My d is autistic and switching therapists would be a bad idea) I have spent weeks making phone calls and I am unable to find a child/adolescent psychiatrist to manage her meds.


We have run into that too with groups that require you to see their psychiatrist and their therapist, etc.  It is just so wrong on so many levels to force someone to change a therapist just to access classes that she needs so much.

Is there any way she could just do the DBT class and see the psychiatrist without seeing a therapist just for the time she is doing the class?  I am just wondering if you could do a brief break with the ED therapist so that she can take the class and see that psychiatrist and then return to the ED therapist once the class is over.  My daughter has done DBT classes and while doing them really honestly has not had time for individual therapy.

I have to be honest and say one time my daughter seeing her regular therapist and did not tell the center that she was seeing her because it was a similar situation.  If the place had known she was still seeing her other therapist, they would not have provided the services she needed so we just never told them.

I hope you can get an exception.
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