Anxious 8-year-old DD: advice on therapy route please

[MmePamplemousse]

My DD is having a variety of anxiety-related problems (headaches, stomach aches, nausea, unwillingness to go to school, lack of appetite, troubles sleeping etc) which are starting to affect her school and social life. Her school and our GP are both involved and she is seeing the school counsellor. A friend, who is a clinical psychologist is strongly recommending that I press the GP to get her referred for a clinical assessment leading to cognitive behavioural therapy. She says that in her work she sees many children who have been working with counsellors for two years or so with no improvement and that CBT will get quickly to the root of the problem. The school counsellor is recommending a child-/play-centred therapy approach because she strongly feels the need to sort out the original cause of the problems. Her view is that CBT may not deal with the source of the anxiety. Does anyone have any advice as I feel confused about where to go with this. Apparently it is my choice, but I don't feel equipped to make the choice. Any help or experience would be gratefully received.

DS1 was referred to the CAMHS anxiety team a year or so ago, turned out at his first appointment that they realised he had Aspergers so rereferred him to a different team. I did have to push GP slightly to get the referal in the first place "all children have worries about things", so had to give some specific examples that even the GP realised weren't normal.
So I would personally get a referal if you could, as certainly where we are the anxiety team seemed fab!

Thank you LittleMissGreen: I have been advised that I will need to 'lay it on thick' to get a referral. So it may be that the first appointment (if we get one!) will make the way forward clearer anyway? Thanks again.

I think its going to depend on the route cause of her anxiety, is that something you know?? (no need to say what it is)

but if there is a realistic cause of her anxiety, realistic in a childs eyes that is, then from personal experience with my own DD then the School counsellor may well be right,

my own DDs issues were related to bullying & a very disturbed & disruptive child who joined her class, she already had stomach issues which began after hospital treatment for a serious illness, & this now flares up with stress amongst other things, so bar not wanting to go to School, my own DD was having all those problems & more - she loved School & is stubborn & very feisty & took the view it was her School first, so refused to be pushed out but was going through hell :( - even after the DC left her School she was still a nervous, poorly wreck :( - the play based counselling worked wonders for her

If YOU feel there may be more going on with your own DD, as in not normal reactions, or perceiving things as stressful that aren't, even from a Childs point of view - class noise, play time etc etc, then pushing your GP as above makes more sense.

Also, as you mention tummy trouble, is it possible she is vitamin, mineral/electrolyte deficient?? - I mean suffering with diareah, or possibly so stressed her digestive system is knotted up & not working efficiently?? - I've found both with DD & even myself due to a drug reaction, that being low in potassium can trigger anxiety & even panic attacks - so that might be something else worth looking into -

Rockinhippy, thanks for your comments. The cause is baffling us all, including her. She either doesn't know or won't say. Her teachers can't see anything and there isn't anything that's happened at home that's different to last year, say. I have asked her friends at school what they think but we've not come up with anything. Your comments about diet are interesting. She may well be suffering from some vitamin/mineral deficiency as her diet is rubbish at the moment. That's certainly something I can start putting right anyway. (She's lost quite a bit of weight since all this started and so I've been so grateful that's she's eating anything that I haven't much cared what she's been eating. But I can see that the quality matters too.) I think that, if I can, I'll try to get the school to start the play therapy as I am sure there will be a wait for the CBT. Perhaps by the time we get a referral for assessment the play therapy will be helping.

Anyway, thank you both for your comments. I do feel completely out of my depth with this and it's good to hear sane and helpful views.

I hope you do get to the bottom of it for all your sakes:(

FWIW for quite a while I couldn't work out what was going on with DD either, talked & tried to get her to open up without putting words into her mouth, tried story writing, roll play games - her playing me, me playing her - her playing other kids at school, teachers etc - nothing :( , she really didn't seem to know, bar what seemed like the usual gripes over school yard squabbles & "the naughty boys" which were a common topic amongst her & her friends, but didn't seem that serious - there had been 1 incident she's told me of, but told me it had happened to her friend

Eventually I took her back to our GP, as even though she was still eating a good diet, she was nibbling & constant diareah & stomach pain, not sleeping etc - she was also often - not sure how to word it - grumpy isn't quite right, but difficult, stroppy to how she usually was, but not always, just some times & always seemed really full of remorse & punishing herself before I could even tell her off - I couldn't put my finger on it, it didn't feel right, but talking with other Mums, even a child psych friend, just thought it was her age -

anyway the GP asked if she had any trouble that was making her Tummy poorly - & she suddenly just spilled it all out mostly centred around 1 out of control boy, who was quite new, smashing up the class room etc, he had attached himself to her & she felt she had to be friends with him, to stop him hurting her teachers - LOTS more, I was gobsmacked & felt like rubbish, as she -

the Teachers weren't aware of any direct bullying, knew there were class problems but didn't realise - or didn't own up to the effect it was having on the rest of the kids - my DD was being bullied, but in a way were she felt she HAD t be friends with a boy she really hated, & it was eating her up - if she kept away from him, he came after her - it also turned out the story she told me about her friend HAD in fact happened to her & lots more, basically she was living in fear, but felt ashamed & didn't want to cause trouble :(

I'm not saying this IS whats happening with your own DD, I really hope its not - but certainly worth baring in mind that even when we have a good relationship with them, sometimes they bottle it all up & can't even bring themselves to open up to us :( - I was devastated by that, but found out its actually not that uncommon :(

The other thing that might be of interest as regards your DDs diet - &I can understand totally that ANY food is better than none when they are wasting away :(- there is a superfood supplement SPIRULINAit comes in compressed tablet form, from GNC & the likes, its totally natural & safe for kids, & is PACKED full of good stuff, vitamins, iron, enzymes for digestion AND lots of pottasium - it really helped DDs health - I still give it to her now if she's looking run down - but used to give her 3 cut up pills a day

Hope thats of some help
Good luck

Oh Rockinhippy, thank you so much. First for the practical spirulina advice but mostly for the other ? your story has just given me an idea based on a very passing comment DD made today. Thank you again for sharing your experience and, perhaps, giving me a very good idea about what might be going in with DD.

Parenting? Who'd have guessed it could be so hard?

Sorry, my emphasis came out wrong!

Hi, I work in child mental health and I would recommend play therapy at least initially for your daughter. I think it might allow her to express a little of what she is anxious about which would be valuable to know....after all, maybe it might be something that needs sorting out e.g bullying. Cognitive Behaviour Therapy CAN be very effective but it is not a magic bullet. I'd generally use it with slightly older children, but it does depend on the child.
If you see your GP they would probably refer to CAMHS who would do their own assessment and decide, with you and your daughter, the best therapeutic approach.
In the meantime there are some good children's books about anxiety e.g. 'the huge bag of worries' by virginia ironside, and 'what to do when you worry too much - a kids guide to overcoming anxiety'. They are available on amazon. These might be useful.
But the main thing that I'd like to stress is that it is really important to give your daughter the message that worrying (feeling anxious) is normal and everyone does it, and sometimes we just need a little help if the worries get too big, and that she does not have a big problem. Keep it matter of fact and reassuring. The last thing you'd want I'm sure is for her to feel that she is 'odd' or has a big problem that she can't overcome. It's important to normalise anxiety...so that she doesn't worry about experiencing anxiety or feel stigmatised by it. Apologies if you're already taking this approach... I'm not meaning to lecture
Best wishes

Selks, lecturing is fine :) Any and all information much appreciated. I bought a copy of the Virginia Ironside book a month or so ago after finding it on a reading list somewhere: we've read it together and discussed it and I do think that she finds the message very reassuring. We are trying to play it all down but I still have to keep reminding myself not to let her see that I am worried about her worrying ? I am hoping that we get a CAMHS assessment so that we can decide how best to move forward. In the meantime, I feel so much better, myself, for having had this chance to get advice and to consider different people's experience. (Actually, I am amazed how much better I feel. I think I've been trying to be calm and matter of fact, while keeping all my worry to myself for too long. It's been lovely to hear from everyone!! Thank you.)