WTF, or Transitory Irritation

So, Tim’s caseworker emails that she wants to have a family session by phone to talk about what happened the Wednesday before Thanksgiving.  I know, I’m repeating myself, but that’s where today’s freak out (on my part) starts.

I set up a time with her for tomorrow, and off-handledly mentioned in my email that they usually don’t go well, because Tim doesn’t like it when we talk about him when he’s there.  She said that Tim had said that as well (which I think is great insight for Tim).

Then she went on about how he needs to understand the different rules and expectations between “school” and home and how he can “behave” better at home, like he does at school.

I went bona fide ape shit on her, in email, which isn’t good.  But she’s Tim’s third caseworker in 18 months and I get freakin’ sick and tired of these 12 year old, just out of grad school, haven’t ever seen a kid with psychosis before numbskulls telling me that my kid is just fine there, he just acts out at home.

Here’s verbatim what I emailed.

Is he calmer there than at home?  Really?  I’m not sure that’s really the case.  I just got November’s report – 5 incidents where he needed to be restrained in November sounds exactly par for the course for November.  He has 21 last January, and Nov – February are his typical times of high agitation and psychosis.  Are the rules really different?  You experienced exactly what we do with his last blood draw. Refusal.  Irrationality about it (although, in the case of the blood draw, maybe not that irrational because the tech had stuck him in a nerve).  

What I don’t want is this to be a “why do you behave here and not at home?” talk.  Tim needs to learn better ways of coping with and expressing his anxiety.  He has anxiety about going to the dentist, not being home. This is no different than when he experiences anxiety there at ODTC.  What techniques are you working with him on to express and cope with anxiety?  What happens when he goes catatonic, or gets very agitated and violent there?  This is not a behavior at ODTC / behavior at home differentiation.  

About 6 months after Tim had been there, we got a call from Casey, Tim’s previous caseworker, because he’d seen Tim get very agitated, go catatonic for nearly an hour, and then rage.  He’d never seen it before.  It took a lot of restraint for me not to laugh, when I asked him, “why did you think Tim was there?”  Tim’s anxiety and fears are irrational.  They’re delusional.  HE’S GOT SCHIZOAFFECTIVE DISORDER.  

It’s not about behavior at home vs at ODTC.  I hate to keep harping on that, but it’s not.  He has the same anxieties and irrationalities and delusions there.  I want to know what you’re doing therapeutically to help him cope with them.  I’m tired of being blamed for the rules at home being different, or not parenting a certain way.  I’m sorry I’m being defensive, but you’re the third caseworker he’s had, and we go through this every time.  It’s like you guys have never seen a child with a psychotic disorder before.  
Some days, I feel like all we’re doing is warehousing him.  
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