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I have 'spearheaded' the movement for a safe and lasting recovery for my son. I have learned specialized techniques to address behavior from an unstabilized individual who suffers from a severe brain disorder in order to keep him home until more in-depth treatment could be found. I obtained information from organizations as well as informed myself through reading books and newsletters. It takes work, but it can be done. It also takes a team effort from our family and the right professionals. And everytime I see my son smile, give love to his dog and other family members, or just jokes around, I am rewarded daily! We have our son back.

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Tuesday, November 30, 2010

Self Medication vs. Sobriety

I've been reading some posts on the NAMI group site on Linkedin and I wanted to express what worked for our family on this issue.

My son has a dual-diagnosis and we went through at long stage in the beginning where he would self-medicate, too. We used some behavioral management using ABA (Applied Behavioral Analysis) with him as well as having probate conseratorship (we controlled his money) as well as had him attend a day program that support sobriety (AA, NA, MA) and with time we were able to decrease his use which allowed his meds to work more effective, which started to give him more self-perspective, which lead him to stop self-medicating.

Our strongest rule was that he was not to self-medicate in order to live at home ( he wanted to live at home because we made it so nice for him to stay. We gave him something that he didn’t want to lose = motivation to comply.) If he came home high or drunk, I would just remark to him that he looked stoned, drunk, etc, smelled, eyes looked dilated and that he would act weird when he would come home under the influence. I even taped him once and played it back for him when he was sober. He didn't like that we would notice that he was high, that he wasn’t getting away with anything, so eventually he stopped.

Plus the next day I would be sure to have the family get up early and do one of his favorite activities. Even if it was just going out to breakfast, he would either not be able to attend and miss it (and we would talk it up to him later ), or he would be 'hung-over' and couldn't enjoy it very much. It was a long process and we reinforced small improvements along the way and was also supported by the day program organizations outside the family as well.

He ‘earned’ extra money (in the beginning it was gift cards for his favorite restaurants, etc. then he was able to move to money rewards by earning our trust through his gradual change in behavior) by attending these sobriety meetings and more if he shared and participated in them. He would bring home a signed note (which at the start of this I would call to confirm the signature) and he would give it to me for extra cash. We are a dry home to also support his sobriety. So he was heavily reinforced through this process to make the right choice and stay sober.

Eventually we would raise the bar in order for him to earn extra money, he would only get extra cash at the end of the week, two weeks, then a month for being compliant to sobriety and we did eventually extinguish the money reinforcement all together now since he is no longer self-medicating. We now are finally able to do family functions that he really enjoys without the drugs. His medication, since he’s been sober, has had a big impact on his insight also which helped him stay sober, too. So it’s an upward spiral effect. Not easy, but it is effective.

I've read several books about dual-diagnosis that were helpful in defining what it was and deepening our understanding, but nothing really addressed changing the unwanted behavior we were experiencing at home. Nothing that could help keep us together as family through this process. That came through Applied Behavior Analysis. Where there is a consequence (Good or Bad) for our actions. By tailoring them to our son's needs we were able to eventually have him make the realization that self-medicating wasn't working for him. For us, that was the pivot point that really helped promote change and the other organizations were then support services.

I hope this helps other families and their loved ones who are suffering from varrious levels of a mental illness find their solution.

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Give Them Something to Hold On To!

This was an article I wrote for Step-Up-On-Second's Summer 2008 newsletter about our journey to be able to give James motivation (something to hold on to) in order for him to stay compliant to treatment.

It explains a little about what we did as a family to facilitate his changing needs while staying safe.

I will be happy to share it on request.

I have also written and had publish a couple of letters to the editor for different newspapers in support of Laura's Law here in California.

Laura's Law is an assisted treatment law that would enable those who suffer from a severe mental illness to get Treatment BEFORE Tragedy!

BEFORE jail, homelessness, or violence!

Please write to your local representatives, your senators, your Board of Directors and the Governor of California. Tell them you want to see Laura's Law fully implemented in the state!

If you live in another state and want your state to have Assisted Outpatient Treatment laws like Laura's Law, click on the link below for the Treatment Advocacy Center and find out who you need to contact.

Early treatment is what gives us hope for a recovery.


HERE ARE THE TWO FIST STEPS WE DID

The first, was as early an intervention as possible.

The second, was putting together the right treatment team for my son.

INTERVENTION

Daniel's Place
www.stepuponsecond.org/services/help.html
1619 Santa Monica Blvd.
Santa Monica, CA. 90404
(310) 392-5855
First stop to getting important information at the beginning of the onset of a severe mental illness. They also serve those with autism.

Lost Hills Sheriff's Department who would send out officers when we needed back-up and to the At Risk program that tried to help our son.

Barry J. Nidoff Juvenile Hall
Sylmar, CA 91342

Some of these people have moved on to other locations but we are very grateful they were here when we needed them the most.

1) His Honor Commissioner Gold who understood what we were facing with James and did all in his power to support us in being successful with his prognosis. He ordered that compliance to treatment be part of James' probation because AB1421, Laura's Law, was not available to us.

2) Public Defender Evan A. Kitahara was what we needed to get James treatment. I would recommend this man to anyone. He is one who spear headed all the conections with the Public Mental Health Attorney for James while he was in Juvenille Hall. Mr. Kitahara understood our situation and he was a big part in our success.

3) Public Mental Health Attorney Lisa Greer. She was responsible for getting James what we needed from the Juvenile Hall school that would qualify him for Emotionally Disturbed status that would allow us to pursue placement through our school system and the Department of Mental Health in an out-of-state lock down facility. She also had James sign over his educational rights to me which was critical in the last years when he wanted to stop the program he was in out-of-state. It also gave me power in the Individual Education Plan meetings (IEP) once James was of legal age. She spent all day in one meeting with us to insure we had the right verbage so that James would have what he needed in our school district. She did so while missing an important meeting for her own special needs child. A great woman.

4) Jerrald. F. Pedrotti - great help in connecting with Even, Lisa, and James when he was in Juvenile Hall. A great advocate for treatment and a great mentor to those lucky enough to get his attention and help.

5) The various probation officers that would listen to our family needs and support treatment.

Child Advocate (name forthcoming) to help us navigate through some tough meetings with the school district to get a lock-down facility approved by the district to meet James' needs at that time.

Las Virgenes School District

Mental Health Attorney (name forthcoming) to get probate conservatorship so we control James' SSI monies until the time when he is ready to take control of his finances.

Devereux Residental Treatment Facility
http://www.devereux.org/
League City, Texas

TREATMENT TEAM

Tracy Rosberg, Ph.D. psychologist
23401 Park Sorrento, Suite 200B
(818) 591-3000
Either Tracy or a member of her team can help with a wide range of disorders including Autism. Tracy helped us with my son getting on a Clozapin trail and she recomended UCLA. She also personalizes her therapy session to fit the needs of the person. She would take walks with my son because he couldn't sit in a room for a long peroid of time.


Dr. Steve Marder at the UCLA Schizophrenia Clinic

Outpatient Schizophrenia Program
http://www.psychiatry.ucla.edu/
Information and referral - (310) 825-9989
or (800) 825-9989
(310) -268-3647 to schedule an appointment.

Sophie at ICPS - (951) 354-6804
ICPS (Independent Consultant Pharmacist Services) - monitors blood test for white blood cell count and more. A great help to both the doctors and the families who have a member on a Clozapine trail.

Ride-On:
http://www.rideon.org/
e-mail: info@rideon..org
10860 Topanga Canyon Blvd.
Chatsworth, CA. 91311
(818) 700-2971
Horse therapy with psychoanalyst. This was a great help to James regaining some of his self-confidence and much more.
They service all types of mental and physical disorders.

Victory Wellness Center- Day Program and much more
14411 Vanowen St.
Van Nuys, CA. 91405
(818) 989-7475

ABA (Applied Behavior Analyisis) - Behavior modification techniques that allowed us to develop personalized programs to keep James compliant to treatment, extinguish unwanted behavior (even when he wasn't yet stable with the right treatment), increase wanted behavior, self-esteem, and over time trust. I learned the basics from an Autism Patnership trainer with on the job training in a Community Based Instuction High School setting but there are many who offer this program. It is designed for those with autism but I found that once I deveolped a plan around the needs of my son, it was still the most effective behavior modification program for when he was not able to reason out problems. Behavior is behavior, in my humble opinion.

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