Dear Dr. Mike:

Our 15 year old son is out of control and we don’t know what to do anymore. He smokes pot and drinks, disobeys us left and right, is truant from school often, comes home whenever he wants to and screams at us when we try to correct him. He used to be an amazing kid and athlete, but he quit all sports and he’s no longer himself. We’ve tried therapy, but he refused to go. The crazy thing with all of this is that we have no idea why he changed. His problems started in freshman year of high school and have gotten worse this academic year. Right now, we are very worried about him and we are also very worried about his younger siblings who are very upset their brother. My husband wants to send our son to military academy right away, but I am worried that he would hate us if we did that and that he would also probably do something crazy like run away or attempt suicide.

The suicide of that freshman boy at Stone Bridge High School last month has really freaked us out. We don’t want that to be our boy and we really don’t know what to do. We know we need to act fast and hope you can respond to this letter.

Dear Concerned Parents:

I’m sorry that your son is struggling as much as he is, and I appreciate the negative and painful impact his behaviors have had on you all as a family. Not having evaluated your son, my recommendations, as well as my support and guidance, will be limited, but I hope the following is helpful to you.

While I understand your husband’s thinking on getting control over things by sending your son to a military academy, your son is likely not a good fit for that sort of setting given his needs. More specifically, your son seems to be a very angry young man who is acting-out in a number of very concerning ways; his struggles may have an emotional or psychological basis (e.g., depression) and/or may be due to his substance use — irritability, anger and oppositionality are common symptoms of teen depression and substance abuse. In my experience, military academies are not equipped to treat, and most will not even accept, teens with significant mental health struggles and needs.  ou should also know that military school tuition isn’t inexpensive, and if your son is dismissed at any point and time after being enrolled, a lot of military schools won’t refund your tuition.

Unfortunately, as a psychologist, I’ve seen many families lose tens of thousands of dollars in these sorts of moments. The wrong sort of placement could actually make things worse for your son as well.

In my opinion, your son needs to be thoroughly evaluated and ASAP. There is a possibility that all he needs is increased structure and discipline away from home for things to improve (i.e. a military school or boarding school setting), but unless you get him evaluated, you won’t really know how bad things are for him or what he really needs to do to get better.

If his emotional and/or substance use issues are significant, and if he remains unwilling to get help locally, and if you feel that you’ve exhausted all other options, I think you should then take unilateral action as parents on your son’s behalf. Similar to if your son had cancer and was refusing treatment that would help him to recover, you would override him at 15 and get him that help. Given what you’ve shared, your son appears to be on a very steep downward spiral, and he may be a candidate for a program outside of the home – a residential treatment center, therapeutic boarding school, and/or a wilderness program – and he may need to go away to get better against his will.

Yes, he will likely be angry with you initially if you decide to send him to a program, but in the right environment and at the right program he will be evaluated and his needs will finally get addressed; his anger should dissipate as he make progress and improves.

Again, I appreciate the seriousness and the urgency of your moment, and at this point, I strongly recommend that you turn to a professional who specializes in placements in your son’s area of need if your son remains unwilling to address his problems with you at home.

The School Counseling Group in DC has been my go-to referral for these sorts of moments, and I have worked with them successfully as a psychologist for over a decade now.  Peter Sturtevant is the director of the group and a top-shelf professional, and he would be a good person to speak to.  He can be reached at: (202) 333-3530.  I also invite you to call me should you have more questions for me or for additional support.

Dr. Michael Oberschneider, Psy.D, is a clinical psychologist and the founder and director of Ashburn Psychological and Psychiatric Services, a private mental health practice based in Loudoun County. He is a regular contributor to the Tribune.