Expert: Peter L. - 12/7/2010

Question
My daughter has been diagnosed with severe mood disorder (Bipolar) among other things, depression, anxiety, etc. She's been hanging with ANYONE who will get high (weed) or drink and is a very lonely person in general.  She's found a bad crowd and every day seems to get worse. Her latest party was among strippers and older men (gangster type) and was fascinated and scared at the same time. She's very promiscuous and her father and I want to put her in a in-patient hospital for kids her age but we're worried she'll leave if it gets hard for her to deal with. She's very stubborn and has a terrible temper.  She's currently on med's (6 different kinds) and is being seen by a very good doctor from the Boston area but it seems she's still looking for good times and isn't picky to whom ever she lands with that evening.  She quit high school after being kept back in the 10th grade. My heart is torn and we want her to be taught how to take care of herself and to get off the Internet and cell phone and re-learn life without those dangerous avenues that are offered on-line. She's met total strangers from FB and has no fear of it.
A friend told me that "Job Corps" could help, but I wonder if they deal with teens with medical issues such as hers. I've read some of your answers and would ask if you could help us with our question on Job Corps and is it good for my wild child?  Thank you.  Michele

Answer
Hi Michele,

I once had a job interview with Job Corp, and was impressed with the organization.  That might be a possibility.

Your daughter could benefit from a structured inpatient program, but the problem is how to get her there.

Most research focuses on the importance of the family in cases such as yours.  The issues she is suffering from psychologically have to be revealed and treated.  What do you feel is happening with her psychologically and emotionally?  She's depressed and anxious, but what issues underlie this?  Any clues, or is she willing to tell you?  You appear to know where she's been, i.e., the very threatening settings, and did you know this because she told you?

I would try to spend time with her and have some non-confrontative conversations, if you haven't done this already.  You might see if she would be willing to attend a family therapy session.  

My sense is she's angry about something, either a self-esteem or self-image problem, or some aspect of her relationship with both of you, her parents.  Try to find the point of onset of her troubles.  Certainly she was a drug-free kid at one time, and her behavior before the onset of the substances might be revealing.

You may mandate that she attend an inpatient or structure program like Job Corp, if she's under your roof.  She has poor judgment, is reckless, and a danger to herself. In my view, the possibility that she might aggressively oppose your attempts at getting her into services does not serve as adequate grounds not to attempt them.  If her behavior worsens, or she has a traumatic encounter with one of the strangers she is mixing up with, you will suffer tremendous guilt that you did not act further.

Young people need a lot of direction, though they will deny that vehemently, as they want to autonomize and break away from parental influence.  Problem is she does not know how to manage risk in the pursuit of pleasure.  And that's dangerous.

I hope this helps,
Peter