Therapy setting failing, but therapist is awesome – what to try?

[Anonymous]

My DD is 5 and has anxiety/social anxiety. She talks more at home than in other settings, and we are working with a selective mutism diagnosis as a spin-off to the anxiety.

She has been in speech therapy with an SLP who just really "gets" her since March. She agrees that my DD's anxiety is hampering her wanting to talk as opposed to her having a language disorder. While I agree that selective mutism is generally not treated with speech therapy, therapy with our SLP has been SO much more than that – it's play therapy, teaches her to trust another adult besides us, and has been very beneficial for ramping up her challenges, then lowering them so that she can desensitize her anxiety. We also do psych therapy.

The positive? She just did two weeks of camp (her SLP happened to be one of the counselors on site) and she actually participated in front of a group, answered questions, talked, made friends, played and had an awesome time! The negative? Therapy sessions now suck – I know it's not our SLP because DD loved her at camp and still cuddles with her during therapy.

But she cries, hates the room, no longer wants to really play the same things and is generally shutting down during therapy (very tiny room and her performance anxiety goes off the charts – the feeling of "I'm here to work on something that scares me" kicks in big time). During camp, she was following directions, taking instruction, playing with other kid and just generally did freaking awesome. But our therapy setting suddenly just seems to be a complete downer for her.

Our SLP said we can shake things up and next week meet at a playground close by, and she is the most amenable, "let's try something new" type of person, but I am worried. What else can we do? Has anyone else had this happen?

[Anonymous]

Keep the SLP, she sounds great. Dump the psych therapy. Therapist should not be cuddling, maybe a hug, but it pushes boundaries a little. Most therapist offices are small and have way to much stuff in them and aren't fun/kid friendly.

[Anonymous]

See how it goes on the playground. I have similar experience as you with my DS. Rather than staying in the therapy room, they would take a big wheel into the parking lot, do stuff in the hallway, etc. She also would do joint sessions with other kids and do fun things. If changing it up doesn't work, just take a break for a bit.

[Anonymous]

Can the SLP see her at school instead (when that starts)? Or put together a group of kids to work with at her office or somewhere else? Because frankly that seems like it might be more beneficial anyway than having your DD work one on one in an office setting.

We, too, have a magical SLP who understands lots of things, including child development, behavior, education, sensory needs, etc. She works with DS at school and it's fabulous. But she doesn't even have an office so that has never been an option.

[Anonymous]

OP here.

Thanks so much for all the kind replies and understanding. I definitely like all the ideas – especially about just being in the halls or taking a walk around outside or something more interactive.

It's so funny – she will talk all the way down the hallway, pointing out things she sees in the pictures or paintings and happy to see our SLP. But as soon as we enter that little room, she's just done. My DH pointed out that it's like at the beginning she's stressed out (takes a few weeks to get going), then gets used to everything and does really well for a few weeks, but then gets bored with what's in there. Which is sort of the pattern.

Your suggestions reminded me of why camp was so great – a mix of outdoor and indoor, a handful of kids, and sort of something new every few minutes. And she got into a routine she really liked, but there was new stuff every day (a play tent one day, sandbox the next).

I will definitely ask about whether she can help with school although right now we have a great private program lined up with a fantastic teacher skilled in helping anxiety-ridden kids, and our SLP is coaching the teacher (who is very engaged with us) on what will help our DD in the daily classroom. Might ask too about getting her in with other kids for therapy more often, versus one-on-one.

Just to clarify – our SLP mostly does high-fives and fist-bumps with the occasional brief hug. After anxious crying jags, my DD will often go to her for cuddling (if I'm not there) and our SLP always keeps it brief but reassuring. So nothing inappropriate. But worth mentioning.