Anxious Kid and Therapy

[nicolewi]

DD, age 10, is generally an anxious kid. She has a lot of trouble sleeping. She worries a lot about random things, but never to the point where we took her to be officially diagnosed or put on any meds. I take her sporadically (it was originally every couple of weeks but now I aim for every month) to see a really nice counselor, which we've been doing for 2 years now. She likes going, and it seems to help at the time, but we continue with a lot of the same issues (or just new issues) from month to month--i.e. nothing really resolves. 

DH is questioning the point of continuing counseling indefinitely and wondering whether there should be a goal or an endpoint.

I don't really know what is typical or recommended. Am I being silly to keep sending her to talk to the counselor? or is this a generally positive and recommendable course of action? As long as she likes going and seems to find it helpful, I thought we should continue. She's having a lot of issues lately re: puberty, and I am happy to have someone else for her to talk to besides me.

Thoughts or advice? I don't want to be throwing away money and time if this is a goofy thing to do. Is DH right? Is there supposed to be a goal or endpoint?

[chw57]

For my CBT for anxiety, we set goals at the outset, and checked in on progress toward those goals each session. After 6 sessions, I'd made a ton of progress, so now we just check in as needed. I think it really depends on the style of therapy, but I would be a little concerned that you're not seeing any changes. When we took DD to therapy for anxiety around the time she started kindergarten, she gave us lots of things to work on at home and things improved a great deal in a few months, so I would probably consider trying out a different counselor.

[expectantsteelerfan]

My ds has seen 3 different therapists for ADHD related issues. The first we left because I didn't feel it was helping. The 2nd and 3rd each set goals and they check in regarding those goals. We left the 2nd because he wasn't making progress towards our main goal (she was a general kids therapist, not ADHD specialized, and felt he'd do better with someone who did specialize in ADHD, it was her idea to seek someone new). I liked her the best. The 3rd, even though we set goals, I felt like he spent a LOT of sessions building rapport with ds (they often played chess while they chatted, but ds couldn't really focus on anything other than the chess game). Like you, my ds liked going and I felt it was beneficial for him to have someone he felt comfortable talking too. So I was really on the fence about him...we weren't making a ton of progress, but still felt it was beneficial. But then our insurance changed and we needed to find a new place. We're currently on the waiting list for someone who comes highly recommended in my local ADHD support group.

Anyway, I do think it's common to have to try out several therapists before you find the right fit. But I also think them 'clicking' with your kid is important. And I also felt like sometimes, I got more out of therapy than ds because they gave me ideas on how to deal with stuff and what expectations were reasonable and whatnot.

So I guess it wouldn't hurt to ask your therapist to set goals, or to try out someone new, but if you feel it is helping at all (either her or you) I wouldn't just totally stop without starting somewhere else.

[waverly]

Could you do a parent meeting with the counselor to check in and set goals? I think sometimes if the counselor and child think it is helping then maybe they are cool with that, but if the parent wants more it is within your right to ask.

DH has been seeing a counselor for 1.5 years now, and it will likely continue. I have seen a lot of improvement with his depression and at this point I think it is just someone else to bounce ideas off of, and with his insurance it was only like $20 a session, and he went at lunch so the cost both money and time wise was low for what he got out of it.

I know if it were me, I would want to probably stop going at some point in time, so I likely would have pushed the counselor for more progress and goals. DH just really likes another person to talk to at this point because he is a big talker (emotive type), and his friends and I don't have the bandwidth or the knowledge to continue to have the same conversations over and over with him. We have nothing new to say, but the counselor does.

I do think there should be goals.  There doesn't have to be an endpoint, but it would be nice to see more progress with the anxiety.

[lolo]

You might also read up about SPACE and the research Yale is doing in this area--it's any how teaching parents can actually help as much or more.

[joy]

I’m only coming from my own experience, but anxiety is an ever-changing and ever-moving target. I learned coping mechanisms and would practice, but real mastery took years. I also would overcome one anxious situation for another to crop up and I’d need to hone my skills again. While life is “stable” for an adult, kids are growing, changing classes, changing peers and experiencing everything for the first time. It’s very possible that her anxiety will be a one step forward/two steps back thing as she grows, changes and practices what works.

[jinkies]

My son did a few sessions of therapy for anxiety last year (5th grade, age 11). We didn't set endpoints, but honestly he just found it took a weight off his shoulders to talk things through with someone. Not that he couldn't talk to us (and he did!) but he was more likely to stay calm and be able to talk things through with the counselor. He found it helpful, even though all she did was listen. He definitely seemed calmer and... I don't know. Relieved? Lighter? after his sessions.

I think if we had started it earlier in the year, she would have worked with him more on goals and coping strategies. But due to insurance issues and a long wait for an appointment, it was close to the end of the school year. His anxiety is school-based, and we are only in our second week of this school year. We'll see if he needs to re-start this fall.

[Dumbledork]

So, question-

I think DD is struggling with anxiety.

Should we get an official diagnosis before looking for counseling, or will a counselor be the one to give us that diagnosis?

[nicolewi]

lolo, I did see that study, and I wish I had those sessions available to me! I would totally try that rather than floundering around trying to decide how best to handle things in the moment! But, no such luck.

As backstory, she did go initially every 2 weeks or so and they kind of worked through a bunch of basic anxiety strategies, and made a book about dealing with "worry monsters." Since then, I think we are supposed to be kind of doing "maintenance," but to the points of joy and spearmintleaf, it's a moving target. For a long time, through mid-August, she was doing great with just a few check-ins. But then, several things happened at once right at the end of summer/in conjunction with the start of school and activities, and she's having a harder time again. School, friend drama, extra curriculars, way more demands on her time, puberty. I feel like we've taken a step backwards lately.

She goes again tomorrow and I will talk to her counselor a bit about what she recommends for a schedule.