Therapy for Depressed/Anxious ASD Kid

[Anonymous]

My late diagnosed, low support needs ASD kid hates therapy. But he’s also an anxious mess and on several serious psych meds to cope. I feel like we need eyes on him regularly beyond just me and my husband. Ostensibly he’s learning skills to manage his anxiety but we’ve been at this for years and he rarely seems able to implement those things in the midst of a meltdown. He’s almost 12.

We even tried switching a few months back to a younger therapist to see if that might help. Given all that he’s dealing with, including being dyslexic and trans, I want to give him every possible tool to manage his emotions and learn about relationships. He says he hates talking about his feelings with non-family grown ups. He’d rather talk to us or to friends. I think his anxiety is too much to lean on friends for. At this point his meltdowns are primarily about how he doesn’t want to go to therapy.

He has a PDA presentation of autism. Part of it is just that he doesn’t like being made to go anywhere.

Thoughts from parents of kids with a similar profile? Was therapy helpful? Were your kids ever able to implement the skills? Did they ever get to a place where they felt safe opening up? Is it worth it continuing to make him go? We don’t compel him to do much (shower, pick up after himself to a degree, go to school, go to doctors) but this seems important to me. I don’t want to discount his repeated protestations that he hates it. The therapist is experienced with ASD kids and pleasant, communicative, and professional.

[Anonymous]

We did many years of completely useless therapy. My kid is also ASD, ADHD and trans. Mine has not been resistant to therapy though, although they did not love it with the ineffective therapy of the past. We recently found the DBT Center of Greater Washington and it has been the only therapy that has ever been effective. I so wish we had found it earlier.

[Anonymous]

Anonymous wrote:We did many years of completely useless therapy. My kid is also ASD, ADHD and trans. Mine has not been resistant to therapy though, although they did not love it with the ineffective therapy of the past. We recently found the DBT Center of Greater Washington and it has been the only therapy that has ever been effective. I so wish we had found it earlier.

OP here. Do they take insurance?

[Anonymous]

I’m sorry OP, I hear you. My DC is similar. As with everything, therapy was not effective until DC was interested. My advice is to keep offering, but drop the mandate that DC has to attend. Keep bringing it up every 6 months & try again.
We tried therapy from 4th grade - college. It was a nonstarter until DC got interested in talking with a therapist near the end of high school.
You can’t make it happen, just keep offering to set up appts.

[Anonymous]

Echoing PPs, if your kid doesn't find therapy helpful right now, it might make sense to step back for a while. Can you drop the frequency of sessions as a trial? Our DC could not process what therapists were trying to do because everything was so overwhelming and frustrating to them. We kept up with meds, tried different therapists, and what finally seemed to really help? Time and maturity. DC got to a place where they could opt-in to treatment and see results.

So there is hope! At that age we focused on regular sleep, exercise, screen limits, structured playdates.

[Anonymous]

If he’s on “several serious psych meds” for anxiety, you’ve done actual evidence based therapy for anxiety right?

[Anonymous]

I don’t think therapy will be useful with this profile at this point. The kid has to buy in and want to do it and for anxiety it shouldn’t be about feelings but about tools. Talking about feelings is not productive with this profile.

[Anonymous]

Anonymous wrote:If he’s on “several serious psych meds” for anxiety, you’ve done actual evidence based therapy for anxiety right?

OP here. Yes. For years.

[Anonymous]

My kid also has many of the same diagnoses and hates individual therapy. We’ve dropped it in favor of a social skills group run by a psychologist. A lot of the issues that come up (dealing with anger, overcoming anxiety, etc) are what he would be trying to address in therapy. Discussing them in group is easier because it’s not all about him. He is now much better at knowing what techniques might be useful and has even improved at being able to use them in the moment.

[Anonymous]

Anonymous wrote:

Anonymous wrote:If he’s on “several serious psych meds” for anxiety, you’ve done actual evidence based therapy for anxiety right?

OP here. Yes. For years.

evidence based therapy for anxiety is not supposed to take “years.”

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:If he’s on “several serious psych meds” for anxiety, you’ve done actual evidence based therapy for anxiety right?

OP here. Yes. For years.

evidence based therapy for anxiety is not supposed to take “years.”

CBT or DBT?