Therapist or other Parenting help for teen

Hi all.  
 

I'm struggling on how to parent one of my teens. They have a lot going on and I'm really not sure how to support and help them. They were just diagnosed a few months ago with inattentive ADHD, dyslexia and dysgraphia. None of which was a surprise. They are also exploring their gender identity. My teen was not able to go to school where most of their friends from middle school did which has been hard but it was a private school and they didn't get in. We found a school that is doing a great job of supporting them academically but socially they are struggling. I can't seem to find much of anything that will get them out of the house. They only want to be in their room on screens. I've tried to have the psychologist that diagnosed them convey that being active will help with the ADHD and sleep but it falls on deaf ears. I limit screens but it almost always involves a battle. They are reluctant to contact their old friends and make plans even though I've told them I will do whatever I can to help them keep those connections. And new friendships are slow to happen. Obviously, there's some depression happening but finding an available therapist that my teen also likes has been extremely difficult. I feel like maybe if we treat the ADHD that will help but we have Kaiser and I'm not even sure where to start.  Given all the issues I'm not exactly sure which boundaries to hold, what to force and what not to. Does anyone have a parenting therapist they like for complicated teens? TIA

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There is a group called therapyfirst.org that helps young people who have gender identity questions in the mix. There is a tendency to view gender distress as the root cause of issues in the US "affirmative model", not accepted in many places in the world which have looked at the systematic reviews of the evidence. Please be aware it is a very controversial issue and that what is being pushed in the US to support young people with gender issues is by no means either evidence based or generally accepted by professionals, especially those who have looked at the evidence reviews.

There's a recent Boston Globe op ed:  Youth gender medicine has become a hall of mirrors, Block, 2023: “What if it’s possible that there are kids who identify as trans who indeed know who they are at very early ages — younger versions of the adult patients who haunted Spack — and there are also kids who identify as trans for a finite period of time? And what if there’s no sure way to tell them apart?”

Reuters had a great investigative series as well ("Youth in Transition") and Block also wrote a peer reviewed journal article in the British Medical Journal (Gender dysphoria in young people is rising—and so is professional disagreement, Block, 2023)--see also the editor's intro (Caring for young people with gender dysphoria, Abbasi, 2023). The Block article describes what many other countries are doing, but since then more countries have called for caution..

And another article: Current Concerns by Levine and Abbruzzese (2023), as well as "The Myth of Reliable Research in Pediatric Gender Medicine..." (Abbruzzese et al., 2023).

Good luck, I bet you're right that more physical activity would likely help, kids are so dissociated from their bodies nowadays...woodworking, metalworking, swimming, ropes courses, bicycling...

 

Hi,

As the parent of a now-adult trans person who is neurodivergent, I can relate. It often felt like a giant pile of different pieces of string that you’re trying to help become a single ball. And teens absolutely don’t want parental interference, even when they want support.

 I’m not with Kaiser, but I found this on their website: https://thrive.kaiserpermanente.org/care-near-you/northern-california/ea... which might be a place to start. The Pacific Center has both programming and mental health services for LGBTQ+ teens. Most of these still happen on line, so your teen can check them out from the safe space of their own room. Meeting other kids like themselves may help with their self confidence, and being part of a community may offer potential friendships and a greater sense of belonging. Another gathering place with LGBTQ+ teen programs is the Oakland LGBTQ Community Center, which offers counseling, support groups, and social activities.

If there are non-screen activities they enjoy(ed), see if there are offerings for queer kids. You might also meet other parents who share your challenges. Also look for summer camps that are for, or have a large number of, queer kids.

While they doubtless miss their friends from “before,” I’d be cautious about encouraging them to connect. At that age shared context is often the linchpin for group identity and friendships. If most of their friends are going to school together, they might find it isolating to spend time with their old friends since they aren’t navigating the stresses of adolescence in the same school. Things change very quickly at that age.

I’m not a psychologist, but my gut says it would be prudent to find resources for supporting your child’s learning challenges that are entirely separate from their other struggles. We were always concerned that our kid might feel that their neurodivergence would make them feel ‘less than’ in school and other settings, and we didn’t want them to see their gender identity as just more proof that they were different, which at that age can easily be conflated with ‘wrong.’ Our kid has executive function challenges, and we hired a coach who helped them manage their schoolwork and scheduling. They were initially resistant, but I lined up a couple of potential coaches and then left my kid to conduct the interviews without me in the room. They agreed to “try out” one of them, and he was a godsend. My kid bonded with him- it turned out he was queer, and he also spoke Mandarin which was our kid’s biggest academic challenge. The coach also helped us understand that our kid’s executive challenges were not spaciness or a lack of attention, which rid us of many of the areas of conflict between them and us parents. We four (coach & family) felt they wouldn’t gain much from an IEP, but your kid is different, so you’ll make choices that are right for them. I think what was most important was our commitment to making our kid an equal partner in the decision-making process about moving forward. We can’t see past the walls adolescents put up, so we must have faith that they know what is in their head and heart. Make sure your kid knows you are there for them, that you love them no matter what, and that your goal is to support - not direct - their journey.

You CAN do this, and well!

I do not have a specific therapist to recommend, but just want to let you know you are not alone, as what you are describing is much like my own teen.   We also have Kaiser and it is a mountain to climb to get help, but help should be a available to your family.  I would contact their pediatrician (start with email, then request phone appointment if that doesn't work) and let them know you want a referral to psychiatry.  My daughter has been able to get services that way, including a middle-school girls group that runs online.  You are doing the right thing by trying to be proactive about getting help.  A number of people told me that the only way to access Kaiser MH services for them was via an emergency room visit in an acute situation.   We have also gotten help from East Bay Art Therapy, and sessions with friendly available clinicians along the way, that maybe weren't the perfect fit, but got us through low points.  We are definitely considering changing out insurance to access better MH care. Kaiser does have some good clinicians and programs, but getting to them is very hard. 

I'm so sorry for what your child and your family are going through.  It is really tough to pry these kids out of their rooms.  My trans ADHD kid is very similar, and I can empathize.

I would recommend Joanna Wise Bradman as a therapist, either for your kid or for you.  She has a lot of experience with teens and exactly this type of struggle, and has helped me so much.    https://www.joannawise-bradmanlcsw.com/

I can also highly recommend my kid's "Neurodivergence coach" Rew Berry who works with them over zoom and has supported and mentored them through so many challenges.  She has a creative and supportive approach and meets my kid where they are at.  https://rewberry.com/

Best of luck to you.  The teens are the hardest part of parenting.