New therapist - what to expect?

[TiredSoul]

So we have only been down this road one time before and didn't get anything out of therapy. difficult child went for about 2-3 mos. last year.

What prompted getting a new therapist is difficult child telling the school counselor and Special Education teacher he was going to kill himself when he was mad and being confronted about something he said he didn't do. He has also had some emotional meltdowns where he cries and tells me how much he hates himself and his life and wishes he could start over. His self esteem is so low. He came home one day and lost it over a test he took that he didn't do well on. He says he is stupid and feels bad and that he feels like this everyday. It breaks my heart that my child feels this miserable.

So what can I expect from counseling? I have my doubts that talk therapy can do anything for him. I initially met with the counselor for 60 mins. then difficult child met with him once. He meets with him again tomw. I am not sure how this works and what to expect. I want to have a plan and know exactly what he is going to work with him on. Is that realistic? How long can we expect to keep going? How do we know if this is the right fit? I already feel uncomfortable because I talked as fast as I could for an hour and then the guy practically pushed me out the door for his next appointment. How is this supposed to work? Any info or insight would be greatly appreciated.

Thanks!

 

[buddy]

It is a great question. I was just thinking of this myself. We have done attachment work, that is specialized. But I have thought that lately Q needs someone to try to talk to. But since he doesn't have conversations that he doesn't start and doesn't take many turns...will mostly ask quesitons to keep a convo going... I wonder if it would help. But tonight he was bawling and said it would all be over if he killed himself. I am not convinced he will since he heard this kind of talk at the psychiatric hospital from others and may be imitating (which he does) but at the same time it was clear he is really sad about some things. Similar to your story. Hates being special needs child, etc. Wants to die but come back "normal". Like he will still find his presents under the tree kind of come back.

I dont know it would help him but I will ask him and give it a try.

did anyone ever find a therapist who worked well with a kid who does not play (so imaginative play therapy is out) and doesn't really have great convo skills?

 

[rejectedmom]

Therapy does help in many cases but it takes time. 2-3 months is barely enough time to gain the trust that a therapist needs from his client. My difficult child was in counciling for two years and never opened up about certain things but it did help him in other ways. I think as parents by the time we decide our kid needs help we are sick with worry. We want them well and we want it to happen quickly. If your child isn't opening up and sharing after a few months or you feel that you are constantly getting the bum's rush, ie telling of problems with no feedback from the therapist it is time for a change.

Buddy I think you need to look for a specialist that deals with autism. They would have many techniques that might work at engaging your son.

 

[Chaosuncontained]

Wow, Jules. Good question. We have our first Psychologist appointment next week. I know the first (looong) visit will be filled with evaluations. But I wonder too, what will happen? How quick should I expect ANY results?

Carson, every time he gets really upset he tells me that he "hates his life". Our boys sound similar. I hope you find answers--and that you get what you and your difficult child need from the doctor.

 

[slsh]

It can be difficult doing therapy with- young kids, from the parent's perspective. It's not like working with- an adult, who by virtue of being in therapy in the first place is obviously is invested in getting better. In my experience, it's hard to get kids invested in their treatment.

Our very best therapist would touch base with- me before taking thank you in, then would see thank you. They would play chess or whatever and talk during. Then he'd meet with- me again, give me some insight/suggestions, and we'd do it again the next week.

I cannot say that therapy from ages 5 to 17 really had any noticeable impact on thank you's day-to-day behaviors. With our good therapist, it absolutely helped husband and me just because we had someone who got thank you, got us, and was involved and aware of our daily struggles with him. Just not feeling like we were out there alone helped a lot. And therapist was able to give us strategies for dealing with- some of the behaviors.

My hope then was that the cumulative effect of years of therapy would someday click for thank you and that the tools that he was learning (sometimes by osmosis) would someday become useful for him. Here we are almost 16 years after first therapist, and I think it worked to some degree. I can't think of a single instance where what thank you learned in therapy was immediately applied, but the kid now definitely is using some of the tools.

Having had some atrocious tdocs along the way, my criteria became pretty firm. therapist had to be willing to communicate with husband and me - not specifics of what he/she and thank you discussed, but broad strokes of his mental state, discussion of behaviors we were dealing with-, and suggestions. therapist and husband/I absolutely had to be on same page in terms of general expectations and appropriate behaviors. While husband/I were open to private discussions with- therapist about changing rules, any therapist who undermined us in front of thank you got fired on the spot.

Just my experience, but if you're looking for concrete results in the near future, you're going to be disappointed unless you have a remarkably self-aware kid who is able to use therapeutic tools now (which I think, developmentally, most kids can't do until at least their teens, if you're lucky). If you look at therapy with a good therapist as laying the foundation for a healthier kid in the future, I think you might be happier with- the results, but the payoff is going to be sometime down the road.

I know this sounds discouraging, and I really don't want it to be - this is just based on my experience with- thank you, who was an extremely resistant kid. He thought he was fine, thought his behavior was totally reasonable, and the rest of us were out of our minds. And I did want to add, that in his most stable periods (rare as they were), we were occasionally able to help him use some of the therapeutic strategies (breathing exercises, visualization, wrapping himself up in blankets, etc.), so it wasn't a complete wash at the time - he would very rarely be able to try to use some of the tools; it was just very inconsistent at the time.

If I had it to do over again, I'd still go thru the years of therapy for him.

 

[exhausted]

The greatest benefit for us has been the insight we have gained about difficult children behaviors and strategies for us as parents. Having another perspective was also helpful. As for difficult child-I don't see much effect except I wonder if just talking helped get some of the issues out. Who knows things could have been worse without this. At times therapy was the only place we could address things without her refusing to talk, being defiant or otherwise a "show stopper".
As for how do you know if it is fit-takes time and you will disagree at times-this doesn't mean the fit is bad. I was affraid to do this at first. Now I just am honest when something doesn't ring true or I disagree. I think you don't have to get along spot on all the time.
No matter what they need to pull you in so you know what you can do to be a supportive parent. As for feeling pushed out the door-they have a schedule and this is a feeling I have had at times. They can't get behind and they are paid by their time. If I feel I need longer-I have scheduled a longer appointment. It just feels bad when your not done and things are so personal/emotional and the time is up. Our latest therapist. asks me to update by email if I need to. She doesn't often respond with any length, but at least it saves time when we do meet and helps me vent if I need to. Ask when your is available and if they have a phone policy. Our difficult child can call in a crisis and this has helped in the past.

 

[crazymama30]

I agree with SLSH, You will not see results quickly. My difficult child has been in therapy for 3 years, and just now? I can see some results some of the time. It took forever to see results, but I hope that it will be worth it.

Is your signature up to date? Is your difficult child still 9? I cannot keep up with everyone's kiddos.

 

[confuzzled]

Really great question!


mine is on 2+ years of therapy too....and honestly, i question whether we should keep going *every week*.

i honestly dont know if my 12 year old is really developmentally able to take much away from it. i DO think its good to have someone besides family to talk to, and i guess thats really my motivation for continuing, along, of course with my overwhelming guilt for not seeing a problem sooner. i like and respect her therapist, but i dont find she's too helpful with reccomendations or opinions or anything that might give *me* a better handle on my kid. (surely, she MUST have an opinion or two as to diagnosis, sx, tx options, whatever!--i'm not expecting her to rewrite the DSM for us!).

i DID just tell ours that we realllly need to decide on a strong focus and make a decision as to what is treatable and what is just "her"...i feel like we rewrite the same goals every 6 weeks with little tangible progress. i do sometimes think we are addressing things that arent really fixable...i highly doubt mine ever suddenly become a social butterfly, no matter HOW much therapy she gets. and honestly, i've decided its *not wrong* to be a loner, and it pretty much IS a part of her, more that a fixable symptom of something. and truthfully, mine picks up on all this "fixing" and it has impacted her self esteem in some ways, so sometimes i actually think maybe we are doing her a disservice with some of the stuff we do.

but it is what it is. ;-)

i felt my money was much better spent on theraputic interventions like Occupational Therapist (OT) and SpT...we were very fortunate to have therapists that had very specific goals that were truly measurable.

i didnt, and don't, expect some miracle quick fix from therapy. but i do have a hard time dragging both of us to weekly therapy without really seeing some kind of progress.

just our experience--take what helps you, leave the rest.

 

[TiredSoul]

Thanks everyone. Yes, difficult child is still 9 and things are getting tougher everyday. We are finally hopefully sort of on a waiting list for a neuropsychologist evaluation - at least the pediatrician finally phoned in a referral and I called to ask them what to expect next. The said they will call in 4-6 weeks to do a history/intake and then if we are the right fit, it will be around Feb/Mar that he is seen. That was around Halloween.

All I want is for my child to be healthy and happy. Seems such a simple request. Yeah right. I don't want him to feel so sad, angry, unhappy, worthless - etc. I have researched and read everything I can get my hands on for ideas how to help him. Sometimes I feel like he would be better off without me. I haven't been dealing with all of this very well - and sometimes he makes me soooo angry I snap. A lot of yelling/screaming and getting a crazy look in my eye when he pushes me to the absolute limit. I don't know how to cope better. I know it doesn't help and makes things much worse.

I spend every second of my life either fighting FOR him or WITH him. It's not fair to my younger son, who is imitating him more and more everyday by hitting himself, saying no one loves me, I hate myself, etc. It's awful. I wish I knew what to do to change this entire situation. We are in a downward spiral.

 

[Chaosuncontained]

Thanks everyone. Yes, difficult child is still 9 and things are getting tougher everyday. We are finally hopefully sort of on a waiting list for a neuropsychologist evaluation - at least the pediatrician finally phoned in a referral and I called to ask them what to expect next. The said they will call in 4-6 weeks to do a history/intake and then if we are the right fit, it will be around Feb/Mar that he is seen. That was around Halloween.

All I want is for my child to be healthy and happy. Seems such a simple request. Yeah right. I don't want him to feel so sad, angry, unhappy, worthless - etc. I have researched and read everything I can get my hands on for ideas how to help him. Sometimes I feel like he would be better off without me. I haven't been dealing with all of this very well - and sometimes he makes me soooo angry I snap. A lot of yelling/screaming and getting a crazy look in my eye when he pushes me to the absolute limit. I don't know how to cope better. I know it doesn't help and makes things much worse.

I spend every second of my life either fighting FOR him or WITH him. It's not fair to my younger son, who is imitating him more and more everyday by hitting himself, saying no one loves me, I hate myself, etc. It's awful. I wish I knew what to do to change this entire situation. We are in a downward spiral.

Wow. I would pull my hair out if I had to wait that long for an appointment. Here, I called 2 weeks ago and made an appointment. That would frusterate me to no end. Sorry you have to wait. Researching ways to help him is another example of what a caring Mother you are. It's so hard to feel like we are doing enough, or even a good job. Loosing your temper is so normal. We have all done it. Normal response to the stress we are under.

We all want our cilldren to live healthy, happy, productive lives. Because we love and care for them.

Unfortunatley we do sometimes put our other children on the back burner. I told my father in law, after he snottingly told me "Well, it's obvious who you love the most". I responded "I don't love Carson more...he just NEEDS me more". It's also amazing how spending a little extra time with my easy child's can make them feel awesome and loved. Quality not quanity really is true.

Hang in there. You are doing the best you can. And you are a great Mother. Don't beat yourself up. Take care of yourself, too. Big Hugs...

 

[TiredSoul]

Thanks Martie! I had a big long cry after I read your post. difficult child met with the therapist for the 2nd time today. I had the opportunity to go in prior for a few minutes and tell him about the emotional meltdown difficult child had last week about doing poorly on his test. He mentioned something about "proximity seeking" and when I google it I find it relates to attachment. So what does that mean?

He already asked me in my first meeting with him if we had a normal attachment after difficult child was born and we did. He was wanted, planned for, and I loved him, and cared for him. No pp depression. Nothing tramatic happened, no death in the family - nothing. He was for the most part a perfect baby until age 1. Then the night terrors and crying for hours and head banging began. But thinking about attachment - is it possible to have attachment problems later even though we had good attachment in the beginning? It's almost like difficult child thinks if I buy him things then that means I love him. And if I don't - then I don't love him. Maybe we really don't connect anymore. Sometimes I think our relationship really has been damaged somewhere along the line. I am just so lost as to what to do.

 

[buddy]

Even if you were bonded and you loved each other, if something medically happened to him (the night terrors/head banging) in the years 0-3, that alone can cause some attachment issue. I read extra things (you have to dig) on kids who have medical conditions that cause attachment problems. Normal cycle: child is in distress/hungry whatever, mom fixes problem as good as she can while comforting etc.... , child then has relief and trust. When a child is in pain or distress, cries out/upset etc.... mom tries to comfort but it doesn't work, nothing works, why trust this person, nothing is fixing this??? It's certainly not that they actually think that, just that the cycle that builds trust is messed with. NO one's fault. Happens to preemies and kids who have serious illnesses (mine had terrible head pain/head banging, seizures, and they thought it was behavior for a while.. a long while/over a year...while he was in foster care (a good one but still he left his parents at 7 months and anyone who has a 7 month old knows they know their parents and are very bonded by that age, that is a huge loss).

I think, at least for us, any kid who has such struggles and behaviors may end up with us having problems being too close at times. I feel like there are times I just go into automatic mode to get thru it.

It may not be anything so daunting, just that this person is puzzling thru, trying to see IF it is anything to do with his bond to you. Still, does not mean you are not a good mother. Just that this is the way it played out and now you will work on it what ever it is.

He has some big challenges. You can do this.

 

[TiredSoul]

When a child is in pain or distress, cries out/upset etc.... mom tries to comfort but it doesn't work, nothing works, why trust this person, nothing is fixing this???

This could be the case - because he would cry for hours during these night terrors and we wouldn't really be able to comfort him. So how do you repair attachment if that is a problem? What would be a normal response from a parent when their child is crying and upset saying they hate themselves and hate their life and want to start over and/or die? I move in, get closer, try to comfort, tell him I love him, ask what I can do to help him feel better. Nothing I say helps him feel better.

When he told the school he was going to kill himself - the school counselor was asking him questions. When asked how his parents would feel if he did that - he said my Dad wouldn't even notice and my Mom would celebrate. I was devastated to hear that. I talked to him later and asked if he really believe that I would celebrate and he said no, but it makes me wonder. I spend so much time on him and have always given him so much attention and praise and all the things I thought I was supposed to say to help build his self confidence - seems like nothing I do makes any difference. I need something to do. I need an action plan. I need to fix this and make everything better. I have a hard time with this being out of my control. Gee wonder where difficult child gets his control issues from? (sigh)

 

[buddy]

Jules, I am so sorry, I guess I didn't put together all of the posts you had written but I do remember you said those things before. There ARE specialized people who do know how to help with this kind of attachment challenge. You did nothing wrong. Some do a re-parenting kind of therapy, where the child is cuddled and loved and brought back to the age where they were emotionally disrupted. Sounds extreme, but for many it works (and it is made clear to the child that this is private, no one will ever tell that you are rocking, feeding what ever level you go to) That may not be your cup of tea but there are other things, holding time, (many do not like the rage/holding stuff, but there are kinds of comfort holding etc). My son actually asks me to rock him at times. He just likes it. Never was a therapy activity, he came up with it on his own.

We did a kind of therapy called Theraplay. It is not Play Therapy... it is a very specific, video taped, kind of therapy. There are exercises that progress starting at the place where the bonding issues are. Like, my son hurt people. We did back and forth time where we pointed out "owies" on eachother... then rubbed lotion on them or whatever, sometimes put bandaids, etc. Showing how we help each other during hurts. (he was little then, would obviously be adjusted for an older child). Not sure if people still do this, but it was one time I can say we really did see improvement. We did lots of back and forth relationship activities...each time I was given specific words to say , things to do and we reviewed the tapes. very intensive.

Though there is not a diagnosis of attachment issues, if you feel this is an area of need, pls make sure you are talking to an expert in this. Much of the info will be on adoption sites because that is where it is common. But every site will describe bio kids who have either the mother with an illness or the child. It is uncontrollable so dont waste time on guilt for that. You couldn't have known and even if you did, pain is pain. distress is distress....there was no way to comfort. That is what is so sad.

It might not be THE issue, but if you feel it, then it is important. check out attach-china.org website. there are some good articles and links there. Specific good therapists with books are listed. those books have links to states and then therapists. I wish there were more sites about kids who do not have full blown Reactive Attachment Disorder (RAD) but still, you can pick and choose what you think applies. There were lots of people who just had clingy kids etc. when I was on it a lot.

To me, if you think this is part, it is really hopeful. IF you find someone good in that area of development.

 

[InsaneCdn]

Nothing I say helps him feel better.

Jules - you are correct. The answer does not lie in words. It lies in action.

Its hard to wrap your brain around, but you have to choose specific actions and activities that are there to build/rebuild the relationship... and relationship-building time cannot be taken away as punishment... in fact, the activity planned can't be taken away as punishment for anything, either... but it can be changed if current-state makes that activity unsafe.

Just like a child learns to walk long before they learn the word "walk"... a child learns the feelings and emotions of attachment long before they understand the language that goes with it. So, trying to use the language of attachment and relationships doesn't work unless they already know what it means to be attached.

Small example: It doesn't matter how good or how bad the day has been... difficult child ends the day with a back-rub. Its part of our day that is non-negotiable (unless he and husband take a trip...). Its a soothing form of physical touch, releases a bit of stress (good or bad...), is something to look forward to - and its directly attached to a parent (me). Its not about ONE thing like this - its about building these into the daily and weekly routines. That's just the tip of the iceberg... but something to think about, maybe.

 

[buddy]

re: IC's back rub example...

wonderful way to put it. That is triggering some of the things that are so automatic now, I forgot they really did start back in attachment therapy. He still LOVES smelly lotion. I rub it on his legs and back and arms. (I still do apply ointment on his scrapes etc. and bandaids, he could do it himself but, it just keeps the caregiving going....if it is private area things, obviously I just provide the materials at his age). We also have some silly things, he wont show anyone else, but he likes me to pretend we are on dancing with the stars and I spin him around...I think we are fast approaching not being able to lift him, but I never fully did anyway. Those special routines are really important.

 

[DammitJanet]

Cory was another one in the SLSH example. In therapy from 4 till 17. Who knows how much of that therapy actually sunk in at the time but I can see the tools being used now. They certainly werent used then. We had some very good therapists too.

 

[TiredSoul]

Thanks everyone. I am not sure if attachment issues are the case - the therapist asked about it and it got me thinking - of course because I over-think everything to death. I just know that I try to give him hugs and kisses and rub his back and he doesn't seem to want me to do any of that. At all. And InsaneCdn, you are right - actions speak louder than words. I am definitely a talker - and I tell him tell him tell him how much I love him and how great I think he is - and he seriously doesn't believe me. My body language must be saying something else - especially when I am flipping out and screaming after he pushes me past the point of sanity. I need to find a way for me to cope better, then maybe it will help him. We didn't use to be a dysfunctional family - I think years of trying to deal with difficult child's issues has brought us here and has created more issues than the initial ones. A snowball effect.

Happy Thanksgiving everyone! Thanks for the support.

 

[soapbox]

I am definitely a talker - and I tell him tell him tell him how much I love him and how great I think he is - and he seriously doesn't believe me

Doesn't "believe" you? Or doesn't really understand what you are saying?
There is a huge difference between those two.

And... there are a raft of OTHER issues that can contribute to that.
Including subtle forms of Central Auditory Processing Disorder (CAPD) - if they don't process verbal language well, but are not impaired enough to trigger school issues, then nobody goes looking for the problem, but it doesn't mean its not there.

Have you ever tried leaving him little notes? like, a love note on his pillowcase when he gets up in the morning, that kind of thing? Can't send it to school (trust me on that), but look for chances to "talk" to him in writing...?

 

[buddy]

Thanks everyone. I am not sure if attachment issues are the case - the therapist asked about it and it got me thinking - of course because I over-think everything to death. I just know that I try to give him hugs and kisses and rub his back and he doesn't seem to want me to do any of that. At all. And InsaneCdn, you are right - actions speak louder than words. I am definitely a talker - and I tell him tell him tell him how much I love him and how great I think he is - and he seriously doesn't believe me. My body language must be saying something else - especially when I am flipping out and screaming after he pushes me past the point of sanity. I need to find a way for me to cope better, then maybe it will help him. We didn't use to be a dysfunctional family - I think years of trying to deal with difficult child's issues has brought us here and has created more issues than the initial ones. A snowball effect.

Happy Thanksgiving everyone! Thanks for the support.

I for one can relate, I have worked and do work really hard to avoid moments when I feel like I am not showing how I really feel deep down. As you say, some days we just get pushed past our limits. I am like you, I think a lot about it and explore the angles because the fact is, our kids were not made to fit into the DSM, they are humans with many facets. It is worth investigating where ever your heart questions..... NEVER hurts to work on our relationships, right? You are really so candid and inspiring. I am glad you are here sharing.