A psychologist can evaluate, diagnose, and treat with therapy (i.e. CBT). A psychiatrist can Rx meds. Ideally you would want a team of both that work together with you.
Any physician or nurse practitioner *can* dx meds. That includes a neurologist, neuropsychiatrist, developmental pediatrician, regular pediatrician, family doctor, etc. That doesn't mean they should, iykwim. But if you already see a dev pedi or neurologist for developmental/neurological issues then it could be the best choice depending on your circumstances.
Sorry; I should have clarified. He had been dx'd by neuropsych a while ago, so he needs someone to work with him on actually addressing the anxiety (i.e. strategies, etc then rx if needed). Neuropsych gave a list of places that may or may not have the right type of provider and who may or may not take our insurance, but neuropsych is not local so couldn't refer us to anyone specific. Now that the anxiety is ramped up even more, it is time for LO to see someone, but I am spacing on what type of provider. I feel like that description still makes little sense. I am apparently not doing well at all with any words today; I can't come up with the type of provider or the words to describe said provider. I got crap for sleep last night, and it has seemingly zapped away 99% of my vocabulary and my ability to form my thoughts into words. Lol.
A number of different clinicians can be involved in the tx of anxiety.
If you want to explore medication- because that is often very effective at helping the child be available for learning the interventions for anxiety- you ideally want a psychiatrist because they are the specialty with the most expertise in psychoactive medication. A dev pedi can also prescribe; personally I would not rely on a PCP or pedi.
For talk therapy, you probably want a therapist, clinical or counseling psychologist. Experience with ASD, anxiety, etc. are probably more important than the actual degree earned by this person. I know people who see PhDs, DEds, MSWs, MAs, CNPs for therapy.
Depending on your child's cognitive abilities and maturity CBT is a great approach.
IME, you may find you have to pay OOP for this kind of care.
CBT has more evidence as the therapy for addressing anxiety apart from pharmaceuticals than anything else. There are a couple of other strategies aimed at anxiety (and depression since they often travel together; in young children the anxiety typically precedes the depression piece) like DBT (which started out for tx of suicide ideation and substance abuse and is more of a subset of CBT), EMDR (which (CBT for social learning) and ECT (because everything old is new again) which are showing real promise.
I have 2 ASD-mom friends who have their own significant anxiety issues. One stumbled into DBT as part of her training for an MSW and found it useful for her and her teen daughter. The other (a clinical psycholgist) is trialing EMDR to deal with issues related to a traumatic childhood and finding it kicks in really quickly- she's sleeping well already). On the other hand, I am watching DN go through the motions with the same psychologist for over 10 years and seeing next to no improvement using traditional talk therapy.
Play Therapy and play therapy are not the same thing.
I think a lot of practitioners throw around the term "play therapy" because it sounds less clinical to the ears of parents- like it's therapy-lite. JMO. PT can be a terrific option for a young- especially preschool aged child. But it is not specific to any one mental health condition in the way CBT and the others are. Any good clinician working with a younger kid- say under age 8- will endeavor to make the sessions as pleasant as possible while doing the work of learning ways to manage general anxiety and anxiety-producing situations. When he was younger, DS's psych often did Legos with his psych or played games; we'd hear them laughing in the waiting room. The psych sometimes took his high school aged clients for short walks in our cute little downtown. My EMDR friend has a big playroom in her practice and has been known to climb trees in the park outside if that's what it takes.
When anxiety is more situational, CBT can be done in a fairly short term manner. My godchild developed anxiety around storms when she was about 10. It was impacting her life because she was afraid to be outside as soon as it got cloudy because it could potentially mean a storm. She stopped going to the beach with family unless the day was perfectly clear, she wouldn't go outside with friends and was just generally miserable. Her therapist did an 8 week CBT desensitization program that helped GC reframe her thinking which she has since applied to other anxiety-producing situations. Like DS, she had a lot of "homework" between sessions.
Play Therapy can be used to treat a range of issues- attachment disorders, trauma, delayed social skills, depression, anxiety, etc- and because of that, you'd want to be certain the person working with your child would have experience specific to working with a child who has anxiety in the context of and comorbid with any other conditions the child might have.
It's funny, I look at DS and my niece- both bright young people who carry a GAD dx along with ADHD. Her ADHD is a more inattentive-EF deficit kind of thing and a big piece of her anxiety focuses on being "found out" by her peers socially and at work- it boils down to "what will people think?" DS's primary is Aspergers (so emotionally immature) with a side of impulsive ADHD; He almost never thinks about what others think of him and when he does, he kind of doesn't care or appreciate the consequences.
auntie , I think those were the providers I was trying to sort out. Thanks! Would you do CBT in addition to or as an alternative to standard therapy?
Curious what you mean by "standard therapy"? CBT is pretty standard, though for a young child play therapy could be a good option as well.
Sorry for any confusion in my word choice that I now see could be taken two ways. I didn't mean "standard" in a common versus less common sense but rather to mean a more generalized or broader therapy such as talk therapy as opposed to the CBT which is more specific in uses (despite both being able to focus in on their targets). I feel like I am not saying any of that well at all, but LO just woke up with allergies bothering him, so I have to run for now.
We're about to try TBRI (trust based relational intervention). It isn't for anxiety specifically but I think it will help in our case, if DD is open to working on it (in the past her anxiety has been so high she hasn't wanted the therapist to know she has these feelings or reactions for fear they would think less of her). It is more for kids who were adopted or have experienced trauma, though, and is more on the relational side vs behavioral.
We're about to try TBRI (trust based relational intervention). It isn't for anxiety specifically but I think it will help in our case, if DD is open to working on it (in the past her anxiety has been so high she hasn't wanted the therapist to know she has these feelings or reactions for fear they would think less of her). It is more for kids who were adopted or have experienced trauma, though, and is more on the relational side vs behavioral.
Good luck! I hope your LO is willing to participate.
Curious what you mean by "standard therapy"? CBT is pretty standard, though for a young child play therapy could be a good option as well.
Sorry for any confusion in my word choice that I now see could be taken two ways. I didn't mean "standard" in a common versus less common sense but rather to mean a more generalized or broader therapy such as talk therapy as opposed to the CBT which is more specific in uses (despite both being able to focus in on their targets). I feel like I am not saying any of that well at all, but LO just woke up with allergies bothering him, so I have to run for now.