The Emotional Phases of Placing a Child in Residential Treatment

If you have a child whose mental health needs are so acute that they required residential treatment, these phases of feelings may resonate with you:

Deciding whether or not to place:

• Worried that it would make you a "bad parent" to have a child who lives away from you

• Self-critical that you weren't able to provide what they needed at home

• Desperate to find anything that will actually work

• Terrified that you'll get that one phone call that something awful has happened

• Exhausted from making treatment decisions and wishing that someone could just tell you what the "right" decision is

During their residential treatment:

• Relieved that they are finally safe, and that you can actually take time for yourself

• Guilty that you feel so relieved

• Worried that they'll have to stay permanently

• Grieving the loss of the things they are missing out on while they're gone

• Embarrassed and unsure what to tell people in your life about this

Planning for their discharge back home:

• Excited because you've missed them so much

• Terrified that the symptoms or behaviors will start back up again

• Obsessed with planning the "perfect" discharge plan to "guarantee" that there won't be a relapse

• Helpless because so much of this feels out of your control

• Optimistic because treatment did seem to help their symptoms

If any of this sounds familiar, that's because you are not alone. I have supported countless families on this incredibly difficult journey, and know that having the right support system in your corner can make or break your ability to manage this process. If you have a child who has been through or might need residential treatment, schedule a free 15-minute consult with me to see if I can support your family.

A Letter to Parents Whose Kids Are in Residential Treatment Centers During the Holidays

I want to start by saying that it's ok if you cried today. And yesterday. And plan to again tomorrow. When planning your "ideal family holidays," it's rare to include that you will be separated from your child because they will be receiving mental health treatment at a residential treatment program. It can feel devastating to picture your child in a sterile treatment center instead of celebrating with your family - and that's not even factoring in what to tell other people about this. You have permission to feel however you feel about this, and your kid being in treatment is an especially appropriate time to focus even more on processing your own feelings, so that you can continue to support them.

Now, please repeat after me:

"Even though my parental guilt is going to try to lie to me and tell me that this makes me a bad parent, I know that my decision to get my kid the support they need is the best parenting I can do. My kid's safety comes before my ego, and while my feelings are important, I'm not going to give weight to any judgments that pop into my head. My energy only belongs to supporting myself and my family in whatever ways we need to get through this."

Onto the practical steps:

• Your child should direct who knows about their treatment. If they want relatives and friends to know, then great - but if they want this to be private, then come up with a mutual agreement with them on what the party line is going to be at family gatherings that they'll miss.

• Do your best to make your child feel included in the family celebration in whatever ways the treatment center allows: visits, bringing their favorite food or an approved gift, etc.

• Recognize that safety is always the #1 priority, not coming home for the holidays. Holidays can be additionally triggering for kids with mental health struggles, so talk to their treatment team to see where they will be best served and most safe during the holidays.

Lastly, as a former staff who has worked many holidays at residential treatment centers, let me reassure you:

We recognize how difficult holidays are for kids and families in these situations, and do everything in our power to make these days as joyful, safe, peaceful, calming, and community-supported as possible. Depending on the center, this might mean: cooking a special meal, having family holiday gatherings onsite, dressing up, going into the community for a special outing, or providing additional therapeutic support to the kids who need it. Trusting us with your child is no small feat, and we never take that for granted.

You can never predict what the future will hold for your family and for treatment, but my hope is that this is the first step in determining a sustainable mental health plan for everyone involved. If you could use support with transitioning your child back home after residential treatment, this is an area I specialize in - schedule a free consult with me to see if I can support you and your family.

Can you tell me what my kid says in therapy?

When a child is receiving therapy, it's common for a parent to ask me how it's going, if I have any updates, or if there's anything they need to know about. In California, the age of minor therapy consent is 12 years old, which means that if a kid is over 12, they are the ones consenting to their own therapy and have control over who sees their information. However, just like parenting a teenager - it's a lot more complicated than that. Here's what you can expect:

• During the intake session, I will explain to both parents and child (separately or together) what confidentiality will look like in the therapy relationship. I don't want there to be any surprises in the process.

• If there is a safety issue (meaning the child is a danger to themselves or others), then I am mandated to report that to the guardians and potentially 911 (if a safety plan cannot be established within the situation)

• To build a good rapport with a kid starting therapy, they need to feel safe within our relationship, which means that some things will be 100% confidential. Some of my work here is helping parents become comfortable with recognizing the benefits of this.

• Part of my process is helping a kid to decide when it might be useful to involve their parents, and figure out how to talk to their parents in the way that feels most authentic to them. Options for this include: holding a family session, having me talk to parents separately, or role playing how the kid can give this information to their parents on their own.

• For any non-safety related information that I believe would be beneficial to share with parents, I will ask the child's consent, and explain transparently why I think it would be useful.

Part of why I recommend family therapy as part of the child therapy process is to help families develop their own conversations about these issues, and become comfortable talking about difficult topics like mental health and tough family relationships. This process looks different for each family, and I individualize it to suit your family's needs. If this sounds like something your family could benefit from, fill out a contact form to set up a free 15-minute consult to see if it's a good fit.