Help! How to evaluate a child psychologist?

[Anonymous]

After a comprehensive diagnostic evaluation, DD (age 8.5) was diagnosed with Generalized Anxiety Disorder and the diagnostician gave us a list of referrals for psychologists. We went with the one who had the best availability and seemed to have the most practical approach, but now that DD has had 5 sessions with her, I'm starting to doubt whether we made the right choice.

DD enjoys her time there, because all they do essentially is play Uno, do some puzzles together and DD fills out a worksheet or two each session. According to DD, the psychologist doesn't ask her any follow-up questions related to her answers on the worksheets (e.g., the worksheet asks, "What was the hardest part of your day?" and DD writes "Worried that I was getting on the wrong bus after school" and psychologist doesn't probe any deeper with any follow-up questions). DD said that they don't really talk while playing Uno or doing puzzles, except occasionally DD will say something like "Yes!" when she gets an Uno card she needed.

I totally understand that the psychologist might play games/puzzles and not converse much with DD during the first session or two, to get DD comfortable. But DD has seemed completely happy and at ease there since half-way through Session 1 (according to DD) so it doesn't seem like they should be spending Sessions 2, 3, 4 and 5 continuing to do this. Money is tight for us and this psychologist isn't covered by our insurance, so I'm feeling stressed that we'll be spending thousands of dollars to have someone play Uno with DD! DD's never been in therapy before so I don't know if this is somehow typical.

DH and I have an appointment to meet with the psychologist next week and I want to ask some pointed questions about specific therapy goals and how they are going to work toward those goals, but I also sense that this psychologist is somewhat sensitive and I don't want to put her on the defensive.

Can anyone share if they think this is typical for the first couple months of therapy with a child? Also, how long do you think I should keep DD with this psychologist before moving on, if this sort of thing continues? And does anyone have any thoughts about specific questions that DH and I might ask next week without insulting the psychologist?

Thanks for your help.

[Anonymous]

Typical - its called play therapy. I'd drop it and find someone else or get her in yoga for breathing techniques.

[Anonymous]

the therapy model that feels the best for me and that works the best for ds is one where the therapist talks to both me and ds so I can bring up anything I need addressed or have found to be an issue or something really positive. then therapist and ds talk. then therapist, ds, and I talk again so I can support strategies that they discussed, or understand why something happened the way it did. this model helps me know things that are being worked on. the therapist where a felt like you didn't work well for us.

[Anonymous]

OP Here. Thanks for your thoughts. I like the idea of participating in some of each session. When DH and I meet with her next week, maybe I will ask if the last 10 minutes of each session can include me so that I can help support strategies. I really like that idea and I don't think it will offend the psychologist. The only concern I have is that I generally have to take my other child (age 3) with us and I'm not sure what I can do with her while participating at the end of the session. Maybe i can get a babysitter every other session -- this is all getting so expensive! But worth it if it will truly help DD's anxiety...

[Anonymous]

I stuck with a therapist like you are describing for my child for far too long and while my child really liked her, she didn't help my child.

I am now looking for a CBT therapist and have learned to ask a lot more questions of the therapist. I need my child to leave therapy with strategies for dealing with anxiety. We do not have unlimited time or money for therapy.

[Anonymous]

I actually found play therapy to be very helpful for my son. My son was younger, though, and I didn't think he had the capacity to participate in talk therapy in any kind of meaningful way. We as parents met separately with the psychologist, which definitely felt like the right way to go.

In the immediate sense, we certainly got more out the parent meetings--but I can't see how they could have been so productive if the psychologist hadn't been working simultaneously with my son. She really knew him and understood him--that part seemed absolutely key to me. At first it did feel like their sessions were a long extended evaluation/get-to-know-you session, but it still felt like a necessary part of the process.

And in the long run, I could see real effects of the play therapy on my child, too. They worked constantly on his flexibility/rigidity and on his emotional reactions to situations. He was a kid with real struggles and he grew so much. Also, over time, they worked on developing and using his emotional vocabulary. At age 12, my son is MUCH more self-aware, in tune with himself, and articulate about his feelings than most kids I know. i have no doubt that much of this was due to therapy.

All that said, a) I think our therapist was amazing and b) it took time, as in, many years of time.

[Anonymous]

Is she learning about anxiety? We have been through several therapists who were not helpful. The excellent one we finally found taught my DC about anxiety and personified it. They have talked about ways that anxiety tricks your brain and body into thinking you are in danger, different places in your body where you feel anxious (and how to know that's anxiety and not illness), ways to calm down (progressive muscle relaxation, positive self talk, visualization, etc.), strategies for dealing with anxiety at school (and then communicated with the teacher and VP at school to get accommodations in place). They talk about the past week and when anxiety was hardest to deal with and goals for the upcoming week.

At first, I was in all the sessions the whole time (not the case for the previous therapists we had). This was so helpful because I was learning the same language and strategies and could help my DC more directly in the moment. Also, I was able to provide info that was helpful to the therapist. Now I just get an update for the last 15 minutes or so with the successes and goals for the week.