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.

Thank you everyone for your great feedback, it's been really helpful! I'm going to speak to the school, speak to CAMHS, speak to work and see if between us we can work out how to move forward with this and get her on the course.

Have you considered asking work for some flexibility? You would be entitled unpaid parental leave as DD would be classed as having a disability.

fantastic news
it will be a tough course
there will be homework
she’ll need support
but
it is a an opportunity you can’t afford to
miss - in the True sense of the word
best of luck

Please look at it from the point of view of getting to session 1, and then session 2 - not the full plan of all or nothing because of certain probable issues down the line. This will almost certainly feed both your anxiety and hers. It's ok not to be optimistic about the sessions, but as time goes on, experience (and maybe even things that are completely unforeseen right now - even the therapist unexpectedly being ill or having to make a change or 2, which happens) might shape the sessions 3, 4, 5 a bit. By trying to predict and protect yourself from everything, it feels like running before you can walk, but trying to think yourself into doing it through water at the same time.

can you hire a mentor to get her to the sessions? A psychology student at a local university might take this as a job, and would get can get a helpful young adult who could show up at your house, encourage DD, organise the taxi, collect her afterwards etc. That might help her get to more of the sessions, and would be cheaper than you skipping work or private therapy.

I think that this might be one of those problems which feels emotional, but is actually deeply practical.

I would get your diary out, write in all the therapy sessions, write in all of your already-booked work meetings and then start sorting them out one at a time.

Any therapy dates likely to clash with trips abroad which aren’t yet in the work diary, book just that day as holiday.

Call in sick for one or two if you have to.

Is her dad around? Or do you have an old friend who knows her well enough to get her there even if she’s unhappy? If so try and book them in for a couple.

Basically, approach it as a logic puzzle rather than trying to look at the emotional side.

A helpful young psychology student is not going to manage a severely anxious young person who uses self harm routinely to manage difficult emotions to get out of the house and to a challenging therapy -

@RocketQ79 you do seem to be oddly resistant to trying to get her to the treatment. I agree with others, think of it as a treatment for cancer that for various reasons can only be done on x day at y time. Surely you would get her there?

This is just as important. This could make such a difference to her life. I have limted personal experience of CAMHS and the therapy it offers; lots of PPs here clearly have much more extensive and close experience and knowledge and they are saying the same. Please listen to them.

Looking at it practically, my suggestion is:

• Forget about the history lessons – GCSEs can be taken later, and anyway history GCSE is not needed for anything (even history A level)
• Catch up outside school on the GCSE work if need be
• If she will only go to the sessions with you (I hear that) then find a way to make it work. Why will it bankrupt you? What have you discussed with your employer?
• You work away – how often and for how long at a time? Can this be moved?
• Please discuss with your employer holidays, parental leave, unpaid leave, compassionate leave. We are talking (from your posts, a bit of a guess by me) missing history one session a week and then for the other one, every fourth week (?) you should be away with work. How long at a time?
• So that is what you need to discuss with work. Can that one day be remote – you are away (how far away?) the day before and the day after and come back for DD's therapy day? Be in Teams meetings and be available early and later, just not from 3pm to 4pm (or whatever time it is)?

ETA: sorry OP x posted. Great stuff that you are going to try to make it work. All the best to you and your DD.

This! I know at least one family who have gone from 2 incomes to 1 (professional, but not very high professional) because neither of their children can attend school at the moment, and for a while one couldn't be alone in the house. If this happens you may find that keeping your child alive means not working at ALL.

Well if it’s group therapy then of course they can’t be flexible. I’d misread earlier and assumed individual therapy but forgot DBT is often group work.
The course is the course. It possibly involves booking rooms/a venue, organizing tech etc

The problem is, whenever you offer a group it won’t work for everyone.
Some want daytime.
Some evenings.
Some Saturdays.
That’s why they come across as rigid, it’s a nightmare to organize.

Op can take it in individual days if her dd has a disability, which she does.

I would absolutely bankrupt myself rather than denying my child the vital treatment they need. You can recover from bankruptcy far quicker than from suicide. If you tell your employers you need compassionate leave because your child is critically ill and can only receive treatment if you can prioritise her treatment over work then yes they may sack you, but they may not, and if they do you will find a way to get by with benefits etc until you have headspace to find a job which allows you to be physically and mentally present for your child. Keeping hold of your worldly goods will not benefit you one iota if you lose your child because of it.

I have two asd daughters who both saw CAMHS therapists and I fully understand the challenges of getting yp to therapy. I guess in your situation I would start the programme on the basis that you will get her there somehow. Once she starts attending, chances are she will not be as anxious as she is atm about it. She will know what's happening, she may make friends, it may start working. She may even genuinely look forward to the sessions and push herself to get to them. You never know.

Btw why do you think she isn't autistic?

Op said she had an assessment and was not diagnosed

Do the dbt it could save her life.

Dd2 has eupd and was barely attending school because of it. She did however attend all of her dbt sessions.
Shes now 26 and thriving. She’s been to college and uni and now works in mental health.
The missed lessons and exams didn’t harm her but not doing the dbt would have.

Is she coming up with these reasons not to go because she doesn't want to stop? If that's the case, then there will always be a reason not to go - just as online was unacceptable to her, she is likely to have another reason, anything from somebody looked at her funny to the weather to an incredibly important piece of work that she is unlikely to complete. It's what the condition is, whether the times and days are set from the outset of whether they were entirely under your/her control, there will be something.

The only reasonable way to get her to those sessions is, if nobody else is prepared to say 'you have to go and you are going', for you to do it, not go along with her completely normal for the condition resistance now it looks as though she's actually going to have to do it.

You won't have the ability to take control and take her to sessions once she hits 18 - as it is, there's still no way of ensuring she actually engages, but at least as a child, you can at least get her through the door - it's an opportunity you won't have again.

Money is helpful, yes, but a) DLA and PIP exist, b) You won't be thinking 'If only she'd done that piece of history homework' at any point in the future and c) you won't be thinking 'I wish I had gone to work and allowed her to be discharged instead'.