diagnosis/Rx Questions...

flutterby96

New Member
So, Tuna has been much worse lately so p-doctor added Prozac (10mg daily) to the Abilify (4mg daily). She's been on the Prozac for 2 months & no benefit, so I took her off. We finally have health insurance again, so we are looking into counseling for all of us. But, my question is, is it reasonable for me to expect someone to meet with her individually to help her develop coping strategies & skills for anger & anxiety management? The person we saw this weekend said she believes in "empowering parents" to deal with their kids, which sounds great & I'm happy to do IN ADDITION to someone meeting with-Tuna. Am I off base here? What have your experiences been with-therapy? What should we be looking for?
 

klmno

Active Member
I couldn't get outpatient tdocs to do that with my son, however once he was sent to Department of Juvenile Justice the therapist there did just that. Now it might have had something to do with a typical outpatient therapist not being able to accomplish anything with a patient who doesn't want to learn that sort of thing. I'm not sure how much of it was a result of blaming the parent and how much of it had to do with difficult child not having too much choice what the therapist talked about in Department of Juvenile Justice.
 

flutterby96

New Member
Bummer... we are totally open (and actually enthusiastic) about working with-the counselor as a couple, but I really feel like Tuna needs some one-on-one time to talk about things with a disinterested third party. She's much more receptive to others than to us (I seem to be her #1 trigger), so I'm hoping that they might be able to get through to her better than we can right now. Plus, maybe she could use a safe place to talk?
 

DammitJanet

Well-Known Member
Your child is extremely young for talk therapy to be very helpful. Play therapy may work well. In most cases, therapy with the family is shown to work the best because as they say, the family is only as healthy as the sickest person. In order for the whole family to work well together, everyone needs to learn better coping skills.
 

klmno

Active Member
Oh- sorry but I didn't notice the age of your child. I agree that at 7 play therapy would probably be a lot more effective. I don't know about family therapy for a child that age, one way or another.
 

flutterby96

New Member
From what I understand, she was only interested in working with-husband & I. I mentioned all of us needing some help, but she said kids don't really benefit from a partial session because it takes them too much time to build rapport. I understand that, but shouldn't she still want to evaluate & meet with-Tuna also? We did get some take home evaluations to fill out (one for me & husband and one for Tuna), but I kinda felt a little nervous when she said she wasn't very familiar with-Ross Greene or his theories. Is that a red flag? Sorry to be so needy... just not really sure what questions to ask a prospective therapist. Also, I don't know if this matters, but she's only a grad student working under the supervision of a Psychologist.
 

susiestar

Roll With It
I would continue to look around for a therapist. Not wanting to meet Tuna at all seems very strange to me. Esp with the problems Tuna has. I don't know much about play therapy. We had many therapist suggest it until they met Wiz. He was astonishingly verbal at a very young age. We still spent at least at much time with the therapist as he did, but NO therapist was ever willing to treat us/him/the family with-o spending some time with him. Mostly they played games, but they talked while they did it, which was a good way to build rapport. Even the AWFUL therapist we saw who swore by Dr. Dobson's early books (when he advocated plentiful use of spanking) needed to spend some time with Wiz to try to see some of what we were dealing with.

Is there a children's hospital or developmental pediatrician around? The dev pediatrician would be able to suggest a good therapist or might have one on staff in the practice. A children's hospital will have an assortment of tdocs that could help you.

Who does her medications? If it is a child psychiatrist, call the office and ask if they have a therapist they refer people to. Don't forget about your insurance company. They may have a list of preferred providers that you can call. Make sure you are comfortable with the therapist. I normally went to the first appointment or two to give the history. Having a Parent Report is incredibly helpful. I often give it to the therapist on the second visit, or at the very end of the first. That gives me time to figure out if I like the doctor and think we can work together. A Parent Report is a document you create to keep ALL the info about your difficult child in one place. Copies of all or part of the report can be given to the people you are working with. You can find the outline on the FAQ/Board Help forum under the title Parent Input/Multidisciplinary Evaluation (MDE). It is amazingly helpful when communicating with the various docs and in keeping all of the info organized into a usable format.

Not all tdocs, or psychiatrists, will know about Ross Greene's book, but they should be willing to take a look at it. If you find one who is already familiar that is a very good thing. The therapist who helped us the most wasn't familiar but LOVED it after I gave her a copy. She learned about Love and Logic around that time and asked me to take a look at it and tell her my opinion. She wanted to know if I thought it was as useful as she thought it might be. I love L&L and it made a GIANT difference in my home, family and even my marriage. It is the ONLY parenting book that made sense to my husband and that he could implement and remember the techniques involved. For more info on L&L, visit www.loveandlogic.com. With your family I would suggest Love and Logic Magic for Early Childhood. It is a birth to age 6 guide, but most difficult children are about 1/3 behind other chronologically aged kids. The website describes all of their books and might be very helpful.

As for if you are off base thinking that a therapist should work with parents in addition to kids, I would say no. Even in family therapy there are times when each person needs an individual session. I am not sure why this therapist sounds not quite right, but she does not sound like a good "fit" for you and your family. At any time that I have to change tdocs for any of us but husband, I make appts with several different tdocs. I go to the first appointments with each of them and then cancel any follow up appts with the ones that are not a good fit.
 

jal

Member
My son is almost 8. We have been at this since he was 3. As we looked, they all wanted to deal with us, not the child. Which we were totally willing to do, but knew that he needed his own support too. We'd done the neuropsychologist (again he was young - around 4). We tried play therapy, which was a crock (for us) because he never engaged in it, but he was still so young. We tried family therapy sessions and one on one with another therapist. Now currently we have to see a therapist to get to the psychiatrist for scripts & that has been a load of hoey as the therapist does nothing with-difficult child (they just want a co-pay). The one thing that worked for us (not saying this is what you should do) was moving him to a therapeutic school (it was warranted - he couldn't handle reg. school) and getting intensive in home services through DCF voluntary (meaning WE asked them for help after our difficult child had his 1st and only hospitalization - due to a medwash being overseen by a psychiatrist). They gave us 2X's a week in home for 1.5 years until he graduated the program. Now that he's older he is learning from one on one therapy and group @ his school. He's mainstreaming and has made HUGE strides and it has finally clicked. We are finally at a point where we are enjoying our child and he is doing very well. So I would second to keep looking for a therapist that is willing to work with your child, not just you.
 

slsh

member since 1999
I think it really just depends on the therapist. My difficult child started therapy at 5, and I've wondered over the years if it was really worth it, because as some of the posters above said, you really cannot do a whole lot of "talk therapy" with a kiddo that young. But we had a simply *fabulous* therapist from age 6-9, and based on our experience with- him, I would absolutely do it again with a kiddo that young. This therapist would touch base with- us before the session to catch up on the latest antics at home/school, and then again after the session to give us whatever input he could (as well as, I think, to give us a pep talk to get us thru until the next session, LOL). The vast majority of his time was spent with- my difficult child.

It might take some time to find a therapist that your difficult child (and your family) will have a good fit with. I know we had a couple of alleged tdocs who were, in my humble opinion, in more serious of need of therapy than my own kid, LOL. ;) There are different schools of thought out there, and I would keep looking until you find someone who you think might possibly meet your needs. I also would not expect to see behavioral changes right away (or even possibly in the relatively near future) in your difficult child just because she's in therapy. I do think it is *really* helpful to have a trained person really get to know our kids, beyond their manipulations and surface junk - that person can be an invaluable resource to you. I also believe (or maybe I just hope) that during the gazillion hours my kid spent in therapy over the years, some coping strategies and tools sank in. I kinda think they did, but on the other hand, he's not the poster child for a functioning adult (yet) so.... I don't know.
 

Josie

Active Member
My daughter was in therapy beginning at age 7. The therapist met with her, but also met with me. It was in meeting with me that she got the full picture of what difficult child was like. difficult child herself presented very well and thought everything was fine.

They did talk about ways difficult child could handle her anger better, but difficult child was never able to put that to use. The therapist's real benefit came from me having someone to talk to about it. This therapist had her own difficult child's so she didn't blame me, but she did offer some new ideas. Not that they worked, for the most part LOL, but I did like having someone to talk to about it.

We figured out that my difficult child needed a diet change and she doesn't need the therapist any more, so I don't know how it would have worked long term. We did go to that therapist for a few years. I still go to her a few times a year, for different reasons.

My younger daughter has Obsessive Compulsive Disorder (OCD) and she did CBT. For that, we were barely involved. She met with the therapist for a few hours a few times a week and did some CBT/ERP work. We met for a few minutes afterwards to talk about what she had done and what she needed to do in between sessions. She was 11 when she did this. It is a very specific type of therapist that does this and I'm not sure if it works for every issue.
 

Marguerite

Active Member
I admit to feeling a bit narky about this sort of response form a therapist - I agree, keep looking for someone who will give you the help where you feel it is needed, or will t least explain why not, in terms you can understand and agree with.

I'd be tempted to ask this therapist for a referral to someone who is more open-minded... but then, as I said, I'm feeling narky. The thing is - YOU are paying for a service. YOU are the customer. YOU should have a say in this, and some choice. And an opinion from you should be sought, not dismissed.

Marg
 

DammitJanet

Well-Known Member
I dont think I explained myself well.

My son was in therapy from age 4 till age 17. As Slsh said, we dont have the poster boys for therapy...lol.

Cory started in this program called Childrens Day Treatment where he went everyday for 3 hours a day and interacted with about 6 other kids and 4 therapists and 2 psychiatrists and I was brought in 2 days a week I think to watch this interaction behind a 2 way mirror. It was a combination of play therapy, 1:1 therapy, group therapy and damned if I know what. He was in this from 4 to age 7. At 8 he started individual therapy and family therapy. The individual was more of a play type where the therapist roll modeled behavior with him. We (his parents and brothers) met with the therapist at least monthly for brothers and weekly for me. I lived for my sessions...lol. This went on until he turned 11 and he left for wilderness camp. Therapist facilitated that.

Now to the present. My therapist also does kids. I have been a bit astounded that I have had to steer her to some of the books from here. There are many times when I suggest ways to deal with a kid she is having problems with. Now she never gives me confidential details about the kid but the "7 year old, doing xxx, dont know what we can do." and I will suggest what I think is the best ideas I have. Many times she is very thankful for advice I have gleaned from here. I would send her here but I dont like the way we talk about therapists on a whole.
 
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