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'My 16-Year-Old Daughter Won't Stay Off Drugs'

From this piece of information as well as your description of how she's acting at the treatment centers, it sounds like there is more going on with your daughter than drug abuse and dependence.
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Sad woman with depression sitting on the floor
Sad woman with depression sitting on the floor

Reader Desperate for Answers writes,

My husband and I have a very troubled teen who has been in and out of drug treatment facilities for the past three of more years. She was clean for 14 months and just recently relapsed and came to me at work and told me which took a lot. I had her on a plane that night to a rehab in Florida which we had a free 30 days promised to us because she completed 90 days last year.

However, she has done nothing but cause problems with the staff, ran away, got taken to the hospital when nothing was really wrong with her and the list goes on. My husband and I now found another facility which is offering us a substantial scholarship because we don't have the money and we need to know how to address this with her when she gets home. This ranch is an all girls ranch and they do schooling, counseling, community services, chores, and DBT, and sounds great, but what if she again won't work the program?

Dear DFA,

This is a very difficult situation. Your daughter is very troubled and does not seem to be motivated to change her behavior in these treatment facilities. You took it as a good sign that she came to your work and told you that she was using drugs again, and say that this "took a lot." I agree in part, because this means that on some level, she does want help. But I wonder why she did not wait until you were at home. It is interesting to me that she chose coming to your workplace as the venue in which to tell you something so personal and emotional.

From this piece of information as well as your description of how she's acting at the treatment centers, it sounds like there is more going on with your daughter than drug abuse and dependence. She also sounds like she has issues with dramatic and histrionic behavior, basically attention-seeking far beyond the norm of what constitutes normative dramatic teenage behavior. Coupled with her impulsivity and destructive behaviors, this makes me wonder if perhaps these facilities are failing to address a deeper issue with your daughter.

To me it sounds like your daughter is exhibiting tendencies toward Borderline Personality Disorder (BPD). Are your daughter's relationships very volatile (like this teenager whose mom feels she is emotionally abusive), does she tend to either idealize people or completely hate them, is she impulsive in many ways (yes, from how she acted in the treatment center), does she self-harm and have issues with maintaining stability in any aspect of her life (identity, friendships, grades, relationships)?

If you say yes to many of these, I would get your daughter evaluated by a professional who is an expert in Borderline Personality Disorder. If this is the issue, she may benefit from an intensive outpatient program that includes group and individual therapy, especially if you can find a program that is focused on Dialectical Behavior Therapy (the DBT you mentioned earlier). I would also start reading books on how to deal effectively with family members who have Borderline Personality Disorder, such as Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder.

Finally, your daughter sounds very angry, deep down, and may be getting back at you or other important family members by throwing away her opportunities to get better in these treatment facilities. She knows full well how expensive these places are and how desperately you are hoping she takes them seriously, yet she flagrantly acts out and gets kicked out. Does she get along with you, her husband, any siblings? Individuals with BPD are very sensitive to perceived or real invalidation. She may have a lot of unresolved hurt and anger toward family members, that is driving her to act out and to use drugs.

Therefore, I recommend that you keep your daughter around, if at all possible, rather than sending her away to another treatment center. This will allow you to begin family therapy with her, which can hopefully address some of these feelings, and allow you and other family members learn how to better communicate with her. Then, possibly, some genuine healing can begin and your daughter may become newly motivated to commit to addiction treatment.

Good luck. Till we meet again, I remain, The Blogapist Who Hopes Everything Works Out.

This post was originally published here on Dr. Psych Mom. Follow Dr. Rodman on Dr. Psych Mom, Facebook, Instagram, Twitter, and Pinterest. Order her book, How to Talk to Your Kids about Your Divorce: Healthy, Effective Communication Techniques for Your Changing Family. Learn about Dr. Rodman's private practice here. This blog is not intended as diagnosis, assessment, or treatment, and should not replace consultation with your medical provider.