Getting “more” out of therapy

[Anonymous]

Anonymous wrote:

Anonymous wrote:I am a therapist, and if I was seeing a child for depression that was improving, I would not guess out of thin air that mom wants me to now work on executive functioning. You have to communicate your goals if you want your goals addressed.

But would you be okay to charge mom $200 to sit and play chess with the child?

Of course a therapist would be happy to do that. Easy money! Such charlatans.

[Anonymous]

My HFA kid won’t play games with rules so I’d be thrilled if they played chess with their therapist. It would be building tolerance for turn taking and rule following and potentially losing or winning gracefully. Perhaps these aren’t issues for your kid.

[Anonymous]

She probably plays games as a way to make it easier for your son to chat. If he is doing well I could not drop her. I would talk about decreasing frequency. You want to make sure the therapy is not the essential part to doing well. Try decreasing for a few months, if it goes well, decrease even more. Make sure to stay on good terms in case you need to resume at some point.

[Anonymous]

YMMV, but I was shocked last year that Kaiser authorized up to 52 visits in a year for out of network psychotherapy for DC with OCD/anxiety for my child. Worth asking about.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I am a therapist, and if I was seeing a child for depression that was improving, I would not guess out of thin air that mom wants me to now work on executive functioning. You have to communicate your goals if you want your goals addressed.

But would you be okay to charge mom $200 to sit and play chess with the child?

I would be if I’m also having meaningful conversations at the same time. Playing games is a great way to build comfort and often facilitates productive conversations. Kids who may be resistant to sitting and talking about their emotions/thoughts often open up when they feel less on the spot, like when playing a game.

All I’m saying is that the parents and therapist should discuss treatment goals now that the depression has stabilized. It might not be a great fit long term, but it seems premature to look for another therapist without actually talking to this therapist about goals and approaches.

This, OP.

[Anonymous]

I have a child who has been in weekly therapy since June for anxiety. We are stepping down to every other week since DC has made a lot of progress and we do a lot of practice at home on skills taught at therapy.

I meet for about 5-10 min at the first part of a session every few weeks to update from my perspective and bring up anything I would like therapist to focus on. My child also has ADHD and sometimes it’s executive function stuff, sometimes it trouble shooting a specific social incident - things come up. But the therapist won’t know unless you tell them and you shouldn’t only rely on your child to say something.

[Anonymous]

Anonymous wrote:YMMV, but I was shocked last year that Kaiser authorized up to 52 visits in a year for out of network psychotherapy for DC with OCD/anxiety for my child. Worth asking about.

+1 I’ve been meaning to try this for my son because a friend also got this approved through Kaiser and the mental health team confirmed it is a thing - they are now doing it more I think but am not sure. Since they don’t have enough therapists you can apparently say you found someone and then they will approve it

[Anonymous]

Have the therapist make a list of goals.

[Anonymous]

Anonymous wrote:My 13 yr old son (HFA, ADHD, 2e, inattentive, anxiety dx) started therapy 6 months ago when he had sudden signs of depression, obsessive thoughts of things that were scary to him, existential dread. We also started him on 10mg of Prozac. He’s doing much better and no longer has the issues that brought us to therapy. However, he and we would like to continue so nothing sneaks up on us again. However, he says he has nothing to talk to her about anymore so the play various games like chess and a board game. I’m not going to lie, paying $200 a session for him to play chess hurts. She came highly recommended and works with neurodivergent kids frequently. Am I wrong to think she could be working on other things with him? I want a therapist like the ADHD Dude that can also work with him on social skills and executive functioning issues but I guess that’s not normal and I’m dreaming. Any advice?

Younger son, similar diagnosis, at similar point with therapist where feels like paying $200 for games and I totally want the ADHD dude! Found this post trying to see if anyone has done his parent training and have any feedback?

And with anxiety (+ ADHD etc) does 1x1 therapist help?

[Anonymous]

Anonymous wrote:

Anonymous wrote:YMMV, but I was shocked last year that Kaiser authorized up to 52 visits in a year for out of network psychotherapy for DC with OCD/anxiety for my child. Worth asking about.

+1 I’ve been meaning to try this for my son because a friend also got this approved through Kaiser and the mental health team confirmed it is a thing - they are now doing it more I think but am not sure. Since they don’t have enough therapists you can apparently say you found someone and then they will approve it

+2
We spent a lot of time paying $250 per week for therapy in 2022 and then in 2023 someone gave me a number to call after they admitted they couldn't serve my kid's specific issue and they very quickly and easily approved outside therapy. They reimbursed everything except our $5 copay for each session. We still switched to a PPO because Kaiser wouldn't refer DD for an eval to diagnose her ASD or pay for OT but with mental health I think they have gotten so many complaints that they do approve these requests.

[Anonymous]

Anonymous wrote:If he’s going weekly maybe cut back to every other week. It stood out to me that he wants to keep going. That’s huge and they have a relationship, which can be hard to find. My kid had a lot of different issues come up when he was 14-16 and it took a long time to find someone he felt comfortable with and where he was willing to attend the sessions. Now at 16, I constantly wonder if I’m wasting money and don’t know most of what they talk about. But he wants to continue so we do. My son sees his therapist every other week now.

I see this thread was revived and quoting myself, since I wrote this 5 months ago. My now, almost 17 year old, hasn’t been going in a long time. He admits he was going through the motions and it was basically a waste of time and money. We’ve stopped all therapy after years of trying people. I remember writing that and thinking it was progress that he agreed to keep going. It was him becoming more mature, not wanting to argue with us and doing what he thought we wanted him to do.