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Chat at 2 p.m. Thursday with Wes Crenshaw

March 27, 2008

This chat has already taken place. Read the transcript below.

Double Take columnist Wes Crenshaw returns to take questions from readers - even if he can't get to your question today, he may address it in a later column, so post away.

Moderator:

Hi, readers. Thanks for joining us today. I'm Christy Little, today's chat moderator. With us is Wes Crenshaw, a Lawrence family psychologist and author of "Double Take." Feel free to post new questions as the chat goes on.

Thanks for joining us, Wes.

Wes Crenshaw:

I'm looking forward to some interesting questions we can flesh out further in the column!

jcstepmom28:

Wes, My husband shares custody with his ex on their son. I'm not a new step, I've been on our son's life for 12 years. Our son has mental health issues that would be hard to handle in a stable situation. Things his mother is chosing to do with her life are impacting him over and over. I've decided to support him as best I can in our home and realize that I just have to "cleanup the mess" that his mother is making.

Am I doing the right thing?

Wes Crenshaw:

Yes. You really are. This is such a tough situation to be in -- where you have to be a mother without replacing the mother. I wrote a book on foster care that discussions how foster parents should try to walk this fine line. As a foster parent I constantly found it difficult to not be angry at the biological parents for their shortcomings -- so I know its hard. But in the long run (say age 25) you get back a great reward for being the supportive and nonjudgmental mom to a child who may know no other. Are there specific things that your finding difficult?

gdiepenb:

Wes,
Do you see prescription drug abuse becoming a more prevalent problem, especially among teenagers? What advice would you have for parents and children about prevention?
Thanks.

Wes Crenshaw:

Yes I do. Its a significant problem. More on the way....

Wes Crenshaw:

I think that prescription drug abuse is particularly hard b/c it is easy to hide, easy to carry to school, doesn't smell, doesn't get picked up by drug dogs, etc. The response depends on why the kid is using the drugs. Adderall and Ritalin are often abused for a "good" reason -- to help one in school. But other times people are just trying to get the high. Neither is helpful at all. Hydrocodone and Robotussin and a bunch of other drugs are abused more for their mind altering properties. More to come.....

Wes Crenshaw:

The response is much as it is with other drugs, you have to really know your kid and not simply believe whatever she tells you. Marissa (now a sophomore in college can you believe it?) and I used to argue about whether teens were "trustworthy." And she is still the only teenager with whom I've had that argument. No teen in my office says that they or any other teen are trustworthy. Now some have better judgment than others, but most will try and do things outside of their parent's awareness. Prescription drugs are very difficult to detect and thus easy to get into an abuse pattern before parents are even aware. I also think you have to start young, know who your kid is hanging out with, keep VERY close track of any prescriptions (I can't believe how many parents turn over meds to kids for self-administration), and talk about the real dangers of misusing these meds -- some of which are really pretty bad.

Wes Crenshaw:

The response is much as it is with other drugs, you have to really know your kid and not simply believe whatever she tells you. Marissa (now a sophomore in college can you believe it?) and I used to argue about whether teens were "trustworthy." And she is still the only teenager with whom I've had that argument. No teen in my office says that they or any other teen are trustworthy. Now some have better judgment than others, but most will try and do things outside of their parent's awareness. Prescription drugs are very difficult to detect and thus easy to get into an abuse pattern before parents are even aware. I also think you have to start young, know who your kid is hanging out with, keep VERY close track of any prescriptions (I can't believe how many parents turn over meds to kids for self-administration), and talk about the real dangers of misusing these meds -- some of which are really pretty bad.

Moderator:

Looks like we have an IEP question, which was the subject of Tuesday's "Double Take" ...

janspan:

I am a local Special Education consultant, and have been for 28 years with cognitive skills rebuilding program development and research. I have a website that has links to Pam and Pete Wright's Public Law books and advice: http://www.memspan.com/parents.html
I have both profit and nonprofit organizations to help parents, teachers, and schools. The IEP process is a big problem, as there are floods of requests.
My question: Are most parents generally aware of cognitive skills retraining to rebuild mental and learning capacity? Are they aware that the school district must offer aptitude testing if there is a need?

Wes Crenshaw:

I really can't believe the amount of response we've gotten on this topic. I have another letter to publish in a few weeks from an educator, and one from a parent regard IEPs and sports. This is a bigger concern than I realized when I was approached by that parent and asked them to put their concerns in writing. More to come.....

Wes Crenshaw:

I don't know if parents are aware of this approach -- but that's largely b/c 90% of all the IEP related cases we work at our Institute are related to mental health concerns -- usually ADHD and Bipolar disorder. That's one thing I don't think I was clear enough about in the article. It sounded like the advice I was giving was as relevant to say, MR or LD as it was to SED (hope readers know those acronyms). So I'm not as much in the loop on the issue you propose. If you'd like to shoot me an overview I'd read it -- or I'll just take a look at the link you gave. More to come....

Wes Crenshaw:

As for school districts and aptitude, NO I was not aware of that either. We have enough trouble getting basic testing done -- as you and most other's I've heard from are aware. The real problem however, is that an IQ test and a Woodcock Johnson (achievement) aren't going to do one a lick of good if you are assessing ADHD or Bipolar disorder and school personnel can't make those diagnoses. So as outside professionals we're often pressing for acknowledgment of how those disorders can have a very negative affect on learning. Some districts really get that and others have blinders on. The reality is that IDEA and PL 94142 are just about as good as the real flesh and blood people that are here to implement them. I think some folks thought I was a little to harsh in suggestion they family (at it for a year) seek counsel. You'll note I didn't say GO SUE THEM! I said they needed to talk to someone who was well versed in the complex legal issues. Does this jibe with your experience?

Moderator:

Let me post another question while this discussion continues ...

booklover:

My daughter has always been a good student, popular, well adjusted growing up. Now she is 21 and beginning to have mental health issues, she is severely depressed, cutting and tried to commit suicide a few days ago. How do we as parents help her. According to the legal system she is an adult now and we have no control over treatment or anything. I am grasping at straws here and need to know how to help her and show my support.

Wes Crenshaw:

I wish I could tell you this was surprising to me -- but it is quite common and we've been seeing a great deal of this sort of thing lately. A lot more to come......

Wes Crenshaw:

Item 1) Your daughter is in fact an adult and it is very difficult to override her free will and ability to consent to treatment. The law sets a very high standard even for what we refer to as an "outpatient order of commitment" much less an actual state hospital commitment. If you follow the Brittany Spears case you'll see just how hard it is to get someone held against their will. More to come.....

Wes Crenshaw:

Item 2) This is an age when bipolar disorder, and much more rarely schizophrenia will tend to appear. This is also when "personality disorders" (bit of a controversial diagnosis these days) also emerge. These symptoms could fit with either bipolar or a personality disorder and only a metnal health provider could really get a grip on it to tell you which.
3) If you can't get some form of commitment, the only real shot here is working to maximize your influence over her. Many of the families facing these issues bring the young person into treatment with the understanding that they'll pay the bill, help keep them afloat, etc. If the young person refuses, this can get really dicy. Sometimes a lot of pressure has to be brought to bear. In other cases, a gentle approach is best. More on the way....

Wes Crenshaw:

I assume you did a hospital tour with her. If she was suicidal, and screened for hospitalization and then refused to go but was still stating suicidal wishes, she can be held for a period of time (I can't recall the exact length offhand) before a hearing is set. Most people go voluntarily at that point. Then you want to get her to a mental health provider on as voluntary a basis as you can. I want to be clear here that I don't have enough info to give you more specific advice -- that of course wouldn't be appropriate. But to the extent that you can get her to at least seek help with your assistance you'll be further ahead of the game. I've seen many of these cases seem terrible and then turn out okay in the end. Hang in there.

janspan:

Most parents and even professionals are not aware of the IDEA (Individuals with Disabilities Education Act of 1997) The Wrightslaw.com website has valuable information and advice for parents. All children with disabilities should be served (and receive appropriate psychological and learning aptitute testing) according to law. Are you going to make this information available to parents in the Lawrence area?

Wes Crenshaw:

Yes. Wrightslaw (for those who don't know) is the publisher of the book I suggested the other day. More on the way.....

Moderator:

We're almost out of time, folks, so please submit any remaining questions you might have.

Wes Crenshaw:

Yes. I'm doing a seminar with an attorney in Kansas City. I got a number of people who expressed interest after the column. If anyone else wants to have me email them when we get the date and location set, I'll be happy to do so. If this goes well we may do some kind of a monthly seminar like this and discuss different issues related to parenting and mental health. The real issue is interest. If there is some we'll do it. It's a good way to serve the community and meet those who read the column and those who don't too.

Wes Crenshaw:

By the way, I meant the attorney is from KC. The seminar will be here or in Baldwin City.

trombeck:

There has been talk over the years about teens in Lawrence needing more activities for them, or more "safe places" to hang out. Do you see a need for this? Does that sort of thing affect the overall mental health of young people in our community?

Wes Crenshaw:

This is the recurrent issue of the teen century. Surely you heard the same thing when you were a kid? More coming up......

Wes Crenshaw:

The problem is so much more complex than this. Where these sorts of "safe places" exist they tend to fail. Now I'd be really open to examples that counter that point because I WISH this would work. The problem is that kids don't want to hang out in a "safe place." They want to hang out in a "dangerous place." So the question becomes how can we create a safe place that is very challenging and novel and so on. For example, survival camps, roap courses, wilderness adventures, and so on. These are great activities that generate the adrenalin and seem scary. But have you ever tried to by liability insurance for such a venture? We used to use boxing rings for kids to let out steam in fair fight situation. Not anymore. More to come.....

Wes Crenshaw:

I have actually struggled with this for a long time. I haven't done any polling, but I don't know how strong church youth programs are any more. When I was younger this was a terrific source of teen interaction. I'm not going to tell you we didn't find some adventure there too (ahem) but it was still in an atmosphere of greater trust and security. I just do not know how to replicate these safe environments in the swirl of super-high-octane fun and danger available to kids in the greater Lawrence community. I don't know how tuned in you are to the kid world, but I remain astonished at how much exposure they get to things that are far from safe. I really like this question and it'll be appearing in a future column. I just don't know how to build the "Boys Dangerous Book" clubhouse for teens. Does that make sense?

Moderator:

OK, we're out of time. Thanks for joining us, and you can still reach Dr. Crenshaw anytime at doubletake@ljworld.com.

Wes Crenshaw:

Thanks so much for the questions. Many will make good fodder for future columns where we can give Julia a chance to put her 2 cents worth. Also if you know a jr. or sr. who'd like to write, nows the time to contact me!

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