Re: How do you find the right psych/ther.

January 7, 2011

Milissa

Welcome to the group. I'm going to address two items in your email - the

one I copied below, and finding help in the Raleigh, NC. We were also very

apprehensive about our daughter going on meds right off the bat. However,

we learned, as you will most likely too, there really IS a reason for it

and it's just as you were told. OCD is like a brick wall for reasoning &

logical thought.

I was blown away by the change in our daughter in just the first two weeks

after starting medication. It calms their anxious thoughts & allows them

concentrate on the therapy that will hopefully & ultimately get the OCD

under control. We also learned (very important) that SLOW is the way to go

with meds. You doctor should start on a low dose and increase the amount

slowly & a little at a time (our daughter started on 5mg Prozac and was

increased only 5mg every 3-4 weeks -- she remained at 20mg for just under a

year

then went off the same way... VERY slowly.) The slow pace helps in two

ways - it allows you to watch for any type of side effect before they are on a

full dose, it allows your child's system to slowly become accustom to the

drug.

Naturally, the decision is ultimately your choice. However, it is quite

true that therapy is more successful if the child is calm and can

concentrate on the therapy/skills that they need to be taught in order to fight

the

OCD. I don't remember if it was an article I read or a TV special, but the

person was trying to convey to someone without OCD the level of anxiety &

fear that a person with OCD feels and they said, " Imagine if someone

suddenly grabbed you from behind and held a knife to your throat " - that (they

said) is the intensity of fear and anxiety OCD can inflict. Maybe that is for

a 'worse case scenario', but I remember my daughter's emotional state when

I would try and help her stop washing herself in the shower....it was near

hysteria, crying, shaking, begging me " mommy I can't stop, help me stop " .

I would have to say that explanation is not far off.

Looking for help in Raleigh, NC - I would definitely try Duke University.

I also found a great link which I shared before on the board:

_http://therapists.psychologytoday.com/rms/prof_search.php_

(http://therapists.psychologytoday.com/rms/prof_search.php) Once you enter

your city, you can refine

your search criteria on the left side (look at the end of the list

" Issues " and click " more " - the list will expand to include OCD, click on that,

and then in the same list click on " child or adolescent " ) each time you click

on a choice, the list of doctors refreshes. Read the " full profile " for

each because the little snippet they show at first does not include all the

info on that doctor.

Good luck to you and your family!

LT

In a message dated 1/7/2011 2:01:03 A.M. Eastern Standard Time,

milissa.elliott@... writes:

It was just about standard they said to calm a child that age to be able

to respond to therapy-.

January 7, 2011

Hi Milissa,

Welcome!

First off, know that OCD IS very treatable. CBT (cognitive behavior therapy),

with the behavioral part - ERP (exposure and response prevention), is considered

the best evidence based treatment to date, with medication as needed. Finding

the best expert you can to do this form of therapy is critical, so you are on

the right track.

Usually it is a psychologist who is trained to do this, psychiatrists mainly

diagnose and prescribe medication. So, it is a psychologist you want to find.

Social workers and other counselors can also do ERP, if they have received

training.

Some suggestions on finding a psychologist -

*www.ocfoundation.org - they have a list of psychologists, but this is just a

list, not a recommendation, you must screen each doctor yourself.

*local support groups (OCD/mental health) - may have a lead on top experts in

your area.

*community resource centre or crisis line for mental health

*universities with mental health research centres, and likewise hospitals

Basically, whoever you can connect with who might have a lead on a local top

expert in OCD. One lead can lead to another...

The decision for medication can be difficult, I understand your concerns and

fears, especially with a young child. Like you, I was very hesitant, and like

you have had bad experiences with medication personally. However, for some it

is necessary, if only for a time, so they can participate in ERP therapy. The

need is generally determined by the level of severity of the OCD and anxiety,

which is indicated by how much their ability to function is impaired, and

quality of life.

ERP therapy can be tried first, without medication, and this will indicate

whether this is possible or not. You can take it from there, with the advise of

professionals.

I would encourage you to stay open to medication, as it gives many their life

back, when it is necessary. As the previous poster mentioned, how the

medication is handled makes all the difference.

Do you have any books yet? There are wonderful books for children and parents,

the ocfoundation has a list. A favorite book for children is " What to do when

your brain gets stuck " , and for parents I like books by Tamar Chansky and Aureen

Pinto Wagner, both are comprehensive.

When you have an understanding of how OCD works, and how to respond, and

likewise your child, you will feel less overwhelmed by it, as you both learn how

to manage it. It does take some time to sort it all out, and is a process, but

know that OCD can be managed, and does not have to rule your child's life (and

yours!).

You can start by explaining how OCD works to your son. OCD is like a bully in

your head telling you that you have to do things, but you don't have to listen.

Everytime you answer this bully it gets bigger.... While you cannot just stop

answering, this is the direction you need to move in.

Encourage your son to give the OCD bully a name and to talk back to it.

Externalizing the OCD, making it clear that it is not " them " , can make a big

difference.

When he comes to you asking for reassurance you can try a few things. First,

explain that you need to work on not answering every time, and then decide on

when you WILL answer or how many times within a certain time period. You want

to try and reduce and/or delay the number of times of a ritual. This will

increase the anxiety, temporarily, and they must learn to tolerate the anxiety

as it comes up, and then the importance of the thought is reduced.

The thoughts are not the problem, how they respond to them are, the rituals.

They must learn to allow the thought and not respond in any way, and to tolerate

any anxiety that comes up(not at all easy). This is where medication often

comes in, as the anxiety that comes up if they don't do their ritual is too

intense, and the idea of not doing the ritual not possible. They get " locked

in " , and stuck in a perpetual cycle, that can be horrifying for both them and

those who live with them.

Again, know that OCD is treatable, and with the right treatment your child can

get better. Stay focused on your search to find the best expert you can, and

keep reading and education yourself - your best defense against this disorder!

Keep posting your questions and concerns. This is a great group for support on

the day to day of living with OCD and more. Long posts are not unique - as you

can see with mine!

Warmly,

Barb

Canada

Son, 19, OCD, LD plus - doing well for over 2 years now!

>

> Hi! My name is Milissa,and I am new to this site. I have a 6 yr old boy named

Caleb who will soon be making his first trip for help that should

> have been made probably 6 months ago.It has been over a yr. now since he has

been exhibiting symptoms of ocd and just extreme anxiety. His fears

> have changed from 1 thing to another.They seem to get worse during stressful

times(I worked part-time,his grandmother died of lung cancer).

> But they are ALWAYS there,and he never gets a day without episodes,and I mean

more than a few!

> At the moment,his ritual is to come to me,and ask me basically the same

question with just a different insert; For ex :(He has a fear of passing

electrical sockets) " I just passed the light socket.

> Is it ok if I still do everything forever & other things forever? "

> & Will get VERY upset if anything takes my attention until I completely hear

this out and answer: " Yes, You are ok,Caleb. "

> Please believe me when I say I am not exaggerating when I say this happens on

the average of 150 times a day-AT LEAST! Anytime he passes a light that is

on,touches a person,an object another person may have touched...and the list

goes on!!

> I AM SO SCARED! I had a reference from his ped. that I interviewed,and

> basically,they told me they would not begin without medication,now..

> they have NEVER seen him.It was just about standard they said to calm a child

that age to be able to respond to therapy-.

> I REALIZE that at some point,that may be a necessity,but he is 6-I would like

to see if there are other ways first, before I start him on a drug at 6 years

old if IT COULD POSSIBLY be avoided.

> I have had personal experiences with antidepressants in my life as an

adult,that were not pretty!--and I definitely would like to try to save my

little boy from that if I can.

> I'm just wondering: What approaches seem to be the most successful to

> dealing with this? Is it possible without meds? Do I need a Therapist,a

psychiatrist,or a Psychologist? & Does anybody out there know where I can find a

WONDERFUL one in the Raleigh, North Carolina

> area?

> I apologize for my first post being SOO long! You can only imagine how I can

talk!!:0) LOL Seriously though, I have over a years worth of

> worry,and guilt,and questons....and I just want my beautiful little boy to

have his life back!

>

> Thank you for reading,

> Milissa in North Carolina

>

January 7, 2011

Hi, Milissa. Welcome to the group.

Is Cary near you? Aureen Wagner recently relocated to that area. She is one of

the experts in the field of OCD, and she treats young children. Some will not

treat young children, so she would be a good one to check into.

Here is a link to her site~

http://www.anxietywellness.com/

The behaviors you are explaining are not uncommon with OCD. Many doctors do not

understand OCD very well. In fact, our son's doctor has asked me for

information, recommendations, references, etc., to share with her other

patients, which I was HAPPY to share. . Anything to help others who suffer with

this wretched disorder.

Sometimes medication is needed. There have been others in here with young

children, who've taken medication and benefited from it. I was the same as you

when our son first went on medication, but it made a huge difference for him.

The first line of recommended treatment is the CBT/ERP (Cognitive Behavioral

Therapy / <including, most importantly> Exposure and Response Prevention). Some

can improve with that alone, as it retrains the brain. The therapist should be

able to tell you if medication is needed, as an assist, after an evaluation and

possibly starting the ERP.

Your son falls into that age group where kids are constantly sick, picking up

everything at school. Has he been sick at all, with strep? Did his OCD some on

suddenly, after an illness? In some (less common) cases of OCD, they can have a

condition called PANDAS. We have some files on our site here available, if you

think it might be a consideration.

In that case, the medication would be different, since PANDAS is treated with

antibiotics, but the CBT/ERP is still recommended.

Glad you found our group.

BJ

>

> Hi! My name is Milissa,and I am new to this site. I have a 6 yr old boy named

Caleb who will soon be making his first trip for help that should

> have been made probably 6 months ago.It has been over a yr. now since he has

been exhibiting symptoms of ocd and just extreme anxiety. His fears

> have changed from 1 thing to another.They seem to get worse during stressful

times(I worked part-time,his grandmother died of lung cancer).

> But they are ALWAYS there,and he never gets a day without episodes,and I mean

more than a few!

> At the moment,his ritual is to come to me,and ask me basically the same

question with just a different insert; For ex :(He has a fear of passing

electrical sockets) " I just passed the light socket.

> Is it ok if I still do everything forever & other things forever? "

> & Will get VERY upset if anything takes my attention until I completely hear

this out and answer: " Yes, You are ok,Caleb. "

> Please believe me when I say I am not exaggerating when I say this happens on

the average of 150 times a day-AT LEAST! Anytime he passes a light that is

on,touches a person,an object another person may have touched...and the list

goes on!!

> I AM SO SCARED! I had a reference from his ped. that I interviewed,and

> basically,they told me they would not begin without medication,now..

> they have NEVER seen him.It was just about standard they said to calm a child

that age to be able to respond to therapy-.

> I REALIZE that at some point,that may be a necessity,but he is 6-I would like

to see if there are other ways first, before I start him on a drug at 6 years

old if IT COULD POSSIBLY be avoided.

> I have had personal experiences with antidepressants in my life as an

adult,that were not pretty!--and I definitely would like to try to save my

little boy from that if I can.

> I'm just wondering: What approaches seem to be the most successful to

> dealing with this? Is it possible without meds? Do I need a Therapist,a

psychiatrist,or a Psychologist? & Does anybody out there know where I can find a

WONDERFUL one in the Raleigh, North Carolina

> area?

> I apologize for my first post being SOO long! You can only imagine how I can

talk!!:0) LOL Seriously though, I have over a years worth of

> worry,and guilt,and questons....and I just want my beautiful little boy to

have his life back!

>

> Thank you for reading,

> Milissa in North Carolina

>

January 7, 2011

Hi Milissa, welcome! I'm not far away from you, in Eden. I don't know that I

can add anything new to the good replies you already have. I saw BJ mentioned

Dr. Wagner, she'd be perfect! Try her first.

Many people try therapy alone first, some do well, some find their child needs

medication added to help them do the therapy. But, yes, you can try therapy

alone first. Dr. Wagner would be great.

You might try Duke University, their OCD/anxiety clinic.

http://www2.mc.duke.edu/pcaad/pcaad_studies.htm

Duke may be able to give you some names to call too, for someone who is

experienced and treats OCD in children.

A therapist or psychologist (experienced with OCD) can do the therapy.

Generally, you only see psychiatrists for medication. And all they do is

prescribe it, see how patient does on it (return visits) and monitor the

medication, prescribe the refills, etc. Not that they won't talk to patient

about OCD and its treatment, they just don't do the therapy part.

Did you read the PANDAS OCD letter sent to you when you joined our group? Where

OCD may start in some children due to strep, etc.? Just making sure, your son

is the age where strep at school goes around the classmates.

Books for children about OCD are helpful, can help the child understand about

OCD, that they need to work against it, boss back. And then that will help him

understand why he needs to stop asking his questions soooo frequently and that

it's OCD making him. And that you will - at some point - have to delay and/or

refuse replying. Not all at once, work on it in steps, make a plan. A

therapist helps with all this.

I'm glad you found our group! It's been my best support with my own son. His

OCD began in 6th grade. He had his little OCD-type quirks before that, nothing

daily, but in 6th grade it seemed to " erupt " and start 24/7! He's 21 now.

single mom, 3 sons

, 21, with OCD, dysgraphia, Aspergers

attending UNC-Chapel Hill

>

> Hi! My name is Milissa,and I am new to this site. I have a 6 yr old boy named

Caleb who will soon be making his first trip for help that should

> have been made probably 6 months ago.It has been over a yr. now since he has

been exhibiting symptoms of ocd and just extreme anxiety. His fears

> have changed from 1 thing to another.They seem to get worse during stressful

times(I worked part-time,his grandmother died of lung cancer).

> But they are ALWAYS there,and he never gets a day without episodes,and I mean

more than a few!

> At the moment,his ritual is to come to me,and ask me basically the

January 8, 2011

I would love to get this info. and who your doctor is? My 7 year old

started with some germ ocd around age 5, then a couple tics this spring,

then after a high fever, full-blown head to toe over a dozen tics, more ocd,

hyper, separation anxiety, can't draw anymore....likely PITAND/pandas.

Nonetheless, she needs help.....so I appreciate info. Thanks!

January 9, 2011

The doctor we were referred to and use is Dr. Mark Janikla ND in Montana.

Website www.vitalhomeopathic.com . We live in Wisconsin so have choosen to work

with him via phone. I would suggest reading 'Beyond Flat Earth Medicine' as an

introduction to the idea behind homeopathy. It was counter intuitive and way

out there for me a first and I expect it seems that way to many. The Dr. does

an initial first consult that will take anywhere from 1.5 to 3 hours doing a

very indepth questioning of the the overall physical,emotional, and intellectual

symptoms the child/person has. A " remedy " will be choosen based on what's

called " law of similars " . The consult is fairly expensive (likely $400-500 I

think) and unless you live in a state that licenses Naturopaths it will not be

covered by insurance (we use flex $$ with a script from our Ped. who recomm

continued use of Hom.). The remedies are very inexpensive - usually $6 per 1-3

month supply - the

doctor will supply or tell you where you can get them online. I would

recommend you be willing to spend at least 6 months committed to working with

this approach as OCD can be tricky to treat, depending on whether or not your

child shows a good range of symtoms.

Our experience: We saw some mood changes very quickly then a bit of worsening

for a couple weeks, then switched to another remedy and saw some huge

improvements over the next couple of months - later some stalling as the remedy

stops the healing - did some more trial and error of a couple more remedies -

some aggravation of symptoms then, but found a remedy in January of 2010 that we

have been using in varying potencies ever since. That is the only thing we use

for her right now. The Dr. did suggest early on that CBT is

sometimes recommended too, to help things along if the child is willing to

proceed with it. We haven't pursued that b/c she is doing very well w/o at this

point. This past spring/summer was a big leap for her/me - her reassurance

seeking has been eliminated (asked maybe 6 times in the last 3 months and that

is usually when her potency needs to move to the next level to continue the

healing) and as of yet no other OCD symptoms

have emerged. I do know of a couple other ND's that have strong training in

classical homeopathy: Amerione in Colorado, Perlynn Goodman Herrick in

NYC, there is one in CT that I can't think of his name but can find if you like,

and Dr. Mark in Charlotte NC (shamless plug - he is my brother in law

and the one that recommended Dr. Mark to us but a good classically trained

homeopathic ND). Hope this helps... let me know if there is anything more

specific you would like to know - you can email direct if you like.

January 9, 2011

I just wanted to add that we just started Homeopathy for out 8yo daughter just.

last month and already are seeing improvements.

I know it will take time but sounds like any TX takes time with OCD.

in NC

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