Anonymous
Post 06/02/2017 17:16     Subject: Therapy for anxious 7yo?
Anonymous wrote:Thanks for all these insightful and helpful responses. I hope the therapist I contacted will point us in the right direction, and I will keep all of your advice in mind.


BTW, you did the right things. Trying to work with the school made sense. They may be out of their depth. I wish the best for your DD.
Anonymous
Post 06/02/2017 16:52     Subject: Therapy for anxious 7yo?
Thanks for all these insightful and helpful responses. I hope the therapist I contacted will point us in the right direction, and I will keep all of your advice in mind.
Anonymous
Post 06/02/2017 15:39     Subject: Therapy for anxious 7yo?
Hang in there, OP. It's hard enough to see your child in pain, but to be berated for your parenting choices when you came here looking for help is awful. I'm sorry you were on the receiving end of so many mean spirited responses. I hope in the future you'll not only get the information you need, but will be treated with kindness, empathy, and respect.
Anonymous
Post 06/02/2017 14:47     Subject: Re:Therapy for anxious 7yo?
I brought up the ADHD as an example of what may cause the anxiety. Anxiety and ADHD can effect executive functioning:
https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/executive-functioning-issues/key-executive-functioning-skills-explained

Trouble with impulse and emotional control can cause kids to do things like skin picking b/c they feel anxiety and try a coping mechanism (which can become habitual). The chronic worrying is related to inflexible thinking. They get fixated on something--like a doctor's appointment and have a hard time thinking of a plan to cope with their anxiety, so they bring up the doctor's appointment again and again months in advance.
Anonymous
Post 06/02/2017 14:46     Subject: Therapy for anxious 7yo?
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Thank you for the constructive advice, especially y7:13. We are actually not in DC so I can't use specific clinic or doctor referrals but I will definitely try to find something similar where we live.

Calling me naive and telling me I messed up by not getting her help earlier really isn't helpful. We did help her significantly over the past year and a half and she is not and never has been out of control with her behavior with the (granted large) exception of the skin picking. When she's anxious about something we calm her down and talk about it and she recognizes when she's anxious and is able to calm down quite quickly. I do realize that can change which is why I'm taking more steps to address it now. And I have been advocating and helping her her entire life.


OP,

I'm sorry you've got so many nasty responses. The SN forum is open to everyone, and many contribute mean, unhelpful comments basically b/c they can. Good for you for realizing there's a potential issue, and taking action. As parents are kids are growing and changing and may start doing certain things that we don't recognize as a pattern. Often as parents, when we reach out for help from likely sources like pediatricians or teachers, we get no where b/c they don't see it either.

There are possible reasons for what your child is doing. It could be anxiety, it could be OCD, it could be related to ADHD. First, has your child ever had a neuropsych evaluation to screen for anxiety and/or ADHD? If so, is she currently on medication that might explain the behavior? Second, even if your child hasn't had this testing, it would be helpful to find a therapist who specializes in OCD. This can be hard to find, especially for children. Therapists who specialize in OCD (Obsessive Compulsive Disorder) usually approach it in a CBT (Cognitive Behavioral Therapy) setting.

CBT is essentially understanding how thoughts, emotions, and behaviors are linked and feed off each other in a cycle. So in the OCD situation, if a child is anxious and starts picking her skin, a therapist will help her recognize the thoughts and emotions that trigger the behavior. Then they work on changing the behavior by substituting appropriate behaviors. So they may substitute a squeeze ball for example.

Although it may sound odd, a local DC area expert in OCD uses The Kazdin Method with children who have OCD. This is a behavioral approach and can be used with in place of or in addition to CBT. The basics of the Kazdin Method is using positive reinforcement to change behavior. So when a kid with an OCD behavior like picking skin will get points and praise for demonstrating an appropriate behavior, e.g., like using a squeeze ball instead of picking the skin.

To find a therapist where you live, I would check with NAMI: https://www.nami.org
You can also contact your nearest Children's Hospital. Please let us know how it goes.


OP - thank you for the very helpful reply and kind words. I have contacted our pediatrician and gotten a recommendation for a therapist who can evaluate her. She has never been evaluated for anxiety or ADHD and in our view (mine, my husbands and her trusted teachers) she doesn't display ADHD traits, though I'd have no issue with her being evaluated for them. She responded very well to an incentive last year - we gave her several options for things to do, including squeezing a ball, when she felt like picking. The picking started and seemed to happen the majority of the time when she went to the bathroom, so we also started monitoring her bathroom time and keeping it shorter at school, or had her go with a buddy. She was able to stop on her own and earned her reward (which was a trip to see Hamilton and she was thrilled). Since the picking hasn't been an issue in a year but the occasional outbursts on anxiety have, it is a good idea to have her evaluated for everything and then we can go from there.



Hamilton??
Omg, do you want to adopt me??? lol

I'm just kidding obviously, but good for you for doing that... what an AWESOME incentive!

It sounds like you'd all benefit greatly from a complete neuropsych evaluation.
Children's hospital will cover almost the entire cost, but the downside is you have to wait 2-3 months for an appointment (although, you can ask to be put on their wait list for cancellations.(which does happen a lot).

If you'd like it done sooner, you can go private.
The downside is that it can cost around $2500 to run a completeneuropsych evaluation.
It's a heavy price to pay, but the upside is that you can get it done almost immediately.

I truly believe that a neuropsych is your best bet, as it will tell you everything you need to know.
No more guessing games, no more using Google as a tool to check for for symptoms, no more confusion & no more denying what we know to be true (and I'm not speaking directly to you in saying that, as every parent with a SN child goes through these same exact emotions).

Once you have the results, you'll know her diagnosis & you can get a game plan going forward, which will only benefit you all & give you the best chance of success (and finding out the diagnosis is half the battle in my opinion).

Good luck!
Anonymous
Post 06/02/2017 14:43     Subject: Re:Therapy for anxious 7yo?
My 7yo DD has had great success with CBT and learning alternative strategies for dealing with her anxious or frustrated feelings. I think the success depends on the maturity/ verbal skills of the child and the fit with the therapist. It isn't too late and you are doing all of the right things helping her figure this out. My child is also very into drama and loves to role play with her therapist.

One thing we have found helpful is the use of an appropriate alternative to picking- so my DD has a piece of velcro stuck on the bottom of her desk that she can rub during class to get sensory input instead of picking at her fingernails. IT is less obtrusive than a fidget.

Good luck!
Anonymous
Post 06/02/2017 14:37     Subject: Re:Therapy for anxious 7yo?
BTW, The Kazdin Method is a book:
https://www.amazon.com/Kazdin-Method-Parenting-Defiant-Child/dp/0547085826/ref=sr_1_1?ie=UTF8&qid=1496426900&sr=8-1&keywords=kazdin+method
(The practices are evidence based meaning they were test through a randomized clinical trial. The kids in the study were diagnosed with Oppositional Defiance Disorder, but behavioral approaches can be used with anyone--child or adult with or without a particular diagnosis.)

I don't want to overload you with books, but I will mention, this one Unstuck and On Target:
https://www.amazon.com/Solving-Executive-Function-Challenges-Unstuck/dp/1598576038/ref=sr_1_2?s=books&ie=UTF8&qid=1496426921&sr=1-2&keywords=unstuck+and+on+target

It summarizes a social skill class curriculum which is also evidence based was developed with children on the spectrum. However, the problem solving approaches can be used any kid. She is getting "stuck" in her thoughts--dreading the doctor's appointment several months off and ruminating over it. She needs the skills to get "unstuck."

Lastly if she's often anxious, and you as parents have been chronically "talking her down" that can become part of the OCD cycle. Every kid gets worried from time to time, and parents comfort them. With the OCD brain, getting the parental comfort becomes the habitual behavior. Many parents don't see how they unwittingly end up reinforcing the anxieties b/c it the pattern isn't clear, it seems like normal kid stuff, and they're trying to approach in a logical way. So in a way, having a clear behavioral habit like skin picking can be helpful in identifying that a kid is more than typically anxious. Once you get her screened by a health professional, you'll be better able to sort out what's going on. It will be a process. GL.
Anonymous
Post 06/02/2017 14:29     Subject: Therapy for anxious 7yo?
Anonymous wrote:
Anonymous wrote:Thank you for the constructive advice, especially y7:13. We are actually not in DC so I can't use specific clinic or doctor referrals but I will definitely try to find something similar where we live.

Calling me naive and telling me I messed up by not getting her help earlier really isn't helpful. We did help her significantly over the past year and a half and she is not and never has been out of control with her behavior with the (granted large) exception of the skin picking. When she's anxious about something we calm her down and talk about it and she recognizes when she's anxious and is able to calm down quite quickly. I do realize that can change which is why I'm taking more steps to address it now. And I have been advocating and helping her her entire life.


OP,

I'm sorry you've got so many nasty responses. The SN forum is open to everyone, and many contribute mean, unhelpful comments basically b/c they can. Good for you for realizing there's a potential issue, and taking action. As parents are kids are growing and changing and may start doing certain things that we don't recognize as a pattern. Often as parents, when we reach out for help from likely sources like pediatricians or teachers, we get no where b/c they don't see it either.

There are possible reasons for what your child is doing. It could be anxiety, it could be OCD, it could be related to ADHD. First, has your child ever had a neuropsych evaluation to screen for anxiety and/or ADHD? If so, is she currently on medication that might explain the behavior? Second, even if your child hasn't had this testing, it would be helpful to find a therapist who specializes in OCD. This can be hard to find, especially for children. Therapists who specialize in OCD (Obsessive Compulsive Disorder) usually approach it in a CBT (Cognitive Behavioral Therapy) setting.

CBT is essentially understanding how thoughts, emotions, and behaviors are linked and feed off each other in a cycle. So in the OCD situation, if a child is anxious and starts picking her skin, a therapist will help her recognize the thoughts and emotions that trigger the behavior. Then they work on changing the behavior by substituting appropriate behaviors. So they may substitute a squeeze ball for example.

Although it may sound odd, a local DC area expert in OCD uses The Kazdin Method with children who have OCD. This is a behavioral approach and can be used with in place of or in addition to CBT. The basics of the Kazdin Method is using positive reinforcement to change behavior. So when a kid with an OCD behavior like picking skin will get points and praise for demonstrating an appropriate behavior, e.g., like using a squeeze ball instead of picking the skin.

To find a therapist where you live, I would check with NAMI: https://www.nami.org
You can also contact your nearest Children's Hospital. Please let us know how it goes.


OP - thank you for the very helpful reply and kind words. I have contacted our pediatrician and gotten a recommendation for a therapist who can evaluate her. She has never been evaluated for anxiety or ADHD and in our view (mine, my husbands and her trusted teachers) she doesn't display ADHD traits, though I'd have no issue with her being evaluated for them. She responded very well to an incentive last year - we gave her several options for things to do, including squeezing a ball, when she felt like picking. The picking started and seemed to happen the majority of the time when she went to the bathroom, so we also started monitoring her bathroom time and keeping it shorter at school, or had her go with a buddy. She was able to stop on her own and earned her reward (which was a trip to see Hamilton and she was thrilled). Since the picking hasn't been an issue in a year but the occasional outbursts on anxiety have, it is a good idea to have her evaluated for everything and then we can go from there.

Anonymous
Post 06/02/2017 14:00     Subject: Therapy for anxious 7yo?
Anonymous wrote:Thank you for the constructive advice, especially y7:13. We are actually not in DC so I can't use specific clinic or doctor referrals but I will definitely try to find something similar where we live.

Calling me naive and telling me I messed up by not getting her help earlier really isn't helpful. We did help her significantly over the past year and a half and she is not and never has been out of control with her behavior with the (granted large) exception of the skin picking. When she's anxious about something we calm her down and talk about it and she recognizes when she's anxious and is able to calm down quite quickly. I do realize that can change which is why I'm taking more steps to address it now. And I have been advocating and helping her her entire life.


OP,

I'm sorry you've got so many nasty responses. The SN forum is open to everyone, and many contribute mean, unhelpful comments basically b/c they can. Good for you for realizing there's a potential issue, and taking action. As parents are kids are growing and changing and may start doing certain things that we don't recognize as a pattern. Often as parents, when we reach out for help from likely sources like pediatricians or teachers, we get no where b/c they don't see it either.

There are possible reasons for what your child is doing. It could be anxiety, it could be OCD, it could be related to ADHD. First, has your child ever had a neuropsych evaluation to screen for anxiety and/or ADHD? If so, is she currently on medication that might explain the behavior? Second, even if your child hasn't had this testing, it would be helpful to find a therapist who specializes in OCD. This can be hard to find, especially for children. Therapists who specialize in OCD (Obsessive Compulsive Disorder) usually approach it in a CBT (Cognitive Behavioral Therapy) setting.

CBT is essentially understanding how thoughts, emotions, and behaviors are linked and feed off each other in a cycle. So in the OCD situation, if a child is anxious and starts picking her skin, a therapist will help her recognize the thoughts and emotions that trigger the behavior. Then they work on changing the behavior by substituting appropriate behaviors. So they may substitute a squeeze ball for example.

Although it may sound odd, a local DC area expert in OCD uses The Kazdin Method with children who have OCD. This is a behavioral approach and can be used with in place of or in addition to CBT. The basics of the Kazdin Method is using positive reinforcement to change behavior. So when a kid with an OCD behavior like picking skin will get points and praise for demonstrating an appropriate behavior, e.g., like using a squeeze ball instead of picking the skin.

To find a therapist where you live, I would check with NAMI: https://www.nami.org
You can also contact your nearest Children's Hospital. Please let us know how it goes.
Anonymous
Post 06/02/2017 13:31     Subject: Re:Therapy for anxious 7yo?
Anonymous wrote:Yes, you did take steps & you ARE her advocate, but you're also not a licensed health care professional.

It's her brain that needs to adapt to a new norm & you don't know how, nor have the training to do so. You need to get this started NOW before her brain stops growing & she has these challenges or worse for life.

Call someone today... don't wait another day (like the 365 you already have).


np - no need to be rude. And her child is 7, she still has plenty of brain growing to do.
Anonymous
Post 06/02/2017 10:31     Subject: Re:Therapy for anxious 7yo?
Yes, you did take steps & you ARE her advocate, but you're also not a licensed health care professional.

It's her brain that needs to adapt to a new norm & you don't know how, nor have the training to do so. You need to get this started NOW before her brain stops growing & she has these challenges or worse for life.

Call someone today... don't wait another day (like the 365 you already have).
Anonymous
Post 06/02/2017 10:27     Subject: Therapy for anxious 7yo?
Our play therapist considers it a type of CBT. Its not one or the other. The therapist needs to adapt the therapy to the child.
Anonymous
Post 06/02/2017 10:23     Subject: Therapy for anxious 7yo?
10:20 again.

We had mental health professionals tell us that 7yo was too early for CBT and that DS should be in play therapy at that age. My suspicion is that a good psychologist can work on elements of CBT with a young child, though. But most will route you towards play therapy. Maybe other people have had different experiences, but we did not see play therapy as any more effective than the strategies you've already used of removing stressors from DC's life.


Anonymous
Post 06/02/2017 10:20     Subject: Therapy for anxious 7yo?
Anonymous wrote:when my child was 8, we tried CBT and play therapy for anxiety. In truth, it didn't really do much. Looking back, I think both of those, as noted by other PPs, rely on maturity to be able to stop in the moment and utilize the methods. Until that maturity happens, I think it does rely on external forces - parents, teachers, etc - to step in and redirect. So I don't really think that you lost that much time or didn't do the right thing by not seeking therapy last year. The gains would likely have not been as great as what people posting here imagine them to be and you likely would have been doing all the same things you did all along and still be in this same place right now.


I agree with this. Maybe it helps a lot with some kids but that wasn't our experience. Our DS is now 9yo and has been in and out of therapy since 6yo. Therapy certainly can't hurt, but it sounds like you took a lot of very effective steps to help your DD already.

I do have some book recommendations too.

For you to read with your DD:
What to do when you worry too much: a kids guide to overcoming anxiety -- https://www.amazon.com/What-When-You-Worry-Much/dp/1591473144 (Get this one even if you don't get anything else)

Mostly for you, but they do contain some pieces you might want to read your DD:
Growth Mindset -- https://www.amazon.com/Mindset-Psychology-Carol-S-Dweck/dp/0345472322 (Get this one if she gets anxious about failure. It can help you to be able to help her recast failure as opportunities to grow. Honestly I think every parent should read this book.)
The Whole Brained Child -- https://www.amazon.com/Whole-Brain-Child-Revolutionary-Strategies-Developing/dp/0553386697 (Some of this is less applicable to anxiety and more towards tantrums/meltdowns, but I found the concept of Mindsight that is introduced in this book helpful for my son. He's not able to apply it all the time, but it is growing his self-awareness).


Anonymous
Post 06/02/2017 09:02     Subject: Therapy for anxious 7yo?
when my child was 8, we tried CBT and play therapy for anxiety. In truth, it didn't really do much. Looking back, I think both of those, as noted by other PPs, rely on maturity to be able to stop in the moment and utilize the methods. Until that maturity happens, I think it does rely on external forces - parents, teachers, etc - to step in and redirect. So I don't really think that you lost that much time or didn't do the right thing by not seeking therapy last year. The gains would likely have not been as great as what people posting here imagine them to be and you likely would have been doing all the same things you did all along and still be in this same place right now.