Experiences of DBT-A through CAMHS for autistic and ADHD teenagers

[DBThelp]

My DD is 16, autistic and ADHD. She's had a terrible few years - self-harming and suicidal.

CAMHS has offered her DBT-A, so DBT for adolescents. Involves individual sessions with a therapist and parents attend the group sessions.

If anyone has experience of this, we would love to hear how it went for you or your child. Thanks so much.

PS name changed for this. And no replies in mental health so trying here. Apologies if you see it twice.

Mine is younger (early secondary) but had the same offered for anxiety and SIB last year. It did help - although the greatest help seemed to be an hour a week talking to someone sympathetic in a quiet space, rather than the content of the therapy. She learned some good techniques but struggled to apply them when she actually needed them in the heat of the moment. But she was really enthusiastic about the sessions and looked forward to them - at the time probably the thing she most looked forward to at school - so if nothing else they were getting her through the doors and having positive moments.

The parents' group was good for shared experiences and feeling like we weren't quite so isolated, but the content I found pretty basic.

DBT is- in my experience- one of the best available therapies for people with ADHD in particular. I'm autistic as well, and had a really good experience with it. Though I was in my early twenties rather than teens, as I spent my teens going through multiple useless attempts at CAMHS CBT.

The important thing about DBT is that it focuses on coping strategies and how to handle your thought processes, unlike CBT which attempts to re-structure your thought processes in a way that autistic people especially often find condescending and difficult. It's not magic, and it takes a while- I did six weeks of standard DBT with a therapist interested specifically in autism and ADHD before moving onto a combined approach (DBT, interpersonal therapy, some other techniques every now and then). I still have that combined-approach counselling now, though not as often and purely for maintenance. I'm now infinitely better at managing my feelings and I don't feel like I'm on a constant roller-coaster of extremes the way I used to. It's been a couple of years now since I had a proper emotional spiral, which is an immense relief.

I've never done group sessions, so hopefully others will come to you with more experiences in that area. I just wanted to reassure you that everyone with autism/ADHD I know who has done DBT has found it at least somewhat helpful, most finding it really successful long-term. I hope both you and your DD have a good experience with it!

Thank you, @audiehd

It's really reassuring to hear this. We will need to upend DD's life quite significantly so that she can actually do the therapy - for example, I think she's likely to have to do her college course over 3 years not 2. I've been so worried that we will upend her life in this way, which she will find hard to cope with, and then she'll get nothing out of it.

It's being presented by CAMHS as her only option.

I'm so glad that it's had a positive impact on your life. Thank you.

Sorry @audiehd did you do this privately? Who did you go through?

Thanks for sharing your experience @VeggPatch

DD already has non-DBT therapy, which gives her a nurturing space, but has not shifted it changed anything.

Do you think your DD is still using the techniques she learned?

I don’t think she is - but the therapy identified that she is alexithymic, and it is very difficult to apply strategies to negative emotions when you can’t work out what the underlying emotion is in the first place. Her ADHD also means that she is very much in the now / not-now, so when she feels overwhelmed she can’t countenance that the feeling will pass.

So a mixed bag in that she definitely understands herself better which is a big plus for her self-esteem and the SIB has reduced. But not really in terms of retaining the strategies. I think because she’s academically ok they underestimated how far behind she is emotionally and expected too much of her, but at 16 your DD should be in a more positive place to be receptive than mine was at 11-12.

I did go private, and I went directly to local therapists found on the PsychologyToday online directory- I tried to get it on the NHS but the doctor said I'd need to wait five years to see if I really needed it before they'd refer me. Obviously a big part of therapy is the rapport you develop with the therapist and that can be variable, but the actual DBT techniques and process are pretty well-defined so the content should be similar regardless of provider.

Thanks @VeggPatch

You've nailed one of my concerns, which is that DD is also alexithymic. I worry how they will adapt (or even if they can adapt) the dbt for this.

It sounds like she’s been through such a difficult time. I’ve heard DBT can be helpful for teenagers who struggle with self-harm and intense emotions, particularly when parents are involved too. I hope you get some useful experiences from other parents here.