Re: Daughter won't do therapy . . .

[Guest guest]

Hi Gale, the therapist has failed to engage your daughter in therapy and is

blaming Emma for her own lack of effectiveness...Emma after all is sick, she

is suffering from untreated OCD which is an anxiety disorder. It's not too

uncommon for a child (or adult for that matter) to be scared or otherwise

reluctant at first to work toward getting better. An expert child therapist

will expect this and have several tricks up his or her sleeve to get over

that initial hump and engage the child in therapy.

It's possible the therapist assigned homework too high on Emma's hierarchy

for her to be successful at this point. Or the disorder may be interfering

with Emma's ability to read the material the therapist assigned her.

Various compulsions that make reading difficult or impossible are common in

OCD. Or Emma may have obsessions similar to my daughter's, that if she does

anything to threaten OCD, it will get much worse, or if she speaks her

obsessional worries out loud, they will come true.

You are lucky at least in that the therapist told you about her limitations

rather than having you continue to bring Emma week after week for

ineffective therapy.

It may be that Emma's OCD is more severe than you realize. Sometimes there

is much more going on than meets the eye, or that the child is willing/able

to describe.

I suggest you continue your search for an expert child CBT. Check out any

nearby universities/med centers for either therapy or suggestions of

practitioners in your area. It's not uncommon for there to be a poor fit

with the first therapist but a great fit with the second (or third.) Please

don't conclude from this experience that your child can't be helped by

effective therapy. If you post your area, perhaps another list member can

suggest the name of a therapist for you to contact.

Good luck,

Kathy R. in Indiana

----- Original Message -----

> Hi, all. I am so frustrated today. We just got back from the therapist

who

> told us that she thinks it's best not to continue with my daughter (Emma,

> 13) for now, because there isn't the motivation to get better . . .

> Apparently Emma has not been doing the " homework " or the reading that the

> therapist has suggested. She said I'm wasting my money (no insurance) at

> the moment. She suggested perhaps Emma go on some kind of medication to

> lessen her anxiety, then try therapy again. Emma says NO WAY to any

> medication. (Another fear.) So what do I do now?? Her OCD isn't severe,

> but she's closing herself off from life because it's safer and more

> comfortable. Any suggestions?

>

> --Gale in Illinois

[Guest guest]

Gale,

Your 13 year old sounds a lot like my 14 year old daughter had been

for about 3 years. Her OCD had been diagnosed when she was 9.

After we tried medication and therapy without much success (and both

the p-doc and therapist said they were not seeing much change in

her) she went off the meds and quit therapy.

With some irritation and concern about her rituals and avoidances,

we made it through about 3 years with no meds or therapy. During

that time she often got mad at me whenever I wanted to discuss her

OCD. Again, though, the OCD was not severe, and we just muddled

along.

Somehow this year the OCD flared up badly. Her rituals, avoidances,

and anxiety all increased. We had some tearful times of me pointing

out that she could not ignore it was OCD anymore. I was surprised

that after 3 years of saying NO WAY to trying meds and doctors

again, she reluctantly agreed.

It may be that until the OCD gets to a certain point, your daughter

is not going to admit she must deal with it. It is certainly better

to tread OCD before it gets too severe, but it may have to get too a

certain point of " inconvenience " before she is ready to face the

problem, as with my daughter.

I can't say this is the " right " way, but it is the scenario we went

through. Good luck.

Kellie - Missouri

> Hi, all. I am so frustrated today. We just got back from the

therapist who

> told us that she thinks it's best not to continue with my daughter

(Emma,

> 13) for now, because there isn't the motivation to get better . . .

> Apparently Emma has not been doing the " homework " or the reading

that the

> therapist has suggested. She said I'm wasting my money (no

insurance) at

> the moment. She suggested perhaps Emma go on some kind of

medication to

> lessen her anxiety, then try therapy again. Emma says NO WAY to

any

> medication. (Another fear.) So what do I do now?? Her OCD isn't

severe,

> but she's closing herself off from life because it's safer and more

> comfortable. Any suggestions?

>

> --Gale in Illinois

[Guest guest]

Kathy, thank you so much for your insightful reply. You said a couple of

things I had not thought of before. Perhaps her OCD really IS more severe

than I had thought.

You also mentioned that reading compulsions are common. I'd like to learn

more about this. My daughter did tell me that sometimes it's just " too much

work to read " -- and she has always loved reading. She reads some parts

over and over because she can't " get it " and has a specific rubbing pattern

she does with her fingers on each page.

We are about 60 miles SW of Chicago, near Aurora, Illinois. But her

insurance said they'd only cover the first visit for OCD. That makes no

sense to me. OK, so once she has a diagnosis, we can go home??? I don't

know how you all cope with all this!

--Gale in Illinois

Mom to Emma, 14, OCD, and , 15, tormenter

> Various compulsions that make reading difficult or impossible are common

in

> OCD.

>

> It may be that Emma's OCD is more severe than you realize. Sometimes

there

> is much more going on than meets the eye, or that the child is

willing/able

> to describe.

>

[Guest guest]

Kellie, thanks so much for your reply and sharing your experience. I know

exactly what you meant by " with some irritation and concern about her

rituals and avoidances. " LOTS of irritation here lately, and no less

concern.

I really don't know how long Emma has had OCD. How can you tell when

strange behavior crosses the line into mental illness? So much of her

struggle is internal. At the beginning of February, she read a novel in

which the main character had OCD and recognized herself. She poured out

" her own story " to me after that. I was astounded. I had no idea what she

had (has) been struggling with. Every once in a while she will tell me that

she remembers something specific from when she was much younger and says,

" That must have been OCD. " She's learning to recognize it, at least.

That's a good thing, right? The beginning of the cognitive part?

You said,

> it may have to get too a

> certain point of " inconvenience " before she is ready to face the

> problem, as with my daughter.

Yes, I can see that happening here.

--Gale in Illinois

Mom to Emma, 14 (in June), OCD; and , 15, tormenter

Re: Daughter won't do therapy . . .

> Gale,

> Your 13 year old sounds a lot like my 14 year old daughter had been

> for about 3 years. Her OCD had been diagnosed when she was 9.

> After we tried medication and therapy without much success (and both

> the p-doc and therapist said they were not seeing much change in

> her) she went off the meds and quit therapy.

>

> With some irritation and concern about her rituals and avoidances,

> we made it through about 3 years with no meds or therapy. During

> that time she often got mad at me whenever I wanted to discuss her

> OCD. Again, though, the OCD was not severe, and we just muddled

> along.

>

> Somehow this year the OCD flared up badly. Her rituals, avoidances,

> and anxiety all increased. We had some tearful times of me pointing

> out that she could not ignore it was OCD anymore. I was surprised

> that after 3 years of saying NO WAY to trying meds and doctors

> again, she reluctantly agreed.

>

> It may be that until the OCD gets to a certain point, your daughter

> is not going to admit she must deal with it. It is certainly better

> to tread OCD before it gets too severe, but it may have to get too a

> certain point of " inconvenience " before she is ready to face the

> problem, as with my daughter.

>

> I can't say this is the " right " way, but it is the scenario we went

> through. Good luck.

>

> Kellie - Missouri

>

>

>

>

>

>

>

>

> > Hi, all. I am so frustrated today. We just got back from the

> therapist who

> > told us that she thinks it's best not to continue with my daughter

> (Emma,

> > 13) for now, because there isn't the motivation to get better . . .

> > Apparently Emma has not been doing the " homework " or the reading

> that the

> > therapist has suggested. She said I'm wasting my money (no

> insurance) at

> > the moment. She suggested perhaps Emma go on some kind of

> medication to

> > lessen her anxiety, then try therapy again. Emma says NO WAY to

> any

> > medication. (Another fear.) So what do I do now?? Her OCD isn't

> severe,

> > but she's closing herself off from life because it's safer and more

> > comfortable. Any suggestions?

> >

> > --Gale in Illinois

>

>

>

>

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[Guest guest]

Hi Gale, you wrote:

> You also mentioned that reading compulsions are common. I'd like to learn

> more about this. My daughter did tell me that sometimes it's just " too

much

> work to read " -- and she has always loved reading. She reads some parts

> over and over because she can't " get it " and has a specific rubbing

pattern

> she does with her fingers on each page.

*****Rereading is a common one, and the rubbing pattern could be one too.

Finding reading to be too much work when she once loved to read is a big

tip-off that OCD is involved now IMO. Basically all the typical issues in

OCD can show up in reading--doubt (did I read that correctly, understand

that thoroughly?), contamination (the book itself can be " contaminated " in

the OCD sense), checking (did I skip a page, did my thoughts wander when I

was reading that page), counting (words on the page for example), etc. My

daughter avoided reading and TV for awhile for fear of being triggered by

seeing or hearing a " bad word " (in the OCD sense.) I read of a man who had

to find a " good " word somewhere in the text to " balance " having read a " bad "

word...so if he read the word " death " (or any of a list of several " bad "

words) he then had to find the word " life " . Imagine how that would slow

down reading and comprehension, anyone would want to avoid such a chore.

ERP can be effective in diminishing or eliminating reading compulsions.

> We are about 60 miles SW of Chicago, near Aurora, Illinois. But her

> insurance said they'd only cover the first visit for OCD. That makes no

> sense to me. OK, so once she has a diagnosis, we can go home??? I don't

> know how you all cope with all this!

*****Insurance carriers are all so different, but I'd call your case manager

at the company (or the administrative person where you work if it is a

company plan) and explain the situation. Many times insurance companies

will authorize treatment if challenged or questioned. Sometimes having the

diagnosing doctor verifying that your child needs X number of therapy

sessions works. It may be she only gets one visit on the medical side of

your insurance, but has further benefits under mental health which is

administrated by a whole different company.

The " only one visit " thing doesn't make much sense anyway: the two

treatments for OCD are therapy (a series of visits) and SSRI medication

(which requires periodic doctor visits for management.)

Good luck, the insurance situation for mental health services is a disgrace

in this country IMO. The very last thing anyone needs when suddenly dealing

with OCD in your child is to have to horse around to discover if and what

any benefits might be. Can you image if we treated heart patients this

way?!!

Kathy R. in Indiana