Psychiatrists/Therapy - Does any of it actually help?

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Step son is High functioning, aged 17. I have been in his life since he was 8. We are experiencing a lot of problems with him and life is very difficult. He steals: Money, food, whatever he likes. Nothing seems to stop him. He has paraphilias which also involve the stealing, or it is better to say that he steals to facilitate his paraphilia. We now live in what is almost like a jail for his father and I. We have to lock up downstairs or there will be no food left and have to keep our bedroom locked up at all times.

He has had 'therapy' for his sexual behaviours and we never let him get away with stealing money etc and he is made to repay us when he has done so. There has been no improvement at all and he has made it obvious that he does not intend to change. I believe he knows he is doing wrong. Therapy and his psychiatrist has talked to him about these things but still no change.

We (his father and I) are emotionally exhausted by it all. I guess my question is: has anyone actually found that any of this 'therapy' and expensive psychiatric treatments actually worked? I am sick of never being able to afford a simple holiday because of all the wasted money on this person. I know some of you will attack me because of my attitude but I really have had enough and I just want him out of the home.

Get a divorce?

So very helpful... not

My question was about therapies not whether I should leave my marriage.

Terse, perhaps, but not unhelpful.

1) Your minor step son has a host of issues (not intrinsically due to autism-by the way-although some autistic persons have them)
2) Your minor step son is apt to need assistance after reaching majority.
3) His father will need to help him.
4) You clearly have no affection for said stepson, despite helping to raise him since he was 8.
5) You resent spending money and effort on this person who clearly needs help.
6) You feel imprisoned in the family residence.
7) Presumably his father recognizes his responsibilities to help his son, if possible, so he is not a ward of the state, or in prison, or you would not be writing here hoping for an out so you don't have to spend money on him and can kick him out.

So, while divorce seems the obvious option, I suppose you could keep your finances separate, and move out while staying married to the boy's father.

As far as whether his therapies are worth the money or not; I doubt anyone here will have any idea as to general success rates especially since your step son's issues are beyond typical autism issues. I do not doubt that many autistic person's have sexual special interests, but you did not say specifically what he is doing. I can make guesses based on your post that he is stealing undergarments, but i doubt anyone is going to have specific information on that.

Food hoarding (He is not stealing food, as he lives there, and presumably is allowed to eat, so I would characterize it as sneaking and hoarding perhaps) is not unheard of either, and it is obviously harder to deal with in a tall-near adult than in a child who you cna just put food out of reach from.

Stealing money is not typical of autistics, but if it is connected with his obsession, I guess I can see how you could draw a tangential relationship. Again, I don't know if anyone can give you % success rates for dealing with that --and locking money in a safe may be the best short-term fix.

Regardless, I stand by my prior shorter answer, because you are clearly miserable and your only options are 1) status quo (which you clearly are not OK with and that is your right. 2) Encouraging the father to abrogate his responsibilities to his son, who is still a minor and who may need guardianship beyond that or 3) Get out.

You have made a lot of assumptions.

'You clearly have no affection for said stepson, despite helping to raise him since he was 8' really? you are surprised at that? You only have some of the information of what his father and I are going through. No, I have no affection for him now. I do not have hate either. I am just tired. His father does all that is in his remit to help his son. The mother checked out a long time ago.

His paraphilia runs to more than stealing panites by the way. The food he steals and yes it is stealing is not his own food. He is very well fed and catered for, he has all he needs and more.

My question about whether people have found therapies helpful still stands and I would like to hear from others about that. I guess from the lack of replies that the answer is no.

No--what I am telling you is you are unlikely to find people with similar experiences as your step son's issues are not intrinsic to autism and therefore the therapies people here mostly use like ABA, Occupational Therapy, Speech Therapy, Physical Therapy are not going to have success rates relevant to you, and so you won't likely get an answer to what you are trying to ask on this site.

So if that is the only information you are looking for and you don't want other input, you need to find a site for parents of children with paraphilia issues, which is going to be more relevant. That therapy is a completely different sort than what the regular posters here are going to be familiar with.

My first thought reading the OP was that you might have a misdiagnosis in your hands.

A mis-diagnosis? It's possible. He was never really given a firm diagnosis. I believe it was PDD nos.

To clarify, i was interested in hearing about if users found psychological therapies helpful. He has had many psychiatrists appointments, check ups, an 8 week in patient stay for diagnosis of his behavioural issues, therapy and counselling, all of which gave not a single piece of help or advice.

He has had therapy/counselling for the sexual behaviour issues. Ostensibly to determine if it was a phase etc. It obviously is not. As far as i'm concerned he can keep his sexual preferences to himself: it's his business but when it affects others in the house (via the stealing objects and lying and let's say odd behaviour) then it becomes a problem for others too.

But yes, maybe a site for parents with these problems might be more suitable. His psychiatrist and therapists are insistent that it is related to AS.

Try different psychologists and therapists, and get a fresh second opinion by people with fresh eyes on the current situation.

It sounds like you have very sincere people, who want to try all kinds of things to fix the problem they have labeled. However, the symptoms sound like they don't really fit that label to some of the posters in this thread, including me. You won't do your stepson any favors by continuing with their treatment under a misdiagnosis. To have a little less generosity to the psych team, I could note that you mentioned you have spent a lot of money with them. At a minimum, that makes them interested parties, and you should evaluate their recommendations in that light. If your stepson has an anti-social personality disorder rather than something on the autism spectrum, would they have to refer him elsewhere for treatment?

I don't think that the two diagnoses have a lot in common internally, despite the common elements in presentation. That means they need different treatment. Given that people with HFA can adapt and integrate into society with far greater success than people with ASPD, any professional who didn't feel sure would prefer to diagnose their patient with the "better" problems. Once people decide, even professionals can fall victim to confirmation bias.

The only relationship I can see between these issues and the autistic spectrum is special interest hyperfocus and possibly OCD which is commonly a co-morbid of autism.

Meaning that paraphilia itself is not an autistic trait, but that because autistic people tend to hyperfocus or fixate on special interests, that autism could make a paraphilia stronger and more intense or urgent. So perhaps what the therapists meant is that the autism (and/or a co-morbid presentation of OCD if he has this) is making his issues that much more intense than they might otherwise be.

In the general case, special interests when positive or neutral are encouraged and used to teach skills and to broaden horizons and educate. When negative, we try to transition them to something positive or neutral that they like equivalently or better. It is also not uncommon for these to burn out on their own when something else of interest comes along.

Your problem is going to be the paraphilia aspect, which is bound up with hormones and other complicating factors which again, I think is a special case, and not something people here are well-versed in. I don't think this is remotely equivalent to other behavioral issues like meltdowns that are more common for us. The rates of success in dealing with meltdowns and other more typical behavioral issues (with a psychiatrist, psychologist, ABA specialist or just on our own) will not be a good comparison.

i would suggest looking for something like this http://www.ironwoodmaine.com/what_we_treat.html

Perhaps he was misdiagnosed? People on the spectrum generally do not like getting in trouble. If your son actually has anti-social personality disorder or psychopathy instead of an ASD, he would likely respond better to rewards for good behavior than punishment for bad behavior.

since OP never came back....
catastophising parents and the continued imprissonement in the resulting oppositional behaviour,
i'd go for parental exageration, which happens when control is lost,
outhouse placing is urgent and necessairy, since he's 17 right now
and break the further following of this nefarious path;
a 24h occupation and a radical break in habbits
oh well....

As a person on the spectrum, I'd say 1 out of 3 counselors, therapists, psychologists, etc, are helpful. The others, often because they're more committed to an ideology than the person right in front of them, I'd say not particularly helpful.

Okay, for issues like depression or anxiety, a general practitioner can prescribe as well as a specialist, especially since it's trial and error in a respectful sense anyway. Plus, important to take it in medium steps if one is choosing to phase down a medication.

Other potentially helpful persons:

an academic tutor, who can also give general life advice in passing without making a particularly big deal about it,

same for martial arts instructor or any other individual athletic instructor,

same for job coach or person trying to help find a job.

==============

Not that any of these are that great, but that they're not hindered by the "training" and ideoology of being a mental health "professional." And I mean really, for I am not a fan.

And I'd say this more relaxed approach to a sexual paraphilia is generally the way to go. For example, maybe books which talk about respecting and accepting others even with differences.

For S&M for example, "safe, sane, consensual," and it's actually a pretty good buzz phrase. And other special interests, probably something similar. That is, bending the path in a medium way,

rather than the fool's errand of trying to completely block the path.

And in practice, a lot of this may come down to how to find reasonable persons on the Internet who through a series of medium steps and sensibly protecting oneself, you can learn to trust. And depending on the interest, probably live meet up groups in cities of a certain size. Hey , these are just regular people, maybe a little more creative, but just regular people. Suspect this is what you'll find at end of day