Intensive Outpatient and PHP Choices

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP, you really need to talk to the psychiatrist urgently. This is an after-hours, don't-have-an-appointment situation but your If your kid is expressing suicidal ideation -- "I really don't want to be around anymore" -- that's a do not pass go, do not collect $200 scenario and the safest place for him is an inpatient unit -- which you get to after going to an ER.

My teenager did two tours at Dominion inpatient, one two years ago and one a year ago. She then went to Newport PHP after the first one and Dominion IOP after the second one. I agree with PP that Dominion IOP is a hard no -- the therapists are young and inexperienced and we left after less than a week (but we had a back-up plan) -- but the inpatient was what she needed at the time, as unfun as it was. I don't have experience with the Dominion PHP, but if it's staffed by the same people as the IOP, then also hard no.

Please do call the psychiatrist first thing tomorrow -- it's good to be proactive but you absolutely need professional guidance on this and you absolutely need to keep your kid safe.

OP: I did call his psychiatrist and they can’t get him in until next week. Frustrating, especially since we pay quite a bit and it’s not covered by insurance. I’ve talked to several places and most have agreed that he’s not a danger to himself. He’s happy as a clam at home, it’s school stressors and reactiveness to rejection from peers at school that prompt these big feelings for him. He’s at home for now but that’s not sustainable forever and he needs to finish out 6th grade.

One of the biggest challenges with this age is that they mask a lot. If he is expressing suicidal ideation, I guarantee you he is not happy as a clam at home. I know you were just saying that as an expression. But as a parent who had been continually blindsided when our DD gives us the impressions and cues different from her internal reality, please be on guard for suicidal ideation triggers at home too.

OP: I don’t disagree with you, and yes happy as a clam was used as an expression . He’s able to manage his triggers at home, and as we all know middle school is a tough time for all kids especially those with ADHD, anxiety, and depression. When he’s not able to manage the social dynamics at school (which occurs during break times) he gets overwhelmed, reactive, and that fight or flight kicks in. We’re currently at a private school which may not be a good fit for him. Taking a break this week and considering our options. We are definitely taking this seriously and want to get him more intense therapy to figure out coping strategies. We also may need to look at his meds again, and definitely keep an eye on the masking. We recently experienced loss in our family (a grandparent who lived with us) so I think death is top of mind for him as well.

[Anonymous]

Discovery would be my first choice followed by The Kellar Center in Sterling.

Does your school offer home based classes where a teacher visits the home for lessons? It might help him to know he won’t be expected to return to school this school year and that there are available options he could consider. I’m not saying this would solve underlying issues, but sometimes the social pressures are so great that lifting them can provide enough relief that the healing process can be expedited.

[Anonymous]

A change in school could do wonders.

I'd lock up your meds, including over the counter ones, and your sharps (knives, razors, etc).

Can your pediatrician help immediately/point you in a direction? It may depend on the ped and also on how well he/she knows your family.

PHPs can be traumatizing as well as unhelpful. I know this from experience.

For a kid with his profile, it's very possible the school is a big piece of the problem.

[Anonymous]

OP, may I ask what you decided? I have a similar situation with an 10 yo at the moment and asking myself many of the same questions you have. Currently, I'm leaning toward Dominion. It's shocking how few options there are for those under 13.

[Anonymous]

We are in the same situation for our 10-year old. Anyone have success with Dominion IOP?!

[Anonymous]

No. To Dominion.

Are you in Maryland? I have heard Sheppard Pratt has good programs for younger kids but they only take MD residents.

[Anonymous]

Anonymous wrote:We are in the same situation for our 10-year old. Anyone have success with Dominion IOP?!

Do you already have a therapist and psychoatrist? If DC is not self-harming or expressing suicidal ideation have you reached out to your current doctors? They may have ideas about programs you're not aware of to add to the list of calls.

If DC is a danger to self or others, go to your hospital's er. It's really hard when they're young. Thinking of you, OP.

[Anonymous]

Anonymous wrote:OP, you really need to talk to the psychiatrist urgently. This is an after-hours, don't-have-an-appointment situation but your If your kid is expressing suicidal ideation -- "I really don't want to be around anymore" -- that's a do not pass go, do not collect $200 scenario and the safest place for him is an inpatient unit -- which you get to after going to an ER.

My teenager did two tours at Dominion inpatient, one two years ago and one a year ago. She then went to Newport PHP after the first one and Dominion IOP after the second one. I agree with PP that Dominion IOP is a hard no -- the therapists are young and inexperienced and we left after less than a week (but we had a back-up plan) -- but the inpatient was what she needed at the time, as unfun as it was. I don't have experience with the Dominion PHP, but if it's staffed by the same people as the IOP, then also hard no.

Please do call the psychiatrist first thing tomorrow -- it's good to be proactive but you absolutely need professional guidance on this and you absolutely need to keep your kid safe.

in my experience the above is not enough to get an in patient bed for a kid

[Anonymous]

sorry just realizing this is old.

[Anonymous]

We are in VA (with 10-year old) does this mean we cannot do Sheppard Pratt? I have also heard good things about them. It seems like Dominion is our only option, but if it will be more harmful we will avoid. Very few options for kids this young...

[Anonymous]

My in-network psych took next day urgent calls. And you pay out-of-pocket for this?

Your kid may need a med increase with shorter daylight hours increasing depression, or just kid getting larger and needing larger dose. I hope you find a good alternative soon.

[Anonymous]

Contact the Fairfax-Falls Church Community Services Board. They might have a better handle on helping a child so young. I have to say, though, the availability for 10 yo are limited. Good luck.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, you really need to talk to the psychiatrist urgently. This is an after-hours, don't-have-an-appointment situation but your If your kid is expressing suicidal ideation -- "I really don't want to be around anymore" -- that's a do not pass go, do not collect $200 scenario and the safest place for him is an inpatient unit -- which you get to after going to an ER.

My teenager did two tours at Dominion inpatient, one two years ago and one a year ago. She then went to Newport PHP after the first one and Dominion IOP after the second one. I agree with PP that Dominion IOP is a hard no -- the therapists are young and inexperienced and we left after less than a week (but we had a back-up plan) -- but the inpatient was what she needed at the time, as unfun as it was. I don't have experience with the Dominion PHP, but if it's staffed by the same people as the IOP, then also hard no.

Please do call the psychiatrist first thing tomorrow -- it's good to be proactive but you absolutely need professional guidance on this and you absolutely need to keep your kid safe.

OP: I did call his psychiatrist and they can’t get him in until next week. Frustrating, especially since we pay quite a bit and it’s not covered by insurance. I’ve talked to several places and most have agreed that he’s not a danger to himself. He’s happy as a clam at home, it’s school stressors and reactiveness to rejection from peers at school that prompt these big feelings for him. He’s at home for now but that’s not sustainable forever and he needs to finish out 6th grade.

Based on this report, it sounds like he needs a lot more support at school. Does he have an IEP?