Curious if anyone could give me advice:
My 6.5 y.o. son is fairly anxious. He has been seeing a therapist for a few months now, but we haven't seen so much improvement. The therapist is not cheap- we pay $54 a session, through our insurance (we haven't hit our deductible yet). Once we hit the deductible, we'll have a small copay, but by that time, the plan year will be over and we'll be starting from the begining again. :)
The therapist told me that her goal is to spend part of the session doing play therapy with him (with the idea of getting him to relax, and relax his standards), and the other part of the session doing more CBT.... However, the problem is that my son doesn't really seem ready to do the CBT yet. Like, he's not really interested in working on it, so not that much progress is being made.
I'm unsure what to do: on one hand, I don't want to have unrealistic expectations of the therapy process... buton the other hand, if he's not interested in doing the CBT work to change is negative/worrying thoughts, then what am I paying $54 a session for? I', wondering if we should take a break: 3, 4, 6 months, whatever..... Maybe work with him at home using workbooks, stories, etc.... and re-evaluate? Has anyone had luck with any of the books on the market, like "when your worries get too big?" or anything like that?
thanks for your advice
our 6 year old's anxiety has been greatly helped with OT. it would probably cost you about the same depending on insurance coverage. it would be something else to try at least.
Does your son's anxiety impact his day to day functioning in a significant way? Is his quality of life impacted by anxiety? If this were the case, I would be reluctant to d/c therapy. Might it be possible to discuss with the therapist your observation that your ds doesn't seem to be able to make effective use of a part of the treatment plan?
Have you ever thought of animal-assisted therapy, like hippotherapy?
My son is now six, almost seven. His anxiety became apparent when he was four, and was starting to play a big role in his life and how he functioned. We lucked out with a wonderful therapist who somehow incorporated CBT with play therapy. She usually met with me alone for the first half hour or so, and then met with him alone for the next half hour or so. I don't know exactly how she did it, but it wasn't clear to my son that at one point he was doing "play therapy" and at a different moment he was doing "CBT". I don't think he could have resisted doing CBT aside from flat out refusing to participate in the therapy - it was just sort of worked into what they did.
But, just to give you an idea of the rate of progress we made -
DS has had 2 big episodes of anxiety. One was at 4.5 y.o. and one was at 5.5 y.o.. Both times it was really impacting his life - he didn't want to go to activities (like the preschool he had been at for 2 years and had previously LOVED) or even his best friend's home (family he had known well since he was a tiny baby, very loving, spent a lot of time there, etc). He would completely freak out, crying, hyperventilating, obsessing about it the night before knowing it was coming up, trying to sneak out of school to follow me, uncontrollable worry, not being able to settle and enjoy once he had been there a while, etc. The concern over going to be away from me (even for very short periods of time) or participating in activities (very secure ones that he had a lot of experience with) was beginning to take over all of our lives. The episode when he was 5.5 also involved an extreme germ fear (explained by the therapist as the maturation process of young childhood anxiety - they are so freaked out by what is making them anxious that as they get older they will start to focus on something that they perceive they can control - in DS's case it was germs). He started fearing germs and illness, things he thought weren't clean, would wash his hands 3 or 4 times in a row before he would eat, etc. Sooo, with both of those episodes, it was greatly resolved after 8 visits the first time and 10 visits the second time. It was a very big turn around in what I thought was a short amount of time. DS went from not eating a treat he really, really wanted when out with a friend and his mom one time because he couldn't wash his hands again and again (so the friend's mom fed him) to 10 weeks later it being pretty much resolved. DS will probably always have a degree of anxiety - I can tell it is present, but it isn't obvious to others at this point and, aside from an extra discussion from time to time, it doesn't impact our lives. I will say that DS really clicked with the therapist and she was highly recommended - maybe check out a couple of other therapists?
Oh - and I forgot to add...
We did do work at home that the therapist would give us - almost like homework - that did really help (a lot of drawing as we told stories). But, it was a supplement to what she was doing. We do have the book What to do when you worry too much, and he likes that. It's been a while, but I know we read some others, too. But, it's just my feeling, that those kinds of things are more supplemental and can't take the place of a good therapist.
My son was in a group therapy for anxiety called "Cool Kids". It had components that were during the session and a workbook for at home. The program focused on realistic thinking (called "detective thinking" in the kid's workbooks) and on gradually dealing with greater and more complex anxieties at home (sort of a 1 to 10 staircase with one being a passing worry and 10 being a huge worry) with a pre-decided reward for facing each fear. Since there were rewards, my son was especially motivated to work on the therapy. Despite not being particularly sociable, I also found there was a certain element of positive peer pressure from working alongside a group of kids with similar issues. I don't know if this would help with your cost problems (I'm Canadian) but I'm guessing group therapies may have lower costs. We are very glad we stuck it out with therapy, as in our son's case fear of failure and mistakes was becoming paralyzing at school and even at home. If your son has a hard time functioning day to day over his anxiety, I really think you should carefully consider discontinuing therapy as the work time lost in helping a child through an escalated anxiety situation may end up equaling therapy, anyway. I agree with PP in that maybe you need a different therapist or a somewhat different therapy delivery rather than discontinuing therapy.
DD has severe anxiety and her clinic has been handling it by doing a modified Worry Dragons course with her where she works one-on-one with a therapist to identify sources and learn to articulate what she's feeling. We''ve found with her that it's such an overwhelming thing for her that she psychologically runs from trying to deal with it. So getting her to even identify it and start to investigate triggers has been hard. They do lots of role playing with dolls to see what she talks about through play and that's been the most effective method of getting to the root of the causes. Now we're working on reinforcing tools to use with her and language to use around the house that encourages *thinking* about it and investigating it. But first she had to get over the fear response and her fear of that itself. Other work she does in the clinic (OT and SLP exercises with interventionists) incorporates the language and strategies into play to reinforce and also to show her methods in different contexts. Part of the challenge of having an ASD kid is that they often can't take information/knowledge out of one context and apply it to another situation or environment. So we have to work with her a lot to show her that she can use her toolbox in many different ways and places to get rid of her worry dragons.
You can work with him on anxiety without a therapist, using the techniques of Rational Emotive Therapy. It's DIY CBT. It's pretty effective.
These two books will show you how to do it:
Also, more exercise really helps control anxiety.