Evaluation and therapist recommendation: anxiety, gifted (IQ 136, so not super high)

[Anonymous]

Good evening! My DD age 9 has anxiety, diagnosed when young but not recently, and is a highly sensitive child. Her WISC-V showed a 133 IQ, so not super high, but there was significant scatter (eg, 139 VSI but only 101 PSI). I follow Dr. Ross Greene’s CPS philosophy, but I worry about her intensity now that puberty is on the horizon. Because of her advanced academic needs paired with her average processing speed, I homeschool, but I also work full-time, so she has outside co-ops several days/week. She swims competitively and dances, and she thrives with all outside instruction. But she can have full meltdowns and very negative self talk when anxious.

I want to get her in with a therapist (Fairfax County). We have tried five therapists (two play therapists, one OT, and a few talk therapists) over the years, and each time they have been a poor fit. She came away feeling like they blamed her for her anxiety and intensity, and the last one she said made her feel like she was “born bad.” My heart broke. I can’t keep making the wrong choices with therapists, and I just don’t know how to ensure fit before scheduling a session for my DD. One bad session does damage.

So, kindly share any and all recommendations for therapists and evaluators who you believe have experience with children like my little girl. I am looking for therapists who validate all her feelings, not try to negate them. I want her to develop the skills to manage the anxieties of life, as I sometimes fear she won’t have the capacity to handle the harder things. (I also want to get an updated evaluation to make sure there aren’t additional things going on.)

Please be kind in your replies, and I greatly thank you for your suggestions.

[Anonymous]

Anonymous wrote:Good evening! My DD age 9 has anxiety, diagnosed when young but not recently, and is a highly sensitive child. Her WISC-V showed a 133 IQ, so not super high, but there was significant scatter (eg, 139 VSI but only 101 PSI). I follow Dr. Ross Greene’s CPS philosophy, but I worry about her intensity now that puberty is on the horizon. Because of her advanced academic needs paired with her average processing speed, I homeschool, but I also work full-time, so she has outside co-ops several days/week. She swims competitively and dances, and she thrives with all outside instruction. But she can have full meltdowns and very negative self talk when anxious.

I want to get her in with a therapist (Fairfax County). We have tried five therapists (two play therapists, one OT, and a few talk therapists) over the years, and each time they have been a poor fit. She came away feeling like they blamed her for her anxiety and intensity, and the last one she said made her feel like she was “born bad.” My heart broke. I can’t keep making the wrong choices with therapists, and I just don’t know how to ensure fit before scheduling a session for my DD. One bad session does damage.

So, kindly share any and all recommendations for therapists and evaluators who you believe have experience with children like my little girl. I am looking for therapists who validate all her feelings, not try to negate them. I want her to develop the skills to manage the anxieties of life, as I sometimes fear she won’t have the capacity to handle the harder things. (I also want to get an updated evaluation to make sure there aren’t additional things going on.)

Please be kind in your replies, and I greatly thank you for your suggestions.

OP here: I used “DD” to mean dear daughter, which I realize has a different meaning in this forum. I apologize.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Good evening! My DD age 9 has anxiety, diagnosed when young but not recently, and is a highly sensitive child. Her WISC-V showed a 133 IQ, so not super high, but there was significant scatter (eg, 139 VSI but only 101 PSI). I follow Dr. Ross Greene’s CPS philosophy, but I worry about her intensity now that puberty is on the horizon. Because of her advanced academic needs paired with her average processing speed, I homeschool, but I also work full-time, so she has outside co-ops several days/week. She swims competitively and dances, and she thrives with all outside instruction. But she can have full meltdowns and very negative self talk when anxious.

I want to get her in with a therapist (Fairfax County). We have tried five therapists (two play therapists, one OT, and a few talk therapists) over the years, and each time they have been a poor fit. She came away feeling like they blamed her for her anxiety and intensity, and the last one she said made her feel like she was “born bad.” My heart broke. I can’t keep making the wrong choices with therapists, and I just don’t know how to ensure fit before scheduling a session for my DD. One bad session does damage.

So, kindly share any and all recommendations for therapists and evaluators who you believe have experience with children like my little girl. I am looking for therapists who validate all her feelings, not try to negate them. I want her to develop the skills to manage the anxieties of life, as I sometimes fear she won’t have the capacity to handle the harder things. (I also want to get an updated evaluation to make sure there aren’t additional things going on.)

Please be kind in your replies, and I greatly thank you for your suggestions.

OP here: I used “DD” to mean dear daughter, which I realize has a different meaning in this forum. I apologize.

Also OP (first time posting, and I made some typos but don’t know how to edit the original): WISC Composite IQ was 133, but GAI was 136, which I inadvertently referenced in the header. Our only test was in Spring 2021 at age 6.

[Anonymous]

My 7 year old has anxiety, ADHD, ASD, and high IQ, and mental healthy therapy has never helped her. OT was fantastic, and Zoloft helps a ton. So fwiw, maybe it’s not that the therapists are a bad fit and more than play and talk therapy isn’t super helpful for some kids at some ages.

[Anonymous]

Anonymous wrote:My 7 year old has anxiety, ADHD, ASD, and high IQ, and mental healthy therapy has never helped her. OT was fantastic, and Zoloft helps a ton. So fwiw, maybe it’s not that the therapists are a bad fit and more than play and talk therapy isn’t super helpful for some kids at some ages.

I 100% agree with this. Not every child is receptive to therapy and if yours is not (like mine was), it ends up hurting the situation rather than helping. Since yours has already been hurt by therapy, I would actually ask her if she is interested in trying again. If she’s not, don’t force it! She might surprise you and when given a choice decide that she does want to try it and if she does, she will be much more open to having a positive interaction.

[Anonymous]

I agree with a PP. We all have anxiety in the family (and I have a panic disorder which really sucks!), and traditional therapy has never been useful. However, I strongly urge you to redo a full neuropsychological evaluation, because you may find more issues that will illuminate the path you need to take.

DS has high GAI/ADHD/ASD/anxiety and low processing speed, and has meds for the ADHD . I have coached him since he was little for the autism: inferencing, explaining other people's motivations, scaffolding emotional responses, teaching social skills. Every day he lived with us, a lot of coaching. He's in college now. He relaxes with a Dungeons and Dragons group and Youtube history videos

DD has high IQ/anxiety/suicidal talk and again, lots of coaching from me to stabilize the ups and downs of her mind (she's also at risk for panic attacks, unfortunately). She relaxes with horseback riding, digital art and design, and intense focus on her instrument (youth orchestra, chamber group, competitions, recitals, volunteer performances, etc). The performances are a form of exposure therapy for the anxiety! We've had to negotiate that

I considered homeschooling, but realized the academics can be outsourced to the school, even when kids have a high IQ. Kids can place in advanced tracks or magnets in middle and high school. Your DD might benefit from that. What I spend my time on, when my kids return home, is all that teaching about self-awareness and self-soothing and self-talk, as well as driving to DD's activities.

Essentially, since these are my bio kids, and they take after me and live or have lived with me, I have an advantage over the random therapist because I know what makes them tick, and I can immediately identify and attempt to address their brain hang-ups.

[Anonymous]

If you don’t want her thinking about it then talk therapy isn’t the way to go.

[Anonymous]

Anonymous wrote:Good evening! My DD age 9 has anxiety, diagnosed when young but not recently, and is a highly sensitive child. Her WISC-V showed a 133 IQ, so not super high, but there was significant scatter (eg, 139 VSI but only 101 PSI). I follow Dr. Ross Greene’s CPS philosophy, but I worry about her intensity now that puberty is on the horizon. Because of her advanced academic needs paired with her average processing speed, I homeschool, but I also work full-time, so she has outside co-ops several days/week. She swims competitively and dances, and she thrives with all outside instruction. But she can have full meltdowns and very negative self talk when anxious.

I want to get her in with a therapist (Fairfax County). We have tried five therapists (two play therapists, one OT, and a few talk therapists) over the years, and each time they have been a poor fit. She came away feeling like they blamed her for her anxiety and intensity, and the last one she said made her feel like she was “born bad.” My heart broke. I can’t keep making the wrong choices with therapists, and I just don’t know how to ensure fit before scheduling a session for my DD. One bad session does damage.


So, kindly share any and all recommendations for therapists and evaluators who you believe have experience with children like my little girl. I am looking for therapists who validate all her feelings, not try to negate them. I want her to develop the skills to manage the anxieties of life, as I sometimes fear she won’t have the capacity to handle the harder things. (I also want to get an updated evaluation to make sure there aren’t additional things going on.)

Please be kind in your replies, and I greatly thank you for your suggestions.

I’m so sorry you and your child are dealing with this.

A good therapist would teach your child that her brain is hyper alert for things to worry about, but that it’s not her fault. Sometimes a 9 year old isn’t ready to learn about how her brain is different than others, but it’s necessary to accept and start to try to change it if you want therapy to work so it’s ok if your child isn’t ready yet! .

As a parent, our first instinct may not be the most helpful in tackling anxiety and we might be inadvertently making it worse. Have hou considered SPACE training? It might be good for your child to take a break from therapy and for you to frame it as - we are going to learn some things that we can do to help you.

[Anonymous]

Abigail Shrier’s “Bad Therapy” might be of some interest to you- basically, therapy can cause the child to perseverate on their mental health which will lead to deterioration of mental health. I find this a reasonable argument (and I have severe anxiety/OCD).

[Anonymous]

"I want her to develop the skills to manage the anxieties of life, as I sometimes fear she won’t have the capacity to handle the harder things."

I'm not sure if she's old enough yet, but once she hits middle school age, cognitive behavior therapy might be the route. Your daughter sounds a lot like me at that age, and CBT in my teen years absolutely changed my life for the better.

[Anonymous]

My daughter had too much anxiety to participate in therapy at that age. Meds were life changing.

[Anonymous]

Similar child. Highly recommend Alison Gardner in McLean. FWIW, my child briefly took anxiety meds (well, I mean for two years) and hasn't since. In college now. Dr. Gardner is wonderful and worth waiting for if she has a waiting list.

[Anonymous]

OP here: My heart swells with gratitude for your kindness, validation, and perspective. I shared my post and your replies with my daughter (I want her to never think I’m behind her back or talking about her to others without her knowing, even if it is anonymous), and she appreciated the acknowledgment that therapy may be harmful at this time. I also thank you for the suggestions on the type of therapy and person with whom we can seek therapy when she is at the appropriate age. Truly, I am so grateful!

[Anonymous]

Your daughter sounds much like mine, though mine is 11. We've tried so many therapists, including ones who were supposed to be the best of the best for kids with anxiety, ones who specialized in gifted kids, ones who were supposed to be good with kids who didn't respond to traditional therapy, etc.. None worked, and I do believe that several made things worse. For us, working with a good developmental pediatrician to get an effective SSRI was what finally made the difference, combined with changing schools.

[Anonymous]

Anonymous wrote:Abigail Shrier’s “Bad Therapy” might be of some interest to you- basically, therapy can cause the child to perseverate on their mental health which will lead to deterioration of mental health. I find this a reasonable argument (and I have severe anxiety/OCD).

This is RWNJ propaganda, not based on actual scientific data.