Residential Programs for OCD: Issues to Consider
I've written before about my son Dan's stay at an intensive residential treatment program for OCD sufferers; it was a mixed blessing. One of our main frustrations with the program stemmed from the way my husband I were regarded by the staff. For reasons that are still not completely clear to me, they saw us as overbearing, controlling parents, and instead of encouraging Dan to include us in the major decisions regarding how he should proceed with his life, they discouraged him from consulting with us at all.
Though this part of Dan's journey occurred almost four years ago, I think about it often. Was it us? Did we really come across as overpowering and manipulative with our son? I honestly don't think so and am still baffled by this scenario. I don't have an explanation, but I have some thoughts which may be helpful to those considering a residential program for their child.
For one thing, the staff at this program not only saw Dan in the worst condition of his life, they saw his parents in pretty bad shape as well. By the time our son entered this program, he had been dealing with severe OCD for several months; OCD so bad that he would often spend entire days just lying on the floor, doing absolutely nothing. Not surprisingly, our whole family was affected by this situation, and my husband's and my nerves were frayed. We were exhausted, stressed, confused, and most of all, terrified. While family and friends who knew us well saw us as caring parents who weren't quite "ourselves," the staff at the program didn't really know us at all. I'm sure they saw us as a dysfunctional family, and, to tell you the truth, by the time Dan arrived at the program, we were. Still, while we may not have been in great condition, we weren't raving maniacs either.
Another issue was Dan's age. He had turned nineteen the week before starting the program, and was considered an adult. The staff felt he should make his own decisions regarding how long he should stay and whether he should go back to school. This still floors me. Of course Dan's opinion mattered, but we should absolutely have been included in these discussions. What amazes me most is that the staff knew how bad Dan's OCD was. How could they expect a nineteen year old who was barely functioning to make these major life decisions without his family's input? Why should he have to? Ultimately, we did have control over Dan's length of stay, as we were paying for it.
Perhaps what the staff at this program disliked about us the most was the fact that we openly disagreed with them over how Dan's treatment should progress. After spending nine weeks there, we knew it was time for Dan to leave the program and go back to college. It was obvious to us he was becoming institutionalized, and the bottom line was that Dan had chosen this summer program because he was so intent on going back to the college he loved. We knew that leaving was the right thing for him to do, and our decision was supported by two psychologists outside of the residential program. But his treatment providers wanted him to stay. This is when it really became "Us vs. Them," and though we tried to work together, they kept insisting that they knew best and we were making a big mistake.
The main problem, as I see it, is that the psychologist, psychiatrist, and social worker at this residential treatment program didn't know the real Dan. They knew the Dan who entered their program in the worst shape of his life, battling severe obsessive-compulsive disorder. But he was our son, and we knew him better than anyone, even better than he knew himself at the time. Rather than viewing us suspiciously, as if we had some type of ulterior motive, it would have been so beneficial to Dan if we could have all worked together. Instead it became adversarial, and this made an already difficult situation worse. Dan had enough to deal with without the added stress that arose from feeling torn between his parents and the staff with whom he had grown so close. While I know his treatment providers may very well have had his best interests at heart, he was still just one of their many clients. But he's our son. And nobody cares about him, loves him, and is as totally vested in his well-being as we are. We had to remind Dan's social worker and therapists of this more than once; we shouldn't have had to tell them at all.
If you are considering a residential treatment program for your teenager or young adult with obsessive-compulsive disorder, I would suggest having some conversations before they even enter the program. How is it determined how long they will stay? Who decides? How is ongoing communication maintained with parents? And if you have any issues, questions, or concerns while your loved one is there, address them immediately with your liaison. And most importantly, remember that you care about your son or daughter more than anyone, and your feelings and opinions should be respected.