Therapy

I try not to make my blog posts seem like one long gripe fest without at least some kind of tip or solution to the problem. If that is my goal, I should stay far, far away from this topic.

But, here I go anyway. So, let me apologize in advance that what you are about to read will be a substantial list of problems and a very short list of solutions (that is if I can think of any by the time I get to the end of this post. Otherwise, it will just be a list of problems).

We've all heard the stories, or maybe experienced first hand, how hard it is to get CPS to intervene and respond to reports of abuse and neglect. We all know about numerous kids who should be helped, but the problems going on in their home do not rise to the level of CPS intervention. So, what does that tell us about the kids in our homes, then? It tells me, the conditions they lived in were worse than most of us can even imagine. The abuse and neglect they suffered was severe. Most of the population will never experience this type of abuse and neglect in their entire lifetimes. Their needs are different than most every other kid you know. So, what kind of therapist would best suit this specialized, rare population?

Well, my answer would be a very experienced therapist, one who understands abuse, neglect, and trauma, one who knows the substantial effect abuse and neglect has on the development of growing children. They also need a therapist who understands that because their "child development" is different from most kids, they need to be parented different from most kids. They need a therapist that knows how to include the children's foster parents in all aspects of treatment and one that can help foster parents understand why these unconventional parenting methods work.

Now, what kind of therapists do kids in foster care get?

They get recent college graduates who may or may not have done some practicum hours on actual live people, but not necessarily children, let alone abused children. They get therapists who have taken this job as an entry level and plan to leave as soon as a better job becomes available (which means over the course of their time in care, foster kids may have as many therapists as they have case managers). They get therapists who are not required to take specialized training on child trauma and attachment disorder. They also get behavior coaches who have degrees in areas not even related to mental health, they often are not parents themselves and would probably struggle to help a parent, that is not a foster parent, understand behavior issues.

According to a study by Casey Family Programs, a disproportionate number of former foster children have mental disorders as adults. Foster children have nearly double the rate of PTSD as U.S. combat veterans. I know that I hear about programs to help veterans that suffer from PTSD (although, I don't doubt this is an underserved population as well). I hear of no such programs for children in foster care. While, I can't assume cause and effect with these studies, it does make me wonder if the number of foster children as adults with mental health issues would be much lower had they received the appropriate care when they were children?

Another huge issue with therapy and foster care is the amount of time and effort it takes to get services started. It often seems to be a big battle just to get services that I am not really sure I want, once I have them.

Here's an example that is not a rarity:

Little Dusty, 3yo (you can read about her here) came to us on 4/2/12. Within a couple of days of being placed with us, Rapid Response came to check on her (step 1 of system in place to ensure children receive services - check!). According to the information we supplied RR, a referral was made for play therapy for Dusty as well as a referral for speech assessment through public school district.

Enter Dusty's oh so wonderful CPS case manager, let's call her, Little Miss Scatterbrain (that's my nice name for her :).

So, Little Miss Scatterbrain did not inform anyone of the intake that had been set up as a result of the RR referral, so the date came and went and the referral closed. As I started reporting Dusty's behaviors to Little Miss Scatterbrain, she informed me that she had let it lapse. So, you would assume she would then get right on it and put in another referral, right? Wrong.

Fast forward to a court date (not sure what hearing this was, I was not informed of it eventhough I repeatedly asked for this info). The court ordered a Best for Babies Assessment (something the court has started routinely doing for 0-5yo in foster care).

We are now over a month into the placement and the Best for Babies assessor determines the same thing the RR person did and that is, Dusty needs play therapy. Due to the behaviros we were now reporting, Dusty was assigned an intensive case manager with Southwest Network (SWN). Oooh. This kind of sounds like someone might be taking her needs seriously.

Nah. Not really.

Now, we have an intensive case manager (ICM), who I will call Little Miss Helpful, which means, she needs to come interview the family about Dusty's behaviors, observe Dusty in the home, at daycare and on visits with mom. THEN she can make a recommendation for services. We have our first meeting with Little Miss Helpful at the end of May. She does her observations in our home and in the daycare over the next couple of weeks. Now, she has to observe during visits with bio mom.

Here's where Little Miss Scatterbrain is able to FUBAR the whole process, yet again. Since she is completely unresponsive to Little Miss Helpful, she is never able to observe Dusty during visits. But since this is how the process is supposed to go, Little Miss Helpful continues to run her head into the brick wall a.k.a. Little Miss Scatterbrain which results in delays for services for Dusty.

Little Miss Helpful eventually gives up on the idea of observing during bio mom's visit and just goes ahead with her recommendation. Shockingly, she recommends Play Therapy. That's right, the very thing RR recommended and put in a referral for within a few days of us being placed with Dusty. Little Miss Helpful came to the same conclusion. She needs Play Therapy.

Now, in order to put in a referral for play therapy (mind you this was already done months ago and let lapse by Little Miss Scatterbrain), Little Miss Helpful must hold a CFT. So, we are now in July. It takes that long for Little Miss Helpful to actually get in contact with Little Miss Scatterbrain and finally nail down a CFT date and time. Nevermind that this date and time conflicts with my schedule. I cancel certain things so that I can be sure to be there and get this whole therapy ball rolling.

Little Miss Scatterbrain does not show up to this CFT that we scheduled around her. Doesn't show up, doesn't call and actually never even addresses the fact that she completely blew this off. When I bring this to her attention a week later in an unrelated conversation, her response "I was sick and I didn't know you were going to be there, so I didn't realize I needed to let you know I wasn't going to make it". The CFT was at MY HOUSE. Not sure how she possibly thought I wasn't goin to be there. Anyway....

Little Miss Helpful gets right back at setting up another CFT. It's now August. Still no CFT, still no referral for therapy. Now, we have a new CPS CM. She is ready and willing to participate in a CFT, however, she feels bio mom should be present as well. So, we need to reschedule to accomodate bio mom.

Fast forward to 3 more reschedules due to bio mom's "family emergencies" and various other needs to cancel. It's now Sept. and Dusty still has no services now because mom a.k.a. Little Miss Attempted Murderer, ok, I shouldn't go there, is being allowed to delay her child's therapy (therapy she needs as a result of the actions of her mom in the first place). Is this making sense to anyone?

Anyone?

We finally decide to proceed with the CFT in mom's absence. And, now we can actually put in a referral for play therapy which was identified as a need over 5mos earlier. Yay for our system! And, yes, we tax payers actually pay for this incompetence.

Now, it's October. I was told a referral was put in weeks ago. I still have not heard anything from the agency that is supposed to be providing the therapy. She has been with us over 6mos. We identified this need immediately. And here we are.

And the worst part is, after all this pushing to get therapy started is over, we will have inadequate, ineffective therapy and I'll wonder why in the world I ever worked so hard to get it!

And that makes me....

Looks like this will just be a post about problems with no tips or solutions. Oh, how I wish it could be different :(