Parents as “Case Managers”

by Shaun Kieran

 

I’ve heard you talk about parenting, especially Special Ed kids, and you spoke about parents being Case Managers.

 

Could you explain a bit?

 

 

Shaun:

 

Here’s a “case” that illustrates some things of the things I’ve seen to be helpful.

 

 

 

Helen never thought it would get to this: thinking and feeling things about her son, and his situation, that were terrifying – and just so sad.

 

Unlike Helen, her husband was able to vent his frustration and indignation more easily, starting when Jonathan was much younger, but now even he was becoming exhausted, and increasingly detached.

 

Yet again, Jonathan (now age 26) had “quit” therapy and stopped taking his meds.  He wasn’t looking for work, and wasn’t even attempting the nominal chores he’d agreed to do as “in-kind” payment of rent – negotiated with the help of the latest family therapist they’d gone to for 4 months.

 

Mostly Jonathan sat in his room – even on warm, sunny days – surfing the net and talking on his cell to either his cousin Rob, or his one remaining friend from Middle School.

 

But even Rob was getting exasperated, and having a hard time being loyal to the idea of who Jonathan once was.  In fact, Rob was becoming filled with dread.

 

Jonathan had been such a delightful youngster, gliding through school so effortlessly – exuberant, creative, really fun to be around. Now, Helen ruefully recalls her early twinges of anxiety about some of what she was seeing, but also remembers being reluctant to say anything, minimizing her husband’s concerns, and even going against some of his efforts to “address” Jonathan’s behavior.  It had definitely strained the marriage.  

 

It wouldn’t quite be fair to say Helen was a parody of June Cleaver, but she’d always intended to be a Mom, which meant loving, supporting, encouraging, defending, protecting, and forgiving her son –  and counting on all that to make everything turn out OK.  But selective denial wasn’t working anymore.

 

One afternoon she saw someone on “Oprah” who called himself as a “parenting coach.”

 

He described some situations very close to home for Helen, including those endless encounters with educational and clinical professionals, most of whom were sincere and competent, but results were disappointing – and expensive. His point: you’re a case manager whether you sought it or not, so why not get it right.

 

 

Amen. Case managers are the ones who keep track of what has happened, and keep the focus on where things are supposed to go – while noticing what’s actually working.  

 

It’s the eye-on-the-ball stance that a good case manager takes that makes the difference for the long haul. Sure, parents love their children more than case managers love their clients, but that should enhance, not harm, the chances for success.

 

Are some aspects of “the problem” innate – biological and medical?  Of course.  Did Helen and her husband contribute to the mess they’re in?  Probably – in fact, almost certainly.

 

But so what?  The point is: where do we go from here?  If Jonathan won’t seek help, that needs to be responded to, but Helen needs to move forward anyway.  Continue to consult with experts.  Ask questions.  Read up. It’s all good.  The Case Manager stays on track, whether the client does or not.

 

Heard about “tough love,” but didn’t like what you heard?  That’s fine – don’t threaten to throw him out of the house.  (Never threaten to do what you don’t really have the stomach to do.)  But use some of the real power you have to not give in, not feed or reinforce, not subsidize, above all not go into denial and “cooperate” with someone who’s not essentially cooperating with you.

 

The point is to feel more and more comfortable managing what’s yours to manage, and sticking to your guns about rules, safety, integrity, etc, with or without ultimatums.

  

It’s not clear whether Jonathan is clinically Depressed or, even worse, suffering from a thought disorder – or other major mental illness.

 

Maybe he’s got the Peter Pan syndrome (“I won’t grow up”) or he’s just a slacker (not likely.)

 

In the postmodern world, parenting often isn’t finished when the kid hits 18 or 21.  Like it or not, effective parenting boils down to love combined with focus, concentration, and learning.  Yes, it’s a job

 

Should his parents talk to Jonathan about it? Of course. They should be totally above board about what she and her husband are up to.

 

Hopefully, Jonathan can finally get his legs under him, and make his way.  In the mean time, the task is having a good life, making the best of what is, and can be, adapting to living together under one roof – but still positioned for future possibilities.

 

 

 

 

 

 

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