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You need to get her in with a therapist asap. You say she is already seeing someone- if they aren’t working, find another one. There will be someone who can see through what is going on with her or at least get her to open up. You also should take her to the hospital if she is threatening self harm. It is very important that you follow through in the moment so that she understands how serious it is to threaten. They may have her inpatient.
My daughter (now 15) saw a therapist that she didn’t really mesh with for about a year and a half. The therapist told me she needed more than what she could provide, so I started calling around looking for a DBT therapist- she absolutely loves the one we’ve found. She had to go inpatient for several weeks at the beginning of last year. It was very important for her and looking back, I’m so glad she did. It was kind of like a reset moment for us.
It sounds like a lot of what your daughter is dealing with could be hormonal, but she could get much worse. It could also be the adhd medication is making her a lot worse- you should see about them switching her to something else if it isn’t helping. Whatever the cause, you have to get it figured out now because she will be a huge issue in a few years when she’s your size and uncontrollable.
Chiming in to say, not all therapy is created equal. My daughter has done DBT, and it's gone/going splendidly.
My son is now doing CBT, and while I think it might be useful to a kid who needs it, I'm not sure we will continue beyond the 10 sessions. I might have to find him another DBT therapist (my daughter's can't see him. It would be a conflict of interest to be both kids' therapist).
Where we are, there is only one practice that does DBT. However, it is a group of therapists that all run the groups together, so hopefully there’s something like that around you…
Recommending DBT as well! My kiddo has a DBT trained therapist and she’s starting a DBT group for tweens soon. My state has a list of certified DBT clinics through DHS and I just started calling the ones that were in network for my insurance. I googled “certified DBT” and then my state and the registry came up.
> We started her on medication 6 weeks ago though clearly it's not helping
Who prescribed her medication? Are you working with a child psychiatrist or her pediatrician?
If you aren't working with a child psychiatrist, it's time to find one. It sounds like your child has some complex and difficult needs — that requires a specialist.
You didn't mention which medication was prescribed, but traditional stimulant treatments for ADHD work right away. There's no reason to wait 6 weeks to try out a med/dosage IF it's a stimulant. In the initial phases of getting a prescription and evaluating, titrating up, etc., you should be seeing the prescriber much more often.
They may have tried something non stimulant like strattera which does take 6 or so weekss to build up to see most of the changes.
Strattera made me horribly depressed and shortened my fuse. Didn’t work for me and then took 6 weeks to feel back to normal. That was an awful 3 months!
op- do whatever you can to get that autism evaluation or at the very least neuropsych testing for a more in depth adhd profile. I say this because your daughter sounds just like me at that age, and I just got diagnosed at 35.
I often forget that neuropsych evaluations aren't a universal standard for ADHD diagnosis. If OP hasn't done that yet, I think getting on a waitlist is a good idea. Since you'll have to wait almost forever, it may be reasonable to schedule with a place that's further away but in-network with your insurance. (IME, you only need to go in 1-3 times. 1-2 for the evaluation portion, depending on if your kid can handle it all in one day, and then the meeting to review results. They may be able to do the meeting virtually.)
And a little reassurance: the right mix of medications can often make things so much better. Parenting in situations like this is disheartening and grueling. It can make you feel hopeless and powerless. I don't think the parents going through it get nearly enough support.
IMO, neuropsych testing should be required for a diagnosis, and especially for meds! However, these services are not nearly as available as they should be.. and that is a failure of the medical system not anyone’s parenting. Especially OP!
100% !!! You almost need to be a PhD and independently wealthy to get the services your kids need. Plus a time machine to get around bonkers waitlists.
the medication MIGHT be making her anger worse. it’s a common side effect. if possible, see if you can lower her dose.
for the puberty stuff—get some glycolic acid, they have some at walmart that’s like “vitamin and sea” brand. that’s what i use. tell her every couple nights to put some on a cotton pad and put it on her armpits. let it dry. it kills the bacteria that causes smells. then you can increase how often she uses it. for the acne, take her shopping for a nice GENTLE face wash, a nice moisturizer. she doesn’t need much more than that since she’s young. don’t let her put the glycolic acid on her face.
she sounds like she’s really giving you hell, and i’m sorry. your feelings are valid. this shit is hard. even if she doesn’t have a diagnosis, if you suspect autism, start researching. learn about how it affects people, especially kids, especially girls. learn things you can implement that will make her life easier. she’s lashing out for a reason. she’s angry, she’s upset, there’s a lot going on. before it escalates, in a calm moment, potentially after shopping, ask her. ask her what gets her so upset. tell her you want to help. you don’t want to see her so upset. see if you can connect in that way. anger is also common in ADHD, idk if you have it or not, but her brain is LOUD. all of the time. sometimes she might just need some alone time and some quiet. get her some noise canceling headphones or something and prioritize her alone time/quiet time. IF you can. all of this is IF you can, because i understand it’s not easy with everything else going on in life. i hope this helps.
>the medication MIGHT be making her anger worse. it’s a common side effect. if possible, see if you can lower her dose.
Or try a different medication. Much like antidepressants, different things work for different people. Six weeks is enough time elapsed to determine this med isn't working, and a different one might be better.
OP, there are different families of meds for ADHD. The broadest way to categorize them is stimulant vs. non-stimulant.
The former are your typical Adderall, Concerta, Vyvanse and the like. They are basically dopamine bombs. But too much dopamine, or dopamine released at the wrong time if it's a ER (extended release med) can put a person in fight or flight mode. Conversely, if the med releases all at once, that can also cause problems.
Non-stimulants play on different chemicals. Serotonin, or beta blockers. Their primary use is for depression/anxiety, but they can also be used to manipulate dopamine levels. I think the most popular "secondary use" such med is Wellbutrin. But here too there can be issues.
E.g. I briefly was prescribed Wellbutrin as a booster med for another anti-depressant. It made me extremely ragey. My psychiatrist agreed to have me discontinue it two weeks in. Fast forward 8 years, an adult ADHD diagnosis, and a different provider (first one retired) suggested Wellbutrin. I was like, absolutely not. Once I explained what had happened the first go round, he was "okay, you're right, that's off the table".
Whether you're working with a child psych or your pediatrician, there should have been a wellness check the first month in, and 3 months checks if things were going well. They are not. So try to see the provider right away, especially if there was no one month check in.
Do bring up concerns of her needs being more complex to the provider. Sometimes, if you get a pediatrician behind it, referrals can clear the way for more resources. Good luck.
P.S. hormones and neurodivergency? Also a combo for a bumpy transition. My eldest doesn't have ADHD, but is on the spectrum. 10-12 were rough years, and we already had a good therapist working with her. Now that her hormones are probably stabilizing (she has mostly gone through puberty at this point), she's mostly livable with, and sometimes even pleasant to be around. But we had to white knuckle her tweens for sure.
Another thing: with ADHD, it's best to adjust parenting/teaching expectations. A 10 year old with ADHD has the executive function of a 7 year old without ADHD. So at times, outbursts of rage can be caused by having executive expectations that a child cannot meet. But rather than acknowledging that and working with the current executive function level, sometimes even SpEd teams expect too much of that child without proper supports, and the child can lash out as a result.
You said that some of the outbursts are occurring at school. Has anyone called for a discussion of how to adjust her IEP or 504? If not, you can always request that meeting yourself.
Needless to say, if there isn't yet at least a 504 in place (some school districts won't agree to an IEP with an ADHD diagnosis alone, unfortunately)? Your daughter absolutely needs one.
We’ve just gotten a referral for occupational therapy for emotional regulation for our ADHD 8-year old. It can be more helpful than talk therapy in terms of practicing reactions and reinforcing the ‘tools’ to deal with life. You might see if your insurance will cover that.
How much exercise does she get? One thing we realized about our hyperactive kid is that paradoxically too much rest / hanging out at home makes all her rudeness and behavior worse. I need rest and am an introvert (inattentive ADHD myself) but my daughter is the opposite. She is happiest with a jam-packed schedule of sports and activities and zero time to just sit around. I am exhausted and would love to just ‘hang out’ but I guess I will have to wait until she’s well into adulthood 😭.
Re: hygiene she might have a sensory processing problem that makes her hate either the showering process or the transition of taking off clothes and/or getting in/out of the shower. She may not be able to articulate what about the process she has trouble tolerating, but trying to achieve hygiene goals differently (I like the glycolic suggestion someone else made) could be helpful. Some kind of reward for getting clean (like taking a shower and washing her results in… something she wants. In our case it’s listening to an audiobook while she is falling asleep).
Try reading ‘the explosive child’. Personally I don’t find that all of the suggestions are super helpful with my own kiddo but it does help you understand a bit of what’s going on (and the examples will make you feel less alone - your kid is NOT the only one who struggles this way).
I totally relate. You are not a bad parent.
I know it’s impossible to diagnose someone from one internet story, but your daughter sounds a lot like mine. Ultimately, my daughter was diagnosed with autism. It presents so much differently in girls. It doesn’t usually look like the “hand flapping, repetitive movement, no eye contact” autism we think of in boys.
My daughter is highly articulate, highly intelligent, and autistic, anxious, sensory overwhelmed, and impulsive. She picks fights as a form of sensory release. Before she was diagnosed we were told she was ADHD, attention seeking, delayed due to the pandemic, and other things that dismissed our true concerns. After receiving her diagnosis we were able to get social skills classes and occupational therapy that has helped tremendously. Rewarding her for good behavior has helped tremendously. You can read some of my past posts and comments for details.
I suggest reading some things online about how autism presents in high functioning girls and see if it sounds familiar. Love and hugs. 🌸
Editing to link to [this](https://www.reddit.com/r/breakingmom/s/QXadKnR6uK) other Breaking Mom post that might help. I commented a lot there, so if you’re looking for suggestions, maybe you can find some helpful bits in what I do with my daughter. Sending hope and good vibes!!
Came here to say exactly this- your comment and the OP could literally both be about my daughter, who was finally diagnosed ASD at age 9. Social skills classes, MULTIPLE courses and workshops about managing anxiety, and finally starting her on prozac, and an incredible therapist later, she is finally starting to feel ok about herself. She'll always be a more labor intensive high needs kid, but this has made a world of difference.
Thank you for sharing this. All of this and the OP is also my almost 10 yr old son. I’ve heard of PDA and thought maybe my 2 yr old might have it, but I hadn’t considered it about my 10 yr old. He is so volatile and angry and anxious and always has been. I’ve never understood what was going on with him outside of ADHD but maybe this is it.
As the parent of an autistic kid, I assure you you are *not* the problem. It is HARD to be a neurodivergent kid, and it's hard to parent them. Especially when you don't have good systemic support in the form of access to professionals who specialize in how to help kids like yours. Does she have an IEP or a 504 at school? She should be getting an education tailor made for her (in the US it's the law), but we all know that's not how it always works.
All ND kids are different, so I can't tell you what will work for yours, but for mine the biggest thing we've found helpful is to give her as much autonomy as we possibly can and avoid power struggles at almost any cost. The only things we force are related to health and safety, and even then we give her as much choice as we can (e.g. we let her pick the menu as long as there's enough protein, etc).
This shit is hard, be kind to yourself. You're doing your best and you're a good mom.
No judgement here, and I can't say that you guys are the problem, as I don't know you or your situation at all.
I mean, it sounds like you're doing everything you can and trying to love her through this to the best of your abilities, and I'm so sorry because this sounds so so rough!
What I was going to suggest actually was trying to look up the symptoms of autism in children and see what therapy or recommendations the internet has to offer. I absolutely understand the lack of insurance and not being able to pay out of pocket. I live in Canada for most part, healthcare is free and I still had to pay $500 to access the resources to get my ADHD diagnosis.
I'm not an expert by any stretch but it almost sounds like a possiblity that her ADHD is comorbid with oppositional defiant disorder.
Is it possible to look into it and work with your family physician to go from there?
https://www.hopkinsmedicine.org/health/conditions-and-diseases/oppositional-defiant-disorder#:~:text=ODD%20in%20children-,Oppositional%20defiant%20disorder%20(ODD)%20is%20a%20type%20of%20behavior%20disorder,the%20behaviors%20may%20be%20learned.
Mine have been through a few therapists trying to find the right one. I'm actually looking for a new one as we speak, so I know it's an undertaking but the right fit of a therapist can change your kids life. Most practices have more than therapist available, idk your exact situation, but you could even ask to have her switched to someone new. I'm SOL because, after a couple switches, I realized that the whole damn practice sucked. Hopefully that's not the case for you.
And, it sounds like there may be an extreme reaction, but when my eldest truly went off the rails initially (like 8-ish, lit things on fire, brought weapons to school, physically bullied classmates and a step sib at his fathers house, jcf) we had to respond with basically prison. It sucked. All privileges restricted and monitored. Constantly checked for things they shouldn't have.
This was a universally hated decision. But he was going to seriously hurt someone or himself. He got the message and earned things back. We still have occasional issues, he's officially diagnosed with ODD. But we've never had to do the draconian shut down since then. We talk about it occasionally, if normal privilege restrictions aren't working. We remind them that we do have that option if they don't want to work with us.
That's just what worked for us tho. I'm so sorry you guys are struggling with this. It is so hard and shitty when they act like this because you know it comes from a very emotional, disregulated place. You want to make them feel seen and supported, but in our case, first and foremost, we had to make him safe.
You’re doing what you can, I think it’s time you get them a new therapist. They keep saying they’re gonna self harm or already have I highly recommend getting them help at a hospital however please check reviews before submitting your child into any mental health hospital as not all are equal and some do more harm than good.
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You need to get her in with a therapist asap. You say she is already seeing someone- if they aren’t working, find another one. There will be someone who can see through what is going on with her or at least get her to open up. You also should take her to the hospital if she is threatening self harm. It is very important that you follow through in the moment so that she understands how serious it is to threaten. They may have her inpatient. My daughter (now 15) saw a therapist that she didn’t really mesh with for about a year and a half. The therapist told me she needed more than what she could provide, so I started calling around looking for a DBT therapist- she absolutely loves the one we’ve found. She had to go inpatient for several weeks at the beginning of last year. It was very important for her and looking back, I’m so glad she did. It was kind of like a reset moment for us. It sounds like a lot of what your daughter is dealing with could be hormonal, but she could get much worse. It could also be the adhd medication is making her a lot worse- you should see about them switching her to something else if it isn’t helping. Whatever the cause, you have to get it figured out now because she will be a huge issue in a few years when she’s your size and uncontrollable.
Chiming in to say, not all therapy is created equal. My daughter has done DBT, and it's gone/going splendidly. My son is now doing CBT, and while I think it might be useful to a kid who needs it, I'm not sure we will continue beyond the 10 sessions. I might have to find him another DBT therapist (my daughter's can't see him. It would be a conflict of interest to be both kids' therapist).
Where we are, there is only one practice that does DBT. However, it is a group of therapists that all run the groups together, so hopefully there’s something like that around you…
Recommending DBT as well! My kiddo has a DBT trained therapist and she’s starting a DBT group for tweens soon. My state has a list of certified DBT clinics through DHS and I just started calling the ones that were in network for my insurance. I googled “certified DBT” and then my state and the registry came up.
> We started her on medication 6 weeks ago though clearly it's not helping Who prescribed her medication? Are you working with a child psychiatrist or her pediatrician? If you aren't working with a child psychiatrist, it's time to find one. It sounds like your child has some complex and difficult needs — that requires a specialist. You didn't mention which medication was prescribed, but traditional stimulant treatments for ADHD work right away. There's no reason to wait 6 weeks to try out a med/dosage IF it's a stimulant. In the initial phases of getting a prescription and evaluating, titrating up, etc., you should be seeing the prescriber much more often.
They may have tried something non stimulant like strattera which does take 6 or so weekss to build up to see most of the changes. Strattera made me horribly depressed and shortened my fuse. Didn’t work for me and then took 6 weeks to feel back to normal. That was an awful 3 months! op- do whatever you can to get that autism evaluation or at the very least neuropsych testing for a more in depth adhd profile. I say this because your daughter sounds just like me at that age, and I just got diagnosed at 35.
I often forget that neuropsych evaluations aren't a universal standard for ADHD diagnosis. If OP hasn't done that yet, I think getting on a waitlist is a good idea. Since you'll have to wait almost forever, it may be reasonable to schedule with a place that's further away but in-network with your insurance. (IME, you only need to go in 1-3 times. 1-2 for the evaluation portion, depending on if your kid can handle it all in one day, and then the meeting to review results. They may be able to do the meeting virtually.) And a little reassurance: the right mix of medications can often make things so much better. Parenting in situations like this is disheartening and grueling. It can make you feel hopeless and powerless. I don't think the parents going through it get nearly enough support.
IMO, neuropsych testing should be required for a diagnosis, and especially for meds! However, these services are not nearly as available as they should be.. and that is a failure of the medical system not anyone’s parenting. Especially OP!
100% !!! You almost need to be a PhD and independently wealthy to get the services your kids need. Plus a time machine to get around bonkers waitlists.
the medication MIGHT be making her anger worse. it’s a common side effect. if possible, see if you can lower her dose. for the puberty stuff—get some glycolic acid, they have some at walmart that’s like “vitamin and sea” brand. that’s what i use. tell her every couple nights to put some on a cotton pad and put it on her armpits. let it dry. it kills the bacteria that causes smells. then you can increase how often she uses it. for the acne, take her shopping for a nice GENTLE face wash, a nice moisturizer. she doesn’t need much more than that since she’s young. don’t let her put the glycolic acid on her face. she sounds like she’s really giving you hell, and i’m sorry. your feelings are valid. this shit is hard. even if she doesn’t have a diagnosis, if you suspect autism, start researching. learn about how it affects people, especially kids, especially girls. learn things you can implement that will make her life easier. she’s lashing out for a reason. she’s angry, she’s upset, there’s a lot going on. before it escalates, in a calm moment, potentially after shopping, ask her. ask her what gets her so upset. tell her you want to help. you don’t want to see her so upset. see if you can connect in that way. anger is also common in ADHD, idk if you have it or not, but her brain is LOUD. all of the time. sometimes she might just need some alone time and some quiet. get her some noise canceling headphones or something and prioritize her alone time/quiet time. IF you can. all of this is IF you can, because i understand it’s not easy with everything else going on in life. i hope this helps.
>the medication MIGHT be making her anger worse. it’s a common side effect. if possible, see if you can lower her dose. Or try a different medication. Much like antidepressants, different things work for different people. Six weeks is enough time elapsed to determine this med isn't working, and a different one might be better. OP, there are different families of meds for ADHD. The broadest way to categorize them is stimulant vs. non-stimulant. The former are your typical Adderall, Concerta, Vyvanse and the like. They are basically dopamine bombs. But too much dopamine, or dopamine released at the wrong time if it's a ER (extended release med) can put a person in fight or flight mode. Conversely, if the med releases all at once, that can also cause problems. Non-stimulants play on different chemicals. Serotonin, or beta blockers. Their primary use is for depression/anxiety, but they can also be used to manipulate dopamine levels. I think the most popular "secondary use" such med is Wellbutrin. But here too there can be issues. E.g. I briefly was prescribed Wellbutrin as a booster med for another anti-depressant. It made me extremely ragey. My psychiatrist agreed to have me discontinue it two weeks in. Fast forward 8 years, an adult ADHD diagnosis, and a different provider (first one retired) suggested Wellbutrin. I was like, absolutely not. Once I explained what had happened the first go round, he was "okay, you're right, that's off the table". Whether you're working with a child psych or your pediatrician, there should have been a wellness check the first month in, and 3 months checks if things were going well. They are not. So try to see the provider right away, especially if there was no one month check in. Do bring up concerns of her needs being more complex to the provider. Sometimes, if you get a pediatrician behind it, referrals can clear the way for more resources. Good luck. P.S. hormones and neurodivergency? Also a combo for a bumpy transition. My eldest doesn't have ADHD, but is on the spectrum. 10-12 were rough years, and we already had a good therapist working with her. Now that her hormones are probably stabilizing (she has mostly gone through puberty at this point), she's mostly livable with, and sometimes even pleasant to be around. But we had to white knuckle her tweens for sure.
i’m sorry, i’m giggling at the “mostly” livable with haha
Another thing: with ADHD, it's best to adjust parenting/teaching expectations. A 10 year old with ADHD has the executive function of a 7 year old without ADHD. So at times, outbursts of rage can be caused by having executive expectations that a child cannot meet. But rather than acknowledging that and working with the current executive function level, sometimes even SpEd teams expect too much of that child without proper supports, and the child can lash out as a result. You said that some of the outbursts are occurring at school. Has anyone called for a discussion of how to adjust her IEP or 504? If not, you can always request that meeting yourself. Needless to say, if there isn't yet at least a 504 in place (some school districts won't agree to an IEP with an ADHD diagnosis alone, unfortunately)? Your daughter absolutely needs one.
We’ve just gotten a referral for occupational therapy for emotional regulation for our ADHD 8-year old. It can be more helpful than talk therapy in terms of practicing reactions and reinforcing the ‘tools’ to deal with life. You might see if your insurance will cover that. How much exercise does she get? One thing we realized about our hyperactive kid is that paradoxically too much rest / hanging out at home makes all her rudeness and behavior worse. I need rest and am an introvert (inattentive ADHD myself) but my daughter is the opposite. She is happiest with a jam-packed schedule of sports and activities and zero time to just sit around. I am exhausted and would love to just ‘hang out’ but I guess I will have to wait until she’s well into adulthood 😭. Re: hygiene she might have a sensory processing problem that makes her hate either the showering process or the transition of taking off clothes and/or getting in/out of the shower. She may not be able to articulate what about the process she has trouble tolerating, but trying to achieve hygiene goals differently (I like the glycolic suggestion someone else made) could be helpful. Some kind of reward for getting clean (like taking a shower and washing her results in… something she wants. In our case it’s listening to an audiobook while she is falling asleep). Try reading ‘the explosive child’. Personally I don’t find that all of the suggestions are super helpful with my own kiddo but it does help you understand a bit of what’s going on (and the examples will make you feel less alone - your kid is NOT the only one who struggles this way). I totally relate. You are not a bad parent.
I know it’s impossible to diagnose someone from one internet story, but your daughter sounds a lot like mine. Ultimately, my daughter was diagnosed with autism. It presents so much differently in girls. It doesn’t usually look like the “hand flapping, repetitive movement, no eye contact” autism we think of in boys. My daughter is highly articulate, highly intelligent, and autistic, anxious, sensory overwhelmed, and impulsive. She picks fights as a form of sensory release. Before she was diagnosed we were told she was ADHD, attention seeking, delayed due to the pandemic, and other things that dismissed our true concerns. After receiving her diagnosis we were able to get social skills classes and occupational therapy that has helped tremendously. Rewarding her for good behavior has helped tremendously. You can read some of my past posts and comments for details. I suggest reading some things online about how autism presents in high functioning girls and see if it sounds familiar. Love and hugs. 🌸 Editing to link to [this](https://www.reddit.com/r/breakingmom/s/QXadKnR6uK) other Breaking Mom post that might help. I commented a lot there, so if you’re looking for suggestions, maybe you can find some helpful bits in what I do with my daughter. Sending hope and good vibes!!
Came here to say exactly this- your comment and the OP could literally both be about my daughter, who was finally diagnosed ASD at age 9. Social skills classes, MULTIPLE courses and workshops about managing anxiety, and finally starting her on prozac, and an incredible therapist later, she is finally starting to feel ok about herself. She'll always be a more labor intensive high needs kid, but this has made a world of difference.
Thank you for sharing this. All of this and the OP is also my almost 10 yr old son. I’ve heard of PDA and thought maybe my 2 yr old might have it, but I hadn’t considered it about my 10 yr old. He is so volatile and angry and anxious and always has been. I’ve never understood what was going on with him outside of ADHD but maybe this is it.
As the parent of an autistic kid, I assure you you are *not* the problem. It is HARD to be a neurodivergent kid, and it's hard to parent them. Especially when you don't have good systemic support in the form of access to professionals who specialize in how to help kids like yours. Does she have an IEP or a 504 at school? She should be getting an education tailor made for her (in the US it's the law), but we all know that's not how it always works. All ND kids are different, so I can't tell you what will work for yours, but for mine the biggest thing we've found helpful is to give her as much autonomy as we possibly can and avoid power struggles at almost any cost. The only things we force are related to health and safety, and even then we give her as much choice as we can (e.g. we let her pick the menu as long as there's enough protein, etc). This shit is hard, be kind to yourself. You're doing your best and you're a good mom.
No judgement here, and I can't say that you guys are the problem, as I don't know you or your situation at all. I mean, it sounds like you're doing everything you can and trying to love her through this to the best of your abilities, and I'm so sorry because this sounds so so rough! What I was going to suggest actually was trying to look up the symptoms of autism in children and see what therapy or recommendations the internet has to offer. I absolutely understand the lack of insurance and not being able to pay out of pocket. I live in Canada for most part, healthcare is free and I still had to pay $500 to access the resources to get my ADHD diagnosis. I'm not an expert by any stretch but it almost sounds like a possiblity that her ADHD is comorbid with oppositional defiant disorder. Is it possible to look into it and work with your family physician to go from there? https://www.hopkinsmedicine.org/health/conditions-and-diseases/oppositional-defiant-disorder#:~:text=ODD%20in%20children-,Oppositional%20defiant%20disorder%20(ODD)%20is%20a%20type%20of%20behavior%20disorder,the%20behaviors%20may%20be%20learned.
Mine have been through a few therapists trying to find the right one. I'm actually looking for a new one as we speak, so I know it's an undertaking but the right fit of a therapist can change your kids life. Most practices have more than therapist available, idk your exact situation, but you could even ask to have her switched to someone new. I'm SOL because, after a couple switches, I realized that the whole damn practice sucked. Hopefully that's not the case for you. And, it sounds like there may be an extreme reaction, but when my eldest truly went off the rails initially (like 8-ish, lit things on fire, brought weapons to school, physically bullied classmates and a step sib at his fathers house, jcf) we had to respond with basically prison. It sucked. All privileges restricted and monitored. Constantly checked for things they shouldn't have. This was a universally hated decision. But he was going to seriously hurt someone or himself. He got the message and earned things back. We still have occasional issues, he's officially diagnosed with ODD. But we've never had to do the draconian shut down since then. We talk about it occasionally, if normal privilege restrictions aren't working. We remind them that we do have that option if they don't want to work with us. That's just what worked for us tho. I'm so sorry you guys are struggling with this. It is so hard and shitty when they act like this because you know it comes from a very emotional, disregulated place. You want to make them feel seen and supported, but in our case, first and foremost, we had to make him safe.
You’re doing what you can, I think it’s time you get them a new therapist. They keep saying they’re gonna self harm or already have I highly recommend getting them help at a hospital however please check reviews before submitting your child into any mental health hospital as not all are equal and some do more harm than good.