Ask Dr. Mike

By Michael Oberschneider, Psy.D. 

Dr. Mike,

Our 16-year-old teenage son has a ton of problems. We’ve tried counseling, medications, hospitalizations, etc., but he’s only gotten worse.  

His main problems now are pot smoking, explosive and volatile anger, school truancy and gaming addiction, and he’s been diagnosed with ADHD, Oppositional Defiant Disorder, depression, and anxiety when he was younger.  

We have zero control over him, and he basically does what he wants and usually spends 12 plus hours a day gaming in the basement. His school can’t seem to do anything, and he’s refused to return to therapy, or to take his medications for over a year. 

My husband thinks it’s time for us to send him away, but we don’t know where to send him. A friend of mine had a difficult teen, and they sent him to military academy, which got him back on track. Our son has been to Dominion Hospital before, but they only kept him for a short time. 

He refused to go to their follow up treatment program, and screamed at us for weeks for sending him to the hospital. I don’t want to send him to another psych hospital, but I guess we will if that’s what’s best. He’s also told us that he will run-away if we try to send him some place again. Your advice is greatly appreciated.

– Mary

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Dear Mary,

It seems that you are at a critical moment for your son; and I’m concerned that his functioning will only worsen if you don’t do something soon.  

Military school can be a very helpful option for struggling children and teens, but your son’s problems go well beyond what any military school can handle. If your son doesn’t follow the rules or runs away, that school may choose to expel him. I’ve seen that happen many times.  

A residential treatment facility or a therapeutic boarding school is probably the more appropriate placement for him given how he is functioning, however, getting that placement right isn’t an easy task for parents.  

A parent I work with whose son is in a similar situation recently asked, “Anyone can have a fancy website, but how do I know if a program is right for my child?” As I told that parent, the decision to send your child away is an important one that you want to get right the first time.  

There can be times when a second program or follow-up program is needed before your son returns home, but given the expense and commitment, moving from program to program isn’t a good thing. Thus, I advise against doing the research yourself or guessing on your own, since there’s a lot that goes into matching a child or teen up with the best program or placement.  

When I work with children or teenagers whose problems go beyond outpatient treatment, I most often recommend The School Counseling Group in Washington, DC.  

The School Counseling Group is comprised of a top-notch team of placement professionals who are very knowledgeable when it comes to finding the exact fit for a child or teen with an away program. I’ve been very impressed with their work with families over the years, and they are outstanding at what they do.  

At 16 you don’t have a lot of time if you do decide to send your son away for treatment. Once he turns 18, he can flat out refuse to go.  

Regarding your concerns about him running away, a good placement professional can speak to you about how best to handle that. There are professionals that can physically escort your son to the residential treatment program or therapeutic boarding school if needed.  

I am hopeful that, with the right program, he will get the help that he needs to get better. While the decision to send a child or teen away for more intensive psychological treatment can be the right thing to do in situations like yours, it can be emotionally difficult for parents. It may be helpful for you and your husband to see a mental health professional for parenting support and guidance. 

Dr. Mike,

Our son is 19 years old and lost. He’s a great kid, but he just can’t seem to find his legs in life.  He tried college, but he didn’t make it to classes, partied too much, played video games all day, and ended up back home after the first quarter with straight F’s.  

He then tried NOVA, but he ended up dropping out of that too with more F’s. The instruction at NOVA was all online due to COVID-19, and he isn’t disciplined enough to learn through a screen. He’s hard set on returning to college, but his GPA is too low for him to apply anywhere.  

My husband and I are thinking that he may not be suited for college. He’s bright, but he’s never been a great student, but we don’t know what else he’d do without a college degree. He also hasn’t wanted to talk to us about school or next steps, and we’ve kind of just left him alone. He recently got a job delivering food, but he only does that every now and then.  It’s also been tough for him to see his friends go off to college and do well. Any thoughts?

– Amanda

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Dear Amanda,

What your son is going through is not that unusual. The expectation is that our teens will head off to college and do great, but for some, the adjustment to college life and independent living can be too much to manage. 

It’s not clear to me why your son has done so poorly at college. You write that he didn’t do well and that he isn’t disciplined enough for on-line learning, so perhaps immaturity is the problem. He was intelligent enough to get into college, but maybe he’s not mature enough to be there.  

It’s also possible that he doesn’t want to be in college, but has gone, and is continuing to try to go, because he believes that’s what’s expected of him. Mental health problems (e.g., depression, anxiety, ADD/ADHD, etc.), social problems or learning problems, could also be factors that are contributing to his failure to do well in college.      

Before he attempts college again, I think you should sit down with him to talk through things.  Asking him why he wants to go to college, why he thinks he’s done poorly, what he plans to do differently, and what he thinks he may want to do with his life, are good questions to ask. Does he have interests or a passion for something that he could pursue at college?  

I recommend he not return until he has greater insight and clarity with a solid game plan, and with understanding your concerns and expectations.

I think you should also explore options beyond college. You write that your son is bright but that he’s never been a great student and may not be suited for college. Perhaps he is better suited to learn a trade – the world will always need electricians, fire fighters, plumbers, chefs, police officers, etc. While these trades require secondary schooling and training, they don’t require a bachelor’s degree. I have worked with dozens of teens over the years who tried college and failed, and then pursued a trade and succeeded.

Your son would also likely benefit by doing some career testing with a psychologist to determine what he’d like to do, and what would fit him best. Career testing could be very helpful with creating a road map for him. If your son has additional mental health struggles, his psychologist will be able to help him with that.  

He also tried to embark on a college career during a global pandemic, which may have contributed to his struggles. I’m hopeful that with the right interventions, good communication, and time and effort, your son will find his way.

Michael Oberschneider, “Dr. Mike,” is a clinical psychologist in private practice. He can be reached at 703-723-2999, and is located at 44095 Pipeline Plaza, Suite 240, Ashburn.