Re: what to do with the unmotivated kid?--long post

[Guest guest]

Hi ,

It sounds like you and your husband have the right idea about stopping the

accomodations you make for her. Maybe if you gradually cut them out and see how

she responds?????

It sounds like she has definitely made some very good progress.

Her ideas about all of this reminds me of my daughter.She always thinks after

she makes a little progress that she has done enough and I am on her case!

Hugs

Judy

________________________________

To: < >

Sent: Saturday, September 12, 2009 10:12:55 PM

Subject: what to do with the unmotivated kid?--long post

 

For those of you who have seen my earlier posts, our daughter Lynn has made a

lot of progress. She is using bathrooms at school and in public restrooms (not

every day, but multiple times a week). She is happy in her new school and making

friends. Her mood is so much improved that I realize she really was depressed

over the summer. Her wash times (arm washing after using the bathroom) have

decreased from an hour each time (in June) to 12-14 minutes each time although

she is still washing up to her shoulders and insists on having two kinds of soap

(bar and liquid). She has even attempted to explain her OCD to some of her new

friends (braver than I was on that). Her tantrums/rages have decreased

significantly.

At this point, we are not sure if her arm-washing ritual still reflects

primarily anxiety (I'm germy), primarily habit/self-soothing (this feels good or

I'm used to it), or both, but she is very unwilling to change and very unwilling

to do any exposures to germs that involve more than very minimal anxiety. Her

ERP therapist basically said that despite her progress (much due to Zoloft), she

is stuck. Her therapist feels there is nothing more she can do with Lynn at this

point although Lynn may agree to do some smaller exposures with us. The

therapist is concerned that Lynn's OCD will worsen with stress (especially

when/if she gets sick or stresses at school increase). Lynn has also been seeing

a psychodynamic play therapist for several years due to a preoccupation with

death that started around age 5 or 6 (prior to her OCD diagnosis) and other

ongoing anxiety and behavior issues. The psychodynamic therapist thinks Lynn

should continue to see her, but

the other (ERP) therapist feels Lynn too easily " talks around the issues " , ie,

strays off topic and does not address what she needs to. So, we are getting

conflicting advice from the two therapists, and our daughter is unwilling to

continue working hard. She does have a psychiatrist for med mgmt.

I am afraid that Lynn may have to see what happens when she doesn't work on her

OCD before she is really willing to own that it is still her problem and she

needs to work further on it. Right now, she mostly seems comfortable with the

improvements she has made and feels like we are pestering her. Her father and I

have told her that if she will not do any more therapy, we will stop as many as

possible of the accommodations that we had still been making during therapy, so

that she will have to take responsibility for getting any supplies (extra soap

for school or outings, etc) that she thinks she needs.

Anyhow, just wanted to vent and to ask for advice from those with older children

or those whose kids have been fighting this battle longer than we have. I keep

remembering the quote from the conference this summer, " you can't want them to

get better more than they do, " ie, you can't make it happen without cooperation.

(mom with OCD), daughter Lynn with OCD (age 9)

[Guest guest]

Personally, I would stop getting her the extra soap. I would want to make it a

little tougher for her and see her reaction. I am curious how they handle that

at school. Do they allow her to spend 12-14 minutes washing her arms? If so,

what reactions has she gotten from the kids? I would imagine if they allow that

it would be disruptive to her learning. Stormy

________________________________

To: < >

Sent: Saturday, September 12, 2009 9:12:55 PM

Subject: what to do with the unmotivated kid?--long post

 

For those of you who have seen my earlier posts, our daughter Lynn has made a

lot of progress. She is using bathrooms at school and in public restrooms (not

every day, but multiple times a week). She is happy in her new school and making

friends. Her mood is so much improved that I realize she really was depressed

over the summer. Her wash times (arm washing after using the bathroom) have

decreased from an hour each time (in June) to 12-14 minutes each time although

she is still washing up to her shoulders and insists on having two kinds of soap

(bar and liquid). She has even attempted to explain her OCD to some of her new

friends (braver than I was on that). Her tantrums/rages have decreased

significantly.

At this point, we are not sure if her arm-washing ritual still reflects

primarily anxiety (I'm germy), primarily habit/self-soothing (this feels good or

I'm used to it), or both, but she is very unwilling to change and very unwilling

to do any exposures to germs that involve more than very minimal anxiety. Her

ERP therapist basically said that despite her progress (much due to Zoloft), she

is stuck. Her therapist feels there is nothing more she can do with Lynn at this

point although Lynn may agree to do some smaller exposures with us. The

therapist is concerned that Lynn's OCD will worsen with stress (especially

when/if she gets sick or stresses at school increase). Lynn has also been seeing

a psychodynamic play therapist for several years due to a preoccupation with

death that started around age 5 or 6 (prior to her OCD diagnosis) and other

ongoing anxiety and behavior issues. The psychodynamic therapist thinks Lynn

should continue to see her, but

the other (ERP) therapist feels Lynn too easily " talks around the issues " , ie,

strays off topic and does not address what she needs to. So, we are getting

conflicting advice from the two therapists, and our daughter is unwilling to

continue working hard. She does have a psychiatrist for med mgmt.

I am afraid that Lynn may have to see what happens when she doesn't work on her

OCD before she is really willing to own that it is still her problem and she

needs to work further on it. Right now, she mostly seems comfortable with the

improvements she has made and feels like we are pestering her. Her father and I

have told her that if she will not do any more therapy, we will stop as many as

possible of the accommodations that we had still been making during therapy, so

that she will have to take responsibility for getting any supplies (extra soap

for school or outings, etc) that she thinks she needs.

Anyhow, just wanted to vent and to ask for advice from those with older children

or those whose kids have been fighting this battle longer than we have. I keep

remembering the quote from the conference this summer, " you can't want them to

get better more than they do, " ie, you can't make it happen without cooperation.

(mom with OCD), daughter Lynn with OCD (age 9)

[Guest guest]

Hi Stormy,

At this point, she is refusing to wash without two kinds of soap. however, I

have told her that this week I will make a list of things she needs to remember

for school and it will be her job to have homework, lunch, any soap supplies. I

know her: she will put it off and one day she will forget and will have to

figure out what to do.

We have met with her teacher and guidance counselor who are great. The initial

agreement was that she could use recess time to use the bathroom. She made some

new friends and did not want to use her recess time, understandably, but her

solution was to pick another time that did not work well or to not use the

bathroom at school. Her teacher and guidance counselor met with her and talked

to us and we agreed that for now she can use silent reading time so she is not

missing instruction. She has been told that this accommodation will not

continue forever, and then her choice will be to get her times down or spend 1/2

of recess in the bathroom. She has been seen by other kids and has actually

explained a little bit to kids she knows. With other children, she just says

she doesn't want to talk about it.

She is a very strong-willed kid. I just wish she would use that willpower to

fight the OCD rather than to resist change. Ah well, she has made a lot of

progress since the beginning of the summer. It is easy to forget how bad things

were, when you want them to be even better.

>

> Subject: Re: what to do with the unmotivated kid?--long post

> To:

> Date: Sunday, September 13, 2009, 11:02 AM

> Personally, I would stop getting her

> the extra soap. I would want to make it a little tougher for

> her and see her reaction. I am curious how they handle that

> at school. Do they allow her to spend 12-14 minutes washing

> her arms? If so, what reactions has she gotten from the

> kids? I would imagine if they allow that it would be

> disruptive to her learning. Stormy

>

>

>

>

> ________________________________

>

> To: < >

> Sent: Saturday, September 12, 2009 9:12:55 PM

> Subject: what to do with the unmotivated

> kid?--long post

>

>  

> For those of you who have seen my earlier posts, our

> daughter Lynn has made a lot of progress. She is using

> bathrooms at school and in public restrooms (not every day,

> but multiple times a week). She is happy in her new school

> and making friends. Her mood is so much improved that I

> realize she really was depressed over the summer. Her wash

> times (arm washing after using the bathroom) have decreased

> from an hour each time (in June) to 12-14 minutes each time

> although she is still washing up to her shoulders and

> insists on having two kinds of soap (bar and liquid). She

> has even attempted to explain her OCD to some of her new

> friends (braver than I was on that). Her tantrums/rages have

> decreased significantly.

>

> At this point, we are not sure if her arm-washing ritual

> still reflects primarily anxiety (I'm germy), primarily

> habit/self-soothing (this feels good or I'm used to it), or

> both, but she is very unwilling to change and very unwilling

> to do any exposures to germs that involve more than very

> minimal anxiety. Her ERP therapist basically said that

> despite her progress (much due to Zoloft), she is stuck. Her

> therapist feels there is nothing more she can do with Lynn

> at this point although Lynn may agree to do some smaller

> exposures with us. The therapist is concerned that Lynn's

> OCD will worsen with stress (especially when/if she gets

> sick or stresses at school increase). Lynn has also been

> seeing a psychodynamic play therapist for several years due

> to a preoccupation with death that started around age 5 or 6

> (prior to her OCD diagnosis) and other ongoing anxiety and

> behavior issues. The psychodynamic therapist thinks Lynn

> should continue to see her, but

> the other (ERP) therapist feels Lynn too easily " talks

> around the issues " , ie, strays off topic and does not

> address what she needs to. So, we are getting conflicting

> advice from the two therapists, and our daughter is

> unwilling to continue working hard. She does have a

> psychiatrist for med mgmt.

>

> I am afraid that Lynn may have to see what happens when she

> doesn't work on her OCD before she is really willing to own

> that it is still her problem and she needs to work further

> on it. Right now, she mostly seems comfortable with the

> improvements she has made and feels like we are pestering

> her. Her father and I have told her that if she will not do

> any more therapy, we will stop as many as possible of the

> accommodations that we had still been making during therapy,

> so that she will have to take responsibility for getting any

> supplies (extra soap for school or outings, etc) that she

> thinks she needs.

>

> Anyhow, just wanted to vent and to ask for advice from

> those with older children or those whose kids have been

> fighting this battle longer than we have. I keep remembering

> the quote from the conference this summer, " you can't want

> them to get better more than they do, " ie, you can't make it

> happen without cooperation.

>

> (mom with OCD), daughter Lynn with OCD (age 9)

>

>

>

>

>      

>

>

[Guest guest]

Hmmm, I would wonder if it is her OCD or not since she is able to change the

time to do this " compulsion " to when it is convenient for her and not something

that she has to do regardless of the situation. Quite honestly my dd never used

a bathroom in her school throughout elementary, middle or high school due to

anxiety of using public restrooms. I am glad your dd has made so much progress,

that is great! Stormy

________________________________

To:

Sent: Sunday, September 13, 2009 12:06:25 PM

Subject: Re: what to do with the unmotivated kid?--long post

 

Hi Stormy,

At this point, she is refusing to wash without two kinds of soap. however, I

have told her that this week I will make a list of things she needs to remember

for school and it will be her job to have homework, lunch, any soap supplies. I

know her: she will put it off and one day she will forget and will have to

figure out what to do.

We have met with her teacher and guidance counselor who are great. The initial

agreement was that she could use recess time to use the bathroom. She made some

new friends and did not want to use her recess time, understandably, but her

solution was to pick another time that did not work well or to not use the

bathroom at school. Her teacher and guidance counselor met with her and talked

to us and we agreed that for now she can use silent reading time so she is not

missing instruction. She has been told that this accommodation will not continue

forever, and then her choice will be to get her times down or spend 1/2 of

recess in the bathroom. She has been seen by other kids and has actually

explained a little bit to kids she knows. With other children, she just says she

doesn't want to talk about it.

She is a very strong-willed kid. I just wish she would use that willpower to

fight the OCD rather than to resist change. Ah well, she has made a lot of

progress since the beginning of the summer. It is easy to forget how bad things

were, when you want them to be even better.

> From: Stormy - <stormyweather19917@ yahoo.com>

> Subject: Re: what to do with the unmotivated kid?--long post

> To: @ yahoogroups. com

> Date: Sunday, September 13, 2009, 11:02 AM

> Personally, I would stop getting her

> the extra soap. I would want to make it a little tougher for

> her and see her reaction. I am curious how they handle that

> at school. Do they allow her to spend 12-14 minutes washing

> her arms? If so, what reactions has she gotten from the

> kids? I would imagine if they allow that it would be

> disruptive to her learning. Stormy

>

>

>

>

> ____________ _________ _________ __

> From: Kusmin <kusminfamverizon (DOT) net>

> To: <@ yahoogroups. com>

> Sent: Saturday, September 12, 2009 9:12:55 PM

> Subject: what to do with the unmotivated

> kid?--long post

>

>  

> For those of you who have seen my earlier posts, our

> daughter Lynn has made a lot of progress. She is using

> bathrooms at school and in public restrooms (not every day,

> but multiple times a week).. She is happy in her new school

> and making friends. Her mood is so much improved that I

> realize she really was depressed over the summer. Her wash

> times (arm washing after using the bathroom) have decreased

> from an hour each time (in June) to 12-14 minutes each time

> although she is still washing up to her shoulders and

> insists on having two kinds of soap (bar and liquid). She

> has even attempted to explain her OCD to some of her new

> friends (braver than I was on that). Her tantrums/rages have

> decreased significantly.

>

> At this point, we are not sure if her arm-washing ritual

> still reflects primarily anxiety (I'm germy), primarily

> habit/self-soothing (this feels good or I'm used to it), or

> both, but she is very unwilling to change and very unwilling

> to do any exposures to germs that involve more than very

> minimal anxiety. Her ERP therapist basically said that

> despite her progress (much due to Zoloft), she is stuck. Her

> therapist feels there is nothing more she can do with Lynn

> at this point although Lynn may agree to do some smaller

> exposures with us. The therapist is concerned that Lynn's

> OCD will worsen with stress (especially when/if she gets

> sick or stresses at school increase). Lynn has also been

> seeing a psychodynamic play therapist for several years due

> to a preoccupation with death that started around age 5 or 6

> (prior to her OCD diagnosis) and other ongoing anxiety and

> behavior issues. The psychodynamic therapist thinks Lynn

> should continue to see her, but

> the other (ERP) therapist feels Lynn too easily " talks

> around the issues " , ie, strays off topic and does not

> address what she needs to. So, we are getting conflicting

> advice from the two therapists, and our daughter is

> unwilling to continue working hard. She does have a

> psychiatrist for med mgmt.

>

> I am afraid that Lynn may have to see what happens when she

> doesn't work on her OCD before she is really willing to own

> that it is still her problem and she needs to work further

> on it. Right now, she mostly seems comfortable with the

> improvements she has made and feels like we are pestering

> her. Her father and I have told her that if she will not do

> any more therapy, we will stop as many as possible of the

> accommodations that we had still been making during therapy,

> so that she will have to take responsibility for getting any

> supplies (extra soap for school or outings, etc) that she

> thinks she needs.

>

> Anyhow, just wanted to vent and to ask for advice from

> those with older children or those whose kids have been

> fighting this battle longer than we have. I keep remembering

> the quote from the conference this summer, " you can't want

> them to get better more than they do, " ie, you can't make it

> happen without cooperation.

>

> (mom with OCD), daughter Lynn with OCD (age 9)

>

>

>

>

>      

>

>

[Guest guest]

>

> For those of you who have seen my earlier posts, our daughter Lynn has made a

lot of progress. She is using bathrooms at school and in public restrooms (not

every day, but multiple times a week). She is happy in her new school and

making friends. Her mood is so much improved that I realize she really was

depressed over the summer. Her wash times (arm washing after using the

bathroom) have decreased from an hour each time (in June) to 12-14 minutes each

time although she is still washing up to her shoulders and insists on having two

kinds of soap (bar and liquid). She has even attempted to explain her OCD to

some of her new friends (braver than I was on that). Her tantrums/rages have

decreased significantly.

>

> At this point, we are not sure if her arm-washing ritual still reflects

primarily anxiety (I'm germy), primarily habit/self-soothing (this feels good or

I'm used to it), or both, but she is very unwilling to change and very unwilling

to do any exposures to germs that involve more than very minimal anxiety. Her

ERP therapist basically said that despite her progress (much due to Zoloft), she

is stuck. Her therapist feels there is nothing more she can do with Lynn at

this point although Lynn may agree to do some smaller exposures with us. The

therapist is concerned that Lynn's OCD will worsen with stress (especially

when/if she gets sick or stresses at school increase). Lynn has also been

seeing a psychodynamic play therapist for several years due to a preoccupation

with death that started around age 5 or 6 (prior to her OCD diagnosis) and other

ongoing anxiety and behavior issues. The psychodynamic therapist thinks Lynn

should continue to see her, but

> the other (ERP) therapist feels Lynn too easily " talks around the issues " ,

ie, strays off topic and does not address what she needs to. So, we are getting

conflicting advice from the two therapists, and our daughter is unwilling to

continue working hard. She does have a psychiatrist for med mgmt.

>

> I am afraid that Lynn may have to see what happens when she doesn't work on

her OCD before she is really willing to own that it is still her problem and she

needs to work further on it. Right now, she mostly seems comfortable with the

improvements she has made and feels like we are pestering her. Her father and I

have told her that if she will not do any more therapy, we will stop as many as

possible of the accommodations that we had still been making during therapy, so

that she will have to take responsibility for getting any supplies (extra soap

for school or outings, etc) that she thinks she needs.

>

> Anyhow, just wanted to vent and to ask for advice from those with older

children or those whose kids have been fighting this battle longer than we have.

I keep remembering the quote from the conference this summer, " you can't want

them to get better more than they do, " ie, you can't make it happen without

cooperation.

>

> (mom with OCD), daughter Lynn with OCD (age 9)

>

[Guest guest]

>

> For those of you who have seen my earlier posts, our daughter Lynn has made a

lot of progress. She is using bathrooms at school and in public restrooms (not

every day, but multiple times a week). She is happy in her new school and

making friends. Her mood is so much improved that I realize she really was

depressed over the summer. Her wash times (arm washing after using the

bathroom) have decreased from an hour each time (in June) to 12-14 minutes each

time although she is still washing up to her shoulders and insists on having two

kinds of soap (bar and liquid). She has even attempted to explain her OCD to

some of her new friends (braver than I was on that). Her tantrums/rages have

decreased significantly.

>

> At this point, we are not sure if her arm-washing ritual still reflects

primarily anxiety (I'm germy), primarily habit/self-soothing (this feels good or

I'm used to it), or both, but she is very unwilling to change and very unwilling

to do any exposures to germs that involve more than very minimal anxiety. Her

ERP therapist basically said that despite her progress (much due to Zoloft), she

is stuck. Her therapist feels there is nothing more she can do with Lynn at

this point although Lynn may agree to do some smaller exposures with us. The

therapist is concerned that Lynn's OCD will worsen with stress (especially

when/if she gets sick or stresses at school increase). Lynn has also been

seeing a psychodynamic play therapist for several years due to a preoccupation

with death that started around age 5 or 6 (prior to her OCD diagnosis) and other

ongoing anxiety and behavior issues. The psychodynamic therapist thinks Lynn

should continue to see her, but

> the other (ERP) therapist feels Lynn too easily " talks around the issues " ,

ie, strays off topic and does not address what she needs to. So, we are getting

conflicting advice from the two therapists, and our daughter is unwilling to

continue working hard. She does have a psychiatrist for med mgmt.

>

> I am afraid that Lynn may have to see what happens when she doesn't work on

her OCD before she is really willing to own that it is still her problem and she

needs to work further on it. Right now, she mostly seems comfortable with the

improvements she has made and feels like we are pestering her. Her father and I

have told her that if she will not do any more therapy, we will stop as many as

possible of the accommodations that we had still been making during therapy, so

that she will have to take responsibility for getting any supplies (extra soap

for school or outings, etc) that she thinks she needs.

>

> Anyhow, just wanted to vent and to ask for advice from those with older

children or those whose kids have been fighting this battle longer than we have.

I keep remembering the quote from the conference this summer, " you can't want

them to get better more than they do, " ie, you can't make it happen without

cooperation.

>

> (mom with OCD), daughter Lynn with OCD (age 9)

>

[Guest guest]

Hi , how long since school began? I'm wondering if just " backing off "

on the school part of washing for now will help (continue with plan that you've

set up with school) because maybe she herself will get tired of OCD interfering

with recess or silent reading time (whichever it was that she goes to bathroom)

and having made some new friends, if that will add some motivation to her later

wanting to stop the washing time at school. -- The peer pressure, social aspect

might motivate her maybe. We often talk about kids holding back at school but

then, sigh, bursting forth with OCD when they get home.

She's made great progress, getting her time washing down so much!

I would think her therapist could keep her from going " off topic " and put her

back on. Confront her that she's doing this. (maybe she has) You said she

" may " do some smaller exposures? I would go for that, get her to choose some

smaller ones to try. Success with those could carry over to the larger issues.

Just quick thoughts. Keep us updated!

>

> For those of you who have seen my earlier posts, our daughter Lynn has made a

lot of progress. She is using bathrooms at school and in public restrooms (not

every day, but multiple times a week). She is happy in her new school and

making friends. Her mood is so much improved that I realize she really was

depressed over the summer.

[Guest guest]

Sorry all, I hit ENTER before typing anything!

> >

> > For those of you who have seen my earlier posts, our daughter

[Guest guest]

Hi ,

Just wanted to say your comment about the strong will, if only she would engage

it, hit home. Ours is the same. We found, as you say, that at some point you

have to let them decide how they will pace it. If she knows what she needs to

do, it's a matter of deciding to do it, just as your other quote states.

Ours is 18 now, and took the OCD on at 17 with a vengeance, just decided. He

was motivated to get his life back he has said. We did basically back off, but

kept reminding what he was missing, and encouraging in general. Ours did not

want to see any more doctors, still doesn't, and is doing it on his own

(teen...).

He will admit to getting lazy sometimes and letting it slide, and seems to know

how far he can push it. At one point, when he figured out he couldn't actually

get rid of it, he wanted to give up. That's when we reminded him what he would

go back to. So, as you say, sometimes they do have to experience the

consequences of not dealing with it.

In short, he has taken it on, and paces it in his own way, which is what you

want. So, just to encourage you, they can get there on this, even a stubborn

teen! Maturity is a big part of it, we found, as well as motivation. That is,

beyond any comorbid conditions that interfere, or medication issues etc. So

individual really.

I would continue some form of support for her though. Even if they are not

fully participating, outside support can be important. Not sure the financial

aspect, but if you can afford this I would.

Warmly,

Barb

>

> For those of you who have seen my earlier posts, our daughter Lynn has made a

lot of progress. She is using bathrooms at school and in public restrooms (not

every day, but multiple times a week). She is happy in her new school and

making friends. Her mood is so much improved that I realize she really was

depressed over the summer. Her wash times (arm washing after using the

bathroom) have decreased from an hour each time (in June) to 12-14 minutes each

time although she is still washing up to her shoulders and insists on having two

kinds of soap (bar and liquid). She has even attempted to explain her OCD to

some of her new friends (braver than I was on that). Her tantrums/rages have

decreased significantly.

>

> At this point, we are not sure if her arm-washing ritual still reflects

primarily anxiety (I'm germy), primarily habit/self-soothing (this feels good or

I'm used to it), or both, but she is very unwilling to change and very unwilling

to do any exposures to germs that involve more than very minimal anxiety. Her

ERP therapist basically said that despite her progress (much due to Zoloft), she

is stuck. Her therapist feels there is nothing more she can do with Lynn at

this point although Lynn may agree to do some smaller exposures with us. The

therapist is concerned that Lynn's OCD will worsen with stress (especially

when/if she gets sick or stresses at school increase). Lynn has also been

seeing a psychodynamic play therapist for several years due to a preoccupation

with death that started around age 5 or 6 (prior to her OCD diagnosis) and other

ongoing anxiety and behavior issues. The psychodynamic therapist thinks Lynn

should continue to see her, but

> the other (ERP) therapist feels Lynn too easily " talks around the issues " ,

ie, strays off topic and does not address what she needs to. So, we are getting

conflicting advice from the two therapists, and our daughter is unwilling to

continue working hard. She does have a psychiatrist for med mgmt.

>

> I am afraid that Lynn may have to see what happens when she doesn't work on

her OCD before she is really willing to own that it is still her problem and she

needs to work further on it. Right now, she mostly seems comfortable with the

improvements she has made and feels like we are pestering her. Her father and I

have told her that if she will not do any more therapy, we will stop as many as

possible of the accommodations that we had still been making during therapy, so

that she will have to take responsibility for getting any supplies (extra soap

for school or outings, etc) that she thinks she needs.

>

> Anyhow, just wanted to vent and to ask for advice from those with older

children or those whose kids have been fighting this battle longer than we have.

I keep remembering the quote from the conference this summer, " you can't want

them to get better more than they do, " ie, you can't make it happen without

cooperation.

>

> (mom with OCD), daughter Lynn with OCD (age 9)

>

[Guest guest]

, our beahvior therapist has us making very very small increases in

exposures. It seems too slow to me but it is working.

Our daughter has been out of school since march of last year

the exposure to school is only 2 hours and it is increased

each week only 15 minutes. She gets too rewards if she

stays longer rather than just one reward for the set goal.

The behaviorist checks to make sure what I am doing is not

too rewarding for avoidance and she changes what I do to make

sure I am nuetral and it is not too fun to keep avoiding.

To keep our daughter motivated she keeps changing the rewards.

She says they have to vary to keep the child motivated.

When our daughter voices anxious thoughts I am not to reason

with her. Sometimes she is so extreme in her thoughts

I want to address the fears she brings up. But it seems

to just prolong the anxious thoughts.

We have been stuck on her not wanting to increase her

medication I have to slice off the end of the tablet.

This also seems to be moving along very slowly.

I have put therapy on hold for my daughter since she

does talk around the issue. So I talk to the behaviorist

and we are addressing it completely from a parental

goal setting and positive reinforcement.

What I have to keep working on is keeping our life

very structured, because the reinforvements have to be

earned not given away (TV time for example). My daughter

is skilled at getting more and more time to procastinate

on her feared areas and getting me to help her make up

for time she wasted. It is hard to keep life on schedule

and stay very positive and upbeat. I really depend on

our behaviorist to help me with this.

I hope some if these ideas are helpful.

Pam

>

> For those of you who have seen my earlier posts, our daughter Lynn has made a

lot of progress. She is using bathrooms at school and in public restrooms (not

every day, but multiple times a week). She is happy in her new school and

making friends. Her mood is so much improved that I realize she really was

depressed over the summer. Her wash times (arm washing after using the

bathroom) have decreased from an hour each time (in June) to 12-14 minutes each

time although she is still washing up to her shoulders and insists on having two

kinds of soap (bar and liquid). She has even attempted to explain her OCD to

some of her new friends (braver than I was on that). Her tantrums/rages have

decreased significantly.

>

> At this point, we are not sure if her arm-washing ritual still reflects

primarily anxiety (I'm germy), primarily habit/self-soothing (this feels good or

I'm used to it), or both, but she is very unwilling to change and very unwilling

to do any exposures to germs that involve more than very minimal anxiety. Her

ERP therapist basically said that despite her progress (much due to Zoloft), she

is stuck. Her therapist feels there is nothing more she can do with Lynn at

this point although Lynn may agree to do some smaller exposures with us. The

therapist is concerned that Lynn's OCD will worsen with stress (especially

when/if she gets sick or stresses at school increase). Lynn has also been

seeing a psychodynamic play therapist for several years due to a preoccupation

with death that started around age 5 or 6 (prior to her OCD diagnosis) and other

ongoing anxiety and behavior issues. The psychodynamic therapist thinks Lynn

should continue to see her, but

> the other (ERP) therapist feels Lynn too easily " talks around the issues " ,

ie, strays off topic and does not address what she needs to. So, we are getting

conflicting advice from the two therapists, and our daughter is unwilling to

continue working hard. She does have a psychiatrist for med mgmt.

>

> I am afraid that Lynn may have to see what happens when she doesn't work on

her OCD before she is really willing to own that it is still her problem and she

needs to work further on it. Right now, she mostly seems comfortable with the

improvements she has made and feels like we are pestering her. Her father and I

have told her that if she will not do any more therapy, we will stop as many as

possible of the accommodations that we had still been making during therapy, so

that she will have to take responsibility for getting any supplies (extra soap

for school or outings, etc) that she thinks she needs.

>

> Anyhow, just wanted to vent and to ask for advice from those with older

children or those whose kids have been fighting this battle longer than we have.

I keep remembering the quote from the conference this summer, " you can't want

them to get better more than they do, " ie, you can't make it happen without

cooperation.

>

> (mom with OCD), daughter Lynn with OCD (age 9)

>

[Guest guest]

Hi Lynn & Pam - I just wanted to take a second to say how great and motivational

your posts were in the last week. ERP (Exposure & Ritual Prevention)is a very

slow and often difficult process that demands committment often by the family as

much as the child. ERP is part of behavorial therapy. I know how hard it can be

when you are taking tiny baby steps, and the rest of the child's life is out of

control. But I've seen it work first hand, and I am just so thrilled that your

children are making progress. I found that just seeing progress relieved much

of the anxiety in our house, and made us all more patient over time.

Pam, we also found that with a younger child, much of the work was about

parental efforts at first. We are in the stage now, where we are transitioning

much of that responsibility to Meg - but without our active involvement and

encouragement, I don't think she would have done as well. It's kind of like

regular homework - without some oversight and encouragement, that would never be

done either! In some ways,the argument about what comes first, motivation or

therapy - is a difficult one to answer. Finding ways for the child to succeed

with the smallest step possible - was the best motivation for the next tiny

step. Rewards, if really thought through, do work, as does education. Even

when a child is not " motivated " , continuing to educate them through reading and

by changing the language that you use about OCD is incredibly helpful as well.

Eventually, they will want something bad enough to change. And if they already

understand the disease, then they will be much more capable of doing the work.

- maybe before your ERP therapist " quits " , she could set up a plan over a

month where most of the accomodations from family cease. This alone might help.

Plateaus are very common in ERP therapy. You may also want to look for another

ERP therapist to ask for additional ideas, or to switch to. You might also want

her to really help your daughter brainstorm on what would motivate her for

taking an additional baby step. My daughter is a year younger - but is very

smart - she talked around the issue with 2 therapist before we found one that

could get to the nut of it, and keep the conversation on track. She uses

parents to help in sessions, which we found essential at this age. I'm sure

there are times when ERP therapy should take a break - but with as much progress

as she has already made, it seems so hopeful! I would guess that Lynn is

actually terrified to take the next step. So it may take a big motivational

push to get what seems like a small next step done. Or it may mean finding a

different OCD " thing " to work on for a few weeks.

I'm thrilled for you both and hope you'll continue to post about your daughters'

progress over time.

Best - in NC.

> >

> > For those of you who have seen my earlier posts, our daughter Lynn has made

a lot of progress. She is using bathrooms at school and in public restrooms

(not every day, but multiple times a week). She is happy in her new school and

making friends. Her mood is so much improved that I realize she really was

depressed over the summer.

...........

The psychodynamic therapist thinks Lynn should continue to see her, but

> > the other (ERP) therapist feels Lynn too easily " talks around the issues " ,

ie, strays off topic and does not address what she needs to. So, we are getting

conflicting advice from the two therapists, and our daughter is unwilling to

continue working hard. She does have a psychiatrist for med mgmt.

> >

> > I am afraid that Lynn may have to see what happens when she doesn't work on

her OCD before she is really willing to own that it is still her problem and she

needs to work further on it. Right now, she mostly seems comfortable with the

improvements she has made and feels like we are pestering her. Her father and I

have told her that if she will not do any more therapy, we will stop as many as

possible of the accommodations that we had still been making during therapy, so

that she will have to take responsibility for getting any supplies (extra soap

for school or outings, etc) that she thinks she needs.

> >

> > Anyhow, just wanted to vent and to ask for advice from those with older

children or those whose kids have been fighting this battle longer than we have.

I keep remembering the quote from the conference this summer, " you can't want

them to get better more than they do, " ie, you can't make it happen without

cooperation.

> >

> > (mom with OCD), daughter Lynn with OCD (age 9)

> >

>

[Guest guest]

thanks for the support! I am going to use your words about " ERP taking

time and committment " with the school and my husband. I do get pressure to hurry

up and fix this problem. Since we have

been at this for 5 years I know that it is not that simple.

Pam

..

-- In , " susangalway " wrote:

>

> Hi Lynn & Pam - I just wanted to take a second to say how great and

motivational your posts were in the last week. ERP (Exposure & Ritual

Prevention)is a very slow and often difficult process that demands committment

often by the family as much as the child. ERP is part of behavorial therapy. I

know how hard it can be when you are taking tiny baby steps, and the rest of the

child's life is out of control. But I've seen it work first hand, and I am just

so thrilled that your children are making progress. I found that just seeing

progress relieved much of the anxiety in our house, and made us all more patient

over time.

>

> Pam, we also found that with a younger child, much of the work was about

parental efforts at first. We are in the stage now, where we are transitioning

much of that responsibility to Meg - but without our active involvement and

encouragement, I don't think she would have done as well. It's kind of like

regular homework - without some oversight and encouragement, that would never be

done either! In some ways,the argument about what comes first, motivation or

therapy - is a difficult one to answer. Finding ways for the child to succeed

with the smallest step possible - was the best motivation for the next tiny

step. Rewards, if really thought through, do work, as does education. Even

when a child is not " motivated " , continuing to educate them through reading and

by changing the language that you use about OCD is incredibly helpful as well.

Eventually, they will want something bad enough to change. And if they already

understand the disease, then they will be much more capable of doing the work.

>

> - maybe before your ERP therapist " quits " , she could set up a plan over

a month where most of the accomodations from family cease. This alone might

help. Plateaus are very common in ERP therapy. You may also want to look for

another ERP therapist to ask for additional ideas, or to switch to. You might

also want her to really help your daughter brainstorm on what would motivate her

for taking an additional baby step. My daughter is a year younger - but is very

smart - she talked around the issue with 2 therapist before we found one that

could get to the nut of it, and keep the conversation on track. She uses

parents to help in sessions, which we found essential at this age. I'm sure

there are times when ERP therapy should take a break - but with as much progress

as she has already made, it seems so hopeful! I would guess that Lynn is

actually terrified to take the next step. So it may take a big motivational

push to get what seems like a small next step done. Or it may mean finding a

different OCD " thing " to work on for a few weeks.

>

> I'm thrilled for you both and hope you'll continue to post about your

daughters' progress over time.

>

> Best - in NC.

>

>

> > >

> > > For those of you who have seen my earlier posts, our daughter Lynn has

made a lot of progress. She is using bathrooms at school and in public

restrooms (not every day, but multiple times a week). She is happy in her new

school and making friends. Her mood is so much improved that I realize she

really was depressed over the summer.

> ..........

> The psychodynamic therapist thinks Lynn should continue to see her, but

> > > the other (ERP) therapist feels Lynn too easily " talks around the

issues " , ie, strays off topic and does not address what she needs to. So, we

are getting conflicting advice from the two therapists, and our daughter is

unwilling to continue working hard. She does have a psychiatrist for med mgmt.

> > >

> > > I am afraid that Lynn may have to see what happens when she doesn't work

on her OCD before she is really willing to own that it is still her problem and

she needs to work further on it. Right now, she mostly seems comfortable with

the improvements she has made and feels like we are pestering her. Her father

and I have told her that if she will not do any more therapy, we will stop as

many as possible of the accommodations that we had still been making during

therapy, so that she will have to take responsibility for getting any supplies

(extra soap for school or outings, etc) that she thinks she needs.

> > >

> > > Anyhow, just wanted to vent and to ask for advice from those with older

children or those whose kids have been fighting this battle longer than we have.

I keep remembering the quote from the conference this summer, " you can't want

them to get better more than they do, " ie, you can't make it happen without

cooperation.

> > >

> > > (mom with OCD), daughter Lynn with OCD (age 9)

> > >

> >

>