Non-Crisis Interventions

Hi Team

Yes, you are my new team! I feel so welcomed and honored to be here. I am looking at whether trying to hold an intervention for my daughter would be helpful? She’s not in a full crisis (yet), but that could change obviously…anyways, if I got some of her friends, my family, etc and a counselor in the room - would it help propel her into therapy and meds? Any thoughts on that? She has depression and schizophrenia and is untreated for both.

Also, I’m wondering - should I encourage therapy first or meds first? I’m thinking meds, but I heard recently that I should push for therapy first. I’d love your experiences as guidance.

Thanks
Nicole

2 Likes

Welcome brave soul and new team member! How old is your daughter? How will she take and perceive this intervention?

1 Like

Nichole,

Have you read Dr. Amador’s book describing the LEAP method as you seem to indicate in another thread, or am I mistaken? If so, have you attempted these methods?

I’m unsure an Alcoholic Anonymous style intervention would be an effective strategy if your daughter has anasognosia (lack of insight). Maybe you have some other style of intervention in mind? Cornering and ganging up on people with active paranoia seems risky to me. I’d be more inclined to seek out a counselor with LEAP training and/or a strong understanding of anasognosia to coach friends and family to intervene individually rather than en masse.

Edit: per your question whether medication or therapy should be “pushed” first, it’s a classic chicken and egg problem: talk therapy isn’t often tolerated or useful without medication, but getting someone to take medication and maintain it is difficult without some kind of counseling or coaching.

My path was a year of talk therapy and then medication in addition after hospitalization, but it’s more typical that medication is the first and only therapy with varying levels of compliance and success.

2 Likes

My daughter had to be forced on medication because she never saw anything wrong. She sometime does now see, but not very often, I had people over, for my sake to tell me that I wasn’t being overreactive about things and something was going on. Till this day she says she hates those people. I think if things are severe enough you just need to somehow get her on meds first. If you think she would listen to people try that. As maggot brane stated Leap may be a good way to go and have her feel involved and not forced.

1 Like

You can get the police to do a welfare check. But that can end up messy sometimes. Do you know if your daughter has any outstanding tickets or a warrant?

I had the police come out twice for a welfare check. The second time my son had a warrant, for speeding and not showing up at court, so they took him to jail. They released him and we were back at square one. At jail they told me they could do an evaluation. Afterward, I found out it was good that I said no as they can hold him for a while until he got the eval.

It had to get to an extreme instance for me where I could finally get some help. I got back from a trip and my son thought I was an intruder and he barricaded me out of the home. I had to get an emergency medical hold and they broke the door down and took him to the hospital where he stayed for 3 weeks and was put on court ordered meds.

Don’t forget about sacosine - it’s advertised on this site. Here is the link - it’s sweet like sugar. I even take it for mild depression. (Which I never thought would happen to me). Sarcosine 180 Gram | BrainVitaminz

@oldladyblue had success with her daughter with this.

I look at this disease like trying to put a round peg in a square hole - you just keep trying different things until something works.

3 Likes

Hi Nicole and welcome to the forum.
I think I read in your other post that your daughter is sneaking in alcohol.
In our son’s recovery; the very first thing that “worked” was clearing the house of all alcohol.
Then cutting off the money supply used to purchase alcohol. He was self medicating his sz symptoms with alcohol. We did this with no judgement, just calmly said that there were meds to give him peace of mind and that alcohol was only making things worse. Once he no longer had access to alcohol, he was more willing to try and stay on meds.
I’m making this sound easier than it was. It was a very hard couple of years to get where we are including a hospital stay but setting boundaries on alcohol was the first truly helpful thing we did.
Our son is 21 months sober, med compliant and working 25 hours/week. Trust me, if he can do it, your daughter can too.

2 Likes

We found, for my 21 YO son, that the acknowledgment of SZ was enough. He is med compliant. He acknowledges that weed is a derailer and will get him cut off. But having a few beers has worked ok.

We talked to a ton of experts. NOBODY agreed with us. But, in short, treating our son as an SZ patient, and an addict that had to (1) start all these SZ meds, and (2) be sober forevermore, was too daunting.

We tried. 6 months. Then 3 months. At Rehab. Then Sober Living Home. Repeated failures and frustrations. Seemed to be hung up on ‘sober forever more’! Just too heavy for him.

Then we decided that we wanted to focus on the SZ and redirected re Sober Living emphasis. Again NOBODY agreed with us. Demanding they go hand in glove.

But it’s working so far. he is currently med compliant. Living w a roommate. And occasionally drinks alcohol.

Helping him understand SZ or at least accept it (and keep taking meds!) and understanding that some drugs like weed will derail him, but that a few beers is ok - has worked for us.

Finding out you have SZ - perhaps NOT accepting it - and also being stone cold sober for life is likely overwhelming to many kids.

2 Likes

Good points @Sando and whole heartedly agree this approach would not have worked at age 20.
In our son’s case, 2 beers a day turned into 10. Then we started finding empties hidden all over the house. I was fearful an alcohol fueled delusion would result in him confronting someone and things turning ugly.
I wish our son could drink 2 beers and then stop. But that us not our reality.
Here’s the interesting thing; his psychiatrist tells him that some day he may be able to drink socially and that the heavy drinking was a symptom of his illness.
He holds on to that hope.
I’m not sure what to think about that.

2 Likes

Yeah, I’m DESPERATE to get her on meds, but since she is 24, I can’t force her and because she has anasognosia, it makes it even harder.

1 Like

She is 24, and refuses to discuss anything of importance…and just locks herself in her room all day. She’s not bad enough for the police or for hospitalization, but I just see her slipping away.

2 Likes

Thanks @Maggotbrane (love that, btw). Yeah, it IS a chicken/egg sort of thing. I’m hoping for medication first, because she is so obstinant, that I know she will sabatoge therapy until she’s ready…you know?

1 Like

@DianeR, I’ve never heard about Sarcosine! I will look into it NOW!! Thank you!

1 Like

Hey Hanginginthere…yeah, she IS sneaking in alcohol. But, she has her own credit cards as she is 24 and I can’t get them from her unless I have guardianship (working on that, btw). And, so until I can do that, she is off buying it with her own money. SUPER frustrating.

1 Like

The medication first route usually comes down to either the cooperative route via LEAP or something similar, or coercion.

On the LEAP front, my experience is the SMI often respond differently to different people. In my family caregiving for my brother is a team sport, but more of a tag-team than a group. We keep into touch with group texts, each sharing intelligence and strategy and each try to do our part waiting for opportunities to step in and get him to Agree and Plan at the right moments.

Coercion hinges more on power-plays and more often than not leveraging crises. We haven’t had much luck manufacturing crises as in a traditional intervention, but stepping in when he’s in legal or medical trouble or wants something works, especially money if he’s overextended say with credit cards buys us leverage. It may help to do a credit check on her. My brother got heavily into debt twice mostly with manic buying and bar tabs, and each time he was bailed-out with bankruptcies. I felt my parents missed in both these opportunities to get him into therapy, med compliance or rehab.

The problem with classic interventions is they are manufactured crises, so asking for a non crisis intervention is a bit of a logical fallacy or oxymoron. To have real teeth ultimatums have to be absolute to the point kicking them out of the house and forcing them into homelessness or incarceration and family and friends shunning them and cutting them off monetarily until they get help. Most people don’t have the stomach for that, especially where mental illnesses are involved.

The closest my family got to a true intervention was getting a restraining order, buying my brother his own house, setting ground rules he can’t drink in their house or be around when he’s drinking and refusing to bail him out of jail.

1 Like

As difficult as this may sound, you may need to draw a line. As you’ve said, she’s 24 and has her own credit cards. Presumably she works or gets some allowance?

So she gets free room and board, possibly some $, yet there is no trade off. She is breaking your rules on alcohol. And refusing therapy or meds.

So draw the line. By April 30th, you will be held to a new level of accountability and responsibility:

  1. No more alcohol. Zero tolerance.
  2. Attend therapy sessions to learn more about this potentially impactful diagnosis.
  3. Try a once a month shot or something…
  4. Clean your room; walk for an hour a day, etc.

And then have enough love to enforce it. She doesn’t believe she’s sick, nor that there’s anything wrong with drinking alcohol and doing whatever. That’s her choice - she’s 24.

But you have choices too. And you’ve chosen to enact these rules over the next 30 days. And after 4/30, if she breaks the house rules, then she moves out. If you need to, find a nearby homeless shelter and give her a map with their hours and rules.

Be compassionate but resolute. Maybe she’ll be more compliant. Likely not. Then you have to suck it up and drop the hammer.

She has to believe “oh mom was 100% serious! Maybe mom has a point” or at least know that you’re going to ask for a reasonable trade for her living w you.

2 Likes

My daughter is 30 and she was court ordered to have outpatient care which means she would have to be med compliant. She of course once she was out of the hospital would stop taking the meds. So they had a warrant sent out for her and she was hospitalized. She is now and for the last 6 months has been in a group home. I’m hoping to get her to come home some time this spring/summer. The good and bad of getting the state/county involved is its like their under arrest they loose their rights, On the other hand she is not taking off at all hrs of the day/night while she isn’t in her right mind sometimes she wasn’t even sure who she was.
To get the courts involved it took two people to sign paperwork at the court house to say she was or could be a harm to herself. or others. When she didn’t know who she was she was under the idea that she was a daemon sometimes. Well anyway from there the courts had her evaluated. The doctors said she was SZ and that brings us to taday. Good luck, with everything. Every situation and every person is different just don’t give up.

2 Likes

@Sando, love the way you think, and I’m right there with you. I have already:

  1. Taken away her wifi access
  2. Taken away my car key
  3. Taken away my credit card

And I told her that when she is back in therapy and on meds, that she gets them back. I’m getting ready to draw that line, for sure. My fear, though, is that she keeps threatening to move back to Scotland (a fantasy, I know). So, I haven’t been as tough as I want because of her threat. So, I’ve been slowly making her life harder and harder here. I’m about to tell her that she needs to:

  1. No more alcohol in her room. I need to see what she is having
  2. Go for a walk for at least an hour, every day

Then I plan on continuing to “turn the screws” a bit more. I feel like I"m on egg shells every day…but trying to find ways to wake her up. Its like she’s in a dream, you know??

2 Likes

Good job! Keep it up. My son threatened to move to Lisbon, Portugal. Told me I needed to get him there to join a group of other Rainbow Children that were in the loop on all of the relevant theories.

He refuses the vaccine or masks so international travel is a big NO. But he had said that he’d kill himself if I didn’t get a private boat or plane to transport him.

Amazingly (sadly?) I checked into both options. Not a reality, even with $$.

So I said, and have continued to say, “obviously we don’t want you to harm or kill yourself (or be homeless, on heroin, in Portugal, etc) But there’s only so much we can do. So you do what you have to do.

Scary thing to say. But we say it with love knowing in our hearts we’ve done EVERYTHING PLUS to help him. Fortunately we’re in a good season for now. But we’re ready to draw the line when it happens again. And we know it will.

1 Like

@Sando
“A good season”….love that phrase.

1 Like