trying to figure out best therapy for anxious 10 yr old

Hello, My 10 year old daughter is dealing with anxiety issues--some disturbing thoughts that make it hard for her to fall asleep at night, worries, scared of certain situations (like doesn't want to read about a hosptial scene becasue she saw our neighbor being carried out to an ambulance when she was younger and it really scared her) some phobias, sometimes some school refusal, some sensory issues around clothes.  She is also delightful, friendly, loves school, does lots of different things :) Anyways, we are working with a pyschiatrist and trying a new med., so hopefully that will help soon but I also want to figure out a good therapist and trying to figure what type of therapy--family therapy (my husband and I are both on the more high strung end of things, i feel overwhelmed alot and have a tendency to worry, my mom is very anxious and she lives in our in law unit)  or CBT or  CBT and exposure therapy.  I've heard different things--what matters most is the relationship and connection the child has with the therapist, it's a family systems issue so we should do family therapy but also that at the end of the day talk/art/play therapy don't help much as much as the CBT/exposure therapy.    so trying to figure out what will be the most helpful and then of course there is the challenge of finding someone and the cost.  so also curious to hear specific recommendations of therapists. Thanks!!

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We, too, have anxious tendencies, and our child started having anxiety issues around 9 / 10 years old. They were having issues with sleep, self esteem, depression. We tried CBT exposure therapy and it wasn’t for us. It is not meant to be for a long term and we do think the few sessions did have immediate improvement in child’s fear but the process was very intense. I do not doubt the effectiveness but we wanted a more warm and supportive / relationship based therapy. The work involved was so hard that the child refused to do the exposure therapy. Also, CBT / exposure therapy tends to be more expensive. I think it’s because it is meant to be a short term, targeted work? When we began exposure therapy, the therapist said she thought it would take about 10-12 sessions to address the  2 main issues. 

We switched to a play based therapy at www.thechildrensinstitute.com and it has been working out well. Child enjoys the warmth, validation and gentle guidance from the therapist. We also meet with the same therapist and she does coaching for us. the improvement may take more time but the process is less painful for us and the child. The coaching sessions are helping us understand our child better.

The cost is a burden. Our child’s current therapist is $200/hr which is less than any CBT therapist we worked with or looked into. I think play based therapists charge anywhere from $175-$225 based on our recent research. Most don’t take insurance. We have Kaiser so we have no options but when we had Cigna PPO, we submitted for reimbursement and we found Cigna to issue reimbursements pretty quickly. 
 

I am sorry you are dealing with this. Hope you find the help you need ASAP. 

Hi, I am a therapist and would recommend talking with a few therapists. I think Cognitive Behavioral Therapy (CBT) or Exposure Response Prevention (ERP) would be a good place to start. But most therapists will assess if the type of treatment is appropriate for your child. And most ERP therapists are also trained in CBT, not always the other way around.

For parents there is also SPACE treatment (Supportive Parenting for Anxious Childhood Emotions) which is a way of treating the child’s anxiety through working with the parents only. It’s a great treatment for school refusal due to anxiety and childhood anxiety in general.

Unless you are scared for their safety I would not go the med route at age 10. You may end up on a non stop road of meds that are not really made for children. I have a lot of experience in this having gone through it with my own child. DBT therapy would be very appropriate. It has groups, parent training, individual therapy all as a part of it. Another option is Equine therapy. Both of these are helpful for anxiety and trauma. They helped my child immensely. 

My child sounds similar to yours and we've had great success with CBT. It does take work in between sessions, but our therapist did an amazing job of getting my child's buy-in when suggesting new things to try. She always takes time at the beginning of the session to check in on general stuff - how things are going with friends, any new school drama, how the soccer game went, etc. And she must take amazing notes because she remembers everything! Which of course makes my child feel connected and heard. It's expensive, but short-term. We did a few months in the spring and successfully addressed panic attacks and some sleep issues. We are now back for some new stuff, but the expectation is that this will also be short-term.