DD hates CBT

[tam409]

My 16yo DD has had problems with mental health for at least 18 months getting steadily worse. Recently it has turned into OCD like behaviours (routines and hygiene obsession) as well as extreme meltdowns at the slightest thing, which result in screaming at the top of her voice, hitting herself etc.

We got a CAMHS referral and during the assessment they only talked to her, not to me, so I am not sure they realise quite how bad it is. Home life is has been awful for ages, I'm really struggling. She got referred for CBT and has had two sessions so far. She finds the therapist patronising and finds it hard to engage at all. She said it's like it is aimed at an 8 year old. She also feels like the therapist doesn't really understand how complicated her problems are (the first thing the therapist said was that she had a "hand washing problem", which is such an understatement it is a joke).

So each time she just comes out seething, then has a huge meltdown and I have to spend hours helping her calm down. I've said she needs to go a few more times, so we can give it a chance. But does CBT work for everyone? Has she been unlucky getting a therapist she doesn't click with? Will CAMHS offer any other help if this doesn't work?

Thanks

It doesn't work for everyone, I believe DBT is offered to neurodivergent people rather than CBT.

I'm an adult and have bipolar and GAD, CBT didn't work for me, even though I actively engaged with it. Apparently it's not for everyone. Hope your dd can get on the road to recovery, it must be so hard for her (and you) x

Hiya. I’m a CAMHS CBT therapist. CBT for OCD is really effective and it’s worth sticking with it. The first few sessions are usually learning about OCD and then you move onto exposure work and addressing the intrusive thoughts. The later parts of the therapy are what make the big difference in my experience.

It does sound like she may not have warmed to the therapist and you can always request a different therapist if you feel strongly like this is a barrier to her engaging.

Unfortunately CBT for OCD is hard work and it is uncomfortable for the young person, but I’ve seen it make such a positive difference for so many young people in the long run.

Ideally CAMHS should be offering you some advice as parents too. As she’s 16 it will be her choice if you’re included in sessions or not. But they may be able to offer sessions to you as a parent to help you understand OCD and how to support her at home as practising the skills at home/school is really important for overcoming OCD.

Also should have said it doesn’t work for everyone, but evidence indicates is the most effective treatment which is why it’s tried first. Usually we’d encourage the young person to try for 6 sessions before considering whether another treatment might be more suitable. It can also be adapted with strategies for managing emotions/sensory differences.

I agree it doesn’t work for everyone, but DBT wouldn’t normally be the next recommended treatment unless the difficulties are driven by trauma or difficulties managing emotions.

Although of course many neurodivergent young people have experienced trauma (bullying, school environment not suited needs etc) so DBT may be considered if it’s felt trauma is driving the obsessive behaviour.

CBT can be adapted for neurodivergent young people but may require a more experienced therapist.

CBT didn’t work for me.

I spoke to an NHS psychologist about CBT and my ND daughter. She said CBT needs adapting for ND people and will take a lot longer than for a NT person.

CBT from CAMHS didn’t work for her either.

Been through the same with my son. Pls message me if you like.

Thanks @Archiesmum671 that's really helpful. I will try and get her to stick with it for a bit longer.

I should have said she is on a waiting list for an ASD assessment, although I don't know how this will turn out as she didn't have obvious traits as a younger child (other than she has always had severe tantrums/meltdowns).

If she does have ASD I did wonder if this meant CBT was less likely to work but it seems that as she doesn't have a diagnosis, CAMHS are treating her as if she is neurotypical.