14 year old with anxiety - do you communicate with her counsellor?

[Jen3651]

hi there,

Can I ask for advice from anyone who has experience of their child seeing a counsellor (or even better is a counsellor themselves).

Our 14 year old suddenly starting experiencing severe anxiety last Christmas. She's a happy, generally confident child with pretty good self-esteem, good bunch of mates, good at and pretty relaxed about schoolwork. She's physically brave (tree-climber, surfer, etc etc) but has always been a bit nervous about scary films, not that fond of going away for sleepovers etc.

The anxiety kept her out of school for 2 months and with the help of her counsellor and an amazing anxiety worker at her school (I know we are very lucky), she is back in school pretty much full time, and in most of her lessons (though some time is spent in their support block).

My fear is that while school has improved, her anxiety away from school is pretty much stopping her doing anything new (which would include any new car journey, visit to a new house, anything that she couldn't visualise from having already done). So I fear it's actually getting worse, and her world is getting smaller and smaller :(

She's been seeing a counsellor for 4 months now and we've had one 30 minute meeting with her (about 2 months ago), and I know that she's keen for her relationship to be direct with our daughter not with us (appropriately for a 14 year old I think).

However I don't have any experience of mental health issues so have no way of judging if this relationship is a good/effective one (though our daughter is keen to see her, which I know is a huge plus).

I've talked to GP about her trying meds (probably propranolol) to just see if it might help. Daughter is very opposed but I've asked her to talk to the GP and then her counsellor and see what she thinks then.

I thought I would email the counsellor and just let her know what i'm thinking. Is this a good idea? I just feel I have no way to judge how effective the work is, or how much communicating there should (or shouldn't) be between us.

Any advice gratefully received!

My DD had counselling aged 15 and we did have some reviews with the counsellor. In those, nothing was discussed with us that hadn't been agreed with DD and we were able access antidepressants and an autism assessment as a result of these reviews (not saying your DD is ND, just what happened for us).

However, her therapist was a very experienced child and adolescent psychotherapist who also worked in the NHS. I think that made a real difference to the way she worked with DD and us. However, no counsellor is going to mind if you ask their opinion or get in touch. Many won't be able to advise on medication though.

If her counsellor has got her back into school then it is probably an effective relationship.

Is there a particular reason you want your daughter on meds?

Anti anxiety and anti depressants in teenagers can help some and make others much much worse which is why they are not recommended for use with under 18s.

evidence.nihr.ac.uk/collection/antidepressants-for-children-and-teenagers-what-works-anxiety-depression/

In theory they are not supposed to be prescribed for under 18s without the child seeing a psychiatrist- this is because it's considered second level care.

ASd girls often present with anxiety as first symptom. Mine did.

thanks both

@Octavia64 I guess my fear is that while school is improving, her general anxiety about anything outside school is basically keeping her away from any new experiences, and that this is in danger of becoming normalised.

Her main problem is the actual transition from one place to another, and propranolol should only help with the physical distress she suffers while scared (racing heart, sweating, dizziness). Once she gets to her destination and calms down (20 mins or so) she's completely fine and back to her old self, has a brilliant time etc. I guess I'm hoping the propranolol could see her through that initial terror, and she'd get more confident about trying new things...

I should add, she shows zero signs of any depression (amazingly) and is apart from the awful panic attacks, a really happy upbeat child most of the day.

Hi @Jen3651 I could have written this except my dd is 16 and mid GCSES.
My dd's counsellor doesn't have any communication with me (aside the bill) and it is very difficult, I don't know if the counselling is helping although, she is very experienced with teens/anxiety/covid. Last week my dd came out in flood's of tears saying she didn't know who she was, had no friends or interests 😞.

School have been amazing but I don't really know what I expect from counselling. My dd's world is becoming very small and I don't know how she will ever get a job.

On the point of medication my dd is already on propranolol (migraines)otherwise that is what GP would have given, I was told medication in this age group is associated with adverse events so it is down to CAMHS if you can see them.

@Allthecatseverywhereallatonce - sending you a hug. I'm a (much) older mum and friends who had kids at a normal age are incredibly reassuring that ours will get through it, and nearly all of them (mainly girls I must say) are now young adults living "normal" lives (some with meds, some with continuing counselling support). I hope this helps.

For me it's that awful fear that I could be doing something different that would improve or speed up the outcome. My daughter says I'm a fix-it freak 😀and need to just let it be. From the mouths of babes etc... (but easier said than done)

My DD saw a clinical psychologist at this age for anxiety and there was quite a lot of contact between me and her. I'd agree with looking into autism too though, especially if there's no obvious cause of the anxiety. Struggling with transitions is an autistic trait. Also we thought my DD was having panic attacks but realised after discussing the possibility of autism that it seems like more of an autistic meltdown/shutdown due to sensory overload.

My DD is also seeing a counsellor, I’ve struggled a bit with not getting ‘reports’ back from her but the counsellor is very clear that she will only tell me what DD agrees to share with me, although obvs if there is a safeguarding need the counsellor will inform whoever is necessary (so when DD told the counsellor she was self harming, the counsellor reported to safeguarding at DD’s school etc).

I think in your case I would ask the counsellor to have a chat, she will be very clear what she can or can’t discuss with you about your daughter.

DD15 has been seeing a clinical psychologist for a couple of years now. I sat in on the initial assessment but otherwise, DD attends alone. The psychologist will fill me in on anything she feels I should know, otherwise I don't get feedback. I think it's important for my daughter to know she can say things in confidence during the sessions. She's always available over email if I have any questions or concerns (or just need a rant) though and has been an absolute godsend. She's been clear that she makes little therapeutic progress with DD (due to her ASD mainly) but DD has so few adults she trust in her life, I'm happy for the sessions to continue.

My experience was similar to Berga's above. Our counsellor was good at keeping in touch.

thanks again all - at the one meeting we had with the counsellor (who specialises in kids/teens, and particularly in neurodiversity - and has worked for decades in the school system and privately) felt that our daughter isn't showing signs of autism or neurodiversity - though as she put it "we all have bits and pieces, but no more than the average person". Her dad is (undiagnosed) a long way on the spectrum so I was definitely considering it a possibility, but the counsellor thinks not the case here.

Our daughter is if anything over-keen for us to talk to the counsellor (in fact it was a struggle to remove myself from the initial meetings), so I think the counsellor's lack of contact is more about encouraging our daughter's self-sufficiency (which feels right, hard as it is at this end).

Your responses have given me the courage to send an email to the counsellor, so thanks all.

Girls can mask for England. I’m not sure the counsellor is correct, especially if your Dh has it.

@ArseInTheCoOpWindow I do agree, but my instinct is that she's on the right tack with our daughter's fear of growing up being more likely the issue (I'm sure there's a better term for that). Though I do agree will keep an open mind, but I would have been more concerned if she'd been completely dismissive of it rather than saying yes, she's definitely got some signs but doesn't think they are at a point where it's a helpful direction to take. Especially as it's the counsellor's speciality. But yes, will keep an open mind

Fear of growing up is classic ASD though.

Autism occured to me too. .

My DDs a bit younger, she's seen a couple of psychologists in the last 3 years until we found the right one. The relationship with a therapist is very different to one with a teacher or GP or other trusted adult. If she can talk to and trust her psychologist that's a great start. My DDs current psychologist is the first she's been able to talk to without me there. I do email DDs psychologist a quick summary of anything that's happened in the last 2 weeks I think might be pertinent. DD is happy for me to do this. The therapeutic relationship is really important and that includes the child having the amount of privacy they want. If she's not against the idea Id be communicating (one way) with the psychologist keeping them up to date with what's going on, but keeping her feeling that her therapy is a safe place would be my first priority.

DDs been seeing her current psychologist for about 18 months now. She's doing a lot better but its taken us 3 years and medication to get there. It's a big improvement in that timeframe that your DD is back at school, Id be happy with that. Being back at school, especially if like my DD she's Autistic, could be taking everything she's got right now. Id expect a period of consolidation until she feels comfortable enough about being at school that any underlying anxiety is gone. Then building on that to the next issue. If your DD trusts her and can talk to her than that is worth a lot and I'd be willing to give this at least a year unless she obviously starts getting worse again. Learning the skills to handle her anxiety and working slowly through the issues at levels she's comfortable with so they don't trigger greater anxiety can be a really slow process but its worth it to get to a place the anxiety doesn't own them anymore.

@EliflurtleAndTheInfiniteMadness really helpful, thank you

I wasn't going to say too much initially about neurodivergence, but as the thread has gone that way, I'll add a bit more.

I'm still not saying that your DD is ND, as I wouldn't have a clue, but the fact that your DH is likely ND and the experience your DD is having means I think it's worth exploring whether the counsellor has actual additional recent training in ND rather than saying it is a specialism and having school system experience, which may not be the most up to date info. The reason I'm saying that is because even the hugely experienced CAMHS psychotherapist my DD saw separately indicated she thought DD has ASD, she could not diagnose and instead arranged a referral. She was very clear throughout that she could be wrong and that it was a hunch. Turned out it was the correct hunch, and not only that, lead to my own AuDHD diagnosis a year later after I realised just how similar DD and I are, and how much own experience of secondary school and anxiety mirrored hers.

I'm just a bit suspicious of any one who says anything along the lines of 'we're all a bit ND', because we really aren't.

hi @Berga - that's actually my (completely ignorant) interpretation of what she said - apologies, and I would agree not helpful.

From the research we did before DD went to see her, my instinct is that she's extremely experienced in the field of ND (mainly chosen because of DH) and has taken a call on it that for the timebeing I'm happy to accept. And yes I would totally agree that it's a hugely complex area that warrants specialist experience to diagnose.