Treatment (cont.)

 
In my multi-faceted role, I operate as a coach, trainer, cheerleader, role model and disciplinarian. I'm also a strong advocate for necessary and appropriate educational services and often meet with school personnel and attend IEP meetings. I also consult regularly with the treating physician or psychiatrist to keep them informed of the client's progress and to monitor medications. And, I work with parents as well as entire families (which can include siblings, grandparents and family friends) in order to assist them in helping their child or teenager.  
 
Clearly, mental health services are expensive and my approach is, perhaps initially, more expensive than traditional interventions. The usual services such as the 50 minute hour once a week (if you can get that), a 15 minute medication check, crisis hospitalizations (if there is a bed available) which often comes with an oversubscribed medication cocktail (with the intent of behavior stabilization), high rates of therapist turnover and/or endless rounds of advocacy confrontations with service providers and managed health care combined with the confusion and frustration that accompanies the quest for meaningful and adequate services, is a nightmare. Further, inappropriate methods of treatment (an almost complete reliance on behavior modification) instituted by untrained and/or incompetent professionals in a disjointed manner, make for a very unhealthy situation for those needing treatment. The bottom line is that it isn't working.  
 
While the main focus of the BTC approach is not on behavioral changes for the sake of better behavior, it does not turn a blind eye to the behavioral concerns. Trust me, if I had the power to overcome or change or even fix how someone's brain is wired and knowing that in doing so it would result in well-behaved individuals, I'd do it in a heart- beat. Constantly trying to alter established, if not ingrained, behavioral patterns is a prescription for endless confrontations, repeated frustration and continual failure. Hence, it's not really a viable option. These people are more than their observed behaviors. They are intelligent, they think and they have feelings like everyone else.  
 
Of course behavior is important, especially in this culture where the pressure to conform is enormous. Demanding or coercing someone to change their behavior is, however, a real quagmire when not done within a context of also attending to the person's emotional, psychological and social states. Although I can't possibly guarantee "success," the BTC approach at least affords a better shot at alleviating distress for the child/adolescent, the family and school personnel alike. This approach has succeeded in lessening the frequency and intensity of meltdowns which result in less stress for everyone. It has also seen significant reductions in the use of medication and fewer, if not an absence of, hospitalizations. Ultimately, with a concerted effort over time, the situation has a good chance of improving. The result is more enjoyable relationships at less cost financially and emotionally.  
 
A couple final notes. While intervening, even later in life, is better than not, early intervention is key to long term success. A student with ADD who receives treatment for the first time when in college would, no doubt, have been better served had s/he received services ln elementary school. Early identification and intervention afford the best chance for sustainable success.  
 
These disorders tend to be chronic, life-long situations. Nothing we know of today can fix them. Accordingly, long-term intervention and support is beneficial. While the more intense, regular therapy described here will not necessarily be needed over time, having someone to touch base with, having a life-line (I call it a tune-up), can assist immeasurably.  
 
Finally, after all is said and done, those with neuro-biological disorders need to find their place in the universe, a place that allows for their particular nuances and one that utilizes their gifts and strengths appropriately. When you think about it, that is not really any different from what anyone else would like to see happen for themself. We all need to feel accepted for who we are and to feel connected in a meaningful way. For those with these disorders, such goals are especially challenging. Beside the individual work on one's self that is critical to success, a more knowledgeable, understanding and tolerant attitude from those less afflicted would go a long way. We really are all in this together.

Treatment - Page 4 of 4      [1] [2] [3] [4]
 
NEXT: Impulsivity, Consequences and the Brain

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