If you’re a parent of a troubled teen, how much decision making power should your child have?
How can your teenager possibly make decisions for themselves if they’re brains aren’t functioning normally? They hate you, or they say and do crazy things for unfathomable reasons. You want to guide them with incentives and consequences but these haven’t worked. You’re traumatized by their history of unstable behavior and it affects your thinking. Perhaps you get stuck in a power struggle, or you give up power because asserting your authority just puts gasoline on their fire. You know they can make good on serious threats, such as running or causing serious personal or material damage. Or they may completely fall apart.
Decent, caring parents, who aren’t out to “fix” or punish their child, often feel their teen has too many rights:
Problem – A teen’s statements to treatment providers are completely confidential after age 14. Privacy is important, and the therapist needs the young person’s trust to help them with therapy, but some information could be shared with parents on a case-by-case, “need to know” basis. A parent should be able to partner with the therapist, so they can structure interactions at home that support therapeutic goals. For example, if the teen talks about dangerous activities with a best friend that the parent doesn’t know about, I think the parent could be coached to appropriately reduce contact with this friend or defuse the dangerous influence they have over the teen. If a therapist can’t reveal this much, can’t they at least tell a parent what to watch for, what to set boundaries on? How to respond?
Problem – A teenager has the right to refuse medication or therapy at age 14 (in practice, most providers are reluctant to force treatment at any age). But if their refusal leads to a serious crisis, I know from experience that most parents have no option but calling 911 or using force to keep themselves and others safe. Yet force undermines the parent-child relationship, and has lead to undeserved charges of child abuse.
Problem – A young person has the right to refuse school attendance even when there are consequences, and the parent can be held liable for neglect. This is of special concern to a parent who risks losing custody to the state or to a vindictive ex.
Problem – A teenager can commit a crime and a parent can lose custody. Sometimes crime is the only way for a young person to get the help they need, but sometimes this means they descend, step-by-step, into a justice system that presumes bad parents create bad kids.
Parents of troubled teens need greater control over their situation, and lots of outside support, to prevent losing too much to the Black Hole of their child’s disability. The emotional, physical, and financial costs to all family members are exceptionally high. If a parent’s authority is undermined by a society that thinks they are the kid’s problem, and an education and health care system that focuses only on the child’s needs, the parent and family see their own rights being trampled.
- Parents and families have a right to personal safety including the safety of pets, and the right to protect themselves, their belongings, and personal space.
- Parents have a right to ensure and sustain their financial, social, and job stability, even if it means periodically putting aside the teen’s needs.
- They have the authority to create house rules based on respect, safety, and shared responsibility.
- And they have the right to enforce houserules and expect them to be followed.
- Parents and families members have the right to be human and make mistakes.
- Parents and families have the right to take time out for their own well being and self-care.
When does a youth’s rights supersede a parent’s rights?
The youth, because of their disability, has a right to make progress at their own pace, and choose their own path of learning. They also have the right to reasonable family accommodations because of their different needs. Like any human being, especially one’s child, they have the right to respect and support regardless of inconvenience. They also have the right to negotiate for what they want, and to expect earnest efforts towards compromise. The last, and this is very important, they have the right to choose incentives and consequences that work best for them.
You know your teen will reach adulthood and independence whether they are ready or not. They will do what they want, perhaps suffer serious consequences, and there’s nothing anyone can do about it. So do something about it now.
Look at the future from their perspective. Young people in the mental health system face life needs and challenges different from peers. They often don’t reach 18 without experiencing significant setbacks due to their disorders. They have missed opportunities for the education and life skills needed for adulthood, and lack of youthful achievements that boost confidence and self-esteem. Teens and young adults with disorders may have to manage these the rest of their lives! Once age 18 is reached, supports they’ve depended on are abruptly dropped. They are exported to an adult system where they must start from scratch to establish a new support network that will assist them towards an independent life. Your job is to change from parent to mentor as these new supports are developed.
What are parent responsibilities?
Acceptance: this is the nature of your child and it’s OK. They will still be part of the family and get your support. Your child would function better if they could.
Positive attitude: yours is not a lost child, there are resources out there to help them, and you really do have the energy to find and use these resources.
Realistic expectations: brain disorders are termed “disabilities” for a reason. You cannot expect their lives to unfold like yours did, or even like others their age. They will redefine what progress means for them.
Support without strings attached: your teen doesn’t owe you for the life you’ve given them, nor must they pay you back for your extra sacrifices.
Take good care of yourself so you can handle your situation.
Access and use information on the disorder and it’s treatment regime.
Learn and practice an entirely different approach to parenting.
What about youth responsibilities?
My previous post, “Youth with mental disorders demand rights!” presents a document created by members or Youth M.O.V.E (Motivating Others through Voices of Experience), a peer-to-peer organization for teens and young adults http://youthmove.us. I have a suggestion for M.O.V.E.: consider developing a youth Responsibilities document. I believe young people are also responsible for acceptance and realistic expectations, like their parents, as well as being accountable for themselves.
The following list is a good place to look for other ideas. It was developed by adult mental health consumers (part of this list has been de-emphasized because it does not yet apply to youth). Everyone, regardless of their medical and mental health situation, should do what they can to take responsibility for their health treatment.
Adult responsibilities that could be applied to youth and young adults:
“In a health care system that protects consumers’ rights, it is reasonable to expect and encourage consumers to assume reasonable responsibilities. Greater individual involvement by consumers in their care increases the likelihood of achieving the best outcomes and helps support a quality improvement, cost-conscious environment. Such responsibilities include:
- Take responsibility for maximizing healthy habits, such as exercising, not smoking, and eating a healthy diet.
- Become involved in specific health care decisions.
- Work collaboratively with health care providers (teachers, parents) in developing and carrying out agreed-upon treatment plans.
- Disclose relevant information and clearly communicate wants and needs.
- Show respect for other patients and health workers (students, coworkers, neighbors, siblings).
- Use the health plan’s internal complaint and appeal processes to address concerns that may arise.
- Recognize the reality of risks and limits of the science of medical care and the human fallibility of the health care professional.
- Be aware of a health care provider’s obligation to be reasonably efficient and equitable in providing care to other patients and the community.
- Become knowledgeable about your health plan coverage and health plan options (when available) including all covered benefits, limitations, and exclusions, rules regarding use of network providers, coverage and referral rules, appropriate processes to secure additional information, and the process to appeal coverage decisions.
- Make a good-faith effort to meet financial obligations.
- Abide by administrative and operational procedures of health plans, health care providers, and Government health benefit programs.
- Report wrongdoing and fraud to appropriate resources or legal authorities.”