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help with child psychologist
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Posted 18 June 2017 - 11:14 PM
I'm back to the child psych tomorrow as our 5yo girl is struggling. Still having meltdowns, she's developing fears, having nightmares, I'm convinced she has anxiety and possibly ASD, there are SPD indicators and her tics are now dominating which I'm guessing means she's under incredible stress. I have no clue how to help her. We have no diagnoses, I haven't yet been able to get a referral to a developmental psych despite my relentless efforts and feel that any help we have pursued has been fobbed off. I'm not sure what a diagnosis will give me but I need someone else to help guide me with a treatment approach. Right now we're lost in a sea of useless nothing based professionals. I am returning to psych tomorrow to ask why there have been no assessements, why she has not addressed my girl and why she has last session told us there is no need to return when I feel uncertain as to how to best manage her anxiety. I don't know what to do when she has a meltdown as everything appears to worsen her aggression. She won't even wait for a sentence to finish before launching into a rage.
I've signed up for a free screening program offered locally but even they were dismissive as they want me to give a diagnosis when I don't have one. They want me to choose a therapist and I'm uncertain. Just feel like we're all at a dead end with it and as hard as it is for us it's far harder for her.
I'm here to ask for assistance from a member who has previously offered behavioural support guidelines for an unrecognised condition. The techniques were helpful but then we've gone down this path of unhelpful practitioners. We're forking out so much money for therapies that aren't providing any real tools for us to use as a family and as parents we're now making this situation far worse. We've moved from RIE style respectful parenting to rewards and punishment and it's feeling like our frustrations are too much for her at her cycle of endless frustrations, shrieking, damaging things.
She's an incredibly sweet child, she's just out of control and so are we. Please be kind in your responses, I'm stupidly sleep deprived and incredibly sensitive right now. I can't remember who the member was or what the condition was so I can't even google it but it was a technique that was similar to ODD. Along the lines of "asking the room" type approach.
Any other suggestions are welcome. Criticism is not.
Posted 18 June 2017 - 11:21 PM
I'm sorry Nup. Is the gp refusing you a referral to developmental paed? My gp said he saw no need but just gave us the referral anyway (currently im waiting on an appointment)- have you tried another gp?
Posted 18 June 2017 - 11:24 PM
PDA Pathological Demand Avoidance?
Your situation sounds really tough. It sucks that you and your DD aren't getting the support that is needed.
Posted 18 June 2017 - 11:25 PM
GP refused and GPs are hard to get into and expensive here. He was recommended by the school as being good for children. He has an interest in paediatrics and seemed to be offended I was asking to see someone else. I have tried a new community health centre to see if there is an alternative solutions, but round 2 was almost as bad as round 1 with the new MCHN. We're having to decide where to spend our money but I will book in with one other GP to see if I can find us a better family doctor. We don't currently have one for a few good reasons.
Posted 18 June 2017 - 11:28 PM
^^Im sorry, that's crap. Wish I had something useful to add.
Posted 18 June 2017 - 11:31 PM
Yes, thank you Paddlepop. Was it you who has shared about your child with this?
Do others think I should ask psych about PDA? I feel like any time I raise a possibility I get grilled about my terminology/language use and the focus becomes me rather than my child. Really hard to not make it about adult ego when sh*t heads south with these people.
Posted 18 June 2017 - 11:34 PM
Oh that link is awesome thanks so much. So hard to read though. THings are much much worse since then. And Cool Little Kids contacted me apologising because the program no longer exists.
Posted 18 June 2017 - 11:40 PM
My DD has ASD, ADHD and anxiety but thankfully not PDA. An enormous stubborn streak but nothing like what I've read on the PDA links.
What about a child psychiatrist? It sounds like your DD might be beyond the ability of the psychologist that you're seeing about your DD. Of course that would involve the difficulty of getting a referral from the GP. You definitely need a new GP. If their ego gets in the way of referring you then that's just not right. If he wants to be a paediatrician he should go and get qualified as one. Seeing as he's not, he needs to swallow his ego and refer you. Easier said than done, obviously.
If you share what general area you're in people might be able to PM recommendations to you for dev. paeds, child psychs, etc.
Has the possibility of anxiety medication been discussed by the child psych? Obviously they can't prescribe it, and you'd need a paed. or psychiatrist for that, but it sounds like an avenue worth considering. My anxious child takes medication and it makes such a difference for her.
Posted 18 June 2017 - 11:42 PM
Can you video her meltdowns? Can you discuss with the psych the issues to see if she will advocate with the GP on your child's behalf?
I would not use her tics as a symptom of stress. For most kids they are not, they are just ticcing as awful as it is. I also would avoid suggesting she has PDA at this stage.
You need to present as a desperate parent rather than a parent with ideas of diagnosis if that makes sense.
Or get a new GP. I think that is the best option.
Posted 18 June 2017 - 11:51 PM
The psych is a child psych but she doesn't seem to be addressing DD. The first session she spent telling me about DHs PTSD which I'm more than familiar with so felt that was wasting time. She sent me home with one technique which helped for one minor issue but the bigger stuff has not been addressed. Last session was telling me that DD appears well because the one technique offered was successful. I've obviously stuffed up by not pushing harder, but everytime I push it becomes about me in that weird doubting way they seem to do. Anyway I left feeling like WTF just happened? I rebooked as a just in case, so 5 months on we're no better off and I'm wondering why I'm bothering to return tomorrow when it appears I'm wasting time with her. I more just want to make sure, give her another chance to offer support.
How will it go down if I bring up the PDA with her? She has overlooked the anxiety so no, meds haven't been discussed as an option yet, by her or the GP.
Posted 18 June 2017 - 11:56 PM
Nup, I have no idea where you are, but I believe you can self refer to places like aspect for an assessment in nsw. May not help at all, but maybe there is something similar near you?
Posted 18 June 2017 - 11:56 PM
OK so no PDA, I'll use those techniques at home for my own reference. Approach as an ignorant person. Psych said to return if nightmares returned so we're definitely in need of having that addressed according to her.
The ticcing is becoming extreme. Relentless head shaking, blinking and throat clearing. How do I reassure her? Is there no support possible for that? I'm thinking of pulling her from school for the end of term. She's not coping well at the moment.
We're in Eastern Suburbs in Sydney but headed to Sunshine Coast for some down time. I can't imagine I'll get into a GP before we go away. Happy to try up there, or Brisbane if there are better doctors there.
Posted 18 June 2017 - 11:58 PM
I would describe all the symptoms and see if she raises PDA. I get what AO is saying- I seem to get further if I play to their egos iykwim? I spend a lot of time at work getting people to do stuff by making them think it's what they want to do, that seems to work better with health professionals rather than appearing to think you have the answers
Posted 19 June 2017 - 12:06 AM
Yes. I'm writing down issues with examples now. I've been told in the past that my examples are too vague but they're very specific. It's really hard to go into each situation again and ignore the past experiences.
And I'll give ASPECT a call tomorrow thanks.
Posted 19 June 2017 - 12:11 AM
If you ever get the point of needing to try another city I can suggest a couple of good places in Melbourne where you can self refer.
You need to sack both the gp and the psych. Incompetent health professionals make me angry.
I'm sorry you're having such a rough time.
Posted 19 June 2017 - 12:14 AM
lol Melbourne hasn't been considered but I think I should be able to find some help in Sydney or north. If I need to go to Melbourne I'll let you know but I'll also be seriously considering Munchausen's by Proxy. I've lost my sh*t at a few too many incompetents over the years.
Posted 19 June 2017 - 12:27 AM
No worries, hopefully things don't get too desperate.
It helps if you cry at consultations. I've done that all too frequently myself. Last paediatrician actually made a note that I was fragile on her report.
(It wasn't deliberate crying, I'm frequently on edge)
Posted 19 June 2017 - 12:33 AM
I cried on Friday on the phone for the book in for the screen. I cry inappropriately, like at the receptionist who can't help me who then will tell me I'm being too vague and my spiral of despair continues. I cry too much in my own psych appointments now and not enough with the children's. I know what you mean.
Posted 19 June 2017 - 07:14 AM
Have you thought about just going into a medical centre and asking for a referral to a developmental paediatrician? They can't deny a referral. I would hve thought that the eastern suburbs would be much easier to find a good doctor. I'm sure if you contacted Randwick children's hospital they would be able to recommend a series of doctors that you can take to your gp and request to be referred to them?
Posted 19 June 2017 - 07:23 AM
There's a bulk billing medical centre in Short street Leichhardt. It's usually pretty busy. They tend to run through people like cattle at an abattoir and don't have much time for nuanced discussion.
Have a professional in mind and ask for a referral. You're busy. They're busy. Only go into as much detail as is required to get what you need. Don't mention possible diagnoses. Manifest as worried, but not desperate.
Posted 19 June 2017 - 07:24 AM
Yep, just seconding WreckTangle. We are in Vic, but I just booked an appointment for my DS at the local medical centre, explained my concerns to the doctor and they wrote a referral to a dev paed straight away.
I'm sorry your GP is being so obstructive, I have no idea why they would refuse to write a referral. Surely it's best that you be allowed to follow up any concerns you may have? Just ridiculous.
Hang in there!
Posted 19 June 2017 - 08:11 AM
What im about to say may or may not be helpful but it is intended to be helpful so if its not, im sorry.
Your appts so far sound to be more about helping you manage her issues? Is anyone working with her to help her develop some coping mechanisms? I know she is very young and that makes it much harder, but there are young versions of behavioural management techniques around. Is the psych only really dealing with your end?
Would it help you to mentally separate the two issues? That you as a parent have needs for support such as managing parenting skills, dealing with the extra demands of a challenging child (apologies for the terminology if that upsets you) etc. Separate that from the needs of your child. Be specific what are those current needs? While I agree with AO that ticcing on its own is not a sign of anxiety, often excessive ticcing can be. My older DS does a lot of excessive blinking and facial tics when he is under stress. So are her issues more anxiety? emotional regulation? Id be asking for a referral to an OT. A good one will probably also suggest a speechie, but that of course depends on your budget. Both professionals should have networks that would enable you to seek a diagnosis and be able to help properly in the meantime.
I noted you said you were frustrated that she wont let you a finish a sentence before the meltdown kicks in? Please keep in mind that true 'meltdowns' are just that. The person is in a state of overload and there is no possibility of self regulation of reasoning by that point. It takes years and years and years to develop the ability for someone to see the signs in themselves that they unsettled and even then a meltdown is often unavoidable. They do tend to be further apart as someone ages. Or that has been the case here. It may not be the case for others.
Youll find loads of threads in here about managing meltdowns. Often the same advice is given. Stay as calm as possible and do your best to keep yourself and your child safe. If you can keep them to a single room and be at the door (either side depending on safety) and resist the temptation to engage until you see signs of calming.
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