The only way to overcome anxiety is through exposure

I think as long as it’s done gently, then maybe. I was forced to do something everyday in my previous career that made me so anxious I became ill and has left me pretty traumatised so I’m not sure it works all the time.

Yes it helps, IF it is led by the person experiencing the anxiety and is at their pace. I think school is a pretty bad example, if someone is being bullied, feeling a failure because they can't keep up with work and experiencing sensory sensitivity, forcing them to go all day every day could be counterproductive.

I pay for private therapy. To be honest 6 sessions from the nhs didn’t even touch the sides and wasn’t helpful.

yes, this is me! Benefits to NHS work include all the usual public sector benefits. In the end though, the negatives outweighed the positives and I couldn’t work ethically in the way I want to. Many others have left too.

I adhere to the ethical framework of my professional association and would never attempt to hold on to a client who is ready to pause sessions. It’s quite insulting that you’d suggest I do!

Many private therapists work in the NHS too or have done. I’ve heard of so many leaving the NHS for private because they’re so disillusioned.

Frankly thank goodness for private practitioners as you are highly unlikely to get anything off the NHs until you’re beyond crisis point and they want to then keep you out of inpatient.

Which is jolly convenient for someone making a living out of it I guess….

just anxiety?
Was he assessed for ASD?
This sounds like a classic ND presentation.
I assume you think he was trying it on or his parents were pandering to him?
I understand that students like this can cause issues for teachers who just want students to shut up and sit down so they can teach. I’ve come across many teachers like you in my career, sadly.

I agree with this and see it mirrored in my private work.
A large percentage are “failed by camhs” (their own words) or “didn’t like, couldn’t do CBT” (also their own words). Not only does it often not work, it often makes problems bigger and harder to turn around. I get why the NHS use it. They can promote six or ten session models and leave the client feeling that they just didn’t try hard enough when it’s barely touched the sides of their issues.
In reality, therapy takes as long as it takes and sometimes that’s short term, more often it’s long term.

It does not work for all ND people
even with adjustments and training as I’ve been told by quite knowledgeable professionals. Forcing CBT when it is inappropriate and not even adjusted or by a properly trained professional as regards autism can be hugely damaging. Also the training NHS therapists receive re autism is woefully lacking. The ignorance we repeatedly come across from supposed trained professionals is shocking.

So we are where we are. CBT is often inappropriate for those with autism and anxiety in autism is often nothing like that experienced in NT people. it’s far harder to treat even before it gets left to get a whole lot worse often with additional conditions such as CPTSD in the mix.

What alternative therapy modalities have your DC benefited from and how did they access those as that would seem to be more constructive to discuss than just complaining about CBT and graded exposure and suggesting it’s harmful which will put people off seeking care and keep them
stuck.

Well thanks Chat GPT for that. Nonetheless I did post you a peer reviewed research paper which concludes that CBT certainly can be effective for people with ASD. It does require adjustments and therapists in our trust have received training.

Financial constraints are what they are. Is it not obvious that there is a trade off and you cannot have a hugely specialist tailored therapy available promptly for free to all as it is unaffordable and will not be necessary for everyone? A stepped care model is in place where the easier cheaper things are tried first because that’s what is affordable. I am old enough to have worked pre IAPT and before there was self referral for short courses of CBT there was nothing at all except a 5 year waiting list. The NHS is doing what it can with the resource constraints that exist and it’s better than nothing.

My dc have achieved huge things without the head on approach which is so damaging for many.I’ll wager many struggling with far more than shyness achieve more without meeting difficulties head on. Avoiding and staggering difficulties has helped my dd to achieve. Meeting difficulties head on made her ill and her difficulties far worse.

Who says conditions shouldn’t be pathologised?Pathologising has got my kids treatment adjusted and lead to the right treatment they need.

The reasons why CBT often doesn’t work for those with autism are as follows;-

Key reasons why standard CBT is challenging for autistic people include:

1. Differences in Thought Processing and Communication

1. Misinterpretation of Sensory and Physical Realities

1. Misalignment with Autistic Cognitive Style

1. Environmental and Social Barriers

The last is key. The lack of reasonable adjustments and expertise across the NHS for anything let alone CBT is frankly appalling
and a reality. Hence CBT being unlikely to work in it’s state as a mop up everything, one size fits all 6 week online course directed from a GP.

My dc have had other far more useful treatments and therapies.

I recently overcome a massive anxiety of mine. I feel so liberated and proud. It has made me think of the other significant anxiety triggers I experienced in life and concluded that all have been overcome through regular, controlled exposure over time.

Totally agree with you @Passaggressfedup Congratulations! And thank you for posting.

It's human to feel anxious - we shouldn't pathologise it. And the freedom one feels after doing something scary is wonderful! I'm glad you're experiencing that.

I suffered from almost pathological shyness till I was about 25. Luckily, my family were compassionate but didn't pander to my shyness. I was pushed to do things - with support of course, but also told that shyness was just extreme self-absorption & people weren't that interested in me. Tough love! And it's true.

Today, I'd have been pandered to and probably medicated. Told I had "social anxiety" and not much expected of me. And I wouldn't have achieved half of what I've achieved! I would have stayed more shut away, too scared to go outside. It's ridiculous to let fear rule one's life.

I still sometimes have to take a deep breath before walking in to a room of strangers, and I don't particularly like doing it, but I do it and lo and behold! Most people are interesting and friendly when you ask them about themselves and listen to them. Great way to get over shyness (or as it's called nowadays "social anxiety").

Why is my idea stupid? I'm telling you how I cope with anxiety and you're telling me it's not anxiety. You have no idea what the thing that's causing me anxiety is but have chosen to diminish it and determining it's not anxiety. Thanks.

There was a lad in a class I taught a couple of years ago with severe anxiety, and I completely agree.

He was in Year 6, no learning issues, just anxiety. He permanently had ear defenders on, a couple of fidgets and a chewy necklace. Wouldn't even go into assembly.

It's a big old world out there, and while I get that some kids are shy, and can be natural worriers, a lot would be improved by some tough love and some jollying along. Pandering and hand-wringing won't do them any favours long term.

As for this particular boy, he went off to a mainstream school. We lost track of him after that, so no idea how it went. I can only imagine, badly.

Some things that make my son anxious cause him to be so distressed it causes behaviours that are a danger to himself and others. I wonder if you are willing to put yourself in the firing line in the aim of exposure.

No I don't think this always works. My DD has a GAD diagnosis which means her baseline anxiety is very high, she just feels anxious a lot of the time. So there's no trigger to use gradual exposure with. Medication has helped though.

Also if anxiety is related to sensory processing issues then accommodations are recommended, not exposure.

Also something like EMDR could be very effective if it's trauma related.

This is really true

I think there is so much pressure on young people to succeed, to be rich, smart, look great, have lots of friends and 'followers'. My daughter is year 5 and there is a divide between the 'old fashioned' parents who don't give heir children phones but then also don't seem to allow their children independence such as walking themselves to school as 'its not safe without a phone'. These children are I think from observation, happier, more playful and kinder to each other, but possibly less resilient as living in a protective bubble. And those who have phones, and all the apps, and talk about skincare etc and behave much older than they actually are, but who are probably better at looking after themselves.

There seems to be no 3rd option. My daughter and most of her friends are in the first group, but when I mentioned letting her walk the 5 mins to school, or playing out with a friend on the green at the end of the road without am adult, the parents looked horrified.

We seem to be either babying or adulting our children, in the name of 'protection against some not quite known threat' or 'preparation for real life' . No wonder they are confused and anxious, they don't quite know where they 'fit' or how they are expected to behave.

Covid fed into that, one minute they are expected to be at school every day because 'school is important and you need a teacher to learn' and then it's 'stay at home and teach yourself'. It's 'listen to adults as they know best' and 'learn to think for yourself'. As adults we can balance 2 apparently contradictory statements as potentially both being true at same time. But children often can't do that. So they see confusion and contradiction, lose trust and feel lost.

I think the push to remove mobiles from schools is great. But one school near us has pre empted that and banned them from the school grounds already and the parents are in uproar, threatening to remove their daughters from an excellent school because of their own fears. Fear which then passes onto their children, and perpetuates a cycle of anxiety

Alternatively, you are just full of crap with your cod-psychological 'just do it!' bullshit.

I think it is showing that this subject of discussion is triggering a defensiveness response.

In most cases camhs are not even accepting referrals when a child is awaiting neurodevelopmental assessment - which can be up to 5 years. And this is despite children not eating, not sleeping, hearing voices and using suicidal language. I know this having battled the system on my dd's behalf.

Interestingly I am under NHS pain clinic and one of the book they recommend actually suggests you do avoid situations that you think might trigger your pain or make you feel trapped with your pain because that can make you anxious and anxiety makes you perceive pain in an amplified way. Might be a bit different with pain but interesting.

I do think we should be more open about our anxieties. I noticed how I mentioned my phobia but didn't say what it was for fear of judgement. If we were all a bit more open it might lead to people learning from each other. For example I used to have a fear of lifts (not my main phobia) that came about after child birth. I used a lift with glass surrounds and for some reason this altered my view of lifts and now I am fine. I shared this with a couple of women I met recently who couldn't get into a lift. It might help them.

Unfortunately, if your child is Autistic and they are referred to CAMHS because they are anxious, suicidal and self harming (for instance) then CAMHS will tell you themselves that CBT might not work for your autistic child and they need to do further assessments to decide if it will work.
If they are unable to offer CBT to your child then they will be taken off the 'list ' and that's it.

The problem is that all CAMHS seem to offer is CBT. But as is evidenced on this thread, CBT doesn't always work.
This is my lived experience with my son.

Combined with medication, sure. But depending on the level and intensity of the anxiety, exposure might be completely useless on its one. I spent all my life constantly exposing myself to all the things that caused me debilitating anxiety, and I saw almost zero improvement until I combined the exposure with medication. Agreed that hiding away is not helpful.