CAMHS insisting on DBT sessions that clash with GCSEs and work commitments

[RocketQ79]

I have a teen diagnosed with EUPD, CAMHS are being very inflexible with treatment, 6 months commitment to DBT, 2 sessions a week, miss 3 sessions and you are removed from the course. One session is set and clashes with my daughter's GCSE History lesson, she does not want to jeopardise her education for a therapy she does not think will work. I work away every month so already know we will miss more than 3 sessions and have no-one else to take her and cannot afford to take the hit financially by reducing hours to accommodate it. CAMHS have said it's this or nothing, I don't really know what the guidelines are or what our rights are in this situation, can anyone help? Tia.

Please don't think I am being flippant about this, I have tried to think of every possible solution but the missing 3 or more sessions is just impossible for us to fix. She won't go without me and with me being the main earner I just cannot afford to drop hours for 6 months (or be in 2 places at one time).

Also it's better pre GCSE than in the middle of actual exams.

I'd be looking thankful to be offered gold standard treatment.

Why can she not go without you ? She’s 16 surely she can get the bus/train/a taxi ?

the same reason she stopped going to her original school and attending special provision school in person - anxiety.

I think PP was correct when they asked if you would be like this if it was treatment for cancer
or another physical condition?

I fully get how hard it is to juggle things I have a ds with complex needs but your child’s health comes first!

You can apply for flexibility, take annual leave or carer’s leave as PP have suggested, even take some sick leave yourself.

anxiety - she stopped attending special provision school in person after 2 weeks as she said the taxi journey triggered her anxiety (we only found this out recently - she wouldn't give us a reason at the time, she would just refuse to get up, get dressed etc.)

Taxi seems the most sensible suggestion if you can’t take her.

speak to the school and see if they will provide extra support for history whilst she is missing the lessons. Lots of teachers are happy to support one to one if the students need help if your daughter is willing to give up a lunch time / after school, particularly for a limited time. That might remove one stressor for her.

You HAVE to get your child to these sessions OP. That is that. If she can't attend school in person, she needs this help more than anything. Do CAMBS do online sessions, which she could go on to with your mum there or around in the building?

If it’s really that bad it’s effecting her life to this extent you need to prioritise her therapy.

Can you ask a neighbour ? Even if you have to pay them ?

Could you pay a friend to take her? Contact local MH services to see if they have any befrienders who would accompany her? Pay for a support worker for those hours to take her? (You’d need to introduce them over time but that’s possible).

This could change her life and I think is really, really important. She’s obviously in a bad place with her anxiety (and I get it, I don’t leave the house) and this will only get worse ax and gets older. Please please please move heaven and earth to make this work.

We tried through my private health but the company could not find any DBT therapists on their books in our area that did in person sessions (she won't do online for therapy).

If she's not attending school in person then surely she can catch up just fine online for the lesson.

I'd move heaven and earth to make these sessions happen. If that meant no work, it means no work.

You could also hire a nanny or private carer or personal assistant to take her there and bring her back if it’s completely impossible for you or your mother to do it. Organise a female taxi driver who will take her every time and she feels safe with. So many options to explore.

She's a school avoider with high levels of anxiety so no, I'm afraid she can't.

I would drop history gsce unless she loves it, then make a catch up plan with teacher

Oh, that’s difficult. I think you said in an earlier post that you were the main earner; is there another parent on the scene who could miss work to take her?

OP you need to speak to your employer about how you can manage this.
It's so important that she gets her therapy.

Can you take annual leave? Or some of it as parental leave?

We could manage one session a week and a lot of weeks we could manage 2 but not without missing more than 3 sessions in 6 months, we're just a bit stuck.

No, they don't do online, someone told me that some offer sessions at 6pm which, without going into the timetable of my life, we could probably do, but unfortunately ours doesn't offer that.

So she can miss the one session for the GCSE - that’s a false argument debating the merit of exam vs treatment when they’ve said you can miss three, what she can’t do it miss continual sessions because you won’t bring her to attend. It’s an expensive, highly intensive therapy, hard to find publicly available and has a good evidence base - really the gold standard for some presentations. Part of the treatment will be minimising therapy interfering behaviours - non- attendance being one of them (obviously- how can therapy work if you don’t show up). As a previous CAMHS clinician, I believe you need to prioritise your child’s mental health and probably reflect on whether you/family dynamics are part of the formulation. In terms of rights, you are being offered therapy, you have the right to accept or decline it. You do not have the right to ask a clinician to collect your child for it, for them to attend your house or to facilitate an appointment at midnight on Saturday. You have a responsibility to engage with the therapy and to support your child. It’s not a magic pill, it’s hard work, but if you want your child’s mental health to improve, it’s worthwhile. Trying to say it’s interfering with education is really irritating, just say you can’t facilitate it. Maybe they’ll offer online sessions, maybe they’ll refer for SW support, maybe another grown up in her life will be invested enough to bring her, maybe they can put her on waitlist so you see how the next six months go and if things are worse, you’ll have more motivation to attend the next one.

You have to prioritise her over work. Even if that means getting up to your eyeballs in debt. The alternative is that you give up work entirely to care for her long term.

Can you use unpaid parental leave? Are you claiming PIP or DLA etc that your daughter may be entitled to?

Would she go with nan in the taxi ?

With parental leave you have to take it in a week block unless your employer agrees otherwise.

But it is an option.

If your dd is diagnosed with a MH condition you can get parental leave for single days. Out in a request for this for the next few months for days off when DD needs the therapy.

it’ll be life changing for her