Therapy update: starting over

Right after I wrote the post on rethinking the direction of Ethan’s therapy, I got an email from R, Ethan’s therapist. He attached a link to the neuropsychologist evaluation process and a list of professionals at the local children’s hospital. As I suspected, he was pushing an evaluation, ignoring my concerns that Ethan’s grief wasn’t being addressed.

I let the email sit for a week before responding. Then I responded (this is the actual email – except I used his name, not “R”):

_______________

Thank you, R. I’ve done a lot of research in the last six weeks or so, and I’ve talked to several people on the issue as well. As I mentioned in Ethan’s last session, I was leaning toward an ADD/ADHD diagnosis when we first started seeing you; however, as I’ve become more aware of the grieving process in children, I think there’s another issue that needs to be addressed before he is evaluated. Ethan *might* very well be ADD/ADHD to some degree, but until the core issue of Ethan’s grief is addressed, it will not benefit him to be labeled. 

To recap what Ethan’s been through: Within weeks during the summer of 2010, Ethan became a big brother, his grandpa died (and my mom moved in with us), his father was sinking deeper into alcoholism (and Ethan saw many things relating to that), and my marriage was crumbling. Literally, all this happened over a four-week period. As if that wasn’t enough to deal with (and he was seeing a counselor at school and another one outside of school), a year later, Mike and I separated, and I decided to relocate the family to Wisconsin. Five months after the separation and just weeks after Ethan moved here, Mike died. 
That’s a lot for a child to take in, absorb, and figure out how to deal with. A lot of his behavior issues at school (and to a lesser degree at home since we don’t see the same behavior outside school) mirror what other children go through as part of the grieving process. The acting out, the aggression, the anger are all part of the process that many children go through. 
You’ve done a good job helping Ethan become more aware of the symptoms and finding ways to deal (i.e., handling his anger), but I think there needs to be a focus on dealing with the grief aspect. If this isn’t an area of expertise, please let me know. I truly believe this is where Ethan needs the most help right now.
_______________
It was a week before I heard back from R. I wasn’t surprised by his response. Turns out, he has very little experience helping younger children with grief issues, and he recommends taking Ethan to a different therapist. Not surprised, but a little ticked off because:
  • My reason for seeking help was very clearly spelled out for R from the first meeting. We spent two hours talking about what Ethan had been through in the last few years, including (very much including) dealing with the deaths of his grandpa and his dad.
  • R had adequate opportunity to indicate this was not an area of specialty. Every session, R prompted Ethan and I to talked about upcoming (or recently passed) anniversaries like the date of my dad’s death, Father’s Day, my wedding anniversary. Hearing me talk about Ethan’s reaction to these dates might have been opportune time to say, “hey, that’s not really my thing, you know? But let me refer you to someone else…” Unfortunately, that didn’t happen.

Ethan really clicked with R, and I haven’t told him that we will be changing therapists. The therapist to which R has referred us has requested that I meet with her alone the first time. I’m a little hesitant to go with someone who R has recommended, but it’s worth (at least) meeting her. I’m going to lay it on the line though – we need to address Ethan’s grief. He needs the tools to comprehend and process these two deaths.

New therapist is going to get grilled: I want to know what kind of experience she has with kids E’s age, and what kind of processes she has for working with kids dealing with grief. And I won’t hesitate to find a different therapist if I don’t feel she can address the issues and REALLY HELP Ethan.

I’m making the call tomorrow to schedule the first meeting with new therapist.

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