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Question for those seeing therapist for OCD


lmkmip67
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I am taking Ian to a psychologist that treats OCD in children and adults. We have went to 6 appointments so far. She does seem to know a lot about OCD. But I am questioning the treatment. It seems totally based on CBT, which is helpful to an extent. But Ian doesn't seem to be able to really utilize it very well. He is 8, so still young. Some of the things she has him do seem right out of the When My Brain Gets Stuck book, which we have. And I know they are good techniques. She has had him name his OCD. But beyond that, she tells him to talk back to the OCD, and they role play a little bit. A typical appointment is suppose to be 45 minutes. But so far all she does is ask how things went the past week, talk about the "fear thermometer" and ask what he wants to work on this week. This all takes about 15 minutes, then we kind of sit there while Ian asks her every question under the sun, tosses balls into the air (because he is an antsy 8 year old boy) and she keeps seeming to try to get him to role play about his OCD. I don't know. I never feel like we really leave there with Ian any more invested in this, or anything new, or like we have really made any progress. I know it is a slow road anyway, and we help remind him at home and put up limitations on behavior, etc. But it doesn't seem like she is doing anything I didn't already know, or couldn't do myself. She hasn't really come up with any more tools or methods to help or for him to try, in 6 sessions. We have a neurologist appointment in two days finally, and she is pushing for him to be on medication so the tools she is trying to teach him will work better. Really? I am not pulling him yet, as we are on a waiting list for another OCD specialist (6 month waiting list, I have a feeling she is very good). This one had lots of open slots, so I wonder if there is a reason. My gut just tells me there should be more meat to the sessions. I don't know. So I figured I would ask here and see if this sounds like a typical session with an OCD therapist for those that do go? Or are we just wasting out time and copays? I figured I will stay here until we try the other psychologist, at least we are trying something, I guess. Thoughts? I may also ask on the OCD forum, but since we are dealing with PANDAS, I thought this might be a better place since these kids can flare and such. Thanks!

 

Lisa

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He sounds like a pretty motivated kid - if so, there should be more meat to the sessions. And at age 8, she should be giving you a lot of training on how to implement the tools to deal with OCD. You do have to pick something to work on, but you and your son could do that as homework, not in a session. Then you would break that OCD issue down into baby steps and start doing homework every day, for about 30 minutes.

 

Naming the OCD (externalizing it) and building a heirarchy of fears are great steps. But now he needs to take the first step towards fighting it, and learning to feel some pride in his success.

 

Has she set up a reward program for him?

 

I think your gut is likely right. She is teaching him some good information, so it's not wasted time - but without implementation and practice, he won't start to see improvement.

 

Maybe ask her for a specific plan for homework for the next week, or tell her what you want to try to work on. Pick something that is really minor, that has a low fear rating - and ask her how to set up a reward plan to use while you do the homework. If she can't answer those questions, then you may be wasting your time. But she may just be trying to get to know your son, and not realize that you guys are ready to start working. I find a lot of pediatric therapists are just slow on the front end. Maybe that is good for some kids - others just want to work.

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We are seeing an OCD specialist and I feel your frustration. It seems to be a very straight forward approach "talk back to the OCD". Although I think my son has benefited from the first few sessions, I feel like we aren't making anymore progress. On a selfish note...i'm exhausted from repeating my son's struggles to multiple people weekly.

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Minnesota mom-

 

For us, talking back to ocd did not work. We have found that the only worthwhile therapy for ocd is ERP (exposure and response prevention). It is a very particular type of CBT proven to work for ocd. It entails breaking individual fears/ocd down into small parts and "facing" them (wonderful if this can be done in the therapy office) one at a time, step by step, practicing many times per day, and going slightly beyond the actual fear.

 

We saw several therapists who liked to "talk" a lot, and frankly, I think this made things worse. When we finally got to a qualified and experienced therapist, there was not a lot of "talking" but lots of "exposures". That is what worked for us.

 

Meg's mom has good advice above. Maybe you can discuss this with your therapist. I find, sadly, I have run completely out of patience in dealing with any medical or psych professional that doesn't "get it" immediately.

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i'd say, sadly, i am with dcmom. we wasted time and money with useless therapists. it was so frustrating -- i know he should be doing x, why do you think i am here -- if i could move him toward that myself, i wouldn't be here!

 

this past fall, we were referred to another dr and we went b/c ds was beginning a new school. she is a needle in a haystack. it's interesting b/c what she does isn't really that earth-shattering, but it's just placed so right -- i think the difference between someone who gets it and doesn't and can make a difference and can't is like a millimeter -- but it is a millimeter that makes all the difference. and that can be all the difference btwn just discussing the issues and moving through them.

 

i've found much help from anxietybc.com and from ross greeen's 'Explosive Child'.

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