I can't believe it's been more than 4 months since DD entered the residential treatment program, but the calendar doesn't lie.
We had her quarterly staffing in August. The short story is that DD is reacting to being in the program as most kids do - they white knuckle it for as long as they can, hoping to "behave" their way out of the program and back home. It never works. Eventually, their grip loosens, the gig is up, and they go back to their "normal" behaviors, which is to say, they behave abnormally. DD was no different. She white knuckled for the first month, and spent the next two months slowly sliding back to her baseline. Challenges cropped up with peers, staff, and her family. She physically attacked both me and her father in July, which resulted in her losing the privilege of overnight passes to visit home.
Since then, she has been slowly earning her way to longer and longer visits. At this point, she can take 8 hour off-campus visits with me and with her father each weekend, but is not allowed to leave campus during the week unless with staff.
All of this is as expected. The staff is actually relieved that she has reverted back to her old behaviors, as they can now see what we've been dealing with and start to address the changes needed. DD has all the necessary components for successfully completing treatment - she's driven, she buys into the program, and she has fantastic family support from me, her father, her brother, and her extended family. Hearing that from the experts at her staffing was a huge relief.
What wasn't expected, however, is that since that quarterly staffing, her aggression has been spiraling out of control. She has been in near constant conflict with another girl in her cottage. DD's anxiety and aggression levels have sky-rocketed, and she is lashing out frequently, both in verbal and physical altercations. A few weeks ago, she had an episode while she was on a day pass with me. While I was driving her back to the program, she shattered the windshield in my van and punched me. It was terrifying. Fortunately, I was a block from the program and was able to quickly pull into their parking lot where staff removed her from the car and isolated her until the episode passed. There have been more aggression episodes since then, both with staff and family. Each episode is heartbreaking. When it passes, she is overwhelmed with guilt and remorse. She is in a very negative place right now, struggling to recognize anything good about herself.
This week, the staff will be modifying her medications in the hopes of reducing her agitation and aggressiveness. The medications she takes are very serious and come with potential side effects that are very troubling to read through. It's been a difficult time weighing those potential effects against the potential benefits for DD. Lots of lost sleep. Lots of anxiety. Tons of time spent on a brain train, questioning my decisions over and over again. I've reached an uneasy peace with those decisions, but they continue to weigh on my heart.
DD's 15th birthday is in a few days. And I will only see her for a few hours that afternoon. I can't take her home. I can’t even take her off campus. I can't have a big family party for her. I can't wake her up in the morning by singing the birthday song to her, make her favorite birthday breakfast... 
We will celebrate her birthday of course, but it will be different, as it must be right now.
There is no better place for her to be right now. I know this. I know she's being cared for by the right people in the right program. I know that this is the right path for her.
It isn't, however, an easy one.
