Taking in a teenager
March 1, 2016 10:29 AM   Subscribe

My 17 year old sister is pretty miserable living at home. She's about 3-4 years behind in school, suffers from severe anxiety, and only leaves the house to go to doctor appointments and therapy. My parents are at their wits end with her; they are spending more time yelling at her than working with her. My husband and I are strongly considering asking her to stay with us, but we could really use advice from anyone who has done this before. Is this a good idea? What do we need to know? What are not considering?

Here's a whole bunch of background:

We have a 12 year age gap and haven't actually lived in the same household since she was a toddler, but we have always been very close. She has been calling me a lot lately for advice on dealing with my parents and she is just very unhappy with the situation. I talk to my parents regularly and they are very frustrated themselves. I left my parents house at 16 under similar circumstances, but I was much independent and industrious. I am getting the impression that my parents will be ok with this - they just both seem really done with her. If not, she turns 18 in the winter, so I guess she could just make that decision on her own at that point. I understand we will need to arrange for guardianship if she moves as a minor.

I'm not actually 100% sure she would actually want to come. She spent a summer with us a few years ago and really thrived, but that was before her anxiety got to such an extreme point. She has vaguely talked about it a few times, but I think she is also scared of the prospect. We live in a different state, halfway across the country, so this isn't just a matter of a quick drive down the road. I would prefer to ask her first to make sure, before talking to my parents, but I don't want to get her hopes up if they say no.

My husband and I both work full-time out of the house and my sister takes high school classes online. Currently, she stays home with our mom all day and is pretty much never alone. Past attempts to get her back in a regular school environment have not lasted more than a few weeks. She has this idea in her head that she will go to college soon, but at this point she has almost no high school credits. She could continue her online classes or potentially switch to a GED course or alternative high school program instead. I'm not sure how well she will do unsupervised if she stays home alone all day.

Her anxiety is in regards to eating and going out in public. She has not really done well following through on the recommendations in therapy, and rarely completes schoolwork or chores when told to do so. She often feigns illness to get out of doing things she doesn't want to do. I'm not exactly sure how to handle this, but any approach should be better than the yelling and belittling she is dealing with now.

On top of things, she has pretty much no daily living skills; she doesn't know how to cook, clean, do laundry, drive, etc. I'd like to work with her on learning these things - not just so she can help carry the added load, but also so she can learn some responsibility and gain a sense of accomplishment.

We also have a 2.5 year old son that she adores, but takes a lot of work to wrangle all the time. My sister has been raised as an only child pretty much her entire life, so I think that will take some adjusting to. She is very interested in early childhood education as a future career, but I don't think she's reliable enough to watch him alone for more than a short period of time.

I don't think she would be too much of a burden financially. I'm more concerned about just having enough time in the day to take care of her needs. I know it's going to be a challenge, but I really want to give her a better chance before it's too late.

We are going for a visit in a few weeks and I want to test the water then, proposing that she comes for the summer. If you have any insight into the situation, I'd love to hear it. I just want to make sure we approach this well and don't end up making things worse for her.
posted by galvanized unicorn to Human Relations (19 answers total) 5 users marked this as a favorite
 
Dealing with my own just turned 18 year old, who had a number of issues throughout high school, I would strongly suggest you have an option for schooling for her, as well as a therapeutic day program initially. I know lots of adults who have done these sorts of programs, and when things started getting bad for my daughter, I knew that it would help her a lot. The formal name is "partial in patient" therapeutic program. They will assess her, get her started on meds, and she will be surrounded by people just like her. My daughter did a program for 2 weeks, and then started a dual enrollment program at a Community College. She had to take a placement test to attend, and they gave her classes based on her scores. This might be a great thing for your niece if such a program exists either where you are, or she is.

The other thing to keep in mind is that teens are a lot like toddlers- they are growing in unbelievable ways, their minds are not fully formed, and they think they have the whole world figured out. Add to that social media, and OH BOY. If you know you can help her out and not get into power struggles with her (and your spouse can do this too) than I think you should take her in, if not, I would try and help her get set up in programs like the ones above and offer her a place for vacations and holidays. That might be a better idea for you all.
posted by momochan at 11:00 AM on March 1, 2016 [11 favorites]


Your sister sounds like my middle (step)son. His biological mom and dad live about 400 miles apart. He used to live with his mom, who is lovely but an enabler. After the boy started escalating his troubles from petty (skipping school, letting his mom do his homework for him, being generally lazy) to serious (a series of cough medicine shoplifting busts, a crazy fight on school grounds, lying even when facing the truth) we gave him no choice but to move in with us. It's been very beneficial, but a tough ride.

Like you, we've been focusing on life skills. We had to start at a really fundamental level--hygiene, laundry, cooking basics, budgeting, you name it. He has a tendency toward social self-isolation, and we learned over time that was coming in part from his growing embarrassment over not having those skills. He still has a tendency to lie, which we're dealing with, but it's much less bad now that we're all on the same page (e.g. he knows that we respond to his fibbing with silence and a subject change, no longer with accusations of lying).

The one possibility I'd prepare you for is that your sister might behave this way no matter her environment. With our kid, changing environment initially just changes the focus of his anxieties and anger. When he was living with mom, it was mom's home environment that took his wrath. When he moved in with us, it was our home environment that took his wrath. We're better prepared to be stern about things than mom, by her own admission, so we battened down the hatches and weathered the tempests until they started to normalize. At the end of the day, that's what we all feel is best for him: stability and predictability, in all things we can control (including consequences of his rule breaking). The best advice I was ever given about this was to always make the conditions and consequences of your situation as clear as possible up front, almost like a contract--if you live here, the rules are ABC and the consequences of breaking those rules are XYZ.
posted by late afternoon dreaming hotel at 11:07 AM on March 1, 2016 [4 favorites]


I would be hesitant moving someone across the country who is in pretty dire need of social supports and therapy.

She should be hitting all kinds of independent milestones and she is working on very basic things. I'm not sure if you can address what is actually going on here. She could have an eating disorder, which requires an extreme amount of intense treatment and can be very deadly. It could account for hey lack of concentration and energy . There really isn't enough to go on here though.

Her current mental health providers need to be a part of this process. Any time one moves across country it is seriously difficult. Adjustments could make the situation worse, not better.
posted by AlexiaSky at 11:10 AM on March 1, 2016 [2 favorites]


Since she does her schooling online, does this need to be an all-or-none solution? How about a trial of about a month or so? So that you can assess her needs a bit better in person, and discuss with your husband whether or not you are really ready to take her in full time. After a few weeks you and your husband can try to prioritize her issues and then come up with a plan and see if you see yourselves fitting into that plan. And then of course discuss the plan with her and see what her expectations and goals are, and if you and hubby can reasonably meet them.

If you decide that she should/could stay, you might look into finding a home schooling co-op. It would give her a bit of socialization and some accountability, without overwhelming her by dropping her into a full-blown school setting.
posted by vignettist at 11:39 AM on March 1, 2016


It sounds like she needs a far more intensive and structured therapeutic and educational structure than she's getting at home or would get in your home. Being largely unsupervised in a new place with new expectations will be a big hurdle for her. Add in a toddler and both you and your husband working away from home, I don't think that your sister will receive the support she needs to transition to a healthier state. Based on what you've written about her current challenges and non-compliance with therapeutic goals and school, I don't think that she has enough resources to succeed in your home.

Maybe there's a third option where she's far more involved in a therapeutic setting that also can help her with education, both practical and formal? Maybe her current therapy team can help with suggestions and creating a more intensive therapeutic program for her in her current location? Certainly her current team is not of the mind that their approach is meeting her needs well. If they do, it is time to find a more robust team and program(s). While I agree that her current situation sounds unhealthy and unproductive, I think you're underestimating how much help she needs. A new environment could help, but it will also bring new challenges that you may be ill-equipped to handle without compromising the attention you need to be devoting to your own child.
posted by quince at 11:50 AM on March 1, 2016 [2 favorites]


I think that you should do some research on Intensive Outpatient Programs (or the less common now Partial Day Programs) and get her into one, whether that is more feasible at her current location (which may be the case because of insurance) or if you think you could better manage that situation or provide her better resources (which may be the case if you live in a larger or better-resourced city and/or compliance issues regarding your parents) from your home.

Your sister has a potentially fatal illness - possibly two potentially fatal illnesses - and y'all are all kind of faffing around. Get her some HELP. 3-5 days a week, several hours a day, for 6-9 weeks to start, someone supervising her when she's not at the hospital, worry about school later when this is no longer an emergent situation.
posted by Lyn Never at 11:55 AM on March 1, 2016 [12 favorites]


Having a messed up teenager alone in your house all day, especially one who has never spent time alone, is a risky proposition. Can you switch to part time for the summer? Half a day sounds a lot less trouble-making to me.

How long is this upcoming visit? Can you make it a week? If a week, you can keep quiet until you size up the situation and decide whether or not to make the offer near the end of the visit.

If you did offer, I would frame it as "visiting for the summer again" and, again, size up how the summer goes before deciding to make the offer permanent. Sounds like your parents might refuse to take her back, though, consider that possibility.

Don't assume her problems are all rooted in anxiety. Your description reminds me of a relative of ours who turned out to have much deeper problems than the obvious ones. Of course I am not saying there must be more, just keep in mind you don't have the full picture yet. Be extra careful leaving her alone with your son.

What you're wanting to do here is commendable. There's no way to get a guarantee on how it will work out, you have to make your best guess and try it or not. I do think leaving her alone 9 hours a day sounds like trouble, at least in the beginning.
posted by mattu at 12:29 PM on March 1, 2016 [3 favorites]


Is your sister medicated? Because that's the one thing you didn't mention in your question as a possible solution. I work with a lot of kids who have the same kind of symptoms you describe, and for many of them, medication is life-changing. It allows them to function. If your sister is not medicated, or if she is and her symptoms are still not improving, she needs to see a psychiatrist and find a medication regimen that helps her. I'd make that a precondition of her moving in with you. Because right now, I can't see any way that living with you is going to improve her situation.
posted by decathecting at 1:01 PM on March 1, 2016 [1 favorite]


I left my parents house at 16 under similar circumstances

Do you think your parents/the environment in their house is contributing to her issues? If so, that seems like a good reason to take her in--I doubt this would be an easy transition for any of you, but if getting her out of there is in itself a positive then it's worth trying.
posted by chaiminda at 2:09 PM on March 1, 2016 [5 favorites]


Response by poster: To clarify:

She is not currently on medication. She has taken it in the past, but not for very long. She spent about two months last year in an intensive outpatient program, but basically revered her progress after leaving.

My parents are very resistant to the recommended treatment (medication, techniques, sometimes refusing to take her to appointments, etc.) and that is why we feel so strongly about taking her in.

Thanks for all the answers so far, this has really given me a lot to think about.
posted by galvanized unicorn at 2:11 PM on March 1, 2016 [5 favorites]


I can see a lot of ways this could go wrong... but I still think it's worth trying to take her in. Yes, she would be alone for much of the day. But it sounds like her parents aren't willing to give her the recommended treatment, and you are. That's big. It also sounds like your parents have given up on her, and you haven't. That's bigger. It may be that being around your mom all day is a lot worse for her than spending time alone.

If she trusts you, hopefully you can sit down with her and have some honest conversations about what you'd both be hoping for, and expecting. I think she should go into this with very clear rules established. If she does this she will get that, and if she doesn't do this then this will happen. I have a feeling that she will thrive in a place where she knows she is loved but there are very clear goals, especially if you are willing to get her the treatment she needs.

Maybe this is too ambitious, but I wonder if there may be some sort of volunteer situation you could get her involved in, where she would simultaneously have a job to do and adults keeping an eye on her during the day. Is there a cause she's very passionate about?
posted by Ursula Hitler at 2:54 PM on March 1, 2016 [1 favorite]


Since she's done it before, do you think your parents lack of support/compliance was why the IOP didn't "stick" or do you feel like she didn't get the right kind of care?

If you can get it to happen, I would definitely say get her to your house and try again, where she'll have interested parties there to help her with her extra-program assignments and medication compliance.
posted by Lyn Never at 3:14 PM on March 1, 2016 [1 favorite]


From an anon commenter:
At 17, I suffered terrible anxiety, attempted suicide, was in therapy and was not getting along with my parents. I also had rather poor "life skills." I was doing better in school than your sister, but I was the family "problem child" and, le gasp!, due to being ill and suicidal, I had at least two grades per year that were lower than a C. This made me the shame of the family and the family Black Sheep.

Growing up, my grades in school were incredibly important to my parents and my older sister had already been trained to be useful to my mother, so it was too much hassle for my mother to bother to teach me to cook or clean. It was easier to do it herself or tell my sister to do it. I also had been sexually abused and had an undiagnosed medical condition. So, saying "I am studying/doing homework" was an easy way to get out of any chores I was asked to do. I felt awful all the time, and I just honestly did not the energy to do everything my sister did. My sister does not have the serious medical condition I have.

I fought to go to therapy. I strongly believe that therapy needs to be something someone chooses. I think it is very different to say "I have a problem and I would like someone to help me work through it. I want therapy." from being told "You have a problem. We want to send you to a mechanic therapist to Get Fixed because it annoys us and we can't bother to deal with you." I know that is probably not what you intend, but very often a child with this level of problems is more like "the presenting problem" than the ACTUAL problem. The actual problem can be the family dynamic, compounded by undiagnosed learning disabilities/health problems/whatever.

At age 16, I had made arrangements with a friend of the family who was willing to take me to therapy etc etc and the therapist would not see me because I was a minor and did not have parental permission. So then I went through official channels at school and I was told that the only way that they could get me the therapy I wanted was to put me in foster care. Otherwise, the lack of cooperation from my parents made therapy a non-starter. I refused foster care. I knew they would not feed me like my parents did and so forth. I had no diagnosis, but I was not stupid. I knew that I needed some of the good things my parents were providing.

My older sister did consider taking me in. It never quite went that way. I am glad it did not. She was rather judgey and controlling and I think it would not have been good for me.

Instead, I got married at a very young age. I soon found myself unexpectedly pregnant. So I ended learning to cook and clean and all that as a wife and new mom. It was ... boot-camp-ish in nature. But I rose to the challenge. I was never the perfect homemaker, but I was a great wife and mom.

I strongly disagree with some of the existing comments that sending her to therapy or getting her mental health problems medicated is critical. For me, just getting away from my rapist and away from people who treated me like I was a total fucking loser for not making Straight As etc etc made me vastly more functional.

Please consider offering her the chance to come visit for the summer without hinting at living with you. One of the ways I survived my teens was by spending the night at an aunt's house frequently and having intensive hobbies that took me away from home for much of the weekend. One spring break, I basically lived at my aunt's house the entire 9 days, only going home to get clean clothes occasionally.

Consider just trying to HELP her learn to care for herself. She may very much be willing to learn this if it is done in a supportive manner and not something she is ordered to do like a bad girl and failure and someone you expect to be lazy and to not try. Please try hard to view 90% of her shitty behavioral issues as a product of the environment.

My anxiety problems were largely resolved by getting a proper diagnosis of my medical condition. I had functional hypoglycemia and it causes anxiety as a side effect. Eating better is a primary treatment of this condition. I had an underlying condition causing the hypoglycemia and when that got treated, my blood sugar stabilized and my anxiety mostly went away.

Consider having her evaluated for hidden health problems and hidden learning disabilities. But start with the assumption that she never got the chance to be a decent human being. It isn't her fault. She isn't lazy or not trying hard enough. She is a child who never got the chance.

It will take time for things to get better, no matter how you handle it. But some of that getting better will occur merely by removing her from a toxic, hellish environment. Try hard to resist sounding like you are judging her or you think she is bad or not trying. She is probably trying a helluva lot harder than you think or she would likely be in jail for assaulting someone. Children have very little power to resolve their problems.

I left home. I moved far away. I mostly stayed away. Yes, I also did therapy, etc. But, mostly, just getting the hell out was the cure I needed.

I hope telling you that will help you give her a real chance. That may be all she really needs. It is something she likely never had.

Best of luck and thank you for trying hard to be a decent human being in a world where that is endlessly hard.
posted by restless_nomad at 3:16 PM on March 1, 2016 [10 favorites]


I strongly disagree with some of the existing comments that sending her to therapy or getting her mental health problems medicated is critical.

She has an eating disorder and she's afraid to go out in public. Those are the kinds of problems therapists are trained to treat, and not problems anybody should have to struggle with alone. Maybe she will thrive just from being apart from her parents, maybe getting a medical diagnosis or being treated for a learning disorder will help her... but I think you are looking at what worked for you and those may not be the same things this girl needs. She is in therapy, and I think it would be a big mistake for her to stop and try and get by alone now. Whether she needs medication or not is something that should be decided by her therapist.

OP, having her stay with you for the summer is a good idea. (But have her continue to see a therapist during that time!) Toward the end of that "visit", if it seems to be going well, you can talk about her staying with you longer.
posted by Ursula Hitler at 3:51 PM on March 1, 2016 [1 favorite]


It really depends on your sister.

My mother was more of the belittling and sending you to therapy for your own good regardless of how you feel about it type. We had explosive fights, I didn't get any better, and therapy just made me more mad at my mother (because I didn't want to be there, didn't trust the therapist she had chosen, resented the implication that I was the problem when I was merely reacting to my shit home environment). I had an eating disorder that nobody knew about (didn't eat lunch for the last 2 years of high school), skipped 49% of my classes (no friends in them, found the content horribly boring and irrelevant, but I knew the cutoff for getting in significant trouble was 50% so I stayed under it), and my mental health was a total mess. Paradoxically, what I needed the most was for people to back off and let me have control over aspects of my life beyond a) did I eat the thing, and b) did I go to class. The scenario you describe for your sister in your house would have been really nice for a kid like me (my sister too but my brother would hate it).

It sounds like you are coming from a place of compassion/support and not fixing/rescuing. It also sounds like her current situation is at a dead end and she's about to be left with even less resources than she currently has (when she turns 18). I understand the desire to do a "trial run" but keep in mind that this is a KID who currently feels like her parents hate her, like she can't do anything right, and who has already been institutionalized (which can be traumatic and lead to feelings of abandonment at very least); telling her "your stay in this environment is conditional because our affection is conditional" might not be the vibe you want to start off with. She already knows that you can kick her out if you choose to, you don't need to remind her of it. Basically, do it but realize that in doing so you are adding a new person to your household and you cannot control this person. Do set rules but don't make the consequence to those rules "or we'll kick you out" because a) that never works, b) she'll resent you for it, and c) it kills the trust (you'd rather she comes to you when she fucks up than have her freak out and hide it, especially since her coping mechanisms seem to lean to the self-destructive side).

Other things to consider: some people crash when they go from an unsafe space to a safer space because they simply don't know how to function without being in crisis so be compassionate and patient, do not suddenly expect her to be able to do things that she currently cannot - start with where she is and help her gradually increase what she is capable of at a pace she finds doable, do not expect her to be Normal by a certain point because Normal may never come and that's just how disabilities work.

When I moved out of my mother's in my 20s, I spent the next year half-assing my classes and playing video games. It took me longer to graduate university, sure, but in the grand scheme of things I really don't regret it. I did what I had to do in order to feel OK with living. Current!me is very glad that younger!me did absolutely nothing then because absolutely nothing > harming myself. I needed to calm down and be safe before I could formulate any kind of plan for my future and in the grand scheme of things, a "lost" year or two is nothing so long as you're around to actually enjoy a few more because of it.

Best of luck to you and your sister!
posted by buteo at 5:02 PM on March 1, 2016 [4 favorites]


Since you already have your child in child care, can you change the budget to have a fantastic nanny instead? One who will focus on your toddler but also be a paid friend to your sister (and hopefully teach her some life skills). Can you have a housekeeper come through and also mentor her in those life skills? Both of these added (but necessary) expenses help YOU as well as your sister. And it is fair to up your own self care. Does your niece have any interests like piano, dance, coding etc where you could find a one-on-one mentor/tutor to help your sister feel accomplished at something, learn a skill, socialise, etc AND you also get an hour or two where you can recharge.
posted by saucysault at 6:04 PM on March 1, 2016 [1 favorite]


If she is interested in getting better then do take her in, since your parents are destroying her. If not, then there are programs for troubled teens that could help her. They are all over the country, some good, some bad. They stay there until they get their shit together. They are offered structure, therapy, medication if needed, and the chance to finish high school. The situation she is in now is very dangerous for her and I think that you should move fast with whatever you decide for her.
posted by myselfasme at 7:51 PM on March 1, 2016


telling her "your stay in this environment is conditional because our affection is conditional" might not be the vibe you want to start off with.

I don't think anybody was suggesting that. Establishing rules isn't the same as telling her she has to achieve certain goals or you'll stop loving her.
posted by Ursula Hitler at 8:17 PM on March 1, 2016


She has severe mental health issues and your parents are blocking her from getting treatment, so just based on that fact alone I think it is a moral imperative to do anything you can to get her out of their house, as long as you can do so without endangering your own health, family, or finances.

I say that as a person with a sibling with severe mental health issues who is now over 30 years old and rarely leaves the house, isn't able to hold down a job, etc. The codependence issues are so tough, but despite not wanting to shoulder their problems, you still don't want to see your sibling suffering or living on the streets. The idea that maybe if you had gotten them more aggressive treatment sooner, maybe life could have been different - that's a painful thought to live with. And when your parents are aging and you may need to do things to care for them, it will definitely be harder on you if you also feel this obligation to care for her to some extent. So my opinion is to move forward with trying to help her and do your very best. If it doesn't work out maybe you'll have to scale back and draw more boundaries later, but at least you will know you tried.
posted by treehorn+bunny at 8:32 PM on March 1, 2016 [7 favorites]


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