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.

Ok so she can’t go by taxi. I spent months working from the camhs car park or waiting room whilst Ds was in sessions and making up the hour I’d lost in travel time in the evening. Have you spoken to your employer about options for flexibility and what the art of the possible is?

Well, if you can’t take time off work to go with your DD, and she won’t go by herself, then no therapy 🤷🏻‍♀️

I am, of course, presuming that you have explained the situation to your work and they’ve just point blank refused to make any kind of compromise or to grant you parental leave and that basically your choice is to either work away for those periods or lose your job completely? Because otherwise it beggars belief that you wouldn’t be grabbing this therapy with both hands no matter what it took to get your DD there…

She doesn't want to change! We have discussed various techniques when she's in a receptive mood but when she's in self-destructive mode her mind is focussed on one thing (which is regularly self harm) and nothing will deter her from that mindset.

That's what the therapy is hopefully going to try and make a difference with.

I hear what you are saying, when they first offered it they said they had 7 kids signed up, when we re-visited after having time to discuss etc 5 had dropped out, the CAMHS lady conveyed people were finding it hard to fit it in around work, school and their other children etc.

And nothing will deter you from a similar mindset it seems.

This is exactly what the DBT will help with.

I agree, it is about priorities but I don't think bankrupting our family would help anyone's MH, thanks for your input, I will keep trying to find a way.

How many sessions will you miss as it is?

Is there no compromise with work?

She doesn’t want to change …..

very typical with EUPD - they get utterly stuck

self destructive - yes

1 in ten people with EUPD die of suicide

get your priorities in order

If you and your DD don’t want to do it, just don’t do it. Leave it for someone who might genuinely appreciate and benefit from the opportunity. I would move heaven and earth to get my child to something that I thought would help them, but you’re discussing it with the same level of interest and concern as you might discuss an inconveniently timed supermarket delivery.

She’s very young for an EUPD diagnosis, are you sure it’s not trauma?

Tbh there are plenty of parents who absolutely would bankrupt themselves to get their child something this important.

I agree with a PP you seem oddly detached. How much work would you actually miss and have you spoken to your employer ?

This opportunity will not come again and it could change the entire course of her life. It may even ensure she has one.

I did some work with CAMHS a few years ago, they are so unbelievably shit I don’t even know where to start.

HOWEVER I think you need to go on a financial page somewhere, put all your incomings and outgoings there and ask what you can drop to make it financially viable for you to temporarily drop your hours if that’s what it takes.

I think most parents would bankrupt themselves actually. She’s so very young for such a diagnosis - it must be right at the severe, life threatening end. So yeah, bankrupt yourself if that’s what it takes.

Sorry but you have a simple choice, the opportunity of DBT on the NHS which many parents would kill for which is proven to be the best treatment or you turn it down and then spend the rest of your child’s life regretting you didn’t do everything you could to help her as her mental health issues continue. You have already explored other avenues to get a private therapist and can’t so that should be telling you something. If I were in your shoes I would be doing everything I could to, including taking a temporary hit on income to make sure my DC got the help they needed. The waiting lists for CAMHS are huge and meaningful therapy has even longer lists. If you decline you will just get put to the bottom of the list and good luck with being able to get another set of sessions any time soon. Therapists are booked months in advance and I’m afraid can’t change their schedule for one individual. The choice is yours but I really would think long and hard about prioritising your DD mental health it’s a long term gain for some short term pain

I’m sure trauma will have played some part in a child having a diagnosis of EUPD -

im utterly shocked by OP’s resistance to finding a way forward -

I’ve known people with this whose self-harm has become so severe their lives and health are ruined, and one who died. DBT is the therapy and people would kill to get access to it.

What did your work say when you approached them to try and find a solution?

What would you do if she needed chemo? Do that.

This.

Have I got it right that you are away for 6 sessions? Can you take annual leave for the first 3 clashes, and determine after that if a)it is starting to work and b) if you need to extend the leave you take to not miss more than 3 sessions?

If she’s out of school is the history lesson part of an out of school provision - they might be able to transfer her to another group or lesson time?

I do get it, my DD had 4 years of weekly therapy with CAMHS which meant she missed an afternoon of school every week and I needed to negotiate with work to take her. I too spent many hours working from a CAMHS waiting room and making up time at work.

Could you negotiate with work to change the days you work away or compress your hours. It is very tricky but it’s part and parcel of caring for a child with complex needs. I know it’ll feel like yet another thing to deal with but DBT is a very structured therapy, which is part of its effectiveness. If you can’t take this place are there other options for your DD to get the care she needs?

We have been in a similar situation with therapy that our DS was supposed to do but we couldn't both give up one morning a week. We decided against it due to lack of evidence base in fact.
However, for you, I'd suggest
Skipping the history lesson.
Taking some AL for the first, say, four weeks and then going in a taxi with her. Work up to her going on her own - for example, start by getting the taxi driver to drop you off first on the way home.
I highly recommend this book for working on anxiety, but hopefully after a month or two you will start to see results from the therapy too.
https://www.spacetreatment.net/manual-and-books

Hi, Head of History here

Talk to the school. For a child in your daughter's situation I would provide a workbook and slide support. She would complete the lesson in her own time and I would take the time to give her 1:1 feedback at a mutually convenient time, e.g. for 10 minutes a week after school. This would be considered a reasonable adjustment.

Therapist here - this is a very rare chance and I would absolutely grab it with everything you've got

If this was a course of chemotherapy of course you would make it work.

EUPD has a significant mortality - this is a serious situation and you need to find a way for her to go, whatever it takes.