teen who refuses to even consider meds or therapy

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Yes, the psychologist discussed the results both separately with my spouse and me (twice) and with my teen.

What if my teen decides that he simply refuses to accept any help, whether meds, therapy, or both? I don't see how we force him into anything -- persuasion and discussion hasn't gotten me anywhere. Yes he is old enough to be a participant in decisions -- but his behavior is significantly negatively affecting the whole family dynamic. What if I can't persuade him into therapy? The rest of us just suffer? I feel we are at an impasse. My respect for his self-determination and my need to help my entire family not simply revolve around him and his behavioral issues are in conflict.

Can you elaborate a bit more on how his behavior is impacting your family? What you have said so far doesn't sound so bad... Maybe your son is right?

I am not looking for family therapy via the SN board, or a judgment by a non-professional based on whatever anecdotes I present. We have a son who has gone through a professional neuropsych examination by a Ph.D. with 30 years' experience in the field, and it is her professional opinion that my son would benefit from discussing meds with a psychiatrist as well as from therapy. Both my spouse and my son refuse to consider the former, and my son refuses to consider the latter. I am doing my best to be a good, involved parent and addressing the issues that are causing my son and my family to have problems. I am not going to type out a bunch of stories because I actually don't care whether you think my son is right to resist professionally-recommended treatment or not and your giving your opinion on that issue is not at all helpful.

My post is asking for similar experiences and recommendations from families in similar situations (i.e. spouse and/or child resistant to following up on psychologist's recommendations) who have BTDT, and recommendations for psychiatrists and therapists who are helpful in this type of situation. The post at 11:45 was super-helpful (thanks, PP!) and is what I'm looking for in terms of learning from families who have struggled with similar issues.

Why can't your neuropsych with the 30 yrs experience recommend a therapist and psychiatrist to speak and outline the pros and cons of meds for your DH and DS?

I have an 8 yr old with Asperger's and ADHD, combined type, and his psychiatrist who was recommended by our neuropsych has done a great job of explaining the how's and whys of ADHD medication to DS. It helps that our psychiatrist understands Asperger's and while Asperger's no longer exists in the DSM-5, it is now called ASD, level 1. Not sure why your psychologist couldn't give the diagnosis.

[Anonymous]

Anonymous wrote:

Anonymous wrote:You can find a good psychiatrist who will discuss medication with your husband. He or she will most likely recommend meds, but it is very helpful to have an expert explain how and why they work. You can try therapy first, but with a resistant teen, you are not likely to have much success without meds. (Therapy with no results is expensive, but I can see your husband's point.) Is there any anxiety? Because my inflexible teen benefitted greatly from anti-anxiety meds.

We had a different situation with our therapy-resistant DS- it was critical that he get in to therapy (major depression and severe anxiety). We cut off everything - money, phone, rides anywhere, haircuts... there was no assistance from us outside the house unless he attended his therapy appointments. We were desperate and it worked. (We also paid him to go, which was a suggestion that several therapists gave us and also helped.)

I agree with PPs that it will be helpful for you (and DH) to go regardless. (And may be even more helpful depending on the level of participation you get from DS.)

Thanks, this is really helpful -- I hate to think about having to go the route of forcing my son, but I can see how that might be where we end up. As I've said to my spouse -- I'm really concerned that our son won't benefit from therapy without also having meds to help with the rigid/inflexible thinking. This has always been a kid who has an infinite capacity to be stubborn -- think of the immovable object. I have two other kids and know plenty of other kids for whom this is not the case, so I have a very good sense of what's within normal limits and what's not. His rigid thinking is only getting worse as he gets older -- I wonder if there's a puberty-onset component here too, and we can see it starting to cause problems not only within the family but outside, too.

We didn't get an anxiety diagnosis for my son but on the other hand that was not a significant issue we had asked the psychologist to look into. My husband has (and is being treated for) anxiety and depression, I have major depression and ADHD, and my youngest has been in therapy for anxiety (but no meds) before, so I wouldn't be surprised about any diagnosis in a similar vein for my son or my other kids but I can't say we have a diagnosis (and I am not sure whether our psychologist looked for it).

ADHD meds are not going to do much for the rigid and inflexible thinking although it will help with processing speed if it is the result of inattention. At best the ADHD meds may help him focus during therapy and make him more aware how rigid and inflexible his thinking is. Awareness is only part of the battle however and will not do anything unless he wants to change.

Is the rigid and flexible thinking from anxiety, ASD or a combination? Did the neuropsych find anxiety? If not then you need to address it as part of the ASD. I would enroll him in either the Unstuck and On Target program at Ivymount Outreach or Dr David Black's PEERS program. Both of these programs have a parent therapy component.

Your neuropsych should have given you recommendations for therapists and programs.

Good luck!

[Anonymous]

In terms of practical advice we also use bribery ( you need to be taking your medicine if you want things like trips to the movies with friends and evenings out etc. ). But I have honestly found that the worst part is the first few times getting started once you have a routine taking that medicine is the same as brushing your teeth and it really will become second have it if you can get started good luck

[Anonymous]

It can also help if your child sees that you take meds for a same or similar issue. I take anxiety meds, and let my son know it and that it's no big deal.

[Anonymous]

I agree that the kid needs to go to family therapy, whether he likes it or not, and he gets no privileges, phone etc, unless he does, but you might need in-home counseling, where the counselors come to the home. Just make sure that whoever comes is experienced, and not newly out of school with no experience. Your school can give you some referrals if the doctor can't.

For the meds, it might be best to approach it as a scientific issue, like having low thyroid means you need thyroid meds. You can't let this kid make the rest of the family miserable.